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Comparing the Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants and Warfarin in the Elderly Asian Patients with Atrial Fibrillation: A Nationwide Cohort Study.
CONCLUSIONS: Compared to warfarin, NOACs were associated with a significantly lower risk of adverse events, with heterogeneity in treatment effects among different age strata. Overall, the clear safety signal in favor of NOACs over warfarin was evident irrespective of age strata, being most marked in the most elderly. PMID: 31809694 [PubMed - as supplied by publisher]
Source: Chest - December 2, 2019 Category: Respiratory Medicine Authors: Chao TF, Chiang CE, Liao JN, Chen TJ, Lip GYH, Chen SA Tags: Chest Source Type: research

Effectiveness and Safety of Four Direct Oral Anticoagulants in Asians with Non-valvular Atrial Fibrillation.
CONCLUSIONS: In the largest real-world practice study among Asians with NVAF, four DOACs were associated with lower risks of thromboembolism and bleeding than warfarin. There was consistency even amongst high risk subgroups and whether standard dose or low dose regimes were compared. PMID: 31103697 [PubMed - as supplied by publisher]
Source: Chest - May 15, 2019 Category: Respiratory Medicine Authors: Chan YH, Lee HF, See LC, Tu HT, Chao TF, Yeh YH, Wu LS, Kuo CT, Chang SH, Lip GYH Tags: Chest Source Type: research

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients with Hypertrophic Cardiomyopathy: A Nationwide Cohort Study.
CONCLUSIONS: Compared with warfarin, patients with HCM and AF on NOACs had similar stroke and major bleeding risks, but lower all-cause mortality and composite fatal cardiovascular events. Our data suggest that patients with HCM and AF can be safely and effectively treated with NOACs. PMID: 30472021 [PubMed - as supplied by publisher]
Source: Chest - November 22, 2018 Category: Respiratory Medicine Authors: Jung H, Yang PS, Jang E, Yu HT, Kim TH, Uhm JS, Kim JY, Pak HN, Lee MH, Joung B, Lip GYH Tags: Chest Source Type: research

Direct oral anticoagulants in patients undergoing cardioversion: insight from randomized clinical trials.
Authors: Di Fusco SA, Colivicchi F, Aspromonte N, Tubaro M, Aiello A, Santini M Abstract Anticoagulation, reducing the risk of thromboembolic events in patients undergoing cardioversion, is a cornerstone of peri-cardioversion management in patients with atrial fibrillation. We aimed to analyse published data on the efficacy and safety of direct oral anticoagulants (DOACs) in patients undergoing cardioversion. We performed a systematic review of randomized prospective clinical trials (RCTs) comparing DOACs with warfarin and reporting data on post-cardioversion outcomes of interest. Outcomes of interest were stroke, ...
Source: Monaldi Archives for Chest Disease - June 23, 2017 Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research

Variation in Warfarin Use at Hospital Discharge After Isolated Bioprosthetic Mitral Valve Replacement - An Analysis of the Society of Thoracic Surgeons Adult Cardiac Surgery Database.
CONCLUSIONS: Although patient characteristics and post-operative events may be associated with the prescription of warfarin following BMVR, substantial surgeon and hospital variability remains. This variability largely ignores the established practice guidelines, and warrants further study to define the optimal anticoagulation strategy in BMVR patients. PMID: 27132702 [PubMed - as supplied by publisher]
Source: Chest - April 27, 2016 Category: Respiratory Medicine Authors: Schwann TA, Habib RH, Suri RM, Brennan JM, He X, Thourani VH, Engoren M, Ailawadi G, Englum BR, Bonnell MR, Gammie JS Tags: Chest Source Type: research

Treatment of very old patients with non valvular atrial fibrillation. The valuable opportunity offered by new oral anticoagulants, to be cautiously used.
Authors: Orso F, Barucci R, Fracchia S, Mannarino G, Pratesi A, Fattirolli F Abstract Atrial Fibrillation (AF) is the most frequent cardiac arrhythmia and its incidence increases with age reaching a 10% prevalence in the oldest old. Patients with AF have a five-fold increase in the risk of stroke. Current guidelines on AF management recommend the prescription of oral anticoagulant therapy in patients at medium and high risk of thromboembolic events. Advanced age is a risk factor for stroke in AF, but despite clear evidences a high rate of OAT under prescription is reported and particularly in the oldest old. Among ...
Source: Monaldi Archives for Chest Disease - December 21, 2015 Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research

Stroke, Major Bleeding and Mortality Outcomes in Warfarin Users with Atrial Fibrillation and Chronic Kidney Disease: A Meta-analysis of Observational Studies.
Conclusions: Based on this meta-analysis, the use of warfarin for AF may have an unfavorable risk/benefit ratio in patients with end-stage CKD but not in those with non-end stage CKD. PMID: 26378611 [PubMed - as supplied by publisher]
Source: Chest - September 17, 2015 Category: Respiratory Medicine Authors: Dahal K, Kunwar S, Rijal J, Schulman P, Lee J Tags: Chest Source Type: research

Time trends of aspirin and warfarin use on stroke and bleeding events in Chinese patients with new-onset atrial fibrillation.
Conclusion: Aspirin use increased amongst newly diagnosed Chinese AF patients with no relationship to the patient's stroke or bleeding risk. Warfarin use was very low. Given the healthcare burden of AF and its complications, our study has major implications for healthcare systems in non-Western countries, given the global burden of this common arrhythmia. PMID: 25501045 [PubMed - as supplied by publisher]
Source: Chest - December 11, 2014 Category: Respiratory Medicine Authors: Guo Y, Wang H, Tian Y, Wang Y, Lip GY Tags: Chest Source Type: research

Intracranial haemorrhage and subsequent ischemic stroke in patients with atrial fibrillation: A nationwide cohort study.
Conclusion:In this large-scale study of AF patients treated with warfarin, first-time ICH was associated with an increased rate of ischaemic stroke/SE/TIA and mortality compared to the non-ICH group. There was a decrease in the warfarin prescription purchase rate post-ICH period compared to pre-ICH, which may partly explain the excess risk. Background: The risk of ischemic stroke/thromboembolic events after an intracranial haemorrhage (ICH) in atrial fibrillation (AF) patients on warfarin treatment is poorly characterised. The aim of this study was to assess the association between the risk of ischaemic stroke/thrombo...
Source: Chest - November 20, 2014 Category: Respiratory Medicine Authors: Nielsen PB, Larsen TB, Gorst-Rasmussen A, Skjøth F, Rasmussen LH, Lip GY Tags: Chest Source Type: research