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Results of percutaneous closure of patent foramen ovale with the GORE® septal occluder
ConclusionPFO closure with the GSO is accompanied by a high technical success rate and closure rates similar to other currently used devices. The incidence of AF was higher than reported with most other devices. This may be a chance finding but warrants further investigation in larger trials. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - January 20, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Meike Knerr, Stefan Bertog, Laura Vaskelyte, Ilona Hofmann, Horst Sievert Tags: Valvular and Structural Heart Diseases Source Type: research

Results of percutaneous closure of patent foramen ovale with the GORE ® Septal Occluder
Conclusion. PFO closure with the GSO is accompanied by a high technical success rate and closure rates similar to other currently used devices. The incidence of atrial fibrillation was higher than reported with most other devices. This may be a chance finding but warrants further investigation in larger trials. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - December 10, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Meike Knerr, Stefan Bertog, Laura Vaskelyte, Ilona Hofmann, Horst Sievert Tags: Original Study Source Type: research

Antithrombotic Therapy for Prevention of Various Thrombotic Diseases
Abstract The majority of sudden onset serious diseases, such as acute myocardial infarction, ischemic stroke, and pulmonary embolism, are thrombotic diseases. Antithrombotic therapy in general has a potential to reduce the risk of thrombotic diseases, though it increases the risk of serious bleeding events. Of the various antithrombotic agents currently available, the antiplatelet agent aspirin and the anticoagulant agent warfarin have the most robust clinical evidence. Aspirin reduces the risk of cardiovascular (CV) death, recurrence of myocardial infarction and ischemic stroke by up to 25%. Aspirin is an establish...
Source: Drug Development Research - November 15, 2013 Category: Drugs & Pharmacology Authors: Shinya Goto, Aiko Tomita Tags: Clinical Overview Source Type: research

The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients: The RE-LY Trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)
Objectives: The goal of this study was to analyze the impact of dabigatran plasma concentrations, patient demographics, and aspirin (ASA) use on frequencies of ischemic strokes/systemic emboli and major bleeds in atrial fibrillation patients.Background: The efficacy and safety of dabigatran etexilate were demonstrated in the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial, but a therapeutic concentration range has not been defined.Methods: In a pre-specified analysis of RE-LY, plasma concentrations of dabigatran were determined in patients treated with dabigatran etexilate 110 mg twice daily (bid) ...
Source: Journal of the American College of Cardiology - September 30, 2013 Category: Cardiology Authors: Paul A. Reilly, Thorsten Lehr, Sebastian Haertter, Stuart J. Connolly, Salim Yusuf, John W. Eikelboom, Michael D. Ezekowitz, Gerhard Nehmiz, Susan Wang, Lars Wallentin, RE-LY Investigators Tags: Antithrombotic Therapy Source Type: research

Meta-Analysis of Randomized Controlled Trials on Risk of Myocardial Infarction from the Use of Oral Direct Thrombin Inhibitors
In conclusion, our data suggest that oral DTIs were associated with increased risk of MI. This increased risk appears to be a class effect of these agents, not a specific phenomenon unique to dabigatran or protective effect of warfarin. These findings support the need for enhanced postmarket surveillance of oral DTIs and other novel agents.
Source: The American Journal of Cardiology - September 27, 2013 Category: Cardiology Authors: Ramin Artang, Eric Rome, Jørn Dalsgaard Nielsen, Humberto J. Vidaillet Tags: Review Source Type: research

Oral Anticoagulation and Antiplatelets in Atrial Fibrillation Patients After Myocardial Infarction and Coronary Intervention
ConclusionsIn real-life AF patients with indication for multiple antithrombotic drugs after MI/PCI, OAC and clopidogrel was equal or better on both benefit and safety outcomes compared to triple therapy.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - September 3, 2013 Category: Radiology Source Type: research

Antithrombotic Regimens in Patients With Atrial Fibrillation and Coronary Disease Optimizing Efficacy and Safety ∗
Clear evidence supports the value of oral anticoagulation (OAC) with vitamin K antagonists in preventing stroke and thromboembolism in patients with atrial fibrillation (AF) who have well-established risk factors. For this indication, vitamin K antagonists have been shown to be superior to single or dual antiplatelet agents in reducing thromboembolic complications (1). Yet, up to 30% of patients with AF also have indications for antiplatelet therapy because of coronary artery disease (2). Dual antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor (e.g., clopidogrel) is usually recommended after stent implantatio...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - September 3, 2013 Category: Radiology Source Type: research

The management of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation
Current recommendations on the management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with stent (PCI‐S) essentially derive from small, single‐center, retrospective datasets. To obtain larger and better quality data, we carried out the prospective, multicenter Atrial Fibrillation undergoing Coronary Artery Stenting (AFCAS) study. Therefore, consecutive patients with history of or ongoing AF undergoing PCI‐S were enrolled, and occurrence of adverse ischemic and bleeding events recorded during 12 months follow‐up. In this article, we report the in‐hospital observations. O...
Source: Catheterization and Cardiovascular Interventions - August 28, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Axel Schlitt, Andrea Rubboli, Gregory Y.H. Lip, Heli Lahtela, Josè Valencia, Pasi P. Karjalainen, Michael Weber, Mika Laine, Paulus Kirchhof, Matti Niemelä, Saila Vikman, Michael Buerke, K.E. Juhani Airaksinen, Tags: Coronary Artery Disease Source Type: research

Antithrombotic Therapy for Patients with Atrial Fibrillation and Atherothrombotic Vascular Disease: Striking the Right Balance between Efficacy and Safety.
Abstract Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is estimated to affect 1.5 to 2.0% of the general population, i.e., at least 100 million people worldwide.(1) Left untreated, patients with nonvalvular AF (NVAF) are exposed to an annual risk of thromboembolic stroke of approximately 5%, resulting in 5 million AF-related strokes each year.(1) Properly dosed anticoagulation (e.g., warfarin adjusted to an international normalized ratio [INR] of 2.0 to 3.0) is extremely effective in preventing AF-related strokes, reducing risk by two-thirds compared with no therapy, and by one-half compared to ...
Source: Circulation - July 16, 2013 Category: Cardiology Authors: Patrono C, Andreotti F Tags: Circulation Source Type: research

Left Atrial Appendage Closure With the Watchman Device in Patients With a Contraindication for Oral Anticoagulation The ASAP Study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology)
ConclusionsLAA closure with the Watchman device can be safely performed without a warfarin transition, and is a reasonable alternative to consider for patients at high risk for stroke but with contraindications to systemic oral anticoagulation. (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology [ASAP]; NCT00851578)
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 17, 2013 Category: Cardiology Source Type: research

The management of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation: In‐hospital‐data from the Atrial Fibrillation undergoing Coronary Artery Stenting (AFCAS) study
ConclusionsThe majority of AF patients undergoing PCI‐S are at high stroke risk, and therefore VKA treatment should not be withdrawn and combined anticoagulant and antiplatelet treatment is warranted. Current management appears largely in accordance with current recommendations, whereby accounting for the limited occurrence of in‐hospital adverse ischemic and bleeding events. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - June 13, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Axel Schlitt, Andrea Rubboli, Gregory H Lip, Heli Lahtela, Josè Valencia, Pasi P. Karjalainen, Michael Weber, Mika Laine, Paulus Kirchhof, Matti Niemelä, Saila Vikman, Michael Buerke, K.E. Juhani Airaksinen, Tags: Original Study Source Type: research

Oral Anticoagulation and Antiplatelets in Atrial Fibrillation Patients After Myocardial Infarction and Coronary Intervention
Conclusions: In real-life AF patients with indication for multiple antithrombotic drugs after MI/PCI, OAC and clopidogrel was equal or better on both benefit and safety outcomes compared to triple therapy.
Source: Journal of the American College of Cardiology - June 10, 2013 Category: Cardiology Authors: Morten Lamberts, Gunnar H. Gislason, Jonas Bjerring Olesen, Søren Lund Kristensen, Anne-Marie Schjerning Olsen, Anders Mikkelsen, Christine Benn Christensen, Gregory Y.H. Lip, Lars Køber, Christian Torp-Pedersen, Morten Lock Hansen Tags: Coronary Artery Disease Source Type: research

Antithrombotic Regimens in Patients With Atrial Fibrillation and Coronary Disease: Optimizing Efficacy and Safety∗
Clear evidence supports the value of oral anticoagulation (OAC) with vitamin K antagonists in preventing stroke and thromboembolism in patients with atrial fibrillation (AF) who have well-established risk factors. For this indication, vitamin K antagonists have been shown to be superior to single or dual antiplatelet agents in reducing thromboembolic complications . Yet, up to 30% of patients with AF also have indications for antiplatelet therapy because of coronary artery disease . Dual antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor (e.g., clopidogrel) is usually recommended after stent implantation or a...
Source: Journal of the American College of Cardiology - June 10, 2013 Category: Cardiology Authors: Steven M. Markowitz Tags: Coronary Artery Disease: Editorial Comment Source Type: research

Novel oral anticoagulants in gastroenterology practice
Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is associated with a 5-fold increase in the risk of ischemic stroke, and AF-related strokes have worse outcomes than those not associated with AF. Warfarin reduces the risk of stroke in patients with AF by approximately two-thirds and is more effective than aspirin or dual antiplatelet therapy with aspirin and clopidogrel. Although effective, warfarin has limitations that complicate its use. These include unpredictable pharmacokinetics and pharmacodynamics related to genetic polymorphisms and to variations in dietary vitamin K intake and numerous ...
Source: Gastrointestinal Endoscopy - May 31, 2013 Category: Gastroenterology Authors: Jay Desai, Christopher B. Granger, Jeffrey I. Weitz, James Aisenberg Tags: Review Articles Source Type: research

Triple Antithrombotic Therapy With Prasugrel in the Stented Patient Concern for More Bleeding ⁎ ⁎
There is a large body of evidence, including results of prospective trials, that supports oral anticoagulation therapy (OAT) as the optimal strategy to prevent fibrin-centric thrombotic events (FCTEs). Examples of FCTEs include thromboembolism in patients with mechanical heart valves, deep vein thrombosis, and atrial fibrillation (AF) (1). In a large prospective trial, warfarin was found to be superior to dual antiplatelet therapy (DAPT) with aspirin + clopidogrel in the prevention of vascular events in patients with AF plus 1 or more risk factors for stroke (2). European and American guidelines include a Class I recommend...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 13, 2013 Category: Cardiology Source Type: research

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