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Outcomes and drivers of inappropriate dosing of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation: a systematic review and meta-analysis
Conclusions Our analysis suggests that off-label underdosing of NOACs does not reduce bleeding outcomes. Patients prescribed off-label NOAC doses are at an increased risk of all-cause mortality. These data underscore the importance of prescriber adherence to NOAC dosing guidelines to achieve optimal clinical outcomes for patients with AF. PROSPERO registration number CRD42020219844.
Source: Heart - January 11, 2023 Category: Cardiology Authors: Caso, V., de Groot, J. R., Sanmartin Fernandez, M., Segura, T., Blomström-Lundqvist, C., Hargroves, D., Antoniou, S., Williams, H., Worsley, A., Harris, J., Caleyachetty, A., Vardar, B., Field, P., Ruff, C. T. Tags: Open access Systematic review Source Type: research

Drug overdose and the risk of cardiovascular diseases: a nested case –control study
ConclusionsDrug overdose appears to be associated with increased risk of cardiovascular diseases.Graphic abstract
Source: Clinical Research in Cardiology - October 15, 2021 Category: Cardiology Source Type: research

Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association
Circulation. 2021 Aug 19:CIR0000000000001007. doi: 10.1161/CIR.0000000000001007. Online ahead of print.ABSTRACTThe misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed...
Source: Circulation - August 19, 2021 Category: Cardiology Authors: Sheryl L Chow Comilla Sasson Ivor J Benjamin Robert M Califf Wilson M Compton Elizabeth M Oliva Chester Robson Eduardo J Sanchez American Heart Association Source Type: research

Optimal Management of Anticoagulation Therapy in Asian Patients With Atrial Fibrillation
Circ J. 2021 Jun 5. doi: 10.1253/circj.CJ-21-0399. Online ahead of print.ABSTRACTStroke prevention is the cornerstone of management of atrial fibrillation (AF), and non-vitamin K antagonist oral anticoagulants (NOACs) are commonly prescribed. Because routine monitoring of anticoagulant effects of NOACs is not necessary, appropriate dosing following the criteria of each NOACs defined in pivotal randomized trials is important. Real-world data demonstrate that underdosing NOACs is associated with a higher risk of ischemic stroke without a lower risk of major bleeding. Furthermore, renal function of AF patients should be asses...
Source: Circulation Journal - June 7, 2021 Category: Cardiology Authors: Wen-Han Cheng Yi-Hsin Chan Jo-Nan Liao Ling Kuo Shih-Ann Chen Tze-Fan Chao Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) Versus Warfarin in Patients with Atrial Fibrillation and (Morbid) Obesity or Low Body Weight: a Systematic Review and Meta-Analysis
ConclusionThe benefit-risk profile of NOACs seems preserved in (morbidly) obese AF patients and patients with low body weight. However, more data are needed on underweight AF patients (BMI<  18.5 kg/m2) and on differences between NOACs in these patients.
Source: Cardiovascular Drugs and Therapy - January 11, 2021 Category: Cardiology Source Type: research

Drug-Induced Arrhythmias: A Scientific Statement From the American Heart Association.
Abstract Many widely used medications may cause or exacerbate a variety of arrhythmias. Numerous antiarrhythmic agents, antimicrobial drugs, psychotropic medications, and methadone, as well as a growing list of drugs from other therapeutic classes (neurological drugs, anticancer agents, and many others), can prolong the QT interval and provoke torsades de pointes. Perhaps less familiar to clinicians is the fact that drugs can also trigger other arrhythmias, including bradyarrhythmias, atrial fibrillation/atrial flutter, atrial tachycardia, atrioventricular nodal reentrant tachycardia, monomorphic ventricular tachy...
Source: Circulation - September 14, 2020 Category: Cardiology Authors: Tisdale JE, Chung MK, Campbell KB, Hammadah M, Joglar JA, Leclerc J, Rajagopalan B, American Heart Association Clinical Pharmacology Committee of the Council on Clinical Cardiology and Council on Cardiovascular and Stroke Nursing Tags: Circulation Source Type: research

Difficulty of stroke management in the dialysis child
ConclusionCause or consequences of the renal disease, HT must be properly treated in order to reach the recommended targeted blood pressure values. The time required to take charge the hypertensive stroke determines the prognosis. The challenge is to optimize the health care sector to reduce mortality and sequelae.
Source: Archives of Cardiovascular Diseases Supplements - July 24, 2019 Category: Cardiology Source Type: research

Apixaban for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation in France: The PAROS cross-sectional study of routine clinical practice.
CONCLUSIONS: Initiation of apixaban versus NOACs was more common among patients with increased age, higher bleeding risk and decreased renal function, whereas initiation of apixaban versus VKAs was more common among patients with lower bleeding risk and better renal function. PMID: 31014991 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - April 19, 2019 Category: Cardiology Authors: Falissard B, Picard F, Mahe I, Hanon O, Touzé E, Danchin N, Lamy FX, Ricci L, Steg PG Tags: Arch Cardiovasc Dis Source Type: research

Inappropriate non-vitamin  K antagonist oral anticoagulants prescriptions: be cautious with dose reductions.
CONCLUSION: An incorrect prescription occurred more often in the reduced-dose NOAC group. Clinical parameters such as renal function are often unknown whilst these are essential to determine the right NOAC and dose. PMID: 30949972 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - April 3, 2019 Category: Cardiology Authors: Jacobs MS, van Hulst M, Campmans Z, Tieleman RG Tags: Neth Heart J Source Type: research

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