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Oral Anticoagulant Use in Patients With Atrial Fibrillation and Chronic Kidney Disease: A Review of the Evidence With Recommendations for Australian Clinical Practice
Chronic kidney disease is common in patients with atrial fibrillation (AF) and is associated with heightened risks of stroke/systemic embolisation and bleeding. In this review we outline the evidence for AF stroke prevention in kidney disease, identify current knowledge gaps, and give recommendations for anticoagulation at various stages of chronic kidney disease.Overall, anticoagulation is underused. Warfarin use becomes increasingly difficult with advancing kidney disease, with difficulty maintaining international normalised ratio (INR) in therapeutic range, increased risk of intracranial and fatal bleeding compared to n...
Source: Heart, Lung and Circulation - November 3, 2022 Category: Cardiology Authors: Christopher Hammett, Sunil V. Badve, Peter G. Kerr, Huyen A. Tran, Benjamin K. Dundon, Sidney Lo, Andrew Wong, Joanne E. Joseph, Jenny Deague, Vlado Perkovic Tags: Review Source Type: research

516 Non-Vitamin K Anticoagulation for Non-Valvular Atrial Fibrillation in Regional Australia
Non-vitamin K antagonist oral anticoagulants (NOACs) are the therapy of choice for stroke prevention in patients with non-valvular atrial fibrillation and at least one risk factor. The Illawarra-Shoalhaven region local health district provides health services for around 400,000 people. In regional centres, many AF patients are managed by GPs. The purpose of this study was to identify the proportion of patients with NVAF who were prescribed different NOACs as well as determine if the dosage follows current guidelines.
Source: Heart, Lung and Circulation - November 8, 2020 Category: Cardiology Authors: J. Moragues Source Type: research

A clinical audit of oral anticoagulant therapy in aged care residents with atrial fibrillation
Conclusion Many residents with non-valvular AF and significant risk of stroke were not receiving oral anticoagulation despite a lack of documented reason for non-prescribing. Non-vitamin K antagonists were widely prescribed but dosing of these agents could still be improved. There remains a need to improve anticoagulant prescribing for aged care residents and optimise stroke prevention in this population.
Source: International Journal of Clinical Pharmacy - April 13, 2020 Category: Drugs & Pharmacology Source Type: research

Stroke Prevention, Evaluation of Bleeding Risk, and Anticoagulant Treatment Management in Atrial Fibrillation Contemporary International Guidelines
Publication date: May 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 5Author(s): Marco Proietti, Deirdre A. Lane, Giuseppe Boriani, Gregory Y.H. LipAbstractIn recent years the management of atrial fibrillation patients has progressively and substantially changed because of the introduction of new treatments and the availability of new data regarding the epidemiology and clinical management of these patients. In the past 2 years alone, there have been 7 new guidelines or guideline updates that have been published, which have introduced new recommendations and significantly revised previously published ones. Tw...
Source: Canadian Journal of Cardiology - April 27, 2019 Category: Cardiology Source Type: research

National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018.
Authors: Brieger D, Amerena J, Attia JR, Bajorek B, Chan KH, Connell C, Freedman B, Ferguson C, Hall T, Haqqani HM, Hendriks J, Hespe CM, Hung J, Kalman JM, Sanders P, Worthington J, Yan T, Zwar NA Abstract INTRODUCTION: Atrial fibrillation (AF) is increasing in prevalence and is associated with significant morbidity and mortality. The optimal diagnostic and treatment strategies for AF are continually evolving and care for patients requires confidence in integrating these new developments into practice. These clinical practice guidelines will assist Australian practitioners in the diagnosis and management of adult ...
Source: Medical Journal of Australia - August 3, 2018 Category: General Medicine Tags: Med J Aust Source Type: research

The impact of non-vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia.
CONCLUSIONS: In rural WA, about one-third of patients with an indication for anticoagulation therapy receive NOACs, but one-third of patients with AF and at risk of stroke received no anticoagulant therapy, and may benefit from NOAC therapy. PMID: 29320668 [PubMed - in process]
Source: Medical Journal of Australia - January 11, 2018 Category: General Medicine Tags: Med J Aust Source Type: research