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Screening over 100 000 patients in 39 general practices in the Netherlands for anticoagulation underprescription in atrial fibrillation: a descriptive, cross-sectional study
Conclusions In this large Dutch study among GPs, we observed 9.8% underprescription of OAC in AF patients. In 76% of the AF patients lacking a prescription for OAC, no documentation for deviating from the guidelines was found. Only in a minority of cases detection of OAC underprescription lead to OAC initiation.
Source: BMJ Open - August 18, 2023 Category: General Medicine Authors: Voorhout, L., Pisters, R., Geurts, C. H. P. H., Oostindjer, A., van Doorn, S., Rila, H., Fuijkschot, W. W., Verheugt, F., Hemels, M. E. W. Tags: Open access, Cardiovascular medicine Source Type: research

Improving outcomes of AF ablation by integrated personalized lifestyle interventions: rationale and design of the prevention to improve outcomes of PVI (POP) trial
This study is a prospective, 1:1 randomized, single centre, investigator-initiated clinical trial in 150 patients with paroxysmal or persistent AF referred for a first pulmonary vein isolation (PVI). Prior to the ablation, patients in the intervention group receive a personalized risk factor treatment programme in a specialized, protocolized, nurse-led outpatient clinic. Patient education and durable lifestyle management is promoted with an e-health platform. Patients in the control group receive standard care by cardiologists before ablation. The primary endpoint is the number of hospitalizations for re-ablation and cardi...
Source: Clinical Research in Cardiology - March 31, 2023 Category: Cardiology Source Type: research

Safety and effectiveness of rivaroxaban for prevention of stroke in patients with nonvalvular atrial fibrillation: analysis of routine clinical data from four countries
CONCLUSIONS: Incidences of intracranial bleeding were generally lower with rivaroxaban than with SOC, whereas incidences of gastrointestinal and urogenital bleeding were generally higher. The safety profile of rivaroxaban for NVAF in routine practice is consistent with findings from randomized controlled trials and other studies.PMID:36795067 | DOI:10.1080/14740338.2023.2181334
Source: Expert Opinion on Drug Safety - February 16, 2023 Category: Drugs & Pharmacology Authors: Luis Alberto Garc ía-Rodríguez Ana Ruig ómez Tania Schink Annemarie Voss Elisabeth Smits Karin M A Swart Yanina Balabanova Kiliana Suzart-Woischnik Gunnar Brobert Ron M C Herings Source Type: research

How is atrial fibrillation detected in everyday healthcare? Results of a  Dutch cohort study
CONCLUSION: Diagnosing AF is a multidisciplinary process. The irregular heartbeat was most often detected by the GP, but cardiologists diagnosed most cases. One-third of all newly diagnosed AF was silent.PMID:36048351 | DOI:10.1007/s12471-022-01719-2
Source: Netherlands Heart Journal - September 1, 2022 Category: Cardiology Authors: N Verbiest-van Gurp S B Uittenbogaart S C M van de Moosdijk U F van Sprang J A Knottnerus H E J H Stoffers W A M Lucassen Source Type: research

The WOEST  2 registry : A prospective registry on antithrombotic therapy in atrial fibrillation patients undergoing percutaneous coronary intervention
CONCLUSIONS: Patients on combined oral anticoagulation and antiplatelet therapy undergoing PCI are elderly and have both a high bleeding and ischaemic risk. Over time, a NOAC plus clopidogrel became the preferred treatment. The rate of thrombotic and bleeding events was not significantly different between patients on triple or dual therapy or between those on VKAs versus NOACs.PMID:35230636 | DOI:10.1007/s12471-022-01664-0
Source: Netherlands Heart Journal - March 1, 2022 Category: Cardiology Authors: A J W M de Veer N Bennaghmouch W L Bor J P R Herrman M Vrolix M Meuwissen T Vandendriessche T Adriaenssens B de Bruyne M Magro W J M Dewilde J M Ten Berg Source Type: research

Cost-effectiveness of a photopethysmographic procedure for screening for atrial fibrillation in 6 European countries
ConclusionThe model results showed a strong dependence of the results on the country-specific costs for stroke treatment. The use of the investigated screening method is close to cost-neutral or cost-reducing in the Western European countries and Greece. In countries with low price levels, higher cost increases due to AF screening are to be expected. Lower costs of anticoagulation, which are expected due to the upcoming patent expiry of direct anticoagulants, have a positive effect on the cost result.
Source: Health Economics Review - February 26, 2022 Category: International Medicine & Public Health Source Type: research

Validating risk models versus age alone for atrial fibrillation in a young Dutch population cohort: should atrial fibrillation risk prediction be expanded to younger community members?
Conclusion Multivariable models accurately discriminate for 5-year and 10-year AF risk among young European community-dwelling individuals. However, their additional discriminatory value over age alone was limited. Selection strategies for primary AF screening using multivariable models should not be expanded to younger individuals.
Source: BMJ Open - February 16, 2022 Category: General Medicine Authors: Himmelreich, J. C. L., Harskamp, R. E., Geelhoed, B., Virdone, S., Lucassen, W. A. M., Gansevoort, R. T., Rienstra, M. Tags: Open access, Cardiovascular medicine Source Type: research

Influence of Onset to Imaging Time on Radiological Thrombus Characteristics in Acute Ischemic Stroke
Conclusion: In our population of acute ischemic stroke patients, we found no clear association between onset-to-imaging time and radiological thrombus characteristics. This suggests that elapsed time from stroke onset plays a limited role in the interpretation of radiological thrombus characteristics and their effect on treatment results, at least in the early time window.
Source: Frontiers in Neurology - June 18, 2021 Category: Neurology Source Type: research

Stroke prevention in patients with atrial fibrillation and comorbidities: evidence and common sense.
PMID: 32897488 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - September 7, 2020 Category: Cardiology Authors: de Groot JR Tags: Neth Heart J Source Type: research

Impact of different anticoagulation management strategies on outcomes in atrial fibrillation: Dutch and Belgian results from the GARFIELD-AF registry.
CONCLUSIONS: In GARFIELD-AF, despite similar characteristics, patients on anticoagulants were treated differently in NL and BE. Although the rate of major bleeding was 33% higher in NL, variations in bleeding, mortality and TE rates were not statistically significant. PMID: 32886853 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - September 3, 2020 Category: Hematology Authors: Seelig J, Hemels MEW, Xhaët O, Bongaerts MCM, de Wolf A, Groenemeijer BE, Heyse A, Hoogslag P, Voet J, Herrman JR, Vervoort G, Hermans W, Wollaert B, Boersma LVA, Hermans K, Lucassen A, Verstraete S, Adriaansen HJ, Mairesse GH, Terpstra WF, Faes D, Piete Tags: J Thromb Haemost Source Type: research

Antithrombotic management of patients with atrial fibrillation-Dutch anticoagulant initiatives anno 2020.
Abstract In recent years, as more and more experience has been gained with prescribing direct oral anticoagulants (DOACs), new research initiatives have emerged in the Netherlands to improve the safety and appropriateness of DOAC treatment for stroke prevention in patients with atrial fibrillation (AF). These initiatives address several contemporary unresolved issues, such as inappropriate dosing, non-adherence and the long-term management of DOAC treatment. Dutch initiatives have also contributed to the development and improvement of risk prediction models. Although fewer bleeding complications (notably intracran...
Source: Netherlands Heart Journal - July 31, 2020 Category: Cardiology Authors: Chu G, Seelig J, Trinks-Roerdink EM, Geersing GJ, Rutten FH, de Groot JR, Huisman MV, Hemels MEW Tags: Neth Heart J Source Type: research

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