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Improved persistence with non-vitamin K oral anticoagulants compared with warfarin in patients with atrial fibrillation: recent Australian experience.
CONCLUSIONS: Persistence with NOAC drugs in patients with AF appears to be superior to warfarin. If continued long-term, this alone will be of clinical importance in the prevention of stroke and death. PMID: 27463735 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - July 29, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life.
CONCLUSION: Patients given rivaroxaban and apixaban in clinical practice have a higher thrombotic and hemorrhagic risk in comparison with patients given dabigatran or VKAs. A considerable proportion of patients receive reduced doses of NOACs. PMID: 27394924 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 5, 2016 Category: Internal Medicine Authors: Giustozzi M, Vedovati MC, Verdecchia P, Pierpaoli L, Verso M, Conti S, Cianella F, Marchesini E, Filippucci E, Agnelli G, Becattini C Tags: Eur J Intern Med Source Type: research

Cost-Effectiveness of Oral Anticoagulants for Ischemic Stroke Prophylaxis Among Nonvalvular Atrial Fibrillation Patients Clinical Sciences
Conclusions— All the newer oral anticoagulants compared were more effective than adjusted dosed warfarin. Our model showed that apixaban was the most effective anticoagulant in a general atrial fibrillation population and has an incremental cost-effectiveness ratio <$50 000/QALY. For those with higher stroke risk (CHADS2≥3), dabigatran was the most cost-effective treatment option.
Source: Stroke - May 22, 2016 Category: Neurology Authors: Shah, A., Shewale, A., Hayes, C. J., Martin, B. C. Tags: Anticoagulants, Cost-Effectiveness, Ischemic Stroke Clinical Sciences Source Type: research

Antithrombotic and Anticoagulant Therapy for Atrial Fibrillation
As atrial fibrillation (AF) substantially increases the risk of stroke and other thromboembolic events, most AF patients require appropriate antithrombotic prophylaxis. Oral anticoagulation (OAC) with either dose-adjusted vitamin K antagonists (VKAs) (eg, warfarin) or non-VKA oral anticoagulants (eg, dabigatran, apixaban, rivaroxaban) can be used for this purpose unless contraindicated. Therefore, risk assessment of stroke and bleeding is an obligatory part of AF management, and risk has to be weighed individually. Antiplatelet drugs (eg, aspirin and clopidogrel) are inferior to OAC, both alone and in combination, with a c...
Source: Heart Failure Clinics - March 9, 2016 Category: Cardiology Authors: Mikhail S. Dzeshka, Gregory Y.H. Lip Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Dabigatran Versus Warfarin After Bioprosthesis Valve Replacement for the Management of Atrial Fibrillation Postoperatively: DAWA Pilot Study
Conclusions The use of dabigatran appears to be similar to warfarin in preventing the formation of intracardiac thrombus. Trial Registration Clinicaltrials.gov NCT01868243.
Source: Drugs in R&D - February 18, 2016 Category: Drugs & Pharmacology Source Type: research

Individualized approaches to thromboprophylaxis in atrial fibrillation
Publication date: March 2016 Source:American Heart Journal, Volume 173 Author(s): Oliver J. Ziff, A. John Camm Atrial fibrillation (AF) is the most common arrhythmia worldwide. The prevalence of AF in persons older than 55 years is at least 33.5 million globally and is predicted to more than double in the next half-century. Anticoagulation, heart rate control, and heart rhythm control comprise the 3 main treatment strategies in AF. Anticoagulation is aimed at preventing debilitating stroke, systemic embolism, and associated mortality. Historically, anticoagulation in AF was achieved with a vitamin K antagonist such as ...
Source: American Heart Journal - January 30, 2016 Category: Cardiology Source Type: research

Dabigatran etexilate as second-line therapy in patients with a left ventricular assist device.
CONCLUSIONS: The safe and effective use of dabigatran as a second-line anticoagulation therapy in patients with HMII seems feasible. However, these data must be confirmed in a randomized study. PMID: 25701968 [PubMed - in process]
Source: Hellenic Journal of Cardiology - November 18, 2015 Category: Cardiology Tags: Hellenic J Cardiol Source Type: research

Individualised approaches to thrombo-prophylaxis in atrial fibrillation
Publication date: Available online 11 November 2015 Source:American Heart Journal Author(s): Oliver J. Ziff, A. John Camm Atrial fibrillation (AF) is the most common arrhythmia worldwide. The prevalence of AF in adults over 55 years of age is at least 33.5 million globally and is predicted to more than double in the next half-century. Anticoagulation, heart-rate control, and heart-rhythm control comprise the three main treatment strategies in AF. Anticoagulation is aimed at preventing debilitating stroke, systemic embolism and associated mortality. Historically, anticoagulation in AF was achieved with a vitamin K antag...
Source: American Heart Journal - November 12, 2015 Category: Cardiology Source Type: research

Dabigatran for left ventricular thrombus.
Abstract Male patient in dilated phase of hypertrophic cardiomyopathy had multiple hospitalizations during the past 2 years either due to congestive heart failure, stroke, scar epilepsy, or atrial fibrillation and ventricular tachycardia. Medication included evidence based therapy for heart failure, cordarone and warfarin. Anticoagulation had to be discontinued due to marked fluctuations in INR. Transthoracic Echocardiography (TTE) revealed a mobile mass in the left ventricle. He was treated with Dabigatran 110mg twice a day for 4 months without any bleeding or embolic episode and complete resolution of thrombus. ...
Source: Indian Heart J - September 1, 2015 Category: Cardiology Authors: Kolekar S, Munjewar C, Sharma S Tags: Indian Heart J Source Type: research

Dabigatran for left ventricular thrombus
Publication date: Available online 8 August 2015 Source:Indian Heart Journal Author(s): Satishkumar Kolekar, Chandrashekhar Munjewar, Satyavan Sharma Male patient in dilated phase of hypertrophic cardiomyopathy had multiple hospitalizations during the past 2 years either due to congestive heart failure, stroke, scar epilepsy, or atrial fibrillation and ventricular tachycardia. Medication included evidence based therapy for heart failure, cordarone and warfarin. Anticoagulation had to be discontinued due to marked fluctuations in INR. Transthoracic Echocardiography (TTE) revealed a mobile mass in the left ventricle. He...
Source: Indian Heart Journal - August 8, 2015 Category: Cardiology Source Type: research

Stroke prevention in atrial fibrillation: evidence from real-life studies
Atrial fibrillation (AF) is an increasing public health issue, especially owing to an accompanying five-fold increased risk of stroke. Anticoagulants are the cornerstone of therapy for stroke prevention in AF. The clinical benefits of vitamin K antagonists (VKAs; namely warfarin) shown in randomized controlled trials (RCTs) have been challenged when used in clinical practice by issues including the need for international normalized ratio (INR) monitoring, food and drug interactions, low time in the therapeutic range in substantial numbers of patients, and serious bleeding events. Combined, these have led to both an under-i...
Source: European Journal of Heart Failure Supplements - July 10, 2015 Category: Cardiology Authors: Akao, M., Beyer-Westendorf, J., Goto, S., Peterson, E. Tags: Articles Source Type: research

Patient Characteristics and Risk of Bleeding With Dabigatran
To the Editor We appreciate the interesting study by Hernandez et al on the risk of bleeding with dabigatran in patients with atrial fibrillation. These are important data to an ongoing controversy. However, we would appreciate an author comment regarding the external validity of the study. To what extent is this sample of Medicare beneficiaries representative of the general population of patients with atrial fibrillation? Comparing the characteristics of patients in the RE-LY Study and the Danish population-based study, it seems that these are not effortlessly comparable. In the study by Hernandez et al, patients are cons...
Source: JAMA Internal Medicine - July 1, 2015 Category: Internal Medicine Source Type: research

Predictors of Gastrointestinal Bleeding Among Patients with Atrial Fibrillation After Initiating Dabigatran Therapy
ConclusionThe risk of GI bleeding in patients receiving dabigatran is highly associated with increased age and cardiovascular, renal, and other comorbidities, even after adjusting for other factors. Fewer than 50% of patients restarted an anticoagulant after experiencing a GI bleed. Clinicians should continue to monitor for these risk factors or consider whether alternative therapies may be appropriate.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - May 1, 2015 Category: Drugs & Pharmacology Authors: Julie C. Lauffenburger, Denise H. Rhoney, Joel F. Farley, Anil K. Gehi, Gang Fang Tags: Original Research Article Source Type: research

Dabigatran anticoagulation
Atrial fibrillation (AF) is a common heart arrhythmia for which anticoagulant agents such as warfarin are prescribed. A recently licensed anticoagulant, dabigatran (Pradaxa), diminishes the risk of stroke or systemic emboli in patients with AF and those having joint replacement surgery. Adult patients with non-valvular AF with previous stroke, transient ischemic attack or systemic embolism, left ventricular ejection fraction less than 40%, symptomatic heart failure exceeding New York Heart Association class 2, or age over 65 years with diabetes mellitus, coronary artery disease or hypertension are also candidates for dabigatran therapy.
Source: Dental Abstracts - May 1, 2015 Category: Dentistry Tags: Hands On Source Type: research

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