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Effect of prior anticoagulation therapy on stroke severity and in-hospital outcomes in patients with acute ischemic stroke and atrial fibrillation
We aimed to assess the prevalence of prior anticoagulation therapy (warfarin or non-vitamin K antagonist oral anticoagulants [NOACs]) among patients with acute ischemic stroke (AIS) and atrial fibrillation (AF) in China and investigate the associations between prior anticoagulation therapy and initial stroke severity and in-hospital outcomes.
Source: International Journal of Cardiology - May 29, 2023 Category: Cardiology Authors: Lue Zhou, Yapeng Li, Xin Yang, Hongqiu Gu, Yanran Duan, Hang Fu, Anran Wang, Kai Liu, Yuan Gao, Bo Song, Yusheng Li, Yingyu Jiang, Jing Zhang, Chunjuan Wang, Meng Wang, Zixiao Li, Yuming Xu, Chengzeng Wang, Yongjun Wang Source Type: research

Persisting stroke risk in patients with atrial fibrillation despite proper anticoagulation – Unmet clinical needs
Oral anticoagulation (OAC) is crucial to prevent cardioembolic stroke in patients with atrial fibrillation (AF). Development of the direct oral anticoagulants (DOAC), which inhibit activities of the coagulant proteases thrombin and activated factor X (FXs), has improved the safety and efficacy of anticoagulation in AF, compared to traditional vitamin K antagonists like warfarin [1,2]. Yet in a small, but numerically relevant proportion of up to 2% of patients, this cornerstone principle fails for unclear reasons.
Source: International Journal of Cardiology - August 6, 2022 Category: Cardiology Authors: Florian Bruns, Dobromir Dobrev, Anke C. Fender Tags: Editorial Source Type: research

Uninterrupted NOAC therapy in patients undergoing catheter ablation of atrial fibrillation: “Dual anticoagulant therapy” ready for primetime or systematic overtreatment?
Catheter ablation of atrial fibrillation (AF) appears as a very promising technique to reduce arrhythmia episodes in patients with AF [1]. The major adverse events of such procedures are bleeding complications and stroke. Therefore, several studies were performed to assess efficacy and safety of different oral anticoagulants like warfarin (VKA) and non-VKA oral anticoagulants (NOAC). NOAC therapy has been explored in patients with chronic AF and in patients undergoing antiarrhythmic procedures [2, 3].
Source: International Journal of Cardiology - June 13, 2018 Category: Cardiology Authors: Andreas Goette Tags: Editorial Source Type: research

Oral anticoagulation alone for concomitant stable coronary artery disease and atrial fibrillation: A definitive strategy?
Thrombus formation, albeit with partially different mechanisms, is the common denominator of adverse ischemic events in both coronary artery disease (CAD) and atrial fibrillation (AF) [1]. Accordingly, long-term oral antiplatelet therapy with aspirin, and oral anticoagulation (OAC) with either warfarin or a direct oral anticoagulant (DOAC), including dabigatran, rivaroxaban, apixaban, and edoxaban, have long been established as the standard treatments for the prevention of (recurrent) cardiac ischemic events and stroke, respectively [2].
Source: International Journal of Cardiology - May 16, 2018 Category: Cardiology Authors: Andrea Rubboli Source Type: research

‘Some doors are better left closed’: Using LAA occluders as an alternative to warfarin in very high-risk dialysed patients with atrial fibrillation
Since 2011, when the EMA approved the treatment with novel oral anticoagulants (NOACs) for primary prevention of cardio-embolic stroke in patients with atrial fibrillation (AF), a reasonable question repeatedly arose: “Will NOACs become the new standard of care in anticoagulation therapy?” [1]. While for many cathegories of patients the answer soon become positive [2], the sub-group of advanced chronic kidney disease (CKD) 5D stage (in dialysis) has never received a “yes” from either FDA or EMA (none of t hem allowing the use of NOACs in 5D CKD).
Source: International Journal of Cardiology - April 27, 2018 Category: Cardiology Authors: Alexandru Burlacu, Adrian Covic Tags: Editorial Source Type: research

Different safety profiles of oral anticoagulants in very elderly non-valvular atrial fibrillation patients: A retrospective propensity score matched cohort study
Vitamin K antagonists (VKAs) have been shown to decrease the risk of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). [1] The non-VKA oral anticoagulants (NOACs) are now increasingly used as an alternative to VKAs thanks to their convenient, fixed dose and no requirement for monitoring. NOACs have shown non-inferiority to warfarin for the prevention of stroke and systemic embolism, with marked reduction in the risk of intracerebral haemorrhage [2].
Source: International Journal of Cardiology - April 25, 2018 Category: Cardiology Authors: Giacomo Zoppellaro, Luca Zanella, Gentian Denas, Nicola Gennaro, Eliana Ferroni, Ugo Fedeli, Seena Padayattil Jose, Giorgio Costa, Maria Chiara Corti, Margherita Andretta, Vittorio Pengo Source Type: research

The effectiveness and safety of low-dose rivaroxaban in Asians with non-valvular atrial fibrillation
The objective of the study is to compare the effectiveness and safety of low-dose rivaroxaban to those of warfarin among Asians with NVAF.
Source: International Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: Hsin-Fu Lee, Yi-Hsin Chan, Hui-Tzu Tu, Chi-Tai Kuo, Yung-Hsin Yeh, Shang-Hung Chang, Lung-Sheng Wu, Lai-Chu See Source Type: research

Percutaneous left atrial appendage closure versus oral anticoagulant: A bird in the hand is worth two in the bush?
Since the technology of percutaneous left atrial closure (LAAC) was developed to prevent thromboembolic events in non-valvular atrial fibrillation (AF) patients, debate continues over its risks and benefits. Some support LAAC as it significantly reduces bleeding and all-cause mortality and is non-inferior, if not superior, to warfarin in terms of stroke prevention [1,2]; however, others question the data retrieved from the LAAC-related trials and argue the efficacy and safety of LAAC devices. The more the device is used, the stronger the voice from both camps.
Source: International Journal of Cardiology - November 30, 2017 Category: Cardiology Authors: Rong Bai Tags: Editorial Source Type: research

Non-vitamin K antagonist oral anticoagulants compared with warfarin at different levels of INR control in atrial fibrillation: A meta-analysis of randomized trials
The efficacy and safety of warfarin for stroke prevention in atrial fibrillation (AF) depend on the time in the therapeutic range (TTR) with an international normalised ratio (INR) of 2.0 –3.0. This meta-analysis focused the relative efficacy and safety of non-VKA oral anticoagulants (NOAC) compared with warfarin at different thresholds of centre's TTR (cTTR).
Source: International Journal of Cardiology - June 2, 2017 Category: Cardiology Authors: Jo ão Carmo, Jorge Ferreira, Francisco Costa, Pedro Carmo, Diogo Cavaco, Salomé Carvalho, Francisco Morgado, Pedro Adragão, Miguel Mendes Source Type: research

Left atrial appendage closure in a patient with left atrial appendage thrombus using a novel fish ball technique
We report on a 47-year-old (body-mass-index 24, 8), male patient who was scheduled for percutaneous left atrial appendage (LAA) closure at our hospital. In this patient permanent atrial fibrillation was known since 2010 with a CHA2DS2-Vasc-score of 3, because of arterial hypertension, diabetes mellitus type II and coronary heart disease). The Hasbled-score was 4, because of arterial hypertension, bleeding and stroke in his history and labile INR values under anticoagulation with warfarin therapy.
Source: International Journal of Cardiology - December 26, 2016 Category: Cardiology Authors: Barbara Bellmann, Andreas Rillig, David Leistner, Mario Kasner, Carsten Skurk, Ulf Landmesser, Jai-Wun Park Source Type: research

Efficacy and safety of novel anticoagulants versus vitamin K antagonists in patients with mild and moderate to severe renal insufficiency: Focus on apixaban
The high risk of both stroke and major bleeding in atrial fibrillation (AF) patients with chronic kidney disease (CKD) defines an important population for whom the assessment of the balance between the risk of ischemic stroke and of bleeding is essential. The use of novel oral anticoagulants (NOACs) may be a viable option in this population due to their greater net clinical benefit than warfarin, as demonstrated by the results of the clinical phase III trials. NOACs have been found to have a greater net clinical benefit than warfarin in patients at high risk of either stroke (CHADS2 ≥1 or CHA2DS2-VASc score≥2) or bleeding (HAS-BLED≥3).
Source: International Journal of Cardiology - September 30, 2016 Category: Cardiology Authors: Francesco Pelliccia, Salvatore Rosanio, Giuseppe Marazzi, Sara Poggi, Alessandra Tanzilli, Cesare Greco, Carlo Gaudio, Giuseppe Rosano Tags: Review Source Type: research

New oral anticoagulants versus Warfarin in patients undergoing cardioversion of atrial fibrillation
Atrial fibrillation (AF) is the most frequently observed sustained cardiac arrhythmia, with a prevalence of about 1% in the general population [1]. Either pharmacological or electrical cardioversion can be used in symptomatic patients to restore sinus rhythm [1,2]. However, cardioversion carries a not negligible peri-procedural risk of thromboembolic events, with stroke rates between 5 and 7% in non-anticoagulated patients [3]. Such incidence of thromboembolic events is reduced by Warfarin therapy to lower than 1% [4].
Source: International Journal of Cardiology - September 30, 2016 Category: Cardiology Authors: Giuseppe And ò, Olimpia Trio Tags: Correspondence Source Type: research

The C of CHADS: Historical Perspective and Clinical Applications for Anticoagulation in patients with Non Valvular Atrial Fibrillation and Congestive Heart Failure
The risk stratification of patients with coexisting non valvular atrial fibrillation and congestive heart failure, is often a clinical challenge, as the definitions of congestive heart failure in the popular CHADS2 and CHA2DS2VASc scoring systems, and amongst major clinical trials on Warfarin and Novel Oral Anticoagulants (NOAC) have heterogeneity. Available evidence reveals that any heart failure and/or left ventricular systolic dysfunction is associated with higher rates of stroke/systemic embolism and bleeding in patients with non valvular atrial fibrillation compared to patients without heart failure and normal left ventricular function.
Source: International Journal of Cardiology - September 16, 2016 Category: Cardiology Authors: Y Chugh, RT Faillace Tags: Editorial Source Type: research

Corrigendum to “Dabigatran in clinical practice: Contemporary overview of the evidence” Int. J. Cardiol. 220 (2016) 417–428
The authors regret errors in the presentation of data in Figs. 2, 3 and 4 for the stroke or systemic embolism and major bleeding outcomes for dabigatran vs warfarin in subgroups with age ≥75years and
Source: International Journal of Cardiology - September 6, 2016 Category: Cardiology Authors: Walter Ageno, John Eikelboom, Gregory Y.H. Lip Tags: Corrigendum Source Type: research

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