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A Real-World Evaluation of Primary Medication Nonadherence in Patients with Nonvalvular Atrial Fibrillation Prescribed Oral Anticoagulants in the United States
ConclusionsMore than one-quarter of patients experienced PMN within 30 days of their initial prescription order. This rate decreased over a longer period, suggesting a delay in fills. Understanding the factors associated with PMN is warranted to develop effective interventions for improving OAC treatment rates in NVAF.
Source: American Journal of Cardiovascular Drugs - June 10, 2023 Category: Cardiology Source Type: research

Safety and effectiveness of appropriately and inappropriately dosed rivaroxaban or apixaban versus warfarin in patients with atrial fibrillation: a cohort study with nested case-control analyses from UK primary care
Conclusions Dosing appropriateness in NVAF was not associated with a significant difference in IS/SE risk or increase in ICB risk versus warfarin. These findings may reflect residual confounding and biases that were difficult to control, as also seen in other observational studies. They should, therefore, be interpreted with caution, and prescribers should adhere to the dosing instructions in the respective Summary of Product Characteristics. Further studies on this topic from real-world populations are needed.
Source: BMJ Open - June 2, 2022 Category: General Medicine Authors: Gonzalez-Perez, A., Roberts, L., Vora, P., Saez, M. E., Brobert, G., Fatoba, S., Garcia Rodriguez, L. A. Tags: Open access, Cardiovascular medicine Source Type: research

Evaluation of antithrombotic use and COVID-19 outcomes in a nationwide atrial fibrillation cohort
Conclusions Pre-existing AT use may be associated with lower odds of COVID-19 death and, while not evidence of causality, provides further incentive to improve AT coverage for eligible individuals with AF.
Source: Heart - May 25, 2022 Category: Cardiology Authors: Handy, A., Banerjee, A., Wood, A. M., Dale, C., Sudlow, C. L. M., Tomlinson, C., Bean, D., Thygesen, J. H., Mizani, M. A., Katsoulis, M., Takhar, R., Hollings, S., Denaxas, S., Walker, V., Dobson, R., Sofat, R., on behalf of the CVD-COVID-UK Consortium Tags: Open access, COVID-19 Cardiac risk factors and prevention Source Type: research

Comparative Outcomes Between Direct Oral Anticoagulants, Warfarin, and Antiplatelet Monotherapy Among Chinese Patients with Atrial Fibrillation: A Population-Based Cohort Study
ConclusionAntiplatelet prescribing and suboptimal warfarin management remain common in Chinese patients with AF at high risk of stroke. DOAC use may be associated with a lower risk of ischemic stroke and all-cause mortality when compared with antiplatelets and with a lower risk of ICH when compared with warfarin.
Source: Drug Safety - June 17, 2020 Category: Drugs & Pharmacology Source Type: research

Rivaroxaban Versus Warfarin in African American Patients with Nonvalvular Atrial Fibrillation.
CONCLUSIONS: Rivaroxaban appeared at least as effective and safe as warfarin when used to manage African American patients with NVAF in routine practice. PMID: 32493618 [PubMed - as supplied by publisher]
Source: Journal of the National Medical Association - June 5, 2020 Category: General Medicine Tags: J Natl Med Assoc Source Type: research

Effectiveness and Safety of Rivaroxaban Versus Warfarin in Obese Nonvalvular Atrial Fibrillation Patients: Analysis of Electronic Health Record Data.
Conclusions: Among obese NVAF patients, prescription of rivaroxaban was associated with a reduced risk of SSE and major bleeding compared to warfarin, which remained consistent across BMI classes. PMID: 32347755 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - May 1, 2020 Category: Research Tags: Curr Med Res Opin Source Type: research

Risks and Benefits of Direct Oral Anticoagulants across the Spectrum of GFR among Incident and Prevalent Patients with Atrial Fibrillation.
CONCLUSIONS: In a large health care system, patients with eGFR<60 ml/min per 1.73 m2 who took direct oral anticoagulants for atrial fibrillation had slightly higher risk of bleeding compared with those on warfarin, but similar benefits from prevention of ischemic stroke. PMID: 30002224 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - July 12, 2018 Category: Urology & Nephrology Authors: Shin JI, Secora A, Alexander GC, Inker LA, Coresh J, Chang AR, Grams ME Tags: Clin J Am Soc Nephrol Source Type: research

Safety and effectiveness of apixaban in comparison to warfarin in patients with nonvalvular atrial fibrillation: a propensity-matched analysis from Japanese administrative claims data.
CONCLUSIONS: Our observational data from clinical practice broadly confirm the safety and efficacy results of pivotal randomized controlled trials of apixaban for stroke prevention among NVAF patients. PMID: 29772946 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - May 19, 2018 Category: Research Tags: Curr Med Res Opin Source Type: research

Treatment and discharge patterns among patients hospitalized with non-valvular atrial fibrillation transitioning from the inpatient to outpatient setting.
CONCLUSIONS: Most patients hospitalized for NVAF were discharged to home support, and the majority did not have OAC treatment during hospitalization or the 30 days post-discharge. Additional investigation should be conducted on trends beyond 30 days post hospitalization and the reasons for not receiving anticoagulation therapy in patients at moderate to severe risk of stroke or systemic embolism. Helping to avoid preventable strokes is an important goal for public health. PMID: 29235900 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - December 15, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research

Impact of renal function on ischemic stroke and major bleeding rates in nonvalvular atrial fibrillation patients treated with warfarin or rivaroxaban: a retrospective cohort study using real-world evidence.
CONCLUSIONS: Ischemic stroke rates were significantly lower in the overall NVAF population for rivaroxaban vs warfarin users, including patients with eCrCl below 50 mL/min. For all renal function groups, major bleeding risks were not statistically different between treatment groups. PMID: 28590785 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - June 8, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research

Net clinical benefit of warfarin in individuals with atrial fibrillation across stroke risk and across primary and secondary care
Conclusions CHA2DS2-VASc accurately stratifies IS risk in individuals with AF across both primary and secondary care. However, the incidence rate of ischaemic stroke at CHA2DS2-VASc=1 are lower than previously reported, which may change the decision to start anticoagulation with warfarin in these individuals.
Source: Heart - January 12, 2017 Category: Cardiology Authors: Allan, V., Banerjee, A., Shah, A. D., Patel, R., Denaxas, S., Casas, J.-P., Hemingway, H. Tags: Open access, Drugs: cardiovascular system, Epidemiology Arrhythmias and sudden death Source Type: research

Abstract 156: Body Mass Index and Outcomes among Patients with Atrial Fibrillation from the ATRIA2-CVRN Study Poster Session II
In conclusion, overweight and moderate obesity appear protective for all-cause mortality in at-risk AF patients during off-warfarin periods, but these effects do not appear to be mediated by reduced risk of thromboembolism or major bleeding.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Black, M. H., Wu, J., Singer, D. E., Udaltsova, N., Harrison, T. N., Shen, A. Y.-J., Fang, M. C., Go, A. S., Reynolds, K. Tags: Poster Session II Source Type: research