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Source: The American Journal of Cardiology
Drug: Coumadin
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Total 64 results found since Jan 2013.
Direct Oral Anticoagulants: Patients Benefit When Prescribers Get the Message
Direct oral anticoagulants (DOACs) have demonstrated similar or better efficacy to warfarin in reducing stroke and systemic embolic events in large-scale prospective trials.1 –4 In addition, these trials demonstrated either noninferiority or superiority in reducing bleeding events compared with warfarin. To treat high-risk patients with atrial fibrillation (AF) and avoid bleeding in low-risk patients, current guidelines recommend oral anticoagulants in high-risk patien ts with AF with CHA2DS2VASc scores of ≥2 in men and ≥3 in women.
Source: The American Journal of Cardiology - September 5, 2023 Category: Cardiology Authors: Gerald V. Naccarelli Tags: Editorial Source Type: research
Systematic Review and Meta-Analysis of Direct Oral Anticoagulants Versus Warfarin in Atrial Fibrillation With Low Stroke Risk
Oral anticoagulation (OAC) in patients with atrial fibrillation (AF) has been shown to prevent thromboembolic complications, but concerns about the increased risk of major bleeding warrant judicious consideration of the risks and benefits.1 Current guidelines recommend OAC prescription for patients with AF at high risk of stroke, as measured by CHA2DS2-VASc scores of ≥2 and ≥3 in men and women respectively.2–4 Men and women with scores of 1 and 2 respectively (i.e., a single nongender-related stroke risk factor) are deemed to be at low-moderate risk of stroke and OAC prescription may be considered to reduce thromboem...
Source: The American Journal of Cardiology - August 11, 2023 Category: Cardiology Authors: Khi Yung Fong, Yiong Huak Chan, Colin Yeo, Gregory Y.H. Lip, Vern Hsen Tan Source Type: research
Quest for the Perfect Anticoagulant
The current referenced meta-analysis study by Selvaraj et al1 examines the relative merits of anticoagulation with a direct oral anticoagulant (DOAC) versus vitamin K antagonist (VKA) after transcatheter aortic valve implantation (TAVI) in patients meeting the indications for anticoagulation because of atrial fibrillation (AF). Although guidelines vary, the general consensus appears to indicate noninferiority to superiority of DOACs in the treatment of nonvalvular AF. In the landmark Apixiban for Reduction In Stroke and Other Thromboemoblic Events in Atrial Fibrillation trial comparing apixaban to warfarin in patients with...
Source: The American Journal of Cardiology - July 27, 2023 Category: Cardiology Authors: Bryant Fisher, Danny Chu Source Type: research
An Updated Meta-Analysis on the Clinical Outcomes of Percutaneous Left Atrial Appendage Closure Versus Direct Oral Anticoagulation in Patients With Atrial Fibrillation
The availability of direct oral anticoagulants (DOACs) with known lower bleeding risk compared with warfarin have raised questions about the role of left atrial appendage closure (LAAC). We aimed to perform a meta-analysis to compare the clinical outcomes for LAAC versus DOACs. All studies directly comparing LAAC with DOACs up to January 2023 were included. The outcomes studied included the combined major adverse cardiovascular (CV) events outcomes, ischemic stroke and thromboembolic events, major bleeding, CV mortality, and all-cause mortality.
Source: The American Journal of Cardiology - June 13, 2023 Category: Cardiology Authors: Haowen Jiang, Tian Hai Koh, Vijay Vengkat, Gao Fei, Zee Pin Ding, See Hooi Ewe, Ignasius Jappar, Soo Teik Lim, Jonathan Yap Source Type: research
Reply to the Comment on “Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation”
We thank Dr. Abrahim et al for their interest and valuable comment on our study.1 In the methodology section, we intended to recruit stable patients who were able to use the standard anticoagulation in the outpatient setting. Therefore, we excluded the patients with acute stroke within 2 weeks or patients with high-bleeding risk. All the patients received standard rate control therapy according to the relevant guideline.2 The proportion of medications for rate control such as β blocker (56% of overall patients), calcium channel blocker (24%), or digitalis (31%) were already prese nted, and the mean heart rate was 74.1 ± 14.2 beats/min.
Source: The American Journal of Cardiology - October 10, 2022 Category: Cardiology Authors: Min Soo Cho, Duk-Hyun Kang, Kee-Joon Choi Source Type: research
Comparison of Dabigatran Versus Warfarin Treatment for the Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation
Atrial fibrillation is one of the most common arrhythmias in the United States and is associated with an increased risk of thromboembolic events.1 The American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines recommend oral anticoagulation with either warfarin or oral non-vitamin K antagonists for patients diagnosed with atrial fibrillation with a high risk for ischemic stroke based on the CHA2DS2-VASc score.2 The recently published article “Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation” discussed the efficacy of...
Source: The American Journal of Cardiology - October 7, 2022 Category: Cardiology Authors: Marwa S.H. Abrahim, Olufemi Sofola-James, Zeina Bani Hani Source Type: research
Comparison of Dabigatran Versus Warfarin Treatment for Prevention of New Cerebral Lesions in Valvular Atrial Fibrillation
Warfarin is the standard anticoagulation therapy for valvular atrial fibrillation (AF); however, new oral anticoagulants have emerged as an alternative. We compared the efficacy and safety of dabigatran with conventional treatment in AF associated with left-sided valvular heart disease (VHD), including mitral stenosis (MS). Patients with AF and left-sided VHD were randomly assigned to receive dabigatran or conventional treatment. The primary end point was the occurrence of clinical stroke or a new brain lesion (silent brain infarct and microbleed) on 1-year follow-up brain magnetic resonance imaging.
Source: The American Journal of Cardiology - May 9, 2022 Category: Cardiology Authors: Min Soo Cho, Minsu Kim, Seung-ah Lee, Sahmin Lee, Dae-Hee Kim, Jun Kim, Jong-Min Song, Gi-Byoung Nam, Sang Joon Kim, Duk-Hyun Kang, Kee-Joon Choi Source Type: research
Effectiveness and Safety of Apixaban Versus Warfarin in Obese Patients with Nonvalvular Atrial Fibrillation Enrolled in Medicare and Veteran Affairs
Real-world studies have evaluated the use of anticoagulants in obese patients with nonvalvular atrial fibrillation (NVAF), but they have been limited by sample size or the use of diagnosis codes on claims to define obesity. This retrospective study used body weight data of ≥100 kg or a body mass index of ≥30 kg/m2 to identify elderly (aged ≥65 years) NVAF patients with obesity in dually enrolled Veterans Affairs and fee-for-service Medicare patients. It evaluated the risk of stroke/systemic embolism (SE) and major bleeding (MB) in patients that initiated apixaba n versus warfarin.
Source: The American Journal of Cardiology - December 18, 2021 Category: Cardiology Authors: Steve Deitelzweig, Janvi Sah, Amiee Kang, Cristina Russ, Madison Preib, Amol D. Dhamane, Anna Ratiu, Matthew Cato, Tamuno Alfred, Edi Levi, Manuela Di Fusco Source Type: research
Comparison of Low and Full Dose Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Renal Dysfunction (from a National Registry)
The use of direct oral anticoagulants for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) is robust. However, the efficacy and safety of different dosage in patients with renal dysfunction is still a clinical challenge. We aimed to evaluate the clinical characteristics and outcomes of patients treated with apixaban in its different doses. A multicenter prospective cohort study, where consecutive eligible apixaban or warfarin treated patients with NVAF and renal impairment, were registered.
Source: The American Journal of Cardiology - September 7, 2021 Category: Cardiology Authors: Chen Gurevitz, Ela Giladi, Alon Barsheshet, Robert Klempfner, Ilan Goldenberg, Ran Kornowski, Avishay Elis Source Type: research
Comparison of Direct Oral Anticoagulants versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves
The objectives of this study were to evaluate the ambulatory utilization of DOACs and to compare the effectiveness and safety of DOACs versus warfarin in patients with AF and BHVs. We conducted a retrospective cohort study at a large integrated health care delivery system in California. Patients with BHVs and AF treated with warfarin, dabigatran, rivaroxaban or apixaban between September 12, 2011 and June 18, 2020 were identified.
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Lewei Duan, Jason N Doctor, John L Adams, John A Romley, Leigh-Anh Nguyen, Jaejin An, Ming-Sum Lee Source Type: research
Meta-Analysis of Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Bioprosthetic Valves
Valvular heart disease is frequently complicated by atrial fibrillation, which is associated with an increased risk of mortality. In the presence of a surgical or transcatheter bioprosthetic valve, patients with atrial fibrillation are at increased risks of systemic thromboembolism.1 Although direct oral anticoagulants (DOACs) have been shown to be non-inferior or superior to warfarin in preventing stroke or thromboembolism associated with nonvalvular atrial fibrillation, the utilization of DOACs in patients with prior bioprosthetic valves has been limited in randomized clinical trials (RCTs).
Source: The American Journal of Cardiology - December 3, 2020 Category: Cardiology Authors: Babikir Kheiri, Ryle Przybylowicz, Timothy F Simpson, Hani Alhamoud, Mohammed Osman, Khidir Dalouk, Babak Nazer, Charles A. Henrikson, Eric Stecker Source Type: research
Network Meta-analysis Comparing Apixaban versus Rivaroxaban in Morbidly Obese Patients with Atrial Fibrillation
The efficacy and safety of DOACs in morbidly obese patients have been well investigated over the last few years.1-4 Our recent meta-analysis showed that the DOAC group did not increase stroke or systemic embolism (SE) event rate compared to the warfarin group and the DOAC use was significantly associated with a lower major bleeding event rate compared to the warfarin group.5 However, it is still unknown which DOAC is more appropriate than others. Apixaban and rivaroxaban are the two most common DOACs prescribed in the U.S but there is no guidance on which agent should be selected in morbidly obese patients with AF.
Source: The American Journal of Cardiology - September 7, 2020 Category: Cardiology Authors: Kazuhiko Kido, Mikiko Shimizu, Tsuyoshi Shiga, Masayuki Hashiguchi Source Type: research
Non-Vitamin K Antagonist Oral Anticoagulant for Atrial Fibrillation in Obese Patients
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It affects 1 in 4 adults aged>40 years,1 and is associated with a 5-fold increased risk of stroke.1 Hence, anticoagulants are universally recommended to prevent stroke and systemic embolism in patients with AF.1 The non-vitamin K antagonist oral anticoagulants (NOACs) are important alternatives to warfarin for prevention of arterial thromboembolism in patients with AF. Currently, the FDA has approved four NOACs for use in patients with AF: dabigatran is a thrombin inhibitor, while rivaroxaban, apixaban, and edoxaban are factor Xa inhibitors.
Source: The American Journal of Cardiology - April 22, 2020 Category: Cardiology Authors: Stephen Y Wang, Robert P Giugliano Tags: Review Article Source Type: research
Real-World Direct Comparison of the Effectiveness and Safety of Apixaban, Dabigatran, Rivaroxaban, and Warfarin in Medicare Beneficiaries with Atrial Fibrillation
It remains unknown whether the comparative effectiveness of direct oral anticoagulants (DOACs) and warfarin differs between atrial fibrillation (AF) patients with and without a history of stroke or transient ischemic attack (TIA). Using 2012-2014 Medicare claims data, we identified patients newly diagnosed with AF in 2013-2014 who initiated apixaban, dabigatran, rivaroxaban or warfarin. We categorized patients based on a history of stroke or TIA. We constructed Cox proportional hazard models that included indicator variables for treatment groups, a history of stroke or TIA, and the interaction between them, and controlled ...
Source: The American Journal of Cardiology - April 9, 2020 Category: Cardiology Authors: Lanting Yang, Maria M. Brooks, Nancy W. Glynn, Yuting Zhang, Samir Saba, Inmaculada Hernandez Source Type: research
Pattern and Impact of Off-label Underdosing of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation Who Are Indicated for Standard Dosing
With safety concerns about increasing bleeding, off-label underdosing of non-vitamin K antagonist anticoagulants (NOACs) is common in East Asian patients with atrial fibrillation (AF). We tried to investigate the pattern of NOAC underdosing and associated clinical outcomes in patients with AF who are indicated for standard dosing. Using the Korean National Health Insurance Service database, we evaluated 16568 patients with a new prescription of NOAC who are indicated for standard NOAC dosing and compared 4536 patients with warfarin with respect to thromboembolic events (ischemic stroke or systemic embolization), all-cause ...
Source: The American Journal of Cardiology - February 6, 2020 Category: Cardiology Authors: Min Soo Cho, Ji Eun Yun, Ji Jeong Park, Yun Jung Kim, Jessie Lee, Hyungmin Kim, Duk-Woo Park, Gi-Byoung Nam Source Type: research
