Query: stroke

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Source: European Heart Journal
Condition: Bleeding

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Total 56 results found since Jan 2013.

Uninterrupted edoxaban vs. vitamin K antagonists for ablation of atrial fibrillation: the ELIMINATE-AF trial
ConclusionUninterrupted edoxaban therapy represents an alternative to uninterrupted VKA treatment in patients undergoing AF ablation.
Source: European Heart Journal - April 11, 2019 Category: Cardiology Source Type: research

‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

Safety and efficacy of dual vs. triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: a systematic review and meta-analysis of randomized clinical trials
ConclusionCompared with TAT, DAT shows a reduction in TIMI major or minor bleeding by 47% with comparable outcomes of MACE. Our findings support the concept that DAT may be a better option than TAT in many patients with AF following PCI.
Source: European Heart Journal - April 13, 2018 Category: Cardiology Source Type: research

The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation
AbstractThe current manuscript is the second update of the original Practical Guide, published in 2013 [Heidbuchelet al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation.Europace 2013;15:625 –651; Heidbuchelet al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467 –1507]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in pati...
Source: European Heart Journal - March 19, 2018 Category: Cardiology Source Type: research

Characteristics of patients with atrial fibrillation prescribed antiplatelet monotherapy compared with those on anticoagulants: insights from the GARFIELD-AF registry
ConclusionPrescribing AP monotherapy in newly diagnosed AF has declined, but even nowadays a substantial proportion of AP-treated patients with AF have no indication for AP.Clinical Trial RegistrationURL:http://www.clinicaltrials.gov. Unique identifier: NCT01090362.
Source: European Heart Journal - December 20, 2017 Category: Cardiology Source Type: research

Traumatic injury: another unjustified reason to stop oral anticoagulation for atrial fibrillation
This editorial refers to ‘Resumption of oral anticoagulation following traumatic injury and risk of stroke and bleeding in patients with atrial fibrillation: a nationwide cohort study’††, by L. Staerket al., on page 1698.
Source: European Heart Journal - December 13, 2017 Category: Cardiology Source Type: research

External applicability of the COMPASS trial: an analysis of the reduction of atherothrombosis for continued health (REACH) registry
ConclusionCOMPASS-Eligible patients represent a substantial fraction of stable CAD/PAD patients encountered in routine clinical practice in the large international REACH registry suggesting good external applicability. COMPASS-Eligible patients experienced a higher rate of the primary outcome compared with COMPASS participants in the aspirin alone treatment arm.
Source: European Heart Journal - November 23, 2017 Category: Cardiology Source Type: research

Resumption of oral anticoagulation following traumatic injury and risk of stroke and bleeding in patients with atrial fibrillation: a nationwide cohort study
ConclusionAF patients resuming VKA and NOAC treatment following traumatic injury have lower hazard of all-cause mortality and ischaemic stroke, increased hazard of major bleeding but without additional hazards of recurrent traumatic injury. Withholding OAC following a traumatic injury in AF patients may not be warranted.
Source: European Heart Journal - November 18, 2017 Category: Cardiology Source Type: research

Benefit of switching dual antiplatelet therapy after acute coronary syndrome: the TOPIC (timing of platelet inhibition after acute coronary syndrome) randomized study
ConclusionA switched DAPT is superior to an unchanged DAPT strategy to prevent bleeding complications without increase in ischaemic events following ACS.
Source: European Heart Journal - May 16, 2017 Category: Cardiology Source Type: research

Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation
Conclusion</div>Radial as compared with femoral access provided consistent benefit across the whole spectrum of patients with ACS, without evidence that type of presenting syndrome affected the results of the random access allocation.</span>
Source: European Heart Journal - February 28, 2017 Category: Cardiology Source Type: research

Personalising the decision for prolonged dual antiplatelet therapy: development, validation and potential impact of prognostic models for cardiovascular events and bleeding in myocardial infarction survivors
Conclusion</div>Prognostic models for cardiovascular events and bleeding using population-based EHRs may help to personalise decisions for prolonged DAPT 1-year following acute MI.</span>
Source: European Heart Journal - February 27, 2017 Category: Cardiology Source Type: research

Revisiting sex differences in outcomes in non-valvular atrial fibrillation: a population-based cohort study
ConclusionIn NVAF, women were not at higher risk of thromboembolic events than men in our study. The small increased risk reported in previous studies may be related to residual confounding, in particular from insufficient control for age.
Source: European Heart Journal - January 10, 2017 Category: Cardiology Source Type: research

A novel risk prediction score in atrial fibrillation for a net clinical outcome from the ENGAGE AF-TIMI 48 randomized clinical trial
Conclusion</div>In VKA naive patients with AF, the TIMI-AF score can assist in the prediction of a poor composite outcome and guide selection of anticoagulant therapy by identifying a differential clinical benefit with a NOAC or VKA.</span>
Source: European Heart Journal - January 7, 2017 Category: Cardiology Source Type: research

Outcomes and costs of left atrial appendage closure from randomized controlled trial and real-world experience relative to oral anticoagulation
Conclusion Left atrial appendage closure in NVAF in a real-world setting may result in lower stroke and major bleeding rates than reported in LAAC clinical trials. Left atrial appendage closure in both settings achieves cost parity in a relatively short period of time and may offer substantial savings compared with current therapies. Savings are most pronounced among higher risk patients and those unsuitable for anticoagulation.
Source: European Heart Journal - December 29, 2016 Category: Cardiology Authors: Panikker, S., Lord, J., Jarman, J. W. E., Armstrong, S., Jones, D. G., Haldar, S., Butcher, C., Khan, H., Mantziari, L., Nicol, E., Hussain, W., Clague, J. R., Foran, J. P., Markides, V., Wong, T. Tags: Thrombosis and antithrombotic therapy Source Type: research

Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry
Conclusion Ticagrelor vs. clopidogrel post-ACS was associated with a lower risk of death, MI, or stroke, as well as death alone. Risk of bleeding was higher with ticagrelor. These real-world outcomes are consistent with randomized trial results.
Source: European Heart Journal - December 21, 2016 Category: Cardiology Authors: Sahlen, A., Varenhorst, C., Lagerqvist, B., Renlund, H., Omerovic, E., Erlinge, D., Wallentin, L., James, S. K., Jernberg, T. Tags: Acute coronary syndromes Source Type: research

Ischaemic and haemorrhagic stroke associated with non-vitamin K antagonist oral anticoagulants and warfarin use in patients with atrial fibrillation: a nationwide cohort study
Conclusions</div>Among anticoagulant-naïve AF patients, treatment with NOACs was not associated with significantly lower risk of stroke/TE compared with VKA, but intracranial bleeding risk was significantly lower with dabigatran and apixaban.</span>
Source: European Heart Journal - October 14, 2016 Category: Cardiology Source Type: research

Aortic valve replacement with mechanical vs. biological prostheses in patients aged 50-69 years
Conclusion Patients aged 50–69 years who received mechanical valves had better long-term survival after AVR than those with bioprostheses. The risk of stroke was similar; however, patients with bioprostheses had a higher risk of aortic valve reoperation and a lower risk of major bleeding. Clinical Trial Registration http://clinicaltrials.gov/show/NCT02276950. ClinicalTrials.gov Identifier NCT02276950.
Source: European Heart Journal - September 20, 2016 Category: Cardiology Authors: Glaser, N., Jackson, V., Holzmann, M. J., Franco-Cereceda, A., Sartipy, U. Tags: Cardiovascular surgery Source Type: research

Left atrial appendage occlusion: rationale, evidence, devices, and patient selection
<span class="paragraphSection">Atrial fibrillation (AF) is a worldwide epidemic associated with significant morbidity and mortality, often due to disabling or fatal thromboembolic stroke. Oral anticoagulation is highly effective at preventing ischaemic stroke and improving all-cause survival in patients with non-valvular AF. Despite the efficacy of oral anticoagulation, many patients are not treated due to either absolute or perceived contraindications to therapy, including bleeding. Left atrial appendage (LAA) closure has emerged as a mechanical alternative to pharmacologic stroke prevention. Initial and mid-term cl...
Source: European Heart Journal - September 14, 2016 Category: Cardiology Source Type: research

Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)
Conclusion</div>For patients with ACS caused by plaque erosion, conservative treatment with anti-thrombotic therapy without stenting may be an option.</span>
Source: European Heart Journal - August 29, 2016 Category: Cardiology Source Type: research

Antithrombotic therapy in heart failure patients with and without atrial fibrillation: update and future challenges
Atrial fibrillation (AF) and heart failure (HF) often coexist, and patients with AF and HF have a higher risk of thromboembolic events and overall mortality compared with those with AF without HF. Additionally, the prevalence of AF increases with the severity of HF. The use of vitamin K antagonists is more unstable in patients with concomitant AF and HF, which is an independent risk factor for reduced time under therapeutic range. More recently, non-vitamin K antagonists oral anticoagulants (NOACs) have emerged as therapeutic alternatives for stroke prevention in patients with non-valvular AF, as they have been shown to be...
Source: European Heart Journal - August 23, 2016 Category: Cardiology Authors: Ferreira, J. P., Girerd, N., Alshalash, S., Konstam, M. A., Zannad, F. Tags: Clinical update Source Type: research

Implant success and safety of left atrial appendage closure with the WATCHMAN device: peri-procedural outcomes from the EWOLUTION registry
Conclusion Left atrial appendage closure with the WATCHMAN device has a high success rate in complete LAAC with low peri-procedural risk, even in a population with a higher risk of stroke and bleeding, and multiple co-morbidities. Improvement in implantation techniques has led to a reduction of peri-procedural complications previously limiting the net clinical benefit of the procedure.
Source: European Heart Journal - August 23, 2016 Category: Cardiology Authors: Boersma, L. V. A., Schmidt, B., Betts, T. R., Sievert, H., Tamburino, C., Teiger, E., Pokushalov, E., Kische, S., Schmitz, T., Stein, K. M., Bergmann, M. W., on behalf of the EWOLUTION investigators, Nooryani, Meincke, Mobius-Winkler, Senatore, Foley, Sch Tags: Atrial fibrillation Source Type: research

Early clinical and echocardiographic outcomes after SAPIEN 3 transcatheter aortic valve replacement in inoperable, high-risk and intermediate-risk patients with aortic stenosis
Conclusions The SAPIEN 3 THV system was associated with low rates of 30-day mortality and major/disabling stroke as well as low rates of moderate or severe paravalvular regurgitation. Trial Registration ClinicalTrials.gov #NCT01314313.
Source: European Heart Journal - July 20, 2016 Category: Cardiology Authors: Kodali, S., Thourani, V. H., White, J., Malaisrie, S. C., Lim, S., Greason, K. L., Williams, M., Guerrero, M., Eisenhauer, A. C., Kapadia, S., Kereiakes, D. J., Herrmann, H. C., Babaliaros, V., Szeto, W. Y., Hahn, R. T., Pibarot, P., Weissman, N. J., Leip Tags: TAVI Source Type: research

Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary
AbstractIn 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation.Europace 2013;15:625 –651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in...
Source: European Heart Journal - June 9, 2016 Category: Cardiology Source Type: research

Growth differentiation factor-15 level predicts major bleeding and cardiovascular events in patients with acute coronary syndromes: results from the PLATO study
Conclusions In patients with ACS, higher levels of GDF-15 are associated with raised risks of all types of major non-CABG-related bleeding, spontaneous MI, and stroke as well as CV and total mortality and seem to improve risk stratification for CV-mortality and major bleeding beyond established risk factors. Clinical Trial Registration www.clinicaltrials.gov; NCT00391872.
Source: European Heart Journal - April 20, 2016 Category: Cardiology Authors: Hagström, E., James, S. K., Bertilsson, M., Becker, R. C., Himmelmann, A., Husted, S., Katus, H. A., Steg, P. G., Storey, R. F., Siegbahn, A., Wallentin, L., for the PLATO Investigators Tags: Acute coronary syndromes Source Type: research

XANTUS: a real-world, prospective, observational study of patients treated with rivaroxaban for stroke prevention in atrial fibrillation
Conclusion XANTUS is the first international, prospective, observational study to describe the use of rivaroxaban in a broad NVAF patient population. Rates of stroke and major bleeding were low in patients receiving rivaroxaban in routine clinical practice. Trial registration number Clinicaltrials.gov: NCT01606995.
Source: European Heart Journal - April 6, 2016 Category: Cardiology Authors: Camm, A. J., Amarenco, P., Haas, S., Hess, S., Kirchhof, P., Kuhls, S., van Eickels, M., Turpie, A. G. G., the XANTUS Investigators Tags: Atrial fibrillation Source Type: research

Correlates of pre-hospital morphine use in ST-elevation myocardial infarction patients and its association with in-hospital outcomes and long-term mortality: the FAST-MI (French Registry of Acute ST-elevation and non-ST-elevation Myocardial Infarction) programme
Conclusion In two independent everyday-life cohorts, pre-hospital morphine use in STEMI patients was not associated with worse in-hospital complications and 1-year mortality. Clinical trial registration Clinicaltrials.gov identifier: NCT00673036 (FAST-MI 2005); NCT01237418 (FAST-MI 2010).
Source: European Heart Journal - March 31, 2016 Category: Cardiology Authors: Puymirat, E., Lamhaut, L., Bonnet, N., Aissaoui, N., Henry, P., Cayla, G., Cattan, S., Steg, G., Mock, L., Ducrocq, G., Goldstein, P., Schiele, F., Bonnefoy-Cudraz, E., Simon, T., Danchin, N. Tags: Acute coronary syndromes Source Type: research

Outcomes and costs of left atrial appendage closure from randomized controlled trial and real-world experience relative to oral anticoagulation
Conclusion</strong> Left atrial appendage closure in NVAF in a real-world setting may result in lower stroke and major bleeding rates than reported in LAAC clinical trials. Left atrial appendage closure in both settings achieves cost parity in a relatively short period of time and may offer substantial savings compared with current therapies. Savings are most pronounced among higher risk patients and those unsuitable for anticoagulation.</span>
Source: European Heart Journal - February 29, 2016 Category: Cardiology Source Type: research

Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 2
<span class="paragraphSection">The choice of oral anticoagulant (OAC) for patients with atrial fibrillation (AF) may be influenced by individual clinical features or by patterns of risk factors and comorbidities. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. non-vitamin K oral anticoagulants (NOACs) for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In addition, we discuss the timing of initiation of anticoagulation. In the second of a two-part review, we discuss the use of NOAC for stroke prevent...
Source: European Heart Journal - February 4, 2016 Category: Cardiology Source Type: research

Stopping or continuing clopidogrel 12 months after drug-eluting stent placement: the OPTIDUAL randomized trial
Conclusions Extended DAPT did not achieve superiority in reducing net adverse clinical events compared to 12 months of DAPT after DES placement. The power of the OPTIDUAL trial was however low and reduced by premature termination of enrolment. ClinicalTrials.gov number NCT00822536.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Helft, G., Steg, P. G., Le Feuvre, C., Georges, J.-L., Carrie, D., Dreyfus, X., Furber, A., Leclercq, F., Eltchaninoff, H., Falquier, J.-F., Henry, P., Cattan, S., Sebagh, L., Michel, P.-L., Tuambilangana, A., Hammoudi, N., Boccara, F., Cayla, G., Douard, Tags: ESC Hot Line Source Type: research

Long-term dual antiplatelet therapy for secondary prevention of cardiovascular events in the subgroup of patients with previous myocardial infarction: a collaborative meta-analysis of randomized trials
Conclusion Compared with aspirin alone, DAPT beyond 1 year among stabilized high-risk patients with prior MI decreases ischaemic events, including significant reductions in the individual endpoints of cardiovascular death, recurrent MI, and stroke. Dual antiplatelet therapy beyond 1 year increases major bleeding, but not fatal bleeding or non-cardiovascular death.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Udell, J. A., Bonaca, M. P., Collet, J.-P., Lincoff, A. M., Kereiakes, D. J., Costa, F., Lee, C. W., Mauri, L., Valgimigli, M., Park, S.-J., Montalescot, G., Sabatine, M. S., Braunwald, E., Bhatt, D. L. Tags: Coronary artery disease Source Type: research

Efficacy and safety of ticagrelor for long-term secondary prevention of atherothrombotic events in relation to renal function: insights from the PEGASUS-TIMI 54 trial
Conclusion In patients with a history of MI, patients with renal dysfunction are at increased risk of MACE and consequently experience a particularly robust absolute risk reduction with long-term treatment with ticagrelor.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Magnani, G., Storey, R. F., Steg, G., Bhatt, D. L., Cohen, M., Kuder, J., Im, K., Aylward, P., Ardissino, D., Isaza, D., Parkhomenko, A., Goudev, A. R., Dellborg, M., Kontny, F., Corbalan, R., Medina, F., Jensen, E. C., Held, P., Braunwald, E., Sabatine, Tags: Thrombosis and antithrombotic therapy Source Type: research

Ascertainment, classification, and impact of neoplasm detection during prolonged treatment with dual antiplatelet therapy with prasugrel vs. clopidogrel following acute coronary syndrome
Conclusions Neoplasm events were infrequent during long-term DAPT after ACS, were associated with differential cancer-screening practices across regions, and the frequency of neoplasm detection was similar with prasugrel vs. clopidogrel. Trial registration ClinicalTrials.gov identifier: NCT00699998.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Roe, M. T., Cyr, D. D., Eckart, D., Schulte, P. J., Morse, M. A., Blackwell, K. L., Ready, N. E., Zafar, S. Y., Beaven, A. W., Strickler, J. H., Onken, J. E., Winters, K. J., Houterloot, L., Zamoryakhin, D., Wiviott, S. D., White, H. D., Prabhakaran, D., Tags: Acute coronary syndromes Source Type: research

Clinical outcomes in patients with atrial fibrillation according to sex during anticoagulation with apixaban or warfarin: a secondary analysis of a randomized controlled trial
Conclusion In the ARISTOTLE trial, women had a similar rate of stroke or systemic embolism but a lower risk of mortality and less clinically relevant bleeding than men. The efficacy and safety benefits of apixaban compared with warfarin were consistent in men and women. Trial registration ARISTOTLE ClinicalTrials.gov number, NCT00412984.
Source: European Heart Journal - December 7, 2015 Category: Cardiology Authors: Vinereanu, D., Stevens, S. R., Alexander, J. H., Al-Khatib, S. M., Avezum, A., Bahit, M. C., Granger, C. B., Lopes, R. D., Halvorsen, S., Hanna, M., Husted, S., Hylek, E. M., Mărgulescu, A. D., Wallentin, L., Atar, D. Tags: Atrial fibrillation Source Type: research

The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation
Conclusions The five-element ORBIT bleeding risk score had better ability to predict major bleeding in AF patients when compared with HAS-BLED and ATRIA risk scores. The ORBIT risk score can provide a simple, easily remembered tool to support clinical decision making.
Source: European Heart Journal - December 7, 2015 Category: Cardiology Authors: O'Brien, E. C., Simon, D. N., Thomas, L. E., Hylek, E. M., Gersh, B. J., Ansell, J. E., Kowey, P. R., Mahaffey, K. W., Chang, P., Fonarow, G. C., Pencina, M. J., Piccini, J. P., Peterson, E. D. Tags: Atrial fibrillation Source Type: research

Edoxaban vs. warfarin in patients with atrial fibrillation on amiodarone: a subgroup analysis of the ENGAGE AF-TIMI 48 trial
Conclusions Patients randomized to the LDE treated with amiodarone at the time of randomization demonstrated a significant reduction in ischaemic events vs. warfarin when compared with those not on amiodarone, while preserving a favourable bleeding profile. In contrast, amiodarone had no effect on the relative efficacy and safety of HDE.
Source: European Heart Journal - September 1, 2015 Category: Cardiology Authors: Steffel, J., Giugliano, R. P., Braunwald, E., Murphy, S. A., Atar, D., Heidbuchel, H., Camm, A. J., Antman, E. M., Ruff, C. T. Tags: Thrombosis and anti-thrombotic therapy Source Type: research

A prospective randomized evaluation of the TriGuard™ HDH embolic DEFLECTion device during transcatheter aortic valve implantation: results from the DEFLECT III trial
Conclusion TriGuard cerebral protection during TAVI is safe and complete cerebral vessel coverage was achieved in 89% of subjects. In this exploratory study, subjects undergoing protected TAVI had more freedom from ischaemic brain lesions, fewer neurologic deficits, and improved cognitive function in some domains at discharge and 30 days compared with controls.
Source: European Heart Journal - August 14, 2015 Category: Cardiology Authors: Lansky, A. J., Schofer, J., Tchetche, D., Stella, P., Pietras, C. G., Parise, H., Abrams, K., Forrest, J. K., Cleman, M., Reinohl, J., Cuisset, T., Blackman, D., Bolotin, G., Spitzer, S., Kappert, U., Gilard, M., Modine, T., Hildick-Smith, D., Haude, M., Tags: FASTTRACK EuroPCR Source Type: research

Uninterrupted rivaroxaban vs. uninterrupted vitamin K antagonists for catheter ablation in non-valvular atrial fibrillation
Conclusion In patients undergoing CA for AF, the use of uninterrupted oral rivaroxaban was feasible and event rates were similar to those for uninterrupted VKA therapy. Name of the Trial Registry Clinicaltrials.gov trial registration number is NCT01729871.
Source: European Heart Journal - July 21, 2015 Category: Cardiology Authors: Cappato, R., Marchlinski, F. E., Hohnloser, S. H., Naccarelli, G. V., Xiang, J., Wilber, D. J., Ma, C.-S., Hess, S., Wells, D. S., Juang, G., Vijgen, J., Hugl, B. J., Balasubramaniam, R., De Chillou, C., Davies, D. W., Fields, L. E., Natale, A., on behalf Tags: Atrial fibrillation Source Type: research

Randomized trial of atrial arrhythmia monitoring to guide anticoagulation in patients with implanted defibrillator and cardiac resynchronization devices
Conclusion In patients with implanted defibrillators, the strategy of early initiation and interruption of anticoagulation based on remotely detected AT did not prevent thromboembolism and bleeding. Clinical trial registration IMPACT ClinicalTrials.gov identifier: NCT00559988 http://clinicaltrials.gov/ct2/show/NCT00559988?term=NCT00559988&rank=1.
Source: European Heart Journal - July 7, 2015 Category: Cardiology Authors: Martin, D. T., Bersohn, M. M., Waldo, A. L., Wathen, M. S., Choucair, W. K., Lip, G. Y. H., Ip, J., Holcomb, R., Akar, J. G., Halperin, J. L., on behalf of the IMPACT Investigators Tags: Atrial fibrillation Source Type: research

Edoxaban vs. warfarin in vitamin K antagonist experienced and naive patients with atrial fibrillation
Conclusion In patients with AF, edoxaban appeared to demonstrate greater efficacy compared with warfarin in patients who were VKA naive than VKA experienced. Edoxaban significantly reduced major bleeding compared with warfarin regardless of prior VKA exposure.
Source: European Heart Journal - June 14, 2015 Category: Cardiology Authors: O'Donoghue, M. L., Ruff, C. T., Giugliano, R. P., Murphy, S. A., Grip, L. T., Mercuri, M. F., Rutman, H., Shi, M., Kania, G., Cermak, O., Braunwald, E., Antman, E. M. Tags: Atrial fibrillation Source Type: research

ISAR-SAFE: a randomized, double-blind, placebo-controlled trial of 6 vs. 12 months of clopidogrel therapy after drug-eluting stenting
Conclusions In the present trial, characterized by low event rates, we did not observe a significant difference in net clinical outcome between 6 and 12 months of clopidogrel therapy after DES implantation. However, the results of the trial must be considered in view of its premature termination and lower than expected event rates. The trial is registered with ClinicalTrials.gov, Identifier: NCT00661206.
Source: European Heart Journal - May 21, 2015 Category: Cardiology Authors: Schulz-Schupke, S., Byrne, R. A., ten Berg, J. M., Neumann, F.-J., Han, Y., Adriaenssens, T., Tolg, R., Seyfarth, M., Maeng, M., Zrenner, B., Jacobshagen, C., Mudra, H., von Hodenberg, E., Wohrle, J., Angiolillo, D. J., von Merzljak, B., Rifatov, N., Kufn Tags: Thrombosis and antithrombotic therapy Source Type: research

Clinical outcomes and management associated with major bleeding in patients with atrial fibrillation treated with apixaban or warfarin: insights from the ARISTOTLE trial
Conclusion Major bleeding was associated with substantially increased risk of death, ischaemic stroke, or MI, especially following ICH, and this risk was similarly elevated regardless of treatment with apixaban or warfarin. These results underscore the importance of preventing bleeding in anti-coagulated patients. Clinical Trials.gov identifier NCT00412984.
Source: European Heart Journal - May 21, 2015 Category: Cardiology Authors: Held, C., Hylek, E. M., Alexander, J. H., Hanna, M., Lopes, R. D., Wojdyla, D. M., Thomas, L., Al-Khalidi, H., Alings, M., Xavier, D., Ansell, J., Goto, S., Ruzyllo, W., Rosenqvist, M., Verheugt, F. W. A., Zhu, J., Granger, C. B., Wallentin, L. Tags: Thrombosis and antithrombotic therapy Source Type: research

Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study)
Conclusion Rheumatic heart disease patients were young, predominantly female, and had high prevalence of major cardiovascular complications. There is suboptimal utilization of secondary antibiotic prophylaxis, oral anti-coagulation, and contraception, and variations in the use of percutaneous and surgical interventions by country income level.
Source: European Heart Journal - May 7, 2015 Category: Cardiology Authors: Zuhlke, L., Engel, M. E., Karthikeyan, G., Rangarajan, S., Mackie, P., Cupido, B., Mauff, K., Islam, S., Joachim, A., Daniels, R., Francis, V., Ogendo, S., Gitura, B., Mondo, C., Okello, E., Lwabi, P., Al-Kebsi, M. M., Hugo-Hamman, C., Sheta, S. S., Haile Tags: Valvular heart disease Source Type: research

Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial
Conclusion In patients with AF at moderate-to-high risk of stroke receiving anticoagulation, those with persistent AF have a higher risk of thrombo-embolic events and worse survival compared with paroxysmal AF.
Source: European Heart Journal - February 2, 2015 Category: Cardiology Authors: Steinberg, B. A., Hellkamp, A. S., Lokhnygina, Y., Patel, M. R., Breithardt, G., Hankey, G. J., Becker, R. C., Singer, D. E., Halperin, J. L., Hacke, W., Nessel, C. C., Berkowitz, S. D., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., Piccini, J. P., on be Tags: Atrial fibrillation Source Type: research

Balancing stroke and bleeding risks in patients with atrial fibrillation and renal failure: the Swedish Atrial Fibrillation Cohort study
Conclusions Patients with both AF and renal failure will probably benefit most from having the same treatment as is recommended for other patients with AF, without setting a higher or lower threshold for treatment. Adding additional points for renal failure to the CHADS2 and CHA2DS2-VASc scores did not improve their predictive value.
Source: European Heart Journal - February 2, 2015 Category: Cardiology Authors: Friberg, L., Benson, L., Lip, G. Y. H. Tags: Atrial fibrillation Source Type: research

Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation
Conclusion Oral rivaroxaban appears to be an effective and safe alternative to VKAs and may allow prompt cardioversion. Name of the trial registry Clinicaltrials.gov; Trial registration number: NCT01674647.
Source: European Heart Journal - December 14, 2014 Category: Cardiology Authors: Cappato, R., Ezekowitz, M. D., Klein, A. L., Camm, A. J., Ma, C.-S., Le Heuzey, J.-Y., Talajic, M., Scanavacca, M., Vardas, P. E., Kirchhof, P., Hemmrich, M., Lanius, V., Meng, I. L., Wildgoose, P., van Eickels, M., Hohnloser, S. H., on behalf of the X-Ve Tags: ESC Hot Line Barcelona Source Type: research

Prognosis and treatment of atrial fibrillation patients by European cardiologists: One Year Follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot registry)
Conclusion In this 1-year follow-up analysis of the EORP-AF pilot general registry, we provide data on the first contemporary registry focused on management practices among European cardiologists, conducted since the publication of the new ESC guidelines. Overall OAC use remains high, although persistence with therapy may be problematic. Nonetheless, continued OAC use was more common than in prior reports. Despite the high prescription of OAC, 1-year mortality and morbidity remain high in AF patients, particularly from heart failure and hospitalizations.
Source: European Heart Journal - December 14, 2014 Category: Cardiology Authors: Lip, G. Y. H., Laroche, C., Ioachim, P. M., Rasmussen, L. H., Vitali-Serdoz, L., Petrescu, L., Darabantiu, D., Crijns, H. J. G. M., Kirchhof, P., Vardas, P., Tavazzi, L., Maggioni, A. P., Boriani, G. Tags: Fast Track ESC Clinical Trial and Registry Update Source Type: research

Clinical characteristics and outcomes with rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation but underlying native mitral and aortic valve disease participating in the ROCKET AF trial
Conclusions Many patients with ‘non-valvular atrial fibrillation’ have significant valve lesions. Their risk of stroke is similar to that of patients without SVD after controlling for stroke risk factors. Efficacy of rivaroxaban vs. warfarin was similar in patients with and without SVD; however, the observed risk of bleeding was higher with rivaroxaban in patients with SVD but was the same among those without SVD. Atrial fibrillation patients with and without SVD experience the same stroke-preventive benefit of oral anticoagulants.
Source: European Heart Journal - December 14, 2014 Category: Cardiology Authors: Breithardt, G., Baumgartner, H., Berkowitz, S. D., Hellkamp, A. S., Piccini, J. P., Stevens, S. R., Lokhnygina, Y., Patel, M. R., Halperin, J. L., Singer, D. E., Hankey, G. J., Hacke, W., Becker, R. C., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Calif Tags: Atrial fibrillation Source Type: research

Management of venous thrombo-embolism: an update
Venous thrombo-embolism is the third most frequent acute cardiovascular syndrome after myocardial infarction and stroke. Recently published landmark trials paved the way for significant progress in the management of the disease and provided the evidence for the ESC Pulmonary Embolism (PE) Guidelines 2014 update. Risk stratification strategies for non-high-risk PE continue to evolve, with an increasing emphasis on clinical prediction rules and right ventricular (RV) assessment on computed tomographic pulmonary angiography. In the field of anticoagulation treatment, pharmacogenetic testing for vitamin K antagonists on top of...
Source: European Heart Journal - November 1, 2014 Category: Cardiology Authors: Konstantinides, S., Torbicki, A. Tags: Frontiers in cardiovascular medicine Source Type: research

Efficacy and safety of apixaban compared with warfarin according to age for stroke prevention in atrial fibrillation: observations from the ARISTOTLE trial
Conclusion The benefits of apixaban vs. warfarin were consistent in patients with AF regardless of age. Owing to the higher risk at older age, the absolute benefits of apixaban were greater in the elderly.
Source: European Heart Journal - July 21, 2014 Category: Cardiology Authors: Halvorsen, S., Atar, D., Yang, H., De Caterina, R., Erol, C., Garcia, D., Granger, C. B., Hanna, M., Held, C., Husted, S., Hylek, E. M., Jansky, P., Lopes, R. D., Ruzyllo, W., Thomas, L., Wallentin, L. Tags: Atrial fibrillation Source Type: research

Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation
Conclusions Based on randomized trial data, apixaban is a cost-effective alternative to warfarin and aspirin, in VKA suitable and VKA unsuitable patients with AF, respectively.
Source: European Heart Journal - July 21, 2014 Category: Cardiology Authors: Dorian, P., Kongnakorn, T., Phatak, H., Rublee, D. A., Kuznik, A., Lanitis, T., Liu, L. Z., Iloeje, U., Hernandez, L., Lip, G. Y. H. Tags: BASIC SCIENCE Source Type: research