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Source: Journal of the American College of Cardiology
Condition: Atrial Fibrillation

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Total 96 results found since Jan 2013.

Comparative Performance of ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Risk Scores Predicting Stroke in Patients With Atrial Fibrillation Results From a National Primary Care Database
ConclusionsThe ATRIA score performed better in the U.K. Clinical Practice Research Datalink AF cohort. It more accurately identified low-risk patients than the CHA2DS2-VASc score, which assigned these patients to higher-risk categories. Such reclassification of stroke risk could prevent overuse of anticoagulants in very low stroke risk patients with AF.
Source: Journal of the American College of Cardiology - October 19, 2015 Category: Cardiology Source Type: research

Device Closure of Patent Foramen Ovale After Stroke Pooled Analysis of Completed Randomized Trials
ConclusionsAmong patients with PFO and cryptogenic stroke, closure reduced recurrent stroke and had a statistically significant effect on the composite of stroke, transient ischemic attack, and death in adjusted but not unadjusted analyses.
Source: Journal of the American College of Cardiology - February 23, 2016 Category: Cardiology Source Type: research

Refining Stroke Prediction in Atrial  Fibrillation Patients by Addition of African-American Ethnicity to CHA 2 DS 2 -VASc Score
Conclusions In patients> 65 years of age with newly diagnosed AF, the addition of ethnicity to CHA2DS2-VASc score  significantly improved stroke prediction.
Source: Journal of the American College of Cardiology - July 26, 2016 Category: Cardiology Source Type: research

Outcomes of Discontinuing Rivaroxaban Compared With Warfarin in Patients With Nonvalvular Atrial Fibrillation: Analysis From the ROCKET AF Trial (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation)
Conclusions: In atrial fibrillation patients who temporarily or permanently discontinued anticoagulation, the risk of stroke or non-CNS embolism was similar with rivaroxaban or warfarin. An increased risk of stroke and non-CNS embolism was observed in rivaroxaban-treated patients compared with warfarin-treated patients after the end of the study, underscoring the importance of therapeutic anticoagulation coverage during such a transition.
Source: Journal of the American College of Cardiology - February 6, 2013 Category: Cardiology Authors: Manesh R. Patel, Anne S. Hellkamp, Yuliya Lokhnygina, Jonathan P. Piccini, Zhongxin Zhang, Surya Mohanty, Daniel E. Singer, Werner Hacke, Günter Breithardt, Jonathan L. Halperin, Graeme J. Hankey, Richard C. Becker, Christopher C. Nessel, Scott D. Berkow Tags: Heart Rhythm Disorders Source Type: research

Oral Anticoagulation, Aspirin, or No Therapy in Patients With Nonvalvular AF With 0 or 1 Stroke Risk Factor Based on the CHA 2 DS 2 -VASc Score
ConclusionsLow-risk patients (CHA2DS2-VASc = 0 [male], 1 [female]) have a truly low risk for stroke and bleeding. With 1 additional stroke risk factor (CHA2DS2-VASc = 1 [male], = 2 [female]), there was a significant increase in event rates (particularly mortality) if nonanticoagulated.
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

N-Terminal Pro–B-Type Natriuretic Peptide for Risk Assessment in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation)
This study sought to assess the prognostic value of N-terminal pro–B-type natriuretic peptide (NT-proBNP) in patients with atrial fibrillation (AF) enrolled in the ARISTOTLE (Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation) trial, and the treatment effect of apixaban according to NT-proBNP levels.Background: Natriuretic peptides are associated with mortality and cardiovascular events in several cardiac diseases.Methods: In the ARISTOTLE trial, 18,201 patients with AF were randomized to apixaban or warfarin. Plasma samples at randomization were available from 14,892 patients. The association bet...
Source: Journal of the American College of Cardiology - April 5, 2013 Category: Cardiology Authors: Ziad Hijazi, Lars Wallentin, Agneta Siegbahn, Ulrika Andersson, Christina Christersson, Justin Ezekowitz, Bernard J. Gersh, Michael Hanna, Stefan Hohnloser, John Horowitz, Kurt Huber, Elaine M. Hylek, Renato D. Lopes, John J.V. McMurray, Christopher B. Gr Tags: Atrial Fibrillation Source Type: research

Time to Cost-Effectiveness Following Stroke Reduction Strategies in AF Warfarin Versus NOACs Versus LAA Closure
ConclusionsBoth NOACs and LAAC with the Watchman device were cost-effective relative to warfarin, but LAAC was also found to be cost-effective and to offer better value relative to NOACs. The results of this analysis should be considered when formulating policy and practice guidelines for stroke prevention in AF.
Source: Journal of the American College of Cardiology - December 14, 2015 Category: Cardiology Source Type: research

Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation
Conclusions: Patients with nonvalvular AF at risk for stroke treated with left atrial appendage closure have favorable QOL changes at 12 months versus patients treated with warfarin. (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation [WATCHMAN PROTECT]; NCT00129545)
Source: Journal of the American College of Cardiology - April 24, 2013 Category: Cardiology Authors: Oluseun Alli, Shepal Doshi, Saibal Kar, Vivek Reddy, Horst Sievert, Chris Mullin, Vijay Swarup, Brian Whisenant, David Holmes Tags: Heart Rhythm Disorders Source Type: research

Age Threshold for Increased Stroke Risk Among Patients With Atrial Fibrillation A Nationwide Cohort Study From Taiwan
This study hypothesized that the age threshold (65 years) used in the CHA2DS2-VASc system for initiating oral anticoagulants (OACs) might be lower in Taiwanese AF patients than in non-Asians.MethodsWe used the National Health Insurance Research Database in Taiwan to study 186,570 nonanticoagulated AF patients. There were 9,416 males with a CHA2DS2-VASc score of 0 and 6,390 females with a CHA2DS2-VASc score of 1. Their risk of ischemic stroke was analyzed with stratification on the basis of age.ResultsThe annual risks of ischemic stroke for males (score 0) and females (score 1) were 1.15% and 1.12%, respectively, and contin...
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research

Stroke Prediction in Atrial Fibrillation Is it Black and White? ∗
Atrial fibrillation (AF) is a common arrhythmia that predisposes patients to risk of stroke (1) that can be prevented with anticoagulation (2) . However, a minority of patients with AF and risk of stroke are treated with anticoagulants (3) , with undertreatment being due to a variety of factors. Optimizing treatment depends, in part, on the ability to understand risks, benefits, and personal preferences of individual patients. The CHADS 2 (congestive heart failure, hypertension, age  ≥75 years, diabetes, and 2 points for prior stroke or transient ischemic attack) scoring system has been useful for stratifying risk of ...
Source: Journal of the American College of Cardiology - July 26, 2016 Category: Cardiology Source Type: research

Patients With Atrial Fibrillation and a CHA 2 DS 2 -VASc Score of 1 Are They at Low or High Stroke Risk? ∗
Nonvalvular atrial fibrillation carries a risk for developing ischemic stroke that is lowered by anticoagulant therapy (1). This risk is not uniform and depends on whether a patient has either none or ≥1 of the following factors, known as the CHA2DS2-VASc stroke risk score: congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65 to 74 years, sex category. Both European (2) and U.S. (3) guidelines advocate estimation of a patient’s stroke risk by use of the CHA2DS2-VASc score for initial risk stratification. The European Society of Cardiol...
Source: Journal of the American College of Cardiology - April 6, 2015 Category: Cardiology Source Type: research

Left Atrial Appendage Closure as an Alternative to Warfarin for Stroke Prevention in Atrial Fibrillation A Patient-Level Meta-Analysis
ConclusionsIn patients with NVAF at increased risk for stroke or bleeding who are candidates for chronic anticoagulation, LAAC resulted in improved rates of hemorrhagic stroke, cardiovascular/unexplained death, and nonprocedural bleeding compared to warfarin.
Source: Journal of the American College of Cardiology - June 15, 2015 Category: Cardiology Source Type: research

Aspirin Instead of Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Risk for Stroke
ConclusionsIn a large, real-world cardiac outpatient population of AF patients with a moderate to high risk of stroke, more than 1 in 3 were treated with aspirin alone without OAC. Specific patient characteristics predicted prescription of aspirin therapy over OAC.
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

Renal Impairment and Ischemic Stroke Risk Assessment in Patients With Atrial Fibrillation: The Loire Valley Atrial Fibrillation Project
Conclusions: Renal impairment was not an independent predictor of IS/TE in patients with AF and did not significantly improve the predictive ability of the CHADS2 or CHA2DS2-VASc scores.
Source: Journal of the American College of Cardiology - March 25, 2013 Category: Cardiology Authors: Amitava Banerjee, Laurent Fauchier, Patrick Vourc'h, Christian R. Andres, Sophie Taillandier, Jean Michel Halimi, Gregory Y.H. Lip Tags: Heart Rhythm Disorders Source Type: research

Reply Comparing the ATRIA, CHADS 2 , and CHA 2 DS 2 -VASc Scores for Stroke Prediction in Atrial Fibrillation
We tested the ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation), CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke), and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, prior stroke or transient ischemic attack, vascular disease, age 65 to 74 years, female) stroke risk scores in the CPRD (Clinical Practice Research Datalink) cohort of incident atrial fibrillation (AF) patients not using oral anticoagulants (OAC) because these are the patients for whom physicians must make the OAC treatment decision (1). The mean patient follo...
Source: Journal of the American College of Cardiology - May 10, 2016 Category: Cardiology Source Type: research