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Source: Journal of the American College of Cardiology
Drug: Coumadin

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Total 32 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

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

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

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

Stroke and Bleeding Risks in NOAC- and Warfarin-Treated Patients With Hypertrophic Cardiomyopathy and Atrial Fibrillation
Hypertrophic cardiomyopathy (HCM) affects>600,000 patients in the United States, and approximately 1 in 5 of them have atrial fibrillation (AF) (1). The incidence of stroke in patients with HCM is markedly increased when complicated by AF, with an annualized risk of nearly 4% (2). AF is an indication for warfarin in nearly all patients with HCM (3,4). Non–vitamin K antagonist oral anticoagulants (NOACs) may be reasonable alternatives to warfarin, but there are no explicit data to support their use (3,4).
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

Anticoagulation Treatment for Stroke Prevention in Atrial Fibrillation Is Increasing, But Further Improvements Needed
A recent paper by Hsu et  al.(1) assessed antithrombotic treatment among atrial fibrillation (AF) patients. The data, from the American College of Cardiology PINNACLE (Practice Innovation and Clinical Excellence) registry between 2008 and 2012, showed that 61.8% of patients with moderate-to-high stroke risk received anticoagulant therapy with either warfarin or newer direct oral anticoagulants (DOACs). The investigators and an editorial commentary noted the alarming prevalence of aspirin-only treatment despite clear evidence that anticoagulants are superior for prevention of thromboembolism in AF (1,2).
Source: Journal of the American College of Cardiology - November 29, 2016 Category: Cardiology Source Type: research

Net Clinical Benefit of Antithrombotic Therapy in Patients With Atrial Fibrillation and Chronic Kidney Disease A Nationwide Observational Cohort Study
ConclusionsCKD is associated with a higher risk of stroke/thromboembolism across stroke risk strata in AF patients. High-risk CKD patients (CHA2DS2-VASc ≥2) with AF benefit from warfarin treatment for stroke prevention.
Source: Journal of the American College of Cardiology - December 8, 2014 Category: Cardiology Source Type: research

Preserve the Brain: Primary Goal in the Therapy of Atrial Fibrillation∗
Treatment of atrial fibrillation (AF) involves 3 major strategies: prevention of stroke, maintenance of sinus rhythm, and rate control . Stroke is the most dreaded complication of AF, and its prevention is key. Anticoagulation with warfarin and the newer agents dabigatran, rivaroxaban, and apixaban is highly effective in preventing strokes in patients with AF . However, defining the appropriate patient for anticoagulant therapy is not an exact science, and the stroke risk schema CHADS2 (Congestive heart failure, Hypertension, Age ≥75 years, Diabetes mellitus, previous Stroke/transient ischemic attack) and CHA2DS2-VASc (...
Source: Journal of the American College of Cardiology - May 17, 2013 Category: Cardiology Authors: Eric N. Prystowsky, Benzy J. Padanilam Tags: Heart Rhythm Disorders: Editorial Comment Source Type: research

Left Atrial Appendage Closure With the Watchman Device in Patients With a Contraindication for Oral Anticoagulation: The ASAP Study (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology)
Conclusions: LAA closure with the Watchman device can be safely performed without a warfarin transition, and is a reasonable alternative to consider for patients at high risk for stroke but with contraindications to systemic oral anticoagulation. (ASA Plavix Feasibility Study With Watchman Left Atrial Appendage Closure Technology [ASAP]; NCT00851578)
Source: Journal of the American College of Cardiology - April 12, 2013 Category: Cardiology Authors: Vivek Y. Reddy, Sven Möbius-Winkler, Marc A. Miller, Petr Neuzil, Gerhard Schuler, Jens Wiebe, Peter Sick, Horst Sievert Tags: Atrial Fibrillation Source Type: research

High-Sensitivity Troponin T and Risk Stratification in Patients With Atrial Fibrillation During Treatment With Apixaban or Warfarin
Objectives: The aim of this study was to evaluate the prognostic value of high-sensitivity troponin T (hs-TnT) in addition to clinical risk factors and the CHA2DS2VASc (congestive heart failure, hypertension, 75 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, 65 to 74 years of age, female) risk score in patients with atrial fibrillation (AF).Background: The level of troponin is a powerful predictor of cardiovascular events and mortality.Methods: A total of 14,897 patients with AF were randomized to treatment with apixaban or warfarin in the ARISTOTLE (Apixaban for...
Source: Journal of the American College of Cardiology - September 23, 2013 Category: Cardiology Authors: Ziad Hijazi, Lars Wallentin, Agneta Siegbahn, Ulrika Andersson, John H. Alexander, Dan Atar, Bernard J. Gersh, Michael Hanna, Veli Pekka Harjola, John D. Horowitz, Steen Husted, Elaine M. Hylek, Renato D. Lopes, John J.V. McMurray, Christopher B. Granger, Tags: Heart Rhythm Disorders Source Type: research