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Stroke prevention in Atrial Fibrillation
<span class="paragraphSection"><strong>Prof. Gregory Lip discusses how to keep the decision-making process for choosing an oral anticoagulant simple and practical</strong> </span>
Source: European Heart Journal - January 20, 2017 Category: Cardiology Source Type: research

Increased use of oral anticoagulants in patients with atrial fibrillation: temporal trends from 2005 to 2015 in Denmark
Conclusion</div>Since 2010, more incident AF patients in Denmark were initiated on OAC therapy with predominant NOAC prescription. The increase was pronounced among females, among patients at high risk of stroke, and among older patients.</span>
Source: European Heart Journal - January 20, 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

Ticagrelor, but not clopidogrel active metabolite, displays antithrombotic properties in the left atrial endocardium
Conclusion</div>Ticagrelor, but not CAM, reduces expression and activity of TF and PAI-1 in LAA endocardial cells isolated from patients with AF, indicating possible local antithrombotic effects. Such pleiotropic properties of ticagrelor may contribute to a reduction in thromboembolic complications in patients with AF.</span>
Source: European Heart Journal - January 8, 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

Comparison of the ATRIA, CHADS2, and CHA2DS2-VASc stroke risk scores in predicting ischaemic stroke in a large Swedish cohort of patients with atrial fibrillation
Conclusion In this SAF cohort, the ATRIA score predicted ischaemic stroke risk better than CHADS2 or CHA2DS2-VASc. However, relative performance of the categorical scores varied by population stroke rates. Score cut-points may need to be optimized to better fit local population stroke rates.
Source: European Heart Journal - November 16, 2016 Category: Cardiology Authors: Aspberg, S., Chang, Y., Atterman, A., Bottai, M., Go, A. S., Singer, D. E. Tags: Prevention and epidemiology Source Type: research

The search for the ideal atrial fibrillation stroke risk prediction schema: is ATRIA a contender?
Source: European Heart Journal - November 16, 2016 Category: Cardiology Authors: Cairns, J. A. Tags: Editorial Source Type: research

Risk of stroke in chronic heart failure patients with preserved ejection fraction, but without atrial fibrillation: analysis of the CHARM-Preserved and I-Preserve trials
Conclusions</div>A small number of clinical variables identify a subset of patients with HF-PEF, but without AF, at elevated risk of stroke.</span>
Source: European Heart Journal - November 12, 2016 Category: Cardiology 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

A frameshift deletion in the sarcomere gene MYL4 causes early-onset familial atrial fibrillation
Conclusions</div>Through a population approach we found a loss of function mutation in the myosin gene <span style="font-style:italic;">MYL4</span> that, in the homozygous state, is completely penetrant for early-onset AF. The finding may provide novel mechanistic insight into the pathophysiology of this complex arrhythmia.</span>
Source: European Heart Journal - October 13, 2016 Category: Cardiology Source Type: research

Specific risk of atrial fibrillation and stroke in oncology patients
Source: European Heart Journal - September 29, 2016 Category: Cardiology Authors: Zamorano, J. L. Tags: CardioPulse 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

Atrial fibrillation and stroke: risk factors, anticoagulation, and left atrial appendage occluders
Source: European Heart Journal - August 23, 2016 Category: Cardiology Authors: Lüscher, T. F. Tags: ISSUE @ A GLANCE 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

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