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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

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

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

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

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

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

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 aspirin in patients who previously tried but failed treatment with vitamin K antagonists: results from the AVERROES trial
Conclusion The efficacy and safety of apixaban compared with aspirin is consistent in subgroups of patients who have previously attempted but failed VKA therapy, irrespective of the reason for discontinuation.
Source: European Heart Journal - July 21, 2014 Category: Cardiology Authors: Coppens, M., Synhorst, D., Eikelboom, J. W., Yusuf, S., Shestakovska, O., Connolly, S. J. 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

Renal function and outcomes in anticoagulated patients with non-valvular atrial fibrillation: the AMADEUS trial
Conclusion Renal impairment (CrCl <60 mL/min) doubles the risk of stroke and increased the risk of major bleeding by almost 60% in anticoagulated patients with AF. Renal impairment was additive to stroke risk prediction scores based on a significant NRI, but no significant improvement in discrimination ability (based on c-indexes) for CHA2DS2VASc or CHADS2 was observed.
Source: European Heart Journal - December 7, 2013 Category: Cardiology Authors: Apostolakis, S., Guo, Y., Lane, D. A., Buller, H., Lip, G. Y. H. Tags: Atrial fibrillation Source Type: research

EHRA Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary
New oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with non-valvular atrial fibrillation (AF). Both physicians and patients will have to learn how to use these drugs effectively and safely in specific clinical situations. This text is an executive summary of a practical guide that the European Heart Rhythm Association (EHRA) has assembled to help physicians in the use of the different NOACs. The full text is being published in EP Europace. Practical answers have been formulated for 15 concrete clinical scenarios: (i) practical start-up and follow-up scheme for ...
Source: European Heart Journal - July 14, 2013 Category: Cardiology Authors: Heidbuchel, H., Verhamme, P., Alings, M., Antz, M., Hacke, W., Oldgren, J., Sinnaeve, P., Camm, A. J., Kirchhof, P. Tags: SPECIAL ARTICLE Source Type: research

Betrixaban compared with warfarin in patients with atrial fibrillation: results of a phase 2, randomized, dose-ranging study (Explore-Xa)
Conclusion Betrixaban was well tolerated and had similar or lower rates of bleeding compared with well-controlled warfarin in patients with AF at risk for stroke.
Source: European Heart Journal - May 21, 2013 Category: Cardiology Authors: Connolly, S. J., Eikelboom, J., Dorian, P., Hohnloser, S. H., Gretler, D. D., Sinha, U., Ezekowitz, M. D. Tags: Arrhythmia/electrophysiology Source Type: research

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