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Source: American Heart Journal
Condition: Hemorrhagic Stroke
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Total 22 results found since Jan 2013.
Four-year trends in oral anticoagulant use and declining rates of ischemic stroke among 194,030 atrial fibrillation patients drawn from a sample of 12 million people
ConclusionThere was a slight increase in the prevalence of AF between 2012 and 2015, while the overall use of antiplatelet agents decreased and that of OAC, particularly DOACs, increased. Over the same period, 1 year hospitalizations for ischemic stroke declined substantially, with a declining rate of hemorrhagic strokes.
Source: American Heart Journal - November 9, 2019 Category: Cardiology Source Type: research
Gastrointestinal bleeding in patients with atrial fibrillation treated with Apixaban or warfarin: Insights from the ARISTOTLE trial
ConclusionsIn patients with AF on oral anticoagulants, prior GIB was associated with an increased risk of subsequent major GIB but not stroke, intracranial bleeding, or all-cause mortality. For the key outcomes of stroke, hemorrhagic stroke, death, and major bleeding, we found no evidence that the treatment effect (apixaban vs. warfarin) was modified by a history of GIB.
Source: American Heart Journal - November 2, 2019 Category: Cardiology Source Type: research
Design and rationale of a pragmatic trial integrating routine screening for atrial fibrillation at primary care visits: The VITAL-AF trial
Publication date: Available online 22 June 2019Source: American Heart JournalAuthor(s): Jeffrey M. Ashburner, Steven J. Atlas, David D. McManus, Yuchiao Chang, Ana T. Trisini Lipsanopoulos, Leila H. Borowsky, Wyliena Guan, Wei He, Patrick T. Ellinor, Daniel E. Singer, Steven A. LubitzAbstractGiven the preventable morbidity and mortality associated with atrial fibrillation (AF), increased awareness of undiagnosed AF, and advances in mobile ECG technology, there is a critical need to assess the effectiveness of using such technology to routinely screen for AF in clinical practice. VITAL-AF is a pragmatic trial that will test...
Source: American Heart Journal - June 24, 2019 Category: Cardiology Source Type: research
Is there a role for pharmacokinetic/pharmacodynamic-guided dosing for novel oral anticoagulants?
Publication date: May 2018 Source:American Heart Journal, Volume 199 Author(s): Noel Chan, Philip T. Sager, Jack Lawrence, Thomas's Ortel, Paul Reilly, Scott Berkowitz, Dagmar Kubitza, John Eikelboom, Jeffry Florian, Norman Stockbridge, Martin Rose, Robert Temple, Jonathan H. Seltzer The novel direct oral anticoagulants (NOACs) represent a major advance in oral anticoagulant therapy and are replacing vitamin K antagonists as the preferred options for many indications. Given in fixed doses without routine laboratory monitoring, they have been shown to be at least as effective in reducing thromboembolic stroke as dose-adjus...
Source: American Heart Journal - February 23, 2018 Category: Cardiology Source Type: research
The Optimal Anti-Coagulation for Enhanced-Risk Patients Post –Catheter Ablation for Atrial Fibrillation (OCEAN) trial
The objective was to assess whether rivaroxaban is superior to acetylsalicylic acid (ASA) in reducing the risk of clinically overt stroke, systemic embolism, or covert stroke among patients without apparent recurrent atrial arrhythmias for at least 1 year after their most recent AF ablation procedure. Methods/design A prospective, multicenter, open-label, randomized trial with blinded assessment of outcomes is under way (NCT02168829). Atrial fibrillation patients with at least 1 stroke risk factor (as defined by the CHA2DS2-VASc score) and without known atrial arrhythmia recurrences for at least 12 months after ablation ar...
Source: American Heart Journal - January 17, 2018 Category: Cardiology Source Type: research
The Optimal Anti-Coagulation for Enhanced Risk Patients Post-Catheter Ablation for Atrial Fibrillation (OCEAN) trial
Discussion The OCEAN trial is a multicenter randomized controlled trial evaluating two antithrombotic treatment strategies for patients with risk factors for stroke after apparently successful AF ablation. We hypothesize that rivaroxaban will reduce the occurrence of clinically overt stroke, systemic embolism, and covert stroke when compared to ASA alone.
Source: American Heart Journal - December 9, 2017 Category: Cardiology Source Type: research
Is There A Role For Pharmacokinetic/Pharmacodynamic Guided Dosing For Novel Oral Anticoagulants?
Publication date: Available online 10 October 2017 Source:American Heart Journal Author(s): Noel Chan, Philip T. Sager, Jack Lawrence, Thomas's Ortel, Paul Reilly, Scott Berkowitz, Dagmar Kubitza, John Eikelboom, Jeffry Florian, Norman Stockbridge, Martin Rose, Robert Temple, Jonathan H. Seltzer The novel direct oral anticoagulants (NOACs) represent a major advance in oral anticoagulant therapy, and are replacing vitamin K antagonists as the preferred options for many indications. Given in fixed doses without routine laboratory monitoring, they have been shown to be at least as effective in reducing thromboembolic stroke ...
Source: American Heart Journal - October 10, 2017 Category: Cardiology Source Type: research
Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research
Acute management of stroke patients taking non –vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - September 23, 2016 Category: Cardiology Source Type: research
Acute Management of Stroke Patients Taking Non-vitamin K Antagonist Oral Anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and Rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - August 26, 2016 Category: Cardiology Source Type: research
Individualized approaches to thromboprophylaxis in atrial fibrillation
Publication date: March 2016 Source:American Heart Journal, Volume 173 Author(s): Oliver J. Ziff, A. John Camm Atrial fibrillation (AF) is the most common arrhythmia worldwide. The prevalence of AF in persons older than 55 years is at least 33.5 million globally and is predicted to more than double in the next half-century. Anticoagulation, heart rate control, and heart rhythm control comprise the 3 main treatment strategies in AF. Anticoagulation is aimed at preventing debilitating stroke, systemic embolism, and associated mortality. Historically, anticoagulation in AF was achieved with a vitamin K antagonist such as ...
Source: American Heart Journal - January 30, 2016 Category: Cardiology Source Type: research
Protocol for analyses of adverse event data from randomized controlled trials of statin therapy
Publication date: Available online 28 January 2016 Source:American Heart Journal Author(s): C. Reith, L. Blackwell, J. Emberson, B. Mihaylova, J. Armitage, J. Fulcher, A. Keech, J. Simes, C. Baigent, R. Collins The Cholesterol Treatment Trialists’ (CTT) Collaboration was originally established to conduct individual patient data meta-analyses of major vascular events, cause-specific mortality and site-specific cancers in large, long-term, randomized trials of statin therapy (and other cholesterol-modifying treatments). The results of the trials of statin therapy, and their associated meta-analyses, have shown ...
Source: American Heart Journal - January 30, 2016 Category: Cardiology Source Type: research
The Atrial Fibrillation Conundrum in Dialysis Patients
Publication date: Available online 23 January 2016 Source:American Heart Journal Author(s): An S. De Vriese, Rogier Caluwé, Paolo Raggi The burden of atrial fibrillation (AF) and the risk of stroke are high in dialysis patients. The decision to use anticoagulation rests heavily on effective risk stratification. As both the pathophysiology of the disease and the response to therapy differ in dialysis, data from the general population cannot be extrapolated. The effect of vitamin K antagonists (VKA) on the risk of stroke in dialysis patients with AF has not been studied in randomized trials. The available observational...
Source: American Heart Journal - January 25, 2016 Category: Cardiology Source Type: research
History of Bleeding and Outcomes with Apixaban versus Warfarin in Patients with Atrial Fibrillation in the ARISTOTLE Trial
Conclusion In patients with AF in a randomized clinical trial of oral anticoagulants, a history of bleeding is associated with several risk factors for stroke, and portends a higher risk of major—but not intracranial— bleeding, during anticoagulation. However, the beneficial effects of apixaban over warfarin for stroke, hemorrhagic stroke, death or major bleeding remains consistent regardless of history of bleeding.
Source: American Heart Journal - January 20, 2016 Category: Cardiology Source Type: research
Edoxaban vs warfarin in patients with nonvalvular atrial fibrillation in the US Food and Drug Administration approval population: An analysis from the Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation–Thrombolysis in Myocardial Infarction 48 (ENGAGE AF–TIMI 48) trial
Conclusion In the FDA-approved cohort of the ENGAGE AF–-TIMI 48 trial, treatment with edoxaban 60/30 mg was superior to warfarin in the prevention of SSE and significantly reduced cardiovascular death and bleeding, especially fatal bleeding and hemorrhagic stroke.
Source: American Heart Journal - December 22, 2015 Category: Cardiology Source Type: research
