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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

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

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

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

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

Edoxaban versus Warfarin in Patients with Non-valvular Atrial Fibrillation in the US FDA Approval Population: An analysis from the 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 1, 2015 Category: Cardiology Source Type: research

Individualised approaches to thrombo-prophylaxis in atrial fibrillation
Publication date: Available online 11 November 2015 Source:American Heart Journal Author(s): Oliver J. Ziff, A. John Camm Atrial fibrillation (AF) is the most common arrhythmia worldwide. The prevalence of AF in adults over 55 years of age 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 three 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 antag...
Source: American Heart Journal - November 12, 2015 Category: Cardiology Source Type: research

Efficacy and Safety of Rivaroxaban in Patients with Diabetes and Nonvalvular Atrial Fibrillation: The ROCKET AF Trial
Conclusions and Relevance The relative efficacy and safety of rivaroxaban vs. warfarin was similar in patients with and without DM, supporting use of rivaroxaban as an alternative to warfarin in diabetic patients with AF.
Source: American Heart Journal - July 30, 2015 Category: Cardiology Source Type: research

Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: Findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry
Conclusions: Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefit outweighed the potential harm posed by the relative contraindication.
Source: American Heart Journal - January 6, 2014 Category: Cardiology Authors: Emily C. O'Brien, DaJuanicia N. Holmes, Jack E. Ansell, Larry A. Allen, Elaine Hylek, Peter R. Kowey, Bernard J. Gersh, Gregg C. Fonarow, Christopher R. Koller, Michael D. Ezekowitz, Kenneth W. Mahaffey, Paul Chang, Eric D. Peterson, Jonathan P. Piccini, Tags: Electrophysiology Source Type: research