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Clinical decision support for stroke prevention in atrial fibrillation (CDS-AF): Rationale and design of a cluster randomized trial in the primary care setting
Conclusion The present study will investigate whether a clinical decision support system integrated in an EHR can increase adherence to guidelines regarding anticoagulant therapy in patients with AF. Trial registration www.clinicaltrials.gov registration number NCT02635685
Source: American Heart Journal - February 15, 2017 Category: Cardiology Source Type: research

Anemia Is Associated With Bleeding and Mortality, but Not Stroke, in Patients With Atrial Fibrillation: Insights From the ARISTOTLE Trial
Conclusions Chronic anemia is associated with a higher incidence of bleeding complications and mortality, but not of stroke, in anticoagulated patients with AF. Apixaban is an attractive anticoagulant for stroke prevention in patients with AF with or without anemia.
Source: American Heart Journal - December 21, 2016 Category: Cardiology Source Type: research

Trial design: Rivaroxaban for the prevention of major cardiovascular events after transcatheter aortic valve replacement: Rationale and design of the GALILEO study
Conclusions GALILEO will test the hypothesis that a rivaroxaban-based antithrombotic strategy reduces the risk of thromboembolic complications post-TAVR with an acceptable risk of bleeding compared with the currently recommended antiplatelet therapy–based strategy in subjects without need of chronic oral anticoagulation.
Source: American Heart Journal - November 25, 2016 Category: Cardiology Source Type: research

Interventional left atrial appendage closure vs novel anticoagulation agents in patients with atrial fibrillation indicated for long-term anticoagulation (PRAGUE-17 study)
Conclusion The PRAGUE-17 trial will determine if LAA occlusion is noninferior to treatment with NOAC in moderate- to high-risk AF patients.
Source: American Heart Journal - November 15, 2016 Category: Cardiology Source Type: research

Trial design: Rivaroxaban for the prevention of major cardiovascular events post transcatheter aortic valve replacement: rationale and design of the GALILEO study
Conclusions GALILEO will test the hypothesis that a rivaroxaban-based antithrombotic strategy reduces the risk of thromboembolic complications post-TAVR with an acceptable risk of bleeding compared with the currently recommended antiplatelet therapy-based strategy in subjects without need of chronic oral anticoagulation.
Source: American Heart Journal - October 31, 2016 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

Trends in antithrombotic therapy for atrial fibrillation: Data from the Veterans Health Administration Health System
Conclusions Among US veterans with new AF and additional risk factors for stroke, only about half receive OAC, and the proportion is declining.
Source: American Heart Journal - September 3, 2016 Category: Cardiology Source Type: research

How Well Does Physician Risk Assessment Predict Stroke and Bleeding in Atrial Fibrillation? Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF)
Conclusion Physician-assigned risk showed a graded relationship with outcomes and both physician-based and empirical scores yielded only moderate discrimination. While empirical scores provided valuable risk stratification information (with or without physician judgement), physician-assessment added little to existing scores. These data support the use of empirical scores for stroke and bleeding risk stratification, and the need for novel approaches to risk stratification in this population.
Source: American Heart Journal - August 26, 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

Incidence and risk factors for thromboembolism and major bleeding in patients with mechanical valve prosthesis; a nationwide population-based study
Conclusions In a nationwide cohort study with MHV and high TTR, heart failure and atrial fibrillation did not appear as risk factors of stroke/TE.
Source: American Heart Journal - August 11, 2016 Category: Cardiology Source Type: research

A comparison of the CHARGE –AF and the CHA2DS2-VASc risk scores for prediction of atrial fibrillation in the Framingham Heart Study
Conclusion The CHARGE-AF risk score performed better than the CHA2DS2-VASc risk score at predicting AF in a community-based cohort.
Source: American Heart Journal - July 20, 2016 Category: Cardiology Source Type: research

Use of concomitant aspirin in patients with atrial fibrillation: Findings from the ROCKET AF trial
Conclusions Aspirin use at baseline was associated with an increased risk for bleeding and all-cause death in ROCKET AF, a risk most pronounced in patients without known CAD. Although these findings may reflect unmeasured clinical factors, further investigation is warranted to determine optimal aspirin use in patients with AF.
Source: American Heart Journal - July 9, 2016 Category: Cardiology Source Type: research

Apixaban compared with parenteral heparin and/or vitamin K antagonist in patients with nonvalvular atrial fibrillation undergoing cardioversion: Rationale and design of the EMANATE trial
Publication date: September 2016 Source:American Heart Journal, Volume 179 Author(s): Michael D. Ezekowitz, Charles V. Pollack, Paul Sanders, Jonathan L. Halperin, Judith Spahr, Nilo Cater, William Petkun, Andrei Breazna, Paulus Kirchhof, Jonas Oldgren Stroke prevention in anticoagulation-naïve patients with atrial fibrillation undergoing cardioversion has not been systematically studied. Objective To determine outcomes in anticoagulation-naïve patients (defined as those receiving an anticoagulant for <48 hours during the index episode of atrial fibrillation) scheduled for cardioversion. Methods This...
Source: American Heart Journal - July 5, 2016 Category: Cardiology Source Type: research

A comparison of the CHARGE–AF and the CHA2DS2-VASc risk scores for prediction of atrial fibrillation in the Framingham Heart Study
Conclusion The CHARGE-AF risk score performed better than the CHA2DS2-VASc risk score at predicting AF in a community-based cohort.
Source: American Heart Journal - May 31, 2016 Category: Cardiology Source Type: research

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