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Edoxaban versus Warfarin in Patients with Atrial Fibrillation in Relation to the Risk of Stroke: A Secondary Analysis of the ENGAGE AF-TIMI 48 Study
Publication date: Available online 22 January 2021Source: American Heart JournalAuthor(s): Joris R. de Groot, Christian T. Ruff, Sabina A. Murphy, Rose A. Hamershock, Jim T. Vehmeijer, Anton J.M. Oude Ophuis, Laura Grip, Hans Lanz, Michele F. Mercuri, Elliott M. Antman, RobertP. Giugliano
Source: American Heart Journal - January 23, 2021 Category: Cardiology Source Type: research

Rivaroxaban versus warfarin in patients with non-valvular atrial fibrillation and stage IV-V chronic kidney disease
ConclusionsNo statistically significant difference in the risk of ISSE or major bleeding was found between rivaroxaban- and warfarin-treated patients. While further study is needed, rivaroxaban appears to be a reasonable alternative to warfarin for ISSE prevention in the setting of NVAF and stage IV-V CKD.
Source: American Heart Journal - January 22, 2020 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

Relationship of stroke and bleeding risk profiles to efficacy and safety of dabigatran dual therapy versus warfarin triple therapy in atrial fibrillation after PCI: An ancillary analysis from the RE-DUAL PCI trial
ConclusionDabigatran dual therapy reduced bleeding events irrespective of bleeding risk category and demonstrated similar efficacy regardless of stroke risk category when compared with warfarin triple therapy.
Source: American Heart Journal - March 4, 2019 Category: Cardiology Source Type: research

Impact of polyvascular disease on patients with atrial fibrillation: Insights from ROCKET AF
Conclusion The use of rivaroxaban compared with warfarin was associated with a higher risk of stroke and bleeding in patients with polyvascular disease enrolled in ROCKET AF. Further studies are needed to understand the optimal management of this high-risk population.
Source: American Heart Journal - May 8, 2018 Category: Cardiology Source Type: research

Predictors of Oral Anticoagulant Non-prescription in Patients with Atrial Fibrillation and Elevated Stroke Risk
Conclusions In this registry of AF patients, older patients at elevated stroke and low bleeding risk were commonly treated with OAC. However, a variety of factors were associated with OAC non-prescription. Specifically, antiplatelet use was prevalent and associated with the highest likelihood of OAC non-prescription. Future studies are warranted to understand provider and patient rationale that may underlie observed associations with OAC non-prescription.
Source: American Heart Journal - March 11, 2018 Category: Cardiology Source Type: research

Percutaneous Coronary Intervention and Antiplatelet Therapy in Patients with Atrial Fibrillation Receiving Apixaban or Warfarin: Insights from the ARISTOTLE Trial
Conclusions PCI occurred infrequently during follow-up. The majority of patients on study drug at the time of PCI remained on study drug in the peri-PCI period; 19% continued the study drug without interruption. Antiplatelet therapy use post-PCI was variable, though the majority of patients received DAPT. Additional data are needed to guide the use of antithrombotics in patients undergoing PCI.
Source: American Heart Journal - November 10, 2017 Category: Cardiology Source Type: research

Edoxaban for the Management of Elderly Japanese Patients with Atrial Fibrillation Ineligible for Standard Oral Anticoagulant Therapies: Rationale and Design of the ELDERCARE-AF Study
Publication date: Available online 24 August 2017 Source:American Heart Journal Author(s): Ken Okumura, Gregory Y.H. Lip, Masaharu Akao, Kimihiko Tanizawa, Masayuki Fukuzawa, Kenji Abe, Masahiro Akishita, Takeshi Yamashita Edoxaban—a nonvitamin K antagonist oral anticoagulant (NOAC)— 60-mg and 30-mg once-daily dose regimens are noninferior vs well-managed warfarin for the prevention of stroke or systemic embolic events (SEE) with less major bleeding in patients with nonvalvular atrial fibrillation (NVAF). There are no published data from phase 3 clinical trials specifically evaluating the use of NOACs in elderly NVAF ...
Source: American Heart Journal - August 24, 2017 Category: Cardiology Source Type: research

Atrial Fibrillation Decision Support Tool: Population Perspective
Conclusions Availability of DOACs increases the proportion of patients for whom oral anticoagulation therapy is recommended in a real-world cohort of AF patients and increased projected QALYs by more than 1500 when all patients are receiving thromboprophylaxis as recommended by the AFDST compared with current treatment.
Source: American Heart Journal - August 23, 2017 Category: Cardiology Source Type: research

Availability of patient decision aids for stroke prevention in atrial fibrillation: A systematic review
The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation. Methods Six databases were searched from inception to March 2016 with a research librarian. Two authors independently reviewed potential articles, selected trials meeting inclusion criteria, and assessed outcome measures. Outcomes included: patient knowledge, involvement, choice, and decisional conflict. Results The search resulted in 666 articles; most were excluded for not examining stroke prevention in...
Source: American Heart Journal - June 3, 2017 Category: Cardiology Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Prevalence and Outcome of Thrombotic and Embolic Complications in Adults after Fontan Operation
Conclusions TEC was not uncommon; risk factors for TEC were APC and atrial arrhythmias. Most patients were treated successfully with warfarin alone. A second TEC occurred in most patients whose anticoagulation was discontinued because of bleeding events.
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

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