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Effect of prior anticoagulation therapy on stroke severity and in-hospital outcomes in patients with acute ischemic stroke and atrial fibrillation
We aimed to assess the prevalence of prior anticoagulation therapy (warfarin or non-vitamin K antagonist oral anticoagulants [NOACs]) among patients with acute ischemic stroke (AIS) and atrial fibrillation (AF) in China and investigate the associations between prior anticoagulation therapy and initial stroke severity and in-hospital outcomes.
Source: International Journal of Cardiology - May 29, 2023 Category: Cardiology Authors: Lue Zhou, Yapeng Li, Xin Yang, Hongqiu Gu, Yanran Duan, Hang Fu, Anran Wang, Kai Liu, Yuan Gao, Bo Song, Yusheng Li, Yingyu Jiang, Jing Zhang, Chunjuan Wang, Meng Wang, Zixiao Li, Yuming Xu, Chengzeng Wang, Yongjun Wang Source Type: research

Persisting stroke risk in patients with atrial fibrillation despite proper anticoagulation – Unmet clinical needs
Oral anticoagulation (OAC) is crucial to prevent cardioembolic stroke in patients with atrial fibrillation (AF). Development of the direct oral anticoagulants (DOAC), which inhibit activities of the coagulant proteases thrombin and activated factor X (FXs), has improved the safety and efficacy of anticoagulation in AF, compared to traditional vitamin K antagonists like warfarin [1,2]. Yet in a small, but numerically relevant proportion of up to 2% of patients, this cornerstone principle fails for unclear reasons.
Source: International Journal of Cardiology - August 6, 2022 Category: Cardiology Authors: Florian Bruns, Dobromir Dobrev, Anke C. Fender Tags: Editorial Source Type: research

The great discovery of DOACs and why physicians insist on misusing it: A paradox of the 21 century
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and has been one of the most studied disease in the world for the last 20  years. As it is a frequent cause of preventable strokes, substantial research efforts were directed toward gaining detailed information about effective prophylactic treatments. New evidence has been continuously published and resulted in the approval of direct-acting oral anticoagulants (DOACs) i n this scenario, which are safer and easier to use than vitamin K antagonists (VKA).[1]Although the randomized clinical trials that substantiated the approval of DOACs were based in ...
Source: International Journal of Cardiology - June 1, 2022 Category: Cardiology Authors: Fl ávia Bittar B. Arantes, Remo H.M. Furtado Tags: Editorial Source Type: research

Percutaneous left atrial appendage closure vs oral anticoagulation: The scariest might be the cheepest
Left Atrial Appendage Closure (LAAC) in patients with atrial fibrillation (AF) and consequent elevated risk of thromboembolic events has an excellent safety profile, with an equal efficacy in preventing stroke, compared with vitamin K antagonists in patients without contraindications to oral anticoagulants [1]. It is also noninferior to direct oral anticoagulants (DOACs) in preventing major AF-related ischemic and haemorrhagic events [2]. Nevertheless, according to the current practice guidelines, percutaneous LAAC is still recommended only in patients with AF at increased risk of stroke and with contraindications to long-term OAC [3,4].
Source: International Journal of Cardiology - January 29, 2022 Category: Cardiology Authors: Patrizio Mazzone, Paolo Della Bella, Francesca Baratto Tags: Editorial Source Type: research

No antiarrhythmic effect of direct oral anticoagulants versus vitamin K antagonists in paroxysmal atrial fibrillation patients undergoing catheter ablation
Direct oral anticoagulants (DOACs) are superior to vitamin K antagonists (VKAs) for the prevention of stroke in atrial fibrillation (AF) patients with elevated stroke risk. Possible antiarrhythmic effects of DOACs have been discussed. We analyzed impact of DOAC treatment on recurrence-free survival after AF catheter ablation.
Source: International Journal of Cardiology - January 25, 2021 Category: Cardiology Authors: David Zweiker, Martin Manninger, Raphael Sieghartsleitner, Jakob Ebner, Bernadette Pratl, Egbert Bisping, Peter Lercher, Dirk von Lewinski, Rita Riedlbauer, Ursula Rohrer, Henri M.H. Spronk, Andreas Zirlik, Ulrich Schotten, Daniel Scherr Tags: Short communication Source Type: research

Stroke risk assessment in atrial fibrillation: Beyond atrial rhythm
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, and is responsible for at least 20% of all strokes. Moreover, strokes associated to AF are largely avoidable, as the use of anti-vitamin K drugs can prevent>65% of all strokes, and direct oral anticoagulants con reduce the rate of stroke by a further 19% [1].
Source: International Journal of Cardiology - May 22, 2019 Category: Cardiology Authors: Giovanni Luca Botto, Francesco Maria Brasca Tags: Editorial Source Type: research

The safety and efficacy of non-vitamin K antagonist oral anticoagulants in atrial fibrillation in the elderly
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence increases with age. Age also increases the risk of thromboembolism related to AF. As a result, elderly patients are at increased risk of AF-related stroke compared to younger patients. Age, however, also increases the risk of bleeding, including that of intracranial haemorrhage, an important cause of death and disability. Elderly patients with AF are, therefore, often undertreated due to the fear of bleeding complications, although recent data suggest an even greater net clinical benefit for anticoagulation in general in the elderly, even the very el...
Source: International Journal of Cardiology - June 7, 2018 Category: Cardiology Authors: Giuseppe Patti, Ilaria Cavallari, Olivier Hanon, Raffaele De Caterina Source Type: research

Different safety profiles of oral anticoagulants in very elderly non-valvular atrial fibrillation patients: A retrospective propensity score matched cohort study
Vitamin K antagonists (VKAs) have been shown to decrease the risk of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). [1] The non-VKA oral anticoagulants (NOACs) are now increasingly used as an alternative to VKAs thanks to their convenient, fixed dose and no requirement for monitoring. NOACs have shown non-inferiority to warfarin for the prevention of stroke and systemic embolism, with marked reduction in the risk of intracerebral haemorrhage [2].
Source: International Journal of Cardiology - April 25, 2018 Category: Cardiology Authors: Giacomo Zoppellaro, Luca Zanella, Gentian Denas, Nicola Gennaro, Eliana Ferroni, Ugo Fedeli, Seena Padayattil Jose, Giorgio Costa, Maria Chiara Corti, Margherita Andretta, Vittorio Pengo Source Type: research

Impact of BMI on clinical outcomes of NOAC therapy in daily care - Results of the prospective Dresden NOAC Registry (NCT01588119)
Direct acting non-Vitamin K antagonist oral anticoagulants (NOAC) are characterized by a fixed dosing regimen. Despite the potential for relative underdosing due to large distribution volumes, dose adjustments for patients with high body mass index (BMI) are not recommended. Since efficacy and safety data in obese patients are scarce, we evaluated the impact of BMI on clinical outcomes in daily care patients treated with NOAC for stroke prevention in atrial fibrillation or venous thromboembolism.
Source: International Journal of Cardiology - March 14, 2018 Category: Cardiology Authors: L. Tittl, S. Endig, S. Marten, A. Reitter, I. Beyer-Westendorf, J. Beyer-Westendorf Source Type: research

Could direct oral anticoagulants be an alternative to vitamin K antagonists in patients with hypertrophic cardiomyopathy and atrial fibrillation?
We read the article “Direct oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation” by Fernando Dominguez et al. [1] interestingly, which has great clinical significance in guiding the use of oral anticoagulants in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrilla tion (AF). Due to the high risk of stroke and thromboembolic complications in patients with HCM and AF, vitamin K antagonists (VKAs) are recommended for those patients, direct oral anticoagulants (NOACs) may represent another option [2].
Source: International Journal of Cardiology - February 15, 2018 Category: Cardiology Authors: Biao Li, Chao Sun, Fen Qin, Na Liu, Zhihong Wu, Qiming Liu Tags: Letter to the Editor Source Type: research

Antiplatelet therapy, vitamin K antagonist and low time in therapeutic range in patients with atrial fibrillation: Highway to bleed
Use of oral anticoagulant (OAC) therapy for stroke prevention is a main aspect of management for patients with atrial fibrillation (AF). Guidelines for the management of AF indicate that OAC is usually needed in patients with at least one stroke risk factor [1]. This has been possibly achieved for a long time using a vitamin K antagonist (VKA). This may also be done for a few years using one of the non-vitamin K oral anticoagulant (NOACs) in case the patient has neither a EHRA (Evaluated Heartvalves, Rheumatic or Artificial) Type 1 valvular AF nor a contraindication to NOAC [2].
Source: International Journal of Cardiology - December 15, 2017 Category: Cardiology Authors: Laurent Fauchier, Arnaud Bisson, Thibaud Genet Tags: Editorial Source Type: research

Non-vitamin K antagonist oral anticoagulants compared with warfarin at different levels of INR control in atrial fibrillation: A meta-analysis of randomized trials
The efficacy and safety of warfarin for stroke prevention in atrial fibrillation (AF) depend on the time in the therapeutic range (TTR) with an international normalised ratio (INR) of 2.0 –3.0. This meta-analysis focused the relative efficacy and safety of non-VKA oral anticoagulants (NOAC) compared with warfarin at different thresholds of centre's TTR (cTTR).
Source: International Journal of Cardiology - June 2, 2017 Category: Cardiology Authors: Jo ão Carmo, Jorge Ferreira, Francisco Costa, Pedro Carmo, Diogo Cavaco, Salomé Carvalho, Francisco Morgado, Pedro Adragão, Miguel Mendes Source Type: research

Vitamin D and Cardiovascular Disease: From atherosclerosis to myocardial infarction and stroke
There continues to be interest in understanding the role of vitamin D in the pathogenesis, epidemiology and prevention of cardiovascular disease (CVD). In fact vitamin D deficiency has been associated to an increased risk of developing CVD given to the relationship between low vitamin D levels and obesity, diabetes mellitus, dyslipidaemia, endothelial dysfunction and hypertension. However, although vitamin D has been identified as a potentially important marker of CVD, the mechanisms through which vitamin D deficiency leads from endothelial dysfunction to myocardial infarction and stroke are not fully understood.
Source: International Journal of Cardiology - December 25, 2016 Category: Cardiology Authors: Giovanna Muscogiuri, Cedric Annweiler, Guillaume Duval, Spyridon Karras, Giacomo Tirabassi, Gianmaria Salvio, Giancarlo Balercia, Samantha Kimball, Kalliopi Kotsa, Luca Mascitelli, Harjit Pal Bhattoa, Annamaria Colao Tags: Review Source Type: research

Response to the letter to editor: Prediction of thromboembolic events for patients with non-valvular atrial fibrillation; CHA2DS2-VASc-UA2-VitD
We are invited to comment on the letter written by Dr. Cerit in reference to our recently article[1]. In the letter, Dr. Cerit concluded that vitamin D (VD) was closely related to atrial fibrillation and ischemic stroke, and hypothesized that CHA2DS2-VASc-UA2-VitD may be an useful score system in risk stratification of patients with non-valvular atrial fibrillation (NVAF). Several reasons were given in the letter: 1) VD regulates oxidative stress [2]. 2) VD may prevent and terminate atrial fibrillation as the direct electromechanically of left atrium [3].
Source: International Journal of Cardiology - December 5, 2016 Category: Cardiology Authors: Jun Guo Tags: Correspondence Source Type: research

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