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Blood Pressure Control and Risk of Stroke or Systemic Embolism in Patients With Atrial Fibrillation: Results From the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) Trial Stroke
Conclusions High BP measurement at any point during the trial was independently associated with a substantially higher risk of stroke or systemic embolism. These results strongly support efforts to treat elevated BP as an important strategy to optimally lower risk of stroke in patients with AF. Clinical Trial Registration URL: https://ClinicalTrials.gov/. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - December 1, 2015 Category: Cardiology Authors: Rao, M. P., Halvorsen, S., Wojdyla, D., Thomas, L., Alexander, J. H., Hylek, E. M., Hanna, M., Bahit, M. C., Lopes, R. D., De Caterina, R., Erol, C., Goto, S., Lanas, F., Lewis, B. S., Husted, S., Gersh, B. J., Wallentin, L., Granger, C. B., the Apixaban Tags: Stroke Source Type: research

Long-Term Antiplatelet Mono- and Dual Therapies After Ischemic Stroke or Transient Ischemic Attack: Network Meta-Analysis Stroke
Conclusions Long-term monotherapy was a better choice than long-term dual therapy, and cilostazol had the best risk–benefit profile for long-term secondary prevention after stroke or transient ischemic attack. More randomized controlled trials in non–East Asian patients are needed to determine whether long-term use of cilostazol is the best option for the prevention of recurrent stroke.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Xie, W., Zheng, F., Zhong, B., Song, X. Tags: Stroke Source Type: research

Clopidogrel Use Is Associated With an Increased Prevalence of Cerebral Microbleeds in a Stroke-Free Population: The Rotterdam Study Stroke
Conclusions In stroke-free individuals, clopidogrel use was associated with a higher prevalence and higher number of CMBs. Whether this association is causal requires confirmation in prospective studies, especially given the small number of participants taking clopidogrel and the possibility of residual confounding in this study.
Source: JAHA:Journal of the American Heart Association - September 26, 2013 Category: Cardiology Authors: Darweesh, S. K. L., Leening, M. J. G., Akoudad, S., Loth, D. W., Hofman, A., Arfan Ikram, M., Vernooij, M. W., Stricker, B. H. Tags: Stroke Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

Efficacy and Safety of Edoxaban in Elderly Patients With Atrial Fibrillation in the ENGAGE AF-TIMI 48 Trial Stroke
Conclusions Age has a greater influence on major bleeding than thromboembolic risk in patients with atrial fibrillation. Given the higher rates of bleeding and death with increasing age, treatment of elderly patients with edoxaban provides an even greater absolute reduction in safety events over warfarin, compared to treatment with edoxaban versus warfarin in younger patients. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00781391.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Kato, E. T., Giugliano, R. P., Ruff, C. T., Koretsune, Y., Yamashita, T., Kiss, R. G., Nordio, F., Murphy, S. A., Kimura, T., Jin, J., Lanz, H., Mercuri, M., Braunwald, E., Antman, E. M. Tags: Atrial Fibrillation, Complications, Mortality/Survival, Intracranial Hemorrhage, Ischemic Stroke Source Type: research

Stroke and Bleeding Risk Associated With Antithrombotic Therapy for Patients With Nonvalvular Atrial Fibrillation in Clinical Practice Health Services and Outcomes Research
Conclusions Continuation of antithrombotic therapy as well as maintaining an adequate level of TTR is beneficial to prevent strokes while minimizing bleeding events.
Source: JAHA:Journal of the American Heart Association - July 17, 2015 Category: Cardiology Authors: An, J., Niu, F., Lang, D. T., Jazdzewski, K. P., Le, P. T., Rashid, N., Meissner, B., Mendes, R., Dills, D. G., Aranda, G., Bruno, A. Tags: Health Services and Outcomes Research Source Type: research

Effectiveness and Safety of Dabigatran, Rivaroxaban, and Apixaban Versus Warfarin in Nonvalvular Atrial Fibrillation Health Services and Outcomes Research
Conclusions In patients with nonvalvular atrial fibrillation, apixaban was associated with lower risks of both stroke and major bleeding, dabigatran was associated with similar risk of stroke but lower risk of major bleeding, and rivaroxaban was associated with similar risks of both stroke and major bleeding in comparison to warfarin.
Source: JAHA:Journal of the American Heart Association - June 12, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Sangaralingham, L. R., Bellolio, M. F., McBane, R. D., Shah, N. D., Noseworthy, P. A. Tags: Atrial Fibrillation, Secondary Prevention, Anticoagulants, Transplantation, Cerebrovascular Disease/Stroke Health Services and Outcomes Research Source Type: research

CYP2C19 Metabolizer Status and Clopidogrel Efficacy in the Secondary Prevention of Small Subcortical Strokes (SPS3) Study Genetics
Conclusions There were significant differences in recurrent stroke by CYP2C19 genotype-inferred metabolizer status in white subcortical stroke patients receiving dual antiplatelet therapy with aspirin and clopidogrel, consistent with cardiovascular studies on CYP2C19 and clopidogrel; however, the bleeding risk that led to early termination of the antiplatelet arm of the SPS3 trial does not appear to be explained by CYP2C19 genotype. This study was relatively underpowered; therefore, these findings should be interpreted with caution and warrant replication. Clinical Trial Registration URL: www.clinicaltrials.gov. Unique id...
Source: JAHA:Journal of the American Heart Association - May 27, 2015 Category: Cardiology Authors: McDonough, C. W., McClure, L. A., Mitchell, B. D., Gong, Y., Horenstein, R. B., Lewis, J. P., Field, T. S., Talbert, R. L., Benavente, O. R., Johnson, J. A., Shuldiner, A. R. Tags: Genetics Source Type: research

Efficacy and Safety of Apixaban Compared With Warfarin in Patients With Atrial Fibrillation and Peripheral Artery Disease: Insights From the ARISTOTLE Trial Arrhythmia and Electrophysiology
ConclusionsPatients with PAD in ARISTOTLE had a higher crude risk of stroke or systemic embolism compared with patients without PAD that was not present after adjustment. The benefits of apixaban versus warfarin for stroke and systemic embolism were similar in patients with and without PAD. These findings highlight the need to optimize the treatment of patients with atrial fibrillation and PAD.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00412984.
Source: JAHA:Journal of the American Heart Association - January 17, 2017 Category: Cardiology Authors: Hu, P. T., Lopes, R. D., Stevens, S. R., Wallentin, L., Thomas, L., Alexander, J. H., Hanna, M., Lewis, B. S., Verheugt, F. W. A., Granger, C. B., Jones, W. S. Tags: Arrhythmias, Atrial Fibrillation, Anticoagulants, Peripheral Vascular Disease Original Research Source Type: research

Reduction in Overall Occurrences of Ischemic Events With Vorapaxar: Results From TRACER Coronary Heart Disease
Conclusions Vorapaxar reduced overall occurrences of ischemic events, but increased bleeding. These exploratory findings broaden our understanding of vorapaxar's potential and expand our understanding of the value of capturing recurrent events. Clinical Trial Registration URL: ClinicalTrials.gov. Unique identifier: NCT00527943.
Source: JAHA:Journal of the American Heart Association - July 10, 2014 Category: Cardiology Authors: White, H. D., Huang, Z., Tricoci, P., Van de Werf, F., Wallentin, L., Lokhnygina, Y., Moliterno, D. J., Aylward, P. E., Mahaffey, K. W., Armstrong, P. W. Tags: Coronary Heart Disease Source Type: research

Efficacy and Safety of Vorapaxar as Approved for Clinical Use in the United States Coronary Heart Disease
Conclusions In patients with prior MI or PAD who have not had a previous stroke or TIA, vorapaxar added to standard therapy is effective for long-term secondary prevention of thrombotic CV events, while increasing moderate or severe bleeding. Clinical Trial Registration URL: clinicaltrials.gov Unique Identifier: NCT00526474.
Source: JAHA:Journal of the American Heart Association - March 19, 2015 Category: Cardiology Authors: Magnani, G., Bonaca, M. P., Braunwald, E., Dalby, A. J., Fox, K. A. A., Murphy, S. A., Nicolau, J. C., Oude Ophuis, T., Scirica, B. M., Spinar, J., Theroux, P., Morrow, D. A. Tags: Coronary Heart Disease Source Type: research

Relationship Between Time in Therapeutic Range and Comparative Treatment Effect of Rivaroxaban and Warfarin: Results From the ROCKET AF Trial Arrhythmia and Electrophysiology
Conclusions The treatment effect of rivaroxaban compared with warfarin for the prevention of stroke and systemic embolism is consistent regardless of cTTR.
Source: JAHA:Journal of the American Heart Association - April 22, 2014 Category: Cardiology Authors: Piccini, J. P., Hellkamp, A. S., Lokhnygina, Y., Patel, M. R., Harrell, F. E., Singer, D. E., Becker, R. C., Breithardt, G., Halperin, J. L., Hankey, G. J., Berkowitz, S. D., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., ROCKET AF Investig Tags: Arrhythmia and Electrophysiology Source Type: research

Effectiveness and Safety of Dabigatran and Warfarin in Real-World US Patients With Non-Valvular Atrial Fibrillation: A Retrospective Cohort Study Health Services and Outcomes Research
Conclusions Dabigatran could be a safe and potentially more effective alternative to warfarin in patients with atrial fibrillation managed in routine practice settings.
Source: JAHA:Journal of the American Heart Association - April 10, 2015 Category: Cardiology Authors: Lauffenburger, J. C., Farley, J. F., Gehi, A. K., Rhoney, D. H., Brookhart, M. A., Fang, G. Tags: Health Services and Outcomes Research Source Type: research

Clinical Characteristics, Oral Anticoagulation Patterns, and Outcomes of Medicaid Patients With Atrial Fibrillation: Insights From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF I) Registry Health Services and Outcomes Research
Conclusions In a contemporary AF cohort, use of OAC overall and use of NOACs were not significantly lower among Medicaid patients relative to others. However, among warfarin users, Medicaid patients spent less time in therapeutic range compared with those with other forms of insurance.
Source: JAHA:Journal of the American Heart Association - May 3, 2016 Category: Cardiology Authors: O'Brien, E. C., Kim, S., Thomas, L., Fonarow, G. C., Kowey, P. R., Mahaffey, K. W., Gersh, B. J., Piccini, J. P., Peterson, E. D. Tags: Atrial Fibrillation, Primary Prevention, Health Services, Quality and Outcomes Health Services and Outcomes Research Source Type: research

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