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Source: Canadian Journal of Cardiology
Drug: Warfarin
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Total 18 results found since Jan 2013.
Oral Anticoagulants and Antiplatelet Agents in Atrial Fibrillation Patients with Concomitant Critical Limb Ischemia: A nationwide cohort study
ConclusionsDOAC was associated with a significantly lower risk of composite net-clinical-benefit outcome than either warfarin or APT in AF patients with concomitant CLI. Further prospective study is necessary to validate the findings in the future.
Source: Canadian Journal of Cardiology - February 19, 2020 Category: Cardiology Source Type: research
Dual-Antithrombotic Therapy With DOACs After Acute Coronary Syndrome or Percutaneous Coronary Intervention in Atrial Fibrillation: A Meta-analysis of Randomized Controlled Trials
ConclusionsIn patients with AF and recent ACS or PCI, the use of dual-antithrombotic therapy with DOACs was associated with less major bleeding and less major bleeding or clinically relevant nonmajor bleeding compared with triple therapy. The use of dual therapy also showed nonsignificantly higher composite of death and ischemic events but no difference in mortality.RésuméContexteIl est difficile de choisir un traitement antithrombotique en cas de fibrillation auriculaire (FA) chez les patients ayant subi un syndrome coronarien aigu (SCA) ou une intervention coronarienne percutanée (ICP). Nous avons comparé les résult...
Source: Canadian Journal of Cardiology - December 24, 2019 Category: Cardiology Source Type: research
Dual antithrombotic therapy with DOACs after ACS or PCI in Atrial Fibrillation: A meta-analysis of Randomized Controlled Trials
ConclusionsIn patients with AF and recent ACS or PCI, the use of dual antithrombotic therapy with DOACs was associated with less major bleeding, and major bleeding or clinically relevant non-major bleeding, compared to triple therapy. The use of dual therapy also shows non-significantly higher composite of death/ischemic events but no difference in mortality.
Source: Canadian Journal of Cardiology - November 14, 2019 Category: Cardiology Source Type: research
Interpatient Variation in Rivaroxaban and Apixaban Plasma Concentrations in Routine Care
Conclusions In this routine care setting, rivaroxaban and apixaban plasma concentrations tended to be more variable than those observed in clinical trials. Identification of additional clinical and molecular determinants that more fully predict patients at risk for excessively high or low DOAC concentrations may enable a more precise DOAC dosing regimen for the individual patient. Teaser Direct-acting oral anticoagulants (DOACs) represent an important new class of medications which are widely prescribed as an alternative to warfarin therapy, however there is a lack of data relating to observed DOAC plasma concentrations wi...
Source: Canadian Journal of Cardiology - April 24, 2017 Category: Cardiology Source Type: research
Warfarin and the risk of stroke and bleeding in patients with atrial fibrillation receiving dialysis: A systematic review and meta-analysis
Conclusion Observational studies suggest that warfarin was not associated with a clear benefit or harm among patients who have atrial fibrillation and are receiving dialysis. These estimates were limited by study heterogeneity including the inability to account for a number of important confounders such as the time in the therapeutic range. Given the high prevalence of atrial fibrillation, stroke, and bleeding complications in this population, well-designed clinical trials of warfarin and other anti-coagulants are urgently needed. Teaser Patients with atrial fibrillation receiving maintenance dialysis are at a high risk of...
Source: Canadian Journal of Cardiology - February 20, 2017 Category: Cardiology Source Type: research
Antithrombotic Treatments for Stroke Prevention in Elderly Patients With Nonvalvular Atrial Fibrillation: Drugs and Doses
Publication date: September 2016 Source:Canadian Journal of Cardiology, Volume 32, Issue 9 Author(s): Mustafa Kilickap, Jackie Bosch, John W. Eikelboom, Robert G. Hart Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are previous stroke and age ≥ 75 years. Canadian guidelines recommend anticoagulant therapy for patients with AF who are older than the age of 65 years, but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagu...
Source: Canadian Journal of Cardiology - August 25, 2016 Category: Cardiology Source Type: research
Antithrombotic treatments for stroke prevention in elderly patients with non-valvular atrial fibrillation: Drugs and doses
Publication date: Available online 14 June 2016 Source:Canadian Journal of Cardiology Author(s): Mustafa Kilickap, Jackie Bosch, John W. Eikelboom, Robert G. Hart Atrial fibrillation (AF) is a common cardiac rhythm disturbance and is associated with a 5-fold increased risk of stroke. The most important risk factors for stroke in patients with AF are prior stroke and age ≥75 years. Canadian guidelines recommend anticoagulant therapy for AF patients over the age of 65 but the elderly often remain undertreated, primarily because of concerns regarding bleeding. Non-vitamin K oral anticoagulants appear to be safer, at l...
Source: Canadian Journal of Cardiology - June 14, 2016 Category: Cardiology Source Type: research
Values and Preferences of Physicians and Patients With Nonvalvular Atrial Fibrillation Who Receive Oral Anticoagulation Therapy for Stroke Prevention
Conclusions Real-world prescriptions do not reflect reported values, which suggests that other factors influence patient-physician decision-making around OAC therapy. Data on self-reported adherence to OAC therapy and discordance in the use of OACs from prescribed regimens are concerning and warrant further investigation.
Source: Canadian Journal of Cardiology - May 24, 2016 Category: Cardiology Source Type: research
Net Clinical Benefit of Dabigatran over Warfarin in Patients with Atrial Fibrillation Stratified by CHA2DS2-VASc Score and Time in Therapeutic Range
Conclusion The combination of CHA2DS2-VASc score and TTR facilitates patient prioritization for dabigatran. The best net clinical benefit for switching warfarin to dabigatran was found in those with both high CHA2DS2-VASc score and poor TTR. Teaser Non-vitamin K antagonist oral anticoagulants (NOAC) are now preferred to warfarin for stroke prevention in atrial fibrillation. In this study, we have shown that combination of CHA2DS2-VASc score and time in therapeutic range (TTR) facilitates patient prioritization for Dabigatran – one of the NOACs. The best net clinical benefit for switching from Dabigatran to warfarin was o...
Source: Canadian Journal of Cardiology - January 26, 2016 Category: Cardiology Source Type: research
Values and preferences of physicians and patients with non-valvular atrial fibrillation receiving oral anticoagulation therapy for stroke prevention
Conclusions Real-world prescriptions do not reflect reported values, suggesting other factors influence patient-physician decision-making around OAC therapy. Data on self-reported adherence to OAC therapy and discordance in the use of OACs from prescribed regimens are concerning and warrant further investigation. Teaser Through a national survey we determined that the preferences of patients and physicians regarding oral anticoagulant (OAC) therapy for stroke prevention in atrial fibrillation differed, but largely focused on characteristics related to safety. However, real-world prescriptions do not reflect the reported va...
Source: Canadian Journal of Cardiology - November 10, 2015 Category: Cardiology Source Type: research
Time in Therapeutic Range and Percentage of INRs in Therapeutic Range as measure of quality of anticoagulation control in atrial fibrillation patients
Conclusions Amongst AF patients on warfarin, the PINRR is a user-friendly alternative to TTR, having a high sensitivity and positive predictive value in predicting TTR. As with TTRs, PINRR is associated with clinical adverse events, i.e. ischemic stroke and intracranial hemorrhage.
Source: Canadian Journal of Cardiology - November 6, 2015 Category: Cardiology Source Type: research
The Risk Stratification and Stroke Prevention Therapy Care Gap in Canadian Atrial Fibrillation Patients
Conclusions In a large Canadian AF population, primary care physicians did not provide a stroke or bleeding risk in a substantial proportion of their AF patients. When estimates were provided, they were on the basis of a predictive stroke and bleeding risk index in less than half of the patients. Furthermore, there was under- and overestimation of stroke and bleeding risk in a substantial proportion of patients. As many as 1 in 3 patients receiving warfarin have their TTR < 60%. These findings suggest an opportunity to enhance knowledge translation to primary care physicians.
Source: Canadian Journal of Cardiology - October 23, 2015 Category: Cardiology Source Type: research
Resident Physicians Choices of Anticoagulation for Stroke Prevention in Patients with Nonvalvular Atrial Fibrillation
This study revealed that, across a wide sampling of disciplines and centers, resident physician choices of anticoagulation in nonvalvular AF differ significantly from contemporary CCS guidelines. Teaser The mainstay of atrial fibrillation (AF) management is stroke prevention using oral anticoagulants. We surveyed 1014 resident physicians from family medicine, emergency medicine, internal medicine and adult cardiology specialties. We found that resident physicians provide care to large number of AF patients and their choices of anticoagulation for stroke prevention are not congruent with the Canadian Cardiovascular Societyâ...
Source: Canadian Journal of Cardiology - August 15, 2015 Category: Cardiology Source Type: research
The Disconnect Between Novel Oral Anticoagulant Eligibility and Provincial Drug Coverage: An Albertan Anticoagulation Clinic Audit
Publication date: August 2015 Source:Canadian Journal of Cardiology, Volume 31, Issue 8 Author(s): Sandeep K. Dhillon, M. Sean McMurtry, Tammy J. Bungard Canadian practice guidelines for nonvalvular atrial fibrillation (NVAF) recommend that most patients receive a novel oral anticoagulant (NOAC) in preference to warfarin to prevent stroke, but not all patients have insurance that covers NOACs. The gap between optimal therapy and drug coverage is unknown. We retrospectively assessed eligibility for NOACs in patients with NVAF at our single-centre anticoagulation clinic and ascertained whether provincial drug coverage w...
Source: Canadian Journal of Cardiology - July 26, 2015 Category: Cardiology Source Type: research
The Effect of Bleeding Risk and Frailty Status on Anticoagulation Patterns in Octogenarians with Atrial Fibrillation: the FRAIL-AF study
Conclusion Our study suggests a higher prevalence of appropriate anticoagulation among octogenarians with atrial fibrillation than reported in previous studies. Further work is needed to develop and disseminate tools to optimize the use of anticoagulants in this high-risk population. Teaser Despite evidence-based recommendations, anticoagulation is not ubiquitous among octogenarians with atrial fibrillation. The objective of this study was to investigate the effect of thromboembolic risk, bleeding risk and frailty on the prevalence of anticoagulation for atrial fibrillation among hospitalized older adults in Montreal, Queb...
Source: Canadian Journal of Cardiology - June 1, 2015 Category: Cardiology Source Type: research
