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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

Reduced dose and reduced exposure to non-vitamin K-antagonist oral anticoagulants: Some considerations on this relationship
For the prevention of stroke and/or systemic embolism (SSE) in non-valvular atrial fibrillation (NVAF), the four available non-vitamin K-antagonist oral anticoagulants (NOACs) are each marketed in a higher and a lower dose: 150 and 110mg for dabigatran, 20 and 15mg for rivaroxaban, 5 and 2.5mg for apixaban and 60 and 30mg for edoxaban. The lower dose is commonly used with the aim to reduce the patient's exposure to the drug (and its anticoagulant effect), thereby reducing the risk of bleeding. This however, may not always be true, depending on the NOAC used and the characteristics of the patients to whom the NOAC is given.
Source: International Journal of Cardiology - August 10, 2016 Category: Cardiology Authors: Andrea Rubboli, Freek W.A. Verheugt Tags: Correspondence Source Type: research

Non-vitamin K oral anticoagulant treatment in elderly patients with atrial fibrillation and coronary heart disease
Atrial fibrillation (AF) is the most frequent sustained arrhythmia. Overall prevalence is estimated to 5.5% and the incidence increases with age. As the population ages, the prevalence and costs of AF are expected to increase. AF is the most important cause of stroke in patients>75years. Until recently, Vitamin K antagonists (VKAs) were the only available oral anticoagulants (OACs) evaluated for long-term treatment of patients with AF with or without coronary heart disease (CHD). This situation was challenged by introduction of non-VKA oral anticoagulants (NOACs).
Source: International Journal of Cardiology - August 3, 2016 Category: Cardiology Authors: Xavier Humbert, Vincent Roule, Mathieu Chequel, Sophie Fedrizzi, Marie Brionne, V éronique Lelong-Boulouard, Paul Milliez, Joachim Alexandre Tags: Review Source Type: research

Comparative effectiveness and safety of non-vitamin K Antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and valvular heart disease
Non-vitamin K antagonist oral anticoagulants (NOACs) are approved for prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF). These agents are as effective as warfarin and are associated with less intracranial bleeding and may be preferable for many patients with NVAF [1]. However, the term non-valvular AF remains a source of confusion because clinical trials and guidelines have adopted variable definitions.
Source: International Journal of Cardiology - February 2, 2016 Category: Cardiology Authors: Peter A. Noseworthy, Xiaoxi Yao, Nilay D. Shah, Bernard J. Gersh Source Type: research

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