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Total 249 results found since Jan 2013.

Cost-Effectiveness of Apixaban Versus Other Noacs And Warfarin, During Hospitalization In The Private Brazilian Health System
Atrial fibrillation (AF) is the most common arrhythmia in the world and it affects around 1% of the world´s population. There are approximately 1.5 million people, in Brazil, that have AF. AF is the fifth cause of hospitalization in the Public Health System. AF patients have an increased risk of developing an ischemic stroke than patients without AF. Current treatment for AF are vitamin K antagonist (AVKs), antiplatelet agents, acetylsalicylic acid (AAS) and the Oral Anticoagulants – NOACs (rivaroxaban, dabigatran and apixaban).
Source: Value in Health - October 23, 2015 Category: Global & Universal Authors: S Tanaka, MC Preto, G Bernardino, F Nogueira, CN Ferreira, BM Donato Source Type: research

Autism in the Son of a Woman with Mitochondrial Myopathy and Dysautonomia: A Case Report
Conclusion Given emerging evidence that mitochondrial dysfunction, particularly in the electron transport chain needed for cellular energy production, is an underlying pathophysiological mechanism for some varieties of ASD, clinicians should have a high index of suspicion for mitochondrial disease, especially when they encounter a patient with unusual neurological or constitutional symptoms. The prevalence of mitochondrial disease in ASD patients may be as high as five percent, which means that it is not the “zebra”[27] diagnosis that it might be in a non-ASD patient, where prevalence is about 0.01 percent.10 Reference...
Source: Innovations in Clinical Neuroscience - October 9, 2015 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Asperger's syndrome Autism Behavioral and Cognitive Neurology Case Report Current Issue Intellectual Disability Neurologic Systems and Symptoms Pervasive Developmental Disorders ASD autism spectrum disorder dysauton Source Type: research

Stroke prevention in AF patients in Poland and other European countries: insights from the GARFIELD-AF registry.
CONCLUSIONS: The GARFIELD-AF Registry data shows how distant every day clinical practice is from the guidelines. It shows that still in Poland, as well as in the rest of Europe, too many patients with low stroke risk are treated with anticoagulants, while too frequently patients at the high stroke risk are left with no stroke prevention. Although the tendency to use non-vitamin K oral anticoagulants grows comparably in Poland and in the rest of Europe, the proportion of patients with intermediate and high stroke risk does not grow and more patients at low stroke risk are treated with anticoagulants. PMID: 26365937 [Pu...
Source: Polish Heart Journal - September 14, 2015 Category: Cardiology Authors: Stępińska J, Kremis E, Konopka A, Wożakowska-Kapłon B, Ruszkowski P, Kukla P, Kayani G Tags: Kardiol Pol Source Type: research

Direct Oral Anticoagulants for the Prevention of Stroke in Patients with Nonvalvular Atrial Fibrillation: Understanding Differences and Similarities
Abstract The presence of atrial fibrillation (AF), the most common sustained cardiac arrhythmia, significantly increases the risk for stroke. Current guidelines recommend that the vitamin K antagonist warfarin or direct oral anticoagulants (DOACs), such as the approved direct thrombin inhibitor dabigatran and the approved direct factor Xa inhibitors apixaban, rivaroxaban, and edoxaban, should be used for thromboprophylaxis in patients with nonvalvular AF at risk for stroke or systemic embolic events (SEE). Warfarin, the mainstay of stroke prevention in AF, increases the risk of major bleeding. Furthermore, warfari...
Source: Drugs - September 14, 2015 Category: Drugs & Pharmacology Source Type: research

Non–Vitamin K Antagonist Oral Anticoagulant Use in Patients With Atrial Fibrillation and Associated Intracranial Hemorrhage: A Focused Review
ABSTRACT Atrial fibrillation (AF) is the most common cardiac arrhythmia and predisposes patients to an increased risk of embolic stroke. After nearly 60 years, warfarin is no longer the only effective therapeutic option for patients with AF. Large randomized trials have consistently shown that non–vitamin K oral anticoagulants (NOACs) including dabigatran, rivaroxaban, apixaban, and edoxaban significantly reduce from the risk of intracranial hemorrhage (ICH) compared with warfarin. We provide a focused review regarding the NOACs and ICH in AF patients by summarizing findings of these large clinical trials, mechanisms of ...
Source: Clinical Cardiology - July 14, 2015 Category: Cardiology Authors: Boris Arbit, Jonathan C. Hsu Tags: Review Source Type: research

How to define valvular atrial fibrillation?
Abstract Atrial fibrillation (AF) confers a substantial risk of stroke. Recent trials comparing vitamin K antagonists (VKAs) with non-vitamin K antagonist oral anticoagulants (NOACs) in AF were performed among patients with so-called "non-valvular" AF. The distinction between "valvular" and "non-valvular" AF remains a matter of debate. Currently, "valvular AF" refers to patients with mitral stenosis or artificial heart valves (and valve repair in North American guidelines only), and should be treated with VKAs. Valvular heart diseases, such as mitral regurgitation, aortic stenosis (AS) and aortic insufficiency, do...
Source: Archives of Cardiovascular Diseases - July 13, 2015 Category: Cardiology Authors: Fauchier L, Philippart R, Clementy N, Bourguignon T, Angoulvant D, Ivanes F, Babuty D, Bernard A Tags: Arch Cardiovasc Dis Source Type: research

Direct oral anticoagulants in atrial fibrillation: can data from randomized clinical trials be safely transferred to the general population? Yes
Abstract Atrial fibrillation is the most common arrhythmia and is associated with significant morbidity and mortality. The current therapeutic options for patients at high thromboembolic risk include the vitamin K antagonists and the direct oral anticoagulants. These novel agents have been evaluated in more than 40,000 patients enrolled in four large randomized controlled trials for stroke prevention in non-valvular atrial fibrillation. When these results were pooled together, a greater efficacy profile, as well as a consistent reduction in life-threatening bleeding was shown in comparison to vitamin K antagonists...
Source: Internal and Emergency Medicine - July 7, 2015 Category: Emergency Medicine Source Type: research

Stroke with atrial fibrillation or atrial flutter: a descriptive population-based study from the Brest stroke registry
The objective of the present prospective study, using data from 2008, was to evaluate the prevalence of AA (atrial fibrillation/flutter) in patients with stroke and the impact of implementing AF guidelines. Methods: The prevalence of AA was studied in patients diagnosed with stroke from January 1 to December 31, 2008 in the population-based Stroke Registry of Brest, France (total population, 363,760 according to the 2008 census, with 295,553 aged 15 years or older). Guidelines implementation was assessed in terms of antithrombotic therapy (VKA, antiplatelet agent, none), and the CHADS2 (Congestive heart failure, Hypertens...
Source: BMC Geriatrics - June 11, 2015 Category: Geriatrics Authors: Virginie JannouSerge TimsitEmmanuel NowakFrançois RouhartPhilippe GoasFrançois-Mathias MerrienIrina Viakhireva-DovganyukAnne Tirel-BadetsArmelle Gentric Source Type: research

Use of Non-Vitamin K Antagonist Oral Anticoagulants in Special Patient Populations with Nonvalvular Atrial Fibrillation: A Review of the Literature and Application to Clinical Practice
The objective of this review is to provide the clinician with an update on the use of NOACs for NVAF, focusing on older adults and patients with renal impairment in light of recently published atrial fibrillation guidelines. Available data on using NOACs in coronary artery stenting, cardioversion, and ablation are also reviewed.
Source: Drugs - May 22, 2015 Category: Drugs & Pharmacology Source Type: research

Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin
Commentary to: Reddy VY, Sievert H, Halperin J, et al.; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA 2014;312:1988–98 . Context Atrial fibrillation (AF) is a common arrhythmia in clinical practice. The major complication of AF is thromboembolic stroke. Patients with AF have a fivefold higher risk of stroke and a twofold increase in mortality.1 As complete cure for AF is never certain, the aims of AF therapy are symptom relief and prevention of thromboembolic events. The latter can be managed by vitami...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Swaans, M. J., Alipour, A., Boersma, L. V. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm Source Type: research

Antiplatelet Therapy in Japanese Patients with Atrial Fibrillation without Oral Anticoagulants: Pooled Analysis of Shinken Database, J-RHYTHM Registry and Fushimi AF Registry
Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke. Oral anticoagulants (OAC) are effective for stroke prevention in patients with AF, and recent evidences have revealed the efficacy and safety of non-vitamin K antagonist OAC (NOAC) as well as warfarin. Although aspirin was shown to be inferior to warfarin or apixaban in preventing stroke [1,2], it is still prescribed to many AF patients in clinical practice [3–5]. This may be because physicians perceived it to be a safer and more convenient alternative to OAC.
Source: International Journal of Cardiology - April 22, 2015 Category: Cardiology Authors: Hisashi Ogawa, Masaharu Akao, Shinya Suzuki, Takeshi Yamashita, Ken Okumura, Hirotsugu Atarashi, Hiroshi Inoue Tags: Letter to the Editor Source Type: research

Non-Vitamin K Antagonist Oral Anticoagulants Do Not Increase Cerebral Microbleeds
Atrial fibrillation (AF) is a cardiac arrhythmia that frequently induces ischemic strokes. Nowadays, non-vitamin K antagonist oral anticoagulants (NOACs) have come into widespread use for cardiogenic embolism prevention in place of warfarin. Recently, cerebral microbleeds (CMBs) have been noticed for their potential implication in cerebral small vessel disease. We hypothesized that NOACs do not have an unfavorable influence over cerebral small vessels and investigated whether NOACs increase CMBs in AF patients in a prospective manner.
Source: Journal of Stroke and Cerebrovascular Diseases - April 3, 2015 Category: Neurology Authors: Tsukasa Saito, Yuichiro Kawamura, Nobuyuki Sato, Kohei Kano, Kae Takahashi, Asuka Asanome, Jun Sawada, Takayuki Katayama, Naoyuki Hasebe Source Type: research

Does Sex Affect Anticoagulant Use for Stroke Prevention in Nonvalvular Atrial Fibrillation?: The Prospective Global Anticoagulant Registry in the FIELD-Atrial Fibrillation Original Articles
Conclusions— These contemporary global data show that anticoagulant use for stroke prevention is no different in men and women with nonvalvular AF. Thromboprophylaxis was, however, suboptimal in substantial proportions of men and women, with underuse in those at moderate-to-high risk of stroke and overuse in those at low risk. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362.
Source: Circulation: Cardiovascular Quality and Outcomes - March 5, 2015 Category: Cardiology Authors: Lip, G. Y. H., Rushton-Smith, S. K., Goldhaber, S. Z., Fitzmaurice, D. A., Mantovani, L. G., Goto, S., Haas, S., Bassand, J.-P., Camm, A. J., Ambrosio, G., Jansky, P., Al Mahmeed, W., Oh, S., van Eickels, M., Raatikainen, P., Steffel, J., Oto, A., Kayani, Tags: Health policy and outcome research, Coumarins, Other anticoagulants, Arrhythmias, clinical electrophysiology, drugs Original Articles Source Type: research

Alternative Calculations of Individual Patient Time in Therapeutic Range While Taking Warfarin: Results From the ROCKET AF Trial Arrhythmia and Electrophysiology
Conclusions TTR, the standard measure of control of warfarin anticoagulation, depends on imputing daily INR values for the vast majority of follow-up days. Our TTR calculation method may better reflect the impact of warfarin dose changes than the Rosendaal approach. In the ROCKET AF trial, this dose change–based approach led to a modest increase in overall mean iTTR but did not materially affect the large inter-regional differences previously reported. Clinical Trial Registration URL: ClinicalTrials.gov. Unique identifier: NCT00403767.
Source: JAHA:Journal of the American Heart Association - March 3, 2015 Category: Cardiology Authors: Singer, D. E., Hellkamp, A. S., Yuan, Z., Lokhnygina, Y., Patel, M. R., Piccini, J. P., Hankey, G. J., Breithardt, G., Halperin, J. L., Becker, R. C., Hacke, W., Nessel, C. C., Mahaffey, K. W., Fox, K. A. A., Califf, R. M., for the ROCKET AF Investigators Tags: Arrhythmia and Electrophysiology Source Type: research