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Atrial fibrillation and coronary artery disease: a review on the optimal use of oral anticoagulants
Rev Cardiovasc Med. 2021 Sep 24;22(3):635-648. doi: 10.31083/j.rcm2203074.ABSTRACTAtrial fibrillation (AF) represents the most prevalent supraventricular arrhythmia in adults population and up to 15% of AF patients undergo percutaneous coronary intervention (PCI) for coronary artery disease (CAD) during their life. While oral anticoagulants (OACs) exert a protective effect in the setting of stroke prevention and systemic embolization in AF patients, patients undergoing PCI are recommended to receive dual antiplatelet therapy (DAPT) to reduce the risk of cardiovascular death, recurrent myocardial infarction and stent thromb...
Source: Reviews in Cardiovascular Medicine - September 26, 2021 Category: Cardiology Authors: Pier Paolo Bocchino Filippo Angelini Elisabetta Toso Source Type: research

Direct-Acting Oral Anticoagulants in Atrial Fibrillation: What’s New in the Literature
Atrial fibrillation (AF) is considered the most common sustained cardiac arrhythmia, and it is associated with a significant risk of adverse events, especially ischemic stroke. Oral anticoagulation is the cornerstone for stroke prevention in AF; for many years, only vitamin K antagonists were used for this purpose, with an absolute risk reduction>60%. However, these agents have limitations, such as narrow therapeutic margins and drug–food and drug–drug interactions. More recently, 4 direct-acting oral anticoagulants (DOACs)—non–vitamin K antagonists—have become available for patients with AF: dabigatran, rivaroxa...
Source: Cardiology in Review - April 17, 2021 Category: Cardiology Tags: Review Articles Source Type: research

Dual therapy with an oral non-vitamin K antagonist and a P2Y12 inhibitor vs triple therapy with aspirin, a P2Y12 inhibitor and a vitamin K antagonist for the treatment of diabetes mellitus patients with co-existing atrial fibrillation following percutaneous coronary intervention: A meta-analysis
Conclusions: DT with a NOAC and a P2Y12 inhibitor was associated with significantly less bleeding events without increasing the adverse cardiovascular outcomes when compared to TT with aspirin, a P2Y12 inhibitor and a Vitamin K antagonist for the treatment of DM patients with co-existing AF following PCI. Hence, DT is comparable in efficacy, but safer compared to TT. This interesting hypothesis will have to be confirmed in future studies.
Source: Medicine - April 16, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Meta-Analysis Comparing Direct Oral Anticoagulants to Vitamin K Antagonists for The Management of Left Ventricular Thrombus
Expert Rev Cardiovasc Ther. 2021 Apr 8. doi: 10.1080/14779072.2021.1915134. Online ahead of print.ABSTRACTINTRODUCTION: To compare vitamin K antagonist (VKAs) and direct oral anticoagulants (DOACs) treatment in patients with left ventricular (LV) thrombus. The primary outcome was stroke or systemic embolism (SSE). Secondary outcomes were thrombus resolution, bleeding, and death.AREAS COVERED: Five observational studies were included (total n=700; VKAs n = 480; DOACs n = 220). There was a trend toward less SSE with VKAs compared to DOACs (5.2% vs. 9%; OR = 0.54, 95% CI= 0.29-1.01, p = 0.05). No significant difference betwee...
Source: Expert Review of Cardiovascular Therapy - April 8, 2021 Category: Cardiology Authors: Hesham K Abdelaziz Michael Megaly Maciej Debski Amr Abdelrahman Shehab Abdelaziz Diaa Kamal Billal Patel Ranjit More Tawfiq Choudhury Source Type: research

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