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Condition: Atrial Fibrillation
Drug: Warfarin

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Total 2924 results found since Jan 2013.

Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients with Atrial Fibrillation: 2.3 Year Follow-Up of the PROTECT AF Trial.
CONCLUSIONS: The "local" strategy of LAA closure is noninferior to "systemic" anticoagulation with Warfarin. PROTECT AF has, for the first time, implicated the LAA in the pathogenesis of stroke in AF. CLINICAL TRIAL REGISTRATION INFORMATION: Clinicaltrials.gov; Unique Identifier: NCT00129545. PMID: 23325525 [PubMed - as supplied by publisher]
Source: Circulation - January 16, 2013 Category: Cardiology Authors: Reddy VY, Doshi SK, Siever H, Buchbinder M, Neuzil P, Huber K, Halperin JL, Holmes D Tags: Circulation Source Type: research

Efficacy and safety of warfarin vs. antiplatelet therapy in patients with systolic heart failure and sinus rhythm: a systematic review and meta‐analysis of randomized controlled trials
ConclusionsWarfarin as compared with antiplatelet therapy reduces risk of ischemic stroke, does not significantly affect death, myocardial infarction, hospitalization due to heart failure or intracranial hemorrhage and increases major hemorrhage in heart failure patients who are in sinus rhythm.
Source: International Journal of Stroke - March 19, 2013 Category: Neurology Authors: Aaron YL. Liew, John W. Eikelboom, Stuart J. Connolly, Martin O' Donnell, Robert G. Hart Tags: Systematic Review Source Type: research

Abstract 217: How well does the CHADS2 Stroke Risk Score Predict Major Hemorrhage in Patients with Atrial Fibrillation? Poster Session II
Conclusions: Although some clinical markers of stroke risk such as those included in the CHADS2 risk score are also associated with increased hemorrhage risk, the CHADS2 risk score should not be used instead of a validated hemorrhage risk tool to estimate hemorrhage risk.
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Quinn, G. R., Singer, D. E., Go, A. S., Chang, Y., Borowsky, L., Pomernacki, N., Udaltsova, N., Fang, M. C. Tags: Poster Session II Source Type: research

Dabigatran etexilate: management in acute ischemic stroke.
Abstract A 54-year-old man treated with dabigatran experienced new onset of a stroke with a score of 9 on the National Institutes of Health Stroke Scale. Administration of recombinant tissue plasminogen activator (rtPA) was not recommended because of the dabigatran therapy. Angiography showed occlusion of the left middle cerebral artery by an embolic thrombus. Suction thrombectomy achieved flow through the inferior division of the artery. Computed tomography of the head showed possible intracranial hemorrhage, and dabigatran reversal was attempted with prothrombin complex concentrate and recombinant factor VIIa. C...
Source: American Journal of Critical Care - March 1, 2013 Category: Nursing Authors: Javedani PP, Horowitz BZ, Clark WM, Lutsep HL Tags: Am J Crit Care Source Type: research

Current Approaches to Anticoagulation for Reducing Risk of Atrial Fibrillation-Related Stroke
Stroke is a major cause of death and disability and, as such, is associated with a heavy socioeconomic burden. Atrial fibrillation (AF) is an independent risk factor for ischemic stroke, and AF-related stroke tends to be more severe and poses a higher risk of recurrence than non-AF-related stroke. Anticoagulant prophylaxis with warfarin is effective in preventing stroke in eligible patients with AF, but in real-world practice this agent, though inexpensive, is underutilized. Moreover, warfarin has notable drawbacks that result in suboptimal anticoagulation and, as a result, greater disease burden and higher costs. Newer or...
Source: Journal of Pharmacy Practice - June 5, 2013 Category: Drugs & Pharmacology Authors: Sanoski, C. A. Tags: Research Articles Source Type: research

Reservations against new oral anticoagulants after stroke and cerebral bleeding
Abstract: Dabigatran, rivaroxaban, and apixaban are the new oral anticoagulants (NOAC) which have been investigated in patients with atrial fibrillation (AF) for primary and secondary prevention of stroke and thromboembolism. In these trials NOAC had a similar efficacy and safety profile compared to traditional vitamin-K-antagonists such as warfarin. We advise caution in the use of NOAC in patients with stroke or cerebral hemorrhage because of the following reasons:1) Patients with cerebral bleeding were excluded from the trials. 2) Stroke within 14days and severe stroke within 6months before screening were exclusion crite...
Source: Journal of the Neurological Sciences - April 29, 2013 Category: Neurology Authors: Claudia Stöllberger, Josef Finsterer Tags: Opinion Source Type: research

Ethnicity and stroke risk in patients with atrial fibrillation
Conclusions Despite a reduced prevalence of AF among South Asian patients, their risk of stroke is higher than for white patients or black African/Caribbean patients in association with diabetes, cardiovascular disease, and hypertension. Under-prescription of anticoagulation persists in all ethnic groups, a deficit most pronounced in the elderly. Use of the CHA2DS2VASc score would enhance optimal management in primary care.
Source: Heart - July 5, 2013 Category: Cardiology Authors: Mathur, R., Pollara, E., Hull, S., Schofield, P., Ashworth, M., Robson, J. Tags: Drugs: cardiovascular system, Hypertension, Epidemiology Heart rhythm disorders Source Type: research

Novel oral anticoagulants in secondary prevention of stroke
In patients with atrial fibrillation (AF) oral anticoagulation with vitamin-K antagonists (warfarin, phenprocoumon) is effective both for primary and secondary stroke prevention yielding a 60–70% relative reduction in stroke risk compared with placebo, as well as a mortality reduction of 26 percent. Vitamin-K antagonists have a number of well documented shortcomings. Recently the results of randomised trials for three new oral anticoagulants that do not exhibit the limitations of vitamin-K antagonists have been published. These include direct factor Xa inhibitors (rivaroxaban and apixaban) and a direct thrombin inhibitor...
Source: Best Practice and Research. Clinical Haematology - June 1, 2013 Category: Hematology Authors: H.C. Diener, J.D. Easton, G.J. Hankey, R.G. Hart Source Type: research

Apixaban versus warfarin in patients with atrial fibrillation according to prior warfarin use: Results from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation trial
Background: Patients with atrial fibrillation who are vitamin K antagonist (VKA)-naive may have a higher risk of thrombosis and/or bleeding than VKA-experienced patients.Methods and results: Using data from ARISTOTLE, we assessed baseline characteristics and the treatment effect of apixaban versus warfarin in the VKA-naive and VKA-experienced cohorts. We compared rates of study drug discontinuation and time-in-therapeutic range. Overall, 7,800 (43%) were VKA naive, and 10,401 were VKA experienced. At baseline, both groups were similar with respect to age and congestive heart failure, hypertension, age, diabetes, stroke sco...
Source: American Heart Journal - July 26, 2013 Category: Cardiology Authors: David A. Garcia, Lars Wallentin, Renato D. Lopes, Laine Thomas, John H. Alexander, Elaine M. Hylek, Jack Ansell, Michael Hanna, Fernando Lanas, Greg Flaker, Patrick Commerford, Denis Xavier, Dragos Vinereanu, Hongqiu Yang, Christopher B. Granger Tags: Electrophysiology Source Type: research

Novel oral anticoagulants in secondary prevention of stroke
In patients with atrial fibrillation (AF) oral anticoagulation with vitamin-K antagonists (warfarin, phenprocoumon) is effective both for primary and secondary stroke prevention yielding a 60–70% relative reduction in stroke risk compared with placebo, as well as a mortality reduction of 26 percent. Vitamin-K antagonists have a number of well documented shortcomings. Recently the results of randomised trials for three new oral anticoagulants that do not exhibit the limitations of vitamin-K antagonists have been published. These include direct factor Xa inhibitors (rivaroxaban and apixaban) and a direct thrombin inhibitor...
Source: Best Practice and Research. Clinical Haematology - June 1, 2013 Category: Hematology Authors: H.C. Diener, J.D. Easton, G.J. Hankey, R.G. Hart Source Type: research

Unanswered questions and research priorities to optimise stroke prevention in atrial fibrillation with the new oral anticoagulants.
Abstract This review article discusses the following, as yet unanswered, questions and research priorities to optimise patient management and stroke prevention in atrial fibrillation with the new direct oral anticoagulants (NOACs): 1. In patients prescribed a NOAC, can the anticoagulant effects or plasma concentrations of the NOACs be measured rapidly and reliably and, if so, can "cut-off points" between which anticoagulation is therapeutic (i.e. the "therapeutic range") be defined? 2. In patients who are taking a NOAC and bleeding (e.g. intracerebral haemorrhage), can the anticoagulant effects of the direct NOACs...
Source: Thrombosis and Haemostasis - November 28, 2013 Category: Hematology Authors: Hankey GJ Tags: Thromb Haemost Source Type: research

Warfarin Use and the Risk for Stroke and Bleeding in Patients with Atrial Fibrillation Undergoing Dialysis.
CONCLUSIONS: Our results suggest that warfarin use is not beneficial in reducing stroke risk but is associated with a higher bleeding risk in patients with AF undergoing dialysis. PMID: 24452752 [PubMed - as supplied by publisher]
Source: Circulation - January 22, 2014 Category: Cardiology Authors: Shah M, Avgil Tsadok M, Jackevicius CA, Essebag V, Eisenberg MJ, Rahme E, Humphries KH, Tu JV, Behlouli H, Guo H, Pilote L Tags: Circulation Source Type: research

Feasibility and cost effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. The SEARCH-AF study.
Abstract Atrial fibrillation (AF) causes a third of all strokes, but often goes undetected before stroke. Identification of unknown AF in the community and subsequent anti-thrombotic treatment could reduce stroke burden. We investigated community screening for unknown AF using an iPhone electrocardiogram (iECG) in pharmacies, and determined the cost-effectiveness of this strategy.Pharmacists performedpulse palpation and iECG recordings, with cardiologist iECG over-reading. General practitioner review/12-lead ECG was facilitated for suspected new AF. An automated AF algorithm was retrospectively applied to collecte...
Source: Thrombosis and Haemostasis - April 1, 2014 Category: Hematology Authors: Lowres N, Neubeck L, Salkeld G, Krass I, McLachlan AJ, Redfern J, Bennett AA, Briffa T, Bauman A, Martinez C, Wallenhorst C, Lau JK, Brieger DB, Sy RW, Freedman SB Tags: Thromb Haemost Source Type: research

Net Clinical Benefit of Warfarin Therapy in Elderly Chinese Patients With Atrial Fibrillation Original Articles
Conclusions— In elderly patients with atrial fibrillation, warfarin therapy is associated with lower death and ischemic stroke and an overall net clinical benefit.
Source: Circulation: Arrhythmia and Electrophysiology - April 15, 2014 Category: Cardiology Authors: Siu, C.-W., Tse, H.-F. Tags: Cerebrovascular disease/stroke, Arrhythmias, clinical electrophysiology, drugs, Anticoagulants Original Articles Source Type: research