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Condition: Atrial Fibrillation
Drug: Coumadin

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Total 2924 results found since Jan 2013.

Primary Prevention of Ischaemic Stroke in Atrial Fibrillation: New Oral Anticoagulant Drugs for all?
Abstract Atrial fibrillation (AF) confers a 4.5% risk of stroke per year. The risk of stroke increases with various risk factors and until recently, warfarin has been the gold standard of thromboembolism prophylaxis in AF for many years. The dosage of warfarin requires regular adjustment dependent on the INR, to keep within a narrow therapeutic range of 2.0- 3.0. The INR can be altered by concomitant drugs, foods and alcohol and requires inconvenient blood monitoring. Underanticoagulation places patients at risk of stroke, whilst over-anticoagulation confers significant bleeding risk. Consequently approximately ha...
Source: Current Vascular Pharmacology - May 24, 2014 Category: Drugs & Pharmacology Authors: Foley J, Kirchhof P, Lip GY Tags: Curr Vasc Pharmacol Source Type: research

Cerebrovascular Events in 21 105 Patients With Atrial Fibrillation Randomized to Edoxaban Versus Warfarin: Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48 Clinical Sciences
Conclusions— In patients with atrial fibrillation, once-daily edoxaban was as effective as warfarin in preventing all strokes, with significant reductions in various subtypes of intracranial bleeding. Ischemic cerebrovascular event rates were similar with high-dose edoxaban and warfarin, whereas low-dose edoxaban was less effective than warfarin. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00781391.
Source: Stroke - July 28, 2014 Category: Neurology Authors: Giugliano, R. P., Ruff, C. T., Rost, N. S., Silverman, S., Wiviott, S. D., Lowe, C., Deenadayalu, N., Murphy, S. A., Grip, L. T., Betcher, J. M., Duggal, A., Dave, J., Shi, M., Mercuri, M., Antman, E. M., Braunwald, E., on behalf of the ENGAGE AF-TIMI 48 Tags: Other anticoagulants, Acute Cerebral Hemorrhage, Acute Cerebral Infarction, Arrhythmias, clinical electrophysiology, drugs Clinical Sciences Source Type: research

Gender and the risk of stroke in atrial fibrillation: impact of old and new anticoagulation regimens
Abstract Atrial fibrillation (AF) is the most common sustained arrhythmia. Thromboembolic events related to AF result in significant morbidity and mortality. An individual’s risk of thromboembolism in the setting of AF varies significantly based on clinical and demographic characteristics. The risk of stroke appears to be greater among women with AF than men. Warfarin provides sufficient protection against stroke, but does not eliminate gender differences in stroke rates. New oral anticoagulants demonstrated similar or superior efficacy compared to warfarin; however rates of stroke in women on new agents remain...
Source: Clinical Research in Cardiology Supplements - April 1, 2013 Category: Cardiology Source Type: research

Recognition of posterior circulation stroke
ConclusionsDespite being of typical age for multiple cardiovascular conditions the PC‐ICH patients less often have a previous history of AF or dyslipidemia than IS patients do. The vomiting PC‐ICH patient with hypertensive BP values often has headache and a red flag for hemorrhage is warfarin treatment.
Source: Acta Neurologica Scandinavica - November 17, 2014 Category: Neurology Authors: V. Puustjärvi, D. Strbian, M. Tiainen, S. Curtze, T. Tatlisumak, T. Sairanen Tags: Original Article Source Type: research

Left atrial appendage occlusion for prevention of stroke in nonvalvular atrial fibrillation: a meta-analysis
Conclusion Our data suggest that LAAO is a reasonable option for stroke prophylaxis in AF when anticoagulation is not an option, and the risk for stroke outweighs the risk of procedural complications. Data were limited with the use of most available devices. To better establish the risk and benefit of LAAO in comparison with standard therapy, more randomized controlled trials are necessary.
Source: Journal of Interventional Cardiac Electrophysiology - February 25, 2015 Category: Cardiology Source Type: research

Stroke prevention with rivaroxaban in higher‐risk populations with atrial fibrillation
ConclusionsThese subgroup analyses demonstrate that the treatment effect for rivaroxaban vs. warfarin is broadly consistent across a wide range of patient groups, with respect to both efficacy and safety.
Source: International Journal of Clinical Practice - April 9, 2015 Category: Internal Medicine Authors: H.‐C. Diener, J. L. Halperin, K. Fox, G. J. Hankey Tags: Review Article Source Type: research

A Health Economic Evaluation of Stroke Prevention in Atrial Fibrillation: Guideline Adherence Versus the Observed Treatment Strategy Prior to 2012 in Denmark
Conclusions Guideline adherence is a cost-effective treatment strategy compared with the strategy employed prior to 2012 for pharmacological stroke prophylaxis in AF.
Source: PharmacoEconomics - May 6, 2015 Category: Health Management Source Type: research

Edoxaban for reducing the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation.
Authors: Dzeshka MS, Lip GY Abstract INTRODUCTION: Oral anticoagulation is central to the management of patients with atrial fibrillation (AF) and at least one additional stroke risk factor. For decades, the vitamin K antagonists (e.g. warfarin) remained the only oral anticoagulant available for stroke prevention in AF. The non-vitamin K oral anticoagulants (NOACs) are now available, and these drugs include the direct thrombin inhibitors and factor Xa inhibitors. The latter class includes edoxaban, which has recently been approved for stroke prevention in AF by the United States Food and Drug Administration and the...
Source: Expert Opinion on Pharmacotherapy - February 14, 2016 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

When a Single Antiplatelet Agent for Stroke Prevention Is Not Enough: Current Evidence and Future Applications of Dual Antiplatelet Therapy.
Abstract OPINION STATEMENT: For secondary stroke prevention, long-term dual antiplatelet therapy is not recommended due to increased bleeding risks. There is no specific evidence for using dual antiplatelet therapy for cervical artery dissection or for adding a second antiplatelet agent after a stroke while taking aspirin monotherapy. For patients with atrial fibrillation and stroke/TIA unable to tolerate warfarin, aspirin monotherapy is reasonable. Dual antiplatelet therapy carries a similar risk of major bleeding as warfarin that offsets reductions in stroke risk. Dual antiplatelet therapy is recommended for end...
Source: Atherosclerosis - February 27, 2016 Category: Cardiology Authors: Yuan K, Kim AS Tags: Curr Treat Options Cardiovasc Med Source Type: research

Challenges and Treatment for Stroke Prophylaxis in Patients with Atrial Fibrillation in Mexico: A Review
Abstract Atrial fibrillation (AF) is associated with an increased risk of stroke. AF-related strokes cause greater disability and mortality than those in patients without AF, and are associated with a significant clinical and economic burden in Mexico. Antithrombotic therapy reduces stroke risk in patients with AF and is recommended for all patients except those classified as having a low stroke risk. However, its use is suboptimal all around the world; one study showed that only 4 % of Mexican patients with AF who presented with ischemic stroke were in the therapeutic range for anticoagulation. Vitamin K antagon...
Source: American Journal of Cardiovascular Drugs - February 29, 2016 Category: Cardiology Source Type: research

Factors Influencing Oral Anticoagulant Prescribing Practices for Atrial Fibrillation among Cardiologists, Internists, and Vascular Neurologists (P1.227)
Conclusions: Medical specialties differ in their reasons for selecting NOACs over warfarin and in their use of aspirin with warfarin. Educational interventions may prevent misinterpretations of clinical trial results, particularly with regards to comparative efficacy in the prevention of ischemic stroke and intracerebral hemorrhage. Disclosure: Dr. Leung has nothing to disclose. Dr. Mcallister has nothing to disclose. Dr. Selim has nothing to disclose. Dr. Fisher has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Leung, L., Mcallister, M., Selim, M., Fisher, M. Tags: Cardiac Mechanisms and Complications of Stroke Source Type: research

Blood Pressure Control and Stroke or Bleeding Risk in Anticoagulated Patients with Atrial Fibrillation: Results from the ROCKET AF Trial
Conclusions In a trial of anticoagulated patients with AF, increasing screening SBP was independently associated with stroke and SE, and one-third of patients had uncontrolled hypertension. The relative effectiveness and safety of rivaroxaban versus warfarin was consistent across all levels of screening SBP. A single SBP may be an important factor in reducing the overall risk of stroke and SE in anticoagulated patients with AF.
Source: American Heart Journal - May 6, 2016 Category: Cardiology Source Type: research

An evidence-based review of edoxaban and its role in stroke prevention in patients with nonvalvular atrial fibrillation
Tushar Acharya, Prakash Deedwania Division of Cardiology, Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA Abstract: Atrial fibrillation is the most common arrhythmia in the elderly. It is responsible for significant morbidity and mortality from cardioembolic complications like stroke. As a result, atrial fibrillation patients are risk-stratified using the CHADS2 or CHA2DS2-VASc scoring systems. Those at intermediate-to-high risk have traditionally been treated with therapeutic anticoagulation with warfarin for stroke prevention. Although effective, warfarin use is fraught with mult...
Source: Core Evidence - April 27, 2015 Category: Drugs & Pharmacology Tags: Core Evidence Source Type: research

Failure of old and new anticoagulants to prevent ischemic stroke in high-risk atrial fibrillation: a case report.
We report the case of an elderly patient with permanent AF and coronary heart disease, who had already suffered an ischemic stroke while on warfarin treatment, and was consequently switched to treatment with an association of Rivaroxaban and Aspirin. Her CHA2DS2-VASc score was 9. The patient developed a severe recurrent disabling ischemic stroke. This case goes to show that the novel direct anticoagulants may fail to prevent recurrent stroke in patients at particularly high risk, even when associated with antiplatelet drugs. PMID: 27228488 [PubMed - as supplied by publisher]
Source: Minerva Cardioangiologica - May 27, 2016 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research

Newer Oral Anticoagulants: Stroke Prevention and Pitfalls.
Authors: Patel A, Goddeau RP, Henninger N Abstract Warfarin is very effective in preventing stroke in patients with atrial fibrillation. However, its use is limited due to fear of hemorrhagic complications, unpredictable anticoagulant effects related to multiple drug interactions and dietary restrictions, a narrow therapeutic window, frequent difficulty maintaining the anticoagulant effect within a narrow therapeutic window, and the need for inconvenient monitoring. Several newer oral anticoagulants have been approved for primary and secondary prevention of stroke in patients with non-valvular atrial fibrillation. ...
Source: Open Cardiovascular Medicine Journal - June 29, 2016 Category: Cardiology Tags: Open Cardiovasc Med J Source Type: research