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Condition: Atrial Fibrillation
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Total 2092 results found since Jan 2013.

What do the guidelines suggest for non-vitamin K antagonist oral anticoagulant use for stroke prevention in atrial fibrillation?
This article provides an overview of the current international guidelines with regard to NOAC use and highlights key areas by which emerging evidence may change the management of stroke prevention in patients with non-valvular AF.
Source: European Journal of Heart Failure Supplements - December 21, 2016 Category: Cardiology Authors: Shahid, F., Shantsila, E., Lip, G. Y. H. Tags: Articles Source Type: research

To occlude or not? Left atrial appendage occlusion for stroke prevention in atrial fibrillation
The cornerstone of atrial fibrillation (AF) management is effective stroke prevention, which by now remains the only proven method of improved survival in patients with AF. Oral anticoagulation with the use of vitamin K antagonists (eg, warfarin) or non-vitamin K antagonist oral anticoagulants (NOACs) has been shown to substantially reduce the risk of AF-related strokes and thus is presently the standard of care for stroke prevention in non-valvular AF. Approximately 90% of thrombi being formed in AF are localised in left atrial appendage (LAA).1 Thus, LAA exclusion seems a tempting method of prophylaxis against stroke, pa...
Source: Heart - January 4, 2017 Category: Cardiology Authors: Mazurek, M., Lip, G. Y. H. Tags: Drugs: cardiovascular system, Epidemiology Editorials Source Type: research

Oral anticoagulation for stroke prevention amongst atrial fibrillation patients with valvular heart disease: an update
This article will review current knowledge, areas of uncertainty and controversy, and ongoing research on oral anticoagulation for stroke prevention amongst patients with valvular heart disease. Recent findings: The rates of stroke, systemic embolism, and major bleeding were similar for patients with and without significant native valvular disease when treated with direct oral anticoagulants (DOACs) or vitamin K antagonists. There are very limited prospective data on the safety and efficacy of DOAC use for patients with bioprosthetic valves or rheumatic mitral stenosis. Summary: Atrial fibrillation patients with concomit...
Source: Current Opinion in Cardiology - February 10, 2017 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma Source Type: research

Quality of warfarin therapy and risk of stroke, bleeding, and mortality among patients with atrial fibrillation: results from the nationwide FinWAF Registry
ConclusionsThe quality of warfarin treatment was strongly associated with the risk of stroke and the prognosis of AF patients. Patient outcomes continued to improve with increasing TTR values up to a TTR ≥80%; therefore, the target for the TTR should exceed 80% instead of the traditional range of at least 60–70%. Copyright © 2017 John Wiley & Sons, Ltd.
Source: Pharmacoepidemiology and Drug Safety - February 28, 2017 Category: Drugs & Pharmacology Authors: Mika Lehto, Jussi Niiranen, Pasi Korhonen, Juha Meht älä, Houssem Khanfir, Fabian Hoti, Riitta Lassila, Pekka Raatikainen Tags: Original Report Source Type: research

Is There an Obesity Paradox for Outcomes in Atrial Fibrillation? Clinical Sciences
Conclusions—There may be an obesity paradox in atrial fibrillation patients, particularly for all-cause and cardiovascular death outcomes. An obesity paradox was also evident for stroke/systemic embolic event outcome in NOAC trials, with a treatment effect favoring NOACs over warfarin for both efficacy and safety that was significant only for normal weight patients.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Marco Proietti, Elisa Guiducci, Paola Cheli, Gregory Y.H. Lip Tags: Catheter Ablation and Implantable Cardioverter-Defibrillator, Obesity, Anticoagulants, Quality and Outcomes Original Contributions Source Type: research

CHADS2 risk score and rate of stroke or systemic embolism and major bleeding in patients with non-valvular atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants.
Authors: VAN Mieghem W, Lancellotti P Abstract Randomized trials showed non-inferior or superior results of the non-vitamin K antagonist oral anticoagulants (NOACs) compared with warfarin in patients with non-valvular atrial fibrillation (AF). Despite the absence of direct head-to-head comparisons between the different NOACs, certain molecules have been proposed for subgroups of patients based mainly on the perception of different bleeding risks. The CHADS2 score has been uniformly used in the inclusion criteria of these studies and shared similar risk factors as the haemorrhagic risk score HAS-BLED. The aim of the...
Source: Acta Cardiologica - July 8, 2017 Category: Cardiology Tags: Acta Cardiol Source Type: research

Pharmacological stroke prevention in the elderly with atrial fibrillation in Poland – Results of PolSenior study
Conclusions The study was unique to determine the frequency of pharmacological stroke prevention among elderly people with AF in Poland. It occurred that oral anticoagulant drugs were applied too rarely in this group of patients. Educational programs should be developed among general practitioners concerning current recommendations for patients with AF.
Source: Polish Journal of Neurology and Neurosurgery - July 12, 2017 Category: Neurosurgery Source Type: research

Standard and reduced doses of dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study
ConclusionsStandard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban, and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban.This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 1, 2017 Category: Internal Medicine Authors: Laila Staerk, Thomas A Gerds, Gregory Y H Lip, Brice Ozenne, Anders N Bonde, Morten Lamberts, Emil L Fosb øl, Christian Torp‐Pedersen, Gunnar H Gislason, Jonas B Olesen Tags: Original Article Source Type: research

DVT Prevention in Stroke
AbstractPurpose of ReviewThe purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention.Recent FindingsWarfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades. More recently, NOACs have become available for both stroke and systemic embolism prevention in n...
Source: Current Neurology and Neuroscience Reports - September 18, 2017 Category: Neuroscience Source Type: research

Standard and reduced doses of dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study
ConclusionsStandard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban.
Source: Journal of Internal Medicine - September 21, 2017 Category: Internal Medicine Authors: L. Staerk, T. A. Gerds, G. Y. H. Lip, B. Ozenne, A. N. Bonde, M. Lamberts, E. L. Fosb øl, C. Torp‐Pedersen, G. H. Gislason, J. B. Olesen Tags: Original Article Source Type: research

Apixaban in the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation in France: Rationale and design of the PAROS cross-sectional study.
CONCLUSION: The PAROS study will provide real-life data on the characteristics of NVAF patients and their anticoagulant prescription in France. PMID: 29191525 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - November 27, 2017 Category: Cardiology Authors: Picard F, Ducrocq G, Danchin N, Falissard B, Hanon O, Mahe I, Touzé E, Steg PG Tags: Arch Cardiovasc Dis Source Type: research

Challenges in comparing the non-vitamin K antagonist oral anticoagulants for atrial fibrillation-related stroke prevention
AbstractThe aim of this review is to provide context for meta-analyses interpreting data from phase III stroke prevention studies of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (NVAF). Differences between the four phase III NOAC stroke prevention studies in patients with NVAF (ROCKET AF, ARISTOTLE, RE-LY, and ENGAGE AF), their potential impact on outcomes, and inter-study differences were evaluated, as well as the potential role of real-world evidence in evaluating NOACs in this setting. Study design differences included blinding strategy, dose-reduction options, a...
Source: Europace - October 13, 2017 Category: Cardiology Source Type: research

Reversal of dabigatran using idarucizumab: single center experience in four acute stroke patients
AbstractDabigatran is a direct thrombin inhibitor and a non-vitamin-K-antagonizing oral anticoagulant, approved for the prevention of stroke and systemic embolization in atrial fibrillation. Idarucizumab is a humanized monoclonal antibody that was recently approved for antagonizing the anticoagulant effects of dabigatran. Here, we report the use of idarucizumab in four acute stroke patients treated with dabigatran in order to enable intravenous thrombolysis in three patients and emergent trepanation in one patient with space occupying subdural hematoma. Since experience on the optimal management of acute stroke patients un...
Source: Journal of Thrombosis and Thrombolysis - April 9, 2018 Category: Hematology Source Type: research

Resumption of oral anticoagulation following traumatic injury and risk of stroke and bleeding in patients with atrial fibrillation: a nationwide cohort study
ConclusionAF patients resuming VKA and NOAC treatment following traumatic injury have lower hazard of all-cause mortality and ischaemic stroke, increased hazard of major bleeding but without additional hazards of recurrent traumatic injury. Withholding OAC following a traumatic injury in AF patients may not be warranted.
Source: European Heart Journal - November 18, 2017 Category: Cardiology Source Type: research

Comparative risks of bleeding, ischemic stroke and mortality with direct oral anticoagulants versus phenprocoumon in patients with atrial fibrillation
ConclusionsWith rivaroxaban, no significant differences were observed compared to phenprocoumon with regard to hospitalized bleedings or ischemic strokes. Dabigatran was associated with fewer bleedings and a similar risk of ischemic strokes compared to phenprocoumon. Apixaban was also associated with fewer bleedings but was unexpectedly associated with more ischemic strokes, possibly reflecting selective prescribing. The association of rivaroxaban with higher all-cause mortality unrelated to bleedings or strokes has been described previously but remains to be explained.
Source: European Journal of Clinical Pharmacology - June 16, 2018 Category: Drugs & Pharmacology Source Type: research