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Acute Management of Stroke Patients Taking Non-vitamin K Antagonist Oral Anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and Rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - August 26, 2016 Category: Cardiology Source Type: research

Acute management of stroke patients taking non –vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - September 23, 2016 Category: Cardiology Source Type: research

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Two-year follow-up of patients treated with dabigatran for stroke prevention in atrial fibrillation: GLORIA-AF Registry
Conclusions These global data confirm the sustained safety and effectiveness of dabigatran over 2years of follow-up, consistent with the results from clinical trials as well as contemporary real-world studies. WHAT IS KNOWN • Non- vitamin K antagonist (VKA) anticoagulants (NOACs) are the preferred therapy for prevention of ischemic stroke based on phase 3 trials, but there is insufficient information on their efficacy and safety in daily practice, based on prospectively collected data WHAT IS NEW • This study shows that in non-valvular AF patient population, with up to 2years of follow-up, the use of dabigatran led to ...
Source: American Heart Journal - September 1, 2017 Category: Cardiology 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

Four-year trends in oral anticoagulant use and declining rates of ischemic stroke among 194,030 atrial fibrillation patients drawn from a sample of 12 million people
ConclusionThere was a slight increase in the prevalence of AF between 2012 and 2015, while the overall use of antiplatelet agents decreased and that of OAC, particularly DOACs, increased. Over the same period, 1 year hospitalizations for ischemic stroke declined substantially, with a declining rate of hemorrhagic strokes.
Source: American Heart Journal - November 9, 2019 Category: Cardiology Source Type: research

Predictors of NOAC versus VKA use for stroke prevention in patients with newly diagnosed atrial fibrillation: Results from GARFIELD-AF
ConclusionGARFIELD-AF data highlights marked heterogeneity in stroke prevention strategies globally. Physicians are adopting an individualized approach to stroke prevention where NOACs are favored in patients with a lower stroke risk, but also in the elderly and patients with ACS.
Source: American Heart Journal - April 11, 2019 Category: Cardiology Source Type: research

Clinical events after transitioning from apixaban versus warfarin to warfarin at the end of the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial
Conclusions The excess in thrombotic and bleeding events in the apixaban group after study drug discontinuation appears to be related to an increased risk associated with the initiation of a VKA rather than a direct effect of apixaban. Whether ≥2 days of apixaban bridging improves outcomes during VKA transition is unknown and deserves further evaluation.
Source: American Heart Journal - December 9, 2014 Category: Cardiology Source Type: research

International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD, ORBIT-AF I, and ORBIT-AF II Registries
Conclusions Among new-onset AF patients, NOAC use has increased and antiplatelet monotherapy has decreased. However, anticoagulation is used frequently in low-risk patients and inconsistently in those at high-risk of stroke. Significant geographic variability in anticoagulation persists and represents an opportunity for improvement.
Source: American Heart Journal - August 24, 2017 Category: Cardiology Source Type: research

Design and rationale of Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation: A global registry program on long-term oral antithrombotic treatment in patients with atrial fibrillation
Conclusions: Novel features of this registry program will add data from clinical practice to those from randomized trials to expand knowledge of antithrombotic treatment in patients with AF.
Source: American Heart Journal - December 23, 2013 Category: Cardiology Authors: Menno V. Huisman, Gregory Y.H. Lip, Hans C. Diener, Sergio J. Dubner, Jonathan L. Halperin, Chang S. Ma, Kenneth J. Rothman, Christine Teutsch, Kristina Zint, Diana Ackermann, Andreas Clemens, Dorothee B. Bartels Tags: Trial Design Source Type: research

Systemic, non-cerebral, arterial embolism in 21,105 patients with atrial fibrillation randomized to edoxaban or warfarin: Results from the ENGAGE AF-TIMI 48 trial
Conclusion Although considerably less frequent than stroke, systemic embolism is associated with significant morbidity and mortality in patients with AF. While the overall number of events was too small to show a significant difference in the risk of SEE between edoxaban and warfarin, a meta-analysis of all the NOAC trials demonstrates that NOACs significantly reduce the risk of SEE compared with warfarin.
Source: American Heart Journal - July 30, 2015 Category: Cardiology Source Type: research

Systemic, noncerebral, arterial embolism in 21,105 patients with atrial fibrillation randomized to edoxaban or warfarin: Results from the Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction Study 48 trial
Conclusion Although considerably less frequent than stroke, systemic embolism is associated with significant morbidity and mortality in patients with AF. Although the overall number of events was too small to show a significant difference in the risk of SEE between edoxaban and warfarin, a meta-analysis of all the NOAC trials demonstrates that NOACs significantly reduce the risk of SEE compared with warfarin.
Source: American Heart Journal - August 6, 2015 Category: Cardiology Source Type: research

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