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Total 120 results found since Jan 2013.

Atrial Fibrillation Patients Treated With Long-Term Warfarin Anticoagulation Have Higher Rates of All Dementia Types Compared With Patients Receiving Long-Term Warfarin for Other Indications Cardiovascular Surgery
BackgroundThe mechanisms behind the association of atrial fibrillation (AF) and dementia are unknown. We previously found a significantly increased risk of dementia in AF patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which AF itself increases dementia risk, in addition to long‐term anticoagulation exposure.Methods and ResultsA total of 10 537 patients anticoagulated with warfarin (target INR 2–3), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included. Warfarin indication was for AF (n=...
Source: JAHA:Journal of the American Heart Association - July 10, 2016 Category: Cardiology Authors: Bunch, T. J., May, H. T., Bair, T. L., Crandall, B. G., Cutler, M. J., Day, J. D., Jacobs, V., Mallender, C., Osborn, J. S., Stevens, S. M., Weiss, J. P., Woller, S. C. Tags: Arrhythmias, Electrophysiology, Atrial Fibrillation Original Research Source Type: research

Factors influencing quality of anticoagulation control and warfarin dosage in patients after aortic valve replacement within the 3 months of follow up.
Abstract Warfarin dosage estimation using the pharmacogenetic algorithms has been shown to improve the quality of anticoagulation control in patients with atrial fibrillation. We sought to assess the genetic, demographic and clinical factors that determine the quality of anticoagulation in patients following aortic valve replacement (AVR). We studied 200 consecutive patients (130 men) aged 63 ± 12.3 years, undergoing AVR, in whom warfarin dose was established using a pharmacogenetic algorithm. The quality of anticoagulation within the first 3 months since surgery was expressed as the time of international normali...
Source: J Physiol Pharmacol - May 31, 2016 Category: Drugs & Pharmacology Authors: Wypasek E, Mazur P, Bochenek M, Awsiuk M, Grudzien G, Plincer D, Undas A Tags: J Physiol Pharmacol Source Type: research

Safety and Use of Anticoagulation After Aortic Valve Replacement With Bioprostheses: A Meta-Analysis Original Articles
Conclusions— Contrary to the current guidelines, a meta-analysis of previous studies suggests that anticoagulation in the setting of an aortic bioprosthesis significantly increases bleeding risk without a favorable effect on thromboembolic events. Larger, randomized controlled studies should be performed to further guide this clinical practice.
Source: Circulation: Cardiovascular Quality and Outcomes - May 16, 2016 Category: Cardiology Authors: Riaz, H., Alansari, S. A. R., Khan, M. S., Riaz, T., Raza, S., Luni, F. K., Khan, A. R., Riaz, I. B., Krasuski, R. A. Tags: Anticoagulants, Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Original Articles Source Type: research

Dabigatran Versus Warfarin After Bioprosthesis Valve Replacement for the Management of Atrial Fibrillation Postoperatively: DAWA Pilot Study
Conclusions The use of dabigatran appears to be similar to warfarin in preventing the formation of intracardiac thrombus. Trial Registration Clinicaltrials.gov NCT01868243.
Source: Drugs in R&D - February 18, 2016 Category: Drugs & Pharmacology Source Type: research

Transient ischemic attack during smoking: The thrombotic state of erythrocytes and platelets illustrated visually.
Abstract Transient ischemic attack (TIA) is an important predictor of future ischemic events, including stroke. Due to the typically brief period of neurologic dysfunction, patients often overlook the importance of reporting a TIA. We have recently shown that platelet activation plays an important role in TIA pathology. In a similar vein, smoking is associated with a hypercoagulable state and is also one of the important risk factors for stroke. Here we present an interesting case where a 61-year-old male, with hypercholesterolemia, and a previous heart valve replacement, developed a TIA 5 months after he started ...
Source: Ultrastructural Pathology - December 21, 2015 Category: Pathology Authors: Bester J, van Rooy MJ, Mbotwe S, Duim W, Pretorius E Tags: Ultrastruct Pathol Source Type: research

Cochrane corner: vitamin K for improved anticoagulation control in patients receiving warfarin
There has been a substantial increase in the use of oral anticoagulants, notably in the ageing population. This is primarily driven by the use of warfarin in people with atrial fibrillation (AF) in order to reduce the risks of thromboembolic events such as stroke.1 In elderly patients with AF, warfarin use has been shown to reduce the relative risk of stroke by >50% compared with aspirin alone.2 Warfarin is also used to treat patients with deep vein thrombosis, mechanical heart valve replacement, cardioversion, cardiomyopathy and antiphospholipid syndrome.1 The clinical benefits of warfarin must also be balanced with po...
Source: Heart - October 11, 2015 Category: Cardiology Authors: Mahtani, K. R., Nunan, D., Heneghan, C. Tags: Drugs: cardiovascular system, Cochrane Corner, Venous thromboembolism, Epidemiology Editorials Source Type: research

How to define valvular atrial fibrillation?
Abstract Atrial fibrillation (AF) confers a substantial risk of stroke. Recent trials comparing vitamin K antagonists (VKAs) with non-vitamin K antagonist oral anticoagulants (NOACs) in AF were performed among patients with so-called "non-valvular" AF. The distinction between "valvular" and "non-valvular" AF remains a matter of debate. Currently, "valvular AF" refers to patients with mitral stenosis or artificial heart valves (and valve repair in North American guidelines only), and should be treated with VKAs. Valvular heart diseases, such as mitral regurgitation, aortic stenosis (AS) and aortic insufficiency, do...
Source: Archives of Cardiovascular Diseases - July 13, 2015 Category: Cardiology Authors: Fauchier L, Philippart R, Clementy N, Bourguignon T, Angoulvant D, Ivanes F, Babuty D, Bernard A Tags: Arch Cardiovasc Dis Source Type: research

Apixaban Compared with Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: Findings From the ARISTOTLE Trial.
CONCLUSIONS: -More than a quarter of the patients in ARISTOTLE with "nonvalvular" atrial fibrillation had moderate or severe valvular heart disease. There was no evidence of a differential effect of apixaban over warfarin in reducing stroke or systemic embolism, causing less bleeding, and reducing death in patients with and without valvular heart disease. Clinical Trial Registration Information-clinicaltrials.gov. Identifier: NCT00412984. PMID: 26106009 [PubMed - as supplied by publisher]
Source: Circulation - June 23, 2015 Category: Cardiology Authors: Avezum A, Lopes RD, Schulte PJ, Lanas F, Gersh BJ, Hanna M, Pais P, Erol C, Diaz R, Bahit MC, Bartunek J, De Caterina R, Goto S, Ruzyllo W, Zhu J, Granger CB, Alexander JH Tags: Circulation Source Type: research

Abstract 234: Comparison of Hospital Length of Stay and Costs between Non-valvular Atrial Fibrillation Patients Treated with Either Apixaban or Warfarin Session Title: Poster Session II
Conclusions: NVAF patients treated with apixaban had significantly shorter hospital LOS and lower index hospitalization costs compared to those treated with warfarin. Costs remained significantly lower for apixaban patients across all CHADS2 scores.
Source: Circulation: Cardiovascular Quality and Outcomes - April 29, 2015 Category: Cardiology Authors: Xie, L., Vo, L., Keshishian, A., Price, K., Singh, P., Mardekian, J., Bruno, A., Baser, O., Kim, J., Tan, W., Trocio, J. Tags: Session Title: Poster Session II Source Type: research

Patients’ time in therapeutic range on warfarin among US patients with atrial fibrillation: Results from ORBIT-AF registry
Conclusions Among patients with AF in US clinical practices, TTR on warfarin is suboptimal, and those at highest predicted risks for stroke and bleeding were least likely to be in therapeutic range.
Source: American Heart Journal - April 23, 2015 Category: Cardiology Source Type: research

Patients’ Time in Therapeutic Range on Warfarin Among U.S. Atrial Fibrillation Patients: Results from ORBIT-AF Registry
Conclusions Among AF patients in US clinical practices, TTR on warfarin is suboptimal and those at highest predicted risks for stroke and bleeding were least likely to be in therapeutic range.
Source: American Heart Journal - April 3, 2015 Category: Cardiology Source Type: research

The Left Atrial Appendage: Target for Stroke Reduction in Atrial Fibrillation.
Abstract A patient with atrial fibrillation (AF) has a greater than 5% annual risk of major stroke, a 5-fold increase compared to the general population. While anticoagulation remains the standard stroke prevention strategy, the nature of lifelong anticoagulation inevitably carries an increased risk of bleeding, increased stroke during periods of interruption, increased cost, and significant lifestyle modification. Many patients with atrial fibrillation have had their left atrial appendage (LAA) ligated or excised by surgeons during cardiac surgery, a decision based largely on intuition and with no clear evidence ...
Source: Methodist DeBakey Cardiovascular Journal - April 1, 2015 Category: Cardiology Authors: Ramlawi B, Abu Saleh WK, Edgerton J Tags: Methodist Debakey Cardiovasc J Source Type: research

Simultaneous Carotid Artery Stenting and Heart Surgery: Expanded Experience of Hybrid Surgical Procedures
Conclusions Same-day hybrid approach appeared safe in terms of early and long-term results not only for CAS and isolated CABG but also for CAS and noncoronary isolated procedures. In complex cases, the rate of stroke and myocardial infarction seemed low; in-hospital mortality, as expected, was higher. Long-term survival appeared similarly satisfactory, thus confirming the hybrid approach as a valid therapeutic option for all patients with significant internal carotid artery stenosis associated with coronary and other cardiac lesions, at least for noncomplex cases.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Changing practice of anticoagulation: will target-specific anticoagulants replace warfarin?
Abstract The target-specific oral anticoagulants are a class of agents that inhibit factor Xa or thrombin. They are effective and safe compared to warfarin for the prevention of stroke and systemic embolism in patients with atrial fibrillation and for the treatment of venous thromboembolism, and they are comparable to low-molecular-weight heparin for thromboprophylaxis after hip or knee arthroplasty. For other indications, however, such as the prevention of stroke in patients with mechanical heart valves, initial studies have been unfavorable for the newer agents, leaving warfarin the anticoagulant of choice. Furt...
Source: Annual Review of Medicine - January 14, 2015 Category: Journals (General) Authors: Arepally GM, Ortel TL Tags: Annu Rev Med Source Type: research

Postoperative warfarin following mitral valve repair or bioprosthetic valve replacement.
CONCLUSION: The use of postoperative warfarin following MVR does not reduce the incidence of stroke at early follow up. However, there remains a trend for improved long-term outcomes in those patients receiving postoperative warfarin therapy. PMID: 24383387 [PubMed - indexed for MEDLINE]
Source: Journal of Heart Valve Disease - December 1, 2014 Category: Cardiology Tags: J Heart Valve Dis Source Type: research