Article
Medicine, General & Internal
Jennifer A. Rymer, Karen Chiswell, Lauren Young, Andy Chiu, Li Liu, Laura Webb, Matthew Carlisle, Daniel Friedman, Tracy Y. Wang
Summary: This study aimed to determine whether underdosing of DOACs is associated with longitudinal adherence to anticoagulation. The study found that a significant number of patients with nonvalvular atrial fibrillation received DOACs with doses that did not follow FDA labeling recommendations. This improper dosing was associated with worse renal function and less consistent long-term anticoagulation.
Review
Medicine, General & Internal
Fabiana Luca, Simona Giubilato, Stefania Angela Di Fusco, Laura Piccioni, Carmelo Massimiliano Rao, Annamaria Iorio, Laura Cipolletta, Emilia D'Elia, Sandro Gelsomino, Roberta Rossini, Furio Colivicchi, Michele Massimo Gulizia
Summary: The therapeutic dilemma between rhythm and rate control remains unresolved in the management of AF, with electrical or pharmacological cardioversion often being useful. Anticoagulation should be based on individual thromboembolic risk, with NOACs representing a significant advancement. Emergency ECV is necessary for hemodynamically unstable patients, with anticoagulation administered prior to CV.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Medicine, General & Internal
Gregory Y. H. Lip, Allison Keshishian, Yan Zhang, Amiee Kang, Amol D. Dhamane, Xuemei Luo, Christian Klem, Mauricio Ferri, Jenny Jiang, Huseyin Yuce, Steven Deitelzweig
Summary: In this study of patients with NVAF and high risk of GI bleed, NOACs were associated with lower rates of stroke and/or SE, but NOACs had varying risks of MB compared with warfarin. These results may help inform treatment options in this patient population.
Article
Oncology
Adam S. Potter, Ashley Patel, Muzamil Khawaja, Christopher Chen, Henry Zheng, Jessica Kaczmarek, Feng Gao, Kaveh Karimzad, Juhee Song, Efstratios Koutroumpakis, Shaden Khalaf, Cezar Iliescu, Anita Deswal, Nicolas L. Palaskas
Summary: Patients with active cancer treated with DOACs for NVAF have similar risks of stroke, intracranial hemorrhage, and gastrointestinal bleeding compared to those treated with warfarin.
JACC: CARDIOONCOLOGY
(2022)
Review
Medicine, General & Internal
Clara Bonanad, Sergio Garcia-Blas, Javier Torres Llergo, Rosa Fernandez-Olmo, Pablo Diez-Villanueva, Albert Ariza-Sole, Manuel Martinez-Selles, Sergio Raposeiras, Ana Ayesta, Vicente Bertomeu-Gonzalez, Francisco Tarazona Santabalbina, Lorenzo Facila, David Vivas, Ana Gabaldon-Perez, Vicente Bodi, Julio Nunez, Alberto Cordero
Summary: Our meta-analysis indicates that DOACs are more effective and safer than warfarin in patients with nonvalvular AF over the age of 80, showing statistical superiority in reducing stroke and all-cause mortality. Despite no significant reduction in major bleeding and gastrointestinal bleeding risk, DOACs were associated with a 43% decrease in intracranial bleeding risk compared to warfarin.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Federico Migliore, Rui Providencia, Michal M. Farkowski, Georghe Andrei Dan, Scherr Daniel, Tatjana S. Potpara, Kristine Jubele, Julian K. R. Chun, Carlo de Asmundis, Alessandro Zorzi, Serge Boveda
Summary: The survey results showed heterogeneity in anticoagulation management before and after cardioversion in low stroke-risk patients with atrial fibrillation duration <48 hours. Periprocedural low-molecular-weight heparin was used more than non-vitamin K antagonist oral anticoagulants, and there was higher utilization of pre-cardioversion transesophageal echocardiography for electrical cardioversion than for pharmacological cardioversion.
Article
Cardiac & Cardiovascular Systems
M. Jansson, S. Sjalander, V Sjogren, F. Bjorck, H. Renlund, B. Norrving, A. Sjalander
Summary: This study compared the effectiveness and safety of reduced-dose direct oral anticoagulants (DOACs) and high-quality warfarin treatment in nonvalvular atrial fibrillation patients. The findings showed that compared to warfarin, DOACs have lower risks of major bleeding and all-cause stroke, with the exception of rivaroxaban, which has a higher risk of major bleeding and a lower risk of stroke or systemic embolism. Therefore, in patients with indications for reduced-dose DOACs, they are the preferred treatment option.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2023)
Review
Pharmacology & Pharmacy
Adane Teshome Kefale, Gregory M. Peterson, Woldesellassie M. Bezabhe, Luke R. Bereznicki
Summary: Switching among oral anticoagulants is common in clinical practice, often related to safety concerns, poor anticoagulation control, and ease of use. Limited studies on reasons for switching and clinical outcomes show inconsistent results, requiring further prospective research to better understand potential rationales for switching and its impact.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2022)
Article
Health Care Sciences & Services
Yung-Chuan Huang, Yu-Chen Cheng, Mao-Jhen Jhou, Mingchih Chen, Chi-Jie Lu
Summary: Our study aims to develop an effective machine learning scheme to predict vascular events and bleeding in patients with nonvalvular atrial fibrillation taking dabigatran and identify important risk factors. The results show that random forest and extreme gradient boosting have better performance in predicting vascular events and bleeding.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Hematology
Shu Yang, Yanjuan Zhang, Ning Chen, Jiaojiao Shi, Weizhu Ju, Hongwu Chen, Gang Yang, Zidun Wang, Hailei Liu, Xiaohong Jiang, Chang Cui, Minglong Chen, Mingfang Li
Summary: A retrospective observational study was conducted to assess the prevalence and management of atrial thrombus in patients with nonvalvular atrial fibrillation (NVAF) and identify the risk factors of the nonresolution of atrial thrombus. The study included patients with NVAF and atrial thrombus detected using transesophageal echocardiography (TEE) or cardiac computed tomography angiography (CTA). The results showed a prevalence of 1.4% atrial thrombus in patients with NVAF, and congestive heart failure and a history of ischemic stroke were identified as independent risk factors for the nonresolution of atrial thrombus. The presence of atrial thrombus in NVAF patients receiving anticoagulation therapy should not be neglected, and additional TEE or cardiac CTA may be necessary.
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
(2023)
Article
Multidisciplinary Sciences
Junpei Koge, Hiroshi Yamagami, Kazunori Toyoda, Masahiro Yasaka, Teruyuki Hirano, Toshimitsu Hamasaki, Takehiko Nagao, Shinichi Yoshimura, Masahito Fujishige, Akira Tempaku, Shinichiro Uchiyama, Etsuro Mori, Masatoshi Koga, Kazuo Minematsu
Summary: This study investigated the factors related to early initiation of rivaroxaban and the differences in clinical outcomes of stroke patients with nonvalvular atrial fibrillation (NVAF) who underwent reperfusion therapy. The results showed that infarct size and successful reperfusion were associated with the timing of starting rivaroxaban. There were no significant differences in the rates of ischemic events and major bleeding between patients who started rivaroxaban < 72 hours and ≥72 hours after the index stroke.
Review
Cardiac & Cardiovascular Systems
Xuyang Liu, Shenghui Feng, Zhuohui Chen, Yue Zhou, Kang Yin, Zhengbiao Xue, Wengen Zhu
Summary: This study conducted a meta-analysis of participant data and found that compared to warfarin, direct oral anticoagulants (DOACs) can reduce the risk of new-onset diabetes in patients with atrial fibrillation (AF). This risk reduction effect was observed for the individual use of dabigatran, rivaroxaban, apixaban, and the combined use of rivaroxaban and apixaban. The risk reduction was seen in both male and female groups.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Medical Laboratory Technology
Raul Rigo-Bonnin, Elena Rossello-Palmer, Arnau Sanchez-Garcia, Mireia Pallares-Borras, Yurema Martinez, Sebastian Videla, Aurema Otero, Nuria Lloberas, Miguel Hueso
Summary: The study developed and validated a UHPLC-MS/MS method for measuring apixaban concentrations in plasma, dialysate liquid, and urine. The results suggest that this method could support pharmacokinetic studies of apixaban-based anticoagulant therapy in chronic kidney disease patients undergoing hemodialysis.
CLINICA CHIMICA ACTA
(2023)
Article
Urology & Nephrology
James B. Wetmore, Eric D. Weinhandl, Heng Yan, Jorge L. Reyes, Charles A. Herzog, Nicholas S. Roetker
Summary: In patients with nonvalvular atrial fibrillation undergoing dialysis, apixaban is associated with lower risk of bleeding and mortality compared to warfarin. However, there is no significant difference in bleeding risk between below-label apixaban dosing and label-concordant dosing.
AMERICAN JOURNAL OF KIDNEY DISEASES
(2022)
Article
Pharmacology & Pharmacy
Sukhdeep Bhogal, Kajal Mawa, Tarun Bhandari, Vijay Ramu
Summary: Uninterrupted use of novel oral anticoagulants is a safe and effective alternative for preventing cerebral thromboembolism and reducing major bleeding in patients undergoing catheter ablation of atrial fibrillation. Dabigatran is superior to vitamin K antagonists in reducing major adverse cardiac events, while rivaroxaban, apixaban, and edoxaban are non-inferior to VKA therapy.
AMERICAN JOURNAL OF THERAPEUTICS
(2022)
Article
Cardiac & Cardiovascular Systems
Renate B. Schnabel, Henning Witt, Jochen Walker, Marion Ludwig, Bastian Geelhoed, Nils Kossack, Marie Schild, Robert Miller, Paulus Kirchhof
Summary: This study used machine learning techniques to explore predictors of incident atrial fibrillation (AF) in German health claims data. The study found that using ICD-coded clinical variables can improve the identification of patients at risk of newly diagnosed AF. This can help target AF screening efforts to high-risk populations in primary care and stroke survivors.
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2023)
Article
Cardiac & Cardiovascular Systems
Renate B. Schnabel, Elena Andreassi Marinelli, Elena Arbelo, Giuseppe Boriani, Serge Boveda, Claire M. Buckley, A. John Camm, Barbara Casadei, Winnie Chua, Nikolaos Dagres, Mirko de Melis, Lien Desteghe, Soren Zoga Diederichsen, David Duncker, Lars Eckardt, Christoph Eisert, Daniel Engler, Larissa Fabritz, Ben Freedman, Ludovic Gillet, Andreas Goette, Eduard Guasch, Jesper Hastrup Svendsen, Stephane N. Hatem, Karl Georg Haeusler, Jeff S. Healey, Hein Heidbuchel, Gerhard Hindricks, F. D. Richard Hobbs, Thomas Huebner, Dipak Kotecha, Michael Krekler, Christophe Leclercq, Thorsten Lewalter, Honghuang Lin, Dominik Linz, Gregory Y. H. Lip, Maja Lisa Lochen, Wim Lucassen, Katarzyna Malaczynska-Rajpold, Steffen Massberg, Jose L. Merino, Ralf Meyer, Lluis Mont, Michael C. Myers, Lis Neubeck, Teemu Niiranen, Michael Oeff, Jonas Oldgren, Tatjana S. Potpara, George Psaroudakis, Helmut Purerfellner, Ursula Ravens, Michiel Rienstra, Lena Rivard, Daniel Scherr, Ulrich Schotten, Dipen Shah, Moritz F. Sinner, Rudiger Smolnik, Gerhard Steinbeck, Daniel Steven, Emma Svennberg, Dierk Thomas, Mellanie True Hills, Isabelle C. van Gelder, Burcu Vardar, Elena Pala, Reza Wakili, Karl Wegscheider, Mattias Wieloch, Stephan Willems, Henning Witt, Andre Ziegler, Matthias Daniel Zink, Paulus Kirchhof
Summary: This article summarizes the key outcomes of the 8th AFNET/EHRA Consensus Conference, which was held in Hamburg in October 2021 and attended by 83 international experts. The consensus paper highlights new evidence-based approaches to improve care for patients with atrial fibrillation (AF), including population-based screening, evolving management strategies, atrial cardiomyopathy characterization, cognitive function assessment, and the role of artificial intelligence (AI).
Editorial Material
Cardiac & Cardiovascular Systems
Stefan Kaab, Hilma Holm, Paulus Kirchhof
Summary: This editorial discusses the study by Marston NA et al., which shows that a polygenic risk score can predict atrial fibrillation in cardiovascular disease.
EUROPEAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Nina Fluschnik, Enver Tahir, Jennifer Erley, Kai Muellerleile, Andreas Metzner, Jan-Per Wenzel, Helena Guerreiro, Gerhard Adam, Stefan Blankenberg, Paulus Kirchhof, Tobias Toennis, Julius Nikorowitsch
Summary: Pending verification in independent series, clinically indicated MRI scans at 3T field strength should not be withheld from patients with cardiac pacemakers or defibrillators, as our data suggest that it is safe and does not result in adverse events in most cases.
Article
Cardiac & Cardiovascular Systems
Molly O'Reilly, Laura C. Sommerfeld, C. O'Shea, S. Broadway-Stringer, S. Andaleeb, J. S. Reyat, S. N. Kabir, D. Stastny, A. Malinova, D. Delbue, L. Fortmueller, K. Gehmlich, D. Pavlovic, B. Skryabin, A. P. Holmes, P. Kirchhof, L. Fabritz
Summary: This study found that the point mutation M1875T in the SCN5A gene is associated with familial AF. A new mouse model was used to show that this mutation causes gain-of-function of the cardiac sodium channel, resulting in increased atrial excitability.
Editorial Material
Cardiac & Cardiovascular Systems
Andreas Metzner, Paulus Kirchhof
EUROPEAN HEART JOURNAL
(2023)
Article
Medicine, General & Internal
Tze-Fan Chao, Martin Unverdorben, Paulus Kirchhof, Yukihiro Koretsune, Takeshi Yamashita, Robert A. Crozier, Ladislav Pecen, Cathy Chen, Amanda P. Borrow, Raffaele De Caterina
Summary: Non-recommended dosing is common in non-vitamin K antagonist oral anticoagulant prescriptions, including edoxaban. Non-recommended dosing is more frequent near dose-reduction thresholds. Overdosed patients (60 mg) have lower rates of ischemic stroke and all-cause death compared to recommended 30 mg, while underdosed patients have higher all-cause death rates.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Christoph Kondziella, Nina Fluschnik, Jessica Weimann, Benedikt Schrage, Peter Moritz Becher, Felix Memenga, Alexander M. Bernhardt, Stefan Blankenberg, Hermann Reichenspurner, Paulus Kirchhof, Renate B. Schnabel, Christina Magnussen
Summary: This study aimed to investigate the impact of sex on selection for and outcomes after heart transplantation. It was found that male heart transplant recipients differed from females in terms of cardiac etiology, cardiovascular risk factors, and treatment. Even after adjusting for multiple factors, male heart transplant recipients still had a higher risk of cardiac allograft vasculopathy and malignancy.
Article
Clinical Neurology
Manuel C. Olma, Serdar Tuetuencue, Ulrike Grittner, Claudia Kunze, Muhammad Jawad-Ul-Qamar, Paulus Kirchhof, Joachim Roether, Goetz Thomalla, Roland Veltkamp, Ulrich Laufs, Darius G. Nabavi, Peter U. Heuschmann, Matthias Endres, Karl Georg Haeusler
Summary: Little is known about the extent and standardization of routine cardiac diagnostic work-up at certified stroke-units in Germany. This study analyzed the routine diagnostic work-up at different stroke centres in Germany and found that detection of atrial fibrillation (AF) varied among the centres, with lower detection rates in university-based comprehensive stroke centres compared to non-university-based and primary stroke centres. The use of echocardiography and Holter-ECG monitoring also differed among the centres.
NEUROLOGICAL RESEARCH AND PRACTICE
(2023)
Article
Cardiac & Cardiovascular Systems
Ilaria My, Marc D. Lemoine, Mahi Butt, Celine Mencke, Fabian W. Loeck, Julius Obergassel, Laura Rottner, Jan-Per Wenzel, Ruben Schleberger, Julia Moser, Fabian Moser, Paulus Kirchhof, Bruno Reissmann, Feifan Ouyang, Andreas Rillig, Andreas Metzner
Summary: This study compared the acute lesion extent after pulmonary vein isolation (PVI) induced by pulsed-field ablation (PFA) and multielectrode radiofrequency balloon (RFB). The results showed that PFA resulted in larger ablation areas and higher release of cardiac injury biomarkers compared to RFB.
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
(2023)
Article
Physiology
Simon P. Wells, Antonia J. A. Raaijmakers, Claire L. Curl, Christopher O'Shea, Sarah Hayes, Kimberley M. Mellor, Jonathan M. Kalman, Paulus Kirchhof, Davor Pavlovic, Lea M. D. Delbridge, James R. Bell
Summary: This study demonstrates that the transmural conduction gradient in rat ventricular slices is abolished when there is increased pericardial adiposity, with slowed epicardial conduction correlating with an increase in cardiomyocyte lipid content. This gradient is important in reducing vulnerability to arrhythmias, and its absence due to conduction slowing and cardiomyocyte lipid accumulation suggests a novel mechanism by which pericardial adiposity may exacerbate ventricular arrhythmias.
JOURNAL OF GENERAL PHYSIOLOGY
(2023)
Article
Medicine, Research & Experimental
Julia Krause, Alexander Nickel, Alexandra Madsen, Hamish M. Aitken-Buck, A. M. Stella Stoter, Jessica Schrapers, Francisco Ojeda, Kira Geiger, Melanie Kern, Michael Kohlhaas, Edoardo Bertero, Patrick Hofmockel, Florian Huebner, Ines Assum, Matthias Heinig, Christian Mueller, Arne Hansen, Tobias Krause, Deung-Dae Park, Steffen Just, Dylan Aissi, Daniela Boernigen, Diana Lindner, Nele Friedrich, Khaled Alhussini, Constanze Bening, Renate B. Schnabel, Mahir Karakas, Licia Iacoviello, Veikko Salomaa, Allan Linneberg, Hugh Tunstall-Pedoe, Kari Kuulasmaa, Paulus Kirchhof, Stefan Blankenberg, Torsten Christ, Thomas Eschenhagen, Regis R. Lamberts, Christoph Maack, Justus Stenzig, Tanja Zeller
Summary: Long-chain acyl-carnitines, specifically C18:1AC, have been found to be potential arrhythmogenic metabolites. This metabolite has biphasic effects on cardiac electrophysiology and metabolism, and has the potential to serve as a circulating biomarker for predicting risk of atrial fibrillation.
JOURNAL OF TRANSLATIONAL MEDICINE
(2023)
Article
Medicine, General & Internal
Felix Memenga, Meike Rybczynski, Christina Magnussen, Alina Gossling, Christoph Kondziella, Nina Becher, Peter Moritz Becher, Julia Bernadyn, Filip Berisha, Wiebke Bremer, Christoph Sinning, Stefan Blankenberg, Paulus Kirchhof, Dorit Knappe
Summary: This study analyzes the impact of heart rate-reducing drugs on the prognosis of heart failure patients and finds a correlation between heart rate reduction and improved survival. However, no specific drug regimen was identified to have a particular effect.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Multidisciplinary Sciences
Winnie Chua, Victor R. Cardoso, Eduard Guasch, Moritz F. Sinner, Christoph Al-Taie, Paul Brady, Barbara Casadei, Harry J. G. M. Crijns, Elton A. M. P. Dudink, Stephane N. Hatem, Stefan Kaeaeb, Peter Kastner, Lluis Mont, Frantisek Nehaj, Yanish Purmah, Jasmeet S. Reyat, Ulrich Schotten, Laura C. Sommerfeld, Stef Zeemering, Andre Ziegler, Georgios V. Gkoutos, Paulus Kirchhof, Larissa Fabritz
Summary: Early detection of atrial fibrillation through the measurement of circulating biomarkers can reduce the risk of stroke, cardiovascular death, and heart failure.
SCIENTIFIC REPORTS
(2023)
Article
Hematology
Fawaz O. Alenazy, Maan H. Harbi, Dean P. Kavanagh, Joshua Price, Paul Brady, Oscar Hargreaves, Paul Harrison, Alexandre Slater, Alok Tiwari, Phillip L. R. Nicolson, Derek L. Connolly, Paulus Kirchhof, Neena Kalia, Martine Jandrot-Perrus, Pierre H. Mangin, Steve P. Watson, Mark R. Thomas
Summary: This study investigated the additional antithrombotic effects of combining glenzocimab, a GPVI inhibitor, with aspirin and ticagrelor. The results showed that glenzocimab enhanced platelet inhibition and reduced atherosclerotic plaque-induced platelet aggregation, adhesion, and activation. Compared to a GPIIb/IIIa inhibitor, glenzocimab exhibited similar antithrombotic effects but with less inhibition of general hemostasis.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)