Article
Pharmacology & Pharmacy
Maxim Grymonprez, Tine L. L. De Backer, Xander Bertels, Stephane Steurbaut, Lies Lahousse
Summary: Although NOACs are recommended over VKAs in AF management, direct long-term head-to-head comparisons are lacking. This study investigates the risk-benefit profiles of NOACs compared to VKAs and between different NOACs.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Hematology
Maxim Grymonprez, Mirko Petrovic, Tine L. De Backer, Stephane Steurbaut, Lies Lahousse
Summary: Polypharmacy is associated with increased thromboembolic, bleeding, and mortality risks in atrial fibrillation (AF) patients. Non-vitamin K antagonist oral anticoagulants (NOACs) have better benefit-risk profiles than vitamin K antagonists (VKAs) in patients with polypharmacy, with lower stroke/systemic embolism, all-cause mortality, major bleeding, and intracranial bleeding risks, but higher gastrointestinal bleeding risks.
THROMBOSIS AND HAEMOSTASIS
(2023)
Editorial Material
Medicine, General & Internal
[Anonymous]
Summary: This interactive feature discusses screening for atrial fibrillation in asymptomatic older adults through a case vignette and two essays that present arguments for and against screening.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Wern Yew Ding, Dhiraj Gupta, Christopher F. Wong, Gregory Y. H. Lip
Summary: Atrial fibrillation and chronic kidney disease are closely related conditions with complex interlinking mechanisms, requiring careful management and treatment for patients with both diseases.
CARDIOVASCULAR RESEARCH
(2021)
Article
Hematology
Ichitaro Abe, Naohiko Takahashi, Yasushi Mukai, Tetsuya Kimura, Keita Yamaguchi, Atsushi Takita, Hideki Origasa, Ken Okumura
Summary: This study found that in Japanese patients with non-valvular atrial fibrillation receiving uninterrupted periprocedural edoxaban for catheter ablation, patients with higher HAS-BLED scores and lower creatinine clearance were more likely to experience bleeding events.
THROMBOSIS JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Maxim Grymonprez, Stephane Steurbaut, Andreas Capiau, Delphine Vauterin, Frauke Van Vaerenbergh, Els Mehuys, Koen Boussery, Tine L. De Backer, Lies Lahousse
Summary: Poor adherence to NOACs is associated with increased risks of thromboembolism and all-cause mortality. The minimal adherence threshold should be ≥ 90%, preferably even ≥ 95%.
CARDIOVASCULAR DRUGS AND THERAPY
(2023)
Article
Multidisciplinary Sciences
Noriko Tsuji, Yoshimitsu Takahashi, Michi Sakai, Shosuke Ohtera, Junji Kaneyama, Kosai Cho, Genta Kato, Shigeru Ohtsuru, Takeo Nakayama
Summary: The use of direct oral anticoagulants (DOACs) has significantly changed the treatment of anticoagulants in patients with non-valvular atrial fibrillation (Af). This study aimed to analyze the changes in anticoagulant prescriptions in Af patients aged >= 65 years, considering the risk of stroke and bleeding. The proportion of anticoagulant prescriptions increased from 41% in 2011 to 56% in 2015, accompanied by an increase in DOAC prescriptions and an increase in prescriptions for high-risk patients. The widespread use of DOACs has greatly impacted the prescription profile of anticoagulant therapy in Af patients.
SCIENTIFIC REPORTS
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Marco Vitolo, Deirdre A. Lane, Giuseppe Boriani, Gregory Y. H. Lip
Summary: This editorial discusses the associations between long-term persistence and adherence with non-vitamin K oral anticoagulants in patients with atrial fibrillation and stroke risk.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2021)
Article
Cardiac & Cardiovascular Systems
Vito A. Mannacio, Luigi Mannacio, Anita Antignano, Ciro Mauro, Pasquale Mastroroberto, Francesco Musumeci, Carlo Zebele, Gabriele Iannelli
Summary: NOACs are more effective than warfarin in preventing thromboembolic events and safer in reducing major bleeding events in patients who develop AF after bioprosthetic AVR.
ANNALS OF THORACIC SURGERY
(2022)
Article
Cardiac & Cardiovascular Systems
Stefan H. Hohnloser, A. John Camm, Riccardo Cappato, Hans-Christoph Diener, Hein Heidbuchel, Lluis Mont, Carlos A. Morillo, Hans-Joachim Lanz, Heiko Rauer, Paul-Egbert Reimitz, Ruediger Smolnik, Josef Kautzner
Summary: This post hoc analysis of ELIMINATE-AF evaluated the requirements of unfractionated heparin (UFH) and procedure-related bleeding in atrial fibrillation (AF) patients undergoing ablation with uninterrupted edoxaban or vitamin K antagonist (VKA) therapy. The study found that despite higher doses of UFH used with edoxaban vs. VKA to achieve a target ACT during AF ablation, the rate of procedure-related major/clinically relevant non-major bleeding did not differ between the treatment arms.
Article
Medicine, General & Internal
Anders Holt, Jarl E. Strange, Peter Vibe Rasmussen, Paul Blanche, Nina Nouhravesh, Mads Hashiba Jensen, Anne-Marie Schjerning, Morten Schou, Christian Torp-Pedersen, Gunnar H. Gislason, Morten Lock Hansen, Patricia McGettigan, Morten Lamberts
Summary: This study investigated the association between the use of systemic fluconazole and topical azoles with bleeding incidents in patients with atrial fibrillation. The results showed an increased risk of bleeding in patients on apixaban who were exposed to systemic fluconazole, while no increased risk was found with topical azole exposure.
AMERICAN JOURNAL OF MEDICINE
(2022)
Review
Hematology
Diana A. Gorog, Ying X. Gue, Tze-Fan Chao, Laurent Fauchier, Jose Luis Ferreiro, Kurt Huber, Stavros V. Konstantinidis, Deirdre A. Lane, Francisco Marin, Jonas Oldgren, Tatjana Potpara, Vanessa Roldan, Andrea Rubboli, Dirk Sibbing, Hung-Fat Tse, Gemma Vilahur, Gregory Y. H. Lip
Summary: This article summarizes the consensus on bleeding risk assessments in patients with atrial fibrillation (AF) and venous thromboembolism (VTE), including bleeding risk factors, definitions, and the consideration of patient values and preferences in balancing bleeding against thromboembolism risks.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Cardiac & Cardiovascular Systems
Rahul Aggarwal, Christian T. Ruff, Saverio Virdone, Sylvie Perreault, Ajay K. Kakkar, Michael G. Palazzolo, Marc Dorais, Gloria Kayani, Daniel E. Singer, Eric Secemsky, Jonathan Piccini, Usman A. Tahir, Changyu Shen, Robert W. Yeh
Summary: A clinical risk score was developed and validated to personalize bleeding risk assessment for individuals with atrial fibrillation taking direct-acting oral anticoagulants (DOACs). The risk score showed superior performance compared to existing clinical decision tools and can help stratify patients based on their expected bleeding risk.
Article
Cardiac & Cardiovascular Systems
Maxim Grymonprez, Laura Carnoy, Andreas Capiau, Koen Boussery, Els Mehuys, Tine L. De Backer, Stephane Steurbaut, Lies Lahousse
Summary: This study investigated the impact of P-glycoprotein (P-gp) and CYP3A4 inhibitors and inducers on clinical outcomes in patients with atrial fibrillation (AF) treated with non-vitamin K antagonist oral anticoagulants (NOACs). The results showed that concomitant use of P-gp/CYP3A4 inhibitors was associated with higher risks of major bleeding and all-cause mortality, while concomitant use of P-gp/CYP3A4 inducers was associated with a higher risk of stroke.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2023)
Article
Oncology
Daniele Pastori, Amelie Marang, Arnaud Bisson, Danilo Menichelli, Julien Herbert, Gregory Y. H. Lip, Laurent Fauchier
Summary: This study investigated the impact of cancer on clinical outcomes in atrial fibrillation (AF) patients, as well as the performance of HAS-BLED and CHA(2)DS(2)-VASc scores. The results showed that cancer increased all-cause mortality, major bleeding, and intracranial hemorrhage risk in AF patients. The risk of ischemic stroke varied among different cancer types, with some showing higher bleeding risk compared to thromboembolic risk.
Article
Medicine, General & Internal
Thomas Vanassche, Christelle Orlando, Kristel Vandenbosch, Alain Gadisseur, Cedric Hermans, Kristin Jochmans, Jean-Marc Minon, Serge Motte, Harlinde Peperstraete, Pierre Peters, Muriel Sprynger, Patrizio Lancellotti, Isabelle Dehaene, Patrick Emonts, Christophe Vandenbriele, Peter Verhamme, Cecile Oury
Summary: This guidance document provides recommendations on anticoagulation management in COVID-19 positive patients for Belgian health-care workers. The recommendations are based on current knowledge and limited evidence and cover prophylaxis and treatment of COVID-related venous thromboembolism in ambulatory and hospitalized patients, as well as antithrombotic drug use in patients with prior indication for anticoagulation who develop COVID-19. It is emphasized that these recommendations are subject to change as more knowledge on the disease and data from ongoing clinical trials become available.
ACTA CLINICA BELGICA
(2022)
Article
Medicine, General & Internal
Olga Gavin, Vanessa Roldan, Pilar Llamas-Sillero, Amparo Santamaria, Daniel Arumi, Susana Fernandez de Cabo
Summary: In Spain, vitamin K antagonists (VKA) are still the standard treatment for atrial fibrillation (AF) patients to prevent thromboembolic and hemorrhagic complications. This study aims to characterize VKA-treated patients with stroke/systemic embolism (SE) or major hemorrhagic episodes, their outcomes, and the actions taken after these events.
Article
Gastroenterology & Hepatology
Luis G. Alcala-Gonzalez, Cesar Jimenez, Vicente Cortina, Alba Jimenez, Maria Cerda, Erik Johansson, Pavel Olivera, Amparo Santamaria, Carmen Alonso-Cotoner
Summary: The severity and clinical outcomes of gastrointestinal bleeding are similar in patients taking direct oral anticoagulants (DOAC) and vitamin K antagonists (VKA), regardless of the etiology of the bleeding.
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS
(2022)
Article
Cardiac & Cardiovascular Systems
Pieter Martens, Chantal Mathieu, Thomas Vanassche
Summary: The presence of type 2 diabetes puts patients at a higher risk for cardiovascular disease, heart failure, and chronic kidney disease. Glucose control alone is not enough to prevent these complications, but new drugs like SGLT2-I and GLP-1RA show promise in reducing these risks. However, the uptake of these drugs in clinical practice, especially GLP-1RA, is low.
Article
Peripheral Vascular Disease
Jesus D. Melgarejo, Jan Eijgen, Gladys E. Maestre, Lama A. Al-Aswad, Lutgarde Thijs, Luis J. Mena, Joseph H. Lee, Joseph D. Terwilliger, Michele Petitto, Carlos A. Chavez, Miguel Brito, Gustavo Calmon, Egle Silva, Dong-Mei Wei, Ella Cutsforth, Karel Keer, C. Gustavo De Moraes, Thomas Vanassche, Stefan Janssens, Ingeborg Stalmans, Peter Verhamme, Jan A. Staessen, Zhen-Yu Zhang
Summary: It was found that dips rather than increases in the 24-h MAP level were associated with an increased risk for OAG.
AMERICAN JOURNAL OF HYPERTENSION
(2022)
Article
Dentistry, Oral Surgery & Medicine
Anna Ockerman, Amber Hendrickx, Wouter Willekens, Heleen Fehervary, Julie Vastmans, Wim Coucke, Peter Verhamme, Constantinus Politis, Thomas Vanassche, Annabel Braem, Marc Quirynen, Reinhilde Jacobs
Summary: The study found that L-PRF membranes from patients on anticoagulants were weaker, less stretchable, and contained fewer leukocytes compared to those from patients not taking these drugs.
JOURNAL OF PERIODONTAL RESEARCH
(2022)
Review
Cardiac & Cardiovascular Systems
Christophe Vandenbriele, Deepa J. Arachchillage, Pascal Frederiks, Gennaro Giustino, Diana A. Gorog, Mario Gramegna, Stefan Janssens, Bart Meyns, Amin Polzin, Mara Scandroglio, Benedikt Schrage, Gregg W. Stone, Guido Tavazzi, Thomas Vanassche, Pascal Vranckx, Dirk Westermann, Susanna Price, Alaide Chieffo
Summary: There is growing interest in the use of mechanical circulatory support for patients with cardiogenic shock, but the delicate balance between bleeding and thrombosis poses challenges for patient outcomes. This article presents an anti-Factor Xa/activated partial thromboplastin time-guided anticoagulation algorithm and discusses the monitoring pitfalls of heparin in critically ill patients, aiming to guide physicians in standardizing anticoagulation treatment to reduce device-related morbidity and mortality.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Dongmei Wei, Jesus D. Melgarejo, Lutgarde Thijs, Xander Temmerman, Thomas Vanassche, Lucas Van Aelst, Stefan Janssens, Jan A. Staessen, Peter Verhamme, Zhen-Yu Zhang
Summary: This study aimed to identify a urinary proteomic profile associated with arterial stiffness and adverse outcomes. The researchers found that a PWV-derived urinary proteomic score (PWV-UP) was highly associated with arterial stiffness and could serve as a biomarker. They also discovered that PWV-UP was associated with all-cause mortality and cardiovascular mortality, indicating the involvement of multifaceted pathological processes.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Cardiac & Cardiovascular Systems
John W. Eikelboom, Jacqueline Bosch, Stuart J. Connolly, Jessica Tyrwitt, Keith A. A. Fox, Eva Muehlhofer, Christoph Neumann, Christoph Tasto, Shrikant Bangdiwala, Rafael Diaz, Marco Alings, Gilles R. Dagenais, Darryl P. Leong, Eva M. Lonn, Alvaro Avezum, Leopoldo S. Piegas, Petr Widimsky, Alexander N. Parkhomenko, Deepak L. Bhatt, Kelley R. H. Branch, Jeffrey L. Probstfield, Patricio Lopez-Jaramillo, Lars Ryden, Nana Pogosova, Katalin Keltai, Matyas Keltai, Georg Ertl, Stefan Stoerk, Antonio L. Dans, Fernando Lanas, Yan Liang, Jun Zhu, Christian Torp-Pedersen, Aldo P. Maggioni, Patrick J. Commerford, Tomasz J. Guzik, Thomas Vanassche, Peter Verhamme, Martin O'Donnell, Andrew M. Tonkin, John D. Varigos, Dragos Vinereanu, Camillo Felix, Jae-Hyung Kim, Khairul S. Ibrahim, Basil S. Lewis, Kaj P. Metsarinne, Victor Aboyans, Phillippe Gabriel Steg, Masatsugu Hori, Ajay Kakkar, Sonia S. Anand, Andre Lamy, Mukul Sharma, Salim Yusuf
Summary: This study describes the outcomes of patients with chronic coronary artery disease and/or peripheral artery disease who were treated with the combination of rivaroxaban and aspirin during a long-term open-label extension. The results showed that the efficacy and bleeding rates during the extended combination treatment were similar to or lower than those during the randomized treatment phase, without any new safety signals.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Meeting Abstract
Peripheral Vascular Disease
Dongmei Wei, Jesus Melgarejo, Thomas Vanassche, Lucas Van Aelst, Stefan Janssens, Peter Verhamme, Zhen-Yu Zhang
JOURNAL OF HYPERTENSION
(2022)
Review
Cardiac & Cardiovascular Systems
Vivencio Barrios, Sergio Cinza-Sanjurjo, Javier Garcia-Alegria, Roman Freixa-Pamias, Frederic Llordachs-Marques, Carlos A. Molina, Amparo Santamaria, David Vivas, Carmen Suarez Fernandez
Summary: Telemedicine has many advantages over face-to-face consultations, including efficient use of resources, reduced burden of care, lower exposure to COVID-19, treatment adjustment, improved healthcare circuits, and patient empowerment. In the management of atrial fibrillation patients, telemedicine is an excellent option, and direct oral anticoagulants may provide added value due to no need for continuous monitoring or dosage adjustments. This multidisciplinary consensus document discusses the role of telemedicine in anticoagulation of this population and provides practical recommendations.
Review
Geriatrics & Gerontology
Nicolas Mendoza, Isabel Ramirez, Esther de la Viuda, Pluvio Coronado, Laura Baquedano, Placido Llaneza, Veronica Nieto, Borja Otero, Sonia Sanchez-Mendez, Visitacion Alvarez de Frutos, Leire Andraca, Patricio Barriga, Zully Benitez, Teresa Bombas, Ma Jesus Cancelo, Antonio Cano, Camil Castelo Branco, Marta Correa, Jose Luis Doval, Maria Fasero, Gabriel Fiol, Nestor C. Garello, Andrea R. Genazzani, Ana Isabel Gomez, Ma Angeles Gomez, Silvia Gonzalez, Dimitrios G. Goulis, Misericordia Guinot, Luis Rolando Hernandez, Sonia Herrero, Eva Iglesias, Ana Rosa Jurado, Inaki Lete, Daniel Lubian, Milagros Martinez, Anibal Nieto, Laura Nieto, Santiago Palacios, Milagros Pedreira, Ezequiel Perez-Campos, Maria Jesus Pla, Jesus Presa, Francisco Quereda, Miriam Ribes, Pablo Romero, Beatriz Roca, Antonio Sanchez-Capilla, Rafael Sanchez-Borrego, Ana Santaballa, Amparo Santamaria, Tommaso Simoncini, Francisco Tinahones, Joaquin Calaf
Summary: This project aims to develop eligibility criteria for menopausal hormone therapy (MHT), using systematic reviews and metanalyses. The eligibility criteria are categorized into four groups based on the WHO international nomenclature for MHT alternatives. Quality assessment was conducted and expert opinions were categorized when direct evidence was lacking. This project provides a powerful decision-making tool for health professionals to manage menopausal symptoms.
Letter
Medicine, General & Internal
Irene Paya, Silvina Judith Rios, Amparo Santamaria
Article
Dentistry, Oral Surgery & Medicine
Cathy Chen, Manish Saxena, Christian von Heymann, Thomas Vanassche, James Jin, Robert Lersch, Sabine Koehler, Amparo Santamaria, Martin Unverdorben, Paolo Colonna
Summary: This study investigated the use of edoxaban in dental procedures and found that most patients undergoing cleaning procedures did not need to interrupt edoxaban, while tooth extraction procedures often required preprocedural interruption. Overall, bleeding rates were low and no thrombotic events occurred.
Article
Hematology
Amparo Santamaria, Cathy Chen, Paolo Colonna, Christian von Heymann, Manish Saxena, Thomas Vanassche, James Jin, Martin Unverdorben
Summary: Patients treated with edoxaban may require interruption of the medication during diagnostic and therapeutic procedures. Although heparin bridging strategies are not recommended, they are still commonly used in clinical practice. Factors predicting edoxaban interruption and heparin bridging strategies include high HAS-BLED scores and high EHRA procedural risk, while CHA(2)DS(2)-VASc scores do not predict either. The use of heparin bridging strategies is associated with higher bleeding rates but does not decrease thromboembolic risk. Individual patient and procedural bleeding risks appear to play a more important role in clinicians' decision on heparin bridging strategy than stroke risk.
CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
(2023)
