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
Multidisciplinary Sciences
Jakub Z. Qazi, Mireille E. Schnitzer, Robert Cote, Marie-Josee Martel, Marc Dorais, Sylvie Perreault
Summary: The study aimed to develop a predictive model for major bleeding in new users of oral anticoagulants with atrial fibrillation, finding similar predictors among different types of anticoagulant users. The final model accurately predicted the risk of bleeding, providing a useful tool for future pharmacoepidemiologic studies.
Article
Medicine, General & Internal
Gregory F. Michaud, William G. Stevenson
Summary: A 63-year-old healthy male with atrial fibrillation presents with symptoms of dyspnea and irregular heartbeat. Physical examination reveals high blood pressure, irregular pulse, and ECG confirms atrial fibrillation. Further evaluation and treatment plan are needed.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
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)
Article
Clinical Neurology
Soonil Kwon, So-Ryoung Lee, Eue-Keun Choi, Euijae Lee, Jin-Hyung Jung, Kyung-Do Han, Myung-Jin Cha, Seil Oh, Gregory Y. H. Lip
Summary: This study compared the effectiveness and safety of NOACs and warfarin among atrial fibrillation patients with prior GIB using the Korean claims database. The findings showed that NOACs were associated with lower risks of ischemic stroke and major bleeding compared to warfarin in this patient population.
Article
Clinical Neurology
Arthur J. Labovitz, David Z. Rose, Michael G. Fradley, John N. Meriwether, Swetha Renati, Ryan Martin, Thomas Kasprowicz, Ryan Murtagh, Kevin Kip, Theresa M. Beckie, Marcus Stoddard, Andrea C. Bozeman, Tara McTigue, Bonnie Kirby, Nhi Tran, W. Scott Burgin
Summary: The study compared the safety of early use of apixaban with warfarin in AF patients after stroke or TIA, showing similar safety profiles but numerically lower rates of recurrent strokes/TIA in the apixaban group.
Article
Medicine, General & Internal
Yi-Hsin Chan, Tze-Fan Chao, Shao-Wei Chen, Hsin-Fu Lee, Wei-Min Chen, Pei-Ru Li, Yung-Hsin Yeh, Chi-Tai Kuo, Lai-Chu See, Gregory Y. H. Lip
Summary: This study suggests a higher risk of incident ILD associated with the use of FXa inhibitors in patients with NVAF. Physicians should be vigilant in monitoring potential adverse lung outcomes related to the use of these drugs.
Article
Cardiac & Cardiovascular Systems
Malik Elharram, Michelle Samuel, Ahmed AlTurki, Michael Quon, Hassan Behlouli, Amal Bessissow, Louise Pilote
Summary: This study aimed to investigate the association between oral anticoagulation (OAC) use and thromboembolic events and major bleeding in patients with new postoperative atrial fibrillation (POAF) after noncardiac surgery. The results showed that OAC was not associated with a reduction in long-term thromboembolic events in these patients, but it did increase the risk for major bleeding. Future prospective clinical studies are needed to better understand the efficacy and safety of anticoagulation therapy in the setting of POAF after noncardiac surgery.
CANADIAN JOURNAL OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Michela Orlandi, Douglas C. Dover, Roopinder K. Sandhu, Nathaniel M. Hawkins, Padma Kaul, Finlay A. McAlister
Summary: This retrospective cohort study found that frail patients with nonvalvular atrial fibrillation (NVAF) were less likely to receive anticoagulation treatment, and if they did, they were more likely to receive warfarin instead of direct oral anticoagulants (DOACs). The introduction of DOACs increased anticoagulation rates but did not resolve the treatment disparities for frail NVAF patients.
CANADIAN JOURNAL OF CARDIOLOGY
(2022)
Article
Biochemistry & Molecular Biology
Sian-De Liu, Shwu-Jiuan Lin, Chin-Ying Ray, Fang-Tsyr Lin, Weei-Chin Lin, Li-Hsuan Wang
Summary: The use of warfarin therapy in patients with new-onset hyperthyroidism-related atrial fibrillation did not show a significant benefit in terms of the risk of ischemic stroke/transient ischemic attack or major bleeding. Warfarin use also did not have a significant association with the risk of stroke/TIA compared to aspirin use.
Article
Medicine, General & Internal
Derek S. Chew, Ke Zhou, Sean D. Pokorney, David B. Matchar, Sreekanth Vemulapalli, Larry A. Allen, Kevin P. Jackson, Zainab Samad, Manesh R. Patel, James V. Freeman, Jonathan P. Piccini
Summary: Left atrial appendage occlusion (LAAO) is a potential alternative to oral anticoagulants in patients with atrial fibrillation (AF) to reduce major bleeding risk. However, there is uncertainty regarding the risk for ischemic stroke compared with anticoagulation. The overall benefit from LAAO depends on the combination of stroke and bleeding risks in individual patients.
ANNALS OF INTERNAL MEDICINE
(2022)
Article
Health Care Sciences & Services
Weijia Wang, Jane S. Saczynski, Darleen Lessard, Robert J. Goldberg, David Parish, Robert Helm, Catarina I. Kiefe, Katherine Trymbulak, Jordy Mehawej, Hawa Abu, Robert Hayward, Joel Gore, Jerry H. Gurwitz, David D. McManus
Summary: In older patients with atrial fibrillation (AF) taking anticoagulants, cognitive impairment and frailty are independently associated with major bleeding.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Hematology
Jean-Pierre Bassand, Saverio Virdone, Marc Badoz, Freek W. A. Verheugt, A. John Camm, Frank Cools, Keith A. A. Fox, Samuel Z. Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Gloria Kayani, Frank Misselwitz, Karen S. Pieper, Alexander G. G. Turpie, Martin van Eickels, Ajay K. Kakkar
Summary: In patients with atrial fibrillation, NOACs show lower risks of bleeding and all-cause mortality compared to VKAs, with major bleeding associated with the highest risk of death. Minor bleeding and CRNM bleeding are also linked to a higher risk of death compared to no bleeding. A significant percentage of deaths within 30 days after a major bleed are due to intracranial/intraspinal hemorrhage.
Article
Medicine, General & Internal
Christopher P. Cannon, Joseph M. Kim, Jane J. Lee, Julie Sutherland, Ravinder Bachireddy, C. Michael Valentine, Steven Hearne, April Trebnick, Sara Jaffer, Sudarshana Datta, Emily Semmel, Fran Thorpe, Gheorghe Doros, Matthew A. Cavender, Matthew R. Reynolds
Summary: This study investigates the reasons for the underuse of oral anticoagulation in patients with nonvalvular atrial fibrillation (AF), finding that patients are more willing to consider anticoagulation than their physicians often believe. This highlights the need to revisit previous decisions against anticoagulation in a shared decision-making manner.
Article
Urology & Nephrology
An S. De Vriese, Rogier Caluwe, Hans Van Der Meersch, Koen De Boeck, Dirk De Bacquer
Summary: In hemodialysis patients with atrial fibrillation, the Valkyrie study found that reduced dose of rivaroxaban significantly decreased the composite outcome of fatal and nonfatal cardiovascular events and major bleeding complications compared with VKA.
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY
(2021)