Resumption of Oral #Anticoagulation After Intracerebral #Hemorrhage is Associated With Decreased Mortality and Favorable Functional Outcome
http://www.abstractsonline.com/pp8/#!/4172/presentation/13142
OAT resumption was associated with decreased mortality and favorable outcome after both non-lobar and lobar ICH. These findings support conducting randomized clinical trials to explore risks and benefits of OAT resumption after ICH
http://www.abstractsonline.com/pp8/#!/4172/presentation/13142
OAT resumption was associated with decreased mortality and favorable outcome after both non-lobar and lobar ICH. These findings support conducting randomized clinical trials to explore risks and benefits of OAT resumption after ICH
C-LBCT02-03 - EWOLUTION trial: 1-Year Efficacy and Safety of Left #Atrial Appendage Closure with WATCHMAN in Patients with or without Contraindication to Oral #Anticoagulation
http://www.abstractsonline.com/pp8/#!/4227/presentation/12994
Methods: 1025 pts scheduled for a WATCHMAN implant were prospectively and sequentially (83% of sites) enrolled at 47 centers. Indication for LAAC was based on ESC guidelines at the discretion of the individual centers. Follow-up and TEE were performed per local practice. Events are given as Kaplan-Meier event rates.
Conclusion: LAA closure with the WATCHMAN device has a high implant and sealing success. Stroke prevention appears to be safe and effective with an ischemic stroke rate as low as 1.2%, even though more than 73% of pts had a contra-indication to and were not using OAC
http://www.abstractsonline.com/pp8/#!/4227/presentation/12994
Methods: 1025 pts scheduled for a WATCHMAN implant were prospectively and sequentially (83% of sites) enrolled at 47 centers. Indication for LAAC was based on ESC guidelines at the discretion of the individual centers. Follow-up and TEE were performed per local practice. Events are given as Kaplan-Meier event rates.
Conclusion: LAA closure with the WATCHMAN device has a high implant and sealing success. Stroke prevention appears to be safe and effective with an ischemic stroke rate as low as 1.2%, even though more than 73% of pts had a contra-indication to and were not using OAC
Less #dementia with oral #anticoagulation in atrial fibrillation
https://academic.oup.com/eurheartj/article-abstract/doi/10.1093/eurheartj/ehx579/4560111/Less-dementia-with-oral-anticoagulation-in-atrial?redirectedFrom=fulltext
The association between atrial fibrillation (AF) and dementia is well documented, but it is not clear if oral anticoagulant treatment offers protection. The aim of the study is therefore to compare the incidence of new dementia in patients with AF with and without oral anticoagulants, and to explore if there is a difference between novel anticoagulants and warfarin in this respect Patients on anticoagulant treatment at baseline was associated with 29% lower risk of dementia than patients without anticoagulant treatment hazard ratio (HR) 0.71, 95% confidence intervals (95% CI) 0.68–0.74 and 48% lower risk analysed on treatment (HR 0.52, 95% CI 0.50–055). Direct comparison between new oral anticoagulants and warfarin showed no difference (HR 0.97, 95% CI 0.67–1.40).
Conclusion
The risk of dementia is higher without oral anticoagulant treatment in patients with AF. This suggests that early initiation of anticoagulant treatment in patients with AF could be of value in order to preserve cognitive function
https://academic.oup.com/eurheartj/article-abstract/doi/10.1093/eurheartj/ehx579/4560111/Less-dementia-with-oral-anticoagulation-in-atrial?redirectedFrom=fulltext
The association between atrial fibrillation (AF) and dementia is well documented, but it is not clear if oral anticoagulant treatment offers protection. The aim of the study is therefore to compare the incidence of new dementia in patients with AF with and without oral anticoagulants, and to explore if there is a difference between novel anticoagulants and warfarin in this respect Patients on anticoagulant treatment at baseline was associated with 29% lower risk of dementia than patients without anticoagulant treatment hazard ratio (HR) 0.71, 95% confidence intervals (95% CI) 0.68–0.74 and 48% lower risk analysed on treatment (HR 0.52, 95% CI 0.50–055). Direct comparison between new oral anticoagulants and warfarin showed no difference (HR 0.97, 95% CI 0.67–1.40).
Conclusion
The risk of dementia is higher without oral anticoagulant treatment in patients with AF. This suggests that early initiation of anticoagulant treatment in patients with AF could be of value in order to preserve cognitive function
OUP Academic
Less dementia with oral anticoagulation in atrial fibrillation | European Heart Journal | Oxford Academic
AimsThe association between atrial fibrillation (AF) and dementia is well documented, but it is not clear if oral anticoagulant treatment offers protection. The aim of the study is therefore to compare the incidence of new dementia in patients with AF with…
Ischaemic #stroke, haemorrhage, and mortality in older patients with chronic #kidney disease newly started on #anticoagulation for atrial fibrillation: a population based study from UK primary care
http://www.bmj.com/content/360/bmj.k342
6977 patients with chronic kidney disease and newly diagnosed atrial fibrillation were identified, of whom 2434 were on anticoagulants within 60 days of diagnosis and 4543 were not. 2434 pairs were matched using propensity scores by exposure to anticoagulant or none and followed for a median of 506 days. The crude rates for ischaemic stroke and haemorrhage were 4.6 and 1.2 after taking anticoagulants and 1.5 and 0.4 in patients who were not taking anticoagulant per 100 person years, respectively. The hazard ratios for ischaemic stroke, haemorrhage, and all cause mortality for those on anticoagulants were 2.60 (95% confidence interval 2.00 to 3.38), 2.42 (1.44 to 4.05), and 0.82 (0.74 to 0.91) compared with those who received no anticoagulation.
Conclusion Giving anticoagulants to older people with concomitant atrial fibrillation and chronic kidney disease was associated with an increased rate of ischaemic stroke and haemorrhage but a paradoxical lowered rate of all cause mortality. Careful consideration should be given before starting anticoagulants in older people with chronic kidney disease who develop atrial fibrillation. There remains an urgent need for adequately powered randomised trials in this population to explore these findings and to provide clarity on correct clinical management.
http://www.bmj.com/content/360/bmj.k342
6977 patients with chronic kidney disease and newly diagnosed atrial fibrillation were identified, of whom 2434 were on anticoagulants within 60 days of diagnosis and 4543 were not. 2434 pairs were matched using propensity scores by exposure to anticoagulant or none and followed for a median of 506 days. The crude rates for ischaemic stroke and haemorrhage were 4.6 and 1.2 after taking anticoagulants and 1.5 and 0.4 in patients who were not taking anticoagulant per 100 person years, respectively. The hazard ratios for ischaemic stroke, haemorrhage, and all cause mortality for those on anticoagulants were 2.60 (95% confidence interval 2.00 to 3.38), 2.42 (1.44 to 4.05), and 0.82 (0.74 to 0.91) compared with those who received no anticoagulation.
Conclusion Giving anticoagulants to older people with concomitant atrial fibrillation and chronic kidney disease was associated with an increased rate of ischaemic stroke and haemorrhage but a paradoxical lowered rate of all cause mortality. Careful consideration should be given before starting anticoagulants in older people with chronic kidney disease who develop atrial fibrillation. There remains an urgent need for adequately powered randomised trials in this population to explore these findings and to provide clarity on correct clinical management.
The BMJ
Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for…
Objective To assess the association between anticoagulation, ischaemic stroke, gastrointestinal and cerebral haemorrhage, and all cause mortality in older people with atrial fibrillation and chronic kidney disease.
Design Propensity matched, population based…
Design Propensity matched, population based…
#Anticoagulation Timing in Cardioembolic #Stroke and Recurrent Event Risk
https://2medical.news/2020/09/25/anticoagulation-timing-in-cardioembolic-stroke-and-recurrent-event-risk/
Guidelines recommend initiating anticoagulation within 4 to 14 days after cardioembolic stroke. Data supporting this did not account for key factors potentially affecting the decision to initiate anticoagulation, such as infarct size, hemorrhagic transformation, or high‐risk features on echocardiography.. ..We pooled data from stroke registries of 8 comprehensive stroke centers across the United States. We included consecutive patients admitted with ischemic stroke and atrial fibrillation. The …
https://2medical.news/2020/09/25/anticoagulation-timing-in-cardioembolic-stroke-and-recurrent-event-risk/
Guidelines recommend initiating anticoagulation within 4 to 14 days after cardioembolic stroke. Data supporting this did not account for key factors potentially affecting the decision to initiate anticoagulation, such as infarct size, hemorrhagic transformation, or high‐risk features on echocardiography.. ..We pooled data from stroke registries of 8 comprehensive stroke centers across the United States. We included consecutive patients admitted with ischemic stroke and atrial fibrillation. The …
Clinical Outcomes Associated With Left #Atrial Appendage Occlusion Versus Direct Oral #Anticoagulation in Atrial #Fibrillation
https://2medical.news/2021/01/15/clinical-outcomes-associated-with-left-atrial-appendage-occlusion-versus-direct-oral-anticoagulation-in-atrial-fibrillation/
This study sought to investigate clinical outcomes associated with left atrial appendage occlusion (LAAO) versus direct oral anticoagulants (DOACs) in patients with high-risk atrial fibrillation (AF).. ..Patients with AF enrolled in the Amulet Observational Registry (n = 1,088) who had successful LAAO with the Amplatzer Amulet device (n = 1,078) were compared with a propensity score–matched control cohort of incident AF patients (n = 1,184) …
https://2medical.news/2021/01/15/clinical-outcomes-associated-with-left-atrial-appendage-occlusion-versus-direct-oral-anticoagulation-in-atrial-fibrillation/
This study sought to investigate clinical outcomes associated with left atrial appendage occlusion (LAAO) versus direct oral anticoagulants (DOACs) in patients with high-risk atrial fibrillation (AF).. ..Patients with AF enrolled in the Amulet Observational Registry (n = 1,088) who had successful LAAO with the Amplatzer Amulet device (n = 1,078) were compared with a propensity score–matched control cohort of incident AF patients (n = 1,184) …
Early initiation of prophylactic #anticoagulation for prevention of #coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study
https://2medical.news/2021/02/24/early-initiation-of-prophylactic-anticoagulation-for-prevention-of-coronavirus-disease-2019-mortality-in-patients-admitted-to-hospital-in-the-united-states-cohort-study/
To evaluate whether early initiation of prophylactic anticoagulation compared with no anticoagulation was associated with decreased risk of death among patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United States. Design Observational cohort study. Setting Nationwide cohort of patients receiving care in the Department of Veterans Affairs, a large integrated national healthcare system. Participants All 4297 patients admitted to hospital from 1 …
https://2medical.news/2021/02/24/early-initiation-of-prophylactic-anticoagulation-for-prevention-of-coronavirus-disease-2019-mortality-in-patients-admitted-to-hospital-in-the-united-states-cohort-study/
To evaluate whether early initiation of prophylactic anticoagulation compared with no anticoagulation was associated with decreased risk of death among patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United States. Design Observational cohort study. Setting Nationwide cohort of patients receiving care in the Department of Veterans Affairs, a large integrated national healthcare system. Participants All 4297 patients admitted to hospital from 1 …
Association of Oral #Anticoagulation With #Stroke in Atrial #Fibrillation or Heart #Failure: A Comparative Meta-Analysis
https://2medical.news/2021/07/24/association-of-oral-anticoagulation-with-stroke-in-atrial-fibrillation-or-heart-failure-a-comparative-meta-analysis/
https://2medical.news/2021/07/24/association-of-oral-anticoagulation-with-stroke-in-atrial-fibrillation-or-heart-failure-a-comparative-meta-analysis/
2Medical.News
Association of Oral #Anticoagulation With #Stroke in Atrial #Fibrillation or Heart #Failure: A Comparative Meta-Analysis
Atrial fibrillation and heart failure with reduced ejection fraction (HFrEF) are common sources of cardioembolism. While oral anticoagulation is strongly recommended for atrial fibrillation, there …