Stroke Prevention in Atrial Fibrillation
Literature review: stroke prevention in atrial fibrillation
The review includes the pivotal randomised controlled trials for warfarin and direct oral anticoagulants as well as relevant publications from the last 18 months. The following search terms were used: ‘stroke prevention’, ‘atrial fibrillation’, dabigatran, rivaroxaban, apixaban, edoxaban, warfarin, ‘oral anticoagulants’, ‘non-VKA oral anticoagulants’, novel oral anticoagulants’, ‘direct oral anticoagulants’, ‘reversal agents’
New This Month
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Calkins H, Willems S, Verma A, et al. EP Europace 2019;21:879–85
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Byrne RA, Colleran R, Kastrati A. EuroIntervention 2019;14:e1793–5.
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Chan NC, Eikelboom JW. Blood 2019;133:2269–78.
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Khaji A, Hanley C, Kowey PR. Cardiol Clin 2019;37:197–206.
Videos
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Webinars
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Dr Robert Byrne, Prof Georg Nickenig, Prof Stefan Hohnloser, Prof Georg Nickenig, Prof Pepe Zamorano, Dr Jose Lopez-Sendon. -
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Dr. Amit Mistri
Key Articles
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Andrade JG, Hawkins NM, Fordyce CB, al. Can J Cardiol 2018;34:1010–8.
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Lane DA, Meyerhoff J, Rohner U, Lip GYH. Clin Cardiol 2018;41:855–61.
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Lee CJ, Gerds TA, Carlson T, et al. J Am Coll Cardiol 2018;72:17–26.
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Hohnloser SH, Eikelboom JW. J Am Coll Cardiol 2018;72:27–8.
Independent Medical Education
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Byrne R, Hohnloser S, Nickenig G, Sendon JL and Zamarano JL, Radcliffe-CME, Feb 2018. -
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Hugh Calkins, John Camm
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Richard Hobbs
Guidelines/ Expert Recommendations
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Dan GA, Iliodromitis K, Scherr D, et al. Europace 2018;20:1382–7.
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Steffel J, Verhamme P, Potpara TS, et al. Eur Heart J 2018;39:1330–93.
Randomised Controlled Trials
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Hohnloser SH, Eikelboom JW. J Am Coll Cardiol 2018;72:27–8.
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O’Brien EC, Holmes DN, Thomas L, et al. J Am Heart Assoc 2018;7:e006391.
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Di Biase L, Romero J. JACC Clin Electrophysiol 2018;4:601–3.
Post-Hoc/Subgroup Analysis Of Pivotal Trials - Dabigatran
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Hohnloser SH, Eikelboom JW. J Am Coll Cardiol 2018;72:27–8.
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Glund S, Gan G, Moschetti V, et al. Clin Appl Thromb Hemost 2018;24:724–33.
Post-Hoc/Subgroup Analysis Of Pivotal Trials - Edoxaban
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Med Lett Drugs Ther 2018;60:99–101.
Post-Hoc/Subgroup Analysis Of Pivotal Trials - Apixaban
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Med Lett Drugs Ther 2018;60:99–101.
Post-Hoc/Subgroup Analysis Of Pivotal Trials - Diabetes
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McAllister DA, Read SH, Kerssens J, et al. Circulation 2018;138:2774–86.
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Nassif ME, Kosiborod M. Circulation 2018;138:4–6.
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Shilpa Vijayakumar, Muthiah Vaduganathan, Javed Butler, et alVijaykumar S et al. Circulation. 2018;137:1060-1073.
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Seferović PM, Petrie MC, Filippatos GS, et al. Eur J Heart Fail 2018;20:853–72.
Post-Hoc/Subgroup Analysis Of Pivotal Trials - Elderly
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Patti G, Cavallari I, Hanon O, De Caterina R. Int J Cardiol 2018;265:118–24.
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Yanagisawa S, Inden Y, Fujii A, et al. JACC Clin Electrophysiol 2018;4:592–600.
Stroke prevention in atrial fibrillation
Despite the evidence-based guidelines for the management of atrial fibrillation (AF), serious gaps continue to exist between clinical knowledge and practice, leaving patients at risk for disabling strokes. It is estimated that up to 67% of AF-related strokes are preventable. The significant increase in mortality and functional impairment is even more alarming, compared to non-AF strokes.
Updated AF treatment guidelines recommend new oral anticoagulants (NOACs) over warfarin for stroke prevention except, in patients with moderate to severe mitral stenosis or a mechanical heart valve. Based on some recent trials, NOACs were superior to warfarin for the prevention of the composite of stroke and systemic embolism in patients with AF and an additional risk factor for stroke. Reversal agents are now also available for NOACs in patients for severe bleeding or emergency procedures.
With the increased utilization of NOACs, it is critical for the clinician to understand the clinical and practical usage of these agents in diverse patient populations and clinical situations.
Radcliffe Cardiology would like to thank Boehringer Ingelheim for their support in the development of this section.
Content on this section was partly provided by Boehringer Ingelheim. For any follow up questions please contact your local Boehringer Ingelheim representative.
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This study also suggests that the heparin units required to reach the desired ACT may be affected by the time from the last preprocedural dose of dabigatran.
AIMS: To describe heparin dosing requirements in patients who...
Calkins H, Willems S, Verma A, et al. EP Europace 2019;21:879–85 -
In this review, the authors illustrate common challenges with anticoagulant use in older patients by describing five clinical cases and discussing how they decide upon the most appropriate antithrombotic therapy in those clinical situations....
Chan NC, Eikelboom JW. Blood 2019;133:2269–78. -
Heart failure (HF) and atrial fibrillation (AF) are the epidemics of the twenty-first century. These often coexist and are the cause of major morbidity and mortality. Management of these patients has posed a significant challenge to the medical...
Khaji A, Hanley C, Kowey PR. Cardiol Clin 2019;37:197–206. -
The authors of this editorial refer to the latest publications from DECLARE-TIMI 58 and the CANVAS Program.
Diabetes intersects with cardiovascular disease at every level. While there has been much focus on understanding atherosclerotic...
Verma S, McMurray JJV. Circulation 2019;139:2537–41. -
In DECLARE-TIMI 58, the sodium glucose co-transporter 2 inhibitor (SGLT2i) dapagliflozin reduced the composite endpoint of cardiovascular (CV) death/ hospitalization for heart failure (HHF) in a broad population of patients with T2DM.
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Kato ET, Silverman MG, Mosenzon O, et al. Circulation 2019;139:2528–36.
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10 Dec 2019 -
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21 May 2019 -
21 May 2019
Videos
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08 Feb 2019
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08 Feb 2019
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06 Feb 2019
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06 Feb 2019
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29 Nov 2018
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Clinical publications
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Limeres J, Lip GYH, Del Blanco BG, et al. Thromb Res 2019;177:180–6.
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Mentias A, Briasoulis A, Shantha G, et al. Am J Cardiol 2019;123:P1649–53.
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Chen N, Lutsey PL, MacLehose RF, et al. J Am Heart Assoc 2018;7:e009561.
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Andrade JG, Hawkins NM, Fordyce CB, al. Can J Cardiol 2018;34:1010–8.
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Lane DA, Meyerhoff J, Rohner U, Lip GYH. Clin Cardiol 2018;41:855–61.
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Trials
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Calkins H, Willems S, Verma A, et al. EP Europace 2019;21:879–85
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Lip GHY, Mauri L, Montalescot G, et al. Am Heart J 2019;212:13–22.
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Madhavan M, Holmes DN, Piccini JP et al. Am Heart J 2019;211:77–89.
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Verma S, McMurray JJV. Circulation 2019;139:2537–41.
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Kato ET, Silverman MG, Mosenzon O, et al. Circulation 2019;139:2528–36.
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Opinion articles
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Byrne RA, Colleran R, Kastrati A. EuroIntervention 2019;14:e1793–5.
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Khaji A, Hanley C, Kowey PR. Cardiol Clin 2019;37:197–206.
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Pokorney SD, Lopes RD. Heart 2019;105:848–54.
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Hohnloser SH, Eikelboom JW. J Am Coll Cardiol 2018;72:27–8.
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Nassif ME, Kosiborod M. Circulation 2018;138:4–6.
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Review articles
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Chan NC, Eikelboom JW. Blood 2019;133:2269–78.
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Ha ACT, Verma A, Mazer CD, et al. Curr Opin Cardio 2019;34:140–6.
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Patti G, Cavallari I, Hanon O, De Caterina R. Int J Cardiol 2018;265:118–24.
Guidelines
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Das SR, Everett BM, Birtcher KK, et al. J Am Coll Cardiol 2018;72:3200–23.
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Dan GA, Iliodromitis K, Scherr D, et al. Europace 2018;20:1382–7.
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Steffel J, Verhamme P, Potpara TS, et al. Eur Heart J 2018;39:1330–93.
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Seferović PM, Petrie MC, Filippatos GS, et al. Eur J Heart Fail 2018;20:853–72.
