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Kawano Y, Nagata M, Nakamura S, Akagi Y, Suzuki T, Tsukada E, Hoshiko M, Kujirai A, Nakamatsu S, Nishikawa T, Enomoto A, Negishi K, Shimada S, Aoyama T, Mano Y. Comprehensive Exploration of Medications That Affect the Bleeding Risk of Oral Anticoagulant Users. Biol Pharm Bull 2021; 44:611-619. [PMID: 33952817 DOI: 10.1248/bpb.b20-00791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Oral anticoagulants (OACs) pose a major bleeding risk, which may be increased or decreased by concomitant medications. To explore medications that affect the bleeding risk of OACs, we conducted a nested case-control study including 554 bleeding cases (warfarin, n = 327; direct OACs [DOACs], n = 227) and 1337 non-bleeding controls (warfarin, n = 814; DOACs, n = 523), using a Japanese health insurance database from January 2005 to June 2017. Major bleeding risk associated with exposure to concomitant medications within 30 d of the event/index date was evaluated, and adjusted odds ratios (aORs) were calculated using logistic regression analysis. Several antihypertensive drugs, such as amlodipine and bisoprolol, were associated with a decreased risk of bleeding (warfarin + amlodipine [aOR, 0.64; 95% confidence interval (CI): 0.41-0.98], DOACs + bisoprolol [aOR, 0.51; 95% CI, 0.33-0.80]). As hypertension is considered a significant risk factor for intracranial bleeding in antithrombotic therapy, antihypertensive drugs may suppress intracranial bleeding. In contrast, telmisartan, a widely used antihypertensive drug, was associated with an increased risk of bleeding [DOACs + telmisartan (aOR, 4.87; 95% CI, 1.84-12.91)]. Since telmisartan is an inhibitor of P-glycoprotein (P-gp), the elimination of rivaroxaban and apixaban, which are substrates of P-gp, is hindered, resulting in increased blood levels of both drugs, thereby increasing the risk of hemorrhage. In conclusion, antihypertensive drugs may improve the safety of OACs, and the pharmacokinetic-based drug interactions of DOACs must be considered.
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Affiliation(s)
- Yohei Kawano
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Masashi Nagata
- Department of Pharmacy, Medical Hospital, Tokyo Medical and Dental University (TMDU)
| | - Saeko Nakamura
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Yuuki Akagi
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS).,Department of Pharmacy, National Hospital Organization Yokohama Medical Center
| | - Tatsunori Suzuki
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Emi Tsukada
- Center Hospital of the National Center for Global Health and Medicine (NCGM)
| | - Mai Hoshiko
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Azusa Kujirai
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Satoshi Nakamatsu
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Tomoki Nishikawa
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Aya Enomoto
- Department of Pharmacy, Medical Hospital, Tokyo Medical and Dental University (TMDU)
| | - Kenichi Negishi
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Shuji Shimada
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Takao Aoyama
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
| | - Yasunari Mano
- Faculty of Pharmaceutical Sciences, Tokyo University of Science (TUS)
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2
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Jhang RS, Lin SY, Peng YF, Chao HC, Tsai IL, Lin YT, Liao HW, Tang SC, Kuo CH, Jeng JS. Using the PCI-IS Method to Simultaneously Estimate Blood Volume and Quantify Nonvitamin K Antagonist Oral Anticoagulant Concentrations in Dried Blood Spots. Anal Chem 2020; 92:2511-2518. [DOI: 10.1021/acs.analchem.9b04063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ren-Shiang Jhang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Shin-Yi Lin
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei 10617, Taiwan
| | - Yu-Fong Peng
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Hsi-Chun Chao
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - I-Lin Tsai
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Ya-Ting Lin
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Hsiao-Wei Liao
- Faculty of Pharmacy, National Yang-Ming University, Taipei 11221, Taiwan
| | - Sung-Chun Tang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 10617, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei 10617, Taiwan
| | - Jiann-Shing Jeng
- Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei 10617, Taiwan
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3
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Khan HR, Kralj-Hans I, Haldar S, Bahrami T, Clague J, De Souza A, Francis D, Hussain W, Jarman J, Jones DG, Mediratta N, Mohiaddin R, Salukhe T, Jones S, Lord J, Murphy C, Kelly J, Markides V, Gupta D, Wong T. Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF): study protocol for a randomised controlled trial. Trials 2018; 19:117. [PMID: 29458408 PMCID: PMC5819216 DOI: 10.1186/s13063-018-2487-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 01/22/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Atrial fibrillation is the commonest arrhythmia which raises the risk of heart failure, thromboembolic stroke, morbidity and death. Pharmacological treatments of this condition are focused on heart rate control, rhythm control and reduction in risk of stroke. Selective ablation of cardiac tissues resulting in isolation of areas causing atrial fibrillation is another treatment strategy which can be delivered by two minimally invasive interventions: percutaneous catheter ablation and thoracoscopic surgical ablation. The main purpose of this trial is to compare the effectiveness and safety of these two interventions. METHODS/DESIGN Catheter Ablation versus Thoracoscopic Surgical Ablation in Long Standing Persistent Atrial Fibrillation (CASA-AF) is a prospective, multi-centre, randomised controlled trial within three NHS tertiary cardiovascular centres specialising in treatment of atrial fibrillation. Eligible adults (n = 120) with symptomatic, long-standing, persistent atrial fibrillation will be randomly allocated to either catheter ablation or thoracoscopic ablation in a 1:1 ratio. Pre-determined lesion sets will be delivered in each treatment arm with confirmation of appropriate conduction block. All patients will have an implantable loop recorder (ILR) inserted subcutaneously immediately following ablation to enable continuous heart rhythm monitoring for at least 12 months. The devices will be programmed to detect episodes of atrial fibrillation and atrial tachycardia ≥ 30 s in duration. The patients will be followed for 12 months, completing appropriate clinical assessments and questionnaires every 3 months. The ILR data will be wirelessly transmitted daily and evaluated every month for the duration of the follow-up. The primary endpoint in the study is freedom from atrial fibrillation and atrial tachycardia at the end of the follow-up period. DISCUSSION The CASA-AF Trial is a National Institute for Health Research-funded study that will provide first-class evidence on the comparative efficacy, safety and cost-effectiveness of thoracoscopic surgical ablation and conventional percutaneous catheter ablation for long-standing persistent atrial fibrillation. In addition, the results of the trial will provide information on the effects on patients' quality of life. TRIAL REGISTRATION ISRCTN Registry, ISRCTN18250790 . Registered on 24 April 2015.
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Affiliation(s)
- Habib Rehman Khan
- Royal Brompton and Harefield NHS Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
- Institute of Cardiovascular Medicine and Science, London, UK
| | | | - Shouvik Haldar
- Royal Brompton and Harefield NHS Trust, London, UK
- Institute of Cardiovascular Medicine and Science, London, UK
| | | | | | | | - Darrel Francis
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - David Gareth Jones
- Royal Brompton and Harefield NHS Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | | | - Simon Jones
- New York University School of Medicine, New York, NY USA
| | - Joanne Lord
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Caroline Murphy
- King’s Clinical Trials Unit, Institute of Psychiatry, King’s College London, London, UK
| | - Joanna Kelly
- King’s Clinical Trials Unit, Institute of Psychiatry, King’s College London, London, UK
| | | | - Dhiraj Gupta
- National Heart and Lung Institute, Imperial College London, London, UK
- Institute of Cardiovascular Medicine and Science, London, UK
- Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK
| | - Tom Wong
- Royal Brompton and Harefield NHS Trust, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
- Institute of Cardiovascular Medicine and Science, London, UK
- Royal Brompton Hospital, Sydney Street, London, UK
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4
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Santarpia G, De Rosa S, Sabatino J, Curcio A, Indolfi C. Should We Maintain Anticoagulation after Successful Radiofrequency Catheter Ablation of Atrial Fibrillation? The Need for a Randomized Study. Front Cardiovasc Med 2017; 4:85. [PMID: 29312960 PMCID: PMC5742595 DOI: 10.3389/fcvm.2017.00085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 12/08/2017] [Indexed: 12/04/2022] Open
Abstract
Background Atrial fibrillation (AF) is associated with a high risk of thromboembolic stroke and oral anticoagulation therapy (OAT) is able to reduce the rate of ischemic events. Nevertheless, the actual benefit of prolonged OAT after successful radiofrequency catheter ablation (RFCA) is not clear yet. Methods Scientific investigations were assumed suitable if they assessed the clinical significance of the use of anticoagulation versus no anticoagulation in AF patients undergoing successful RFCA. The odds ratio (OR) with 95% confidence interval (CI) was used as the study summary measure. Results At meta-analysis, the rate of total thromboembolic events was not significantly different between the groups (OR 1.83, 95% CI 0.69–4.88; p = 0.221), while a lower incidence of total bleeding events in patients not treated with OAT was found (OR 6.5, 95% CI 1.93–21.86; p = 0.002). Conclusion This meta-analysis raises doubts about the net clinical benefit (NCB) of a long-term prophylactic OAT in patients with AF underwent to successful RFCA. In fact, despite similar rate of thromboembolic events, the apparent increase in bleeding risk suggests caution in prolonging OAT after RFCA. However, the lack of prospective randomized studies does not allow a comprehensive appraisal of this issue. Thus, we propose the design of a novel prospective randomized trial to evaluate the NCB of prolonged OAT after successful RFCA of AF.
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Affiliation(s)
- Giuseppe Santarpia
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Salvatore De Rosa
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Jolanda Sabatino
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Antonio Curcio
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy.,URT-CNR, Department of Medicine, Consiglio Nazionale delle Ricerche, Catanzaro, Italy
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5
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Mukai Y, Wada K, Miyamoto K, Nakagita K, Fujimoto M, Hosomi K, Kuwahara T, Takada M, Kusano K, Oita A. The influence of residual apixaban on bleeding complications during and after catheter ablation of atrial fibrillation. J Arrhythm 2017; 33:434-439. [PMID: 29021846 PMCID: PMC5634723 DOI: 10.1016/j.joa.2017.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/14/2017] [Accepted: 06/22/2017] [Indexed: 11/29/2022] Open
Abstract
Background The periprocedural protocol for atrial fibrillation (AF) ablation commonly includes anticoagulation therapy. Apixaban, a direct oral anticoagulant, is currently approved for clinical use; however, little is known about the effects of residual apixaban concentration on bleeding complications during/after AF ablation. Therefore, we measured residual apixaban concentration by using mass spectrometry and examined the anticoagulant's residual effects on bleeding complications. Methods Fifty-eight patients (Mean age of 64.7±12.5 years; 31 males, 27 females) were enrolled and administered apixaban twice daily. We analyzed trough apixaban concentration, activated clotting time (ACT), heparin dose, and bleeding complications during/after AF ablation. Apixaban concentrations were directly measured using mass spectrometry. Results Bleeding complications were observed in 19 patients (delayed hemostasis at the puncture site, 16; hematuria, 3; hemosputum, 1). No patient required blood transfusion. The mean trough apixaban concentration was significantly lower in patients with bleeding complications than without (152.4±73.1 vs. 206.8±98.8 ng/mL respectively, P=0.037), while the heparin dose to achieve ACT>300 s was significantly higher in patients with bleeding complications (9368.4±2929.0 vs. 7987.2±2135.2 U/body respectively, P=0.046). Interestingly, a negative correlation was found between the trough apixaban concentration and the heparin dose to achieve ACT>300 s (P=0.033, R=-0.281). Conclusions Low residual plasma apixaban is associated with a higher incidence of bleeding complications during/after AF ablation, potentially because of a greater heparin requirement during AF ablation.
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Affiliation(s)
- Yutaro Mukai
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Division of Cardiovascular Drugs, Therapy, Kindai University Graduate School of Pharmacy, Higashi-osaka, Japan
| | - Kyoichi Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Division of Cardiovascular Drugs, Therapy, Kindai University Graduate School of Pharmacy, Higashi-osaka, Japan
| | - Koji Miyamoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kazuki Nakagita
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Division of Cardiovascular Drugs, Therapy, Kindai University Graduate School of Pharmacy, Higashi-osaka, Japan
| | - Mai Fujimoto
- Division of Clinical Drug Informatics, Kindai University School of Pharmacy, Higashi-osaka, Japan
| | - Kouichi Hosomi
- Division of Clinical Drug Informatics, Kindai University School of Pharmacy, Higashi-osaka, Japan
| | - Takeshi Kuwahara
- Department of Pharmacy, National Center for Global Health and Medicine, Tokyo, Japan
| | - Mitsutaka Takada
- Division of Cardiovascular Drugs, Therapy, Kindai University Graduate School of Pharmacy, Higashi-osaka, Japan.,Division of Clinical Drug Informatics, Kindai University School of Pharmacy, Higashi-osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akira Oita
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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6
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Canavero I, Micieli G, Paciaroni M. Decision Algorithms for Direct Oral Anticoagulant Use in Patients With Nonvalvular Atrial Fibrillation: A Practical Guide for Neurologists. Clin Appl Thromb Hemost 2017; 24:396-404. [PMID: 28914077 DOI: 10.1177/1076029617720068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Direct oral anticoagulants (DOACs) are valid alternative options to vitamin K antagonists due to their limited interactions with drugs or food and the fact that they do not require regular coagulation monitoring. To this regard, recent practice guidelines recommend that DOACs should be considered as first-line anticoagulant therapy for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). This review (1) outlines current international guidelines for the management of DOACs to prevent stroke in patients with NVAF, (2) outlines indications for elderly patients as well as specific settings including acute coronary syndromes and intracranial hemorrhage, and (3) offers a practical guide for the use of DOACs in neurological settings.
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Affiliation(s)
- Isabella Canavero
- 1 Department of Emergency Neurology, IRCCS National Neurological Institute "Casimiro Mondino," Pavia, Italy
| | - Giuseppe Micieli
- 1 Department of Emergency Neurology, IRCCS National Neurological Institute "Casimiro Mondino," Pavia, Italy
| | - Maurizio Paciaroni
- 2 Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, "Santa Maria della Misericordia" Hospital, Perugia, Italy
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7
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Pfeilschifter W, Steinstraesser T, Paulus P, Zeiner PS, Bohmann F, Theisen A, Lindhoff-Last E, Penski C, Wagner M, Mittelbronn M, Foerch C. Risk of long-term anticoagulation under sustained severe arterial hypertension: A translational study comparing warfarin and the new oral anticoagulant apixaban. J Cereb Blood Flow Metab 2017; 37:855-865. [PMID: 27189904 PMCID: PMC5363464 DOI: 10.1177/0271678x16642443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
New oral anticoagulants for the prevention of stroke and systemic embolism in patients with atrial fibrillation have recently been introduced. In this translational study, we explored the risk of long-term anticoagulation on intracerebral hemorrhage under sustained severe arterial hypertension. We initiated anticoagulation with warfarin or apixaban in spontaneously hypertensive rats prone to develop severe hypertension and subsequent intracerebral bleeding complications. A non-anticoagulated group served as control. During an 11-week-study period, blood pressure, anticoagulation parameters, and clinical status were determined regularly. The incidence of histopathologically proven intracerebral hemorrhage was defined as the primary endpoint. Both warfarin and apixaban anticoagulation was fairly stable during the study period, and all rats developed severe hypertension. Intracerebral hemorrhage was determined in 29% (4/14) of warfarin rats and in 10% (1/10) of apixaban rats. Controls did not show cerebral bleeding complications (chi-square not significant). Mortality rate at study termination was 33% (2/6) in controls, 43% (6/14) in the warfarin group, and 60% (6/10) in the apixaban group. Animals died from extracerebral complications in most cases. Our study describes an experimental intracerebral hemorrhage model in the context of sustained hypertension and long-term anticoagulation. Extracerebral bleeding complications occurred more often in warfarin-treated animals compared with apixaban and control rats.
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Affiliation(s)
| | | | - Patrick Paulus
- 2 Department of Anesthesiology and Operative Intensive Care Medicine, Kepler University Hospital, Linz, Austria
| | - Pia Susan Zeiner
- 1 Department of Neurology, Goethe-University, Frankfurt am Main, Germany
| | - Ferdinand Bohmann
- 1 Department of Neurology, Goethe-University, Frankfurt am Main, Germany
| | - Alf Theisen
- 3 Zentrale Forschungseinheit, Goethe-University, Frankfurt am Main, Germany
| | - Edelgard Lindhoff-Last
- 4 Department of Internal Medicine, Goethe-University, Frankfurt am Main, Germany.,5 CCB Coagulation Research Center, Bethanien Hospital, Frankfurt am Main, Germany
| | - Cornelia Penski
- 6 Neurological Institute (Edinger Institute), Goethe-University, Frankfurt am Main, Germany
| | - Marlies Wagner
- 7 Institute of Neuroradiology, Goethe-University, Frankfurt am Main, Germany
| | - Michel Mittelbronn
- 6 Neurological Institute (Edinger Institute), Goethe-University, Frankfurt am Main, Germany
| | - Christian Foerch
- 1 Department of Neurology, Goethe-University, Frankfurt am Main, Germany
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8
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Shibata N, Morishima I, Okumura K, Morita Y, Takagi K, Yoshida R, Nagai H, Tomomatsu T, Ikai Y, Terada K, Tsuzuki K, Tsuboi H, Sone T, Murohara T. Non-vitamin K antagonist oral anticoagulants versus warfarin for cardioversion of atrial fibrillation in clinical practice: A single-center experience. J Arrhythm 2016; 33:7-11. [PMID: 28217222 PMCID: PMC5300843 DOI: 10.1016/j.joa.2016.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/06/2016] [Accepted: 04/14/2016] [Indexed: 12/01/2022] Open
Abstract
Background Anticoagulation therapy with the vitamin K antagonist (VKA) warfarin has been demonstrated to reduce thromboembolic risk after electrical cardioversion (ECV). However, data concerning ECV with non-VKA oral anticoagulants (NOACs) is limited. The objective of this study was to determine the efficacy and safety of NOACs in patients undergoing ECV in a real-world clinical practice at a single center in Japan. Methods We retrospectively analyzed the data of 406 consecutive patients who underwent ECV for atrial fibrillation (AF) or flutter under anticoagulation with one of the three NOACs (n=149) or with a VKA (n=257). Results The CHADS2 and HAS-BLED scores were significantly higher in the VKA group, whereas the NOACs group had a tendency toward greater spontaneous echo contrast grades. After ECV, ischemic stroke occurred in three patients of the VKA group and one patient in the NOAC group, all of whom had persistent AF, indicating no significant difference in the thromboembolic event rate within 30 days following ECV. No other thromboembolic events, major bleeding, or death occurred in either group. Among the NOAC and VKA patients in whom we newly introduced an oral anticoagulant to perform ECV, the number of days leading to ECV was significantly lesser for the NOAC patients. Conclusion NOACs may be used as an alternative to VKAs for ECV and may allow prompt ECV in clinical practices.
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Affiliation(s)
- Naoki Shibata
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Itsuro Morishima
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Kenji Okumura
- Department of Cardiology, Tohno Kosei Hospital, Mizunami, Japan
| | - Yasuhiro Morita
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Kensuke Takagi
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Ruka Yoshida
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Hiroaki Nagai
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | | | - Yoshihiro Ikai
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Kazushi Terada
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Kazuhito Tsuzuki
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Hideyuki Tsuboi
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Takahito Sone
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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9
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Yamane T. Silent Cerebral Embolism After Catheter Ablation for Atrial Fibrillation - Unresolved Issue or Too Much Concern? Circ J 2016; 80:814-5. [PMID: 26948985 DOI: 10.1253/circj.cj-16-0186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Teiichi Yamane
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
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10
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Nakamura K, Naito S, Sasaki T, Minami K, Take Y, Goto E, Shimizu S, Yamaguchi Y, Suzuki N, Yano T, Senga M, Kumagai K, Kaseno K, Funabashi N, Oshima S. Silent Cerebral Ischemic Lesions After Catheter Ablation of Atrial Fibrillation in Patients on 5 Types of Periprocedural Oral Anticoagulation – Predictors of Diffusion-Weighted Imaging-Positive Lesions and Follow-up Magnetic Resonance Imaging –. Circ J 2016; 80:870-7. [DOI: 10.1253/circj.cj-15-1368] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Kohki Nakamura
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Shigeto Naito
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Takehito Sasaki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Kentaro Minami
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Yutaka Take
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Eri Goto
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Satoru Shimizu
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | | | - Naoko Suzuki
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Toshiaki Yano
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Michiharu Senga
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Koji Kumagai
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Kenichi Kaseno
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | - Nobusada Funabashi
- Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine
| | - Shigeru Oshima
- Division of Cardiology, Gunma Prefectural Cardiovascular Center
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11
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Innovative Therapeutics for Atrial Fibrillation: Imminent Breakthroughs or Much Ado About Nothing? J Cardiovasc Pharmacol 2015; 66:409-11. [PMID: 26371951 DOI: 10.1097/fjc.0000000000000319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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