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Net Clinical Benefit of Non-Vitamin K Antagonist vs Vitamin K Antagonist Anticoagulants in Elderly Patients with Atrial Fibrillation

The risks of thromboembolic and hemorrhagic events in patients with atrial fibrillation both increase with age; therefore, net clinical benefit analyses of anticoagulant treatments in the elderly population are crucial to guide treatment. We evaluated the 1-year clinical outcomes with non-vitamin-K antagonist and vitamin K antagonist oral anticoagulants (NOACs vs VKAs) in elderly (≥75 years) […]

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Clinical presentation patterns of AF versus likelihood of detection with monitoring. Dark bars indicate times that AF is present. AF = atrial fibrillation; ECV = elective cardioversion.

Mass Screening for Atrial Fibrillation: The Hype, The Methods, and The Application

Recently, Apple launched new heart-related features for their Apple Watch, including an app cleared by the US Food and Drug Administration that notifies wearers if atrial fibrillation has occurred. Apple admits, however, that the watch cannot detect all episodes; inconclusive results are possible; and it is not intended for people with known atrial fibrillation.1 Notably, this comes shortly […]

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Comparative Stroke, Bleeding, and Mortality Risks in Older Medicare Patients Treated with Oral Anticoagulants for Nonvalvular Atrial Fibrillation

Nonvitamin K antagonist oral anticoagulants (NOACs) are alternatives to warfarin in patients with nonvalvular atrial fibrillation. Randomized trials compared NOACs with warfarin, but none have compared individual NOACs against each other for safety and effectiveness. Methods We performed a retrospective new-user cohort study of patients with nonvalvular atrial fibrillation enrolled in US Medicare who initiated […]

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Concomitant Use of Direct Oral Anticoagulants with Antiplatelet Agents and the Risk of Major Bleeding in Patients with Nonvalvular Atrial Fibrillation

  Patients with nonvalvular atrial fibrillation commonly have comorbidities requiring concurrent use of oral anticoagulants and antiplatelets. There are no real-world data on the comparative safety of concomitant antithrombotic treatments in the era of direct oral anticoagulant (DOACs). Thus, we compared the incidence of intracranial hemorrhage, gastrointestinal bleeding, and other major bleeding between concomitant DOAC-antiplatelet […]

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Concomitant Use of Direct Oral Anticoagulants with Antiplatelet Agents and the Risk of Major Bleeding in Patients with Nonvalvular Atrial Fibrillation

Patients with nonvalvular atrial fibrillation commonly have comorbidities requiring concurrent use of oral anticoagulants and antiplatelets. There are no real-world data on the comparative safety of concomitant antithrombotic treatments in the era of direct oral anticoagulant (DOACs). Thus, we compared the incidence of intracranial hemorrhage, gastrointestinal bleeding, and other major bleeding between concomitant DOAC-antiplatelet use […]

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Monitoring of Apixaban in a Super Obese Patient

Direct oral anticoagulants (DOACs) are considered advantageous compared to vitamin K antagonists in eligible atrial fibrillation patients.1 Increased body weight is associated with 30% lower exposure to standard doses of DOACs, raising concerns about adequate dosing in obese patients.2, 3 Due to lack of sufficient clinical data, use of DOACs in patients with a body mass index (BMI) […]

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