scholarly journals CORRIGENDUM: Use of Oral Anticoagulants According to the Degree of Renal Impairment in Japanese Patients With Atrial Fibrillation　– Which Non-Vitamin K Antagonist Oral Anticoagulant to Select? –

2016 ◽  
Vol 80 (3) ◽  
pp. 777
Author(s):  
Takanori Ikeda
Keyword(s):  
Atrial Fibrillation ◽  
Renal Impairment ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Oral Anticoagulants ◽  
Japanese Patients ◽  
Vitamin K Antagonist

scholarly journals Stroke Prevention in Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (24) ◽  
pp. 2371-2388
Author(s):  
Aristeidis H Katsanos ◽  
Hooman Kamel ◽  
Jeff S. Healey ◽  
Robert G. Hart
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Trials ◽  
High Risk ◽  
Vitamin K ◽  
Stroke Prevention ◽  
Oral Anticoagulant ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Bleeding Complications ◽  
Secondary Stroke Prevention

Ischemic strokes related to atrial fibrillation are highly prevalent, presenting with severe neurologic syndromes and associated with high risk of recurrence. Although advances have been made in both primary and secondary stroke prevention for patients with atrial fibrillation, the long-term risks for stroke recurrence and bleeding complications from antithrombotic treatment remain substantial. We summarize the major advances in stroke prevention for patients with atrial fibrillation during the past 30 years and focus on novel diagnostic and treatment approaches currently under investigation in ongoing clinical trials. Non–vitamin K antagonist oral anticoagulants have been proven to be safer and equally effective compared with warfarin in stroke prevention for patients with nonvalvular atrial fibrillation. Non–vitamin K antagonist oral anticoagulants are being investigated for the treatment of patients with atrial fibrillation and rheumatic heart disease, for the treatment of patients with recent embolic stroke of undetermined source and indirect evidence of cardiac embolism, and in the prevention of vascular-mediated cognitive decline in patients with atrial fibrillation. Multiple clinical trials are assessing the optimal timing of non–vitamin K antagonist oral anticoagulant initiation after a recent ischemic stroke and the benefit:harm ratio of non–vitamin K antagonist oral anticoagulant treatment in patients with atrial fibrillation and history of previous intracranial bleeding. Ongoing trials are addressing the usefulness of left atrial appendage occlusion in both primary and secondary stroke prevention for patients with atrial fibrillation, including those with high risk of bleeding. The additive value of prolonged cardiac monitoring for subclinical atrial fibrillation detection through smartphone applications or implantable cardiac devices, together with the optimal medical management of individuals with covert paroxysmal atrial fibrillation, is a topic of intensive research interest. Colchicine treatment and factor XIa inhibition constitute 2 novel pharmacologic approaches that might provide future treatment options in the secondary prevention of cardioembolic stroke attributable to atrial fibrillation.

scholarly journals Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants vs. Warfarin in Japanese Patients With Atrial Fibrillation

2015 ◽  
Vol 79 (2) ◽  
pp. 339-345 ◽  
Author(s):  
Keitaro Senoo ◽  
Yee Cheng Lau ◽  
Mikhail Dzeshka ◽  
Deirdre Lane ◽  
Ken Okumura ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Japanese Patients ◽  
Vitamin K Antagonist ◽  
Efficacy And Safety

scholarly journals Appropriateness of initial dose of non-vitamin K antagonist oral anticoagulants in patients with non-valvular atrial fibrillation in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031341 ◽  
Author(s):  
Luis Alberto García Rodríguez ◽  
Mar Martín-Pérez ◽  
Pareen Vora ◽  
Luke Roberts ◽  
Yanina Balabanova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Renal Impairment ◽  
Vitamin K ◽  
Oral Anticoagulants ◽  
Vitamin K Antagonist ◽  
Reduced Dose ◽  
Daily Dose ◽  
The Uk ◽  
The Eu

ObjectiveTo evaluate the appropriateness of the initial prescribed daily dose of non-vitamin K antagonist oral anticoagulants (NOACs) according to label in patients with non-valvular atrial fibrillation (NVAF) in the UK.DesignPopulation-based cross-sectional study.SettingUK primary care.Population30 467 patients with NVAF and a first prescription for apixaban, dabigatran or rivaroxaban between January 2011 and December 2016.Main outcome measuresPercentage of patients prescribed a NOAC dose according to the European Union (EU) labels (appropriately dosed), and not according to the EU labels (inappropriately dosed—including both underdosed and overdosed patients); percentage of patients prescribed an initial NOAC dose according to renal function status.ResultsA total of 15 252 (50.1%) patients started NOAC therapy on rivaroxaban, 10 834 (35.6%) on apixaban and 4381 (14.4%) on dabigatran. Among patients starting NOAC therapy on rivaroxaban, 17.3% were eligible to receive a reduced dose compared with 12.8% of patients starting on apixaban and 53.8% of patients starting on dabigatran. The majority of patients were prescribed an appropriate dose according to the EU labels: apixaban 74.9 %, dabigatran, 74.4%; rivaroxaban, 84.2%. Underdosing occurred in 21.6% (apixaban), 8.7% (dabigatran), 9.1% (rivaroxaban). Overdosing was more frequent for dabigatran (16.9%) than for rivaroxaban (6.6%) or apixaban (3.5%). There was a trend towards dose reduction with increasing renal impairment. Among patients with severe renal impairment, the majority received a reduced dose NOAC: apixaban, 91.1%, dabigatran, 80.0%, rivaroxaban, 83.0%.ConclusionBetween 2011 and 2016, the majority of patients starting NOAC therapy in UK primary care were prescribed a daily dose in line with the approved EU drug label. Underdosing was more than twice as common among patients starting on apixaban than those starting on dabigatran or rivaroxaban. Research into the patient characteristics that may influence inappropriate underdosing of NOACs in UK primary care is warranted.

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