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Background: Non-vitamin K direct oral anticoagulant is a non-vitamin K-based anticoagulant that is used to reduce embolic events in nonvalvular atrial fibrillation patients. However, DOAC's effectiveness and safety in AF patients with bioprosthetic heart valves is largely unknown. Methods: Between 2013 and 2018, we retrospectively identified patients with AF and BPHV by using the diagnostic code and medical device and surgery information from the Korean National Health Insurance Service database. The death was non-inferior to warfarin in preventing ischemic stroke and systemic embolism, widespread bleeding, and all-cause deaths. DOAC was also similar to warfarin in terms of the net clinical results. Conclusion: DOAC was at least as efficient and safe as warfarin for the prevention of systemic embolic events in this national Korean AF population with a BPHV. These findings indicate that DOAC may be a safe alternative to warfarin in AF patients with BPHV.
Source link: https://doi.org/10.1371/journal.pone.0268113
Background: Atrial fibrillation is a significant risk factor for ischaemic stroke, and AF incidence is expected to rise. However, studies have shown that OACs are often underused in AF patients. Methods and findings: We conducted a population-based retrospective cohort study using the UK Clinical Practice Research Datalink database to find patients with NVAF aged u226518 years and registered in English general practices between 2009 and 2019. Patients at risk of stroke were analyzed for patients at risk of stroke and classified into the following: OAC, aspirin only, or no treatment. To determine relative risk ratios and 95% confidence intervals of the factors associated with OAC or aspirin-only prescribing in patients with NVAF who are advised to take OAC, we used a multivariable multinomial logistic regression model. OAC prescribing rose from 50. 8 percent in 2009 to 83. 2% in 2019. Patients from black and other ethnic minorities were less likely to receive OAC than white ethnicity; 0. 78 and 0. 76 respectively. Patients living in the most impoverished areas were less likely to receive OAC 0. 85 than patients living in the least deprived areas. Aspirin prescription risks were higher in the East of England, despite no diagnosis or London routines. Alyaa Ajabnoor and co-workers investigate the prevalence of non-valvular atrial fibrillation in England and apparent care inequalities.
Source link: https://doi.org/10.1371/journal.pmed.1004003
However, community-based studies on untreated AF screening in Japan have yet to be conducted in Japan, and there has been no study of the benefits of early screening for AF in the elderly. Methods: The Kyoto Prefectural University of Medicine Education Initiative ran an AF awareness campaign that consisted of screening results using a blood pressure monitor, electrocardiogram, and educational lectures for seniors from 2019 to 2020. In a Japanese setting, a modeled effectiveness evaluation was conducted comparing the life-years and QALYs between direct-acting oral anticoagulation treatment-treated AF and untreated AF. Compared to non-treatment, 0. 859 QALYs for 65 years-old men increased over the lifetime of 65 years-old men and 0. 856 QALYs for 65 years-old women increased over the lifetime of 65 years-old women. If properly handled with DOAC, an increasing number of patients with AF is likely to result in a decrease in the number of strokes per year relative to subjects with a lifetime of AF.
Source link: https://doi.org/10.1371/journal.pone.0269506
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