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Purpose of this study was to determine the safety and effectiveness of resuming immediate-acting oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation and prior gastrointestinal bleeding. Results The final analysis contained 59,244 AF patients with prior GIB, of whom 27,793 returned DOACs, 24,635 restarted warfarin, and 6816 did not restart anticoagulation, with 5813 reporting that gastrointestinal bleeding did not occur. Warfarin resuming with an elevated risk of recurrent GIB was found with an elevated risk of recurrent GIB, but no increased risk of recurrent GIB was found with resuming of DOACs; in particular DOACs, only rivaroxaban was associated with an elevated risk of recurrent GIB. Conclusions In AF patients with prior GIB, resuming DOAC therapy may be safer, except for rivaroxaban.
Source link: https://doi.org/10.1007/s00228-022-03300-7
It is also unknown if catheter ablation for atrial fibrillation may have improved clinical outcomes in the general AF population. We found 537 patients with first-time catheter ablation or conservative management in Kyoto University Hospital's outpatient department between January 2005 and March 2015, matched for age, gender, AF duration, AF type, AF symptoms, and recent heart failure. The cumulative 5-year prevalence of the primary outcome measure in the ablation group was much lower than in the conservative group. Even after accounting for the baseline variables' inequalities, the ablation group's lower risk of the ablation group relative to the conservative group for the primary outcome measure remained highly significant.
Source link: https://doi.org/10.1007/s00380-022-02023-0
Although a high risk of thromboembolism in elderly patients with heart failure and atrial fibrillation, poor control of prothrombin time/international normalized ratio was common in patients using vitamin K antagonists. Patients treated with oral anticoagulants should have a greater outcome than those treated with VKAs, according to We hypothesized that patients treated with direct oral anticoagulants would have a better outcome. The aim of this research was to determine the effectiveness of DOACs and VKAs in elderly patients with HF and AF. According to the anticoagulant therapy they received, we screened 329 patients aged > 65 years old with non-valvular AF and divided them into two groups. In the crude population, the incidence rates of non-cardiovascular death and stroke were not significantly different, according to the Kaplanu2013Meier report, although all-cause mortality was significantly lower in the DOAC group than in the VKA group, although the incidence rates of non-cardiovascular death and stroke were not significantly different.
Source link: https://doi.org/10.1007/s00380-022-02027-w
Purpose Indian patients undergoing surgical revascularization are younger than their Western counterparts and are predominantly revascularized using the off-pump coronary artery bypass grafting method. This study was designed to determine the incidence of POAF, assess its effect on outcomes, and determine predictors of POAF in the Indian patients undergoing OPCAB. In addition, the effectiveness of the European System for Cardiac Operative Risk Evaluation and Society of Thoracic Surgeons in predicting POAF was also evaluated. The receiver operating characteristic curve was used to determine the capability of EuroSCORE and STS scores to assess the risk of developing POAF. Patients with chronic POAF were significantly higher in both the EuroSCORE and the STS score. These patients' scores were 0. 62 percent and for the STS score was 0. 64, indicating that both the scores were consistent and similar discriminatory ability of both the scores to forecast POAF.
Source link: https://doi.org/10.1007/s12055-022-01358-7
Patients with diabetes Aims Atrial fibrillation raises cardiovascular disease and mortality in patients with diabetes. Diabetes is a risk factor for AF; however, risk factors for AF among patients with type 2 diabetes, especially Asian people, remain unclear. We established the prevalence of AF in Japanese patients with T2D, regardless of the cause, and even outlined the triggers associated with AF. We analyzed medical data in patients with and without AF. Conclusions AF among patients with T2D was 5. 9%; it became more prevalent in men than in women as age increased and was typically higher in men than in women. As albuminuria or proteinuria progressed, the incidence of asthma increased as the eGFR decreased. Multiple logistic regression studies revealed that older age, male sex, and reduced eGFR were all independently and significantly associated with AF coexistence. In Japanese patients with T2D, older age, male sex, and reduced eGFR were all associated with AF.
Source link: https://doi.org/10.1007/s13340-021-00563-w
Patients with nonvalvular atrial fibrillation are at a higher risk of experiencing thromboembolic events in hypertrophic cardiomyopathy. Vitamin K antagonist oral anticoagulants have been used as therapy, but there is still no evidence on the safety of prescribing non-vitamin K antagonist oral anticoagulants. This retrospective review examines the effectiveness and safety of NOAC therapy in patients with HCM and AF. Between January 2015 and December 2019, a total of 124 patients with HCM and AF on an oral anticoagulant therapy was recruited between January 2015 and December 2019, and these patients were followed up until March 31, 2020. Patients receiving NOACs had a reduced risk of clinically relevant bleeding over a period of 53. 6 months, according to a survival study. NOACs were associated with a reduced risk of clinically relevant bleeding in HCM patients with AF, relative to warfarin, as shown by the similar incidence of death among all causes, cardiovascular disease, and thromboembolic events.
Source link: https://doi.org/10.1007/s00380-022-02021-2
The majority of the commonly used treatment options for heart failure, as well as rhythm or rate control, and anticoagulation are common in atrial fibrillation can be obtained with either pharmaceutical or non-pharmaceutical techniques.
Source link: https://doi.org/10.1007/s10741-021-10133-6
To restore and maintain sinus rhythm, AF treatment plans currently focus on monitoring heart rate and rhythm with drugs in order to restore and maintain sinus rhythm, but this strategy has limitations. Catheter ablation is not entirely correct, and does not address the issues that underpin AF. For improved prevention, diagnosis, and treatment of AF, research into the causes of AF is urgently required. Exosomes are tiny vesicles that are released by cells that exchange information between cells. MicroRNAs in exosomes play a key role in the onset of AF and have been used as a biomarker for AF. A summary of exosomes' role in AF is included in this article. The role of exosomes and microRNAs in AF formation, their therapeutic potential, and potential roles as clinical biomarkers is considered. A better understanding of exosomes has the ability to enhance AF patients' prognosis worldwide, lowering the global medical burden of this disease.
Source link: https://doi.org/10.1007/s10741-021-10142-5
Long noncoding RNAs, which usually refer to noncoding RNA transcripts greater than 200 nucleotides in length, have been shown to play a part in cardiovascular diseases such as coronary artery disease, heart arrest, and myocardial fibrosis by a variety of regulatory approaches. This article explores the possibility of LncRNAs as new biomarkers and therapeutic targets in AF, as well as the LncRNAs that play a regulatory role in AF-related processes.
Source link: https://doi.org/10.1007/s12033-022-00449-5
We investigated the connection between left atrial epicardial adipose tissue and left atrial appendage flow velocity in patients with nonvalvular atrial fibrillation in this research. Patients with NV-AF who underwent their first radiofrequency ablation were recruited. A total of 145 patients with NV-AF who underwent their first radiofrequency ablation were enrolled. According to independent predictors of LAA-FV, the left atrial low voltage zone, the left atrial low voltage zone, LA-EAT volume, left atrial appendage shape, LAVI, and a form of fibrillation were all independent predictors of LAA-FV. The rise in LA-EAT volume in NV-AF patients is attributed to the decrease in LAA-FV.
Source link: https://doi.org/10.1038/s41598-022-13988-3
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