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Dabigatran vs. warfarin as long-term anticoagulant therapy in atrial fibrillation
August 31, 2009The anticoagulant dabigatran is more effective than warfarin in the prevention of stroke in patients with atrial fibrillation, according to results from the RE-LY study (Randomized Evaluation of Long-term anticoagulant therapY).
"Although researchers have been looking for a replacement for warfarin for several decades, nothing has been successful as an oral blood thinner," says Professor Stuart Connolly, Director of the Division of Cardiology at McMaster University, Canada, and one of the leading investigators of the study.
The RE-LY study compared two doses of dabigatran with the current standard therapy, warfarin, in 18,113 patients with atrial fibrillation at increased risk of stroke. The study included more than 951 centres in 44 countries. Patients were enrolled over a two-year period and then followed for one further year. The study was designed to evaluate whether either of two doses of dabigatran were non-inferior to warfarin (ie, at least as good as warfarin). The results show, however, that the higher dose of dabigatran, 150 mg twice daily, significantly reduces the risk of stroke by 34% compared to warfarin. The lower dose, 110 mg twice daily, had a similar effect to warfarin in the prevention of stroke, but with significantly less major bleeding.
According to Professor Connolly, although warfarin has been the gold standard for reducing stroke in atrial fibrillation for more than 20 years, it has many problems; these include a need for monitoring by blood test measurement, and a significant risk of increased bleeding, which makes it unsuitable for many patients. "Several new drugs have been recently studied to see if they could replace warfarin," says Professor Connolly. "None, however, has been satisfactory. Either they were not effective enough, they had too many side effects or they caused too much bleeding. This is the first time in more than 50 years that a new oral blood thinner has been developed which has been found to be both safer and more effective than existing therapy."
Atrial fibrillation is a common disorder of the heart rhythm that affects about 1% of the population and up to 10% of people over the age of 80. The major complication of atrial fibrillation is stroke. About one in six strokes are caused by atrial fibrillation. Patients with atrial fibrillation have an annual risk of stroke of 1-10%. Anticoagulants such as warfarin are the only way to prevent these strokes.
European Society of Cardiology
According to Professor Connolly, although warfarin has been the gold standard for reducing stroke in atrial fibrillation for more than 20 years, it has many problems; these include a need for monitoring by blood test measurement, and a significant risk of increased bleeding, which makes it unsuitable for many patients. "Several new drugs have been recently studied to see if they could replace warfarin," says Professor Connolly. "None, however, has been satisfactory. Either they were not effective enough, they had too many side effects or they caused too much bleeding. This is the first time in more than 50 years that a new oral blood thinner has been developed which has been found to be both safer and more effective than existing therapy."
Atrial fibrillation is a common disorder of the heart rhythm that affects about 1% of the population and up to 10% of people over the age of 80. The major complication of atrial fibrillation is stroke. About one in six strokes are caused by atrial fibrillation. Patients with atrial fibrillation have an annual risk of stroke of 1-10%. Anticoagulants such as warfarin are the only way to prevent these strokes.
European Society of Cardiology
Atrial Fibrillation Current Events and Atrial Fibrillation News RSSSize matters: Obesity leading risk factor of left atrial enlargement during aging
Aside from aging itself, obesity appears to be the most powerful predictor of left atrial enlargement (LAE), upping one's risk of atrial fibrillation (the most common type of arrhythmia), stroke and death.
Experts unveil new CVD guidelines and position papers
Several new guidelines and position papers offering the most up to date information to ensure that clinicians practice evidence-based medicine were released at the Canadian Cardiovascular Congress 2009 this week.
Learning the risks for stroke - and taking action
With this theme in mind, the European Society of Cardiology (ESC) emphasises that most of the risks for stroke are also the major risks for coronary heart disease - and thus the object of the ESC's far-reaching prevention programme.
Afib triggered by a cell that resembles a pigment-producing skin cell
The source and mechanisms underlying the abnormal heart beats that initiate atrial fibrillation (Afib), the most common type of abnormal heart beat, have not been well determined.
New blood-thinning drug safer than rat poison
In an article reviewed by F1000 Medicine Faculty Members Robert Ruff, Brian Olshansky and Luis Ruilope, the blood-thinner dabigatran is shown to protect against stroke, blood clotting and major bleeding as effectively as warfarin, but with fewer side effects.
Women with diabetes at increased risk for irregular heart rhythm
Diabetes increases by 26 percent the likelihood that women will develop atrial fibrillation (AF), a potentially dangerous irregular heart rhythm that can lead to stroke, heart failure, and chronic fatigue.
Women with Atrial Fibrillation Are at Significantly Higher Risk of Stroke and Death Compared to Men and Receive Less Attention
Even though the incidence of atrial fibrillation is higher in men than women, a review of past studies and medical literature completed by cardiac experts at Rush University Medical Center shows that women are more likely than men to experience symptomatic attacks, a higher frequency of recurrences, and significantly higher heart rates during atrial fibrillation, which increases the risk of stroke.
Mount Sinai first in nation to ablate atrial fibrillation using new visually-guided balloon catheter
Physicians at The Mount Sinai Medical Center in New York became the first in the U.S. to ablate atrial fibrillation using a visually-guided laser balloon catheter.
Atrial fibrillation: Drugs or ablation?
Atrial fibrillation ablation is one of the fastest growing techniques in cardiology and due to the very high number of patients that might be candidates to this procedure, a significant number of resources will have to be devoted to it to be able to treat them in the following years.
Irbesartan reduces heart failure in patients with quivering heart
Most research in atrial fibrillation (AF) has focused on reducing stroke and other embolic events. Yet heart failure occurs more frequently in AF patients, but has not been the focus of intervention research.
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Atrial Fibrillation: From Bench to Bedside (Contemporary Cardiology) by Andrea Natale (Editor), José Jalife (Editor) Advancements in the treatment and prevention of Atrial Fibrillation are presented in this important new book. Atrial Fibrillation affects approximately 2.5 million individuals in the United States and is projected to affect 15 million individuals by 2050. In Atrial Fibrillation: From Bench to Bedside, the reader is provided with the latest information that is critically important in the daily care and for the potential cure of patients with Atrial Fibrillation. Each chapter deals with a different aspect of Atrial Fibrillation and was authored by internationally recognized experts in the evolving field of cardiac electrophysiology. This book is a single source that provides a multi-perspective look at and approach to Atrial Fibrillation. Because Atrial Fibrillation is so prevalent and... |
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Atrial Fibrillation Part of the award winning public television series Healthy Body/Healthy Mind. You know the signs...rapid heart beat... shortness of breath... panic! Sounds like a heart attack, or panic disorder. More often, it is Atrial Fibrillation, an irregular heartbeat disorder than can cause the heart to beat more than 300 times a minute. More than 2 million people have Atrial Fibrillation. Here's what happens: because of a problem with the electrical wiring in the heart, the two small upper chambers, the atria, quiver instead of beating effectively. This quivering causes the discomfort the patient feels, and can cause the blood to pool and clot. If a piece of blood clot leaves the heart and becomes lodged in an artery in the brain, a stroke results. About fifteen percent of strokes occur in people... |
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Atrial Fibrillation : My Heart, the Doctors, and Me by E. A. Butler (Author) An Investigative Report by an Inquisitive Patient The author felt compelled to write this story after discovering he had paroxysmal atrial fibrillation. He had little previous experience with personal illnesses. Now he found himself dealing with production line medicine. This experience fostered skepticism, doubts, apprehensions and grave concerns. He discovered he was afflicted with one of the most elusive and complex cardiovascular problems that involves the electrical impulse of the heart. This led him to unleash his investigative experience to find out why more hasn't been done to cure the malady. |
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Atrial Fibrillation (Fundamental and Clinical Cardiology) by Peter Kowey (Editor), Gerald Naccarelli (Editor) Filling a gap in the literature, this all-encompassing reference explores the epidemiology, mechanisms, and pathophysiology of atrial fibrillation and compiles the latest diagnostic and treatment practices for patient care. The book summarizes the most recent advances in symptom relief, drug development, device management, and long-term control of heart rhythm abnormalities and reviews the latest studies on the prevention of stroke and other thromboembolic events in patients with valvular and nonvalvular atrial fibrillation. Finally, it offers new strategies to improve the therapy and outcomes of patients suffering from the myriad of complications associated with atrial fibrillation. |
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Atrial Fibrillation - The Most Common Arrhythmia (Have A Heart Series) Starring: Dr. Gerry Maddoux Directed By: Mark Baer Also With: Dr. Gerry Maddoux (Writer), Mark Baer (Producer) | |
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Atrial Fibrillation - The Most Common Arrhythmia (Have A Heart Series) Directed By: Mark Baer Also With: Mark Baer (Producer), Dr. Gerry Maddoux (Writer) * 2 Million people in America have atrial fibrillation. * Advancing age, high blood pressure and diabetes are common causes. * Embolic stroke (clot from the fibrillating left atrium) is the most common complication. This can be largely prevented with anticoagulation. * You can have a normal, healthy lifespan with atrial fibrillation. This product is manufactured on demand using DVD-R recordable media. Amazon.com's standard return policy will apply. |
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A Practical Approach To Catheter Ablation Of Atrial Fibrillation by Lippincott Williams & Wilkins A Practical Approach to Catheter Ablation of Atrial Fibrillation : A Practical Approach to Catheter Ablation of Atrial Fibrillation Pub Date: April 2008 Product Type: Print Author/s: Hugh Calkins MD; Pierre Jais MD; Jonathan S Steinberg MD Written and edited by expert electrophysiologists, this book is a practical, well-illustrated guide to the most successful techniques for catheter ablation of atrial fibrillation. While other texts address ablation of different arrhythmias, this is the first book to focus specifically on atrial fibrillation.Chapters explain how to establish programs and laboratories for treating atrial fibrillation; use complex imaging modalities and guidance systems; implement a variety of catheter-based ablation strategies, either isolated or in... |
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A Practical Approach to Catheter Ablation of Atrial Fibrillation (Practical Approach (Lippincott & Wilkins)) by Hugh Calkins (Editor), Pierre Jais (Editor), Jonathan S Steinberg (Editor) Written and edited by expert electrophysiologists, this book is a practical, well-illustrated guide to the most successful techniques for catheter ablation of atrial fibrillation. While other texts address ablation of different arrhythmias, this is the first book to focus specifically on atrial fibrillation. Chapters explain how to establish programs and laboratories for treating atrial fibrillation; use complex imaging modalities and guidance systems; implement a variety of catheter-based ablation strategies, either isolated or in tandem; monitor the ablated patient's course for complications and arrhythmia recurrence; and manage these problems should they arise. The chapters on lab staffing and equipment, pre-procedure preparation, and post-procedure care will be of special interest to... |
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Critical Care Compendium by Mind-Forge Education Services LLC This is a collection of Self Learning Modules and pocket guides. Below are some of the modules and pocket guides in this product. **A quick handy guide to quickly interpret the 12 lead electrocardiogram, identify ischemia, reciprocal changes and to quickly localize a myocardial infarction and involved coronary arteries. **A brief presentation on atrial fibrillation/flutter, optimal monitoring leads, causes and complications related to open heart surgery. **A brief over view of current Advanced Cardiac Life Support treatment algorithms. **ACLS 2006 Code Drugs: Detailed description of 2006 ACLS code drugs and drip charts. (Current for 2007) **A detailed guide to the autonomic nervous system with emphasis placed on parasympathetic and sympathetic involvement and pharmacological... |
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Atrial Fibrillation, An Issue of Medical Clinics (The Clinics: Internal Medicine) by Ranjan K. Thakur (Author), Andrea Natale MD FACC FHRS (Author) Atrial fibrillation is the most common sustained arrhythmia in humans. An incredible worldwide effort from physicians, scientists and industry over the last decade has brought forth new insights and therapeutic tools. We are fortunate to have achieved a level of understanding about this complex disease that we can indeed cure some patients. While we proceed at full speed ahead looking for cures for the rest, we have taken this opportunity in the Medical Clinics of North America to reflect on how much we have learned and on the task that lies ahead. This issue opens with a historical perspective, discusses many of the clinical issues in the management of atrial fibrillation, such as cardioversion, anticoagulation and ablation, and concludes with the current guidelines for treatment and... |
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