Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Arai, Hideki; Ueda, Shinichiro; Uchida, Keiji; Sakakibara, Fumihiro; Kinjo, Norito; Nezu, Mari; Morimoto, Takeshi

doi:10.1016/j.ijcrp.2022.200135

Cited by 3 publications

(3 citation statements)

References 26 publications

(53 reference statements)

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“…Those with a history of stroke or major bleeding were included. The Institutional Review Boards of all 71 participating centers approved the study protocol (electronic supplementary Table 1), which conforms to the Ethical Guidelines for Medical and Health Research Involving Human Subjects in Japan [15][16][17]. Written informed consent was replaced with the opt-out method in line with the guidelines.…”

Section: Methodsmentioning

confidence: 99%

“…This study was a subanalysis of an historical registry study from 71 centers in Japan [ 15 , 16 ]. We included patients with NVAF, taking VKAs, on 2 February 2013 and excluded those with mechanical heart valves or a history of pulmonary thrombosis or deep vein thrombosis.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical research coordinators reviewed the hospital charts to collect clinical information [ 15 , 16 ]. We collected follow-up information such as patient characteristics, laboratory data, medication use, risk for ischemic stroke (CHADS 2 score), and risk for hemorrhagic stroke (HAS-BLED score) at 1, 2, 3, and 4 years for the same procedure.…”

Section: Methodsmentioning

confidence: 99%

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Association between Acid-Suppressive Drugs and Clinical Outcomes in Patients with Nonvalvular Atrial Fibrillation

et al. 2022

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Purpose Acid-suppressive drugs (ASDs) are often prescribed for patients with nonvalvular atrial fibrillation (NVAF) taking oral anticoagulants (OACs). However, the risk-benefit balance of ASDs prescription for patients with NVAF taking OACs is still unclear. This study aimed to assess the association between ASDs and clinical outcomes in patients taking OACs for NVAF. Methods This study is a subanalysis of an historical registry study from 71 centers in Japan. We included patients taking vitamin K antagonists for NVAF and excluded those with mechanical heart valves or a history of pulmonary thrombosis or deep vein thrombosis. We registered consecutive patients in February 2013 and followed them up until February 2017. The primary outcomes were ischemic events, major bleedings, and all-cause mortality. Ischemic stroke, acute myocardial infarction, and hemorrhagic stroke comprised the secondary outcomes. ResultsWe included 7826 patients with a mean age of 73 years, 5274 (67%) of whom were males. The adjusted hazard ratios (95% confidence intervals) for ischemic events, major bleedings, and all-cause mortality in the ASD group compared with the no-ASD group were 0.998 (0.78-1.27), 0.98 (0.81-1.18), and 1.22 (1.02-1.47), respectively, while those for ischemic stroke, acute myocardial infarction, and hemorrhagic stroke were 0.96 (0.74-1.24), 0.82 (0.36-1.88), and 1.17 (0.69-1.99), respectively. Conclusions ASDs were significantly associated with all-cause mortality in patients with NVAF taking OACs.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Association between Acid-Suppressive Drugs and Clinical Outcomes in Patients with Nonvalvular Atrial Fibrillation

et al. 2022

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Emulating a target trial to assess effect modification: an application to obesity in the comparative effectiveness and safety of apixaban versus warfarin in non-valvular atrial fibrillation using electronic health records

Bin Hammad,

Powell,

Baptiste

et al. 2023

Preprint

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Anticoagulation therapy is recommended for patients with non-valvular atrial fibrillation (NVAF) and an increased risk of stroke. Although apixaban showed superiority over warfarin in the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) study, little is known about their effects in overweight and obese patients, with concerns that obesity might undermine apixaban's effects due to the fixed dosing across body mass index (BMI) groups. We emulated a target trial similar to the ARISTOTLE study using Clinical Practice Research Datalink (CPRD) linked data to estimate the 36-month risk ratios (RR) and risk differences of the effects of apixaban compared to warfarin in NVAF patients in a composite of stroke/systemic embolism (SE), major bleeding and all-cause mortality. In 55,826 patients, apixaban did not differ across groups of BMI in stroke/SE with RR (95% CI) of 1.15 (0.81, 1.62) in normal weight, 1.06 (0.70, 1.61) in overweight and 1.23 (0.69, 2.17) in obese patients. In major bleeding, apixaban was not superior to warfarin in the normal weight group (RR (95% CI) 1.10 (0.76, 1.60) but superior in overweight (RR (95% CI) 0.73 (0.57, 0.93) and obese (RR (95 % CI) 0.67 (0.52, 0.87) groups. In NVAF, the effectiveness and safety of apixaban compared to warfarin were consistent across BMI groups.

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Standardizing Evidence-Based Care for Atrial Fibrillation Using Clinical Pathways - A Practical Approach

Diaz,

Bujnowski,

E. Tabit

2024

Atrial Fibrillation - Current Management and Practice [Working Title]

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While atrial fibrillation remains the most common cardiac arrhythmia and cause of stroke, management of atrial fibrillation varies widely from institution to institution and from provider to provider despite the existence of widely-published, multi-society guidelines. Initial diagnostic workup, first-line anticoagulant choice, rate- vs. rhythm-control approaches, and timing of referral for ablation or left atrial appendage closure devices vary. Standardization of these and other care processes leads to more reproducible outcomes and overall improvement in patients’ symptoms and quality of life. However, distilling this large volume of available evidence and guidelines into practical care algorithms which providers can use to guide care in the real world can be a daunting task. In this chapter, we will discuss the practical approach to building a clinical pathway for the management of atrial fibrillation in the Inpatient and Emergency Department settings including our approach to weighing available evidence, building provider consensus, designing and refining the pathway, initial pathway launch, sustaining the change, measuring success, and updating the pathway as new evidence emerges. This chapter will draw heavily from our 10 years of experience building clinical pathways at the University of Chicago with special focus on generalizable points that can be applied to readers’ home institutions.

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Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Cited by 3 publications

References 26 publications

Association between Acid-Suppressive Drugs and Clinical Outcomes in Patients with Nonvalvular Atrial Fibrillation

Association between Acid-Suppressive Drugs and Clinical Outcomes in Patients with Nonvalvular Atrial Fibrillation

Emulating a target trial to assess effect modification: an application to obesity in the comparative effectiveness and safety of apixaban versus warfarin in non-valvular atrial fibrillation using electronic health records

Standardizing Evidence-Based Care for Atrial Fibrillation Using Clinical Pathways - A Practical Approach

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