A new integrated strategy for direct current cardioversion in non-valvular atrial fibrillation patients using short term rivaroxaban administration: The MonaldiVert real life experience

Russo, Vincenzo; Napoli, Lucia; Bianchi, Valter; Tavoletta, Vincenzo; Vivo, Stefano De; Cavallaro, Ciro; F, Vecchione; Rago, Anna; Sarubbi, Berardo; Calabrò, Paolo; Nigro, Gerardo; D’Onofrio, Antonio

doi:10.1016/j.ijcard.2016.09.022

Cited by 21 publications

(15 citation statements)

References 8 publications

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“…Previous studies proved that the patients receiving NOACs enjoyed similar preventive effects and a lower risk of major bleeding [ 12 , 13 , 21 ]. Efficacy and safety have also been highlighted in electrical cardioversion and transcatheter radiofrequency cardiac ablation [ 22 , 23 , 24 ]. The evidence supported that NOACs would be some of the first drug choices in the treatment of non-valvular atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

The CHA2DS2-VASc Score Predicts Major Bleeding in Non-Valvular Atrial Fibrillation Patients Who Take Oral Anticoagulants

Lee

Chang

Yeh

et al. 2018

JCM

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Background: Patients with atrial fibrillation (AF) are at a substantial risk of ischemic stroke. The CHA2DS2-VASc score predicts the risk of thromboembolism, but its role in predicting major bleeding in patients taking oral anticoagulants is unclear. Methods: We used the National Health Insurance Research Database (NHIRD) of Taiwan to identify patients with AF from 2010 to 2016. They were divided into four groups according to the oral anticoagulants. The outcomes were ischemic stroke/systemic thromboembolism, and major bleeding. Results: A total of 279,776 patients were identified. Ischemic stroke or systemic embolism events were observed in 1.73%, 3.62%, 4.36%, and 5.02% of the patients in the apixaban, rivaroxaban, dabigatran, and warfarin groups, respectively. Major bleeding was recorded in 1.18%, 2.66%, 3.23%, and 4.70% of the patients in the apixaban, rivaroxaban, dabigatran, and warfarin groups, respectively. The highest rates for both ischemic stroke and bleeding events occurred in the patients with a CHA2DS2-VASc score of five or more. Conclusion: Non-valvular AF patients with high CHA2DS2-VASc scores are susceptible to both systemic thromboembolism and major bleeding. The trend was consistently observed in patients who took non-vitamin K oral anticoagulants (NOACs) or warfarin. NOACs might be potentially more effective in reducing overall events.

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Section: Discussionmentioning

confidence: 99%

The CHA2DS2-VASc Score Predicts Major Bleeding in Non-Valvular Atrial Fibrillation Patients Who Take Oral Anticoagulants

Lee

Chang

Yeh

et al. 2018

JCM

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“…Standard triple therapy (VKA, clopidogrel, and aspirin) may minimize the risk of stent thrombosis and ischemic events [3], but it is associated with an increased risk of bleeding. NOACs offer a safe and effective alternative to VKA for anticoagulation in AF [4, 10–16]. However, they have not been specifically tested—at the dose used for stroke prevention—as components of a triple oral antithrombotic therapy regimen for coexisting AF and PCI with stenting; hence, there is no clear worldwide indication for this clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Triple Antithrombotic Therapy with Dabigatran versus Vitamin K Antagonist in Atrial Fibrillation Patients: A Pilot Study

Russo

Rago

Proietti

et al. 2019

BioMed Research International

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Background. Combination of dual antiplatelet (DAPT) and oral anticoagulation therapy is required to decrease cardioembolic stroke and stent thrombosis risk in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS). We compared the safety and efficacy of dabigatran etexilate with vitamin K antagonist (VKA), in combination with DAPT (aspirin plus clopidogrel) treatment in AF patients who underwent percutaneous coronary intervention (PCI) with stenting for ACS. Methods. Consecutive nonvalvular AF patients who received twice-daily dabigatran 110 mg (n = 389) or VKA (n = 510) and DAPT were included. Primary endpoints were major bleeding (safety) and the composite of ischemic stroke, systemic embolism, and myocardial infarction (efficacy). The secondary efficacy endpoint was hospitalization for cardiovascular disease. Results. After propensity score matching, comparative treatment groups comprised 175 dabigatran recipients and 175 VKA recipients. The cumulative incidence of major bleeding was lower in the dabigatran group (2.3%) compared with the VKA group (10.3%) with a hazard ratio (HR) of 4.81 [95% confidence interval (CI) 1.6–14.2, p < 0.005]. The cumulative incidence of thromboembolic events with dabigatran was slightly higher (8.0%) than with VKA (6.85%), but not statistically significantly so (0.8, 0.39–1.8; p = 0.6). Cumulative incidence of hospitalization for cardiovascular disease was lower with dabigatran (10.3%) compared with VKA (20.6%) treatment (2.2, 1.25–3.8; p < 0.006). Conclusion. Dabigatran at the dose used for stroke prevention appears safer than VKA and maintains a similar efficacy profile, when used with DAPT, in AF patients who have undergone PCI with stenting for ACS.

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“…Follow-up data were obtained through visits to the outpatient department every 3 to 6 months for assessing the clinical status, adherence to treatment, occurrence of stroke, transient ischemic attack (TIA), major and minor bleeding events, other side effects, and major cardiovascular complications. 11,12 All patients provided written, informed consent before inclusion in the database. The project was approved by the local institutional review committee.…”

Section: Patient Populationmentioning

confidence: 99%

Use of Non–Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients with Malignancy: Clinical Practice Experience in a Single Institution and Literature Review

Russo

Rago

Papa

et al. 2017

Semin Thromb Hemost

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This observational study aimed to investigate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with malignancy. A total of 76 patients (mean age: 73.2 ± 8.9; 28 females) with AF and malignancy treated with NOAC were included in the analysis. The mean CHADS-VASc and HAS-BLED scores were 3.2 ± 1.2 and 2.2 ± 0.9, respectively. The study population was taking dabigatran 150 mg (25%) twice daily (BID), apixaban 5 mg BID (25%), dabigatran 110 mg BID (24%), rivaroxaban 20 mg (18%) once a day (OD), rivaroxaban 15 mg OD (5%), or apixaban 2.5 mg OD (3%). NOAC therapy began, on average, 248 ± 238 days before malignancy diagnosis for an average duration of 1,000 ± 289 days. Stroke, transient ischemic attack, major and minor bleeding events, other adverse effects, and major cardiovascular complications during the follow-up period were collected. In our study population, no patients experienced thromboembolic events during therapy with any NOAC. We recorded a low global incidence of major bleeding (3.9%) with a mean annual incidence of 1.4%. No hemorrhagic stroke or subarachnoid hemorrhage was observed. Only nine patients (11.8%) experienced minor bleeding. According to our data, anticoagulation therapy with NOACs seems to be an effective and safe treatment strategy for nonvalvular AF patients with malignancy.

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A new integrated strategy for direct current cardioversion in non-valvular atrial fibrillation patients using short term rivaroxaban administration: The MonaldiVert real life experience

Cited by 21 publications

References 8 publications

The CHA2DS2-VASc Score Predicts Major Bleeding in Non-Valvular Atrial Fibrillation Patients Who Take Oral Anticoagulants

The CHA2DS2-VASc Score Predicts Major Bleeding in Non-Valvular Atrial Fibrillation Patients Who Take Oral Anticoagulants

Safety and Efficacy of Triple Antithrombotic Therapy with Dabigatran versus Vitamin K Antagonist in Atrial Fibrillation Patients: A Pilot Study

Use of Non–Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients with Malignancy: Clinical Practice Experience in a Single Institution and Literature Review

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