Thromboembolism and Mortality in the Tasmanian Atrial Fibrillation Study

Admassie, Endalkachew; Chalmers, Leanne; Bereznicki, Lre

doi:10.1177/1074248418769638

Cited by 2 publications

(2 citation statements)

References 43 publications

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“…In patients with atrial fibrillation, oral anticoagulation reduces the risks of ischemic stroke and systemic embolism in patients with atrial fibrillation by 60–70% [6]. In comparison to VKA, a retrospective study showed that the overall thrombosis rate and transient ischemic attack (TIA) rate after taking DOACs were 1.7 per 100 person-years and 1.3 per 100 person-years, respectively, significantly lower than the 3.2 per 100 person-years and 2.1 per 100 person-years in the VKA group, but there was still a risk of thromboembolism [7]. Therefore, a scoring system that can reliably predict the risk of DOAC-induced thromboembolism is an essential tool for the clinician.…”

Section: Introductionmentioning

confidence: 99%

New score for predicting thromboembolic events in patients with atrial fibrillation using direct oral anticoagulants

Ma,

Chen,

Chang

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

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Determinants of thrombotic events remain uncertain in patients with atrial fibrillation treated with direct oral anticoagulants (DOACs). Our aim was to identify risk factors associated with thromboembolism in patients with at atrial fibrillation on DOACs and to construct and externally validate a predictive model that would provide a validated tool for clinical assessment of thromboembolism. In the development cohort, prediction model was built by logistic regression, the area under the curve (AUC), and Nomogram. External validation and calibration of the model using AUC and Hosmer–Lemeshow test. This national multicenter retrospective study included 3263 patients with atrial fibrillation treated with DOACs. The development cohort consisted of 2390 patients from three centers and the external validation cohort consisted of 873 patients from 13 centers. Multifactorial analysis showed that heavy drinking, hypertension, prior stroke/transient ischemic attack (TIA), cerebral infarction during hospitalization were independent risk factors for thromboembolism. The Alfalfa-TE risk score was constructed using these four factors (AUC = 0.84), and in the external validation cohort, the model showed good discriminatory power (AUC = 0.74) and good calibration (Hosmer–Lemeshow test P value of 0.649). Based on four factors, we derived and externally validated a predictive model for thromboembolism with DOACs in patients with atrial fibrillation (Alfalfa-TE risk score). The model has good predictive value and may be an effective tool to help reduce the occurrence of thromboembolism in patients with DOACs.

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Section: Introductionmentioning

confidence: 99%

New score for predicting thromboembolic events in patients with atrial fibrillation using direct oral anticoagulants

Ma,

Chen,

Chang

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

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“…Atrial fibrillation (AF) is associated with significant morbidity, mortality and increased healthcare costs 1,2 . AF‐associated morbidity and mortality are mainly due to thromboembolic 3 and other cardiovascular complications, such as stroke, myocardial infarction (MI), ischaemic heart disease, heart failure and cardiac arrest 4–7 . Stroke associated with AF is usually more severe and fatal than stroke of other aetiologic origins, but is largely preventable with oral anticoagulation 3 .…”

Section: Introductionmentioning

confidence: 99%

Switching of oral anticoagulants in patients with nonvalvular atrial fibrillation: A narrative review

Kefale

Peterson

Bezabhe

et al. 2021

Brit J Clinical Pharma

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Approval of direct-acting oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation (AF) was an important milestone, providing a wider range of treatment options and creating the possibility for drug switching after initiation. In addition to improved utilisation of oral anticoagulants (OACs) for stroke prevention, reports of switching among OACs are growing in the literature; switching may influence clinical outcomes, healthcare costs and patient satisfaction. This review aimed to summarise the current literature on the pattern of OAC switching in patients with AF, including reasons for switching and clinical consequences following switching. A literature search was conducted in PubMed, Scopus and Embase on 27 June 2020. We included 39 articles published after 2013, following the introduction of apixaban. The review found that switching among OACs was common in clinical practice, significantly varying with the type of OAC. Studies reporting the reason for switching and clinical outcomes were comparatively limited. The decision to switch was often related to safety issues (usually bleeding), poor anticoagulation control and ease of use. Patient characteristics, clinical conditions and drug interactions were found to be associated with switching from OACs. Findings regarding bleeding outcomes following switching were inconsistent, possibly confounded by the rationale for switching and the switching protocol. Noting the limited number of studies included and their relatively short follow-up periods, switching did not have a significant impact on the risk of stroke and other thrombotic outcomes. Further prospective studies are needed to understand better potential rationales for switching and the clinical outcomes.

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Thromboembolism and Mortality in the Tasmanian Atrial Fibrillation Study

Abstract: Thromboembolic event and all-cause mortality rates were lower following the widespread availability of DOACs in this population.

Cited by 2 publications

References 43 publications

New score for predicting thromboembolic events in patients with atrial fibrillation using direct oral anticoagulants

New score for predicting thromboembolic events in patients with atrial fibrillation using direct oral anticoagulants

Switching of oral anticoagulants in patients with nonvalvular atrial fibrillation: A narrative review

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