Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
|
|
- Lee Bond
- 5 years ago
- Views:
Transcription
1 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
2 AF review Petr Polasek
3 Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or by any means graphic, electronic, or mechanical, including photocopying, recording, or information storage and retrieval systems without prior written permission of Sea Courses Inc. except where permitted by law. Sea Courses is not responsible for any speaker or participant s statements, materials, acts or omissions.
4 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
5 Atrial Fibrillation: 4 Principles 1. PREVENT Stroke/Embolization 2. Render patient ASYMPTOMATIC/ functional 3. Investigate ETIOLOGY 4. Consider benefit/risk ratio of SINUS restoration
6 A quiz World is getting Younger Older Older world equals Less Strokes More Strokes
7 We are in trouble! More than 37 million people are age 65. By 2030, this number will exceed 70 million. By 2040, those aged 75 years will exceed the population 65 to 74 years old. By 2050, 12%, or 1 in 8 Americans, will be age 75 or older.
8 Prevalence, percent AF Prevalence: Age and Gender Prevalence of atrial fibrillation with age JAMA 2001; 285: 2370 Age, years
9 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
10 Atrial Fibrillation: 4 Principles 1. PREVENT Stroke/Embolization 2. Render patient ASYMPTOMATIC/ functional 3. Investigate ETIOLOGY 4. Consider benefit/risk ratio of SINUS restoration
11 Note to self: CVA prevention is the MOST important issue
12
13 CHADS 2 Score (Simple Prediction Tool for Assessing Stroke Risk) CHADS 2 Score* Stroke Rate, %/yr (95 %CI) ( ) 1 point for Congestive Heart Failure 1 point for Hypertension 1 point for Age 75 years 1 point for Diabetes Mellitus 2 points for Prior Stroke or TIA ( ) ( ) ( ) ( ) ( ) ( ) *Score 0: Patients can be administered aspirin *Score 1: Patients can be administered aspirin or anticoagulant therapy *Score 2: Patients should be administered anticoagulant therapy 1. Gage BF, et al. JAMA. 2001;285:
14 CHA 2 DS 2 -VASc Score 1 point for Congestive Heart Failure/ LV Dysfunction 1 point for Hypertension 2 points for Age 75 years 1 point for Diabetes Mellitus 2 points for Prior Stroke or TIA 1 or TE 2 1 point for Vascular Disease 3 1 point for Age years 1 point for Sex category (female gender) CHA 2 DS 2 -VASc Score* One year event rate (95% CI) of hospital admission and death due to thromboembolism per 100 person years ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) *Score 0: Patients can be administered aspirin *Score 1: Patients can be administered aspirin or anticoagulant therapy *Score 2: Patients should be administered anticoagulant therapy Includes peripheral artery embolism, ischemic stroke, and pulmonary embolism 1 TIA = Transient ischemic attack; 2 TE = Thromboembolism 3 Prior myocardial infarction, peripheral artery disease, aortic plaque 1. Lip GY et al. Chest 2010;137: Olesen JB, et al. BMJ 2011;342:d Task Force or the Management of Atrial Fibrillation of the ESC. Eur Heart J 2010;31:
15 Figure 1 Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright 2014 Canadian Cardiovascular Society Terms and Conditions
16
17 HAS-BLED Bleeding Score (Simple Tool for Assessing Bleeding Risk) Letter Clinical Characteristic* Points Awarded: Score H Hypertension 1 A Abnormal renal or liver function (1 point each) 1 or 2 S Stroke 1 B Bleeding 1 L Labile INRs 1 E Elderly 1 D Drugs or alcohol (1 point each) 1 or 2 *Hypertension - uncontrolled, >160 mm Hg systolic; Abnormal renal/liver function (one point for presence of renal or liver impairment, maximum two points); Stroke (previous history, particularly lacunar); Bleeding history or predisposition (anemia); Labile international normalized ratio (INR) (i.e. therapeutic time in range < 60%); Elderly ( >65 years); Drugs/alcohol concomitantly (antiplatelet agents, nonsteroidal anti-inflammatory drugs; one point for drugs plus one point for alcohol excess, maximum two points). 1. Pisters R, et al. Chest 2010; 138(5):
18 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
19 Newly discovered AF WHAT to USE? ASA Warfarin NOAC's Which NOAC?
20 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
21 Figure 2 Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright 2014 Canadian Cardiovascular Society Terms and Conditions
22 Note to self: We are looking for a reason to anticoagulate
23
24 Food Interactions Green leafy vegetables counteract effects of warfarin Foods with high amounts of vitamin K, e.g: - Cauliflower - Green cabbage - Seaweed (1350) - Broccoli (270) - Green tea - Turnip greens - Soybean oil (often used to fry foods in restaurants) - Raw spinach 1. Ansell J, et al. Chest. June :160S-198S.
25 Warfarin Has a Narrow Therapeutic Window Relationship between clinical events and INR intensity 1. Hylek EM et al. Ann Intern Med. 1994;120: Hylek EM et al. N Engl J Med. 1996;335: ICH=intracranial hemorrhage INR=international normalized ratio
26 % of eligible patients receiving warfarin INR Control: Clinical Trial vs Clinical Practice (TTR) 70% 60% 50% 40% 30% 20% 10% 0% 25% 38% TTR = Time in Therapeutic Range (INR ) 1. Kalra L, et al. BMJ 2000;320: Matchar DB, et al. Am J Med 2002; 113: % 44% Clinical trial Clinical practice 9% < > 3.0 International Normalised Ratio (INR) %
27 Intensity of Anticoagulation with Warfarin and Stroke Rates 1. Hylek EM et al. N Engl J Med. 2003;349:
28 Note to self: Warfarin might not be the best drug
29 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
30 Anti-Factor Xa activity (IU/mL) Direct comparison of the pharmacodynamics of apixaban and rivaroxaban Healthy volunteers (n=14) Crossover design 10.0 ANTI-XA APIXABAN 2.5MG BID RIVAROXABAN 10MG QD Peak (IU/mL) Trough (IU/mL) Ratio Apixaban 2.5 mg BID 0.1 Rivaroxaban 10 mg QD Time (h) Adapted from Frost et al. J Thromb Haemost [XXIII Congress of the ISTH, Kyoto, Japan, 2011] 2011;9 (Suppl 2): abstract no. P-WE-159. Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 30
31 Rivaroxaban plasma concentrations (μg/l) Food significantly affects the PK profile of rivaroxaban At the AF dose, rivaroxaban must be taken with food 2 In the ROCKET-AF study, rivaroxaban study drug had to be taken with the evening meal 3 FASTED FED* C max (ng/ml) T max (h) AUC (ng*h/ml) 1 1,477 2, % higher AUC 76% higher Cmax Rivaroxaban 20 mg in 22 healthy volunteers After a single oral dose of 20mg rivaroxaban, AUC was increased by 39% and Cmax by 76% after administration with food Time (hours) Fasted Fed 1. Stampfuss et al., Int J Clin Pharmacol Ther. 2013;51(7): Rivaroxaban PM, Protocol for: Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365: DOI: /NEJMoa Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 31
32 Oral Anticoagulants: New Agents Warfarin (vitamin K antagonist) has traditionally been used as the anticoagulant of choice for stroke prevention. Recently, three new oral anticoagulants have been studied in clinical trials for stroke prevention in AF patients: AGENT CLASS APPROVAL STATUS IN CANADA FOR STROKE PREVENTION IN AF Dabigatran Direct thrombin inhibitor Approved Rivaroxaban Factor Xa inhibitor Approved Apixaban Factor Xa inhibitor Approved 1. Connoly SJ, et al. N Engl J Med 2009;361: Patel MR, et al. N Engl J Med 2011;365: Granger C, et al. N Engl J Med 2011;365:
33 NOAC dosing recommendations in patients with renal impairment APIXABAN 1 RIVAROXABAN 2 DABIGATRAN 3 Mild - Moderate renal impairment (CrCl ml/min) Yes Generally no dose reduction Dose adjustment only if 2 of ABC* criteria Yes 15mg QD Yes Dose reduction to be considered in elderly or those with other risk factors for bleeding Severe renal impairment (CrCl ml/min) No Not recommended No Not recommended (CrCl ml/min) no dosing recommendation can be made CrCl <15 ml/min or patients undergoing dialysis No Not recommended *ABC criteria: Dose reduction to 2.5 mg BID if at least 2 of the following: Age 80, Body weight 60kg, serum Creatinine 133micromol/L NOAC: novel oral anticoagulant CrCL: estimated creatinine clearance 1. Eliquis PM, Rivaroxaban PM, Dabigatran PM, 2013 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 33
34 Event rate (%/yr) Novel Oral Anticoagulants Compared to Warfarin: Primary safety endpoint*, Major Bleeding Apixaban and dabigatran 110 significantly decrease major bleeding compared to warfarin Rivaroxaban and dabigatran 150 cause as much bleeding as warfarin ARISTOTLE 1 RE-LY 2 ROCKET-AF 3 p= p< p=0.003 p= % 2.13% % 2.71% 3.11% % 3.6% Warfarin Apixaban 0 Warfarin Dabi 110 Dabi Warfarin Rivaroxaban HR 0.69 (95% CI: ) Dabi 110 vs warfarin: HR: 0.80 ( ) HR 1.04 (95% CI: ) Dabi 150 vs warfarin: HR: 0.93 ( ) No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. * The primary safety endpoint in ROCKET-AF was major bleeding + CRNM; major bleeding was a secondary safety endpoint 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 34
35 Novel Oral Anticoagulants Compared to Warfarin: Primary safety endpoint*, Major Bleeding Apixaban and dabigatran 110 significantly decrease major bleeding compared to warfarin Rivaroxaban and dabigatran 150 cause as much bleeding as warfarin Hazard Ratio Apixaban 1 HR 0.69 (95%CI, ); p<0.001 Dabigatran 150 mg 2 HR 0.93 (95%CI, ); p=0.31 Dabigatran 110 mg 2 HR 0.80 (95%CI, ); p=0.003 Rivaroxaban 3 HR 1.04 (95%CI, ); p=0.58* Study Drug Better Warfarin Better No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. * The primary safety endpoint in ROCKET-AF was major bleeding + CRNM; major bleeding was a secondary safety endpoint 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 35
36 Event rate (%/yr) Novel Oral Anticoagulants Compared to Warfarin: Intracranial Hemorrhage (ICH) Apixaban, dabigatran and rivaroxaban significantly decrease intracranial bleeding compared to warfarin 1 ARISTOTLE 1 1 RE-LY 2 1 ROCKET-AF p< p= % 0.33% % p< % 0.4 p< % 0.30% % 0 Warfarin Apixaban 0 Warfarin Dabi 110 Dabi Warfarin Rivaroxaban HR 0.42 (95% CI: ) Dabi 110 vs warfarin: HR: 0.31 ( ) HR 0.67 (95% CI: ) Dabi 150 vs warfarin: HR: 0.40 ( ) No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 36
37 Novel Oral Anticoagulants Compared to Warfarin: Intracranial Hemorrhage (ICH) Apixaban, dabigatran and rivaroxaban significantly decrease intracranial bleeding compared to warfarin Hazard Ratio Apixaban 1 HR 0.42 (95%CI, ); p<0.001 Dabigatran 150 mg 2 HR 0.40 (95%CI, ); p<0.001 Dabigatran 110 mg 2 HR 0.31 (95%CI, ); p<0.001 Rivaroxaban 3 HR 0.67(95%CI, ); p= Study Drug Better Warfarin Better No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 37
38 Event rate (%/yr) Novel Oral Anticoagulants Compared to Warfarin: GI bleeding Rivaroxaban and dabigatran 150 increase GI bleeding compared to warfarin Apixaban and dabigatran 110 cause as much GI bleeding as warfarin 3 ARISTOTLE 1 3 RE-LY 2 3 ROCKET-AF 3,4, p< p=0.43 p< p= % 0.76% % 1.12% 1.51% % 2% 0 Warfarin Apixaban 0 Warfarin Dabi 110 Dabi Warfarin Rivaroxaban HR 0.89 (95% CI: ) Dabi 110 vs warfarin: HR: 1.10 ( ) HR 1.61 (95% CI: ) Dabi 150 vs warfarin: HR: 1.5 ( ) No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Desai et al., Gastrointest Endosc 2013; 78: Nessel et al., Chest J 2012; 142: 84A Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 38
39 Novel Oral Anticoagulants Compared to Warfarin: GI bleeding Rivaroxaban and dabigatran 150 increase GI bleeding compared to warfarin Apixaban and dabigatran 110 cause as much GI bleeding as warfarin Hazard Ratio Apixaban 1 HR 0.89 (95%CI, ); p=0.37 Dabigatran 110 mg 2 HR 1.10 (95%CI, ); p=0.43 Dabigatran 150 mg 2 HR 1.50 (95%CI, ); p<0.001 Rivaroxaban 3,4,5 HR 1.61 (95%CI, ); p< Study Drug Better 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Desai et al., Gastrointest Endosc 2013; 78: Nessel et al., Chest J 2012; 142: 84A Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution Warfarin Better No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established.
40 Event rate (%/yr) Apixaban Bleeding endpoints as compared to Aspirin Apixaban is the only NOAC tested against ASA in a blinded randomised trial, the AVERROES clinical trial Apixaban is superior to ASA in the reduction of stroke or systemic embolism Apixaban did not significantly increase major, ICH nor GI bleeding, when compared to ASA 2 MAJOR BLEEDING 2 ICH 2 GI 1.6 p= % 1.4% p= p= % 0.4% 0.4% 0.4% 0 ASA Apixaban 0 ASA Apixaban 0 ASA Apixaban HR 1.13 (95% CI: ) HR 0.85 (95% CI: ) HR 0.86 (95% CI: ) NOAC: novel oral anticoagulant Bleeding endpoints in the AVERROES study are calculated on the ITT population, as prespecified Adapted from Connolly et al. N Engl J Med 2011;364: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 40
41 Event rate (%/yr) Novel Oral Anticoagulants Compared to Warfarin: All cause death Apixaban significantly decreases all cause death as compared to warfarin Dabigatran and rivaroxaban have no significant effect on mortality, as compared to warfarin ARISTOTLE RE-LY ROCKET-AF p= p= p=0.13 p= % 3.52% % 3.75% 3.64% 2 4.9% 4.5% Warfarin Apixaban 0 Warfarin Dabi 110 Dabi Warfarin Rivaroxaban HR 0.89 (95% CI: ) Dabi 110 vs warfarin: HR: 0.91 ( ) HR 0.92 (95% CI: ) Dabi 150 vs warfarin: HR: 0.88 ( ) No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. Adapted from Granger et al. N Engl J Med 2011;365: Adapted from Connolly SC et al. N Engl J Med 2009;361: Adapted from Patel MR, et al. N Engl J Med Sep 8;365(10): Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 41
42 New Anticoagulant Therapies Compared to Warfarin: All-Cause Mortality Apixaban significantly decreases all cause death as compared to warfarin Dabigatran and rivaroxaban have no significant effect on mortality, as compared to warfarin Hazard Ratio Apixaban 1 HR 0.89 (95% CI, 0.80 to 0.998) Dabigatran 150 mg 2 HR 0.88 (95% CI, 0.77 to 1.00) Dabigatran 110 mg 2 HR 0.91 (95% CI, 0.80 to 1.03) Rivaroxaban 3 HR 0.92 (95% CI, 0.82 to 1.03) Study Drug Better Warfarin Better No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 42
43 Novel Oral Anticoagulants as Compared to Warfarin APIXABAN 1 VS. WARFARIN DABIGATRAN VS. WARFARIN DABIGATRAN VS. WARFARIN RIVAROXABAN 3 VS. WARFARIN RR (95% CI) P RR (95% CI) P RR (95% CI) P RR (95% CI) P Stroke/SE 0.79 ( ) = ( ) ( ) < ( ) 0.12 Major Bleed 0.69 ( ) < ( ) ( ) ( ) 0.58 Intra Cranial Bleed 0.42 ( ) < ( ) < ( ) < ( ) 0.02 GI bleeding 0.89 ( ) ( ) ( ) < ( ) <0.001 All cause Death 0.89 ( ) ( ) ( ) ( ) 0.15 No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 43
44 Novel Oral Anticoagulants as Compared to Warfarin APIXABAN 1 DABIGATRAN DABIGATRAN RIVAROXABAN 3 VS. WARFARIN Stroke/SE Major Bleed Intra Cranial Bleed GI bleeding All cause Death = = = = = = = = = No head-to-head trials between dabigatran, apixaban and rivaroxaban have been conducted, therefore comparative efficacy and safety have not been established. 1. Granger et al., NEJM 2011; 365: Connolly et al., NEJM 2009; 361: Patel et al., NEJM 2011; 365: Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution 44
45 Real Life Data All drugs safer than Warfarin Rivoraxaban INR testing controversy 45
46 Note to self: NOAC is a safer choice
47
48 Newly discovered AF Symptom relief Strict vs. lenient Younger patients tolerate HR poorly Younger need better rate control, 2+ meds If slow w/o meds: high chance of pacemaker Rx: Beta Blockers, Calcium Blockers, Digoxin, Amiodarone
49 Figure 3 Canadian Journal of Cardiology , DOI: ( /j.cjca ) Copyright 2014 Canadian Cardiovascular Society Terms and Conditions
50 Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
51 Note to self: Not every new AF needs ER or CARDIOVERSION
52
53 Newly discovered AF Etiology/testing: Paroxysmal/Permanent CVA risk difference? AFib or AFlutter - CVA risk/management difference? Common: Age, Resp (COPD, OSA, p/e, PuHTN, lobectomy, pneumonia), LVH producers (HTN, Valve, CoArct), Noncardiac (Hg, Thyroid, Rx, Infection)
54
55 Newly discovered AF - SR restoration? Consider in : young (<65), very symptomatic ER visit is not an indication Chemical (Sotalol-Propafenone- Amiodarone)/Electrical/Mechanical EP AF ablation: 80-90%, better chance of SR with low CHADS
56 Note to self: Sinus rhythm is not a necessity
57
58 Atrial Fibrillation: 4 Principles 1. PREVENT Stroke/Embolization 2. Render patient ASYMPTOMATIC/ functional 3. Investigate ETIOLOGY 4. Consider benefit/risk ratio of SINUS restoration
59
AF review. Petr Polasek
AF review Petr Polasek Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or by any means graphic, electronic,
More informationNOAs for stroke prevention in Atrial Fibrillation: potential advantages in the elderly patients. Giancarlo Agnelli
NOAs for stroke prevention in Atrial Fibrillation: potential advantages in the elderly patients Giancarlo Agnelli Internal & Cardiovascular Medicine - Stroke Unit University of Perugia, Italy My talk today
More informationNUOVI ANTICOAGULANTI NELL ANZIANO: indicazioni e controindicazioni. Mario Cavazza Medicina d Urgenza Pronto Soccorso AOU di Bologna
NUOVI ANTICOAGULANTI NELL ANZIANO: indicazioni e controindicazioni Mario Cavazza Medicina d Urgenza Pronto Soccorso AOU di Bologna Two major concerns Atrial Fibrillation: Epidemiology The No. 1 preventable
More informationIndications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute
Indications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute Disclosures Research Support/P.I. Employee Leo Pharma
More informationMODULE 1: Stroke Prevention in Atrial Fibrillation Benjamin Bell, MD, FRCPC
MODULE 1: Stroke Prevention in Atrial Fibrillation Benjamin Bell, MD, FRCPC Specialty: General Internal Medicine Lecturer, Department of Medicine University of Toronto Staff Physician, General Internal
More informationESC Congress 2012, Munich
ESC Congress 2012, Munich Anticoagulation in Atrial Fibrillation 2012: Which Anticoagulant for Which Patient? Stefan H. Hohnloser J.W. Goethe University Frankfurt am Main S.H.H. has served as a consultant,
More informationAntithrombotics in Stroke management
Antithrombotics in Stroke management Faculty: Robert Beveridge Relationships with commercial interests: Grants/Research Support: N/A Speakers Bureau/Honoraria: Astra Zeneca, Bayer, Boerhinger Ingelheim,
More informationAnti-thromboticthrombotic drugs
Atrial Fibrillation 2011: Anticoagulation strategies and clinical outcomes Panos E. Vardas President Elect of the ESC, Prof. of Cardiology, University Hospital of Crete Clinical outcomes affected by AF
More informationEvaluate Risk of Stroke & Bleeding in AF Patients
XV World Congress of Arrhythmias, Beijing, China - 17-20 September, 2015 Evaluate Risk of Stroke & Bleeding in AF Patients Antonio Raviele, MD, FESC, FHRS President ALFA Alliance to Fight Atrial fibrillation
More informationApixaban for Atrial Fibrillation in Patients with End-Stage Renal Disease on Dialysis
Apixaban for Atrial Fibrillation in Patients with End-Stage Renal Disease on Dialysis Caitlin Reedholm, PharmD PGY1 Pharmacy Resident St. David s South Austin Medical Center November 2, 2018 Abbreviations
More informationNeuroPI Case Study: Anticoagulant Therapy
Case: An 82-year-old man presents to the hospital following a transient episode of left visual field changes. His symptoms lasted 20 minutes and resolved spontaneously. He has a normal neurological examination
More informationAF stroke prevention in the Canadian context
AF stroke prevention in the Canadian context 5 th Annual State of the Heart Toronto, May 31, 2014 Andrew C.T. Ha, MD, MSc, FRCPC Cardiac Electrophysiology Toronto General Hospital, University Health Network
More informationA Patient Unsuitable for VKA Treatment
Will Apixaban change practice in atrial fibrillation? A Patient Unsuitable for VKA Treatment Professor Yoseph Rozenman The E. Wolfson Medical Center Jerusalem June 2013 Disclosures I have the following
More informationCanadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC
Canadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC DEBATE: DOAC vs Good Old Warfarin André Roussin MD, FRCP, CSPQ CHUM and ICM/MHI Associate professor University of Montreal A. Roussin
More informationAnticoagulation Therapy in LTC
Anticoagulation Therapy in LTC By: Cynthia Leung, RPh, BScPhm, PharmD. Clinical Consultant Pharmacist MediSystem Pharmacy Jun 11, 2013 Agenda Stroke and Bleeding Risk Assessment Review of Oral Anticoagulation
More informationShow Me the Outcomes!
Show Me the Outcomes! Real-World Safety Data on Oral Anticoagulants in Nonvalvular Atrial Fibrillation Gabby Anderson, PharmD PGY1 Pharmacy Resident anderson.gabrielle@mayo.edu Pharmacy Grand Rounds October
More informationAtrial Fibrillation Topics for Today. Clinical Controversies Management of Atrial Fibrillation. Atrial Fibrillation in the ER Topics for Today
Clinical Controversies Management of Atrial Fibrillation Yerem Yeghiazarians, M.D. Associate Professor of Medicine Leone-Perkins Family Endowed Chair in Cardiology Atrial Fibrillation Topics for Today
More informationSurvey patients for Sx, signs of AF. Establish AF Dx. Evaluate & Tx underlying heart disease/other causes. Assess adequacy of rate or rhythm control
Suggested General Approach to Managing Atrial Fibrillation Survey patients for Sx, signs of AF Establish AF Dx ECG Holter Event monitor Implanted device (pacer) Determine & Tx stroke risk (CHA 2 DS 2 VASc)
More informationNew options in Stroke Prevention in AF Paul Dorian University of Toronto St Michael s Hospital
New options in Stroke Prevention in AF Paul Dorian University of Toronto St Michael s Hospital Disclosures: Honoraria, research support, and consulting f Sanofi, Boehringer-Ingleheim, Portola, BMS, Bayer,
More informationNewer Anti-Anginal Agents and Anticoagulants
Newer Anti-Anginal Agents and Anticoagulants Satish Gadi, MD FACC FSCAI Interventional Cardiologist, Cardiovascular Institute of the South (CIS) Baton Rouge Clinical Assistant Professor, Tulane University
More informationScoring Systems in AF 8/10/2016. Strategies in the Prevention of Atrial Fibrillation-Related Strokes. Overview
Strategies in the Prevention of Atrial Fibrillation-Related Strokes Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania September
More informationStratificazione del rischio, corretto bilancio tra ischemia e bleeding: il beneficio clinico netto
Fibrillazione atriale: rischio tromboembolico, Venezia - 27/28 Novembre 2015 Stratificazione del rischio, corretto bilancio tra ischemia e bleeding: il beneficio clinico netto Antonio Raviele, MD, FESC,
More informationUpdates in Stroke Management. Jessica A Starr, PharmD, FCCP, BCPS Associate Clinical Professor Auburn University Harrison School of Pharmacy
Updates in Stroke Management Jessica A Starr, PharmD, FCCP, BCPS Associate Clinical Professor Auburn University Harrison School of Pharmacy Disclosure I have no actual or potential conflict of interest
More informationOral Anticoagulation Drug Class Prior Authorization Protocol
Oral Anticoagulation Drug Class Prior Authorization Protocol Line of Business: Medicaid P & T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed through review
More informationSecondary Preven-on of Thromboembolic Stroke: Clinical Data and Recommenda-ons from the ESC Atrial Fibrilla-on Guideline Update 2012
Secondary Preven-on of Thromboembolic Stroke: Clinical Data and Recommenda-ons from the ESC Atrial Fibrilla-on Guideline Update 2012 Professor Dan Atar Head, Dept. of Cardiology Councillor of the ESC,
More informationPRESENTATION TITLE. Case Studies
PRESENTATION TITLE Case Studies 1) SH is a 67 year old male. He has a history of type 2 diabetes, controlled hypertension and peripheral artery disease. He takes naproxen 500mg bd for arthritis and admits
More informationIndividual Therapeutic Selection Of Anti-coagulants And Periprocedural. Miguel Valderrábano, MD
Individual Therapeutic Selection Of Anti-coagulants And Periprocedural Management Miguel Valderrábano, MD Outline Does the patient need anticoagulation? Review of clinical evidence for each anticoagulant
More informationAtrial Fibrillation and Heart Failure: A Cause or a Consequence
Atrial Fibrillation and Heart Failure: A Cause or a Consequence Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania November
More informationDrug Class Monograph
Drug Class Monograph Class: Oral Anticoagulants Drug: Coumadin (warfarin), Eliquis (apixaban), Pradaxa (dabigatran), Savaysa (edoxaban), arelto (rivaroxaban) Formulary Medications: Eliquis (apixaban),
More informationPatient with high risk for bleeding
Will Apixaban change practice in atrial fibrillation Luncheon Satellite Sponsored by Pfizer Patient with high risk for bleeding Prof. Amos Katz M.D August 2012: patient background 67-year-old woman History
More informationDr Chris Ellis. Consultant Cardiologist Auckland City Hospital Auckland
Dr Chris Ellis Consultant Cardiologist Auckland City Hospital Auckland 8:30-9:25 WS #189: Anticoagulation in AF 9:35-10:30 WS #201: Anticoagulation in AF (Repeated) Anticoagulation in Atrial Fibrillation
More informationPCI in Patients with AF Optimizing Oral Anticoagulation Regimen
PCI in Patients with AF Optimizing Oral Anticoagulation Regimen Walid I. Saliba, MD Director, Atrial Fibrillation Center Heart and Vascular Institute Cleveland Clinic 1 Epidemiology and AF and PCI AF and
More informationPrimary Prevention of Stroke
Primary Prevention of Stroke Dr Chris Ellis Cardiologist Green Lane CVS Service, Auckland City Hospital & Auckland Heart Group, Mercy Hospital, Auckland 67 Pages Long, 735 References 29 Sub-Headings for
More informationClinical issues which drug for which patient
Anticoagulants - a matter of heart! Towards a bright future? Clinical issues which drug for which patient Sabine Eichinger Dept. of Medicine I Medical University of Vienna/Austria Conflicts of interest
More informationHalf Moon Bay Treatment of Atrial Fibrillation. Dr. Roger A. Winkle MD. Silicon Valley Cardiology, PAMF, Sutter Health Sequoia Hospital
Half Moon Bay 2018 Treatment of Atrial Fibrillation Dr. Roger A. Winkle MD Silicon Valley Cardiology, PAMF, Sutter Health Sequoia Hospital Disclosures: Investor Farapulse Things a Primary Care Doctor Should
More informationAtrial Fibrillation in the Emergency Department
Atrial Fibrillation in the Emergency Department Disclosures Edward Jauch, MD MS Research support National Institutes of Health funding (multiple trials) Novo Nordisk (drug in kind) STOP-IT Study Genentech
More informationThrombosis and Thromboembolsim October Stroke Prevention in Atrial Fibrillation Risk Stratification and Choice of Antithrombotic Therapy
Thrombosis and Thromboembolsim October 2012 Stroke Prevention in Atrial Fibrillation Risk Stratification and Choice of Antithrombotic Therapy Christian T. Ruff, MD, MPH TIMI Study Group Brigham and Women
More informationAtrial Fibrillation: Risk Stratification and Treatment New Cardiovascular Horizons St. Louis September 19, 2015
Atrial Fibrillation: Risk Stratification and Treatment New Cardiovascular Horizons St. Louis September 19, 2015 Christopher E. Bauer, MD, FACC, FHRS SSM Health Heart & Vascular Care Clinical Cardiac Electrophysiology
More informationAims. AF and Stroke risk Guidance re anticoagulation Novel oral anticoagulants (NOACs) in non-valvular AF (NVAF) Practical Issues Patient Case Studies
Aims AF and Stroke risk Guidance re anticoagulation Novel oral anticoagulants (NOACs) in non-valvular AF (NVAF) Practical Issues Patient Case Studies AF and Stroke AF prevalence approx doubles with each
More informationAnticoagulation: Novel Agents
Anticoagulation: Novel Agents Scott C. Woller, MD Medical Director, Anticoagulation Management, Intermountain Healthcare Central Region, co-director Venous Thromboembolism Program, Intermountain Medical
More informationAtrial Fibrillation Implementation challenges. Lesley Edgar Ross Maconachie
Atrial Fibrillation Implementation challenges Lesley Edgar Ross Maconachie Atrial Fibrillation Most common heart rhythm disturbance Rapid and irregular electrical signals Reduced efficiency of blood flow
More informationAtrial Fibrillaiton and Heart Failure: Anticoagulation therapy in all cases?
Atrial Fibrillaiton and Heart Failure: Anticoagulation therapy in all cases? Nicolas Lellouche Fédération de Cardiologie Hôpital Henri Mondor Créteil Disclosure Statement of Financial Interest I currently
More informationNOAC trials for AF: A review
NOAC trials for AF: A review Chern-En Chiang, MD, PhD, FACC, FESC General Clinical Research Center Division of Cardiology Taipei Veterans General Hospital National Yang-Ming University Taipei, Taiwan Presenter
More informationDIRECT ORAL ANTICOAGULANTS
2017 Cardiovascular Symposium DIRECT ORAL ANTICOAGULANTS ERNESTO UMAÑA, MD, FACC ORAL ANTICOAGULANTS Vitamin K Antagonists (VKAs): Warfarin Non Vitamin K Antagonists Direct oral anticoagulants Novel Oral
More informationDr Mammen Ninan GPwSI in Cardiology
Dr Mammen Ninan GPwSI in Cardiology AF affects up to 835,000 people in England alone and is expected to rise year after year. AF is a known risk factor for stroke, the 3 rd highest cause of mortality in
More informationDisclosure. Objectives. New Anticoagulants 6/5/2014 GHASSAN HADDAD M.D FHM. South Miami hospital Director of the Anticoagulation clinic.
/5/1 New Anticoagulants: Opportunities, Challenges and Practical Considerations GHASSAN HADDAD M.D FHM. Chief of Hospital Medicine i South Miami hospital Director of the Anticoagulation clinic. Financial
More informationNOACs in AF. Dr Fiona Stewart. Auckland Heart Group and Auckland DHB
NOACs in AF Dr Fiona Stewart Auckland Heart Group and Auckland DHB NOACS for AF True/False All patients should have a CHA 2 DS 2 VASc risk assessment on diagnosis of AF NOACS are more effective than warfarin
More informationADC Slides for Presentation 02/10/2017
ADC 2017 Slides for Presentation ANTI THROMBOTIC THERAPY FOR NON VALVULAR ATRIAL FIBRILLATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: CURRENT VIEWS Martin A. Alpert, MD Brent M. Parker Professor of Medicine
More informationStepheny Sumrall, FNP, AGACNP Cardiovascular Clinic of Hattiesburg
Novel Oral Anticoagulants Analyzing Clinical Trial Findings of the Efficacy and Safety Profiles of Novel Anticoagulants for the Treatment of Atrial Fibrillation and Prevention of Stroke Stepheny Sumrall,
More informationAtrial Fibrillation. Alan Bell, MD, CCFP. Staff Physician, Humber River Regional Hospital. University of Toronto
Pearls in Thrombosis 1 Atrial Fibrillation Alan Bell, MD, CCFP Staff Physician, Humber River Regional Hospital Assistant tprofessor, Department tof Family and Community Mdii Medicine University of Toronto
More informationKCS Congress: Impact through collaboration
Stroke Prevention in Atrial Fibrillation (SPAF) in Kenya Elijah N. Ogola FACC University of Nairobi Kenya Cardiac Society Annual Scientific Congress Mombasa 28 th June 1 st July 2017 KCS Congress: Impact
More informationHERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) DABIGATRAN RECOMMENDED What it is Indications Date decision last revised
Name: generic (trade) Dabigatran etexilate (Pradaxa ) HERTFORDSHIRE MEDICINES MANAGEMENT COMMITTEE (HMMC) DABIGATRAN RECOMMENDED What it is Indications Date decision last revised Direct thrombin inhibitor
More informationModern management of atrial fibrillation, from blood pressure control to anticoagulation
Modern management of atrial fibrillation, from blood pressure control to anticoagulation Adel Khalifa S. Hamad, BMS, MD, FRCP(Canada) Consultant Cardiologist & Interventional Cardiac Electrophysiologist
More informationThe INR: No Need Anymore? Daniel Blanchard, MD Professor of Medicine Director, Cardiology Fellowship Program UCSD Sulpizio Cardiovascular Center
The INR: No Need Anymore? Daniel Blanchard, MD Professor of Medicine Director, Cardiology Fellowship Program UCSD Sulpizio Cardiovascular Center What is the INR? Tissue Factor (Factor III) is added to
More informationDraft Agreed by Cardiovascular Working Party 25 Jan Adoption by CHMP for release for consultation 17 Feb 2011
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 London, 25 January 2011 EMA/CHMP/68875/2011 Committee for Medicinal Products for Human Use (CHMP) Concept paper on the need for a guideline on clinical investigation
More informationHypertension and Atrial Fibrillation in 2017
Boma Inn, Eldoret, 24th 25thFebruary 2017 Hypertension and Atrial Fibrillation in 2017 Dr Mzee Ngunga Consultant Cardiologist Aga Khan University Hospital, Nairobi Objectives 1. Understand the relationship
More informationEdoxaban. Direct Xa inhibitor Direct thrombin inhibitor Direct Xa inhibitor Direct Xa inhibitor
This table provides a summary of the pharmacotherapeutic properties, side effects, drug interactions and other important information on the four anticoagulant medications currently in use or under review
More informationcontroversies in anticoagulation: optimizing outcome for atrial fibrillation
controversies in anticoagulation: optimizing outcome for atrial fibrillation SUNDAY, NOVEMBER 13, 2016 WESTIN HOTEL NEW ORLEANS CANAL PLACE COLLABORATE INVESTIGATE EDUCATE PROVIDING PERSPECTIVE: CURRENT
More informationNOAC vs. Warfarin in AF Catheter Ablation
KHRS 2013 2013-Jun-15 NOAC vs. Warfarin in AF Catheter Ablation Jin-Seok Kim, MD Department of Cardiology Sejong General Hospital Bucheon, Republic of Korea Clinical Burden of AF Rhythm Disturbance Thromboembolic
More informationDr Calum Young Cardiologist Tauranga
Dr Calum Young Cardiologist Tauranga 8:30-9:25 WS #93: New Oral Anticoagulant Drugs and Management of AF 9:35-10:30 WS #105: New Oral Anticoagulant Drugs and Management of AF (Repeated) GPCME 2016: Anticoagulation
More informationΣεμινάπιο Ομάδων Δπγαζίαρ ΟΜΑΓΑ ΔΡΓΑΣΙΑΣ ΗΛΔΚΤΡΟΦΥΣΙΟΛΟΓΙΑΣ ΚΑΙ ΒΗΜΑΤΟΓΟΤΗΣΗΣ Κολπική μαπμαπςγή
Σεμινάπιο Ομάδων Δπγαζίαρ ΟΜΑΓΑ ΔΡΓΑΣΙΑΣ ΗΛΔΚΤΡΟΦΥΣΙΟΛΟΓΙΑΣ ΚΑΙ ΒΗΜΑΤΟΓΟΤΗΣΗΣ Κολπική μαπμαπςγή Δξελίξειρ ζηην ανηιπηκηική αγωγή ζε αζθενείρ με κολπική μαπμαπςγή Ξςδώναρ Σωηήπιορ Μονάδα Δμθπαγμάηων και
More informationWhat s new with DOACs? Defining place in therapy for edoxaban &
What s new with DOACs? Defining place in therapy for edoxaban & Use of DOACs in cardioversion Caitlin M. Gibson, PharmD, BCPS Assistant Professor, Department of Pharmacotherapy University of North Texas
More informationDefining Sub-Clinical Atrial Fibrillation and its management
Defining Sub-Clinical Atrial Fibrillation and its management Jeff Healey MD, MSc, FRCP, FHRS PHRI Chair in Cardiology Research Population Health Research Institute McMaster University, Canada Sub-Clinical
More informationAtrial fibrillation and anticoagulation JIR-PING BOEY, DEPARTMENT OF HAEMATOLOGY, FLINDERS MEDICAL CENTRE FEBRUARY 2016
1 Atrial fibrillation and anticoagulation JIR-PING BOEY, DEPARTMENT OF HAEMATOLOGY, FLINDERS MEDICAL CENTRE FEBRUARY 2016 Disclosures 2 No conflicts of interest Some questions 3 Should my patient with
More informationAnticoagulation with Direct oral anticoagulants (DOACs) and advances in peri-procedural interruption of anticoagulation-- Bridging
Anticoagulation with Direct oral anticoagulants (DOACs) and advances in peri-procedural interruption of anticoagulation-- Bridging Scott C. Woller, MD Co-Director, Thrombosis Program Intermountain Medical
More informationUtilizing Anticoagulants for Atrial Fibrillation Related Stroke Prevention
Utilizing Anticoagulants for Atrial Fibrillation Related Stroke Prevention Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania
More informationAtrial Fibrillation and the NOAC s. John Raymond MS, PA-C, MHP February 10, 2018
Atrial Fibrillation and the NOAC s John Raymond MS, PA-C, MHP February 10, 2018 Pathogenesis EPIDEMIOLOGY Arrhythmia-related hospitalisations in the US Ventricular fibrillation 2% Atrial fibrillation 34%
More informationJoshua D. Lenchus, DO, RPh, FACP, SFHM Associate Professor of Medicine and Anesthesiology University of Miami Miller School of Medicine
Joshua D. Lenchus, DO, RPh, FACP, SFHM Associate Professor of Medicine and Anesthesiology University of Miami Miller School of Medicine Antithrombotics Antiplatelets Aspirin Ticlopidine Prasugrel Dipyridamole
More informationANTI-THROMBOTIC THERAPY in NON-VALVULAR ATRIAL FIBRILLATION
ANTI-THROMBOTIC THERAPY in NON-VALVULAR ATRIAL FIBRILLATION Colin Edwards Auckland Heart Group Waitemata Health June 2015 PFIZER Lecture series Disclosures EPIDEMIOLOGY Atrial fibrillation is the most
More informationDabigatran Evidence in Real Practice
ADVANCES IN CARDIAC ARRHYTHMIAS and GREAT INNOVATIONS IN CARDIOLOGY XXVII GIORNATE CARDIOLOGICHE TORINESI Torino, Centro Congressi Unione Industriale 23-24 Ottobre 2015 Dabigatran Evidence in Real Practice
More informationPros and Cons of Individual Agents Based on Large Trial Results: RELY, ROCKET, ARISTOTLE, AVERROES
Pros and Cons of Individual Agents Based on Large Trial Results: RELY, ROCKET, ARISTOTLE, AVERROES Ralph L. Sacco, MS MD FAAN FAHA Olemberg Family Chair in Neurological Disorders Miller Professor of Neurology,
More informationWeighing the risk of stroke vs the risk of bleeding: Which AF patients should be anticoagulated?
Weighing the risk of stroke vs the risk of bleeding: Which AF patients should be anticoagulated? Albert L. Waldo, MD, PhD (Hon) The Walter H. Pritchard Professor of Cardiology, Professor of Medicine,and
More informationAfib, Stroke, and DOAC. Albert Luo, MD. Cardiology Lindsey Frischmann, DO. Neurology Xiao Cai, MD. HBS
Afib, Stroke, and DOAC Albert Luo, MD. Cardiology Lindsey Frischmann, DO. Neurology Xiao Cai, MD. HBS Disclosure of Relevant Financial Relationships I have no relevant financial relationships with commercial
More informationAnticoagulation Beyond Coumadin
Anticoagulation Beyond Coumadin Saturday, September 21, 2013 Crystal Mountain Resort and Spa Pratik Bhattacharya MD, MPH Stroke Neurologist, Michigan Stroke Network; Assistant Professor of Neurology; Wayne
More informationStroke prevention, Clinical trials
Received: 13 May 2016 Revised: 8 August 2016 Accepted: 18 August 2016 DOI 10.1002/clc.22596 REVIEWS Special considerations for therapeutic choice of non vitamin K antagonist oral anticoagulants for Japanese
More informationWhat s New in the AF Guidelines
Impact on New AF Guidelines on Heart Failure Management Gothenburg - May 22 nd 2011 Europace (2010) 12, 1360-420 http://europace.oxfordjournals.org JACC (2011) 57, 223-42 http://www.cardiosource.org What
More informationFred Kusumoto Professor of Medicine
Fred Kusumoto Professor of Medicine Faculty photo will be placed here Kusumoto.Fred@mayo.edu 2015 MFMER 3543652-1 Atrial Fibrillation Presentation Subtitle Here Mayo School of Continuous Professional Development
More informationAtrial Fibrillation and Heart failure
Atrial Fibrillation and Heart failure and a bit about anticoagulation Tim Sutton, Consultant Cardiologist Middlemore Hospital, Manukau City and Auckland Heart Group Why Does AF Cause Heart Failure Impaired
More informationDirect Oral Anticoagulants (DOACs). Dr GM Benson Director NI Haemophilia Comprehensive Care Centre and Thrombosis Unit BHSCT
Direct Oral Anticoagulants (DOACs). Dr GM Benson Director NI Haemophilia Comprehensive Care Centre and Thrombosis Unit BHSCT OAC WARFARIN Gold standard DABIGATRAN RIVAROXABAN APIXABAN EDOXABAN BETRIXABAN
More informationThe Role of Oral Anticoagulants in Atrial Fibrillation: What You Need to Know Now. Bradley A. Hardin, MD Richard F.
The Role of Oral Anticoagulants in Atrial Fibrillation: What You Need to Know Now Bradley A. Hardin, MD Richard F. Otten, MD, FACC Outline Atrial Fibrillation Overview Overview of New Oral Anticoagulants
More informationModeling the Risk of Stroke and Bleeding in Atrial Fibrillation: What Are the Optimal Risk Scores? Roxana Mehran, MD
Modeling the Risk of Stroke and Bleeding in Atrial Fibrillation: What Are the Optimal Risk Scores? Roxana Mehran, MD Mount Sinai School of Medicine New York, NY Session II. Weighing the Risks and Benefits
More informationOld and New Anticoagulants For Stroke Prevention Benefits and Risks
Old and New Anticoagulants For Stroke Prevention Benefits and Risks September 15, 2014 Jonathan L. Halperin, M.D. The Cardiovascular Institute Mount Sinai Medical Center Disclosure Relationships with Industry
More informationIS THERE STILL A PLACE FOR VITAMINE K ANTAGONISTS?
IS THERE STILL A PLACE FOR VITAMINE K ANTAGONISTS? J.Y. LE HEUZEY Georges Pompidou Hospital, René Descartes University, Paris H E G P Munich, August 27, 2012 Disclosure Consultant / Conferences / Advisory
More informationUC SF. Division of General Internal Medicine UNIVERSITY OF CALIFORNIA SAN FRANCISCO, DIVISION OF HOSPITAL MEDICINE
Updates in the Management of Atrial Fibrillation Margaret C. Fang, MD, MPH Associate Professor of Medicine UCSF Division of Hospital Medicine Medical Director, Anticoagulation Clinic UC SF Division of
More informationCurrent Guideline for AF Treatment. Young Keun On, MD, PhD, FHRS Samsung Medical Center Sungkyunkwan University School of Medicine
Current Guideline for AF Treatment Young Keun On, MD, PhD, FHRS Samsung Medical Center Sungkyunkwan University School of Medicine Case 1 59 year-old lady Sudden palpitation and breathlessness for 12 hours
More informationAnticoagulant therapy, coumadines or direct antithrombins
ATRIAL FIBRILLATION (AF) Anticoagulant therapy, coumadines or direct antithrombins Felicita Andreotti, MD PhD Aggregated Professor Dept of Cardiovascular Sciences, Catholic University, Rome, IT Consultant
More informationRETROSPECTIVE CLAIMS DATABASE STUDIES OF DIRECT ORAL ANTICOAGULANTS (DOACS) FOR STROKE PREVENTION IN NONVALVULAR ATRIAL FIBRILLATION
RETROSPECTIVE CLAIMS DATABASE STUDIES OF DIRECT ORAL ANTICOAGULANTS (DOACS) FOR STROKE PREVENTION IN NONVALVULAR ATRIAL FIBRILLATION Craig I. Coleman, PharmD Professor, University of Connecticut School
More informationNOACs Update PD Dr. Jan Steffel Leitender Arzt, Klinik für Kardiologie Co-Leiter Rhythmologie Universitätsspital Zürich
NOACs Update 2016 PD Dr. Jan Steffel Leitender Arzt, Klinik für Kardiologie Co-Leiter Rhythmologie Universitätsspital Zürich Conflict of Interest Statement o o o o Consulting: Amgen, Astra Zeneca, AtriCure,
More informationAtrial Fibrillation is Common. The (S)Low-down on Rapid Afib Resuscitation Step ED Dx - Rx 4/4/2017. There Are 5 Causes of Atrial Fibrillation
The (S)Low-down on Rapid Afib Resuscitation 2017 Corey M. Slovis, M.D. Vanderbilt University Medical Center Metro Nashville Fire Department Nashville International Airport Nashville, TN Atrial Fibrillation
More informationLeft Atrial Appendage Closure: The Rationale
Left Atrial Appendage Closure: The Rationale JOHN D. HUMMEL, MD DIRECTOR OF CLINCAL ELECTROPHYSIOLOGY RESEARCH PROFESSOR OF CLINICAL INTERNAL MEDICINE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER 1 Disclosures
More informationXarelto (rivaroxaban)
Xarelto (rivaroxaban) Policy Number: 5.01.575 Last Review: 7/2018 Origination: 6/2014 Next Review: 7/2019 LoB: ACA Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will provide coverage for Xarelto
More informationAtrial Fibrillation. 2 nd Annual National Hospitalist Conference San Antonio, TX September 7, 2018
2 nd Annual National Hospitalist Conference San Antonio, TX September 7, 2018, MSc, FACP, SFHM Division of Hospital Medicine Henry Ford Hospital Detroit, USA Clinical Associate Professor of Medicine Wayne
More informationSubclinical AF: Implications of device based episodes
Subclinical AF: Implications of device based episodes Michael R Gold, MD, PhD Medical University of South Carolina Charleston, SC Disclosures: Clinical Trials and Consulting: Medtronic, Boston Scientific
More informationCost and Prevalence of A fib. Atrial Fibrillation: Guideline Directed Treatment. Prevalence of A Fib. Risk Factors for A Fib. Risk Factors for A Fib
Atrial Fibrillation: Guideline Directed Treatment Melissa Wendell, FNP-C, MSN Heart Failure - Lead Nurse Practitioner, Aspirus Wausau Hospital and Aspirus Cardiology Cost and Prevalence of A fib 33.5 million
More informationRole of NOACs in AF Management. From Evidence to Real World Data Focus on Cardioversion
Role of NOACs in AF Management. From Evidence to Real World Data Focus on Cardioversion John Rickard MD, MPH Staff Electrophysiologist Cleveland Clinic Agenda NOACs: Update on Real World Data NOAC reversal:
More informationAsif Serajian DO FACC FSCAI
Anticoagulation and Antiplatelet update: A case based approach Asif Serajian DO FACC FSCAI No disclosures relevant to this talk Objectives 1. Discuss the indication for antiplatelet therapy for cardiac
More informationState of art in anticoagulation in non valvular Atrial Fibrillation: the additional value of Rivaroxaban real life data
State of art in anticoagulation in non valvular Atrial Fibrillation: the additional value of Rivaroxaban real life data Massimo Grimaldi Ospedale F. Miulli Acquaviva delle Fonti - Bari Disclosure Biosense
More informationINR as a Biomarker: Anticoagulation in Atrial Fib, Heart Failure, and Cardiovascular Disease Daniel Blanchard, MD, FACC, FAHA
INR as a Biomarker: Anticoagulation in Atrial Fib, Heart Failure, and Cardiovascular Disease Daniel Blanchard, MD, FACC, FAHA Professor of Medicine Director, Cardiology Fellowship Program Sulpizio Cardiovascular
More informationNew Oral Anticoagulants
New Oral Anticoagulants Tracy Minichiello, MD Associate Professor of Medicine Chief, San FranciscoVA Anticoagulation and Thrombosis Services What percentage of time do patients on warfarin spend in therapeutic
More informationNOACs in AF. Dr Colin Edwards Auckland Heart Group and Waitemata DHB. Dr Fiona Stewart Auckland Heart Group and Auckland DHB
NOACs in AF Dr Colin Edwards Auckland Heart Group and Waitemata DHB Dr Fiona Stewart Auckland Heart Group and Auckland DHB Conflict of Interest Dr Fiona Stewart received funding from Pfizer to attend the
More information