Apr 23, 2014

Newsletter - ACC.14 - Selected abstracts

Newsletter - ACC.14 - Selected abstracts: Venous thromboembolism, real world, and risk scores

Venous thromboembolism

1177-74 - Comparative Efficacy and Safety of New Oral Anticoagulants versus Warfarin for Long-Term Treatment of Venous Thromboembolism: A Meta-Analysis
Ajay Vallakati, Tilak Pasala, Sanjay Gandhi, et al.
“...We performed a meta-analysis of all randomized controlled trials (RCTs) to assess the safety and efficacy of NOACs for long-term treatment of VTE.
Conclusions: NOACs are effective for the long term treatment of VTE with reduced risk of VTE or VTE related deaths compared with placebo but similar efficacy to warfarin.”

Newsletter - ACC.14 - Selected abstracts: NOAC + antiplatelet

1217-103 - Novel Oral Anticoagulants and Concomitant Antiplatelet Therapy for Stroke Prevention in Patients with Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials
Shashi Kumar, Stephan B. Danik, Robert K. Altman, et al.
“…Data from four RCTs, with a total of 28,511 patients, were included in the meta-analysis.
Conclusions: In the data available thus far regarding novel oral anticoagulants apixaban, rivaroxaban and dabigatran, patients on NOACs and antiplatelet therapy have higher rates of both thromboembolic events and major bleeding than those on NOACs alone. In this meta-analysis, patients were not randomized to antiplatelet therapy use and thus further prospective studies are needed.”

Newsletter - ACC.14 - Selected abstracts: Cardioversion and periprocedural use


1109-118 - Safety and Efficacy of Dabigatran versus Warfarin in Patients with Persistent and Long-Acting Atrial Fibrillation Undergoing Electrical Cardioversion
Oskars Kalejs, Sandis Sakne, Olga Litunenko, et al.
“Methods. We have analysed the data collected before, during and after electrical cardioversion (ECV) in 588 patients…
Conclusions. Dabigatran 150 mg twice is a safe, effective and reasonable alternative to warfarin for patients undergoing ECV despite CHA2DS2VASc risk score and AF duration. The frequencies of stroke and embolic events were lower in dabigatran 150 mg versus warfarin with lower major bleeding within 30 and 90 days after ECV. Patients undergoing dabigatran therapy have shorter time before procedures and can save time for INR test in normal range.”

Newsletter - ACC.14 - Selected abstracts: Laboratory monitoring, bleeding, and reversal

Laboratory monitoring

1219-158 - Low APTT and BMI Predicts the Occurrence of Ischemic Stroke in Patients with Atrial Fibrillation Receiving Dabigatran
Masao Sakabe, Ryozo Yoshioka, Akira Fujiki, et al.
“Methods: We prospectively evaluated the relationship among the background of the patients and the outcome of dabigatran therapy, and investigated the clinical usefulness of activated partial thromboplastin time (APTT) to quantify the anti-thrombotic effect and safety. We enrolled consequent 129 patients with AF… who were prescribed dabigatran… Within 2 weeks of enrollment, blood sampling for APTT measurement was performed 150+7 minutes after dabigatran taken…
Conclusions: Among AF patients who received dabigatran, APTT less than 35 sec, low BMI, and high CHADs2 score were independently predictive of ischemic stroke. Fixed point measurement of APTT might be useful to evaluate the anticoagulant effect of dabigatran.”