Atrial fibrillation is the most common arrhythmia and its combination with a history of acute myocardial infarction or coronary angioplasty is quite frequent. According to this study (recently published in JACC), in a real-world population, the combination of direct anticoagulant agents and dual antiplatelet therapy reduces significantly the risk of bleeding and provides similar thromboembolic…
New Anticoagulant Agents in Atrial Fibrillation in Latin American Patients, Specifically
There is limited information on the use of antithrombotic therapies and their outcomes in Latin American patients with atrial fibrillation. This stands true in almost all aspects of medicine: large multicenter randomized studies rarely include Latin American countries, and when they do, the population included is not representative of the overall population. The only exception…
New Atrial Fibrillation After TAVR Indicates Prognosis
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as an important treatment alternative for intermediate- and high-risk patients. In that sense, the presence of atrial fibrillation (AF) before TAVR is high and it has been associated with worse outcomes and higher mortality. However, there is not much evidence available regarding new-onset atrial…
Five-Year Outcomes for Appendage Closure
The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that left atrial appendage closure with the Watchman device was equivalent to warfarin for preventing stroke in atrial fibrillation, but it had a high rate of peri-procedural complications. The follow-up randomized trial was PREVAIL (Evaluation of the…
NCDR ACTION Registry: Anticoagulated Patients with No Higher Risk of Bleeding in Emergency Procedures
Patients with a history of atrial fibrillation treated with warfarin or any of the new direct oral anticoagulants undergoing acute myocardial infarction do not present higher risk of bleeding when receiving angiography or angioplasty. In fact, this subgroup of anticoagulated patients showed lower in-hospital mortality than the control group. After analyzing 6471 patients undergoing ST elevation MI…