Abstract:
:Nonvalvular atrial fibrillation (AF) confers an increased risk of thromboembolism, with a 5-fold higher risk of ischemic stroke. Oral anticoagulation (OAC) has shown to be highly effective in preventing stroke and mortality compared to placebo and is also used in patients without AF for both treatment and prophylaxis of venous thromboembolism. The OAC halts the coagulation by different mechanisms. Until recently, the only option was the vitamin K antagonists (VKAs), but their inherent limitations have promoted the development of novel oral anticoagulants (NOACs), which may offer efficacious and safer alternatives. Patients should be carefully selected to receive the most suitable treatment for each one. As the VKA efficacy and safety largely rely on the time the patient remains within the therapeutic range, this could be a useful selection criterion. Bleeding remains the main complication of all OACs. Although clinical trials of stroke prevention in AF have shown a significant reduction in hemorrhagic stroke and intracranial bleeding with the NOACs, as prescriptions are increasing, clinicians need to be prepared to accurate management of bleeding complications. Withholding the drug is usually enough for most cases of mild bleeding, but in patients with major, life-threatening bleeding, other measures, such as fluid replacement and blood transfusion, might be necessary while waiting for specific reversal agents that may reach the market soon. In case of acute bleeding, the accurate estimation of anticoagulant effect could also be needed, but the currently available coagulation tests only offer a qualitative measure. While awaiting long-term safety data, the choice between all these available therapies should be based on patient preferences, compliance, and ease of administration as well as on local factors affecting cost-effectiveness. But the increasing variety of therapeutic options when chronic OAC is needed can only improve the provided health care.
journal_name
J Cardiovasc Pharmacol Therjournal_title
Journal of cardiovascular pharmacology and therapeuticsauthors
Gallego P,Roldán V,Lip GYdoi
10.1177/1074248413501392subject
Has Abstractpub_date
2014-01-01 00:00:00pages
34-44issue
1eissn
1074-2484issn
1940-4034pii
1074248413501392journal_volume
19pub_type
杂志文章,评审abstract:BACKGROUND:epidemiologic studies indicate that elevated heart rate (HR) is an independent risk factor for mortality and morbidity in patients (pts) with chronic heart failure (CHF). Clinical trials with β-blockers suggest that HR reduction is an important mechanism of their benefit in pts with stable CHF. Pharmacologic...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1177/1074248410370326
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Allogeneic cardiosphere-derived cells (CDCs) exert cardioprotective effects when administered intracoronarily after reperfusion in animal models of acute myocardial infarction (AMI). The "no-reflow" phenomenon develops rapidly post-reperfusion and may undermine the efficacy of cell therapy, due to poor cell ...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248420941672
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Myocardial infarction causes the acidification of the cellular environment and the resultant acidosis maybe arrhythmogenic. The effect of acidosis on the action of antiarrhythmic drugs, an important issue in the antiarrhythmic drug therapy after myocardial infarction, remains to be studied. METHODS:To evalu...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424840501000108
更新日期:2005-03-01 00:00:00
abstract::BACKGROUND: The effects of sotalol on the 24-hour profile of the QT interval relative to that of the heart rate (HR) may be helpful in determining the time course of the drug's action in controlling cardiac arhythmias. This has not been previously determined. Thus, the objective of the current study was to evaluate th...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849900400104
更新日期:1999-01-01 00:00:00
abstract::Low-molecular-weight heparins (LMWHs) endure as important drugs for thromboprophylaxis. Although clinical use relies on the subcutaneous (SC) route, our previous studies show that single-dose orally administered LMWHs have antithrombotic activity. Since thromboprophylaxis requires long-term treatment, we examined anti...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248416667601
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Patients with coronary artery disease (CAD) should be treated with statins to attain very low cholesterol levels, in order to reduce cardiovascular adverse events. More than 70% of these patients do not reach the appropriate cholesterol goal despite moderate statin doses. However, it is not known whether the...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,随机对照试验
doi:10.1177/1074248413489771
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:The administration of aspirin is traditionally discontinued prior to coronary artery bypass grafting (CABG), given a potential risk of excessive postoperative bleeding. Few studies have previously suggested the benefits of continuing aspirin until the time of surgery. The primary aim of this review is to eva...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,meta分析,评审
doi:10.1177/1074248413509026
更新日期:2014-01-01 00:00:00
abstract::The results of numerous long-term, randomized trials show that statins significantly decrease the risks of myocardial infarction, stroke, and vascular death as well as total mortality. The benefits of statins on cardiovascular disease in patients who are not experiencing acute coronary syndromes generally become appar...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,评审
doi:10.1177/107424840400900i109
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Fluvastatin is an inhibitor of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, effectively lowering serum cholesterol concentrations. A high-performance liquid chromatography (HPLC) assay was developed that determined the pharmacokinetics of fluvastatin in healthy individuals after administrat...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 临床试验,杂志文章
doi:10.1177/107424840100600205
更新日期:2001-04-01 00:00:00
abstract:PURPOSE:It is known that selective cyclooxygenase 2(COX-2) inhibitors increase mortality in patients with previous myocardial infarction, and it has been suggested that COX-2 plays an important role in cardioprotection against ischemia. The current study was carried out to determine whether COX-2 is involved in the mec...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248410380208
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:The oral vasopressin-2 receptor antagonist, tolvaptan, causes aquaresis and improves symptoms in patients with congestive heart failure. However, few studies have explored the effect of tolvaptan in acute heart failure (AHF) patients ≥90 years old. METHODS:This study enrolled 106 AHF patients treated with t...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248419861962
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Limited data are available on the clinical management of atrial fibrillation (AF) and its outcomes from an Australian perspective. OBJECTIVE:To describe the appropriateness of antithrombotic prescribing for patients who presented with a diagnosis of AF to the Hawkesbury St John of God Hospital, New South Wa...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248418786264
更新日期:2019-01-01 00:00:00
abstract::Atrial fibrillation has recently come into clinical and research focus. In particular, ventricular rate control has been carefully compared with atrial rhythm control. Additionally, the recent discovery of atrial stunning has initiated clinical and research interest in atrial remodeling. Atrial fibrillation is more li...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,评审
doi:10.1177/107424840300800105
更新日期:2003-06-01 00:00:00
abstract::We evaluated whether carotenoid astaxanthin (ASX) could prevent oxidative and atherosclerotic damage in rabbits. Rabbits received regular chow (control) or an atherogenic diet (1% cholesterol) alone or supplemented with 50, 100, and 500 mg% ASX for 60 days (n = 5-9 per group). The atherogenic diet increased the serum ...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248409350136
更新日期:2009-12-01 00:00:00
abstract::BACKGROUND: The electrophysiologic mechanisms of the persistence of atrial fibrillation (AF) after its initiation are not well understood. Therefore, the electrophysiologic characteristics of the right atrium were evaluated in an acute, pacing-induced model of AF in the pig in order to identify parameters associated w...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849900400206
更新日期:1999-04-01 00:00:00
abstract::BACKGROUND: In recent years, there has been an increasing use of antiarrhythmic drugs that act predominantly by prolonging myocardial repolarization. An inevitable electrophysiologic consequence of these drugs is the development of torsade de pointes as a proarrhythmic reaction. Both intravenous lidocaine and magnesiu...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849700200206
更新日期:1997-04-01 00:00:00
abstract::Recently, cyclooxygenase-2 (COX-2) inhibitors (coxibs), a class of drugs intended to be painkillers, have created unprecedented controversy because of their cardiovascular risk profile. The controversy has affected the patients, health-care providers, the Food and Drug Administration, and the manufacturers of these ag...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,评审
doi:10.1177/107424840501000203
更新日期:2005-06-01 00:00:00
abstract::BACKGROUND: Clinical trials have shown that the use of lipid-lowering agents in postmyocardial infarction (MI) patients reduces rates of subsequent coronary events, reduces coronary artery bypass surgery rates, and improves survival. Physician decisions to prescribe lipid-lowering drugs is influenced by a number of pa...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849800300303
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Brief periods of reocclusion (postconditioning) during early reperfusion reduce myocardial infarct size. Whether postconditioning has an effect on lethal ventricular arrhythmias independent of infarction in an in-vivo regional ischemia model is unknown. The purpose of this study was to determine if postcondi...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424840601100105
更新日期:2006-03-01 00:00:00
abstract:INTRODUCTION:Limited data exist comparing the efficacy and safety of bumetanide- or metolazone-based diuretic regimens to furosemide in acute heart failure (HF). Our purpose was to evaluate the comparative effect on urine output (UO) and renal function between these regimens. METHODS:A retrospective study of hospitali...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248413482755
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Although a gradual increase in heart rate (HR) during dobutamine stress testing (DST) is desired, few data exists regarding whether this is similarly achieved in patients of widely varying body mass index (BMI). Whether difference in BMI contributes to variation in the hemodynamic and symptomatic response to...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248410384709
更新日期:2011-06-01 00:00:00
abstract::BACKGROUND: The insulin-resistant (IR) syndrome is causally related to hypertension and cardiovascular events; however, the underlying mechanism remains elusive. The current study was designed to determine (1) whether the IR syndrome causes vascular dysfunction and (2) whether insulin resistance alters the activity of...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849800300205
更新日期:1998-04-01 00:00:00
abstract::BACKGROUND: The effectiveness of antisense oligodeoxynucleotides for in vitro and in vivo studies is limited by a low efficiency of cellular uptake and instability due to degradation by nucleases. To overcome some of these problems, we recently developed a transfer method that utilizes inactivated Sendai virus (hemagg...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849700200308
更新日期:1997-07-01 00:00:00
abstract:INTRODUCTION:Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased s...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248418772814
更新日期:2018-09-01 00:00:00
abstract::Congestive heart failure is a chronic and debilitating disease responsible for high cardiac morbidity and mortality in the world and is associated with more than 290 000 deaths in the United States each year. Recent advances in heart failure therapy target many of the mechanical and structural aspects of heart failure...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章,评审
doi:10.1177/1074248410366447
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Mortality after acute myocardial ischemia has been reduced by aspirin (ASA) but mechanisms other than the antiplatelet effect have not been established. This article evaluates an antiarrhythmic action during sympathetic stimulation in the intact anesthetized dog with and without ischemia. METHODS AND RESULT...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1053/XV.2000.5492
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Overexpression of the L-type voltage-dependent calcium channel alpha(1C)-subunit (L-VDCC OE) in transgenic mice results in adaptive hypertrophy followed by a maladaptive phase associated with a decrease in sarcoplasmic reticulum adenosine triphosphatase (SERCA)2a expression at 8 to 10 months of age. Overexpr...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424840501000404
更新日期:2005-12-01 00:00:00
abstract::BACKGROUND: The tendency for the electrophysiologic effect of class III antiarrhythmic agents (action potential prolongation) to be diminished at faster heart rates represents a major drawback of this class of drug and is usually referred to as "reverse use dependence." A novel class III agent, MS-551, has recently be...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/107424849700200105
更新日期:1997-01-01 00:00:00
abstract::Catestatin (CST), which is emerging as a novel cardiac modulator, can protect the heart against excessive sympathetic drive in hypertensive cardiomyopathy. The aim of this study is to investigate whether exogenous CST decreases excessive cardiac sympathetic drive and improves autonomic function and exerts cardioprotec...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248416628676
更新日期:2016-11-01 00:00:00
abstract::Phosphodiesterase inhibitors as inodilators in heart failure are associated with promotion of arrhythmias. Calcium sensitizers have been proposed for the treatment of severe decompensated heart failure. The effect of levosimendan, a calcium sensitizer, and milrinone, a phosphodiesterase inhibitor, on ventricular arrhy...
journal_title:Journal of cardiovascular pharmacology and therapeutics
pub_type: 杂志文章
doi:10.1177/1074248406289286
更新日期:2006-06-01 00:00:00