Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 …
Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation: FANTASIIA Study.
Introduction: Atrial fibrillation (AF) is associated with an increased risk of thromboembolic events. Many patients with AF receive chronic anticoagulation, either with vitamin K antagonists (VKAs) or with non-VKA oral anticoagulants (NOACs). We sought to analyze variables associated with prescription of NOAC. Methods: Patients with AF under anticoagulation treatment were prospectively recruited in this observational registry. The sample comprised 1290 patients under chronic anticoagulation for AF, 994 received VKA (77.1%) and 296 NOAC (22.9%). Univariate and multivariate analyses were performed to identify variables associated with use of NOAC. Results: Mean age was 73.8 ± 9.4 years, and 4…
Quality of Anticoagulation With Vitamin K Antagonists
Background Vitamin K antagonists (VKA) have a narrow therapeutic range, and literature analysis reveals poor quality of anticoagulation control. We sought to assess the prevalence of poor anticoagulant control in patients under VKA treatment in the prevention of stroke for atrial fibrillation (AF). Hypothesis Control of anticoagulation with VKA is inadequate in a high percentage of patients with AF. Methods Patients with AF under VKA treatment were prospectively recruited in this observational registry. The sample comprised 948 patients. The estimated time spent in the therapeutic range (TTR) was calculated, and variables related with a TTR >65% were analyzed. Results Mean age was 73.8 ± 9.…
Anticoagulation prescription in atrial fibrillation.
We seek to assess the factors associated with the anticoagulation prescription in a cohort of patients with atrial fibrillation (AF) collected from out-patient clinics.A total of 1524 patients with a history of AF were collected from out-patients clinics. CHADS(2), CHA(2)DS(2)-VASc and HAS-BLED scores were calculated in every patient. Variables associated with anticoagulant treatment prescription were analyzed in univariant and multivariant models.Most patients received either anticoagulant (62%) or antiplatelet treatment (37%). Anticoagulation rates increased among higher CHADS(2) and CHA(2)DS(2)-VASc score values. A logistic regression model was performed to assess the variables associate…
Hemorrhage in patients under oral anticoagulation for atrial fibrillation. The other side of the coin
Abstract Introduction and objectives Oral anticoagulation therapy is prescribed to most patients with atrial fibrillation. The main limitation of anticoagulant treatment is the occurrence of bleeding episodes. We sought to assess the type of hemorrhages and mortality in patients anticoagulated for nonvalvular atrial fibrillation. Methods Observational retrospective study analyzing 2 081 138 hospitalization reports from 2014 corresponding to 151 hospitals of the Spanish National Health System. Patients were selected with the diagnosis of hemorrhage, nonvalvular atrial fibrillation, and oral anticoagulation. Results A total of 5783 hospitalizations were analyzed. Most hemorrhages were digesti…