Less is more in atrial fibrillation stroke prevention — please, drop the aspirin

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A recent study in the Journal of the American College of Cardiology shed more light on the commonly used drug combination of aspirin and a vitamin-K antagonist (such as warfarin).  It was a small registry study from one region of France but I believe it offered confirmatory evidence against this dangerous practice. Investigators followed patients […]

Apixaban (Eliquis) gets FDA approval

Yesterday afternoon, the FDA finally approved apixaban (Eliquis) for the prevention of stroke in patients with non-valvular atrial fibrillation. I use the words ‘finally approved’ because the markedly positive ARISTOTLE trial was published 15 months ago in the New England Journal of Medicine. The long delay was mysterious. On paper, apixaban looks to be the […]

What’s the best blood thinner for AF ablation?

Let’s get off cell biology and back to something I really know. Atrial fibrillation, AF ablation and blood thinners. There was an important study published today in the Journal of the American College of Cardiology concerning the use of the new blood thinner, dabigatran (Pradaxa), around the time of AF ablation. A very concise overview, […]

Female gender and stroke risk in atrial fibrillation: Know your CHA2DS2-VASc Score

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When it comes to the risk of stroke in atrial fibrillation, it pays to be a boy. Sorry, ladies. An important question came up on my recent post on AF and stroke. Why does being female give you an automatic point on CHADS2-VASc?  I keep seeing it, but I don’t see why that is. It […]

The new blood thinners and personal accountability

I recently came across a very important blog post on the use of the novel new blood-thinner, dabigatran (Pradaxa). Fellow Kentucky cardiologist, and frequent TheHeart.org contributor, Dr. Melissa Walton-Shirley wrote this very detailed case presentation involving a cantankerous non-compliant rural patient with AF (atrial fibrillation) that sustained a stroke while “taking” dabigatran. Dr. Walton-Shirley details […]

An update on AF: New blood thinners

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It’s been awhile since I have written about the treatment of atrial fibrillation (AF). I would like to remedy this by sharing a few thoughts on three recent stories about AF: one involved a soon-to-be-approved blood-thinning drug; the second highlighted a potentially exciting new device for ablating AF, and the third story irresponsibly sensationalized the […]