Switching Anticoagulants and Managing Complexity in Frail Patients With Atrial Fibrillation: An Integrated Approach.

J Am Coll Cardiol

Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Medical University of Bialystok, Bialystok, Poland. Electroni

Published: August 2025


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jacc.2025.06.020DOI Listing

Publication Analysis

Top Keywords

switching anticoagulants
4
anticoagulants managing
4
managing complexity
4
complexity frail
4
frail patients
4
patients atrial
4
atrial fibrillation
4
fibrillation integrated
4
integrated approach
4
switching
1

Similar Publications

Background: Medicare plans employ drug utilization management strategies, including prior authorization (PA) and step therapy (ST), or formulary tier increases, to control spending. However, PA and ST can delay treatment access and encourage use of less effective/safe therapies, while formulary tier increases can lead to treatment switching/discontinuation due to higher patient out-of-pocket costs. This study modeled the impact of restricted access to direct oral anticoagulants (DOACs), and a tier increase for apixaban, on incidence and cost of clinical events in patients with non-valvular atrial fibrillation (NVAF) in the United States.

View Article and Find Full Text PDF

Background: The benefits of switching from warfarin to direct oral anticoagulants in atrial fibrillation remain unclear.

Methods: This retrospective study used the Medicare fee-for-service (2013-2020) and Optum Deidentified Clinformatics Data Mart databases (2013-2023). Among patients with atrial fibrillation who received warfarin for at least 180 days, we created 2 cohorts: (1) patients switching to apixaban versus continuing warfarin (the apixaban cohort) and (2) patients switching to rivaroxaban versus continuing warfarin (the rivaroxaban cohort).

View Article and Find Full Text PDF

Background: Absorption of apixaban, a direct oral anticoagulant (DOAC), may be impaired after metabolic and bariatric surgery (MBS). The Dutch guideline advises to switch to vitamin K antagonists (VKA), while patients prefer the use of DOACs. Apixaban is not regularly prescribed after MBS due to a lack of evidence regarding its efficacy and safety.

View Article and Find Full Text PDF

ObjectiveTo assess the risk of further thrombosis with using HRT containing transdermal estradiol in women with a personal history of venous thromboembolism (VTE) or arterial thromboembolism (ATE).MethodsWe undertook analysis of patients with a history of VTE/ATE who had been seen in the menopause clinic at King's College Hospital. They were followed up for a minimum of a 12 months period to assess for recurrence of VTE/ATE.

View Article and Find Full Text PDF