Tag Archives: ARISTOTLE

Obstructive sleep apnoea and neurovascular disease The association between obstructive sleep apnoea (OSA) and neurovascular disease was discussed by Dr David Hargroves (British Association of Stroke Physicians Education and Training Chair) and colleagues from East Kent during the training day at the conference. Dr Hargroves presented previously published data which shows that OSA is not uncommon: 24% of men and 9% of women in the general population may have OSA, 3−4% with clinically ‘obvious’ sequelae, and 60% of older and obese people may have OSA.1 Clinicians treating patients with neurological presentations should have a high index o

ESC guidelines and differences between NOACs Following the roll-out of the novel oral anticoagulants (NOACs), the European Society of Cardiology (ESC) published in 2012 a focused update of its guidelines for the management of atrial fibrillation (AF). Since the NOACs tested in clinical trials all showed at least non-inferiority when compared with vitamin K antagonists (VKAs), with a better safety profile, particularly with reduction in intracranial haemorrhage (ICH), the ESC 2012 guideline recommended NOACs as broadly preferable to VKAs in the vast majority of patients with non-valvular AF (NVAF).1 In 2013, the European Heart Rhythm Associati

New NICE guidance Dr Andrew Cox (St George’s, University of London) Stroke prevention is the major focus of the new National Institute of Health and Care Excellence (NICE) guidelines on atrial fibrillation (AF), which were discussed by Dr Campbell Cowan (Chair, NICE Guidelines Development Group) in one ‘Hot topics’ session at the meeting. This presentation was in anticipation of the release of the final version of the guidelines a fortnight following the conference. This limited discussion covered the already published draft guidance, but points from this draft which were discussed have since been confirmed in the published guidance

NICE draft guidance on acute heart failure published The draft acute heart failure clinical guideline from the National Institute of Health and Care Excellence (NICE) is now out for consultation with stakeholders. Guideline recommendations, available on http://www.nice.org.uk, include advice that people with suspected acute heart failure should be seen by a specialist team with a heart failure service at hospital. Currently practice is not standardised across hospitals and many patients are not treated by a dedicated service. …and also on ICDs and CRT   Draft technology appraisal guidance on the most clinically and cost-effective impla

ARISTOTLE: apixaban superior to warfarin in AF patients Another oral anticoagulant has shown good results in comparison to warfarin for use in the prevention of stroke in patients with atrial fibrillation (AF). The new oral factor Xa inhibitor, apixaban, was superior to warfarin in preventing stroke or systemic embolism and was also associated with less bleeding and lower mortality than warfarin in the ARISTOTLE trial. Apixaban is the third of the new generation of oral anticoagulants to be tested in this indication, and seems to have performed the best. The other two agents – dabigatran and rivaroxaban – have also been shown to be viable