No Net Benefit from Adding Antiplatelet Therapy to Anticoagulation After Stroke in Patients with Atrial Fibrillation and Atherosclerosis: Results from the ATIS‑NVAF Randomized Trial
Posted inCardiology Neurology news

No Net Benefit from Adding Antiplatelet Therapy to Anticoagulation After Stroke in Patients with Atrial Fibrillation and Atherosclerosis: Results from the ATIS‑NVAF Randomized Trial

In older patients with ischemic stroke/TIA, nonvalvular atrial fibrillation, and atherosclerotic cardiovascular disease, adding a single antiplatelet agent to anticoagulation did not reduce ischemic events but markedly increased bleeding, providing no net clinical benefit versus anticoagulant monotherapy.
No Net Benefit from Adding Antiplatelet Therapy to Anticoagulation After Ischemic Stroke With Atrial Fibrillation and Atherosclerosis — Higher Bleeding Risk
Posted inCardiology Neurology news

No Net Benefit from Adding Antiplatelet Therapy to Anticoagulation After Ischemic Stroke With Atrial Fibrillation and Atherosclerosis — Higher Bleeding Risk

In a randomized trial of 316 patients with ischemic stroke/TIA, nonvalvular atrial fibrillation, and atherosclerotic disease, adding an antiplatelet to anticoagulation did not reduce ischemic events but doubled clinically relevant bleeding compared with anticoagulant monotherapy.
Common, Rare and Somatic Genetic Drivers Together Double 5‑Year Atrial Fibrillation Risk: Toward an Integrated Genomic Model (IGM‑AF)
Posted inCardiology news Pathology & Lab Medicine

Common, Rare and Somatic Genetic Drivers Together Double 5‑Year Atrial Fibrillation Risk: Toward an Integrated Genomic Model (IGM‑AF)

A UK Biobank whole‑genome study finds polygenic, rare monogenic, and somatic (CHIP) variants each independently associate with incident atrial fibrillation (AF); combined genomic profiling plus clinical risk (CHARGE‑AF) improves discrimination (C=0.80) and reclassification.
Widespread Anticoagulation Has Lowered Stroke but Not Intracranial Bleeding in the Very Elderly: Insights from a Danish Nationwide AF Cohort (1999–2022)
Posted inCardiology news

Widespread Anticoagulation Has Lowered Stroke but Not Intracranial Bleeding in the Very Elderly: Insights from a Danish Nationwide AF Cohort (1999–2022)

Danish registry data (1999–2022) show large reductions in stroke across age groups with widespread oral anticoagulant (OAC) uptake, but only modest stroke gains and rising intracerebral hemorrhage in patients ≥85 years, highlighting the need for individualized strategies in the very elderly.
Cryoballoon Ablation Is Non‑Inferior to Radiofrequency for 1‑Year Arrhythmia Control in Persistent AF — but Left Atrium Shrinks Less: Insights from the CRRF‑PeAF Trial
Posted inCardiology news

Cryoballoon Ablation Is Non‑Inferior to Radiofrequency for 1‑Year Arrhythmia Control in Persistent AF — but Left Atrium Shrinks Less: Insights from the CRRF‑PeAF Trial

The randomized CRRF‑PeAF trial (n=499) found cryoballoon pulmonary vein isolation non‑inferior to radiofrequency ablation for 1‑year atrial tachyarrhythmia recurrence in persistent atrial fibrillation, but radiofrequency produced greater left atrial reverse remodelling.
Vernakalant Beats Procainamide for Rapid ED Cardioversion of Recent-Onset Atrial Fibrillation: Results from RAFF4
Posted inCardiology Emergency Medicine news

Vernakalant Beats Procainamide for Rapid ED Cardioversion of Recent-Onset Atrial Fibrillation: Results from RAFF4

The RAFF4 randomized trial found intravenous vernakalant superior to procainamide for rapid cardioversion of acute atrial fibrillation in the emergency department — higher conversion within 30 minutes, faster time to sinus rhythm, and fewer electrical cardioversions, with similar short-term safety.
Daily Caffeinated Coffee After Cardioversion Cuts Atrial Fibrillation Recurrence: Results from the DECAF Randomized Trial
Posted inCardiology news

Daily Caffeinated Coffee After Cardioversion Cuts Atrial Fibrillation Recurrence: Results from the DECAF Randomized Trial

The DECAF randomized trial found that encouraging caffeinated coffee consumption (≈1 cup/day) after successful cardioversion reduced clinically detected AF/flutter recurrence over 6 months versus caffeine abstinence (47% vs 64%; HR 0.61). Results challenge routine caffeine restriction in AF patients but require confirmation and contextualization.
Does Anticoagulation After Successful AF Ablation Matter? The OCEAN Trial Shows No Clear Advantage of Rivaroxaban over Aspirin
Posted inCardiology Neurology news

Does Anticoagulation After Successful AF Ablation Matter? The OCEAN Trial Shows No Clear Advantage of Rivaroxaban over Aspirin

In patients who underwent successful catheter ablation for atrial fibrillation at least one year earlier, rivaroxaban did not significantly reduce the composite of clinical or covert embolic stroke compared with aspirin over 3 years, while numerically more major bleeding occurred with rivaroxaban.
Mitochondrial Calcium Deficit Links Structural Remodeling to Atrial Fibrillation — and an Old Cholesterol Drug, Ezetimibe, Shows Unexpected Anti‑AF Potential
Posted inCardiology news

Mitochondrial Calcium Deficit Links Structural Remodeling to Atrial Fibrillation — and an Old Cholesterol Drug, Ezetimibe, Shows Unexpected Anti‑AF Potential

New human tissue and cellular data implicate impaired mitochondrial Ca2+ uptake, structural uncoupling of sarcoplasmic reticulum–mitochondria contacts, and oxidative stress in atrial fibrillation (AF); ezetimibe restored mitochondrial Ca2+ handling and reduced AF burden in exploratory analyses.