European Heart Journal — Cardiovascular Pharmacotherapy最新文献

{"title":"Impact of liver disease on oral anticoagulant prescription and major adverse events in patients with atrial fibrillation: analysis from a population-based cohort study.","authors":"Marco Proietti,&nbsp;Irene Marzona,&nbsp;Tommaso Vannini,&nbsp;Pierluca Colacioppo,&nbsp;Mauro Tettamanti,&nbsp;Andreana Foresta,&nbsp;Ida Fortino,&nbsp;Luca Merlino,&nbsp;Gregory Y H Lip,&nbsp;Maria Carla Roncaglioni","doi":"10.1093/ehjcvp/pvaa015","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa015","url":null,"abstract":"<p><strong>Aims: </strong>Data on the impact of liver disease (LD) in patients with atrial fibrillation (AF) and the role of oral anticoagulant (OAC) drugs for stroke prevention are limited.</p><p><strong>Methods and results: </strong>A retrospective observational population-based cohort study on the administrative health databases of Lombardy region Italy. All AF patients ≥40 years admitted to hospital from 2000 to 2018 were considered. Atrial fibrillation and LD diagnosis were established using ICD9-CM codes. Use of OAC was determined with Anatomical Therapeutic Chemical codes. Primary study outcomes were stroke, major bleeding, and all-cause death. Among 393 507 AF patients, 16 168 (4.1%) had concomitant LD. Liver disease AF patients were significantly less treated with OAC. Concomitant LD was associated with an increased risk in all the study outcomes [hazard ratio (HR): 1.18, 95% confidence interval (CI): 1.11-1.25 for stroke; HR: 1.57, 95% CI: 1.47-1.66 for major bleeding; HR: 1.41, 95% CI: 1.39-1.44 for all-cause death]. Use of OAC in patients with AF and LD resulted in a reduction in stroke (HR: 0.80, 95% CI: 0.70-0.92), major bleeding (HR: 0.86, 95% CI: 0.74-0.99), and all-cause death (HR: 0.77, 95% CI: 0.73-0.80), with similar results according to subgroups. A net clinical benefit (NCB) analysis suggested a positive benefit/risk ratio in using OAC in AF patients with LD (NCB: 0.408, 95% CI: 0.375-0.472).</p><p><strong>Conclusion: </strong>In AF patients, concomitant LD carries a significantly higher risk for all clinical outcomes. Use of OAC in AF patients with LD was associated with a significant favourable benefit/risk ratio, even in high-risk patient subgroups.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f84-f92"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37703792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial fibrillation and stroke prevention.","authors":"Basil S Lewis","doi":"10.1093/ehjcvp/pvab023","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvab023","url":null,"abstract":"","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f1-f2"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvab023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25586049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of adherence and persistence with oral anticoagulation treatment in patients with atrial fibrillation.","authors":"Marco Vitolo,&nbsp;Deirdre A Lane,&nbsp;Giuseppe Boriani,&nbsp;Gregory Y H Lip","doi":"10.1093/ehjcvp/pvaa020","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa020","url":null,"abstract":"","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f81-f83"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37863921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of double vs. triple antithrombotic therapy in patients with atrial fibrillation with or without acute coronary syndrome undergoing percutaneous coronary intervention: a collaborative meta-analysis of non-vitamin K antagonist oral anticoagulant-based randomized clinical trials.","authors":"Giuseppe Gargiulo,&nbsp;Christopher P Cannon,&nbsp;Charles Michael Gibson,&nbsp;Andreas Goette,&nbsp;Renato D Lopes,&nbsp;Jonas Oldgren,&nbsp;Serge Korjian,&nbsp;Stephan Windecker,&nbsp;Giovanni Esposito,&nbsp;Pascal Vranckx,&nbsp;Marco Valgimigli","doi":"10.1093/ehjcvp/pvaa116","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa116","url":null,"abstract":"<p><strong>Aims: </strong>Safety and efficacy of antithrombotic regimens in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) may differ based on clinical presentation. We sought to compare double vs. triple antithrombotic therapy (DAT vs. TAT) in AF patients with or without acute coronary syndrome (ACS) undergoing PCI.</p><p><strong>Methods and results: </strong>A systematic review and meta-analysis was performed using PubMed to search for non-vitamin K antagonist oral anticoagulant (NOAC)-based randomized clinical trials. Data on subgroups of ACS or elective PCI were obtained by published reports or trial investigators. A total of 10 193 patients from four NOAC trials were analysed, of whom 5675 presenting with ACS (DAT = 3063 vs. TAT = 2612) and 4518 with stable coronary artery disease (SCAD; DAT = 2421 vs. TAT = 2097). The primary safety endpoint of ISTH major bleeding or clinically relevant non-major bleeding was reduced with DAT compared with TAT in both ACS (12.2% vs. 19.4%; RR 0.63, 95% CI 0.56-0.71; P < 0.0001; I2 = 0%) and SCAD (14.6% vs. 22.0%; RR 0.68, 95% CI 0.55-0.85; P = 0.0008; I2 = 66%), without interaction (P-int = 0.54). Findings were consistent for secondary bleeding endpoints, including intra-cranial haemorrhage. In both subgroups, there was no difference between DAT and TAT for all-cause death, major adverse cardiovascular events, or stroke. Myocardial infarction and stent thrombosis were numerically higher with DAT vs. TAT consistently in ACS and SCAD (P-int = 0.60 and 0.86, respectively). Findings were confirmed by multiple sensitivity analyses, including a separate analysis on dabigatran regimens and a restriction to PCI population.</p><p><strong>Conclusions: </strong>DAT, compared with TAT, is associated with lower bleeding risks, including intra-cranial haemorrhage, and a small non-significant excess of cardiac ischaemic events in both patients with or without ACS.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f50-f60"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38541092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term persistence and adherence with non-vitamin K oral anticoagulants in patients with atrial fibrillation and their associations with stroke risk.","authors":"Joris J Komen,&nbsp;Eibert R Heerdink,&nbsp;Olaf H Klungel,&nbsp;Aukje K Mantel-Teeuwisse,&nbsp;Tomas Forslund,&nbsp;Björn Wettermark,&nbsp;Paul Hjemdahl","doi":"10.1093/ehjcvp/pvaa017","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa017","url":null,"abstract":"<p><strong>Aims: </strong>Studies on adherence and persistence with non-vitamin K oral anticoagulant (NOAC) treatment have relied on data from the early years of NOAC availability. We aimed to study long-term adherence and persistence with NOACs and their association with stroke risk.</p><p><strong>Methods and results: </strong>From the Stockholm Healthcare database, we included 21 028 atrial fibrillation patients claiming a first NOAC prescription from July 2011 until October 2018, with more than 1000 patients having more than 5 years of follow-up (median: 2.0, interquartile range: 1.0-3.2). Persistence rates, defined as continuing to claim NOAC prescriptions within a 90-day gap, decreased to 70% at the end of follow-up. However, 85% of the patients were treated at the end of the study due to reinitiations. Adherence, calculated as medication possession rate (MPR) in 3 and 6-month intervals among persistent users, remained stable at 90%, with 75% of patients having an MPR >95% throughout the study period. Using a case-control design, we calculated associations of persistence and adherence with stroke risk, adjusting for potential confounders. The outcome was a composite of ischaemic or unspecified stroke and transient ischaemic attack. Non-persistence and poor adherence were both associated with increased stroke risk [non-persistence adjusted odds ratio (aOR): 2.05; 95% confidence interval (CI): 1.49-2.82, 1% reduction MPR aOR: 1.03; CI: 1.01-1.05]. There was no association between non-persistence or poor adherence and the falsification endpoints; fractions and respiratory infections, indicating no 'healthy-adherer' effect.</p><p><strong>Conclusion: </strong>Persistence rates decreased slowly over time, but persistent patients had high adherence rates. Both non-persistence and poor adherence were associated with an increased stroke risk.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f72-f80"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37862869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world safety and efficacy of direct oral anticoagulants in atrial fibrillation: a systematic review and meta-analysis of 605 771 patients.","authors":"Danilo Menichelli, Francesco Del Sole, Arianna Di Rocco, Alessio Farcomeni, Annarita Vestri, Francesco Violi, Pasquale Pignatelli, Gregory Y H Lip, Daniele Pastori","doi":"10.1093/ehjcvp/pvab002","DOIUrl":"10.1093/ehjcvp/pvab002","url":null,"abstract":"<p><strong>Aims: </strong>To analyse the safety and efficacy of direct oral anticoagulants (DOACs) in real-world studies including atrial fibrillation (AF) patients.</p><p><strong>Methods and results: </strong>Systematic review and meta-analysis of observational studies including AF patients on DOACs. Primary endpoints: any, major, gastrointestinal (GI), intracranial haemorrhage (ICH), and haemorrhagic stroke (HS). Secondary endpoints: ischaemic stroke (IS), systemic embolism (SE), myocardial infarction (MI), and all-cause of death. A set of pair-wise meta-analyses using a random effect model and a random effect network meta-analysis under a Bayesian framework were performed. Prospero registration number: CRD42019137111. We included 21 studies with 605 771 AF patients. Apixaban was associated with lower major and GI bleeding compared with Rivaroxaban [hazard ratio (HR) 2.0, 95% confidence interval (CI) 1.6-2.5] and Dabigatran (HR 1.6, 95% CI 1.3-2.1). The latter drug performed better than Rivaroxaban (HR 1.2, 95% CI 1.0-1.5). Dabigatran and Apixaban had a similar association with HS, but Apixaban performed better than Rivaroxaban (HR 1.8, 95% CI 1.1-3.0). Apixaban had a similar association with Rivaroxaban and Dabigatran for ICH, the latter drug performing better than Rivaroxaban (HR 1.3, 95% CI 1.0-1.7). Rankograms showed that Apixaban was likely to be the first-choice treatment in relation to any (65%) major (100%) and GI bleeding (100%) followed by Dabigatran (46%, 100%, 99%, respectively). Dabigatran and Apixaban had similar rank as first choice for ICH (44% and 55%) and HS (52% and 48%). DOACs showed similar association with IS/SE, MI, all-cause of death.</p><p><strong>Conclusions: </strong>Analysis of real-world studies shows significant differences for safety among DOACs.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f11-f19"},"PeriodicalIF":0.0,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38858311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with diabetes mellitus and atrial fibrillation treated with non-vitamin K antagonist oral anticoagulants: meta-analysis of eight outcomes in 58 634 patients across four randomized controlled trials.","authors":"Anna Plitt,&nbsp;Thomas A Zelniker,&nbsp;Jeong-Gun Park,&nbsp;Darren K McGuire,&nbsp;Christian T Ruff,&nbsp;Elliott M Antman,&nbsp;Eugene Braunwald,&nbsp;Robert P Giugliano","doi":"10.1093/ehjcvp/pvaa120","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa120","url":null,"abstract":"<p><strong>Aims: </strong>Concomitant atrial fibrillation (AF) and diabetes mellitus (DM) increases the risk of stroke and systemic embolic events (SEE). This meta-analysis assessed the benefit/risk balance of non-vitamin K antagonist oral anticoagulants (NOACs) vs. warfarin, and explored whether there was effect modification by DM or heterogeneity in outcomes between NOACs in patients with and without DM.</p><p><strong>Methods and results: </strong>We performed a meta-analysis of 58 634 patients from four Phase 3 trials of NOAC vs. warfarin in patients with AF, comparing the primary outcomes of efficacy and safety and six other secondary outcomes in patients stratified by the presence of DM. Interaction testing was used to assess for heterogeneity of treatment effects. A meta-regression was performed to evaluate the influence of baseline characteristics. NOACs reduced the risk of stroke/SEE in 18 134 patients with DM [hazard ratio (HR) 0.80; 95% confidence interval (CI) (0.69-0.93), I2 3.90] to a similar degree as in 40 500 patients without DM [HR 0.82; 95% CI (0.74-0.91), I2 16.33; P-int 0.81]. There was no effect modification of DM on the relative reduction with NOACs vs. warfarin in major bleeding (DM: 0.95, 95% CI 0.75-1.20, I2 43.83; no DM: 0.83, 95% CI 0.55-1.24; I2 87.90; P-int 0.37). Intracranial haemorrhage (HRs 0.51 and 0.47, P-int 0.70) and cardiovascular death (HRs 0.87 and 0.90, P-int 0.70) were significantly reduced by NOACs in the presence or absence of DM.</p><p><strong>Conclusion: </strong>Non-vitamin K antagonist oral anticoagulants are more effective and safer than warfarin in AF patients with or without DM. Absent contraindications, NOACs should be the anticoagulation treatment choice in patients with diabetes.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f40-f49"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38499549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of non-vitamin K antagonist oral anticoagulants in elderly patients with atrial fibrillation: systematic review and meta-analysis of 22 studies and 440 281 patients.","authors":"Angelo Silverio,&nbsp;Marco Di Maio,&nbsp;Costantina Prota,&nbsp;Elena De Angelis,&nbsp;Ilaria Radano,&nbsp;Rodolfo Citro,&nbsp;Albino Carrizzo,&nbsp;Michele Ciccarelli,&nbsp;Carmine Vecchione,&nbsp;Davide Capodanno,&nbsp;Gennaro Galasso","doi":"10.1093/ehjcvp/pvz073","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvz073","url":null,"abstract":"<p><strong>Aims: </strong>The aim of the present meta-analysis was to evaluate the efficacy and safety of non-vitamin K oral antagonists (NOACs) vs. vitamin K antagonists (VKAs) in elderly patients with atrial fibrillation (AF) and indirectly compare NOACs in this population.</p><p><strong>Methods and results: </strong>MEDLINE, Cochrane, ISI Web of Sciences, and SCOPUS were searched for randomized or adjusted observational studies comparing NOACs vs. VKAs for stroke prevention in AF patients ≥75 years. The primary efficacy and safety outcomes of this meta-analysis were the composite of stroke and systemic embolism (SSE) and major bleedings, respectively. Other secondary outcomes were also analysed. The analysis included 22 studies enrolling 440 281 AF patients ≥ 75 years. The risk of SSE was significantly lower with NOACs vs. VKAs [hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.70-0.89], whereas no differences were found for major bleedings (HR 0.94; 95% CI 0.85-1.05). NOACs reduced the risk of intracranial bleeding (HR 0.46; 95% CI 0.38-0.58), haemorrhagic stroke (HR 0.61; 95% CI 0.48-0.79) and fatal bleeding (HR 0.46; 95% CI 0.30-0.72) but increased gastrointestinal (GI) bleedings (HR 1.46; 95% CI 1.30-1.65), compared to VKAs. The adjusted indirect comparison showed no significant differences in term of SSE between NOAC agents. Conversely, the risk of major bleeding was higher for rivaroxaban vs. apixaban (HR 1.69; 95% CI 1.39-2.08) and edoxaban (HR 1.37; 95% CI 1.14-1.67), and for dabigatran vs. apixaban (HR 1.47; 95% CI 1.18-1.85).</p><p><strong>Conclusion: </strong>In elderly patients with AF, NOACs are associated to a lower risk of SSE, intracranial bleeding, haemorrhagic stroke and fatal bleeding than VKAs, but increase GI bleedings. In this analysis, the safety profile of individual NOAC agents was significantly different.</p>","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"f20-f29"},"PeriodicalIF":7.1,"publicationDate":"2021-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvz073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37451387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on-Switching from vitamin K antagonist to dabigatran in atrial fibrillation: differences according to dose.","authors":"Jutta Heinrich-Nols,&nbsp;Joanne van Ryn","doi":"10.1093/ehjcvp/pvaa022","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa022","url":null,"abstract":"We thank Vinding et al. for their evaluation of the Danish patients with atrial fibrillation, who were switched from vitamin K antagonists (VKA) to dabigatran etexilate. The authors evaluated data, from Danish national registries, for 1626 patients with atrial fibrillation who switched from VKA to dabigatran 110 mg or 150 mg, between 22 August 2011 and 31 December 2012. Among the VKA-experienced patients with atrial fibrillation, they found that one in four were switched to a dabigatran dose, contrary to the recommendations outlined in the European Society of Cardiology guidelines. There are some statements in the article that we would like to clarify. Vinding et al. state that in the RE-LY study of dabigatran 110 mg and 150 mg vs. warfarin, ‘Both doses reduced the risk of haemorrhagic stroke, but increased the risk of gastrointestinal bleedings’. They are correct that, compared with warfarin, 110 mg and 150 mg dabigatran reduced the risk of haemorrhagic stroke [relative risk (95% confidence interval (CI)) 0.31 (0.17–0.56), and 0.26 (0.14–0.49), respectively; P < 0.001 for both], and that 150 mg dabigatran increased the risk of gastrointestinal bleeding [relative risk (95% CI) 1.50 (1.19–1.89); P < 0.001]. However, the authors failed to note that 110 mg dabigatran did not increase the risk of gastrointestinal bleeding when compared with warfarin [relative risk (95% CI) 1.10 (0.86– 1.41); P = 0.43]. The authors also reported that ‘14% of patients were underdosed’. This statement is misleading, as there is no underdosing for dabigatran. The 110 mg dabigatran dose has been powerfully tested vs. warfarin, and in the RE-LY trial, showed non-inferiority for stroke prevention [relative risk (95% CI) 0.92 (0.74–1.13); P = 0.41] and superiority for the risk of major bleeding events [relative risk (95% CI) 0.80 (0.69–0.93); P = 0.003] compared with warfarin. While we acknowledge the authors’ definition of underdosing (‘patients switched to 110 mg without guideline criteria justifying this’), it would have been more accurate to have used ‘switched to a low dose incorrectly’ rather than use ‘underdosed’. We also consider that their statement ‘Since dabigatran was approved with specific guideline recommendations for dose reduction’ could be misread. We would like to clarify that the guidelines do not approve drugs, they provide recommendations on their use in clinical practice. The approval of both doses of dabigatran only occurs through regulatory and health authorities.","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"74"},"PeriodicalIF":7.1,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37794961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on-Switching from vitamin K antagonist to dabigatran in atrial fibrillation: differences according to dose: reply.","authors":"Naja Emborg Vinding,&nbsp;Lars Køber,&nbsp;Emil Loldrup Fosbøl","doi":"10.1093/ehjcvp/pvaa023","DOIUrl":"https://doi.org/10.1093/ehjcvp/pvaa023","url":null,"abstract":"","PeriodicalId":11995,"journal":{"name":"European Heart Journal — Cardiovascular Pharmacotherapy","volume":" ","pages":"75"},"PeriodicalIF":7.1,"publicationDate":"2021-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/ehjcvp/pvaa023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37795032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}