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Coronary Artery Disease: HELP
Articles by Paulus Kirchhof
Based on 8 articles published since 2008
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Between 2008 and 2019, Paulus Kirchhof wrote the following 8 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Guideline Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. 2015

Heidbuchel, Hein / Verhamme, Peter / Alings, Marco / Antz, Matthias / Diener, Hans-Christoph / Hacke, Werner / Oldgren, Jonas / Sinnaeve, Peter / Camm, A John / Kirchhof, Paulus. · ·Europace · Pubmed #26324838.

ABSTRACT: The current manuscript is an update of the original Practical Guide, published in June 2013[Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-51; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, et al. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-106]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with non-valvular atrial fibrillation (AF). Both physicians and patients have to learn how to use these drugs effectively and safely in clinical practice. Many unresolved questions on how to optimally use these drugs in specific clinical situations remain. The European Heart Rhythm Association set out to coordinate a unified way of informing physicians on the use of the different NOACs. A writing group defined what needs to be considered as 'non-valvular AF' and listed 15 topics of concrete clinical scenarios for which practical answers were formulated, based on available evidence. The 15 topics are (i) practical start-up and follow-up scheme for patients on NOACs; (ii) how to measure the anticoagulant effect of NOACs; (iii) drug-drug interactions and pharmacokinetics of NOACs; (iv) switching between anticoagulant regimens; (v) ensuring adherence of NOAC intake; (vi) how to deal with dosing errors; (vii) patients with chronic kidney disease; (viii) what to do if there is a (suspected) overdose without bleeding, or a clotting test is indicating a risk of bleeding?; (xi) management of bleeding complications; (x) patients undergoing a planned surgical intervention or ablation; (xi) patients undergoing an urgent surgical intervention; (xii) patients with AF and coronary artery disease; (xiii) cardioversion in a NOAC-treated patient; (xiv) patients presenting with acute stroke while on NOACs; and (xv) NOACs vs. VKAs in AF patients with a malignancy. Additional information and downloads of the text and anticoagulation cards in >16 languages can be found on an European Heart Rhythm Association web site (www.NOACforAF.eu).

2 Guideline 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). 2015

Priori, Silvia G / Blomström-Lundqvist, Carina / Mazzanti, Andrea / Blom, Nico / Borggrefe, Martin / Camm, John / Elliott, Perry Mark / Fitzsimons, Donna / Hatala, Robert / Hindricks, Gerhard / Kirchhof, Paulus / Kjeldsen, Keld / Kuck, Karl-Heinz / Hernandez-Madrid, Antonio / Nikolaou, Nikolaos / Norekvål, Tone M / Spaulding, Christian / Van Veldhuisen, Dirk J / Anonymous330841. · ·Eur Heart J · Pubmed #26320108.

ABSTRACT: -- No abstract --

3 Guideline 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. 2013

Anonymous3190768 / Montalescot, Gilles / Sechtem, Udo / Achenbach, Stephan / Andreotti, Felicita / Arden, Chris / Budaj, Andrzej / Bugiardini, Raffaele / Crea, Filippo / Cuisset, Thomas / Di Mario, Carlo / Ferreira, J Rafael / Gersh, Bernard J / Gitt, Anselm K / Hulot, Jean-Sebastien / Marx, Nikolaus / Opie, Lionel H / Pfisterer, Matthias / Prescott, Eva / Ruschitzka, Frank / Sabaté, Manel / Senior, Roxy / Taggart, David Paul / van der Wall, Ernst E / Vrints, Christiaan J M / Anonymous3200768 / Zamorano, Jose Luis / Achenbach, Stephan / Baumgartner, Helmut / Bax, Jeroen J / Bueno, Héctor / Dean, Veronica / Deaton, Christi / Erol, Cetin / Fagard, Robert / Ferrari, Roberto / Hasdai, David / Hoes, Arno W / Kirchhof, Paulus / Knuuti, Juhani / Kolh, Philippe / Lancellotti, Patrizio / Linhart, Ales / Nihoyannopoulos, Petros / Piepoli, Massimo F / Ponikowski, Piotr / Sirnes, Per Anton / Tamargo, Juan Luis / Tendera, Michal / Torbicki, Adam / Wijns, William / Windecker, Stephan / Anonymous3210768 / Knuuti, Juhani / Valgimigli, Marco / Bueno, Héctor / Claeys, Marc J / Donner-Banzhoff, Norbert / Erol, Cetin / Frank, Herbert / Funck-Brentano, Christian / Gaemperli, Oliver / Gonzalez-Juanatey, José R / Hamilos, Michalis / Hasdai, David / Husted, Steen / James, Stefan K / Kervinen, Kari / Kolh, Philippe / Kristensen, Steen Dalby / Lancellotti, Patrizio / Maggioni, Aldo Pietro / Piepoli, Massimo F / Pries, Axel R / Romeo, Francesco / Rydén, Lars / Simoons, Maarten L / Sirnes, Per Anton / Steg, Ph Gabriel / Timmis, Adam / Wijns, William / Windecker, Stephan / Yildirir, Aylin / Zamorano, Jose Luis. ·The disclosure forms of the authors and reviewers are available on the ESC website www.escardio.org/guidelines. ·Eur Heart J · Pubmed #23996286.

ABSTRACT: -- No abstract --

4 Guideline EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. 2013

Heidbuchel, Hein / Verhamme, Peter / Alings, Marco / Antz, Matthias / Hacke, Werner / Oldgren, Jonas / Sinnaeve, Peter / Camm, A John / Kirchhof, Paulus. ·Department of Cardiovascular Medicine, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium. hein.heidbuchel@uzleuven.be ·Eur Heart J · Pubmed #23625209.

ABSTRACT: New oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with non-valvular atrial fibrillation (AF). Both physicians and patients will have to learn how to use these drugs effectively and safely in specific clinical situations. This text is an executive summary of a practical guide that the European Heart Rhythm Association (EHRA) has assembled to help physicians in the use of the different NOACs. The full text is being published in EP Europace. Practical answers have been formulated for 15 concrete clinical scenarios: (i) practical start-up and follow-up scheme for patients on NOACs; (ii) how to measure the anticoagulant effect of NOACs; (iii) drug-drug interactions and pharmacokinetics of NOACs; (iv) switching between anticoagulant regimens; (v) ensuring compliance of NOAC intake; (vi) how to deal with dosing errors; (vii) patients with chronic kidney disease; (viii) what to do if there is a (suspected) overdose without bleeding, or a clotting test is indicating a risk of bleeding?; (ix) management of bleeding complications; (x) patients undergoing a planned surgical intervention or ablation; (xi) patients undergoing an urgent surgical intervention; (xii) patients with AF and coronary artery disease; (xiii) cardioversion in a NOAC-treated patient; (xiv) patients presenting with acute stroke while on NOACs; (xv) NOACs vs. VKAs in AF patients with a malignancy. Since new information is becoming available at a rapid pace, an EHRA web site with the latest updated information accompanies the guide (www.NOACforAF.eu). It also contains links to the ESC AF Guidelines, a key message pocket booklet, print-ready files for a proposed universal NOAC anticoagulation card, and feedback possibilities.

5 Review Choosing a particular oral anticoagulant and dose for stroke prevention in individual patients with non-valvular atrial fibrillation: part 1. 2017

Diener, Hans-Christoph / Aisenberg, James / Ansell, Jack / Atar, Dan / Breithardt, Günter / Eikelboom, John / Ezekowitz, Michael D / Granger, Christopher B / Halperin, Jonathan L / Hohnloser, Stefan H / Hylek, Elaine M / Kirchhof, Paulus / Lane, Deirdre A / Verheugt, Freek W A / Veltkamp, Roland / Lip, Gregory Y H. ·Department of Neurology, University Hospital Essen, Essen, Germany. · Icahn School of Medicine at Mount Sinai, New York, USA. · Hofstra North Shore/LIJ School of Medicine, Hempstead, USA. · Division of Medicine, Oslo University Hospital, Ullevål and University of Oslo, Oslo, Norway. · Division of Rhythmology, Department of Cardiovascular Medicine, Hospital of the University Münster, Münster, Germany. · Population Health Research Institute, McMaster University, Hamilton, ON, Canada. · Cardiovascular Research Foundation, New York, NY, USA. · Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, PA, USA. · Lankenau Medical Center, Wynnewood, PA, USA. · Department of Medicine, Duke University, Durham, NC, USA. · Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA. · Division of Clinical Electrophysiology, Department of Cardiology, J. W. Goethe University, Frankfurt, Germany. · Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. · Institute of Cardiovascular Sciences, University of Birmingham, SWBH and UHB NHS Trusts, Birmingham, UK. · Department of Cardiovascular Medicine, Hospital of the University of Münster, Münster, Germany. · University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham, UK. · Afdeling Cardiologie, Hartcentrum OLVG, Amsterdam, The Netherlands. · Stroke Medicine, Imperial College London, London, UK. · University of Birmingham, Birmingham, UK. · Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. ·Eur Heart J · Pubmed #26848149.

ABSTRACT: Patients with atrial fibrillation (AF) have a high risk of stroke and mortality, which can be considerably reduced by oral anticoagulants (OAC). Recently, four non-vitamin-K oral anticoagulants (NOACs) were compared with warfarin in large randomized trials for the prevention of stroke and systemic embolism. Today's clinician is faced with the difficult task of selecting a suitable OAC for a patient with a particular clinical profile or a particular pattern of risk factors and concomitant diseases. We reviewed analyses of subgroups of patients from trials of vitamin K antagonists vs. NOACs for stroke prevention in AF with the aim to identify patient groups who might benefit from a particular OAC more than from another. In the first of a two-part review, we discuss the choice of NOAC for stroke prevention in the following subgroups of patients with AF: (i) stable coronary artery disease or peripheral artery disease, including percutaneous coronary intervention with stenting and triple therapy; (ii) cardioversion, ablation and anti-arrhythmic drug therapy; (iii) mechanical valves and rheumatic valve disease, (iv) patients with time in therapeutic range of >70% on warfarin; (v) patients with a single stroke risk factor (CHA2DS2VASc score of 1 in males, 2 in females); and (vi) patients with a single first episode of paroxysmal AF. Although there are no major differences in terms of efficacy and safety between the NOACs for some clinical scenarios, in others we are able to suggest that particular drugs and/or doses be prioritized for anticoagulation.

6 Article Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary. 2017

Heidbuchel, Hein / Verhamme, Peter / Alings, Marco / Antz, Matthias / Diener, Hans-Christoph / Hacke, Werner / Oldgren, Jonas / Sinnaeve, Peter / Camm, A John / Kirchhof, Paulus / Anonymous8070870. ·Hasselt University and Heart Center, Stadsomvaart 11, Hasselt 3500, Belgium. · Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium. · Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands. · Department of Cardiology, Klinikum Oldenburg, Oldenburg, Germany. · Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany. · Department of Neurology, Ruprecht Karls Universität, Heidelberg, Germany. · Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden. · Clinical Cardiology, St George's University, London, UK. · University of Birmingham Centre for Cardiovascular Sciences, Birmingham, UK. · Department of Cardiology and Angiology, University of Münster, Münster, Germany. ·Eur Heart J · Pubmed #27282612.

ABSTRACT: In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-2106). The document received widespread interest, not only from cardiologists but also from neurologists, geriatricians, and general practitioners, as became evident from the distribution of >350 000 copies of its pocket version (the EHRA Key Message Booklet) world-wide. Since 2013, numerous new studies have appeared on different aspects of NOAC therapy in AF patients. Therefore, EHRA updated the Practical Guide, including new information but also providing balanced guiding in the many areas where prospective data are still lacking. The outline of the original guide that addressed 15 clinical scenarios has been preserved, but all chapters have been rewritten. Main changes in the Update comprise a discussion on the definition of 'non-valvular AF' and eligibility for NOAC therapy, inclusion of finalized information on the recently approved edoxaban, tailored dosing information dependent on concomitant drugs, and/or clinical characteristics, an expanded chapter on neurologic scenarios (ischaemic stroke or intracranial haemorrhage under NOAC), an updated anticoagulation card and more specifics on start-up and follow-up issues. There are also many new flow charts, like on appropriate switching between anticoagulants (VKA to NOAC or vice versa), default scenarios for acute management of coronary interventions, step-down schemes for long-term combined antiplatelet-anticoagulant management in coronary heart disease, management of bleeding, and cardioversion under NOAC therapy. The Updated Guide is available in full in EP Europace (Heidbuchel H, Verhamme P, Alings M, Antz M, Diener HC, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, Advisors. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507), while additional resources can be found at the related ESC/EHRA website (www.NOACforAF.eu).

7 Article Characteristics and outcomes of atrial fibrillation patients with or without specific symptoms: results from the PREFER in AF registry. 2016

Bakhai, Ameet / Darius, Harald / De Caterina, Raffaele / Smart, Angela / Le Heuzey, Jean-Yves / Schilling, Richard John / Zamorano, José Luis / Shah, Mit / Bramlage, Peter / Kirchhof, Paulus. ·Royal Free London NHS Trust, Barnet Hospital, London, UK. · Vivantes Clinics for Health, Berlin, Germany. · G. d'Annunzio University, Chieti-Pescara, Italy. · Daiichi Sankyo UK Ltd, Gerrards Cross, UK. · Georges Pompidou Hospital, René Descartes University, Paris, France. · Cardiology Department, Barts and The London School of Medicine and Dentistry, London, UK. · Department of Cardiology, Hospital Universitario Ramón y Cajal, Madrid, Spain. · Institut für Pharmakologie und Präventive Medizin, Mahlow, Germany. · University of Birmingham, Institute of Cardiovascular Sciences and SWBH and UHB NHS trusts, Birmingham, UK. ·Eur Heart J Qual Care Clin Outcomes · Pubmed #29474715.

ABSTRACT: Aims: Atrial fibrillation (AF) is a common condition that is a major cause of stroke. A significant proportion of patients with AF are not classically symptomatic at diagnosis or soon after diagnosis. There is little information comparing their characteristics, treatment, and outcomes of patients with symptoms, which predominate in clinical trials to those without. Methods and results: We analysed data from the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation. This was a prospective, real-world registry with a 12-month follow-up that included AF patients aged 18 years and over. Patients were divided into those with and without AF symptoms using the European Heart Rhythm Association (EHRA) score (Category I vs. Categories II-IV). Of the 6196 patients (mean age 72 years) with EHRA scores available, 501 (8.1%) were asymptomatic. A lower proportion of asymptomatic patients was female (22.8 vs. 41.2%), with less noted to have heart failure and coronary artery disease (P < 0.01 for all). There were no differences in terms of the prevalence of diabetes, obesity, or prior stroke. Asymptomatic patients had a lower CHA2DS2-VASc score (2.9 ± 1.7 vs. 3.4 ± 1.8; P < 0.01) and HAS-BLED score (1.8 ± 1.1 vs. 2.1 ± 1.2; P < 0.01). During the 1-year follow-up, adverse events occurred at similar frequencies in asymptomatic and symptomatic patients (1.6 vs. 0.8% for ischaemic stroke; P = 0.061; 1.4 vs. 1.3% for transient ischaemic attack; P = 0.840). Patients with higher CHA2DS2-VASc and HAS-BLED scores experienced more events, independent of symptoms. Antithrombotic therapy was comparable for both groups at baseline and at follow-up. Conclusions: The similar clinical characteristics and frequency of adverse events between asymptomatic and symptomatic AF patients revives the question of whether screening programmes to detect people with asymptomatic AF are worthwhile, particularly in those aged 65 and over potentially likely to have clinical and economic benefits from anticoagulants. This evidence may be informative if clinicians may not be comfortable participating in future clinical trials, leaving asymptomatic patients with AF and high stroke risk without anticoagulation.

8 Article The management of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation: in-hospital-data from the Atrial Fibrillation undergoing Coronary Artery Stenting study. 2013

Schlitt, Axel / Rubboli, Andrea / Lip, Gregory Y H / Lahtela, Heli / Valencia, Josè / Karjalainen, Pasi P / Weber, Michael / Laine, Mika / Kirchhof, Paulus / Niemelä, Matti / Vikman, Saila / Buerke, Michael / Airaksinen, K E Juhani / Anonymous1870761. ·Medical Faculty, Martin Luther-University Halle-Wittenberg, Halle, Germany; Department of Cardiology, Paracelsus Harz-Clinic, Bad Suderode, Germany. ·Catheter Cardiovasc Interv · Pubmed #23765437.

ABSTRACT: Current recommendations on the management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with stent (PCI-S) essentially derive from small, single-center, retrospective datasets. To obtain larger and better quality data, we carried out the prospective, multicenter Atrial Fibrillation undergoing Coronary Artery Stenting (AFCAS) study. Therefore, consecutive patients with history of or ongoing AF undergoing PCI-S were enrolled, and occurrence of adverse ischemic and bleeding events recorded during 12 months follow-up. In this article, we report the in-hospital observations. Out of the 963 patients, in the majority of cases (49.1%) AF was permanent. The associated risk of stroke, as defined by a CHADS2 -score ≥2, was in 70% of patients moderate to high. Upon enrollment in the registry, 69.3% of patients were on VKA therapy. Overall occurrence of in-hospital major adverse cardiac events was 4.5% (cardiovascular death 1.9%, urgent revascularization in 1.5%, and stroke/arterial thromboembolism in 0.6%). Bleeding complications occurred in 7.1% of patients, being severe in 2.5%. In a logistic regression analysis, no risk factor was independently associated with bleeding events, whereas Clopidogrel treatment decreased and female gender/treatment with gpIIb/IIIa-antagonists, respectively increased the risk for the combined ischemic endpoint. The majority of AF patients undergoing PCI-S are at high stroke risk, and therefore VKA treatment should not be withdrawn and combined anticoagulant and antiplatelet treatment is warranted. Current management appears largely in accordance with current recommendations, whereby accounting for the limited occurrence of in-hospital adverse ischemic and bleeding events.