Protein Information

Name angiotensin II
Synonyms AGT; ANG II; ANHU; Angiotensin I; Angiotensin II; Angiotensinogen; Angiotensinogen precursor; SERPINA 8…

Compound Information

Name warfarin
CAS

Reference List

PubMed Abstract RScore(About this table)
19179199 Shah B, Hernandez AF, Liang L, Al-Khatib SM, Yancy CW, Fonarow GC, Peterson ED: Hospital variation and characteristics of implantable cardioverter-defibrillator use in patients with heart failure: data from the GWTG-HF (Get With The Guidelines-Heart Failure) registry. J Am Coll Cardiol. 2009 Feb 3;53(5):416-22.

Hospital Centers for Medicare and Medicaid Services/Joint Commission on the Accreditation of Healthcare Organizations performance measures (discharge instructions, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker use, smoking cessation; p > or= 0.05) were similar across ICD, whereas higher ICD-rate hospitals had higher adherence to GWTG-HF performance measures (beta-blocker use, evidence-based beta-blocker use, aldosterone-antagonist, hydralazine/nitrate; p < 0.05) except warfarin in patients with atrial fibrillation (p = 0.18).
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18594479 Hammwohner M, Goette A: Will warfarin soon be passe? New approaches to stroke prevention in atrial fibrillation. J Cardiovasc Pharmacol. 2008 Jul;52(1):18-27.

Furthermore, the pathophysiology of prothrombotic endocardial remodeling in fibrillating atria suggests that angiotensin II increases prothrombotic expression of vascular adhesion molecules at the atrial endocardium.
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18257025 Savelieva I, Camm J: Update on atrial fibrillation: part I. Clin Cardiol. 2008 Feb;31(2):55-62.

The limitations of warfarin prompted the development of new antithrombotic drugs, which include anticoagulants, such as direct oral thrombin inhibitors (dabigatran) and factor Xa inhibitors (rivaroxaban, apixaban).
Angiotensin II has been recognized as a key element in atrial remodeling in association with AF opening the possibility of exploitation of "upstream" therapies to prevent or delay atrial remodeling.
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19522057 Stewart RA: Clinical trials in heart valve disease. . Curr Opin Cardiol. 2009 Jul;24(4):279-87.

Other medical therapies with the potential to reduce progression of valve disease or decrease myocardial dysfunction include vasodilators in aortic regurgitation, angiotensin II receptor antagonists or beta-blockers in mitral regurgitation and angiotensin-converting enzyme inhibitors in aortic stenosis.
Meta-analysis of randomized studies of antithrombotic strategies in patients with mechanical valves suggests overall risk is lower with the combination of warfarin with a lower target international normalized ratio and an antiplatelet drug.
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19138236 Vermeer NS, Bajorek BV: Utilization of evidence-based therapy for the secondary prevention of acute coronary syndromes in Australian practice. J Clin Pharm Ther. 2008 Dec;33(6):591-601.

Furthermore, 82% of eligible patients received a beta-blocker at discharge, 86% a statin and 79% received either an ACE-I or angiotensin-II receptor antagonist.
Only six patients (4%) received three or more antithrombotics at discharge; five of these received the triple combination of aspirin, clopidogrel and warfarin.
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