AF is frequent in HCM and stroke affects younger patients. Warfarin, is recommended in HCM patients and AF. NOACs can be an alternative to warfarin. HCM patients were not adequately represented in NOACS trials. The aim of the study is to provide understanding of the anti-coagulation therapy and thromboembolic and bleeding events and quality of life of these patients.It is a multi-center prospective randomised observational study. We will enroll HCM patients and non-valvular AF and will divide them into subgroups: treated with warfarin and with NOACs : dabigatran , rivaroxaban, apixaban and edoxaban. Patients will be followed up at 1,6,12, 24 months post AF diagnosis. The primary endpoints: major bleeding and major tromboembolic event between the warfarin and NOACs groups and between NOACs subgroups. Secondary endpoints: stroke; cardiovascular death; total mortality; major and minor bleeding; major gastro intestinal bleeding; intracranial hemorrhages between the warfarin and NOACs groups and between NOACs subgroups. Quality of life: number of emergency room access or hospital admissions for suspect tromboembolic or adverse event. HCM does not increase risk of bleeding and the risks of major adverse effects of NOACs are equivalent or lower than warfarin in the normal population; HCM treated with NOACS could have similar or lower embolic and bleeding rates t. NAOCs may be more convenient.

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