Simple Logistic Regression - ANSWER-2+ categorical or continuous independent
variables
One categorical dependent variable
,Non-valvular AF - ANSWER-AF in the absence of moderate or severe mitral stenosis,
mitral valve repair, or mechanical heart valves
CHADS2 vs CHADS2VASc - ANSWER-CHADS2 = CHF, HTN, Age 75+, DM, stroke (2)
CHADS2VASc = CHF, HTN, Age 75+ (2), DM, stroke (2), vascular disease, Age 65-74,
female
OAC indicated for score 2+ in men and 3+ in women
When to cardiovert AF - ANSWER-AF >48h, anticoagulate for at least 3 weeks before
cardioversion and at least 4 weeks after cardioversion regardless of CHADS2VASc
score
May utilize a TEE to visualize the atria to skip the anticoagulation prior to
cardioversion
Warfarin - ANSWER-MOA: Inhibits vitamin K epoxide reductase, preventing
production of clotting factors 2 (72h), 7 (6h), 9 (24h), 10 (36h) and inhibits
activation of protein C and S
, S-warfarin is 5x more potent than R-warfarin
Antibiotics reduce vitamin K synthesis by the intestinal flora
Warfarin clearance affected by amiodarone, propafenone, cimetidine
Enzyme inducers - ANSWER-phenytoin
phenobarbital
carbamazepine
rifampin
St. John's Wort
Dabigatran for AF - ANSWER-150mg twice daily
75mg twice daily for CrCl 15-30 or CrCl 30-50 with ketoconazole or dronedarone
Avoid with CrCl <15, dialysis, rifampin, CrCl 15-30 with amiodarone, verapamil,
ketoconazole, dronedarone, diltiazem, clarithromycin
Bleeding, dyspepsia, cannot use pillbox
To warfarin: Overlap by 3 days (CrCl >50), 2 days (CrCl 31-50), or 1 day (CrCl 15-30)
From warfarin: INR <2
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