Safety and efficacy of uninterrupted treatment with edoxaban or warfarin during the peri-procedural period of catheter ablation for atrial fibrillation.

BACKGROUND: The real-world safety and efficacy of uninterrupted anticoagulation treatment with edoxaban (EDX) or warfarin (WFR) during the peri-procedural period of catheter ablation (CA) for atrial fibrillation (AF) are yet to be investigated. METHODS: We conducted a two-center experience, observational study to retrospectively investigate consecutive patients who underwent CA for AF and received EDX or WFR. We examined the incidence of thromboembolic and bleeding complications during the peri-procedural period. RESULTS: The EDX and WFR groups included 153 and 103 patients, respectively (total: 256 patients). Demise or thromboembolic events did not occur in either of the groups. The incidence of major bleeding in the EDX and WFR groups was 0.7% and 2.9%, respectively. The total incidence of major/minor bleeding in the EDX and WFR groups was 7.8% and 8.7%, respectively. Of note, the incidence of bleeding complications in the uninterrupted WFR strategy group was markedly high in patients with an estimated glomerular filtration rate (eGFR) <30 (75%) or a HAS-BLED score ≥3 (60%). Patients with eGFR ≥30 and a HAS-BLED score ≤2 had a lower incidence of bleeding (<10%), regardless of the administered anticoagulation drug (EDX or WFR). CONCLUSIONS: This study confirmed the safety and efficacy of uninterrupted anticoagulation therapy using EDX or WFR in real-world patients undergoing CA for AF. Patients with severely impaired renal function and/or a higher bleeding risk during uninterrupted therapy with WFR were at a prominent risk of bleeding. Therefore, particular attention should be paid in the treatment of these patients.

Simultaneous determination of arylpropionic acidic non-steroidal anti-inflammatory drugs in pharmaceutical formulations and human plasma by HPLC with UV detection.

A simple and sensitive high-performance liquid chromatography-UV detection method was developed for the simultaneous determination of non-steroidal anti-inflammatory drugs (NSAIDs) having an arylpropionic acid moiety in pharmaceutical formulations and human plasma. Isocratic separation was employed on ODS column (250 x 4.6 mm i.d., 5 microm) at ambient temperature. The mobile phase consisted of acetonitrile, phosphate buffer (pH 3.5; 50 mM), methanol and tetrahydrofuran. The NSAIDs in the eluent were monitored under a wavelength-programme to provide their maximum absorbance. Mefenamic acid was used as an internal standard. Drugs were found to be 96.8-101.9% of their label claim in pharmaceutical formulations. One hundred microliters of human plasma samples were pretreated with a simple liquid-liquid extraction using ethyl acetate. The detection limits of compounds studied at a signal-to-noise ratio of 3 were 11.5-75 ng/ml in human plasma samples. The proposed method is simple, selective and could be applicable for routine analysis of arylpropionic acidic NSAIDs in pharmaceutical as well as in human plasma samples.