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Novel oral anticoagulant

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https://www.readbyqxmd.com/read/28298749/perioperative-considerations-and-management-of-patients-receiving-anticoagulants
#1
REVIEW
Safiya Imtiaz Shaikh, R Vasantha Kumari, Ganapati Hegade, M Marutheesh
Anticoagulants remain the primary strategy for the prevention and treatment of thrombosis. Unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, and warfarin have been studied and employed extensively with direct thrombin inhibitors typically reserved for patients with complications or those requiring interventions. Novel oral anticoagulants have emerged from clinical development and are expected to replace older agents with their ease to use and more favorable pharmacodynamic profiles...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28293114/novel-stroke-risk-reduction-in-atrial-fibrillation-left-atrial-appendage-occlusion-with-a-focus-on-the-watchman-closure-device
#2
REVIEW
Arash Alipour, Lisette I S Wintgens, Martin J Swaans, Jippe C Balt, Benno J W M Rensing, Lucas V A Boersma
Atrial fibrillation (AF) remains an important clinical problem with severe complications such as stroke, which especially harms those with risk factors as calculated by the CHADS2 or CHA2DS2-VASc. Until now, no therapy has proven 100% effective against AF. Since the left atrial appendage (LAA) is the most prominent nonvalvular AF-related thromboembolic source and (novel) oral anticoagulant [(N)OAC] carries the hazard of bleeding, LAA occlusion may be an alternative, especially in patients who are ineligible for (N)OAC therapy...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28290994/derivation-and-validation-of-the-predicting-bleeding-complications-in-patients-undergoing-stent-implantation-and-subsequent-dual-antiplatelet-therapy-precise-dapt-score-a-pooled-analysis-of-individual-patient-datasets-from-clinical-trials
#3
Francesco Costa, David van Klaveren, Stefan James, Dik Heg, Lorenz Räber, Fausto Feres, Thomas Pilgrim, Myeong-Ki Hong, Hyo-Soo Kim, Antonio Colombo, Philippe Gabriel Steg, Thomas Zanchin, Tullio Palmerini, Lars Wallentin, Deepak L Bhatt, Gregg W Stone, Stephan Windecker, Ewout W Steyerberg, Marco Valgimigli
BACKGROUND: Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor prevents ischaemic events after coronary stenting, but increases bleeding. Guidelines support weighting bleeding risk before the selection of treatment duration, but no standardised tool exists for this purpose. METHODS: A total of 14 963 patients treated with DAPT after coronary stenting-largely consisting of aspirin and clopidogrel and without indication to oral anticoagulation-were pooled at a single-patient level from eight multicentre randomised clinical trials with independent adjudication of events...
March 11, 2017: Lancet
https://www.readbyqxmd.com/read/28290810/-single-dosing-regimen-of-new-peroral-anticoagulants-in-the-aspect-of-adherence-to-treatment-the-assumptions-and-evidence
#4
M Yu Gilarov
The article discusses the adherence to the treatment with novel oral anticoagulants (NOACs), analyzed the currently available evidence and assumptions about the relationship between different dosing frequency and adherence to treatment with these drugs. The data of comparative studies in real life settings dedicated to the evaluation of persistence and treatment adherence to the NOACs with different dosing regimens.
December 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290558/-real-world-data-on-novel-oral-anticoagulants-the-added-value-of-registries-and-observational-studies-focus-on-apixaban
#5
Francesco Pelliccia, Gaetano Tanzilli, Michele Schiariti, Nicola Viceconte, Cesare Greco, Carlo Gaudio
Anticoagulant therapy has been used with great effect for decades for the prevention of stroke among patients with atrial fibrillation. In recent years, the therapeutic armamentarium has been strengthened considerably, with the addition of anticoagulants acting through novel pathways. The currently available novel agents are apixaban, rivaroxaban and dabigatran. These novel oral anticoagulants (NOACs) were approved for use on the basis of major clinical trials clearly demonstrating improved risk reductions compared to warfarin for stroke and/or major bleeding events...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28287377/use-of-dabigatran-and-rivaroxaban-in-non-valvular-atrial-fibrillation-one-year-follow-up-experience-in-an-italian-centre
#6
Mario Schiavoni, Maurizio Margaglione, Antonella Coluccia
BACKGROUND: Direct oral anticoagulants (DOAC) have been shown to be non-inferior to traditional vitamin K antagonists in preventing stroke and arterial thromboembolism in patients with non-valvular atrial fibrillation. Nevertheless, it is mandatory to record side effects and individual adherence to DOAC treatment. MATERIALS AND METHODS: In this single-centre experience, patients with non-valvular atrial fibrillation were prospectively observed after switching from a vitamin K antagonist to dabigatran or rivaroxaban...
January 31, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28286749/factors-xi-and-xii-as-targets-for-new-anticoagulants
#7
REVIEW
Jeffrey I Weitz, James C Fredenburgh
Compared with vitamin K antagonists, the direct oral anticoagulants (DOACs) are simpler to administer and are associated with less intracranial bleeding. Nonetheless, even with the DOACs, bleeding still occurs and many patients with atrial fibrillation fail to receive anticoagulant thromboprophylaxis because of the fear of bleeding. Therefore, there is an urgent need for safer anticoagulants. Recent investigations into the biochemistry of hemostasis and thrombosis have identified new targets for development of novel anticoagulants...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28286333/early-non-persistence-with-dabigatran-and-rivaroxaban-in-patients-with-atrial-fibrillation
#8
Cynthia A Jackevicius, Meytal Agvil Tsadok, Vidal Essebag, Clare Atzema, Mark J Eisenberg, Jack V Tu, Lingyun Lu, Elham Rahme, P Michael Ho, Mintu Turakhia, Karin H Humphries, Hassan Behlouli, Limei Zhou, Louise Pilote
OBJECTIVE: Dabigatran and rivaroxaban are novel oral anticoagulants (NOACs) approved for stroke prevention in atrial fibrillation (AF). Although NOACs are more convenient than warfarin, their lack of monitoring may predispose patients to non-persistence. Limited information is available on NOAC non-persistence rates and related clinical outcomes in clinical practice. METHODS: We conducted a retrospective cohort study using administrative data from Ontario, Canada, from January 1998 to March 2014 of patients with AF who were dispensed dabigatran or rivaroxaban...
March 12, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28282497/andexanet-alfa-for-the-reversal-of-anticoagulant-activity-in-patients-treated-with-direct-and-indirect-factor-xa-inhibitors
#9
Tarek Nafee, Aysha Aslam, Gerald Chi, Seyedmahdi Pahlavani, Dima Nimri, Aravind Reddy Kuchkuntla, Usama Talib, Nathan Michalak, Yazan Daaboul, Serge Korjian, Anthony Gallo, C Michael Gibson
Andexanet alfa is a recombinant factor Xa decoy molecule that inhibits direct and indirect factor Xa inhibitors to allow the normal coagulation process to resume. Its development arises in a space where novel oral anticoagulants are receiving expanded indications yet their use is limited by the lack of an effective reversal agent. Areas Covered: This article reviews the biochemical properties, mechanism of action and the preclinical and clinical trials on andexanet alfa. It additionally aims to provide expert commentary and future perspectives on the efficacy, safety and challenges facing andexanet alfa as a universal antidote for direct and indirect factor Xa inhibitors...
March 10, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28279251/oral-anticoagulants-for-primary-prevention-treatment-and-secondary-prevention-of-venous-thromboembolic-disease-and-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#10
Jonathan Ac Sterne, Pritesh N Bodalia, Peter A Bryden, Philippa A Davies, Jose A López-López, George N Okoli, Howard Hz Thom, Deborah M Caldwell, Sofia Dias, Diane Eaton, Julian Pt Higgins, Will Hollingworth, Chris Salisbury, Jelena Savović, Reecha Sofat, Annya Stephens-Boal, Nicky J Welton, Aroon D Hingorani
BACKGROUND: Warfarin is effective for stroke prevention in atrial fibrillation (AF), but anticoagulation is underused in clinical care. The risk of venous thromboembolic disease during hospitalisation can be reduced by low-molecular-weight heparin (LMWH): warfarin is the most frequently prescribed anticoagulant for treatment and secondary prevention of venous thromboembolism (VTE). Warfarin-related bleeding is a major reason for hospitalisation for adverse drug effects. Warfarin is cheap but therapeutic monitoring increases treatment costs...
March 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28278524/management-of-thrombotic-antiphospholipid-syndrome
#11
Cecilia Beatrice Chighizola, Maria Gabriella Raimondo, Pier Luigi Meroni
Persistent serum positivity for antiphospholipid antibodies (aPL) is required to diagnose antiphospholipid syndrome (APS), an autoimmune disease characterized by recurrent vascular thrombosis and/or pregnancy morbidity. The current therapeutic management of patients with thrombotic APS aims at preventing recurrences and long-term complications by attenuating the procoagulant state. There is overall consensus to reserve moderate-intensity anticoagulation to aPL-positive patients with a previous venous thrombosis; the therapeutic options for those with a history of arterial event comprise antiplatelet agents and high-intensity anticoagulation...
March 9, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28277769/reversal-of-direct-oral-anticoagulants
#12
X-Y Zhang, M J Desborough, S Shapiro
An understanding of how to counteract the anticoagulant effect of direct oral anticoagulants is essential in the event of haemorrhage, emergency surgery and overdose. This review summarizes strategies for the reversal of direct oral anticoagulants, including the use of novel agents.
March 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28276567/patient-values-and-preferences-for-antithrombotic-therapy-in-atrial-fibrillation-a-narrative-systematic-review
#13
Peter S Loewen, Angela Tianshu Ji, Anita Kapanen, Alison McClean
Guidelines recommend that patients' values and preferences should be considered when selecting stroke prevention therapy for atrial fibrillation (SPAF). However, doing so is difficult, and tools to assist clinicians are sparse. We performed a narrative systematic review to provide clinicians with insights into the values and preferences of AF patients for SPAF antithrombotic therapy. Narrative systematic review of published literature from database inception. RESEARCH QUESTIONS: 1) What are patients' AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included...
March 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28266823/cardiovascular-disease-update-atrial-fibrillation
#14
Johnathan D McDivitt, Craig Barstow
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The prevalence increases with age, especially in the seventh and eighth decades of life. AF also is associated with multiple risk factors and conditions that are managed commonly in family medicine settings, such as hypertension and diabetes. Rhythm control and rate control are primarily equivalent for mortality rate, but patients treated for rhythm control have more hospitalizations; however, rhythm control may be a viable option for select patients...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28260714/a-case-of-collagenous-colitis-associated-with-novel-oral-anticoagulants-use
#15
Juri Ikemoto, Kouichi Nakadoi, Seiji Onogawa, Motomitsu Fukuhara, Takayoshi Shishido, Keiji Hanada, Shuji Yonehara
An 84-year-old man was referred to our hospital because of watery diarrhea. Due to cerebral infarction, he had started treatment with a novel oral anticoagulants (NOAC) 1 month prior to admission. The patient underwent blood tests, enhanced computed tomography, and colonoscopy, which indicated infectious or medicinal colitis. The diarrhea persisted and he developed hypokalemia, so a second colonoscopy was performed, which showed edematous mucosa. Colonic mucosal biopsies showed a thick collagen band in the subepithelial region, and collagenous colitis was diagnosed...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28258654/novel-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-diabetes-good-or-excellent
#16
Aviv A Shaul, Alon Eisen
No abstract text is available yet for this article.
March 4, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28255372/upper-gastrointestinal-endoscopy-in-emergency-setting-for-patients-receiving-oral-anticoagulants-practice-updates
#17
REVIEW
R Oprita, B Oprita, B Diaconescu, M R Bratu, D Berceanu
Anticoagulants are frequently used medications in diverse cardiovascular diseases. Their uses highly increase the risk of bleeding from upper and lower gastrointestinal sources, whether there is a classic vitamin K antagonist or a novel oral anticoagulant. Their interruption can promote procoagulation status with different thromboembolic accidents. Discontinuation of oral anticoagulants before the elective procedures is standardized but there are no guidelines for managing bleeding lesions of upper gastrointestinal tract concomitant with anticoagulation...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28245798/left-atrial-appendage-morphology-and-risk-of-stroke-following-pulmonary-vein-isolation-for-drug-refractory-atrial-fibrillation-in-low-cha2ds2vasc-risk-patients
#18
Faith R Kelly, Robert A Hull, Takor B Arrey-Mbi, Michael U Williams, Joshua S Lee, Ahmad M Slim, Dustin M Thomas
BACKGROUND: Cardiac CT angiography (CCTA) has become an important adjunct in the structural assessment of the pulmonary veins (PV) prior to pulmonary vein isolation (PVI). Published data is conflicting regarding a relationship between left atrial appendage (LAA) and the risk of ischemic stroke (CVA) following PVI. We investigated the associations of volumetric and morphologic left atrial (LA) and LAA measurements for CVA following PVI. METHODS: We retrospectively reviewed 332 consecutive patients with drug refractory atrial fibrillation who obtained cardiac CT angiogram (CCTA) prior to PVI...
February 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28225876/anticoagulation-in-acute-ischemic-stroke-a-systematic-search
#19
Nayara L Froio, Richard Murdoch Montgomery, Elias David-Neto, Ivan Aprahamian
INTRODUCTION: Stroke is one of the most important diseases worldwide. Several clinical scenarios demand full dose of anticoagulants primary to stroke etiology or to the treatment of comorbidity. However, controversy exists over many issues regarding anticoagulation treatment in stroke such as time for initiation, efficacy according to stroke etiology, the ideal dose of anticoagulants, and whether novel anticoagulants should be used. METHOD: Computerized search for clinical trials and randomized controlled clinical trials was done to the present date at Medline, Scielo, Embase, PsychInfo, and Cochrane Library using MeSH terms and the keywords stroke, ischemic stroke, anticoagulation, anticoagulants, heparin, low-molecular-weight heparin, warfarin, dabigatran, rivaroxaban, apixaban...
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28223868/assessment-of-novel-oral-anticoagulant-use-within-a-community-teaching-hospital
#20
Sultan Alghadeer, Lori Hornsby
Background: Novel oral anticoagulants (NOACs) are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. SETTING: A community teaching hospital in the United States...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
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