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https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#1
REVIEW
Christopher Goshgarian, Philip B Gorelick
PURPOSE OF REVIEW: The purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention. RECENT FINDINGS: Warfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades...
September 18, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#2
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28901221/direct-oral-anticoagulant-reversal-how-when-and-issues-faced
#3
Mikhail S Dzeshka, Daniele Pastori, Gregory Y H Lip
The number of atrial fibrillation (AF) patients requiring thrombo-prophylaxis with oral anticoagulation is greatly increasing. The introduction of non-vitamin K oral anticoagulants (NOACs) in addition to standard therapy with dose-adjusted warfarin has increased the therapeutic options for AF patients. Despite a generally better safety profile of the NOACs, the risk of major bleedings still persists, and the management of serious bleeding is a clinical challenge. Areas covered: In the current review, risk of major bleeding in patients taking NOACs and general approaches to manage bleeding depending on severity, with a particular focus on specific reversal agents, are discussed...
September 13, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28899946/secondary-prevention-treatment-after-acute-stroke-in-older-south-asian-chinese-and-other-canadians-a-retrospective-data-analysis
#4
Nadia A Khan, Finlay A McAlister, Louise Pilote, Anita Palepu, Hude Quan, Michael D Hill, Jiming Fang, Moira K Kapral
BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009)...
September 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28894528/notification-of-international-normalized-ratio-test-in-atrial-fibrillation-patients-treated-with-warfarin-via-short-message-service-study-protocol-for-a-randomized-controlled-trial
#5
Reza Sheibani, Mehdi Sheibani, Yamin Hejazi, Saeid Eslami
BACKGROUND: Atrial Fibrillation (AF) is the most common abnormal heart rhythm. AF patients usually use warfarin therapy. Safety and efficacy of warfarin are dependent on maintaining the International Normalized Ratio (INR) within the therapeutic range. OBJECTIVE: We will use a Short Message Service (SMS) to evaluate the effect of a reminder on carrying out the INR laboratory test in a timely manner. METHODS: This study (a Randomized Controlled Trial) will be done in Loghman hospital Tehran, Iran...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28892526/rivaroxaban-vs-warfarin-sodium-in-the-ultra-early-period-after-atrial-fibrillation-related-mild-ischemic-stroke-a-randomized-clinical-trial
#6
Keun-Sik Hong, Sun U Kwon, Sang Hun Lee, Ji Sung Lee, Yong-Jae Kim, Tae-Jin Song, Young Dae Kim, Man-Seok Park, Eung-Gyu Kim, Jae-Kwan Cha, Sang Min Sung, Byung-Woo Yoon, Oh Young Bang, Woo-Keun Seo, Yang-Ha Hwang, Seong Hwan Ahn, Dong-Wha Kang, Hyun Goo Kang, Kyung-Ho Yu
Importance: In atrial fibrillation (AF)-related acute ischemic stroke, the optimal oral anticoagulation strategy remains unclear. Objective: To test whether rivaroxaban or warfarin sodium is safer and more effective for preventing early recurrent stroke in patients with AF-related acute ischemic stroke. Design, Setting, and Participants: A randomized, multicenter, open-label, blinded end point evaluation, comparative phase 2 trial was conducted from April 28, 2014, to December 7, 2015, at 14 academic medical centers in South Korea among patients with mild AF-related stroke within the previous 5 days who were deemed suitable for early anticoagulation...
September 11, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28888264/availability-of-patient-decision-aids-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#7
REVIEW
Elizabeth S O'Neill, Stuart W Grande, Ariel Sherman, Glyn Elwyn, Megan Coylewright
BACKGROUND: Atrial fibrillation is a common irregular heart rhythm that increases patients' risk of stroke. Aspirin, warfarin, direct oral anticoagulants, and an implantable device can reduce this risk. Given the availability of multiple comparable options, this decision depends on patient preferences and is appropriate for the use of decision aids and other efforts to promote shared decision making. The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28887689/-reduced-noak-dose-in-atrial-fibrillation-efficacy-and-safety-compared-with-warfarin
#8
Kerstin Amadori
No abstract text is available yet for this article.
September 8, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28887344/medication-therapy-disease-management-geisinger-s-approach-to-population-health-management
#9
Laney K Jones, Gerard Greskovic, Dante M Grassi, Jove Graham, Haiyan Sun, Michael R Gionfriddo, Michael F Murray, Kandamurugu Manickam, Douglas C Nathanson, Eric A Wright, Michael A Evans
PURPOSE: Pharmacists' involvement in a population health initiative focused on chronic disease management is described. SUMMARY: Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS)...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28886856/outcome-of-patients-receiving-thrombolytic-therapy-while-on-rivaroxaban-for-nonvalvular-atrial-fibrillation-from-rivaroxaban-once-daily-oral-direct-factor-xa-inhibition-compared-with-vitamin-k-antagonism-for-prevention-of-stroke-and-embolism-trial-in-atrial
#10
Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Keith A A Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
The safety of intravenous thrombolysis in patients taking rivaroxaban has not been well established. We retrospectively analyzed the outcomes of all patients who received thrombolytic therapy in the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF). A review of medical and adverse event records for patients receiving thrombolytic therapy while enrolled in ROCKET AF was performed to determine their baseline characteristics, indications for thrombolysis, and type of agent used...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28879343/delayed-bleeding-after-implant-surgery-in-patients-taking-novel-oral-anticoagulants-a-case-report
#11
Chihun Kim, Chugeum Dam, Jieun Jeong, Eun-Jung Kwak, Wonse Park
The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28874129/comparative-effectiveness-of-rivaroxaban-versus-warfarin-or-dabigatran-for-the-treatment-of-patients-with-non-valvular-atrial-fibrillation
#12
Faye L Norby, Lindsay G S Bengtson, Pamela L Lutsey, Lin Y Chen, Richard F MacLehose, Alanna M Chamberlain, Ian Rapson, Alvaro Alonso
BACKGROUND: Rivaroxaban is an oral anticoagulant approved in the US for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). We determined the effectiveness and associated risks of rivaroxaban versus other oral anticoagulants in a large real-world population. METHODS: We selected NVAF patients initiating oral anticoagulant use in 2010-2014 enrolled in MarketScan databases. Rivaroxaban users were matched with warfarin and dabigatran users by age, sex, enrolment date, anticoagulant initiation date, and high-dimensional propensity score...
September 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28869793/the-relationship-between-knowledge-health-literacy-and-adherence-among-patients-taking-oral-anticoagulants-for-stroke-thromboprophylaxis-in-atrial-fibrillation
#13
Chanelle A Rolls, Kehinde O Obamiro, Leanne Chalmers, Luke R E Bereznicki
BACKGROUND: Patients' knowledge regarding their oral anticoagulant (OAC) treatment for stroke prevention in atrial fibrillation (AF), their level of medication adherence and health literacy are known to affect treatment outcomes. However, contemporary data regarding the relationships between these variables are lacking. OBJECTIVE: To investigate the relationships between anticoagulant knowledge, health literacy and self-reported adherence in patients taking warfarin and the directly acting oral anticoagulants...
September 4, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28867127/utilization-of-standard-and-target-specific-oral-anticoagulants-among-adults-in-the-united-kingdom-with-incident-atrial-fibrillation
#14
Todd A Durham, Kristen Hassmiller Lich, Anthony J Viera, Jason P Fine, Jayanti Mukherjee, Morris Weinberger, Stacie B Dusetzina
New oral anticoagulants (OACs) and updated risk stratification have the potential to improve the quality of care for patients with atrial fibrillation (AF). To describe the time from AF diagnosis to the initiation of an OAC, characteristics associated with treatment, and the incidence of switching OACs, we conducted this retrospective cohort study of 23,018 adults with incident AF receiving care between 2010 and 2014 in 647 primary care practices participating in the United Kingdom Clinical Practice Research Datalink...
August 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28864318/comparison-of-the-effectiveness-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-newly-diagnosed-atrial-fibrillation
#15
Inmaculada Hernandez, Yuting Zhang, Samir Saba
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862960/selection-of-stent-type-in-patients-with-atrial-fibrillation-presenting-with-acute-myocardial-infarction-an-analysis-from-the-action-acute-coronary-treatment-and-intervention-outcomes-network-registry-get-with-the-guidelines
#16
Amit N Vora, Tracy Y Wang, Shuang Li, Karen Chiswell, Connie Hess, Renato D Lopes, Sunil V Rao, Eric D Peterson
BACKGROUND: Patients receiving oral anticoagulation in addition to dual-antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug-eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI). METHODS AND RESULTS: From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry-Get With the Guidelines, we identified 14 427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28862952/sex-specific-associations-of-oral-anticoagulant-use-and-cardiovascular-outcomes-in-patients-with-atrial-fibrillation
#17
Ghanshyam Palamaner Subash Shantha, Amgad Mentias, Chakradhari Inampudi, Anita A Kumar, Kongkiat Chaikriangkrai, Viraj Bhise, Abhishek Deshmukh, Nileshkumar Patel, Samir Pancholy, Phillip A Horwitz, Steven Mickelsen, Prashant D Bhave, Michael Giudici, Hakan Oral, Mary S Vaughan Sarrazin
BACKGROUND: Sex-specific effectiveness of rivaroxaban (RIVA), dabigatran (DABI), and warfarin in reducing myocardial infarction (MI), heart failure (HF), and all-cause mortality among patients with atrial fibrillation are not known. We assessed sex-specific associations of RIVA, DABI, or warfarin use with the risk of MI, HF, and all-cause mortality among patients with atrial fibrillation. METHODS AND RESULTS: Medicare beneficiaries (men: 65 734 [44.8%], women: 81 135 [55...
August 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28862934/impact-of-spontaneous-extracranial-bleeding-events-on-health-state-utility-in-patients-with-atrial-fibrillation-results-from-the-engage-af-timi-48-trial
#18
Kaijun Wang, Haiyan Li, Winghan J Kwong, Elliott M Antman, Christian T Ruff, Robert P Giugliano, David J Cohen, Elizabeth A Magnuson
BACKGROUND: The impact of different types of extracranial bleeding events on health-related quality of life and health-state utility among patients with atrial fibrillation is not well understood. METHODS AND RESULTS: The ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) Trial compared edoxaban with warfarin with respect to the prevention of stroke or systemic embolism in atrial fibrillation...
August 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28862063/the-safety-of-edoxaban-for-treating-atrial-fibrillation
#19
Matthias Hammwoehner, Andreas Goette
Atrial Fibrillation (AF) has a worldwide increasing incidence and prevalence, putting patients at risk for atrial thrombus formation and consecutive thromboembolic events. Morbidity and mortality have become a significant global public health care burden. Thus, there is increasing need for safe and effective medical prophylaxis of thromboembolic events. Edoxaban is the fourth approved non-vitamin K oral anticoagulant (NOAC) that has been introduced into the market for the prophylaxis of stroke or systemic embolism in non valvulär AF patients after dabigatran, rivaroxaban, and apixaban...
September 1, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28861455/baseline-characteristics-and-event-rates-among-anticoagulated-patients-with-atrial-fibrillation-in-practice-and-pivotal-noac-trials
#20
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
The data report details the baseline characteristics and observed outcomes among patients included in a large US administrative claims database (Optum Labs Data Warehouse) and those enrolled in the pivotal phase III clinical trials examining apixaban, dabigratan, edoxaban and rivaroxaban versus warfarin for the prevention of cardio embolism (Granger et al., 2011; Cannolly et al., 2009; Patel et al., 2011; Giugliano et al., 2013) [1], [2], [3], [4]. These data are to be interpreted in the context of the linked publication (Noseworthy et al...
October 2017: Data in Brief
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