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https://www.readbyqxmd.com/read/28100898/new-oral-anticoagulants-turkey-noac-turk-multicenter-cross-sectional-study
#1
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
January 17, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28091833/the-gap-between-indicated-and-prescribed-stroke-prevention-therapies-in-a-high-risk-geriatric-population
#2
Mohammed Shurrab, Eugene Crystal, Denis O'Donnell, Hrishikesh Navare, Paula Neves, Rasha Khatib, Ilan Lashevsky, David Newman
PURPOSE: The use of oral anticoagulation (OAC) in the elderly population with atrial fibrillation (AF) treated in long-term care (LTC) facilities is inconsistent. We examined the magnitude and sources of the gap between indicated and prescribed OAC in the elderly population with AF. METHODS: We retrospectively scanned the electronic medical record (EMR) and pharmacy data of 25 LTC facilities in Ontario, Canada. The diagnosis of AF was drawn from EMR. Different attributable risk factors for possible failure to prescribe OAC were examined...
January 16, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28079536/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-severe-inherited-thrombophilia-a-series-of-33-patients
#3
Anetta Undas, Tadeusz Goralczyk
The aim of the study was to investigate whether treatment with non-vitamin K antagonist oral anticoagulants (NOACs) is effective and well tolerated in real-life patients following venous thromboembolism (VTE) associated with severe inherited thrombophilia. We evaluated 33 consecutive patients with severe inherited thrombophilia, defined as the presence of deficiencies in protein C, protein S, or anti-thrombin, homozygous factor V Leiden and prothrombin G20210A mutations, or combined defects. The patients were recruited from March 2010 to December 2015 and followed till July 2016...
January 12, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28074293/-management-of-noak-administration-during-invasive-or-surgical-interventions-when-and-how-to-pause-and-when-to-restart
#4
M Buerke, H M Hoffmeister
Many patients under oral anticoagulation therapy need percutaneous or surgical interventions/operations. For vitamin K antagonists (VKA), there are recommendations regarding preoperative or postoperative administration. Management of the new oral anticoagulants (NOAC) was supposed to be easier - but some aspects must be considered. Due to the different pharmacokinetic profiles of substances such as dabigatran, rivaroxaban, apixaban, and edoxaban, different recommendations are given.Upon periprocedural management, thromboembolic risk has to be considered in patients treated with NOACs...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28070883/pilot-of-a-computerised-antithrombotic-risk-assessment-tool-version-2-caratv2-0-for-stroke-prevention-in-atrial-fibrillation
#5
Yishen Wang, Beata Bajorek
BACKGROUND: The decision-making process for stroke prevention in atrial fibrillation (AF) requires a comprehensive assessment of risk vs. benefit and an appropriate selection of antithrombotic agents (e.g., warfarin, non-vitamin K antagonist oral anticoagulants [NOACs]). The aim of this pilot-test was to examine the impact of a customised decision support tool - the Computerised Antithrombotic Risk Assessment Tool (CARATV2.0) using antithrombotic therapy on a cohort of patients with AF...
January 10, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28062209/thromboelastogram-does-not-detect-pre-injury-anticoagulation-in-acute-trauma-patients
#6
Jawad T Ali, Mitchell J Daley, Nina Vadiei, Zachary Enright, Joseph Nguyen, Sadia Ali, Jayson D Aydelotte, Pedro G Teixeira, Thomas B Coopwood, Carlos Vr Brown
PURPOSE: Thromboelastography (TEG) has been recommended to characterize post-traumatic coagulopathy, yet no study has evaluated the impact of pre-injury anticoagulation (AC) on TEG variables. We hypothesized patients on pre-injury AC have a greater incidence of coagulopathy on TEG compared to those without AC. METHODS: This retrospective chart review evaluated all trauma patients admitted to an urban, level one trauma center from February 2011 to September 2014 who received a TEG within the first 24h...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28058458/-vitamin-k-antagonists-is-their-prescription-really-medical-malpractice-%C3%A2-today
#7
E Rafflenbeul, J Müller-Ehmsen
Atrial fibrillation and venous thromboembolisms are frequent cardiovascular diseases. Until a few years ago only vitamin K antagonists (VKA) were available for oral anticoagulation as primary and secondary prevention of thrombembolic events. Currently, the non-vitamin K dependent new oral anticoagulants (NOAC) dabigatran, rivaroxaban, apixaban and edoxaban are approved for use. The approval studies, meta-analyses and data from registries provide evidence for the superiority of NOAC vs. VKA with respect to reduction of thrombembolisms and reduced bleeding complications; therefore, in the 2016 European Society of Cardiology (ESC) guidelines the use of NOAC is recommended as first line therapy for anticoagulation in atrial fibrillation (recommendation grade I/evidence level A)...
January 2017: Der Internist
https://www.readbyqxmd.com/read/28057799/prospective-study-of-oral-anticoagulants-and-risk-of-liver-injury-in-patients-with-atrial-fibrillation
#8
Alvaro Alonso, Richard F MacLehose, Lin Y Chen, Lindsay Gs Bengtson, Alanna M Chamberlain, Faye L Norby, Pamela L Lutsey
OBJECTIVE: To assess the risk of liver injury hospitalisation in patients with atrial fibrillation (AF) after initiation of direct oral anticoagulants (DOACs) or warfarin and to determine predictors of liver injury hospitalisation in this population. METHODS: We studied 113 717 patients (mean age 70, 39% women) with AF included in the MarketScan Commercial and Medicare Supplemental databases with a first prescription for oral anticoagulation after 4 November 2011, followed through 31 December 2014...
January 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28056758/thrombotic-management-of-antiphospholipid-syndrome-towards-novel-targeted-therapies
#9
Md Asiful Islam, Fahmida Alam, Kah Keng Wong, Mohammad Amjad Kamal, Siew Hua Gan
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity with persistent levels of antiphospholipid antibodies (aPLs). The development of thrombosis in APS is mediated by aPLs and contributes to the high mortality rate in APS patients. However, although APS has been reported for more than 30 years, there has been no optimal regimen for its prevention or for the management of thrombosis, mainly because the mainstay treatment strategies for managing APS are not targeted towards aPL-mediated thrombotic pathophysiology...
5, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28050755/effect-of-major-gastrointestinal-tract-surgery-on-the-absorption-and-efficacy-of-direct-acting-oral-anticoagulants-doacs
#10
REVIEW
Hakeam A Hakeam, Nasser Al-Sanea
Direct-acting oral anticoagulants (DOACs) have been introduced as alternatives to warfarin for stroke prevention in non-valvular atrial fibrillation and for treatment of venous thromboembolism. Many patients undergoing major gastrointestinal resections or bypass receive anticoagulants for various indications, including the treatment of thrombotic complication of surgery and prevention of visceral vessels events recurrence. DOACs have a wide therapeutic range that allows fixed dosing determined based on studies conducted in healthy subjects with normal absorptive capacity...
January 3, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28043992/direct-oral-anticoagulants-and-heparins-laboratory-values-and-pitfalls-in-bridging-therapy
#11
Thomas Eller, Tobias Flieder, Vanessa Fox, Tatjana Gripp, Marcus Dittrich, Joachim Kuhn, Susanne Alban, Cornelius Knabbe, Ingvild Birschmann
OBJECTIVES: The three direct oral anticoagulants (DOACs) dabigatran, apixaban and rivaroxaban are now widely used in clinical practice. For patients requiring perioperative interruption of DOACs, heparin bridging is still under discussion. Here we show, for the first time, the influence of concomitantly used DOACs and heparins on laboratory assays. METHODS: For spiking experiments, 10 healthy donors and nine patients treated with DOACs were investigated. The measurement of DOACs and heparins was performed with routine methods on the ACL TOP [HEMOCLOT(®) direct thrombin inhibitor (CoaChrom Diagnostica, Austria), COAMATIC(®) Heparin (Chromogenix, USA) calibrated with rivaroxaban, apixaban, unfractionated heparin (UFH) and low molecular weight heparin (LMWH), additionally PT reagent RecombiPlasTin 2G and aPTT reagent SynthASil (Instrumentation Laboratory, Germany)] and the DOACs were additionally quantified with liquid chromatography-mass spectrometry...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043907/gastrointestinal-safety-of-direct-oral-anticoagulants-a-large-population-based-study
#12
Neena S Abraham, Peter A Noseworthy, Xiaoxi Yao, Lindsey R Sangaralingham, Nilay D Shah
BACKGROUND & AIMS: Direct oral anticoagulant (DOAC) agents increase the risk of gastrointestinal (GI) bleeding. We investigated which DOAC had the most favorable GI safety profile and compared differences among these drugs in age-related risk of GI bleeding. METHODS: We conducted a retrospective, propensity-matched study using administrative claims data from the OptumLabs Data Warehouse of privately insured individuals and Medicare Advantage enrollees. We created 3 propensity-matched cohorts of patients with non-valve atrial fibrillation with incident exposure to dabigatran, rivaroxaban, or apixaban, from October 1, 2010 through February 28, 2015...
December 30, 2016: Gastroenterology
https://www.readbyqxmd.com/read/28042443/differences-between-warfarin-and-new-oral-anticoagulants-in-dental-clinical-practice
#13
REVIEW
M Miranda, L S Martinez, R Franco, V Forte, A Barlattani, P Bollero
The oral anticoagulant therapy is used for the cure and the prevention of thromboembolic diseases. In the last fifty years the warfarin has been considered the oral anticoagulant of choice. However, its use is limited by a narrow therapeutic index and by a complex pharmacodynamics, which requires regular adjustments and monitoring of the dose. Recently, three new oral anticoagulant - dabigatran etexilato (direct thrombin inhibitor), rivaroxaban and apixaban (Xa factor direct inhibitor) - have been approved for use in europe...
July 2016: Oral & Implantology
https://www.readbyqxmd.com/read/28029411/atrial-fibrillation-and-heart-failure-factors-influencing-the-choice-of-oral-anticoagulant
#14
REVIEW
Louise A E Brown, Christopher J Boos
Atrial fibrillation (AF) and heart failure (HF) frequently coexist. AF is identified in approximately one third of patients with HF and is linked to increased morbidity and mortality than from either condition alone. AF is relatively more common in HF with preserved ejection fraction (HFpEF) than with reduced ejection fraction (HFrEF). Nevertheless, the risk of stroke and systemic embolism (SSE) is significantly increased with both HF types and the absolute risk is heavily influenced by the presence and severity of associated additional stroke risk factors...
September 30, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28028988/direct-oral-anticoagulants-in-patients-with-thrombophilia-challenges-in-diagnostic-evaluation-and-treatment
#15
REVIEW
Anetta Undas, Tadeusz Góralczyk
Direct oral anticoagulants (DOACs) or non-vitamin K oral anticoagulants (NOACs) are increasingly used in the prevention of recurrent venous thromboembolism (VTE), including that associated with thrombophilia. The efficacy of DOACs in thrombophilic patients, especially those with severe trombophilia or triple positive antiphospholipid syndrome (APS) with arterial thromboembolic events, remains controversial. Most case reports and case series indicate that DOACs are an attractive therapeutic option in the vast majority of these patients at high risk of recurrent VTE with more concerns raised in high-risk APS patients and these deficient in protein S (PS)...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28017344/extended-non-vitamin-k-antagonist-oral-anticoagulation-therapy-for-prevention-of-recurrent-venous-thromboembolism
#16
REVIEW
Franco Piovella, Diana I Iosub
Evidence from the use of traditional therapy (low-molecular-weight heparin/vitamin K antagonists) for venous thromboembolism (VTE) treatment and prevention suggests that extending treatment beyond the acute phase reduces recurrence. More recently, several non-vitamin K antagonist oral anticoagulants (NOACs) have been approved in the acute setting; accumulating evidence suggests continuing treatment with these agents beyond 12months offers additional benefits to patients with VTE. This review examines the evidence for NOAC use in longer-duration anticoagulation treatment, and discusses guidelines from major societies...
December 7, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28009346/risk-of-intraocular-hemorrhage-with-new-oral-anticoagulants
#17
G Talany, M Guo, M Etminan
PurposeTo assess the risk of intraocular hemorrhage with warfarin and new oral anticoagulants (NOACs).MethodsWe ascertained all reported cases of intraocular hemorrhage (vitreous, choroidal, or retinal) with warfarin and NOACs (including dabigatran, rivaroxaban, apixaban) from the World Health Organizations's Vigibase database from 1968-2015. We used a disproportionality analysis to compute reported odds ratios (RORs) and corresponding 95% confidence by comparing the number of events with the study outcomes and study drugs compared with all other drugs reported to Vigibase...
December 23, 2016: Eye
https://www.readbyqxmd.com/read/28008269/perioperative-management-of-direct-oral-anticoagulants-doacs-a-systemic-review
#18
REVIEW
Tagore Sunkara, Emmanuel Ofori, Vadim Zarubin, Megan E Caughey, Vinaya Gaduputi, Madhavi Reddy
Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. In this review, we performed an extensive literature search summarizing the management of patients on direct-acting anticoagulants in the perioperative period...
2016: Health Services Insights
https://www.readbyqxmd.com/read/28007305/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-chronic-kidney-disease-a-systematic-review-and-network-meta-analysis
#19
Giuseppe Andò, Piera Capranzano
BACKGROUND: Currently there is lack of head-to-head comparisons between different Non-Vitamin K Antagonist Oral Anticoagulants (NOACs), especially in more risky subgroups, as those with chronic kidney disease (CKD). METHODS: We assessed the relative efficacy and safety of the four NOACs on the market in a systematic review and network meta-analysis of patients with atrial fibrillation (AF) and moderate CKD enrolled in the phase 3 randomized trials. A Bayesian framework was used to perform the network meta-analysis...
December 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28004413/direct-oral-anticoagulant-use-in-nonvalvular-atrial-fibrillation-with-valvular-heart-disease-a-systematic-review
#20
REVIEW
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
December 22, 2016: Clinical Cardiology
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