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https://www.readbyqxmd.com/read/28820359/clinical-outcomes-of-direct-oral-anticoagulants-after-lower-extremity-arterial-procedures
#1
Afsha Aurshina, Pavel Kibrik, Justin Eisenberg, Ahmad Alsheekh, Anil Hingorani, Natalie Marks, Enrico Ascher
Objectives The use of postoperative anticoagulation is not uncommon for patients undergoing lower extremity arterial procedures as adjunctive therapy. Longer postoperative length of stay is necessary to achieve adequate therapeutic international normalized ratio with traditional protocols that call for the use of unfractionated heparin and warfarin therapy. We hypothesized the direct oral anticoagulants are an attractive alternative to provide adequate anticoagulation in patients who undergo lower extremity arterial procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28814943/comparison-of-different-laboratory-tests-in-the-evaluation-of-hemorrhagic-risk-of-patients-using-rivaroxaban-in-the-critical-care-setting-diagnostic-accuracy-study
#2
Marjorie Paris Colombini, Priscilla Bento Matos Cruz Derogis, Valdir Fernandes de Aranda, João Carlos de Campos Guerra, Nelson Hamerschlak, Cristóvão Luis Pitangueiras Mangueira
BACKGROUND: Rivaroxaban is a direct oral anticoagulant designed to dispense with the necessity of laboratory monitoring. However, monitoring rivaroxaban levels is necessary in certain clinical conditions, especially in the critical care setting. METHODS: This is a diagnostic accuracy study evaluating sensitivity and specificity of prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilute Russell viper venom time (dRVVT), to evaluate the hemorrhagic risk in patients taking rivaroxaban...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28813774/pulmonary-embolism-caused-by-popliteal-vein-aneurysm-a-case-report
#3
Kevin Marquez, Kalyan Chakravarthy Potu, Chad Laurich, Randall Lamfers
In this case report, we describe an unusual episode of bilateral submassive pulmonary embolism (PE) caused by a popliteal vein aneurysm (PVA). The development of PE stems from many risk factors including obesity (BMI³ 30 kg/m2), hypertension, cigarette smoking (greater than 25 cigarettes per day), increasing age, surgery, immobility, malignancy, and inherited thrombophilia. A PVA is a rare but significant cause of PE. A 28-year-old male presented to the emergency department with progressive shortness of breath...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28808888/has-time-come-for-the-use-of-direct-oral-anticoagulants-in-the-extended-prophylaxis-of-venous-thromboembolism-in-acutely-ill-medical-patients-yes
#4
Walter Ageno
Betrixaban is a direct factor Xa inhibitor with a renal excretion of only approximately 5-7%. On June 23rd 2017, it became the first direct oral anticoagulant to receive Food and Drug Administration approval for the prevention of venous thromboembolism in acutely ill medical patients, and the first anticoagulant agent to be approved for extended-duration thromboprophylaxis after hospital discharge in this setting. Approval followed the results of the APEX trial, a phase III clinical trial comparing betrixaban (80 mg) administered for 35-42 days with enoxaparin (40 mg) administered for 10 ± 4 days...
August 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28808596/the-severity-of-intracranial-hemorrhages-measured-by-free-hemoglobin-in-the-brain-depends-on-the-anticoagulant-class-experimental-data
#5
Kyle M Ware, Douglas L Feinstein, Israel Rubinstein, Prudhvi Battula, Jose Otero, Lee Hebert, Tzu-Fei Wang, Alexandra Ivanova, Shweta Chaudhary, Jessica Hemminger, Sergey V Brodsky
Background and Purpose. Anticoagulant therapy is broadly used to prevent thromboembolic events. Intracranial hemorrhages are serious complications of anticoagulation, especially with warfarin. Direct oral anticoagulants reduce but do not eliminate the risk of intracranial hemorrhages. The aim of this study is to determine the degree of intracranial hemorrhage after application of anticoagulants without additional triggers. Methods. Rats were treated with different anticoagulant classes (vitamin K antagonists, heparin, direct thrombin inhibitor, and factor Xa inhibitor)...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28806802/in-nonvalvular-af-doac-related-risk-for-gi-bleeding-was-lower-with-apixaban-than-dabigatran-or-rivaroxaban
#6
Ronald L Koretz
No abstract text is available yet for this article.
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#7
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28805299/dissociation-between-the-pharmacokinetics-and-pharmacodynamics-of-once-daily-rivaroxaban-and-twice-daily-apixaban-a-randomized-crossover-study
#8
Reinhold Kreutz, Pontus B Persson, Dagmar Kubitza, Kirstin Thelen, Stefan Heitmeier, Stephan Schwers, Michael Becka, Melanie Hemmrich
BACKGROUND: The anticoagulant actions of the oral direct factor Xa inhibitors, rivaroxaban and apixaban, have not previously been directly compared. OBJECTIVES: To compare directly the steady-state pharmacokinetics and anticoagulant effects of rivaroxaban and apixaban at doses approved for stroke prevention in nonvalvular atrial fibrillation. METHODS: Twenty-four healthy Caucasian male volunteers were included in this open-label, two-period crossover, phase 1 study (EudraCT number: 2015-002612-32)...
August 14, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28804832/measuring-direct-oral-anticoagulants
#9
Robert C Gosselin, Jonathan Douxfils
Direct oral anticoagulants (DOACs) can be quantified using methods that can be performed in any clinical or research laboratory using manual or automated instrument platforms. Dabigatran etexilate, the oral direct thrombin inhibitor, can be quantified by drug-calibrated clot or chromogenic-based assays using either thrombin or ecarin as substrates. Oral direct anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban, can be quantified with drug-calibrated anti-Xa kits or reagents as typically used for measuring heparins (unfractionated, low molecular weight, or pentasaccharides)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803521/evaluation-of-direct-acting-oral-anticoagulant-use-in-patients-with-cancer
#10
Daphne O Davis, Kyle A Davis
PURPOSE: To evaluate the use of direct-acting oral anticoagulants in patients with cancer and venous thromboembolism (VTE) treated at Ochsner Medical Center with the intent of determining the efficacy and safety of these agents. METHODS: Patients were identified by a retrospective data extraction of patients treated at Ochsner Medical Center from January 1, 2013, through December 31, 2015. Patients were included for review if they were ≥18 years of age, with a confirmed diagnosis of VTE and active or history of cancer, and if they received dabigatran, apixaban, rivaroxaban, or edoxaban for at least 6 months...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28803520/probable-rivaroxaban-induced-full-body-rash-a-case-report
#11
Evan Sasson, Marian James, Mark Russell, Darko Todorov, Henry Cohen
INTRODUCTION: Rivaroxaban is a novel oral anticoagulant with several indications, one of which is for stroke prevention in nonvalvular atrial fibrillation. We present a case of probable rivaroxaban-induced rash. CASE SUMMARY: A 79-year-old female with a medical history of atrial fibrillation experienced a stroke, after which she was prescribed rivaroxaban 20 mg. After several days, she developed a rash requiring admission to the emergency department and several days of treatment...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28802808/novel-oral-anticoagulants-in-direct-current-cardioversion-for-atrial-fibrillation
#12
Giuseppe Femia, Taufik Fetahovic, Pratap Shetty, Astin Lee
BACKGROUND: For some patients with atrial fibrillation, direct current cardioversion (DCCV) is one strategy that can be used to establish sinus rhythm but appropriate anticoagulation is mandatory to prevent thromboembolic events. Historically, patients were anticoagulated with warfarin with bridging with unfractionated or low molecular weight heparin, however, recently novel oral anticoagulants (NOACs), apixaban, dabigatran and rivaroxaban have become more popular. Despite the increase in use, real world data on safety and efficacy is limited...
July 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#13
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28794370/the-successful-prevention-of-thromboembolism-using-rivaroxaban-in-a-patient-with-antithrombin-deficiency-during-the-perioperative-period
#14
Hidetsugu Kawai, Hiromichi Matsushita, Hiroshi Kawada, Yoshiaki Ogawa, Kiyoshi Ando
Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28793291/effectiveness-and-tolerability-of-anticoagulants-for-thromboprophylaxis-after-major-joint-surgery-a-network-meta-analysis
#15
Zhen Wang, Jia Zheng, Yongqiang Zhao, Yungai Xiang, Xiao Chen, Yi Jin
BACKGROUND/AIMS: Venous thromboembolism (VTE) is the most common complication after major joint surgery. VTE can easily develop into pulmonary embolism (PE), leading to cardiopulmonary dysfunction or sudden death. We aimed to comprehensively analyse the thromboprophylactic drugs that are used to prevent thrombosis and reduce bleeding risk. METHODS: We searched the PubMed, EMBASE, and Cochrane databases for randomized controlled trials that evaluated the use of thromboprophylaxis after major joint surgery...
August 9, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28790786/direct-acting-oral-anticoagulant-bench-to-bedside
#16
REVIEW
D S Chadha, P Bharadwaj
Vitamin K antagonists are an effective group of oral anticoagulants. However because of genetic variability in their metabolism and multiple food and drug interactions, these drugs have narrow therapeutic window with unpredictable anticoagulant effects requiring constant monitoring. Several newer direct acting oral anticoagulants have been approved for prevention of stroke in patients with nonvalvular atrial fibrillation and treatment or prevention of venous thromboembolism. The direct acting oral anticoagulants include the direct thrombin inhibitor (dabigatran) and the factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban)...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28781876/comparison-of-hospital-length-of-stay-in-patients-treated-with-non-vitamin-k-oral-anticoagulants-or-parenteral-agents-plus-warfarin-for-venous-thromboembolism
#17
Catherine A Saint, Michelle R Castelli, Andrew J Crannage, Zachary A Stacy, Erin K Hennessey
OBJECTIVES: Existing research comparing hospital length of stay for patients treated with non-vitamin K oral anticoagulants or parenteral bridging to warfarin has been conducted primarily with the agent rivaroxaban. The objective of this study was to compare hospital length of stay between patients initiated on the non-vitamin K oral anticoagulants, apixaban or rivaroxaban, and patients initiated on parenteral anticoagulation agents plus warfarin for the treatment of venous thromboembolism...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28780343/the-role-of-heparin-lead-in-in-the-real-world-management-of-acute-venous-thromboembolism-the-prefer-in-vte-registry
#18
Rupert Bauersachs, Giancarlo Agnelli, Anselm K Gitt, Manuel Monreal, Patrick Mismetti, Stefan N Willich, Petra Laeis, Eva-Maria Fronk, Peter Bramlage, Alexander T Cohen
INTRODUCTION: The appropriate strategy for initiating oral anticoagulant (OAC) therapy after an acute venous thromboembolism (VTE) depends on the intermediate-term anticoagulant to be used. While heparin bridging to vitamin K antagonists (VKA) is required, the direct oral anticoagulants (DOAC) rivaroxaban (30mg/day) and apixaban (10mg/day) can be initiated directly without parenteral anticoagulation. The objective was to evaluate OAC initiation patterns in clinical practice. MATERIALS AND METHODS: PREFER in VTE was an international, non-interventional registry conducted between January 2013 and August 2015...
July 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28775134/emergency-coagulation-assessment-during-treatment-with-direct-oral-anticoagulants-limitations-and-solutions
#19
Matthias Ebner, Ingvild Birschmann, Andreas Peter, Florian Härtig, Charlotte Spencer, Joachim Kuhn, Gunnar Blumenstock, Christine S Zuern, Ulf Ziemann, Sven Poli
BACKGROUND AND PURPOSE: In patients receiving direct oral anticoagulants (DOACs), emergency treatment like thrombolysis for acute ischemic stroke is complicated by insufficient availability of DOAC-specific coagulation tests. Conflicting recommendations have been published concerning the use of global coagulation assays for ruling out relevant DOAC-induced anticoagulation. METHODS: Four hundred eighty-one samples from 96 DOAC-treated patients were tested using prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT), DOAC-specific assays (anti-Xa activity, diluted TT), and liquid chromatography-tandem mass spectrometry...
August 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28771571/optical-sensing-of-anticoagulation-status-towards-point-of-care-coagulation-testing
#20
Diane M Tshikudi, Markandey M Tripathi, Zeinab Hajjarian, Elizabeth M Van Cott, Seemantini K Nadkarni
Anticoagulant overdose is associated with major bleeding complications. Rapid coagulation sensing may ensure safe and accurate anticoagulant dosing and reduce bleeding risk. Here, we report the novel use of Laser Speckle Rheology (LSR) for measuring anticoagulation and haemodilution status in whole blood. In the LSR approach, blood from 12 patients and 4 swine was placed in disposable cartridges and time-varying intensity fluctuations of laser speckle patterns were measured to quantify the viscoelastic modulus during clotting...
2017: PloS One
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