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https://www.readbyqxmd.com/read/29346128/management-of-heavy-menstrual-bleeding-during-direct-oral-anticoagulant-therapy-for-recurrent-venous-thromboembolism-a-case-report
#1
Michela Giustozzi, Maria C Vedovati, Giancarlo Agnelli
: A high risk of venous thromboembolism (VTE) recurrence requires extended anticoagulation but limits the options to control heavy menstrual bleeding (HMB) in women of reproductive age. We report the management of HMB in a 48-year-old woman with a history of menometrorrhagia, recurrent VTE and multiple VTE risk factors. Due to the occurrence of HMB during extended rivaroxaban treatment, the presence of a uterine fibroid and the contraindication to interrupt anticoagulation for high risk of VTE recurrence, she received hormonal treatment first with a gonadotropin-releasing hormone agonist and then with progestin...
January 15, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29346127/rivaroxaban-with-or-without-aspirin-for-prevention-of-cardiovascular-disease
#2
Paul C Kruger, John W Eikelboom, Salim Yusuf
No abstract text is available yet for this article.
January 17, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29345985/cyp3a-activity-and-rivaroxaban-serum-concentrations-in-russian-patients-with-deep-vein-thrombosis
#3
Dmitriy Alexeyevich Sychev, Arshak Vardanyan, Aleksandr Rozhkov, Edita Hachatryan, Ani Badanyan, Valery Smirnov, Anna Ananichuk, Natalya Denisenko
BACKGROUND: Rivaroxaban is metabolized in the liver via CYP3A4, the cytochrome involved in the metabolism of nearly 50% of all medications. Thus, its effective concentration depends on multiple pharmacologic parameters. METHODS: The primary goal of our research was to study the correlation between the CYP3A family activity and the safety and efficacy of anticoagulant therapy with rivaroxaban in patients with deep vein thrombosis (DVT). Thirty one patients with DVT aged 21-83 years, 18 men and 13 women, received rivaroxaban (Xarelto) 30 mg/day for 21 days after diagnosis and 20 mg/day for the follow-up period of 6 months...
January 2018: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/29345686/reversal-agents-for-non-vitamin-k-antagonist-oral-anticoagulants
#4
REVIEW
Jerrold H Levy, James Douketis, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban, and rivaroxaban, which inhibit coagulation factor Xa. Although clinical studies of NOACs were conducted without antidotes, patient outcomes with major bleeding when receiving NOACs were no worse than those in patients treated with a vitamin K antagonist. Nonetheless, in patients with life-threatening bleeding or requiring urgent surgery, the capacity for rapid NOAC reversal is likely to increase patient safety...
January 18, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#5
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344007/four-factor-prothrombin-complex-concentrate-improves-thrombin-generation-and-prothrombin-time-in-patients-with-bleeding-complications-related-to-rivaroxaban-a-single-center-pilot-trial
#6
Bettina Schenk, Stephanie Goerke, Ronny Beer, Raimund Helbok, Dietmar Fries, Mirjam Bachler
Background: Direct oral anticoagulants (DOACs) pose a great challenge for physicians in life-threatening bleeding events. The aim of this study was to test the efficacy of reversing the DOAC rivaroxaban using four-factor PCC (prothrombin complex concentrate), a non-specific reversing agent. Methods: Patients with life-threatening bleeding events during rivaroxaban treatment were included and administered 25 U kg-1 of PCC. Blood samples were collected immediately prior to as well as after PCC treatment at predefined time intervals...
2018: Thrombosis Journal
https://www.readbyqxmd.com/read/29339679/a-rare-complication-in-a-patient-taking-rivaroxaban-alveolar-hemorrhage
#7
Salih Kılıç, Erhan Saraçoğlu, Gülin Alkan
Alveolar hemorrhage (AH) is a heterogeneous clinical syndrome with a high mortality rate that is characterized by extensive bleeding into the alveolar spaces. AH usually develops secondary to immunological disease and, less frequently, to drug use. Presently described is the case of an 86-year-old woman with AH who had been using rivaroxaban for 6 months.
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29339167/comparison-of-anticoagulant-therapy-for-atrial-fibrillation-novel-oral-anticoagulants-versus-vitamin-k-antagonists
#8
REVIEW
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#9
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29334815/impact-of-medication-adherence-on-risk-of-ischemic-stroke-major-bleeding-and-deep-vein-thrombosis-in-atrial-fibrillation-patients-using-novel-oral-anticoagulants
#10
Chinmay G Deshpande, Stephen Kogut, Robert Laforge, Cynthia Willey
OBJECTIVES: Our study examined the impact of adherence to Novel Oral Anticoagulants (dabigatran and rivaroxaban) [NOACs] on ischemic-stroke (IS), major-bleeding (MB), deep-vein-thrombosis and pulmonary-embolism (DVTPE) risk in a large, nationwide, propensity-matched sample. METHODS: A retrospective cohort study utilized data from a US commercial insurance database (2010-2012). Adults patients with ≥1 diagnosis of atrial fibrillation/flutter (ICD-9 427.31/32), >1 prescription of NOACs and CHA2DS2-VASc score ≥1 were included...
January 16, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29324466/rivaroxaban-used-for-treatment-of-a-left-ventricular-thrombus-in-a-patient-with-nonischemic-cardiomyopathy
#11
Hossam Abubakar, Ahmed S Yassin, Mohamed Shokr
No abstract text is available yet for this article.
January 8, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29324334/rivaroxaban-versus-warfarin-for-the-prevention-of-post-thrombotic-syndrome
#12
K K Utne, A Dahm, H S Wik, L P Jelsness-Jørgensen, P M Sandset, W Ghanima
INTRODUCTION: Despite treatment of acute deep vein thrombosis (DVT) with low molecular weight heparin and warfarin, up to 50% of patients develop post-thrombotic syndrome (PTS). Our aims were to assess whether treatment of DVT with rivaroxaban would reduce the rate of subsequent PTS and improve health-related quality of life (HRQoL) as compared to conventional anticoagulation with low molecular weight heparin (LMWH)/warfarin. MATERIALS AND METHODS: Consecutive patients with an objectively confirmed DVT diagnosed between 2011 and 2014 and treated with either rivaroxaban or warfarin were included in this study 24 (±6) months after DVT...
January 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29322630/inter-laboratory-variability-for-the-measurement-of-direct-oral-anticoagulants-results-from-the-external-quality-assessment-scheme
#13
Armando Tripodi, Veena Chantarangkul, Cristina Legnani, Sophie Testa, Alberto Tosetto
BACKGROUND: Tests for direct oral anticoagulants (DOAC) are not widely available. The perception that they are difficult to be run and are subjected to large between-laboratory variation makes their implementation difficult. AIMS: We carried out proficiency-testing surveys for DOAC within the activity of the external quality-assessment scheme of the Italian Federation of Thrombosis Centers. DESIGN: Participants were provided with coded freeze-dried plasmas without or with graded concentrations of the three main DOAC and asked to measure PT, APTT, thrombin time and DOAC concentrations by dedicated tests...
January 10, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29322206/-perioperative-handling-of-anticoagulation
#14
REVIEW
J F Lock, J Wagner, V Luber, U A Dietz, S Lichthardt, N Matthes, K Krajinovic, C-T Germer, S Knop, A Wiegering
A growing number of patients in Germany receive a long-term prophylactic anticoagulation with phenprocoumone or one of the novel direct oral anticoagulants (NOAC), such as dabigatran, rivaroxaban or apixaban. The most common indication for an oral anticoagulant therapy is atrial fibrillation (approximately 75%) where the anticoagulant therapy can reduce the risk for an embolic event, particularly stroke by 60%. Operations carried out during such a therapy can result in major bleeding complications. On the other hand, suspending anticoagulant therapy can lead to an increased risk of thromboembolisms...
January 10, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29320795/direct-oral-anticoagulants-in-end-stage-renal-disease
#15
Adi J Klil-Drori, Vicky Tagalakis
Patients with end-stage renal disease (ESRD) were excluded from pivotal clinical trials with oral anticoagulants. While such patients are at an increased risk of venous and arterial thromboembolism, their risk of bleeding is also elevated. It is thus of little surprise that stroke prevention with vitamin K antagonists (VKAs) in ESRD patients with atrial fibrillation is controversial, with observational evidence ranging from beneficial to harmful. This uncertainty extends to the less studied use of VKAs for venous thromboembolism in ESRD...
January 10, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29319249/stroke-prevention-in-atrial-fibrillation-which-is-the-best-balanced-in-efficacy-and-safety-as-a-thromboprophylactic
#16
Viraj Suvarna
Stroke prevention in atrial fibrillation (AF) has reached an exciting phase with a plethora of newer, potentially more efficacious and safer agents being introduced for physicians to select from. Dabigatran belongs to a class of anticoagulants called direct thrombin inhibitors, while rivaroxaban, apixaban, and edoxaban are direct Factor Xa inhibitors. Purely from a therapeutic endpoint perspective-based on the action of anticoagulants in reducing cardioembolic stroke-in clinical trials, one should look at whether a new anticoagulant in patients with AF prevents ischemic stroke...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29318683/prospective-surveillance-pilot-of-rivaroxaban-safety-within-the-us-food-and-drug-administration-sentinel-system
#17
Elizabeth A Chrischilles, Joshua J Gagne, Bruce Fireman, Jennifer Nelson, Sengwee Toh, Azadeh Shoaibi, Marsha E Reichman, Shirley Wang, Michael Nguyen, Rongmei Zhang, Rima Izem, Margie R Goulding, Mary Ross Southworth, David J Graham, Candace Fuller, Hannah Katcoff, Tiffany Woodworth, Catherine Rogers, Ryan Saliga, Nancy D Lin, Cheryl N McMahill-Walraven, Vinit P Nair, Kevin Haynes, Ryan M Carnahan
PURPOSE: The US Food and Drug Administration's Sentinel system developed tools for sequential surveillance. METHODS: In patients with non-valvular atrial fibrillation, we sequentially compared outcomes for new users of rivaroxaban versus warfarin, employing propensity score matching and Cox regression. A total of 36 173 rivaroxaban and 79 520 warfarin initiators were variable-ratio matched within 2 monitoring periods. RESULTS: Statistically significant signals were observed for ischemic stroke (IS) (first period) and intracranial hemorrhage (ICH) (second period) favoring rivaroxaban, and gastrointestinal bleeding (GIB) (second period) favoring warfarin...
January 10, 2018: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29306643/drug-induced-thrombocytopenia-after-anticoagulation-with-rivaroxaban
#18
Marianne K Pop, Farhad Farokhi, Lela Iduna
A 66-year-old man presented to the emergency department with complaints of dark-colored stool and rash developing over the last couple of days. The patient was started on rivaroxaban and flecainide for months prior for atrial fibrillation. Upon arrival, he was awake, alert, and oriented with a blood pressure of 111/63mmHg, heart rate of 68 beats per minute, and oxygen saturation of 96% on room air. A review of systems was unremarkable with the exception of skin rash and light-headedness. The patient's initial laboratory results were significant for red blood cell (RBC) count of 4...
December 24, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29305143/bleeding-complications-after-use-of-novel-oral-anticoagulants-in-patients-undergoing-cardiac-surgery
#19
Kambiz Hassan, Nikolai Bayer, Friederike Schlingloff, Martin Oberhoffer, Peter Wohlmuth, Michael Schmoeckel, Stephan Geidel
BACKGROUND: To analyze the results of open-heart surgery and bleeding complications after administration of novel oral anticoagulants (NOAC). METHODS: We investigated 81 consecutive patients (age: 74 [IQR 68, 78] years) who underwent open-heart operations at our institution between July 2014 and June 2016. All patients presented for surgery while on NOAC therapy: 37 had Rivaroxaban (45.7%), 35 Apixaban (43.2%) and 9 Dabigatran (11.1%). The calculated risk, using the European System for Cardiac Operative Risk Evaluation II, was 3...
January 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29304527/is-there-a-preferred-stroke-prevention-strategy-for-diabetic-patients-with-non-valvular-atrial-fibrillation-comparing-warfarin-dabigatran-and-rivaroxaban
#20
Chih-Cheng Hsu, Pai-Feng Hsu, Shih-Hsien Sung, Shih-Te Tu, Ben-Hui Yu, Chi-Jung Huang, Hao-Min Cheng
BACKGROUND:  The prevalence of diabetes is growing, and diabetes is an independent risk factor for both atrial fibrillation (AF) and stroke. However, the relative effectiveness and safety of different oral anticoagulants for diabetic patients with non-valvular AF remain unclear. We aimed to compare thromboembolic events, bleeding and mortality in diabetic AF patients treated with rivaroxaban, dabigatran and warfarin. METHODS AND RESULTS:  Diabetic AF patients taking dabigatran (n = 322), rivaroxaban (n = 320) or warfarin (n = 1,899) were identified from the nationwide diabetes pay-for-performance program (n = 814,465) in Taiwan...
January 2018: Thrombosis and Haemostasis
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