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https://www.readbyqxmd.com/read/28078536/new-oral-anticoagulants-compared-to-warfarin-for-perioperative-anticoagulation-in-patients-undergoing-atrial-fibrillation-catheter-ablation-a-meta-analysis-of-continuous-or-interrupted-new-oral-anticoagulants-during-ablation-compared-to-interrupted-or-continuous
#1
REVIEW
Yue Zhao, Yuan Yang, Xuejiao Tang, Xiang Yu, Lei Zhang, Hua Xiao
BACKGROUND: New oral anticoagulants (NOACs) have been shown to be comparable to warfarin in patients with non-valvular atrial fibrillation (AF). This meta-analysis was performed to evaluate the efficacy and safety of NOACs for perioperative anticoagulation of AF catheter ablation. METHODS: PubMed, Embase, the Cochrane Library, CNKI, VIP, and SinoMed were searched for articles published up to August 30, 2015. The data were calculated with RevMan 5.2 using a fixed-effects model...
January 12, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28074293/-management-of-noak-administration-during-invasive-or-surgical-interventions-when-and-how-to-pause-and-when-to-restart
#2
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/28058458/-vitamin-k-antagonists-is-their-prescription-really-medical-malpractice-%C3%A2-today
#3
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 5, 2017: Der Internist
https://www.readbyqxmd.com/read/28042443/differences-between-warfarin-and-new-oral-anticoagulants-in-dental-clinical-practice
#4
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/28042233/gastrointestinal-endoscopy-in-patients-on-anticoagulant-therapy-and-antiplatelet-agents
#5
REVIEW
Angelo Zullo, Cesare Hassan, Franco Radaelli
Periprocedural management of antithrombotics for gastrointestinal endoscopy is a common clinical issue, given the widespread use of these drugs for primary and secondary cardiovascular prevention. For diagnostic procedures, with or without biopsy, no adjustments in antithrombotics are usually needed. For operative procedures, balancing the risk of periprocedural hemorrhage with the continuation of antithrombotics against the chance of recurrent thromboembolic events with their discontinuation may be challenging...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28042092/increased-risk-of-major-bleeding-in-underweight-patients-with-atrial-fibrillation-who-were-prescribed-novel-oral-anticoagulants
#6
Chan Soon Park, Eue-Keun Choi, Hyue Mee Kim, So-Ryoung Lee, Myung-Jin Cha, Seil Oh
BACKGROUND: There is a paucity of evidence regarding the effects of new oral anticoagulants (NOACs) in underweight patients with atrial fibrillation (AF). OBJECTIVE: We sought to evaluate the efficacy and safety of NOACs in underweight AF patients. METHODS: We analyzed 1353 AF patients who were prescribed NOACs according to their body mass index (BMI): underweight (UW, n = 62, BMI < 18.5 kg/m(2)), normal weight (NW, n=753, BMI 18.5-24.9 kg/m(2)), and overweight-to-obese (OW, n = 538, BMI ≥ 25...
December 29, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28033129/new-oral-anticoagulants-and-prevention-of-thromboembolic-events-in-patients-with-hypertension-and-atrial-fibrillation-an-appraisal
#7
Claudio Borghi, Stefania Paolillo, Arrigo F G Cicero, Paola Gargiulo, Bruno Trimarco, Pasquale Perrone Filardi
Arterial hypertension (HTN) and atrial fibrillation often coexist and the combination of these two conditions carries an increased risk of stroke. HTN is one of the most important risk factors included in the scores for stoke prediction in atrial fibrillation used to assess the need of anticoagulation, and HTN has also been strictly related to bleeding complications of antithrombotic therapy. Antithrombotic drugs options include vitamin K antagonists, or new oral anticoagulants, recently approved for stroke prevention in nonvalvular atrial fibrillation...
December 28, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/28003013/oral-antiplatelet-and-anticoagulant-agents-in-the-prevention-and-management-of-ischemic-stroke
#8
Shreya Shrestha, Shannon Coy, Kimon Bekelis
Despite numerous advances over the last 50 years, stroke continues to be a leading cause of death and disability worldwide. The treatment and prevention of stroke has undergone extensive study, and significant advances in medical management have occurred within the past decade principally with the development of new classes of orally active anticoagulant drugs. Here we review these recent breakthroughs and the varying roles of anticoagulants and antiplatelet agents in the prevention and management of different ischemic stroke subtypes, as well as describe the benefits and ongoing challenges to incorporating the novel oral anticoagulants (NOACs) into clinical management guidelines...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28002996/oral-antiplatelet-and-anticoagulant-agents-in-the-prevention-and-management-of-ischemic-stroke
#9
Shreya Shrestha, Shannon Coy, Kimon Bekelis
Despite numerous advances over the last 50 years, stroke continues to be a leading cause of death and disability worldwide. The treatment and prevention of stroke has undergone extensive study, and significant advances in medical management have occurred within the past decade principally with the development of new classes of orally active anticoagulant drugs. Here we review these recent breakthroughs and the varying roles of anticoagulants and antiplatelet agents in the prevention and management of different ischemic stroke subtypes, as well as describe the benefits and ongoing challenges to incorporating the novel oral anticoagulants (NOACs) into clinical management guidelines...
December 21, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27996999/-real-life-clinical-management-of-nonvalvular-atrial-fibrillation-results-from-the-italian-epidemiological-survey-experience-on-the-use-of-rivaroxaban
#10
Paolo Colonna, Fabrizio Ammirati
BACKGROUND: Atrial fibrillation-related stroke prevention with anticoagulant drugs is currently evolving towards the introduction into clinical practice of the new oral anticoagulants, including rivaroxaban. Our aim was to evaluate in a real-life setting the characteristics and management of patients with nonvalvular atrial fibrillation to whom Italian doctors decided to prescribe rivaroxaban. METHODS: Between January and February 2014, a group of 95 physicians collected aggregate retrospective data, through an online questionnaire, on 1127 patients with nonvalvular atrial fibrillation receiving rivaroxaban...
November 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27995007/direct-new-oral-anticoagulants-follow-up-guidelines-and-bleeding-complications-in-general-practice-a-survey-of-swiss-general-internal-medicine-practitioners
#11
Thomas C Sauter, Carlo Melis, Wolf E Hautz, Meret E Ricklin, Aristomenis K Exadaktylos
BACKGROUND: The present study investigated how much Swiss general internal medicine practitioners (GPs) know about new direct oral anticoagulants (NOACs), particularly the relevant guidelines, follow-up tests, dosing adjustments, indications and complications. We conducted a paper-based survey of GPs, performed in Bern, Switzerland. Our questionnaire assessed the physicians' preference for NOACs rather than vitamin K antagonists (VKA), prevalence and choice of NOAC, clinical follow-up including follow-up blood testing, and bleeding complications...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27988509/rivaroxaban-induced-gastrointestinal-bleeding-presenting-as-acute-colon-obstruction
#12
Merav Cohen, Hadar Nevo, Dan Hershko, Alexander Becker
Rivaroxaban is a member of the novel target-specific oral anticoagulants (TSOACs) family of drugs recently approved for the prevention and treatment of venous thromboembolism events. A major drawback of the drug is its potential for causing severe hemorrhagic events, which may be difficult to treat in an emergency setting due to lack of effective antidote. Here, we describe a case of acute gastrointestinal (GI) hemorrhage leading to complete colon obstruction in a patient treated with rivaroxaban. Summary and Key Messages: The case presented here demonstrates a chain of events originating from an unprovoked intramural bleeding in a patient using rivaroxaban, leading to an organized giant clot formation, and to complete colon obstruction...
December 15, 2016: Pharmacology
https://www.readbyqxmd.com/read/27986971/management-of-bleeding-in-patients-receiving-non-vitamin-k-antagonists
#13
REVIEW
Sudarshan Balla, Scott Koerber, Greg Flaker
Anticoagulation with non-vitamin K antagonists (Non vitamin K oral anticoagulant (NOACs)) including dabigatran, rivaroxaban, apixaban and edoxaban is at least as effective as warfarin, has fewer drug and food interactions and does not require monthly monitoring. Although major bleeding with NOACs is infrequent, there remains concern about the ability to effectively treat episodes of major bleeding. New agents have been developed that are capable of providing rapid reversal of the anticoagulation effect of NOACs...
December 16, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27980542/antithrombotic-management-in-patients-with-percutaneous-coronary-intervention-requiring-oral-anticoagulation
#14
REVIEW
Jarosław Zalewski, Anetta Undas
The dynamic evolution of therapeutic options including the use of vitamin K antagonists (VKA), non-vitamin K oral anticoagulants (NOAC), more potent antiplatelet drugs as well as new generation drug-eluting stents could lead to the view that the current recommendations on the management of patients with percutaneous coronary intervention (PCI) requiring oral anticoagulation do not keep up with the results of several clinical studies published within the last 5 years. In the present overview, we summarize the recent advances in antithrombotic management used in atrial fibrillation patients undergoing PCI for stable coronary artery disease or acute coronary syndrome (ACS)...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/27939514/new-oral-anticoagulants-in-patients-with-chronic-kidney-disease
#15
Lara Belmar Vega, A L M de Francisco, Jairo Bada da Silva, Luis Galván Espinoza, Gema Fernández Fresnedo
Patients with chronic kidney disease (CKD) develop bleeding and thrombotic tendencies, so the indication of anticoagulation at the onset of atrial fibrillation (AF) is complex. AF is the most common chronic cardiac arrhythmia, and thromboembolism and ischemic stroke in particular are major complications. In recent years, new oral anticoagulant drugs have been developed, and they have shown superiority over the classical AVK in preventing stroke, systemic embolism and bleeding risk, constituting an effective alternative to those resources...
December 8, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27931607/causes-of-death-in-anticoagulated-patients-with-atrial-fibrillation
#16
Antonio Gómez-Outes, Julián Lagunar-Ruíz, Ana-Isabel Terleira-Fernández, Gonzalo Calvo-Rojas, Maria Luisa Suárez-Gea, Emilio Vargas-Castrillón
BACKGROUND: Oral anticoagulation reduces the risk of mortality in atrial fibrillation (AF), but examination of the causes of death is essential to design new strategies to further reduce the high mortality rates observed in this population. OBJECTIVES: The authors sought to analyze and compare causes of death in patients receiving direct oral anticoagulants (DOAC) or warfarin for prevention of stroke and systemic embolism (SE) in AF. METHODS: The authors systematically searched for randomized trials of DOAC versus warfarin for prevention of stroke/SE in AF...
December 13, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27929577/a-practical-approach-to-the-new-oral-anticoagulants-used-for-stroke-prevention-in-patients-with-atrial-fibrillation
#17
S Bashir, A Al-Mohammed, S Gupta
This review evaluates the research undertaken in the last six years on the use of new oral anticoagulants for stroke prevention in atrial fibrillation and provides evidence-based answers to common clinical questions. Two types of new oral anticoagulants - direct thrombin (IIa) inhibitors, and Xa inhibitors - are currently available. These drugs have similar pharmacokinetics and pharmacodynamics. They are more predictable than, though in many respects comparable to, warfarin. They do not require frequent laboratory tests, nor do they have a narrow therapeutic window...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27926465/freestyle-stentless-bioprosthesis-for-aortic-valve-therapy-17-year-clinical-results
#18
Juergen Ennker, Markus Meilwes, Joern Pons-Kuehnemann, Bernd Niemann, Philippe Grieshaber, Ina C Ennker, Andreas Boening
BACKGROUND: Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. METHODS: Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center...
November 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27917690/pharmacological-management-of-pulmonary-embolism
#19
Bobby Gouin, Helia Robert-Ebadi, Marc Righini, Marc Blondon
Pulmonary embolism (PE) is a common and potentially severe manifestation of venous thromboembolism. Its management has relied on anticoagulation by vitamin K antagonists (VKA) for the past fifty years. Recently, new alternative drugs have been developed and dramatically modified both the treatment of acute PE and its secondary prevention. Areas covered: This review discusses the contemporary pharmacological treatment for PE, with a focus on anticoagulation options for non-high risk PE. In particular, the advent of direct oral anticoagulants (rivaroxaban, apixaban, edoxaban and dabigatran) and modalities for long-term prevention will be described...
January 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27911120/new-frontiers-in-anticoagulation-non-vitamin-k-oral-anticoagulants-in-stroke-prevention
#20
Valentina Arnao, Marianna Riolo, Antonino Tuttolomondo, Antonio Pinto, Brigida Fierro, Paolo Aridon
Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert commentary: Although warfarin is effective in cardioembolic stroke prevention, easier handling and more favorable risk-benefit profile often render NOACs a more preferable therapy choice for neurologists...
December 12, 2016: Expert Review of Neurotherapeutics
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