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https://www.readbyqxmd.com/read/28902808/-anticoagulant-therapy-of-venous-thromboembolic-complications-balancing-between-risks
#1
K V Lobastov, S V Sapelkin
This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their secondary prevention. The problems of determining the rational duration of anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
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
#2
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/28875370/how-prepared-are-pharmacists-to-support-atrial-fibrillation-patients-in-adhering-to-newly-prescribed-oral-anticoagulants
#3
Nadya Hamedi, Filipa Alves da Costa, Robert Horne, Michael Levitan, Amanda Begley, Sotiris Antoniou
Background The New Medicines Service (NMS) was implemented in the United Kingdom in 2011 and first evaluated in 2014, showing 10% increase on adherence. Objective To assess community pharmacists' current practice, knowledge and confidence in supporting patients' adherence as part of the NMS for patients on Oral Anti-Coagulants (OACs) for stroke prevention in Atrial Fibrillation. Setting Community pharmacists in London. Method An online cross-sectional survey was sent to pharmacists from their Local Pharmaceutical Committees and advertised by the Royal Pharmaceutical Society...
September 5, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28867804/fviia-stf-and-thrombin-inhibitory-activities-of-compounds-isolated-from-microcystis-aeruginosa-k-139
#4
Andrea Roxanne J Anas, Akane Mori, Mineka Tone, Chiaki Naruse, Anna Nakajima, Hirohiko Asukabe, Yoshiaki Takaya, Susumu Y Imanishi, Tomoyasu Nishizawa, Makoto Shirai, Ken-Ichi Harada
The rise of bleeding and bleeding complications caused by oral anticoagulant use are serious problems nowadays. Strategies that block the initiation step in blood coagulation involving activated factor VII-tissue factor (fVIIa-TF) have been considered. This study explores toxic Microcystis aeruginosa K-139, from Lake Kasumigaura, Ibaraki, Japan, as a promising cyanobacterium for isolation of fVIIa-sTF inhibitors. M. aeruginosa K-139 underwent reversed-phase solid-phase extraction (ODS-SPE) from 20% MeOH to MeOH elution with 40%-MeOH increments, which afforded aeruginosin K-139 in the 60% MeOH fraction; micropeptin K-139 and microviridin B in the MeOH fraction...
August 30, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28864318/comparison-of-the-effectiveness-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-newly-diagnosed-atrial-fibrillation
#5
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/28854073/major-bleeding-risk-during-anticoagulation-with-warfarin-dabigatran-apixaban-or-rivaroxaban-in-patients-with-nonvalvular-atrial-fibrillation
#6
Gboyega Adeboyeje, Gosia Sylwestrzak, John J Barron, Jeff White, Alan Rosenberg, Jacob Abarca, Geoffrey Crawford, Rita Redberg
BACKGROUND: The use of non-vitamin K oral anticoagulants (NOACs) has increased steadily following marketing approval; however, their relative safety in nonvalvular atrial fibrillation (NVAF) patients in real-world clinical practice remains unclear. OBJECTIVE: To compare the risk of major bleeding during anticoagulation therapy between warfarin and NOACs. METHODS: This retrospective cohort study analyzed administrative claims data on new NVAF users of warfarin, dabigatran, apixaban, or rivaroxaban in routine clinical care from November 2010 to February 2015 in a commercially insured population in the United States...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28843806/treatment-of-cryptogenic-stroke-with-active-cancer-with-a-new-oral-anticoagulant
#7
Ki-Woong Nam, Chi Kyung Kim, Tae Jung Kim, Sang Joon An, Kyungmi Oh, Sang-Bae Ko, Byung-Woo Yoon
BACKGROUND: Low-molecular weight heparin (LMWH) was shown to be effective and safe in treating venous thromboembolism, and generally used for stroke in cancer patients, but its effects on stroke are unclear. We compared clinical outcomes between LMWH and new oral anticoagulant (NOAC) in patients with cancer-related stroke. METHODS: We enrolled patients with cryptogenic ischemic stroke with active cancer who were treated with LMWH or NOAC between May 2012 and June 2015...
August 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28840739/-rivaroxaban-in-high-risk-patients
#8
Jindřich Špinar, Lenka Špinarová
Blockade of factor Xa becomes a routine part of clinical practice instead of vitamin K blockade with warfarin, providing a more beneficial and safer effect. The main indications are prevention of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, deep vein thrombosis and pulmonary embolism. Rivaroxaban has the largest number of data across high risk patients. Rivaroxaban is an oral selective anti Xa inhibitor with well predictive pharmacokinetics and pharmacodynamics. It inhibits thrombin formation for 24 hours, is well absorbed and biological availability is 80-100 %...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28837204/inducing-heat-shock-protein-70-expression-provides-a-robust-antithrombotic-effect-with-minimal-bleeding-risk
#9
Mikel Allende, Eva Molina, Ramón Lecumberri, Juan Antonio Sanchez-Arias, Ana Ugarte, Elizabeth Guruceaga, Julen Oyarzabal, José Hermida
Antithrombotic medications target coagulation factors. Their use is associated with an increased bleeding risk. Safer drugs are needed. The heat shock protein 70 (Hsp70) exhibits antithrombotic properties that do not influence bleeding. By using murine models, we aimed to test the hypothesis that overexpressing Hsp70 with CM-695, a first in class dual inhibitor of HDAC6 and phosphodiesterase 9, protects against thrombosis while leaves bleeding tendency unaltered. CM-695 was used to induce Hsp70 overexpression...
August 30, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28822583/-misuse-and-adverse-effects-of-new-direct-oral-anticoagulants-a-prospective-observational-study-in-patients-admitted-to-an-emergency-unit-of-a-french-university-hospital
#10
Thomas Lafon, Christine Vallejo, Mathilde Hadj, Marie-Laure Laroche, Hélène Geniaux
INTRODUCTION: The use of direct oral anticoagulants (NOAC) is complex: indications, dosage adjustments and precautions. Emergency departments (ED) are increasingly faced with patients receiving NOAC. The aim of this study was to evaluate the misuse and the adverse effects (AE) of NOAC. METHODS: All subjects with NOAC admitted to the Limoges University Hospital ED from 1/8/2013 to 1/4/2014 were included in a prospective observational study. Misuse was identified from the NOAC summary of product characteristics and from the 2014 ANSM guideline (indication, dose, co-medications, age, hepatic and renal function); adverse effects were recorded...
July 19, 2017: Thérapie
https://www.readbyqxmd.com/read/28820069/apixaban-effective-and-safe-in-preventing-thromboembolic-events-in-patients-with-atrial-fibrillation-and-renal-failure
#11
Francesca Cortese, Pietro Scicchitano, Michele Gesualdo, Gabriella Ricci, Santa Carbonara, Carlo Franchini, Brigida Immacolata Pia Schiavone, Filomena Corbo, Marco Matteo Ciccone
Thromboembolic events, principally stroke, represent among the leading causes of morbidity and mortality of subjects with atrial fibrillation, with an incidence about 5 times higher compared to healthy subjects. Chronic kidney disease, frequently associated with atrial fibrillation, determines itself a further increase of thromboembolic events, bleeding and mortality. In addition, the presence of renal failure complicates the pharmacological management of these patients, mainly due to the side effects of antiarrhythmic and anticoagulant drugs with renal excretion, due to their accumulation...
August 17, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28802751/acute-management-of-hemostasis-in-patients-with-neurological-injury
#12
REVIEW
M Irem Baharoglu, Anneke Brand, Maria M Koopman, Marinus Vermeulen, Yvo B W E M Roos
Neurological injuries can be divided into those with traumatic and nontraumatic causes. The largest groups are traumatic brain injury (TBI) and nontraumatic stroke. TBI patients may present with intracranial hemorrhages (contusions, or subdural or epidural hematomas). Strokes are ischemic or hemorrhagic. In all these disorders, thrombosis and hemostasis play a major role. Treatment aims to either cease bleeding and/or restore perfusion. We reviewed hemostatic and thrombolytic therapies in patients with neurological injuries by MEDLINE and EMBASE search using various key words for neurological disorders and hemostatic therapies restricted to English language and human adults...
July 13, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28765771/2017-consensus-of-the-asia-pacific-heart-rhythm-society-on-stroke-prevention-in-atrial-fibrillation
#13
Chern-En Chiang, Ken Okumura, Shu Zhang, Tze-Fan Chao, Chung-Wah Siu, Toon Wei Lim, Anil Saxena, Yoshihide Takahashi, Wee Siong Teo
Atrial fibrillation (AF) is the most common sustained arrhythmia, causing a 2-fold increase in mortality and a 5-fold increase in stroke. The Asian population is rapidly aging, and in 2050, the estimated population with AF will reach 72 million, of whom 2.9 million may suffer from AF-associated stroke. Therefore, stroke prevention in AF is an urgent issue in Asia. Many innovative advances in the management of AF-associated stroke have emerged recently, including new scoring systems for predicting stroke and bleeding risks, the development of non-vitamin K antagonist oral anticoagulants (NOACs), knowledge of their special benefits in Asians, and new techniques...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28758284/new-oral-anticoagulant-prescription-rate-and-risk-of-bleeding-in-an-italian-region
#14
Francesca Valent
PURPOSE: The purpose of this study was to measure the prescription rate of new oral anticoagulants (NOACs) and to investigate whether there is an increased risk of bleeding associated with these medications in the 1 220 000-inhabitant Italian region Friuli Venezia Giulia. METHODS: The administrative data of the Regional Health Information System, linkable with each other at the individual patient level through an anonymous stochastic key, were used as the source of information...
July 31, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28751847/anmco-position-paper-the-use-of-non-vitamin-k-dependent-new-oral-anticoagulant-s-in-pulmonary-embolism-therapy-and-prevention
#15
Iolanda Enea, Loris Roncon, Michele Massimo Gulizia, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Franco Casazza, Claudio Cuccia, Carlo D'Agostino, Matteo Rugolotto, Marco Vatrano, Eugenio Vinci, Paride Fenaroli, Dario Formigli, Paolo Silvestri, Federico Nardi, Maria Cristina Vedovati, Marino Scherillo
The new oral anticoagulants (NOACs) have radically changed the approach to the treatment and prevention of thromboembolic pulmonary embolism. The authors of this position paper face, in succession, issues concerning NOACs, including (i) their mechanism of action, pharmacodynamics, and pharmacokinetics; (ii) the use in the acute phase with the 'double drug single dose' approach or with 'single drug double dose'; (iii) the use in the extended phase with demonstrated efficacy and with low incidence of bleeding events; (iv) the encouraging use of NOACs in particular subgroups of patients such as those with cancer, the ones under- or overweight, with renal insufficiency (creatinine clearance > 30 mL/min), the elderly (>75 years); (v) they propose a possible laboratory clinical pathway for follow-up; and (vi) carry out an examination on the main drug interactions, their potential bleeding risk, and the way to deal with some bleeding complications...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28743214/management-of-dental-patients-receiving-antiplatelet-therapy-or-chronic-oral-anticoagulation-a-review-of-the-latest-evidence
#16
Csaba András Dézsi, Balázs Bence Dézsi, András Döme Dézsi
The perioperative management of patients treated with antithrombotic medications who undergo surgical procedures represents a common clinical problem. Dental interventions are usually associated with a low risk of bleeding; however, the dental implications of new antithrombotic agents are not yet fully understood. The present review is based on the latest evidence and recommendations published on the periprocedural management of dental patients treated with single or dual antiplatelet therapy, vitamin K antagonists, or direct oral anticoagulants for a variety of indications...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28730948/nonvitamin-k-antagonist-oral-anticoagulants-versus-warfarin-in-patients-with-atrial-fibrillation-and-previous-stroke-or-transient-ischemic-attack-an-updated-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
George Ntaios, Vasileios Papavasileiou, Hans-Chris Diener, Konstantinos Makaritsis, Patrik Michel
Background In a previous systematic review and meta-analysis, we assessed the efficacy and safety of nonvitamin-K antagonist oral anticoagulants versus warfarin in patients with atrial fibrillation and stroke or transient ischemic attack. Since then, new information became available. Aim The aim of the present work was to update the results of the previous systematic review and meta-analysis. Methods We searched PubMed until 24 August 2016 for randomized controlled trials using the following search items: "atrial fibrillation" and "anticoagulation" and "warfarin" and "previous stroke or transient ischemic attack...
August 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28730690/incorporating-comprehensive-management-of-direct-oral-anticoagulants-into-anticoagulation-clinics
#18
Insaf Mohammad, Bianca Korkis, Candice L Garwood
Anticoagulation clinics emerged as a means to optimize warfarin effectiveness and minimize bleeding risks. Anticoagulation clinics have traditionally been warfarin-based models due to the need for frequent blood-level monitoring, drug interactions, dietary considerations, and periprocedural management with warfarin. These models have demonstrated improved anticoagulation control and reduced bleeding complications for patients taking warfarin. Direct oral anticoagulants (DOACs) emerged with the perception of improved convenience due to the lack of blood-level monitoring and lack of dietary considerations...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28727359/-stroke-prevention-in-patients-with-atrial-fibrillation
#19
Gaia Sirimarco, Lorenz Hirt, Roman Sztajzel, Fabienne Perren
Oral anticoagulation with vitamin K antagonists (VKA) was the cornerstone of stroke prevention in atrial fibrillation (AF). This review article presents the state of the art, with regard to the treatment options developed over the past few years, the new oral anticoagulants (NOAC). A search in PubMed for relevant published studies has been performed. Dabigatran and apixaban were superior to warfarin to reduce stroke risk or systemic embolism ; dabigatran, rivaroxaban and edoxaban were non-inferior. All NOAC are globally non-inferior to warfarin for stroke prevention in non-valvular AF and they have a superior safety profile, with a reduced intracranial bleeding risk...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28681581/risk-analysis-of-new-oral-anticoagulants-for-gastrointestinal-bleeding-and-intracranial-hemorrhage-in-atrial-fibrillation-patients-a-systematic-review-and-network-meta-analysis
#20
Wei-Wei Xu, Shen-Jiang Hu, Tao Wu
BACKGROUND: Antithrombotic therapy using new oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) has been generally shown to have a favorable risk-benefit profile. Since there has been dispute about the risks of gastrointestinal bleeding (GIB) and intracranial hemorrhage (ICH), we sought to conduct a systematic review and network meta-analysis using Bayesian inference to analyze the risks of GIB and ICH in AF patients taking NOACs. METHODS: We analyzed data from 20 randomized controlled trials of 91 671 AF patients receiving anticoagulants, antiplatelet drugs, or placebo...
July 2017: Journal of Zhejiang University. Science. B
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