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https://www.readbyqxmd.com/read/29025267/direct-oral-anticoagulants-in-cardioversion-a-review-of-current-evidence
#1
Caitlin M Gibson, Amanda N Basto, Meredith L Howard
OBJECTIVE: Direct oral anticoagulants (DOACs) are recommended for the prevention of stroke or systemic embolism in nonvalvular atrial fibrillation. Dabigatran, rivaroxaban, apixaban, and edoxaban represent possible alternatives to warfarin in the setting of cardioversion. A literature review was conducted to evaluate the safety and efficacy of DOAC use pericardioversion. DATA SOURCES: A PubMed and MEDLINE search through August 2017 was conducted using the following search terms alone or in various combinations: dabigatran, rivaroxaban, apixaban, edoxaban, betrixaban, DOAC, NOAC, TSOAC, cardioversion...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29023526/antithrombotic-therapy-strategies-for-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-network-meta-analysis
#2
Xiaoxuan Gong, Shaowen Tang, Jiangjin Li, Xiwen Zhang, Xiaoyi Tian, Shuren Ma
OBJECTIVE: The aim of this systematic review and network meta-analysis was to evaluate the comparative efficacy and safety of antiplatelet agents, vitamin K antagonist (VKA) and non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify clinical trials comparing antiplatelet drugs with VKA and NOACs or their combination in AF patients undergoing PCI with a mean/median follow-up of at least 12 months...
2017: PloS One
https://www.readbyqxmd.com/read/29018536/efficacy-and-safety-of-non-vitamin-k-antagonist-oral-anticoagulants-compared-with-warfarin-in-patients-with-atrial-fibrillation
#3
Leif Friberg, Jonas Oldgren
AIMS: Non-vitamin K antagonist oral anticoagulants (NOACs) were in pivotal randomised controlled trials at least non-inferior to warfarin for stroke prevention in atrial fibrillation, but time in therapeutic range (TTR) for warfarin was lower (mean 55%-65%) than in Swedish general care where TTR is >70%. We compared efficacy and safety of NOACs and warfarin treatment for stroke prevention in Sweden. METHODS: Retrospective cohort study of all non-selected oral anticoagulation naïve atrial fibrillation patients with first prescription for NOACs or warfarin between December 2011 and December 2014, excluding patients with mitral stenosis or mechanical valvular prosthesis...
2017: Open Heart
https://www.readbyqxmd.com/read/29017288/management-of-arrhythmias-noacs-digoxin-alcohol-light-and-devices
#4
Thomas F Lüscher
No abstract text is available yet for this article.
July 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29017215/-pulmonary-embolism-despite-rivaroxaban-in-an-obese-patient
#5
Thomas Schuh, Claudia Stöllberger
Introduction Rivaroxaban, an oral factor Xa inhibitor, is approved for therapy of venous thromboembolism. It is unclear whether the standard dose for patients with a body mass index (BMI) > 40 kg/m(2) is sufficient. History The 45-year-old patient was admitted because of increasing respiratory distress. She had a history of pulmonary embolism 30 months before the admission, a factor V Leiden mutation and several hospitalisations due to dermatomycoses. The patient briefly took phenprocoumon which was changed to 20 mg rivaroxaban due to a lack of adherence...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29016832/contemporary-stroke-prevention-strategies-in-11%C3%A2-096-european-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-on-atrial-fibrillation-eorp-af-long-term-general-registry
#6
Giuseppe Boriani, Marco Proietti, Cécile Laroche, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Igor Diemberger, Luigi Tavazzi, Aldo P Maggioni, Gregory Y H Lip
Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed. Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84...
September 14, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016758/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-undergoing-elective-cardioversion
#7
Saga Itäinen, Mika Lehto, Tuija Vasankari, Pirjo Mustonen, Mervi Kotamäki, Anna Numminen, Heli Lahtela, Aissa Bah, Juha Hartikainen, Anna-Mari Hekkala, Juhani K E Airaksinen
Aims: Non-vitamin K antagonist oral anticoagulants (NOAC) have been shown to be safe and effective alternatives to warfarin for the prevention of thromboembolic complications in patients with non-valvular atrial fibrillation (AF). The aim of this study was to investigate the complications and the use of NOACs in AF patients undergoing elective cardioversion. Methods and results: This nationwide multicentre study included consecutive elective cardioversions in AF patients treated with NOACs between October 2011 and May 2016...
July 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28992319/atrial-fibrillation-in-kidney-transplant-recipients-is-there-a-place-for-the-novel-drugs
#8
Jolanta Malyszko, Paulina Lopatowska, Elzbieta Mlodawska, Dominika Musialowska, Jacek S Malyszko, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia of high clinical importance, occurring in 2% of the general population and in 19-24% in patients with chronic kidney disease. It is a well-known risk factor for cardiovascular morbidity and mortality. Kidney transplant recipients with a history of AF were associated with significantly higher rate of ischaemic strokes, graft failure and post-transplant mortality. AF occurs in over 7% of kidney transplant recipients in the first 3 years after transplantation and is associated with reduced graft and patient survival...
September 7, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28988597/dosing-issues-with-non-vitamin%C3%A2-k-antagonist-oral-anticoagulants-for-the-treatment-of-non-valvular-atrial-fibrillation-why-we-should-not-underdose-our-patients
#9
Jean-Guillaume Dillinger, Boris Aleil, Saida Cheggour, Ygal Benhamou, Yannick Béjot, Sylvestre Marechaux, Aurelien Delluc, Laurent Bertoletti, Nicolas Lellouche
Non-vitamin K antagonist oral anticoagulants (NOACs) - dabigatran, rivaroxaban, apixaban and edoxaban - are well established in terms of preventing stroke or systemic embolism in patients with non-valvular atrial fibrillation and high thromboembolism risk. When prescribed incorrectly, NOACs are associated with an increased risk of ischaemic events and bleeding. Current NOAC labels explicitly address dose adjustments according to age, body weight, renal function and concomitant treatment with P-glycoprotein inhibitors...
October 2, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28985259/effectiveness-and-safety-of-oral-anticoagulants-in-older-patients-with-atrial-fibrillation-a-systematic-review-and-meta-regression-analysis
#10
Ying Bai, Shi-Dong Guo, Hai Deng, Alena Shantsila, Laurent Fauchier, Chang-Sheng Ma, Gregory Y H Lip
Background and objective: the study analysed the effectiveness and safety of warfarin use compared with warfarin non-use and non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients aged ≥65 years. Methods: after searching PubMed and the Cochrane Library, 26 studies were included, with 10 comparing warfarin with warfarin non-use and 16 comparing warfarin with NOACs, in older AF patients (≥65 years). Results: warfarin use was superior to no antithrombotic therapy [relative risk (RR) 0...
September 8, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28984052/patterns-of-long-term-use-of-non-vitamin-k-antagonist-oral-anticoagulants-for-non-valvular-atrial-fibrillation-quebec-observational-study
#11
Antonios Douros, Christel Renoux, Janie Coulombe, Samy Suissa
PURPOSE: Studies on long-term utilization of non-vitamin K antagonist oral anticoagulants (NOACs) in non-valvular atrial fibrillation (NVAF) are scarce. We evaluated predictors of use and long-term persistence of NOACs in a real-world setting. METHODS: This population-based cohort study used the computerized databases of the Canadian Province of Quebec's health insurance. Patients with a first NVAF diagnosis from 2011 until 2014 were included. A logistic regression model yielded adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for predictors of treatment initiation with NOACs versus VKAs...
October 6, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28974629/effectiveness-and-safety-of-non-vitamin-k-antagonist-oral-anticoagulants-in-asian-patients-with-atrial-fibrillation
#12
Myung-Jin Cha, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Seil Oh, Gregory Y H Lip
BACKGROUND AND PURPOSE: There are limited real-world data comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with nonvalvular atrial fibrillation. We aimed to compare the effectiveness and safety between NOACs and warfarin users in the Korean atrial fibrillation population, with particular focus on high-risk patients. METHODS: Using the Korean National Health Insurance Service database, we analyzed the risk of ischemic stroke, intracranial hemorrhage (ICH) events, and all-cause death in NOAC users (n=11 611 total, n=5681 taking rivaroxaban, n=3741 taking dabigatran, and n=2189 taking apixaban) compared with propensity score-matched warfarin users (n=23 222) among patients with high-risk atrial fibrillation (CHA2DS2-VASc score ≥2) between 2014 and 2015...
October 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28973247/association-between-use-of-non-vitamin-k-oral-anticoagulants-with-and-without-concurrent-medications-and-risk-of-major-bleeding-in-nonvalvular-atrial-fibrillation
#13
Shang-Hung Chang, I-Jun Chou, Yung-Hsin Yeh, Meng-Jiun Chiou, Ming-Shien Wen, Chi-Tai Kuo, Lai-Chu See, Chang-Fu Kuo
Importance: Non-vitamin K oral anticoagulants (NOACs) are commonly prescribed with other medications that share metabolic pathways that may increase major bleeding risk. Objective: To assess the association between use of NOACs with and without concurrent medications and risk of major bleeding in patients with nonvalvular atrial fibrillation. Design, Setting, and Participants: Retrospective cohort study using data from the Taiwan National Health Insurance database and including 91 330 patients with nonvalvular atrial fibrillation who received at least 1 NOAC prescription of dabigatran, rivaroxaban, or apixaban from January 1, 2012, through December 31, 2016, with final follow-up on December 31, 2016...
October 3, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28972957/comparison-of-different-oral-anticoagulant-regimens-in-patients-with-atrial-fibrillation-undergoing-ablation-or-cardioversion
#14
Monika Gawałko, Agnieszka Kapłon-Cieślicka, Monika Budnik, Aldona Babiarz, Aleksandra Bodys, Robert Ulińśki, Maciej Żochowski, Michał Peller, Piotr Scisło, Janusz Kochanowski, Krzysztof J Filipiak, Grzegorz Opolski
INTRODUCTION Non-vitamin K antagonist oral anticoagulants (NOAC) are an alternative to vitamin K antagonists (VKA) for stroke prevention in atrial fibrillation (AF).  OBJECTIVES To assess the incidence of left atrial appendage (LAA) thrombus, dense spontaneous echo contrast (DSEC) and to compare clinical characteristics of AF patients treated with different  anticoagulant regiments. PATIENTS AND METHODS We studied 1033 consecutive AF patients, who underwent transoesophageal echocardiography (TOE) before AF ablation or cardioversion...
September 30, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28968483/antiplatelet-and-anticoagulant-agents-for-secondary-prevention-of-stroke-and-other-thromboembolic-events-in-people-with-antiphospholipid-syndrome
#15
REVIEW
Malgorzata M Bala, Magdalena Celinska-Lowenhoff, Wojciech Szot, Agnieszka Padjas, Mateusz Kaczmarczyk, Mateusz J Swierz, Anetta Undas
BACKGROUND: Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by arterial or venous thrombosis (or both) and/or pregnancy morbidity in association with the presence of antiphospholipid antibodies. The prevalence is estimated at 40 to 50 cases per 100,000 people. The most common sites of thrombosis are cerebral arteries and deep veins of the lower limbs. People with a definite APS diagnosis have an increased lifetime risk of recurrent thrombotic events. OBJECTIVES: To assess the effects of antiplatelet or anticoagulant agents, or both, for the secondary prevention of recurrent thrombosis, particularly ischemic stroke, in people with antiphospholipid syndrome...
October 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28968197/safety-of-once-or-twice-daily-dosing-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-in-patients-with-nonvalvular-atrial-fibrillation-a-noac-tr-study
#16
Sadık Volkan Emren, Mehdi Zoghi, Rida Berılgen, İbrahim Halil Özdemir, Oğuzhan Çelik, Nurullah Çetin, Asım Enhoş, Cemal Köseoğlu, Abdurrahman Akyüz, Volkan Doğan, Fatih Levent, Yüksel Dereli, Tolga Doğan, Özcan Başaran, Ilgın Karaca, Özkan Karaca, Yılmaz Ömür Otlu, Çağlar Özmen, Selvi Coşar, Mutlu Sümerkan, Erdal Gürsul, Sinan İnci, Ersel Onrat, Oktay Ergene
Once-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) may increase patient adherence to treatment but may also be associated with a higher risk of bleeding. In this study, we investigated the adherence to once- or twice-daily dosing of NOACs and the risk of bleeding in nonvalvular atrial fibrillation (NVAF) patients. This multicenter cross-sectional study, conducted between 1 September 2015 and 28 February 2016, included 2214 patients receiving NOACs for at least 3 months, due to NVAF. Patients receiving once-daily or twice-daily NOAC doses were 1:1 propensity score matched for baseline demographic characteristics and the presence of other diseases...
October 2, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28966115/elective-cardioversion-in-the-era-of-novel-oral-anticoagulants-does-a-nurse-administered-verbal-questionnaire-for-compliance-negate-the-need-for-routine-transoesophageal-echocardiography
#17
Matthew K Rowe, Naomi Lollback, Leanne Slater, John Hill, Paul A Gould, Gerald C Kaye
BACKGROUND: Anticoagulation prior to elective external direct current cardioversion (EDCCV) is mandatory. The inability to monitor compliance with novel oral anticoagulants (NOACs) raises a potential safety issue. We aimed to evaluate whether a structured, nurse-led assessment of compliance prior to EDCCV ensures safety without the need for routine transoesophageal echocardiography (TOE). METHODS: Data was prospectively collected on consecutive patients undergoing EDCCV during 2014-2015...
September 12, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28956866/-the-importance-of-defining-methodology-for-post-marketing-observational-studies-on-cardiovascular-therapies
#18
Francesco Pelliccia, Francesco Barillà, Gaetano Tanzilli, Nicola Viceconte, Vincenzo Paravati, Enrico Mangieri, Carlo Gaudio
In recent years, a growing number of observational studies in cardiology have been carried out following the criticism that rigid design of randomized clinical trials produces information that is not applicable to the general patient. This approach is very common in several branches of medicine, first of all oncology, but has often been considered marginal in cardiology. The recent introduction of new oral anticoagulants (NOACs) on the market, however, has seen a proliferation of "real-life" studies, drawing the attention of cardiologists to the advantages and limitations of post-marketing studies...
July 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28956288/pharmacological-and-non-pharmacological-treatments-for-stroke-prevention-in-patients-with-atrial-fibrillation
#19
REVIEW
Laura Ueberham, Nikolaos Dagres, Tatjana S Potpara, Andreas Bollmann, Gerhard Hindricks
Atrial fibrillation (AF) is associated with significant risk of stroke and other thromboembolic events, which can be effectively prevented using oral anticoagulation (OAC) with either vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, or edoxaban. Until recently, VKAs were the only available means for OAC treatment. NOACs had similar efficacy and were safer than or as safe as warfarin with respect to reduced rates of hemorrhagic stroke or other intracranial bleeding in the respective pivotal randomized clinical trials (RCTs) of stroke prevention in non-valvular AF patients...
September 27, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28954085/case-report-of-myeloperoxidase-deficiency-associated-with-disseminated-paracoccidioidomycosis-and-peritoneal-tuberculosis
#20
Maurício Domingues-Ferreira, Ariel Levy, Noac Chuffi Barros, Dalton Luis Bertolini, Dewton de Moraes Vasconcelos
Myeloperoxidase (MOP) is present in monocyte and neutrophil lysosomes, catalyzing hydrogen peroxide and chloride ion conversion to hypochlorous acid. MOP seems to destroy pathogens during phagocytosis by neutrophils and is considered an important defense against innumerous bacteria. We present a patient who had MOP deficiency, who presented with a subacute form of paracoccidioidomycosis and later with peritoneal tuberculosis. MOP deficiency leads to the diminished destruction of phagocytized pathogens. This case gives important evidence of an association between MOP deficiency and increased susceptibility to infection by Paracoccidioides brasiliensis and Mycobacterium tuberculosis...
July 2017: Revista da Sociedade Brasileira de Medicina Tropical
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