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https://www.readbyqxmd.com/read/28752255/the-representativeness-of-direct-oral-anticoagulant-clinical-trials-to-hospitalized-patients-with-atrial-fibrillation
#1
Laura Fanning, Jenni Ilomäki, J Simon Bell, Pēteris Dārziņš
PURPOSE: Trials of the direct oral anticoagulants (DOACs) dabigatran, rivaroxaban and apixaban provide the basis for prescribing for the prevention of stroke and systemic embolism in atrial fibrillation (AF). The objective of this study was to assess the representativeness of the three pivotal DOAC randomized controlled trials of dabigatran, rivaroxaban and apixaban for unselected hospitalized patients with AF. METHODS: A cross-sectional study was undertaken. All patients discharged with AF between 2012 and 2015 from a large public hospital network in Melbourne, Australia, were identified...
July 27, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28744136/quick-reference-guide-to-apixaban
#2
REVIEW
Katherine Victoria Hurst, John Matthew O'Callaghan, Ashok Handa
Direct oral anticoagulants (DOACs) are being increasingly used in the clinical setting for patients at risk of venous thromboembolism (VTE) and/or stroke. These medications offer valued benefits for long-term use, including a fast onset of anticoagulation, fixed anticoagulation profile (and consequent prescription of specified doses) and no requirement for routine monitoring. Apixaban is a selective factor Xa inhibitor, approved for use in the prevention of stroke in patients with nonvalvular atrial fibrillation and in the prevention and treatment of acute VTE...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28739198/efficacy-and-safety-of-apixaban-versus-warfarin-in-patients-with-atrial-fibrillation-and-a-history-of-cancer-insights-from-the-aristotle-trial
#3
Chiara Melloni, Allison Dunning, Christopher B Granger, Laine Thomas, Michel G Khouri, David A Garcia, Elaine M Hylek, Michael Hanna, Lars Wallentin, Bernard J Gersh, Pamela S Douglas, John H Alexander, Renato D Lopes
BACKGROUND: Cancer is associated with a prothrombotic state and increases risk of thrombotic events in patients with atrial fibrillation. We described clinical characteristics and outcomes and assessed safety and efficacy of apixaban versus warfarin in patients with atrial fibrillation and cancer in ARISTOTLE. METHODS AND RESULTS: The association between cancer and clinical outcomes was assessed using Cox regression models. At baseline, 1236 (6.8%) patients had a history of cancer; 12...
July 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28645934/repeated-measurements-of-cardiac-biomarkers-in-atrial-fibrillation-and-validation-of-the-abc-stroke-score-over-time
#4
Ziad Hijazi, Bertil Lindahl, Jonas Oldgren, Ulrika Andersson, Johan Lindbäck, Christopher B Granger, John H Alexander, Bernard J Gersh, Michael Hanna, Veli-Pekka Harjola, Elaine M Hylek, Renato D Lopes, Agneta Siegbahn, Lars Wallentin
BACKGROUND: Cardiac biomarkers are independent risk markers in atrial fibrillation, and the novel biomarker-based ABC stroke score (age, biomarkers, and clinical history of prior stroke) was recently shown to improve the prediction of stroke risk in patients with atrial fibrillation. Our aim was to investigate the short-term variability of the cardiac biomarkers and evaluate whether the ABC stroke risk score provides a stable short-term risk estimate. METHODS AND RESULTS: According to the study protocol, samples were obtained at entry and also at 2 months in 4796 patients with atrial fibrillation followed for a median of 1...
June 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28592625/current-clinical-practice-guidelines-for-the-treatment-of-renal-cell-carcinoma-a-systematic-review-and-critical-evaluation
#5
Aristotle Bamias, Bernard Escudier, Cora N Sternberg, Flora Zagouri, Athanasios Dellis, Bob Djavan, Kimon Tzannis, Loukas Kontovinis, Konstantinos Stravodimos, Athanasios Papatsoris, Dionysios Mitropoulos, Charalampos Deliveliotis, Meletios-Athanasios Dimopoulos, Constantine A Constantinides
The landscape of local and systemic therapy of renal cell carcinoma (RCC) is rapidly changing. The increase in the incidental finding of small renal tumors has increased the application of nephron-sparing procedures, while ten novel agents targeting the vascular endothelial growth factor (VEGF) or the mammalian target of rapamycin pathways, or inhibiting the interaction of the programmed death 1 receptor with its ligand, have been approved since 2006 and have dramatically improved the prognosis of metastatic RCC (mRCC)...
June 2017: Oncologist
https://www.readbyqxmd.com/read/28516318/effect-of-apixaban-on-all-cause-death-in-patients-with-atrial-fibrillation-a-meta-analysis-based-on-imputed-placebo-effect
#6
Patrícia O Guimarães, Renato D Lopes, Daniel M Wojdyla, Azmil H Abdul-Rahim, Stuart J Connolly, Greg C Flaker, Junyuan Wang, Michael Hanna, Christopher B Granger, Lars Wallentin, Kennedy R Lees, John H Alexander, John J V McMurray
PURPOSE: Vitamin K antagonists (VKAs) are the standard of care for stroke prevention in patients with atrial fibrillation (AF); therefore, there is not equipoise when comparing newer oral anticoagulants with placebo in this setting. METHODS: To explore the effect of apixaban on mortality in patients with AF, we performed a meta-analysis of apixaban versus placebo using a putative placebo analysis based on randomized controlled clinical trials that compared warfarin, aspirin, and no antithrombotic control...
May 18, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28508233/sentinel-lymph-node-mapping-with-isosulfan-blue-or-indocyanine-green-in-colon-cancer-shows-comparable-results-and-identifies-patients-with-decreased-survival-a-prospective-single-center-trial
#7
Benjamin Weixler, Andreas Rickenbacher, Dimitri Aristotle Raptis, Carsten T Viehl, Ulrich Guller, Jessica Rueff, Andreas Zettl, Markus Zuber
BACKGROUND: Sentinel lymph node (SLN) mapping was reported to improve lymph node staging in colon cancer. This study compares isosulfan blue (IB) with indocyanine green (ICG)-based SLN-mapping and assesses the prognostic value of isolated tumor cells (ITC) and micro-metastases in upstaged patients. METHODS: A total of 220 stage I-III colon cancer patients were included in this prospective single-center study. In 170 patients, SLN-mapping was performed in vivo with IB and in 50 patients ex vivo with ICG...
September 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28355434/economic-analysis-of-apixaban-therapy-for-patients-with-atrial-fibrillation-from-a-us-perspective-results-from-the-aristotle-randomized-clinical-trial
#8
Patricia A Cowper, Shubin Sheng, Renato D Lopes, Kevin J Anstrom, Judith A Stafford, Linda Davidson-Ray, Sana M Al-Khatib, Jack Ansell, Paul Dorian, Steen Husted, John J V McMurray, P Gabriel Steg, John H Alexander, Lars Wallentin, Christopher B Granger, Daniel B Mark
Importance: The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial reported that apixaban therapy was superior to warfarin therapy in preventing stroke and all-cause death while causing significantly fewer major bleeds. To establish the value proposition of substituting apixiban therapy for warfarin therapy in patients with atrial fibrillation, we performed a cost-effectiveness analysis using patient-level data from the ARISTOTLE trial...
May 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28300870/effectiveness-and-safety-of-apixaban-versus-warfarin-in-non-valvular-atrial-fibrillation-patients-in-real-world-clinical-practice-a-propensity-matched-analysis-of-76-940-patients
#9
Xiaoyan Shawn Li, Steve Deitelzweig, Allison Keshishian, Melissa Hamilton, Ruslan Horblyuk, Kiran Gupta, Xuemei Luo, Jack Mardekian, Keith Friend, Anagha Nadkarni, Xianying Pan, Gregory Y H Lip
The ARISTOTLE trial showed a risk reduction of stroke/systemic embolism (SE) and major bleeding in non-valvular atrial fibrillation (NVAF) patients treated with apixaban compared to warfarin. This retrospective study used four large US claims databases (MarketScan, PharMetrics, Optum, and Humana) of NVAF patients newly initiating apixaban or warfarin from January 1, 2013 to September 30, 2015. After 1:1 warfarin-apixaban propensity score matching (PSM) within each database, the resulting patient records were pooled...
June 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28297590/insight-into-illness-and-cognition-in-schizophrenia-in-earlier-and-later-life
#10
Philip Gerretsen, Aristotle N Voineskos, Ariel Graff-Guerrero, Mahesh Menon, Bruce G Pollock, David C Mamo, Benoit H Mulsant, Tarek K Rajji
OBJECTIVE: Impaired insight into illness in schizophrenia is associated with illness severity and deficits in premorbid intellectual function, executive function, and memory. A previous study of patients aged 60 years and older found that illness severity and premorbid intellectual function accounted for variance in insight impairment. As such, we aimed to test whether similar relationships would be observed in earlier life. METHODS: A retrospective analysis was performed on 1 large sample of participants (n = 171) with a DSM-IV-TR diagnosis of schizophrenia aged 19 to 79 years acquired from 2 studies: (1) a psychosocial intervention trial for older persons with schizophrenia (June 2008 to May 2014) and (2) a diffusion tensor imaging and genetics study of psychosis across the life span (February 2007 to December 2013)...
April 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28295799/your-algorithm-might-think-the-hippocampus-grows-in-alzheimer-s-disease-caveats-of-longitudinal-automated-hippocampal-volumetry
#11
Tejas Sankar, Min Tae M Park, Tasha Jawa, Raihaan Patel, Nikhil Bhagwat, Aristotle N Voineskos, Andres M Lozano, M Mallar Chakravarty
Hippocampal atrophy rate-measured using automated techniques applied to structural MRI scans-is considered a sensitive marker of disease progression in Alzheimer's disease, frequently used as an outcome measure in clinical trials. Using publicly accessible data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we examined 1-year hippocampal atrophy rates generated by each of five automated or semiautomated hippocampal segmentation algorithms in patients with Alzheimer's disease, subjects with mild cognitive impairment, or elderly controls...
June 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28267467/anemia-is-associated-with-bleeding-and-mortality-but-not-stroke-in-patients-with-atrial-fibrillation-insights-from-the-apixaban-for-reduction-in-stroke-and-other-thromboembolic-events-in-atrial-fibrillation-aristotle-trial
#12
B Daan Westenbrink, Marco Alings, Christopher B Granger, John H Alexander, Renato D Lopes, Elaine M Hylek, Laine Thomas, Daniel M Wojdyla, Michael Hanna, Matyas Keltai, P Gabriel Steg, Raffaele De Caterina, Lars Wallentin, Wiek H van Gilst
BACKGROUND: Patients with atrial fibrillation (AF) are prone to cardiovascular events and anticoagulation-related bleeding complications. We hypothesized that patients with anemia are at increased risk for these outcomes. METHODS: We performed a post hoc analysis of the ARISTOTLE trial, which included >18,000 patients with AF randomized to warfarin (target international normalized ratio, 2.0-3.0) or apixaban 5 mg twice daily. Multivariable Cox regression analysis was used to determine if anemia (defined as hemoglobin <13...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28185643/oral-triiodothyronine-for-infants-and-children-undergoing-cardiopulmonary-bypass
#13
Eva M Marwali, Cindy E Boom, Novik Budiwardhana, Dicky Fakhri, Poppy S Roebiono, Anwar Santoso, Sudigdo Sastroasmoro, April Slee, Michael A Portman
BACKGROUND: This study evaluated the efficacy and safety of oral triiodothyronine (T3; Tetronine, Dalim BioTech, Korea) for infants and children undergoing cardiopulmonary bypass in an Indonesian population. METHODS: We performed a single-center, randomized, double-blind, and placebo-controlled trial in children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass. We administered oral T3 (1 μg/kg per body weight/dose) or placebo (saccharum lactis) by nasogastric tube every 6 hours for 60 hours after induction of anesthesia...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28096100/efficacy-and-safety-of-apixaban-compared-with-warfarin-in-patients-with-atrial-fibrillation-and-peripheral-artery-disease-insights-from-the-aristotle-trial
#14
Peter T Hu, Renato D Lopes, Susanna R Stevens, Lars Wallentin, Laine Thomas, John H Alexander, Michael Hanna, Basil S Lewis, Freek W A Verheugt, Christopher B Granger, W Schuyler Jones
BACKGROUND: We studied (1) the rates of stroke or systemic embolism and bleeding in patients with atrial fibrillation and peripheral artery disease (PAD) and (2) the efficacy and safety of apixaban versus warfarin in patients with atrial fibrillation with and without PAD. METHODS AND RESULTS: The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial randomized 18 201 patients with atrial fibrillation to apixaban or warfarin for stroke/systemic embolism prevention; 884 (4...
January 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28004413/direct-oral-anticoagulant-use-in-nonvalvular-atrial-fibrillation-with-valvular-heart-disease-a-systematic-review
#15
REVIEW
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
December 22, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27882517/cost-effectiveness-of-apixaban-versus-warfarin-or-aspirin-for-stroke-prevention-in-patients-with-atrial-fibrillation-a-greek-perspective
#16
Kostas Athanasakis, Nadia Boubouchairopoulou, Eleftheria Karampli, Filippos Tarantilis, Paraskevi Savvari, Aikaterini Bilitou, John Kyriopoulos
BACKGROUND: Strokes attributed to atrial fibrillation (AF) represent a major cause of adult disability and a great burden to society and healthcare systems. OBJECTIVES: Our objective was to assess the cost effectiveness of apixaban, a direct acting oral anticoagulant (DOAC), versus warfarin or aspirin for patients with AF in the Greek healthcare setting. METHODS: We used a previously published Markov model to simulate clinical events for patients with AF treated with apixaban, the vitamin K antagonist (VKA) warfarin, or aspirin...
April 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27852444/anticoagulation-therapy-and-clinical-outcomes-in-patients-with-recently-diagnosed-atrial-fibrillation-insights-from-the-aristotle-trial
#17
Patrícia O Guimarães, Daniel M Wojdyla, John H Alexander, Laine Thomas, Marco Alings, Greg C Flaker, Sana M Al-Khatib, Michael Hanna, John D Horowitz, Lars Wallentin, Christopher B Granger, Renato D Lopes
BACKGROUND: Evidence supporting use of antithrombotic therapy in atrial fibrillation (AF) is based mainly on data from patients with permanent, persistent, or paroxysmal AF. Less is known about the risk following a new diagnosis of AF and the efficacy and safety of apixaban in these patients. METHODS: Using data from ARISTOTLE, we assessed the relationship between timing of AF diagnosis and clinical outcomes and the efficacy and safety of apixaban versus warfarin in these patients...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27815232/enhancing-self-efficacy-for-help-seeking-among-transition-aged-youth-in-postsecondary-settings-with-mental-health-and-or-substance-use-concerns-using-crowd-sourced-online-and-mobile-technologies-the-thought-spot-protocol
#18
David Wiljer, Alexxa Abi-Jaoude, Andrew Johnson, Genevieve Ferguson, Marcos Sanches, Andrea Levinson, Janine Robb, Olivia Heffernan, Tyson Herzog, Gloria Chaim, Kristin Cleverley, Gunther Eysenbach, Joanna Henderson, Jeffrey S Hoch, Elisa Hollenberg, Huan Jiang, Wanrudee Isaranuwatchai, Marcus Law, Sarah Sharpe, Tim Tripp, Aristotle Voineskos
BACKGROUND: Seventy percent of lifetime cases of mental illness emerge prior to age 24. While early detection and intervention can address approximately 70% of child and youth cases of mental health concerns, the majority of youth with mental health concerns do not receive the services they need. OBJECTIVE: The objective of this paper is to describe the protocol for optimizing and evaluating Thought Spot, a Web- and mobile-based platform cocreated with end users that is designed to improve the ability of students to access mental health and substance use services...
November 4, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27771008/cost-effectiveness-of-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation-at-high-risk-of-bleeding-and-normal-kidney-function
#19
Inmaculada Hernandez, Kenneth J Smith, Yuting Zhang
INTRODUCTION: The comparative cost-effectiveness of all oral anticoagulants approved up to date has not been evaluated from the US perspective. The objective of this study was to compare the cost-effectiveness of edoxaban 60mg, apixaban 5mg, dabigatran 150mg, dabigatran 110mg, rivaroxaban 20mg and warfarin in stroke prevention in atrial fibrillation patients at high-risk of bleeding (defined as HAS-BLED score≥3). MATERIALS AND METHODS: We constructed a Markov state-transition model to evaluate lifetime costs and quality-adjusted life years (QALYs) with each of the six treatments from the perspective of US third-party payers...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27751896/non-vitamin-k-antagonist-oral-anticoagulants-for-cardioversion-in-atrial-fibrillation-an-updated-meta-analysis
#20
Giulia Renda, Fabrizio Ricci, Raffaele De Caterina
BACKGROUND: Non-vitamin K oral anticoagulants are now proven alternatives to vitamin K antagonists for stroke prevention in atrial fibrillation. However, there are few data on the efficacy and safety of their use for cardioversion, in which the risk of thromboembolic events is heightened. METHODS: We performed a random-effects meta-analysis of patients undergoing both electrical and pharmacologic cardioversion for atrial fibrillation in the RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE AF-TIMI 48, X-VeRT, and ENSURE-AF trials...
April 2017: American Journal of Medicine
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