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https://www.readbyqxmd.com/read/28346967/anticoagulation-therapy-in-children
#1
Vlad Calin Radulescu
Venous thromboembolism (VTE) is very uncommon in children and adolescents compared with older adults, though its incidence has significantly increased over the past two decades. Given the rarity of the condition, the data on pediatric VTE lag behind the adult experience and consequently the management of VTE in children is, in large part, modeled on the adult strategies. This approach has certain limitations, given that young children have developmental particularities of the hemostatic system and differences in the pharmacokinetics and pharmacodynamics of various anticoagulant agents...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28346965/point-of-care-coagulation-tests-monitoring-of-direct-oral-anticoagulants-and-their-reversal-therapy-state-of-the-art
#2
Giacomo E Iapichino, Paolo Bianchi, Marco Ranucci, Ekaterina Baryshnikova
Direct oral anticoagulants (DOACs) exert similar anticoagulant effects to vitamin K antagonists and are increasingly used worldwide. Nevertheless, an evidence-based approach to patients receiving DOACs when any unplanned urgent surgery or bleeding (either spontaneous or traumatic) occurs is still missing. In this review, we investigate the role of point-of-care coagulation tests when other, more specific tests are not available. Indeed, thromboelastography and activated clotting time can detect dabigatran-induced coagulopathy, while their accuracy is limited for apixaban and rivaroxaban, mostly in cases of low drug plasma concentrations...
March 27, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28344132/management-of-anticoagulants-and-antiplatelet-agents-during-colonoscopy
#3
REVIEW
Linda Anne Feagins
Colonoscopy frequently is performed for patients who are taking aspirin, NSAIDs, antiplatelet agents and other anticoagulants. These colonoscopies often involve polypectomy, which can be complicated by bleeding. The risks of precipitating thromboembolic complications if anticoagulants are stopped must be weighed against the risk of postpolypectomy bleeding if these agents are continued. This article systematically reviews the management of anticoagulation during elective and emergency colonoscopy. For patients undergoing colonoscopic polypectomy, the overall of risk of postpolypectomy bleeding is less than 0...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28343849/oral-anticoagulant-therapy-for-older-patients-with-atrial-fibrillation-a-review-of-current-evidence
#4
REVIEW
Mario Bo, Enrica Grisoglio, Enrico Brunetti, Yolanda Falcone, Niccolò Marchionni
Atrial fibrillation is more frequent in older patients, who have a higher risk of cardioembolic stroke and thromboembolism. Oral anticoagulant therapy is the standard of treatment for stroke prevention; however, under-prescription is still very common in older patients. The reasons underlying this phenomenon have not been systematically investigated, and true contraindications only partially account for it. An intimate skepticism on the real benefit-risk balance of oral anticoagulant therapy in the oldest patients seems to derive from the fact that most studies supporting it were conducted decades ago and included younger patients, with overall better functional and clinical status...
March 24, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28343719/thromboprophylaxis-after-knee-arthroscopy-out-of-the-maze
#5
Giuseppe Lippi, Gianfranco Cervellin
The use of thromboprophylaxis after knee arthroplasty is heterogeneous among orthopedic surgeons. Two recent studies showed that low molecular weight heparin is not effective for preventing venous thromboembolism, whereas thrombotic episodes may be significantly reduced using direct oral anticoagulants, thus opening an interesting perspective for periprocedural management of knee arthroscopy.
March 23, 2017: Trends in Pharmacological Sciences
https://www.readbyqxmd.com/read/28337750/efficacy-and-safety-of-the-drugs-used-to-reverse-direct-oral-anticoagulants-a-systematic-review-and-meta-analysis
#6
REVIEW
Luis Teodoro da Luz, Mylene Marchand, Bartolomeu Nascimento, Homer Tien, Avery Nathens, Prakesh Shah
BACKGROUND: Direct oral anticoagulants (DOACs) are effective and safe for prophylaxis and treatment of thromboembolic phenomena. However, managing DOACs during bleeding emergencies is challenging. A systematic review and meta-analysis was conducted on studies addressing efficacy and safety of the drugs used for reversal of DOACs. STUDY DESIGN AND METHODS: Medline, Embase, Cochrane Library, and ClinicalTrials.gov were searched up to September 2016. Studies that examined clinical and laboratory effects of drugs used to reverse DOACs were included...
March 24, 2017: Transfusion
https://www.readbyqxmd.com/read/28337024/angiotensin-ii-promotes-the-anticoagulant-effects-of-rivaroxaban-via-angiotensin-type-2-receptor-signaling-in-mice
#7
Dan Yang, Junjie Shao, Ruifeng Hu, Haimei Chen, Ping Xie, Chang Liu
Rivaroxaban is an oral direct factor Xa inhibitor approved for the treatment of stroke and systemic thromboembolism in patients with non-valvular atrial fibrillation. Despite its efficacy, rivaroxaban therapy results in adverse effects and complications, such as bleeding. Angiotensin II (AngII) is implicated in many cardiovascular conditions, such as hypertension and heart failure. In this study, we investigate whether AngII influences anticoagulant effects of rivaroxaban by using an experimental mouse model with type 2 diabetes mellitus and advanced glycation end product (AGE)-exposed human umbilical vein endothelial cells (HUVECs)...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28336758/evaluation-of-a-pharmacist-led-outpatient-direct-oral-anticoagulant-service
#8
Emily Ashjian, Brian Kurtz, Elizabeth Renner, Robert Yeshe, Geoffrey D Barnes
PURPOSE: The impact of a pharmacist-led direct oral anticoagulant (DOAC) service on prescription appropriateness and patient adherence was simultaneously evaluated. METHODS: In this retrospective analysis, patients age 18 years or older for whom a DOAC was prescribed from September 20, 2013, through December 31, 2014, were identified through electronic medical record review of all DOAC prescriptions within the University of Michigan Health System. Patients had their DOAC therapy managed by a pharmacist-led DOAC service or by their physician (usual care)...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#9
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
March 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28331354/utilization-and-prescribing-patterns-of-direct-oral-anticoagulants
#10
Maegan M Whitworth, Krystal K Haase, David S Fike, Ravindra M Bharadwaj, Rodney B Young, Eric J MacLaughlin
BACKGROUND: Scant literature exists evaluating utilization patterns for direct oral anticoagulants (DOACs). OBJECTIVES: The primary objective was to assess DOAC prescribing in patients with venous thromboembolism (VTE) and nonvalvular atrial fibrillation (NVAF) in outpatient clinics. Secondary objectives were to compare utilization between family medicine (FM) and internal medicine (IM) clinics, characterize potentially inappropriate use, and identify factors associated with adverse events (AEs)...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28328524/paramagnetic-micro-particles-as-a-tool-for-rapid-quantification-of-apixaban-dabigatran-edoxaban-and-rivaroxaban-in-human-plasma-by-uhplc-ms-ms
#11
Martin H J Wiesen, Cornelia Blaich, Thomas Streichert, Guido Michels, Carsten Müller
BACKGROUND: Assessment of the anticoagulant activity of direct oral anticoagulants (DOACs) is justified in special clinical situations. Here, we evaluated two independent extraction methods and developed a multi-analyte ultra-high performance liquid chromatography tandem mass (UHPLC-MS/MS) method for the quantification of apixaban, dabigatran, edoxaban and rivaroxaban in human plasma. METHODS: Routine extraction based on protein precipitation with acetonitrile and subsequent centrifugation was compared to sample clean-up using commercial paramagnetic micro-particles and subsequent magnetic depletion...
March 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28326589/risk-of-myocardial-infarction-in-patients-with-atrial-fibrillation-using-vitamin-k-antagonists-aspirin-or-direct-acting-oral-anticoagulants
#12
Leo M Stolk, Frank de Vries, Chiel Ebbelaar, Anthonius de Boer, Tom Schalekamp, Patrick Souverein, Arina Ten Cate-Hoek, Andrea M Burden
AIM: Direct-acting oral anticoagulants (DOACs) have become available for the prevention of stroke in patients with atrial fibrillation (AF). Conflicting results have been published on the risk of acute myocardial infarction (AMI) with the use of DOACs in comparison with vitamin K antagonists (VKAs). The objective of the present study was to evaluate the risk of AMI in patients with AF who are exposed to either VKAs, DOACs or low-dose (< 325 mg) aspirin. METHODS: We conducted a population-based cohort study using data from the Clinical Practice Research Datalink (2008-2014)...
March 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28320002/review-in-af-direct-oral-anticoagulants-reduce-all-cause-and-vascular-mortality-compared-with-warfarin
#13
Eric R Bates
No abstract text is available yet for this article.
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28319471/early-secondary-prevention-after-initially-ineffective-revascularization-treatments-for-acute-ischemic-stroke-due-to-tandem-occlusion
#14
Stefano Forlivesi, Elia Pancheri, Giuseppe Moretto, Paolo Bovi, Manuel Cappellari
The most effective treatment of patients with stroke due to tandem occlusion is still unclear. We report the case of a man with stroke due to tandem internal carotid artery/middle cerebral artery occlusion, who underwent initially ineffective intravenous thrombolysis (IVT) and endovascular treatment. Early anticoagulation with apixaban was started after 48 h of IVT, given a newly diagnosed nonvalvular atrial fibrillation. Spontaneous partial recanalization of the cervical internal carotid artery was noted, and carotid endarterectomy was performed 72 h after IVT and 8 h after the last dose of apixaban...
March 17, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28314985/the-role-of-new-oral-anticoagulants-in-orthopaedics-an-update-of-recent-evidence
#15
REVIEW
Dimitrios V Papadopoulos, Ioannis Kostas-Agnantis, Ioannis Gkiatas, Andreas G Tsantes, Panagiota Ziara, Anastasios V Korompilias
Rivaroxaban, dabigatran, apixaban and edoxaban are the four available new oral anticoagulants (NOAC) which are currently approved for venous thromboembolism prophylaxis after total hip and knee replacement. Large phase 3 and phase 4 studies comparing NOAC with low molecular weight heparins have shown similar results regarding the efficacy and safety of these two categories of anticoagulants. Management of bleeding complications is a matter of great significance. Three reversal agents have been developed: idarucizumab, andexanet alfa and ciraparantag...
March 17, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28304137/influence-of-apixaban-on-commonly-used-coagulation-assays-results-from-the-belgian-national-external-quality-assessment-scheme
#16
M Van Blerk, E Bailleul, B Chatelain, A Demulder, K Devreese, J Douxfils, M Jacquemin, K Jochmans, F Mullier, W Wijns, B China, K Vernelen, M R Soumali
INTRODUCTION: The Belgian national External Quality Assessment Scheme performed a survey to assess the effect of the direct oral anticoagulant apixaban on the coagulation assays prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and antithrombin as performed with a large number of reagent/instrument combinations. METHODS: Four lyophilized plasma samples spiked with apixaban (0, 41, 94 and 225 ng/mL) were sent to the 195 Belgian and Luxembourg clinical laboratories performing coagulation testing...
March 17, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28301915/emerging-role-of-direct-oral-anticoagulants-in-the-management-of-heparin-induced-thrombocytopenia
#17
Phu Ngoc Tran, Minh-Ha Tran
Heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia with thrombosis (HITT) are rare but potentially limb- and life-threatening complications of heparin therapy. Continuation of heparin or low-molecular-weight heparin is contraindicated due to platelet activation in the presence of (heparin-dependent) HIT antibodies. Primary treatment options currently include argatroban, fondaparinux, or bivalirudin. However, the parenteral administration routes and interference of argatroban with traditional coagulation markers complicate management...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28298749/perioperative-considerations-and-management-of-patients-receiving-anticoagulants
#18
REVIEW
Safiya Imtiaz Shaikh, R Vasantha Kumari, Ganapati Hegade, M Marutheesh
Anticoagulants remain the primary strategy for the prevention and treatment of thrombosis. Unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, and warfarin have been studied and employed extensively with direct thrombin inhibitors typically reserved for patients with complications or those requiring interventions. Novel oral anticoagulants have emerged from clinical development and are expected to replace older agents with their ease to use and more favorable pharmacodynamic profiles...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296069/thrombotic-and-bleeding-outcomes-following-perioperative-interruption-of-direct-oral-anticoagulants-in-patients-with-venous-thromboembolic-disease
#19
J Shaw, C de Wit, G Le Gal, M Carrier
BACKGROUND: Direct Oral Anticoagulants (DOACs) are increasingly being used in the setting of venous thromboembolic disease (VTE). There is little evidence to guide the peri-procedural interruption of DOACs in this patient population. A number of studies have evaluated the perioperative interruption of DOACs based on half-life of the anticoagulant and the underlying procedural bleeding risk in patient with atrial fibrillation, but it remains unclear whether these findings can be extended to patients with VTE...
March 12, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28295882/identifying-atrial-fibrillation-in-outpatients-initiating-oral-anticoagulants-based-on-medico-administrative-data-results-from-the-french-national-healthcare-databases
#20
Cécile Billionnet, François Alla, Éric Bérigaud, Antoine Pariente, Géric Maura
PURPOSE: Identifying atrial fibrillation (AF) in outpatients treated with oral anticoagulants (OACs) from claims databases is challenging when the outpatient indication is not available, as OACs are also prescribed for deep vein thrombosis/pulmonary embolism (DVT/PE) that may be treated in the ambulatory setting. An algorithm was developed to identify AF in outpatients initiating OAC from medico-administrative data. METHODS: Among patients initiating OAC in 2013 in the French healthcare databases, those treated for orthopaedic indications were excluded...
March 14, 2017: Pharmacoepidemiology and Drug Safety
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