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Novel Oral Anticoagulants

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https://www.readbyqxmd.com/read/28728316/use-of-novel-oral-anticoagulant-to-treat-pulmonary-thromboembolism-in-patient-with-ulcerative-colitis-superinfected-cytomegalovirus-colitis
#1
Seok Hwan Kim, Sunhee Jang, Yegyu Sung, Jun Kyu Park, Yunjung Park, Jintak Yun, Sang Bum Kang
Crohn's disease and ulcerative colitis are the two major types of inflammatory bowel disease, and affect mainly the gastrointestinal tract but also have extraintestinal sequelae, such as arterial and venous thromboembolism. Thromboembolic complications, particularly pulmonary thromboembolism, can be life threatening and require prompt management with anticoagulants. Conventional vitamin K antagonists have been used for the treatment of thromboembolic complications, but the development of novel oral anticoagulants has shifted the paradigm...
July 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28725275/ash-meeting-2016-developments-in-hemostaseology
#2
REVIEW
Clemens Feistritzer, Birgit Mosheimer
During the annual meeting of the American Society of Hematology (ASH) in San Diego/California, novel developments in the field of hemostaseology were presented. Alternative treatment strategies besides factor replacement were discussed for patients with hemophilia. One of the highlights of the meeting in this year's plenary session was the presentation of successful adeno-associated virus mediated gene transfer in patients with hemophilia B leading to sustained elevation of factor IX:C (FIX:c). Other alternative treatment approaches in patients with hemophilia A may include bispecific antibodies mimicking factor VIIIa (FVIIIa) activity or disrupting anticoagulant proteins...
2017: Memo
https://www.readbyqxmd.com/read/28724512/the-health-buddies-app-as-a-novel-tool-to-improve-adherence-and-knowledge-in-atrial-fibrillation-patients-a-pilot-study
#3
Lien Desteghe, Kiki Kluts, Johan Vijgen, Pieter Koopman, Dagmara Dilling-Boer, Joris Schurmans, Paul Dendale, Hein Heidbuchel
BACKGROUND: Atrial fibrillation (AF) constitutes an important risk for stroke, especially in an ageing population. A new app (Health Buddies) was developed as a tool to improve adherence to non-vitamin K antagonist oral anticoagulants (NOACs) in an elderly AF population by providing a virtual contract with their grandchildren, spelling out daily challenges for both. OBJECTIVE: The aim of this pilot study was to assess the feasibility and usability of the Health Buddies app in AF patients...
July 19, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28721825/biomarkers-associated-with-stroke-risk-in-atrial-fibrillation
#4
Adam Ioannou, Nikolaos Papageorgiou, Debbie Falconer, Onkar Rehal, Emma Sewart, Effimia Zacharia, Konstantinos Toutouzas, Charalampos Vlachopoulos, Gerasimos Siasos, Constantinos Tsioufis, Dimitris Tousoulis
Atrial fibrillation is associated with increased risk for cardioembolic stroke. The risk of cardioembolism is not adequately reduced with the administration of oral anticoagulants, since a number of patients continue to experience thromboembolic events despite receiving anti-thrombotic treatment. Several biomarkers have been proposed to predict cardioembolic stroke in patients with atrial fibrillation. Some of them are already used in the clinical practice, such as D-Dimers, Troponin and brain natriuretic peptide...
July 18, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28713598/development-of-new-deep-venous-thrombosis-while-on-apixaban
#5
Munish Sharma, Sabarina Ramanathan, Koroush Khalighi
The efficacy of novel oral anticoagulants (NOACs) in preventing deep venous thrombosis (DVT) has been established in large multicenter trials. Predictable pharmacokinetics, avoidance of routine laboratory monitoring, and lesser drug interactions have made NOACs safer and more tolerable treatment option in comparison to warfarin. However, cases of treatment failure mainly due to interindividual variation in plasma drug levels can be seen rarely. In this report we describe a case of acute DVT of right lower extremity in a patient who was on apixaban for prevention of venous thromboembolism (VTE) due to underlying nonvalvular atrial fibrillation (NVAF)...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28689334/safety-and-interactions-of-direct-oral-anticoagulants-with-antiarrhythmic-drugs
#6
REVIEW
Ipek Celikyurt, Christoph R Meier, Michael Kühne, Beat Schaer
Direct oral anticoagulants (DOACs) are novel direct-acting medications that are selective for either thrombin or activated factor X. Due to their obvious benefits for patients (fewer interactions, broader therapeutic window, etc.), they are increasingly used as an alternative to warfarin, phenprocoumon, or acenocoumarol. One of the major indications for use of DOACs is stroke prevention in patients with atrial fibrillation (AF). However, interactions still exist, especially in combination with antiarrhythmic drugs (AADs), which are frequently given to AF patients for rhythm or rate control...
July 8, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28688719/how-safe-are-noacs-compared-with-phenprocoumon-after-pulmonary-vein-isolation-with-the-cryoballoon-technique-using-purse-string-suture-closure
#7
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Nikolas Deubner, Harald Greiss, Andreas Hain, Christian W Hamm, Johannes Sperzel, Malte Kuniss, Thomas Neumann
INTRODUCTION: The aim of this observational study was to compare the postprocedural incidence of bleeding and thromboembolic complications associated with novel oral anticoagulants (NOACs) with that of interrupted and continuous phenprocoumon after pulmonary vein isolation (PVI) using a purse-string suture (PSS) closure of the puncture site. METHODS AND RESULTS: Consecutive patients who had undergone PVI via cryoballoon ablation were divided into the following groups: (1) interrupted phenprocoumon with heparin bridging (n=101), (2) continuous phenprocoumon targeting an internationally normalized ratio>2 (n=70), and (3) NOACs without bridging that were restarted 2-4h after the procedure (n=185)...
June 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28687831/risk-of-intraocular-bleeding-with-novel-oral-anticoagulants-compared-with-warfarin-a-systematic-review-and-meta-analysis
#8
Michelle T Sun, Megan K Wood, WengOnn Chan, Dinesh Selva, Prashanthan Sanders, Robert J Casson, Christopher X Wong
Importance: It is unclear if the risk of intraocular bleeding with novel oral anticoagulants differs compared with warfarin. Objective: To characterize the risk of intraocular bleeding with novel oral anticoagulants compared with warfarin. Data Sources: A systematic review and meta-analysis was undertaken in an academic medical setting. MEDLINE and ClinicalTrials.gov were searched for randomized clinical trials published up until August 2016...
July 6, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28684097/an-update-on-anticoagulation-in-atrial-fibrillation
#9
REVIEW
John Amerena, Daryl Ridley
Cerebrovascular accidents related to atrial fibrillation (AF) are potentially preventable with anticoagulation. Until recently, warfarin was the only proven anticoagulant to be effective in stroke prevention, however the novel, direct acting oral anticoagulants (DOACs) are now available, triggering a paradigm shift in treatment philosophy. Today, physicians need to consider in which patients anticoagulation should not be used rather than, as in the past, deciding in which patients it should be used. Although warfarin will continue to have a place in managing some patients with AF, in the future, the DOACs should be the predominant therapy for stroke prevention in patients with non-valvular AF...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28678604/a-post-marketing-assessment-of-major-bleeding-in-total-hip-and-total-knee-replacement-surgery-patients-receiving-rivaroxaban
#10
Louis M Kwong, Alexander G G Turpie, Capt Sally Tamayo, W Frank Peacock, Zhong Yuan, Nicholas Sicignano, Kathleen Pillsbury Hopf, Manesh Patel
BACKGROUND: Rivaroxaban is a novel oral anticoagulant indicated for prophylaxis against deep vein thrombosis and pulmonary embolism in patients undergoing total hip replacement (THR) or total knee replacement (TKR) surgery. OBJECTIVE: To evaluate major bleeding (MB) in THR/TKR patients receiving post-operative rivaroxaban. METHODS: Electronic medical records of nearly 10 million U.S. Department of Defense (DoD) beneficiaries were queried from January 1, 2013 through June 30, 2015...
July 5, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28676032/anticoagulation-in-tuberculosis-patients-not-achieving-a-therapeutic-range-with-vitamin-k-antagonists-a-systematic-review
#11
Marco Fiore, Alberto Enrico Maraolo, Paolo Chiodini, Claudio Cerchione, Ivan Gentile, Guglielmo Borgia, Maria Caterina Pace
Background Approximaly 3% of Tuberculosis (TB) patients have a venous thromboembolic events (VTE). The use of Vitamin K antagonists (VKAs), as anticoagulant, in patients receiving anti TB antimicrobials is often complicated by drug interactions, especially rifampicin. These patients require frequent monitoring of the International Normalized Ratio (INR), and it is reported that warfarin can not achieve a therapeutic INR. In such cases, abruptly stopping the rifampicin once the course of anti TB antimicrobials is not completed is potentially hazardous...
July 3, 2017: Cardiovascular & Hematological Disorders Drug Targets
https://www.readbyqxmd.com/read/28674871/real-life-use-of-rivaroxaban-in-the-netherlands-data-from-the%C3%A2-xarelto-for-prevention-of-stroke-in-patients-with-atrial-fibrillation%C3%A2-xantus-registry
#12
R Pisters, S P G van Vugt, M A Brouwer, A Elvan, W L Ten Holt, P A G Zwart, P Kirchhof, H J G M Crijns, M E W Hemels
BACKGROUND: The Xarelto for Prevention of Stroke in Patients with Atrial Fibrillation (XANTUS) registry investigated the safety and efficacy of the factor Xa inhibitor rivaroxaban. We studied the Dutch XANTUS cohort to a ssess drug safety and prescription patterns in the Netherlands. METHODS: The XANTUS registry was designed as a European prospective, observational study among patients with non-valvular atrial fibrillation. Major bleeding and all-cause mortality were assessed every three months during a 1-year follow-up period...
July 3, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28664799/dabigatran-versus-warfarin-in-patients-with-atrial-fibrillation
#13
Ruth Sander
Atrial fibrillation is associated with an increased risk of ischaemic stroke and mortality. Guidelines recommend non-vitamin K antagonist oral anticoagulants, or novel oral anticoagulants, as first choice of drug. While they do not require the meticulous dose adjustments that are required for warfarin, a clinical evaluation of appropriate dose is still necessary. Age and chronic kidney disease in patients with atrial fibrillation increase the risk of bleeding during anti-thrombotic treatment.
June 30, 2017: Nursing Older People
https://www.readbyqxmd.com/read/28662704/thrombocytopenia-induced-by-dabigatran-two-case-reports
#14
Hyun Goo Kang, Seung Jae Lee, Ji Yeon Chung, Jin Sung Cheong
BACKGROUND: Vitamin K inhibitors (e.g. warfarin) and indirect thrombin inhibitors (e.g. heparin) are widely used to prevent thromboembolic disorders (e.g. myocardial infarction, venous thromboembolism, and stroke). These agents have been mainstays of anticoagulation for people older than 60 years. However, their administration is associated with a risk of bleeding and requires careful monitoring of patients. Novel oral anticoagulants (NOACs), such as dabigatran, are significantly safer in preventing thromboembolism than warfarin and heparin (sporadically causes thrombocytopenia) and are more specific for their target protein, thrombin...
June 29, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28662693/transesophageal-vs-intracardiac-echocardiographic-screening-in-patients-undergoing-atrial-fibrillation-ablation-with-uninterrupted-rivaroxaban
#15
A Tsyganov, A Shapieva, V Sandrikov, S Fedulova, S Mironovich, A Dzeranova, E Lyan
BACKGROUND: Patients with atrial fibrillation (AF) routinely undergo different imaging modalities for the evaluation of the left atrial (LA) appendage to rule out thrombus prior to the AF ablation procedure. Recently, uninterrupted novel oral anticoagulants were introduced for patients undergoing atrial fibrillation (AF) ablation to minimize the peri-procedural thromboembolism risk. We performed a retrospective analysis to evaluate the safety of uninterrupted rivaroxaban and whether transesophageal (TEE) or intracardiac echocardiography (ICE) is necessary for patients undergoing AF ablation...
June 29, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28661896/vitamin-k-antagonists-versus-novel-oral-anticoagulants-for-elective-electrical-cardioversion-of-atrial-fibrillation
#16
Diana Ţînţ, Antoniu O Petriş, Ioana Pop, Rimma Melnic, Andreea-Mihaela Ignat, Liliana M Rogozea
BACKGROUND: The management strategy for patients with atrial fibrillation (AF) is often very complex, electrical cardioversion (EC) being often used to restore sinus rhythm in those patients. The increased risk of thromboembolic complications was lowered using anticoagulation therapy. Usually, the anticoagulation was achieved using vitamin K antagonists (VKAs), but over the last years we witnessed a wide implementation of the novel oral anticoagulants (NOACs). STUDY QUESTION: Study question was to compare the efficacy of NOACs versus VKAs in patients undergoing elective EC for persistent AF, by assessing the presence of left atrial spontaneous contrast and left atrial thrombi (LACS), as well as the occurrence of the thromboembolic events in the first month after the procedure...
April 26, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28647660/novel-oral-anticoagulants-in-patients-undergoing-cranial-surgery
#17
Davide Marco Croci, Maria Kamenova, Raphael Guzman, Luigi Mariani, Jehuda Soleman
BACKGROUND: The number of patients treated with NOACS is increasing. Despite growing clinical relevance, guidelines on the perioperative management of neurosurgical patients treated with NOACS are still lacking. OBJECTIVES: The aim of this study was to analyze the occurrence of postoperative bleeding events and factors which might influence bleeding rates of these patients. METHODS: Out of 1353 consecutive patients undergoing cranial neurosurgical procedures 30 patients (2...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644924/intravenous-thrombolysis-for-acute-ischemic-stroke-a-bridge-between-two-centuries
#18
Georgios Tsivgoulis, Odysseas Kargiotis, Andrei Alexandrov
Intravenous tissue-plasminogen activator (tPA) remains the only approved systemic reperfusion therapy suitable for most patients presenting timely with acute ischemic stroke. Accumulating real-word experience for over 20 years regarding tPA safety and effectiveness lead to re-appraisal of original contraindications for intravenous thrombolysis (IVT). Areas covered: This narrative review focuses on fast yet appropriate selection of patients for safe administration of tPA per recently expanded indications. Novel strategies for rapid patient assessment will be discussed...
June 23, 2017: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/28643004/effectiveness-and-safety-of-apixaban-therapy-in-daily-care-patients-with-atrial-fibrillation-results-from-the-dresden-noac-registry
#19
Sindy Helmert, Sandra Marten, Heike Mizera, Antje Reitter, Kurtulus Sahin, Luise Tittl, Jan Beyer-Westendorf
The effectiveness and safety of apixaban for stroke prevention in atrial fibrillation (SPAF) demonstrated in ARISTOTLE needs to be confirmed in daily care. To evaluate effectiveness and safety of apixaban therapy in SPAF patients in daily care, we used data from an ongoing, prospective, non-interventional registry of more than 3000 patients on novel oral anticoagulants in daily care. Between 1 December 2012 and 31 August 2015, 514 patients receiving apixaban were enrolled. During a mean follow-up of 803.5 ± 228...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28637460/healthcare-utilization-and-costs-for-patients-initiating-dabigatran-or-warfarin
#20
Shannon L Reynolds, Sameer R Ghate, Richard Sheer, Pranav K Gandhi, Chad Moretz, Cheng Wang, Stephen Sander, Mary E Costantino, Srinivas Annavarapu, George Andrews
BACKGROUND: Novel oral anticoagulants (NOAC) such as dabigatran, when compared to warfarin, have been shown to potentially reduce the risk of stroke in patients with non-valvular atrial fibrillation (NVAF) together with lower healthcare resource utilization (HCRU) and similar total costs. This study expands on previous work by comparing HCRU and costs for patients newly diagnosed with NVAF and newly initiated on dabigatran or warfarin, and is the first study specifically in a Medicare population...
June 21, 2017: Health and Quality of Life Outcomes
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