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https://www.readbyqxmd.com/read/29681367/effectiveness-and-safety-of-direct-oral-anticoagulants-and-warfarin-stratified-by-stroke-risk-in-patients-with-atrial-fibrillation
#1
Inmaculada Hernandez, Yuting Zhang, Samir Saba
The objective of the study was to examine how the comparative effectiveness and safety of direct oral anticoagulants (DOACs) and warfarin differ across subgroups of patients with atrial fibrillation defined by stroke risk (CHA2DS2-VASc score ≤3, 4 to 5, ≥6). Using Medicare claims data, we identified patients newly diagnosed with atrial fibrillation in 2013 to 2014 who initiated warfarin (n=12,354), apixaban (n=2,358), dabigatran (n=1,415), or rivaroxaban (n=5,139), and categorized them according to their CHA2DS2-VASc score (≤3, 4 to 5, ≥6)...
March 28, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29679144/antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-should-we-change-our-practice-after-the-pioneer-af-pci-and-re-dual-pci-trials
#2
D Duerschmied, J Brachmann, H Darius, N Frey, H A Katus, W Rottbauer, A Schäfer, H Thiele, C Bode, Uwe Zeymer
The number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2 DS2 -VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known...
April 20, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29672182/oral-anticoagulant-use-in-cardiovascular-disorders-a-perspective-on-present-and-potential-indications-for-rivaroxaban
#3
A John Camm, Keith A A Fox
BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) have been approved for use in various cardiovascular indications. The direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors apixaban, edoxaban, and rivaroxaban are now increasingly used in clinical practice. For some of these agents, available data from real-world studies support the efficacy and safety data in phase III clinical trials. OBJECTIVES: This review aims to summarize the current status of trials and observational studies of oral anticoagulant use over the spectrum of cardiovascular disorders (excluding venous thrombosis), provide a reference source beyond stroke prevention for atrial fibrillation (AF) and examine the potential for novel applications in the cardiovascular field...
April 19, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29671011/-rectal-bleeding-in-a-60-year-old-woman-under-anticoagulation-and-platelet-aggregation-inhibition
#4
J Pohlan, N Willamowski, C Jürgensen, E Zimmermann, M Möckel
CASE REPORT: We report on a woman with lower gastrointestinal bleeding under effective oral anticoagulation with both phenprocoumon and apixaban (with intention to switch to the latter) as well as the antiplatelet agent acetylsalicylic acid for aortic bifurcation kissing stents after stent thrombosis. Our patient presented with weakness and rectal bleeding. Upon examination, she looked anemic and had sinus tachycardia (104 beats per minute). The digital rectal examination revealed bright red blood mixed with clots...
April 18, 2018: Der Internist
https://www.readbyqxmd.com/read/29670777/iatrogenic-spinal-subdural-hematoma-due-to-apixaban-a-case-report-and-review-of-the-literature
#5
Alba Colell, Adrià Arboix, Francesco Caiazzo, Elisenda Grivé
In the last decade, the clinical relevance for developing safer oral anticoagulants prompted the development of new classes of drugs that have shown a lower risk of life-threatening bleeding events as compared to standard warfarin. Nontraumatic spinal subdural hematoma is an uncommon urgent complication that can be associated with the use of these agents. An unusual case of spinal subdural hematoma related to apixaban treatment for nonrheumatic atrial fibrillation is reported here.
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29664236/use-of-non-vitamin-k-antagonist-oral-anticoagulants-2008-2016-a-danish-nationwide-cohort-study
#6
Simone Haastrup, Maja Hellfritzsch, Lotte Rasmussen, Anton Pottegård, Erik Lerkevang Grove
We aimed to provide detailed utilization data on the total use of non-vitamin K antagonist oral anticoagulants (NOACs) since their introduction in 2008. Using the nationwide Danish National Prescription Registry, we identified all individuals filling prescriptions for NOACs 2008-2016. We reported the development in incident and prevalent users and explored baseline characteristics and treatment persistence according to treatment indication. A total of 126,691 NOAC users were identified within the Danish population of 5...
April 17, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29662871/cancer-associated-phlegmasia-cerulea-dolens-successfully-treated-with-apixaban
#7
Irene García-Fernández-Bravo, Pablo Demelo-Rodríguez, Lucia Ordieres-Ortega, Arturo Álvarez-Luque, Jorge Del Toro-Cervera
No abstract text is available yet for this article.
March 2018: Blood Research
https://www.readbyqxmd.com/read/29662292/post-polypectomy-bleeding-and-thromboembolism-risks-associated-with-warfarin-vs-direct-oral-anticoagulants
#8
Naohiro Yanagisawa, Naoyoshi Nagata, Kazuhiro Watanabe, Tatsuhiro Iida, Mariko Hamada, Sakurako Kobayashi, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
AIM: To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants (DOAC). METHODS: We collected data from 218 patients receiving oral anticoagulants (73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics (age- and sex-matched controls) who underwent polypectomy. (1) We evaluated post-polypectomy bleeding (PPB) risk in patients receiving warfarin or DOAC compared with controls; (2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge (HPB) (endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29659797/apixaban-compared-to-heparin-vitamin-k-antagonist-in-patients-with-atrial-fibrillation-scheduled-for-cardioversion-the-emanate-trial
#9
Michael D Ezekowitz, Charles V Pollack, Jonathan L Halperin, Richard D England, Sandra VanPelt Nguyen, Judith Spahr, Maria Sudworth, Nilo B Cater, Andrei Breazna, Jonas Oldgren, Paulus Kirchhof
Aim: The primary objective was to compare apixaban to heparin/vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) and ≤48 h anticoagulation prior to randomization undergoing cardioversion. Methods: One thousand five hundred patients were randomized. The apixaban dose of 5 mg b.i.d. was reduced to 2.5 mg b.i.d. in patients with two of the following: age ≥ 80 years, weight ≤ 60 kg, or serum creatinine ≥ 133 µmol/L...
April 6, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29643143/spontaneous-rectus-sheath-haematoma-due-to-cough-on-apixaban
#10
Kalaimani Elango, Swetha Murthi, Joe Devasahayam, Kulothungan Gunasekaran
No abstract text is available yet for this article.
April 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29629262/thrombolysis-followed-by-apixaban-for-massive-pulmonary-embolism-and-free-floating-thrombus-in-right-ventricle-in-a-patient-with-breast-cancer
#11
Sergio Fasullo, Nicola Morabito, Sergio Cannizzaro, Gioacchino Cosenza, Vito Pinto, Filippo Ganci, Sebastiano Scalzo, Stefania Davi, Giorgio Maringhini
Free-floating thrombus in the right ventricle, associated with a massive acute pulmonary embolism (PE), is a rare phenomenon. PE is an important clinical entity with considerable mortality despite advances in diagnosis and treatment. The prognosis of PE depends on right ventricular dysfunction, myocardial injury markers, and early treatment. In this report, we present the case of a 71-year-old woman with a history of breast cancer admitted to intensive care unit for PE complicated by syncope. Although our case may seem complex because it is not represented in the guidelines, the result was satisfactory and showed how treatment with new anticoagulants (in this case apixaban) after massive thrombolysis of PE could be considered and included in the new guidelines...
January 2018: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/29628941/early-outcome-after-intracranial-hemorrhage-related-to-non-vitamin-k-oral-anticoagulants
#12
Senta Frol, Janja Pretnar Oblak
Background: Intracranial hemorrhage (ICH) is a serious, life-threatening, but fortunately rare complication of non-vitamin K oral anticoagulant (NOAC) therapy. There are limited data on NOAC-related ICH prognosis. Methods: All consecutive patients admitted to a single center due to acute NOAC-related ICH from September 2012 until the beginning of 2017 were included. Risk factors, type of NOAC, and location of ICH were evaluated. Risk for ischemic and bleeding events and clinical status upon admission and at discharge were evaluated using standard scales...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29627719/interference-of-doacs-in-different-drvvt-assays-for-diagnosis-of-lupus-anticoagulants
#13
T Flieder, M Weiser, Th Eller, M Dittrich, K von Bargen, S Alban, J Kuhn, C Knabbe, I Birschmann
OBJECTIVE: Determination of lupus anticoagulants (LA) is an important, but still challenging test in the diagnosis of antiphospholipid syndrome (APS). This is especially the case in patients using one of the direct oral anticoagulants (DOACs). The aim of our study was to examine the influence of these drugs on DRVVT assays from two companies (in each case: screening test, confirming test and calculated ratio) and on aPTT and lupus-sensitive aPTT. METHODS: We used plasma samples from healthy volunteers spiked with the DOACs dabigatran, rivaroxaban and apixaban (0, 10, 30, 50, 100 ng/mL) for testing...
March 21, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29627150/postoperative-bleeding-risk-of-direct-oral-anticoagulants-after-oral-surgery-procedures-a-systematic-review-and-meta-analysis
#14
REVIEW
C Bensi, S Belli, D Paradiso, G Lomurno
Direct oral anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban; DOACs) have been introduced to improve safety and superior therapeutic value compared to their predecessors such as warfarin or enoxaparin. The aim of this systematic review and meta-analysis was to assess the postoperative bleeding risk of DOACs during oral surgery procedures. Systematic searches were performed in electronic databases including PubMed, Scopus, Web of Science and Cochrane Library. Thirteen studies were included in the qualitative synthesis: two retrospective case-control studies, five prospective case-control studies, three cross-sectional studies, two case series and a case report; while only six studies were statistically analysed...
April 4, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29626281/hospital-length-of-stay-in-patients-initiated-on-direct-oral-anticoagulants-versus-warfarin-for-venous-thromboembolism-a-real-world-single-center-study
#15
Hisham Badreldin
This study was conducted to describe the real-world hospital length of stay in patients treated with all of the U.S. Food and Drug Administration approved direct oral anticoagulants (DOACs) versus warfarin for new-onset venous thromboembolism (VTE) at a large, tertiary, academic medical center. A retrospective cohort analysis of all adult patients diagnosed with acute onset VTE was conducted. Of the 441 patients included, 261 (57%) patients received DOACs versus 180 (41%) patients received warfarin. In the DOAC group, a total of 92 (35%) patients received rivaroxaban, followed by 83 (32%) patients received apixaban, 50 (19%) patients received dabigatran, and 36 (14%) patients received edoxaban...
April 6, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29623236/does-use-of-oral-anticoagulants-at-the-time-of-admission-affect-outcomes-following-hip-fracture
#16
Ariana Lott, Jack Haglin, Rebekah Belayneh, Sanjit R Konda, Philipp Leucht, Kenneth A Egol
Purpose: The purpose of this study was to compare hospital quality outcomes in patients over the age of 60 undergoing fixation of hip fracture based on their anticoagulation status. Materials and Methods: Patients aged 60 and older with isolated hip fracture injuries treated operatively at 1 academic medical center between October 2014 and September 2016 were analyzed. Patients on the following medications were included in the anticoagulation cohort: warfarin, clopidogrel, aspirin 325 mg, rivaroxaban, apixaban, dabigatran, and dipyridamole/aspirin...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29622587/efficacy-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-asians-with-nonvalvular-atrial-fibrillation
#17
Yi-Hsin Chan, Lai-Chu See, Hui-Tzu Tu, Yung-Hsin Yeh, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Chun-Li Wang, Chang-Fu Kuo, Chi-Tai Kuo
BACKGROUND: Whether non-vitamin K antagonist oral anticoagulants (NOACs) are superior to warfarin among Asians with nonvalvular atrial fibrillation remains unclear. METHODS AND RESULTS: In this nationwide retrospective cohort study collected from Taiwan National Health Insurance Research Database, there were 5843, 20 079, 27 777, and 19 375 nonvalvular atrial fibrillation patients taking apixaban, dabigatran, rivaroxaban and warfarin, respectively, from June 1, 2012 to December 31, 2016...
April 5, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29622509/impact-of-bmi-on-clinical-outcomes-of-noac-therapy-in-daily-care-results-of-the-prospective-dresden-noac-registry-nct01588119
#18
L Tittl, S Endig, S Marten, A Reitter, I Beyer-Westendorf, J Beyer-Westendorf
Direct acting non-Vitamin K antagonist oral anticoagulants (NOAC) are characterized by a fixed dosing regimen. Despite the potential for relative underdosing due to large distribution volumes, dose adjustments for patients with high body mass index (BMI) are not recommended. Since efficacy and safety data in obese patients are scarce, we evaluated the impact of BMI on clinical outcomes in daily care patients treated with NOAC for stroke prevention in atrial fibrillation or venous thromboembolism. Using prospectively collected data from a non-interventional registry, cardiovascular (CV), major bleeding events (MB) and all-cause mortality were evaluated according to BMI classes...
March 14, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29621248/adherence-to-rivaroxaban-versus-apixaban-among-patients-with-non-valvular-atrial-fibrillation-analysis-of-overall-population-and-subgroups-of-prior-oral-anticoagulant-users
#19
Colleen A McHorney, Concetta Crivera, François Laliberté, Guillaume Germain, Willy Wynant, Patrick Lefebvre
BACKGROUND: Medication non-adherence can result in poor health outcomes. Understanding differences in adherence rates to non-vitamin K oral anticoagulants (NOACs) could guide treatment decisions and improve clinical outcomes among patients with non-valvular atrial fibrillation (NVAF). OBJECTIVE: To compare adherence to rivaroxaban and apixaban among the overall NVAF population and subgroups of prior oral anticoagulant (OAC) users (e.g., multiple comorbidities, non-adherence risk factors)...
2018: PloS One
https://www.readbyqxmd.com/read/29616407/a-meta-summary-of-case-reports-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-left-ventricular-thrombus
#20
Aloysius Sheng-Ting Leow, Ching-Hui Sia, Benjamin Yong-Qiang Tan, Joshua Ping-Yun Loh
Left ventricular (LV) thrombus is commonly seen in patients with extensive anterior ST-elevation myocardial infarction. The standard of care for LV thrombus is anticoagulation with warfarin. However, there has been an increasing trend of case reports using non-vitamin K antagonist oral anticoagulants (NOAC) for the treatment of LV thrombus. This study aimed to perform a meta-summary of the literature to characterise and evaluate the safety and feasibility of using NOAC in patients with LV thrombus. We searched for articles published in four electronic databases: PubMed, EMBASE, Scopus and Google Scholar using an appropriate keyword/MeSH term search strategy...
April 3, 2018: Journal of Thrombosis and Thrombolysis
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