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https://www.readbyqxmd.com/read/29034832/new-advances-in-atrial-fibrillation-management-the-role-of-apixaban
#1
Giuseppe Mc Rosano, Ilaria Spoletini, Walter Gianni, Cristiana Vitale
Prevention of stroke is a pivotal intervention in the management of patients with atrial fibrillation (AF) at increased risk of systemic embolism. Because of the difficulties of safely implementing Vitamin K Antagonists in all patients, there has been a growing interest in improving the pharmacological management of AF, with newer antithrombotic agents. The new oral anticoagulants (NOACs) have been developed to overcome the limitations and improve the efficacy of the conventional oral anticoagulant drugs. Among the NOACs, apixaban - a very specific antagonist of activated factor Xa - has pharmacokinetic and pharmacodynamic properties that allow significant efficacy in AF management...
October 12, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/29034033/novel-anticoagulant-therapy-of-venous-thromboembolism-current-status-and-future-directions
#2
REVIEW
Mashio Nakamura, Norikazu Yamada, Masaaki Ito
The first-line treatment of venous thromboembolisms (VTE) is anticoagulant therapy, and unfractionated heparin and warfarin are used in Japan. However, as both drugs require dosage adjustments that are difficult, VTE recurrences occur relatively frequently, and hemorrhagic complications are extremely common. The parenteral factor Xa inhibitor fondaparinux and the direct oral anticoagulants (DOACs) edoxaban, rivaroxaban, and apixaban have recently become available as treatments for VTE in Japan. These novel anticoagulants have more stable effects than traditional therapies and are thus considered safer and more effective than the traditional agents...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29033229/analysis-of-recurrent-stroke-volume-and-prognosis-between-warfarin-and-four-non-vitamin-k-antagonist-oral-anticoagulants-administration-for-secondary-prevention-of-stroke
#3
Yukie Kanai, Hiroaki Oguro, Nao Tahara, Hanako Matsuda, Hiroyuki Takayoshi, Shingo Mitaki, Keiichi Onoda, Shuhei Yamaguchi
OBJECTIVE: We investigated recurrent stroke volume with nonvalvular atrial fibrillation (NVAF) patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) about clinical backgrounds and number of recurrent stroke. METHODS: We administered 4 NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban in 101 postcardioembolic strokes with NVAF. In a retrospective study, we measured recurrent stroke volume with magnetic resonance imaging volumetric software and compared them between 10 vitamin K anticoagulant (VKA: warfarin) cases and 13 NOAC cases under anticoagulant therapy...
October 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29032872/assessing-bleeding-risk-in-patients-with-intentional-overdoses-of-novel-antiplatelet-and-anticoagulant-medications
#4
Michael Levine, Michael C Beuhler, Anthony Pizon, F Lee Cantrel, Meghan B Spyres, Frank LoVecchio, Aaron B Skolnik, Daniel E Brooks
STUDY OBJECTIVE: In recent years, the use of novel anticoagulants and antiplatelet agents has become widespread. Little is known about the toxicity and bleeding risk of these agents after acute overdose. The primary objective of this study is to evaluate the relative risk of all bleeding and major bleeding in patients with acute overdose of novel antiplatelet and anticoagulant medications. METHODS: This study is a retrospective study of acute ingestion of apixaban, clopidogrel, ticlopidine, dabigatran, edoxaban, prasugrel, rivaroxaban, and ticagrelor reported to 7 poison control centers in 4 states during a 10-year span...
October 9, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29029905/perioperative-complications-with-new-oral-anticoagulants-dabigatran-apixaban-and-rivaroxaban-in-mohs-micrographic-surgery-a-retrospective-study
#5
Camila Antia, Natalie Hone, Hugh Gloster
No abstract text is available yet for this article.
November 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29025267/direct-oral-anticoagulants-in-cardioversion-a-review-of-current-evidence
#6
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/29023465/in-vitro-effects-of-apixaban-on-5-different-cancer-cell-lines
#7
Luigina Guasti, Alessandro Squizzato, Paola Moretto, Davide Vigetti, Walter Ageno, Francesco Dentali, Andrea M Maresca, Leonardo Campiotti, Anna M Grandi, Alberto Passi
BACKGROUND: Cancer is associated with hypercoagulability. However, several data suggest that anticoagulant drugs may have an effect on tumor development and progression mediated by both coagulation dependent processes and non-coagulation dependent processes. Therefore, we investigated the in vitro effects of Apixaban on cell proliferation, mortality, cell migration, gene expression and matrix metalloproteinase in 5 different cancer cell lines. METHODS: The following cancer cell lines, and 2 normal fibroblast cultures (lung and dermal fibroblasts), were studied: OVCAR3 (ovarian cancer), MDA MB 231 (breast cancer), CaCO-2 (colon cancer), LNCaP (prostate cancer) and U937 (histiocytic lymphoma)...
2017: PloS One
https://www.readbyqxmd.com/read/29021853/indications-for-suboptimal-low-dose-direct-oral-anticoagulants-for-non-valvular-atrial-fibrillation-patients
#8
Masahiko Umei, Mikio Kishi, Takahiro Sato, Akito Shindo, Masayuki Toyoda, Masaaki Yokoyama, Masashiro Matsushita, Satoshi Ohnishi, Masao Yamasaki
BACKGROUND: Direct oral anticoagulants (DOACs) have been developed for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). We conducted a retrospective cohort study of patients with NVAF who were newly treated with DOACs in a real-world clinical setting. METHODS: We retrospectively analyzed patients with NVAF newly treated with one of three DOACs-dabigatran, rivaroxaban, or apixaban-between January 1, 2013, and December 31, 2015. RESULTS: A total of 670 patients with NVAF who were newly prescribed one of the three DOACs were analyzed; 74 patients (10...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29021846/the-influence-of-residual-apixaban-on-bleeding-complications-during-and-after-catheter-ablation-of-atrial-fibrillation
#9
Yutaro Mukai, Kyoichi Wada, Koji Miyamoto, Kazuki Nakagita, Mai Fujimoto, Kouichi Hosomi, Takeshi Kuwahara, Mitsutaka Takada, Kengo Kusano, Akira Oita
BACKGROUND: The periprocedural protocol for atrial fibrillation (AF) ablation commonly includes anticoagulation therapy. Apixaban, a direct oral anticoagulant, is currently approved for clinical use; however, little is known about the effects of residual apixaban concentration on bleeding complications during/after AF ablation. Therefore, we measured residual apixaban concentration by using mass spectrometry and examined the anticoagulant's residual effects on bleeding complications. METHODS: Fifty-eight patients (Mean age of 64...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29018538/replacement-of-warfarin-with-a-novel-oral-anticoagulant-in-endoscopic-mucosal-resection-a-multicentre-open-label-randomised-controlled-trial
#10
Takuya Yamada, Akiko Kada, Toshio Uraoka, Toshio Kuwai, Noriko Watanabe, Yoshihiro Sasaki, Katsuhiro Mabe, Yasuo Takahashi, Takashi Kagaya, Toshihisa Kimura, Hiroshige Hamada, Akiko M Saito, Naohiko Harada
INTRODUCTION: This randomised controlled trial aims to compare the efficacy of warfarin replacement with apixaban without postoperative resumption of heparin with that of conventional heparin bridging in patients taking warfarin and scheduled to undergo endoscopic mucosal resection (EMR): specifically, by checking for reduction in proportion of postoperative bleeding following EMR. METHODS AND ANALYSIS: The multicentre, open-label randomised parallel-group, controlled intervention study regards patients taking warfarin who are scheduled to undergo colon EMR...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29016758/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-undergoing-elective-cardioversion
#11
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/29016695/oral-anticoagulant-persistence-in-patients-with-non-valvular-atrial-fibrillation-a-cohort-study-using-primary-care-data-in-germany
#12
Shuk-Li Collings, Cinira Lefèvre, Michelle E Johnson, David Evans, Guido Hack, Gillian Stynes, Andrew Maguire
This study examined characteristics and treatment persistence among patients prescribed oral anticoagulants (OACs) for stroke prevention in non-valvular atrial fibrillation (NVAF). We identified 15,244 patients (51.8% male, 72.7% aged ≥70) with NVAF and no prior OAC therapy who were prescribed apixaban (n = 1,303), rivaroxaban (n = 5,742), dabigatran (n = 1,622) or vitamin-K antagonists (VKAs, n = 6,577) between 1-Dec-2012 and 31-Oct-2014 in German primary care (IMS® Disease Analyzer). We compared OAC persistence using Cox regression over patients' entire follow-up and using a data-driven time-partitioned approach (before/after 100 days) to handle non-proportional hazards...
2017: PloS One
https://www.readbyqxmd.com/read/28992764/use-of-guidelines-for-reducing-stroke-risk-in-patients-with-nonvalvular-atrial-fibrillation-a-review-from-a-latin-american-perspective
#13
Carlos Cantú-Brito, Gisele Sampaio Silva, Sebastián F Ameriso
Atrial fibrillation (AF) is a prominent risk factor for stroke and a leading cause of death and disability throughout Latin America. Contemporary evidence-based guidelines for the management of AF and stroke incorporate the use of practical and relatively simple scoring methods to estimate both stroke and bleeding risk, in order to assist in matching patients with appropriate interventions. This review examines consistencies and differences among guidelines for reducing stroke risk in patients with AF, assessing the role of user-friendly scoring methods to determine appropriate patients for anticoagulation and other treatment options...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
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
#14
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/28984761/effects-of-different-anticoagulant-drugs-on-the-prevention-of-complications-in-patients-after-arthroplasty-a-network-meta-analysis
#15
Ji-Hai Gao, Xiu-Cheng Chu, Lin-Liang Wang, Bo Ning, Chuan-Xin Zhao
BACKGROUND: After arthroplasty treatment, some complications commonly occur, such as early revision, infection/dislocation, and venous thromboembolism (VTE). This study aims to use a network meta-analysis to compare effects of 9 anticoagulant drugs (edoxaban, dabigatan, apixaban, rivaroxaban, warfarin, heparin, bemiparin, ximelagatran, and enoxaparin) in preventing postoperative complications in arthroplasty patients. METHODS: After retrieving PubMed, Embase, and Cochrane Library database from the inception to November 2016, randomized controlled trials were enrolled...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28981556/apixaban-auto-intoxication-toxicokinetics-and-coagulation-tests
#16
Lodi Mast, R J Verheul, R Reijnen, R C J M van Rossen, J W P M Overdiek, E B Wilms
No abstract text is available yet for this article.
October 4, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28981200/soluble-fibrin-causes-an-acquired-platelet-glycoprotein-vi-signaling-defect-implications-for-coagulopathy
#17
Mei Yan Lee, Christopher C Verni, Bradley A Herbig, Scott L Diamond
BACKGROUND: In coagulopathic blood, circulating thrombin may drive platelet dysfunction. METHODS/RESULTS: Using calcium dye-loaded platelets, the effect of thrombin exposure and soluble fibrin generation on subsequent platelet GPVI function was investigated. Exposure of apixaban-treated platelet-rich plasma (12% PRP) to thrombin (1-10 nM), but not ADP or thromboxane mimetic U46619 exposure, dramatically blocked subsequent GPVI activation by convulxin, collagen-related peptide, or fibrillar collagen...
October 5, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28980758/impact-of-four-direct-oral-anticoagulants-on-rotational-thromboelastometry-rotem
#18
L Seyve, C Richarme, B Polack, R Marlu
INTRODUCTION: Rotational Thromboelastometry (ROTEM) is a point of care method used to monitor coagulation during surgery and to guide transfusion strategies in patients presenting with severe bleeding. The aim of our study was to determine the impact of four direct oral anticoagulants (DOACs) on 3 commonly used ROTEM tests. METHODS: Whole blood samples from 20 healthy donors were spiked in vitro with apixaban, edoxaban, rivaroxaban or dabigatran at 5 different plasma concentrations (0-1000 ng/mL)...
October 5, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28979172/reversing-factor-xa-inhibitors-clinical-utility-of-andexanet-alfa
#19
REVIEW
Scott Kaatz, Hardik Bhansali, Joseph Gibbs, Robert Lavender, Charles E Mahan, David G Paje
Approximately half of patients started on an oral anticoagulant in the USA now receive one of the newer direct oral anticoagulants (DOACs). Although there is an approved reversal agent for the direct thrombin inhibitor dabigatran, a specific reversal agent for the anti-factor Xa (FXa) DOACs has yet to be licensed. Unlike the strategy to reverse the only oral direct thrombin inhibitor with idarucizumab, which is a humanized monoclonal antibody fragment, a different approach is necessary to design a single agent that can reverse multiple anti-FXa medications...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28974629/effectiveness-and-safety-of-non-vitamin-k-antagonist-oral-anticoagulants-in-asian-patients-with-atrial-fibrillation
#20
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
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