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https://www.readbyqxmd.com/read/29220330/early-recurrence-and-major-bleeding-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation-treated-with-non-vitamin-k-oral-anticoagulants-raf-noacs-study
#1
Maurizio Paciaroni, Giancarlo Agnelli, Nicola Falocci, Georgios Tsivgoulis, Kostantinos Vadikolias, Chrysoula Liantinioti, Maria Chondrogianni, Paolo Bovi, Monica Carletti, Manuel Cappellari, Marialuisa Zedde, George Ntaios, Efstathia Karagkiozi, George Athanasakis, Kostantinos Makaritsis, Giorgio Silvestrelli, Alessia Lanari, Alfonso Ciccone, Jukka Putaala, Liisa Tomppo, Turgut Tatlisumak, Azmil H Abdul-Rahim, Kennedy R Lees, Andrea Alberti, Michele Venti, Monica Acciarresi, Cataldo D'Amore, Cecilia Becattini, Maria Giulia Mosconi, Ludovica Anna Cimini, Rossana Soloperto, Luca Masotti, Vieri Vannucchi, Gianni Lorenzini, Rossana Tassi, Francesca Guideri, Maurizio Acampa, Giuseppe Martini, Sung-Il Sohn, Simona Marcheselli, Nicola Mumoli, Maria Luisa De Lodovici, Giorgio Bono, Karen L Furie, Prasanna Tadi, Shadi Yaghi, Danilo Toni, Federica Letteri, Tiziana Tassinari, Odysseas Kargiotis, Enrico Maria Lotti, Yuriy Flomin, Michelangelo Mancuso, Miriam Maccarrone, Nicola Giannini, Fabio Bandini, Alessandro Pezzini, Loris Poli, Alessandro Padovani, Umberto Scoditti, Licia Denti, Domenico Consoli, Franco Galati, Simona Sacco, Antonio Carolei, Cindy Tiseo, Vanessa Gourbali, Giovanni Orlandi, Martina Giuntini, Alberto Chiti, Elisa Giorli, Gino Gialdini, Francesco Corea, Walter Ageno, Marta Bellesini, Giovanna Colombo, Serena Monaco, Mario Maimone Baronello, Theodore Karapanayiotides, Valeria Caso
BACKGROUND: The optimal timing to administer non-vitamin K oral anticoagulants (NOACs) in patients with acute ischemic stroke and atrial fibrillation is unclear. This prospective observational multicenter study evaluated the rates of early recurrence and major bleeding (within 90 days) and their timing in patients with acute ischemic stroke and atrial fibrillation who received NOACs for secondary prevention. METHODS AND RESULTS: Recurrence was defined as the composite of ischemic stroke, transient ischemic attack, and symptomatic systemic embolism, and major bleeding was defined as symptomatic cerebral and major extracranial bleeding...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#2
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
December 4, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29199435/-laboratory-aspects-of-novel-oral-anticoagulant-treatment
#3
Zsuzsanna Bereczky, Zsolt Oláh, Éva Ajzner, János Kappelmayer
The introduction of novel oral anticoagulants (NOAC) have long been expected drugs and they quickly became used widespread as their clinical effectiveness was as good as, or even better than the previously used only oral anticoagulant drug, the coumarins. Thus, the direct thrombin inhibitor dabigatran and the activated factor X inhibitors (rivaroxaban, apixaban, edoxaban) have become the part of daily therapeutic practice. Their permeation was facilitated by the guideline which suggested that no laboratory monitoring was required during NOAC treatment and this was very convenient for both patients and doctors...
December 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29198080/laboratory-measurement-of-apixaban-using-anti-factor-xa-assays-in-acute-ischemic-stroke-patients-with-non-valvular-atrial-fibrillation
#4
Hyoshim Shin, Min-Chul Cho, Rock Bum Kim, Chang-Hun Kim, Nack-Cheon Choi, Soo-Kyung Kim, Eun-Ha Koh
Apixaban is effective and safe for preventing stroke, and its usage has increased exponentially in recent years. However, data concerning the therapeutic range of apixaban is limited. This study determined the trough and peak levels of apixaban-specific anti-factor Xa activity (AFXaA) in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF) in Korea. The study included 85 patients who received apixaban. Blood samples were taken to measure the trough and peak levels of AFXaA using a chromogenic anti-factor assay, as well as prothrombin time (PT) and activated partial thromboplastin time (aPTT)...
December 2, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29195825/meta-analysis-of-the-safety-and-efficacy-of-the-oral-anticoagulant-agents-apixaban-rivaroxaban-dabigatran-in-patients-with-acute-coronary-syndrome
#5
REVIEW
Safi U Khan, Adeel Arshad, Irbaz Bin Riaz, Swapna Talluri, Fahad Nasir, Edo Kaluski
The significance of adding new oral anticoagulants (NOACs) to antiplatelet therapy in patients with acute coronary syndrome (ACS) is unclear. We conducted a meta-analysis to assess the safety and efficacy of adding NOACs (apixaban, rivaroxaban, and dabigatran) to single antiplatelet agent (SAP) or dual antiplatelet therapy (DAPT) in patients with ACS. Seven randomized controlled trials were selected using PubMed or MEDLINE, Scopus, and Cochrane library (inception to August 2017). The summary measure was random effects hazard ratio (HR) with 95% confidence interval (CI)...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29193737/laboratory-testing-in-patients-treated-with-direct-oral-anticoagulants-a-practical-guide-for-clinicians
#6
REVIEW
Jonathan Douxfils, Walter Ageno, Charles-Marc Samama, Sarah Lessire, Hugo Ten Cate, Peter Verhamme, Jean-Michel Dogné, François Mullier
One of the key benefits of the direct oral anticoagulants (DOACs) is that they do not require routine laboratory monitoring. Nevertheless, assessment of DOAC exposure and anticoagulant effects may become useful in various clinical scenarios. The four approved DOACs - apixaban, dabigatran etexilate, edoxaban and rivaroxaban - have different characteristics impacting assay selection and the interpretation of results. This article provides an updated overview on 1) which test to use (and their advantages and limitations), 2) when to assay DOAC levels, 3) how to interpret the results relating to bleeding risk, emergency situations and perioperative management, and 4) what is the impact of DOACs on routine and specialised coagulation assays...
November 29, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29191640/incidence-of-visible-haematuria-among-antithrombotic-agents-a-systematic-review-of-over-175-000-patients
#7
Nikita R Bhatt, Niall F Davis, William J Nolan, Robert J Flynn, T E D McDermott, Arun Z Thomas, Rustom P Manecksha
OBJECTIVE: To determine the probability of visible haematuria with antithrombotic agents and to evaluate association of urological etiology in antithrombotic-related haematuria METHODS: PRISMA guidelines were followed to conduct a systematic review using search engines PUBMED and SCOPUS with the terms "(haematuria) OR (haematuria) OR urinary bleeding)) AND ((anticoagulants) OR anticoagulation) OR noac) OR novel anticoagulants) OR antiplatelet) OR dabigatran) OR rivaroxaban) OR apixaban) OR warfarin) OR aspirin) OR heparin) OR dipyridamole)"...
November 27, 2017: Urology
https://www.readbyqxmd.com/read/29191525/apixaban-in-the-prevention-of-stroke-and-systemic-embolism-in-patients-with-non-valvular-atrial-fibrillation-in-france-rationale-and-design-of-the-paros-cross-sectional-study
#8
Fabien Picard, Gregory Ducrocq, Nicolas Danchin, Bruno Falissard, Olivier Hanon, Isabelle Mahe, Emmanuel Touzé, Philippe Gabriel Steg
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia worldwide, and its prevalence is expected to increase with population ageing. The use of vitamin K antagonists (VKAs) for the prevention of stroke and/or systemic embolism in patients with non-valvular atrial fibrillation (NVAF) was recently challenged by non-VKA oral anticoagulants (NOACs), demonstrating a favourable risk-benefit profile, with reductions in stroke, intracranial haemorrhage and mortality, similar major bleeding, but increased gastrointestinal bleeding...
November 27, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29188721/comparison-of-major-bleeding-risk-in-patients-with-non-valvular-atrial-fibrillation-receiving-direct-oral-anticoagulants-in-the-real-world-setting-a-network-meta-analysis
#9
S Deitelzweig, C Farmer, X Luo, X Li, L Vo, J Mardekian, K Fahrbach, A Ashaye
OBJECTIVE: To conduct a systematic literature review (SLR) and network meta-analysis (NMA) of real-world studies comparing major bleeding risk among patients with non-valvular atrial fibrillation (NVAF) on direct oral anticoagulants (DOACs) or warfarin. METHODS: Systematic searches were conducted in MEDLINE and Embase for full-text articles published between January 1, 2003 and March 18, 2017. Eligible studies compared at least two of the following in a real-world setting: warfarin, apixaban, dabigatran, rivaroxaban, or edoxaban...
November 30, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29186393/inappropriate-doses-of-direct-oral-anticoagulants-in-real-world-clinical-practice-prevalence-and-associated-factors-a-subanalysis-of-the-fantasiia-registry
#10
Martín Ruiz Ortiz, Javier Muñiz, Paula Raña Míguez, Inmaculada Roldán, Francisco Marín, María Asunción Esteve-Pastor, Angel Cequier, Manuel Martínez-Sellés, Vicente Bertomeu, Manuel Anguita
Aims: To describe the prevalence and associated factors of inappropriate doses of direct oral anticoagulants (DOAC) in a national registry of patients of real clinical practice. Methods and results: Five hundred and thirty outpatients with atrial fibrillation treated with DOAC were included in a prospective, national, multicentre study. The appropriateness of the doses of DOAC was defined according to the recommendations of the European Heart Rhythm Association...
November 27, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29183961/oral-anticoagulants-for-prevention-of-stroke-in-atrial-fibrillation-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#11
José A López-López, Jonathan A C Sterne, Howard H Z Thom, Julian P T Higgins, Aroon D Hingorani, George N Okoli, Philippa A Davies, Pritesh N Bodalia, Peter A Bryden, Nicky J Welton, William Hollingworth, Deborah M Caldwell, Jelena Savović, Sofia Dias, Chris Salisbury, Diane Eaton, Annya Stephens-Boal, Reecha Sofat
Objective To compare the efficacy, safety, and cost effectiveness of direct acting oral anticoagulants (DOACs) for patients with atrial fibrillation.Design Systematic review, network meta-analysis, and cost effectiveness analysis. Data sources Medline, PreMedline, Embase, and The Cochrane Library.Eligibility criteria for selecting studies Published randomised trials evaluating the use of a DOAC, vitamin K antagonist, or antiplatelet drug for prevention of stroke in patients with atrial fibrillation.Results 23 randomised trials involving 94 656 patients were analysed: 13 compared a DOAC with warfarin dosed to achieve a target INR of 2...
November 28, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29176379/thrombin-generation-estimates-the-anticoagulation-effect-of-direct-oral-anticoagulants-with-significant-interindividual-variability-observed
#12
Joseph Rigano, Cheryl Ng, Harshal Nandurkar, Prahlad Ho
: Direct oral anticoagulants (DOACs) are increasingly being used, primarily due to their drug stability and patient convenience. Although these drugs have been evaluated to be well tolerated in numerous clinical trials, their impact on in-vivo anticoagulation effect, variability and therapeutic drug level remains unknown. Hence, we aim to study the effect and variability of DOACs on thrombin generation via the calibrated automated thrombogram. Anonymized coagulation specimens from outpatients on warfarin were collected...
November 25, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29175298/does-type-2-diabetes-affect-the-on-treatment-levels-of-direct-oral-anticoagulants-in-patients-with-atrial-fibrillation
#13
Matej Samoš, Tomáš Bolek, Lucia Stančiaková, Ingrid Škorňová, Jela Ivanková, František Kovář, Peter Galajda, Peter Kubisz, Ján Staško, Marián Mokáň
AIMS: Type 2 diabetes (T2D) is connected with several abnormalities in haemostasis; and with higher risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NV-AF). However, it is recently unknown whether T2D affects the activity of direct oral anticoagulants (DOACs). The aim of this study was to determine the impact of T2D on DOACs activity in patients with NV-AF. METHODS: This pilot prospective study enrolled totally 65 patients with NV-AF (20 dabigatran-treated, 110 mg/twice daily; 28 rivaroxaban-treated, 15 mg/daily; 17 apixaban-treated, 5 mg/twice daily)...
November 23, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29175237/severity-of-gastrointestinal-bleeding-in-patients-treated-with-direct-acting-oral-anticoagulants
#14
Mark M Brodie, Jill C Newman, Tyler Smith, Don C Rockey
BACKGROUND: Direct-acting oral anticoagulants (DOACs), which have gained approval for stroke prevention in non-valvular atrial fibrillation and treatment of venous thromboembolism, have become increasingly preferred over warfarin given their predictable pharmacodynamics, lack of required monitoring, and superior outcomes. DOACs have been shown to be associated with an increased frequency of gastrointestinal bleeding compared to warfarin, but the severity and characteristics of gastrointestinal bleeding in these patients is poorly understood...
November 22, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29172203/-factor-xa-inhibitor-for-the-treatment-of-cerebral-venous-thrombosis-with-intracerebral-hemorrhage-during-anticoagulation-therapy-a-case-report
#15
Takehiro Kitagawa, Tetsuhiro Kitahara
A 46-year-old man presented with headache, right hemiparesis, and motor aphasia. A diagnosis of cerebral venous thrombosis with subarachnoid hemorrhage was made. We started intravenous administration of unfractionated heparin. After 6 days in hospital, the right hemiparesis and motor aphasia worsened, and brain computed tomographic(CT)images demonstrated intracerebral hemorrhage in the left parietal lobe. Therefore, we switched treatment from heparin to apixaban. His condition improved and a brain magnetic resonance(MR)venogram after 7 days in hospital showed recanalization of the cerebral veins...
November 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29171776/extended-thromboprophylaxis-in-the-acutely-ill-medical-patient-after-hospitalization-a-paradigm-shift-in-post-discharge-thromboprophylaxis
#16
Charles E Mahan, Allison E Burnett, Megan Fletcher, Alex C Spyropoulos
Venous thromboembolism (VTE) is a significant healthcare burden with approximately 900,000 events annually in the United States, over half of which are healthcare-associated. This number is anticipated to double by 2050. Group prophylaxis strategies confined to the inpatient setting appear to have minimal impact on the reduction of post-discharge VTE in medically ill patients due to shortened lengths of stay and a heterogenous population that includes patients at low risk for VTE. In accordance with current guideline recommendations, very few (<5%) medically ill patients are discharged with extended prophylaxis, which potentially creates a clinical gap for at-risk patients as VTE risk has been shown to persist for up to 90 days...
November 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29171208/real-world-data-and-recommended-dosage-of-non-vitamin-k-oral-anticoagulants-for-korean-patients
#17
REVIEW
Boyoung Joung
Regulatory approvals of non-vitamin K antagonist oral anticoagulants (NOACs) have been based on large randomized phase III trials evaluating dabigatran, rivaroxaban, apixaban, or edoxaban relative to warfarin for atrial fibrillation (AF). The results of the trials showed that all NOACs were at least non-inferior to warfarin in the prevention of stroke/thromboembolism and showed lower rates of intracranial bleeding than those associated with warfarin. However, the trials were designed differently, varied in the inclusion/exclusion criteria, and used either one dose or a low/high dose of the NOAC drug...
October 17, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29169468/renal-outcomes-in-anticoagulated-patients-with-atrial-fibrillation
#18
Xiaoxi Yao, Navdeep Tangri, Bernard J Gersh, Lindsey R Sangaralingham, Nilay D Shah, Karl A Nath, Peter A Noseworthy
BACKGROUND: Lifelong oral anticoagulation, either with warfarin or a non-vitamin K antagonist oral anticoagulant (NOAC), is indicated for stroke prevention in most patients with atrial fibrillation (AF). Emerging evidence suggests that NOACs may be associated with better renal outcomes than warfarin. OBJECTIVES: This study aimed to compare 4 oral anticoagulant agents (apixaban, dabigatran, rivaroxaban, and warfarin) for their effects on 4 renal outcomes: ≥30% decline in estimated glomerular filtration rate (eGFR), doubling of the serum creatinine level, acute kidney injury (AKI), and kidney failure...
November 28, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29167388/real-world-use-of-apixaban-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review-and-meta-analysis
#19
Marco Proietti, Imma Romanazzi, Giulio Francesco Romiti, Alessio Farcomeni, Gregory Y H Lip
BACKGROUND AND PURPOSE: The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published...
November 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29166800/comparison-of-all-cause-costs-and-healthcare-resource-use-among-patients-with-newly-diagnosed-non-valvular-atrial-fibrillation-newly-treated-with-oral-anticoagulants
#20
Adrienne M Gilligan, Jessica Franchino-Elder, Xue Song, Cheng Wang, Caroline Henriques, Amy Sainski-Nguyen, Kathleen Wilson, David M Smith, Stephen Sander
OBJECTIVES: Compare costs and healthcare resource utilization (HCRU) among newly diagnosed non-valvular atrial fibrillation (NVAF) patients newly treated with dabigatran versus apixaban, rivaroxaban, or warfarin. METHODS: Newly diagnosed adult NVAF patients initiating dabigatran, apixaban, rivaroxaban, or warfarin (index event) between 10/01/2010-12/31/2014 were identified using MarketScan claims data, and followed until medication discontinuation, switch, inpatient death, enrollment end or study end (12/15/2015)...
November 22, 2017: Current Medical Research and Opinion
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