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Atrial fibrilation , Dabigatran, apixaban, rivaroxaban

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https://www.readbyqxmd.com/read/28644048/risk-of-major-bleeding-in-patients-with-non-valvular-atrial-fibrillation-treated-with-oral-anticoagulants-a-systematic-review-of-real-world-observational-studies
#1
S Deitelzweig, C Farmer, X Luo, L Vo, X Li, M Hamilton, R Horblyuk, A Ashaye
OBJECTIVE: To conduct a systematic review of real-world (RWD) studies comparing the risk of major bleeding (MB) among patients with non-valvular atrial fibrillation (NVAF) on direct oral anticoagulants (DOACs) or warfarin Methods: MEDLINE, Embase, NHS-EED, and EconLit were searched for RWD studies published between January 2003 and November 2016 comparing MB risk among DOACs and warfarin. Proceedings of clinical conferences from 2012-2016 were reviewed. RESULTS: A total of 4,218 citations were identified, 26 of which met eligibility criteria...
June 23, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28640321/effects-of-direct-oral-anticoagulants-on-lupus-anticoagulant-assays-in-a-real-life-setting
#2
Aleksandra Antovic, Eva-Marie Norberg, Maria Berndtsson, Agnes Rasmuson, Rickard E Malmström, Mika Skeppholm, Jovan Antovic
Laboratory diagnosis of lupus anticoagulant (LA) is based on prolongation in at least one coagulation assay (diluted Russell's viper venom time - dRVVT or activated partial thromboplastin time - aPTT), which normalises after addition of phospholipids. Both assays may be influenced by anticoagulants and therefore LA should not be tested during warfarin or heparin treatment. It has been shown (primarily in vitro) that direct oral anticoagulants (DOACs - dabigatran [DAB], rivaroxaban [RIV] and apixaban [API]) may also influence LA testing...
June 22, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28635338/risk-of-stroke-systemic-embolism-major-bleeding-and-associated-costs-in-non-valvular-atrial-fibrillation-patients-who-initiated-apixaban-dabigatran-or-rivaroxaban-compared-with-warfarin-in-the-united-states-medicare-population
#3
Alpesh Amin, Allison Keshishian, Jeffrey Trocio, Oluwaseyi Dina, Hannah Le, Lisa Rosenblatt, Xianchen Liu, Jack Mardekian, Qisu Zhang, Onur Baser, Lien Vo
OBJECTIVE: To compare the risk and cost of stroke/systemic embolism (SE) and major bleeding between each direct oral anticoagulant (DOAC) and warfarin among non-valvular atrial fibrillation (NVAF) patients. METHODS: Patients (≥65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Medicare database from 01/01/2013-12/31/2014. Patients initiating each DOAC were matched 1:1 to warfarin patients using propensity score matching to balance demographics and clinical characteristics...
June 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28625380/factors-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-new-onset-atrial-fibrillation-results-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-ii-orbit-af-ii
#4
Benjamin A Steinberg, Peter Shrader, Laine Thomas, Jack Ansell, Gregg C Fonarow, Bernard J Gersh, Elaine Hylek, Peter R Kowey, Kenneth W Mahaffey, Emily C O'Brien, Daniel E Singer, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS: The ORBIT-AF II study is a national, US, prospective, observational, cohort study of anticoagulation treatment in patients with AF receiving NOACs or warfarin in the United States from 2013 to 2016...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28614582/effectiveness-and-safety-of-standard-dose-nonvitamin-k-antagonist-oral-anticoagulants-and-warfarin-among-patients-with-atrial-fibrillation-with-a-single-stroke-risk-factor-a-nationwide-cohort-study
#5
Gregory Y H Lip, Flemming Skjøth, Peter Brønnum Nielsen, Jette Nordstrøm Kjældgaard, Torben Bjerregaard Larsen
Importance: The randomized clinical trials comparing nonvitamin K antagonist oral anticoagulants (NOACs) vs warfarin largely focused on recruiting high-risk patients with atrial fibrillation with more than 2 stroke risk factors, with only the trials testing dabigatran or apixaban including few patients with 1 stroke risk factor. Despite this, regulatory approvals of all NOACs have been based on stroke prevention for patients with atrial fibrillation with 1 or more stroke risk factors...
June 14, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28607611/report-of-periprocedural-oral-anticoagulants-in-catheter-ablation-for-atrial-fibrillation-the-japanese-catheter-ablation-registry-of-atrial-fibrillation-j-caraf
#6
Yuji Murakawa, Akihiko Nogami, Morio Shoda, Koichi Inoue, Shigeto Naito, Koichiro Kumagai, Yasushi Miyauchi, Teiichi Yamane, Norishige Morita, Hideo Mitamura, Ken Okumura, Kenzo Hirao
BACKGROUND: To obtain a perspective of the current status of catheter ablation for the cure of atrial fibrillation, the Japanese Heart Rhythm Society conducted a nationwide survey: the Japanese Catheter Ablation Registry of Atrial Fibrillation. In this report, we aimed to evaluate the periprocedural use of direct oral anticoagulants with respect to thromboembolic or bleeding complications. METHODS: Using an online questionnaire, the Japanese Heart Rhythm Society requested electrophysiology centers in Japan to register the relevant data of patients who underwent atrial fibrillation ablation over selected five-months from 2011 to 2014...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28604139/major-bleeding-risk-and-healthcare-economic-outcomes-of-nonvalvular-atrial-fibrillation-patients-newly-initiated-with-oral-anticoagulant-therapy-in-the-real-world-setting
#7
Jay Lin, Jeffrey Trocio, Kiran Gupta, Jack Mardekian, Melissa Lingohr-Smith, Brandy Menges, Min You, Anagha Nadkarni
AIMS: This study compared the risk for major bleeding (MB) and healthcare economic outcomes of patients with nonvalvular atrial fibrillation (NVAF) after initiating treatment with apixaban versus rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients who initiated apixaban, rivaroxaban, dabigatran, or warfarin were identified from the IMS Pharmetrics Plus database (1/1/2013-9/30/2015). Propensity score matching (PSM) was used to balance differences in patient characteristics between study cohorts: patients treated with apixaban versus rivaroxaban, apixaban versus dabigatran, and apixaban versus warfarin...
June 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28595692/non-vitamin-k-antagonist-oral-anticoagulant-dosing-in-patients-with-atrial-fibrillation-and-renal-dysfunction
#8
Xiaoxi Yao, Nilay D Shah, Lindsey R Sangaralingham, Bernard J Gersh, Peter A Noseworthy
BACKGROUND: Dose reduction of non-vitamin K antagonist oral anticoagulants (NOACs) is indicated in patients with atrial fibrillation (AF) with renal impairment. Failure to reduce the dose in patients with severe kidney disease may increase bleeding risk, whereas dose reductions without a firm indication may decrease the effectiveness of stroke prevention. OBJECTIVES: The goal of this study was to investigate NOAC dosing patterns and associated outcomes, i.e., stroke (ischemic stroke and systemic embolism) and major bleeding in patients treated in routine clinical practice...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28592382/incidence-of-mri-detected-brain-lesions-and-neurocognitive-function-after-electrical-cardioversion-in-anticoagulated-patients-with-persistent-atrial-fibrillation
#9
B Bellmann, J B Fiebach, S Guttmann, T Lin, K G Haeusler, R Bathe-Peters, L Köhler, D Steffens, M Kasner, V Tscholl, P Nagel, M Roser, U Landmesser, A Rillig
BACKGROUND: After electrical cardioversion (eCV) in patients with atrial fibrillation (AF), the risk for clinically apparent cerebral thromboembolism is increased in the subsequent weeks. To date, there is little evidence on the incidence of acute brain lesions (ABL) detected with cerebral magnetic resonance imaging (MRI) after eCV, in particular in patients treated with the Non-Vitamin K Antagonist oral anticoagulants (NOAC). AIMS: The aim of this pilot study was to evaluate the incidence of MRI-detected ABL, as well as the neuro-cognitive function after eCV in patients with persistent AF using NOACs as compared to phenprocoumon...
June 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28567119/direct-oral-anticoagulants-and-digestive-bleeding-therapeutic-management-and-preventive-measures
#10
REVIEW
David Deutsch, Christian Boustière, Emile Ferrari, Pierre Albaladejo, Pierre-Emmanuel Morange, Robert Benamouzig
The use of direct oral anticoagulants (DOACs) was an important step forward in the management of atrial fibrillation and venous thromboembolism (VTE). The DOACs, anti-IIa for dabigatran and anti-Xa for rivaroxaban, apixaban and edoxaban, all have a rapid onset of action and a short half life. There is no need for routine hemostasis testing for treatment monitoring of a DOAC. Compared with vitamin K antagonists (VKAs), DOACs may increase the risk of gastrointestinal bleeding (relative risk 1.25). Withholding the DOAC treatment, evaluating the time of the last intake and estimating the patient's renal function are the first steps in the management of gastrointestinal bleeding...
June 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28535119/comparison-of-effectiveness-and-safety-of-treatment-with-apixaban-vs-other-oral-anticoagulants-among-elderly-nonvalvular-atrial-fibrillation-patients
#11
Steven Deitelzweig, Xuemei Luo, Kiran Gupta, Jeffrey Trocio, Jack Mardekian, Tammy Curtice, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
OBJECTIVE: To compare the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) of elderly (≥65 years of age) nonvalvular atrial fibrillation (NVAF) patients initiating apixaban vs. rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients with Medicare Advantage coverage in the US initiating oral anticoagulants (OACs, index event) were identified from the Humana database (1/1/2013-9/30/2015) and grouped into cohorts depending on OAC initiated. Propensity score matching (PSM), 1:1, was conducted among patients treated with apixaban vs...
May 23, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28532773/comparison-of-the-incidences-of-complications-after-second-generation-cryoballoon-ablation-of-atrial-fibrillation-using-vitamin-k-antagonists-versus-novel-oral-anticoagulants
#12
Giacomo Mugnai, Carlo de Asmundis, Saverio Iacopino, Erwin Stroker, Massimo Longobardi, Valentina De Regibus, Hugo Enrique Coutino-Moreno, Ken Takarada, Rajin Choudhury, Juan Pablo Abugattas de Torres, Cesare Storti, Pedro Brugada, Gian-Battista Chierchia
Data evaluating the impact of the periprocedural administration of novel oral anticoagulants (NOACs) on complications in the setting of pulmonary vein (PV) isolation using cryoballoon (CB) is limited. In the present study, our aim was to analyze procedural characteristics and incidence of complications in those patients who underwent CB ablation for atrial fibrillation and the impact of NOACs on adverse events compared with vitamin K antagonists (VKAs). Consecutive patients with drug resistant atrial fibrillation who underwent PV isolation by CB as index procedure were retrospectively included in our analysis...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28506981/contemporary-trends-in-oral-anticoagulant-prescription-in-atrial-fibrillation-patients-at-low-to-moderate-risk-of-stroke-after-guideline-recommended-change-in-use-of-the-chads2-to-the-cha2ds2-vasc-score-for-thromboembolic-risk-assessment-analysis-from-the-national
#13
David F Katz, Thomas M Maddox, Mintu Turakhia, Anil Gehi, Emily C O'Brien, Steven A Lubitz, Alexander Turchin, Gheorghe Doros, Lanyu Lei, Paul Varosy, Lucas Marzec, Jonathan C Hsu
BACKGROUND: Use of the CHA2DS2-VASc score instead of the CHADS2 score for thromboembolic risk stratification and initiation of oral anticoagulation (OAC) was recommended in the 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society atrial fibrillation (AF) guidelines. We sought to define the proportion of patients with AF qualifying for and receiving OAC in contemporary practice by applying the CHA2DS2-VASc score to patients with a low CHADS2 score. METHODS AND RESULTS: Among patients with AF enrolled in the American College of Cardiology National Cardiovascular Data Registry's outpatient Practice Innovation and Clinical Excellence registry (2008-2014) CHADS2 score of 0 or 1, we calculated the impact of adoption of the CHA2DS2-VASc score on the proportion of patients with an indication for OAC...
May 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28480507/initiation-of-anticoagulation-in-atrial-fibrillation-which-factors-are-associated-with-choice-of-anticoagulant
#14
A Gundlund, L Staerk, E L Fosbøl, K Gadsbøll, C Sindet-Pedersen, A N Bonde, G H Gislason, J B Olesen
BACKGROUND: The use of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prophylaxis in atrial fibrillation (AF) is increasing rapidly. We compared characteristics of AF patients initiated on NOACs versus vitamin K antagonists (VKAs). METHODS: Using Danish nationwide registry data, we identified AF patients initiating either a VKA or a NOAC from 22 August 2011 until 30 September 2016. We compared patient characteristics including age, gender, comorbidities, concomitant pharmacotherapy and CHA2 DS2 -VASc and HAS-BLED scores in patients initiated on a VKA, dabigatran, rivaroxaban or apixaban...
May 8, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28466408/incidence-and-predictors-of-silent-cerebral-thromboembolic-lesions-after-catheter-ablation-for-atrial-fibrillation-in-patients-treated-with-direct-oral-anticoagulants
#15
Atsushi Doi, Masahiko Takagi, Jun Kakihara, Yusuke Hayashi, Hiroaki Tatsumi, Kohei Fujimoto, Kenichi Sugioka, Minoru Yoshiyama
There are few reports about the incidence and predictors of silent cerebral thromboembolic lesions (SCLs) after atrial fibrillation (AF) ablation in patients treated with direct oral anticoagulants (DOACs). The purpose of this study is to evaluate the incidence and predictors of SCLs after AF ablation with cerebral magnetic resonance imaging (C-MRI) in patients treated with DOACs. We enrolled 117 consecutive patients who underwent first AF ablation and received DOACs, including apixaban, dabigatran, edoxaban, and rivaroxaban...
May 2, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28458008/risk-of-gastrointestinal-bleeding-in-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-a-systematic-review-and-meta-analysis
#16
Corey S Miller, Alastair Dorreen, Myriam Martel, Thao Huynh, Alan N Barkun
BACKGROUND AND AIMS: Non-vitamin K antagonist oral anticoagulants (NOACs) are convenient and effective in prevention and treatment of venous thromboembolism and prevention of stroke in patients with atrial fibrillation. However, these drugs have been associated with increased risk of gastrointestinal (GI) bleeding. We conducted a systematic review and meta-analysis to determine the risk of GI bleeding in patients receiving these drugs. METHODS: We searched the EMBASE, Medline, Cochrane, and ISI Web of knowledge databases through January 2016 for randomized trials that compared NOACs to conventional anticoagulants for approved indications...
April 27, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#17
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
June 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28425296/medium-to-long-term-persistence-with-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-australian-experience
#18
Leon A Simons, Michael Ortiz, Ben Freedman, Benjamin J Waterhouse, David Colquhoun
OBJECTIVE: Long-term anticoagulant therapy with non-valvular atrial fibrillation (AF) is essential to prevent thromboembolic complications, especially ischemic stroke. This study examines medium-term persistence in AF patients using a non-vitamin-K antagonist oral anticoagulant drug (NOAC). RESEARCH DESIGN AND METHODS: We assessed national Pharmaceutical Benefit Scheme records December 2013 through September 2016 for initial prescription of a NOAC in a 10% random sample of concessional patients...
May 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28416977/trends-in-physiological-coagulation-factors-in-japanese-patients-receiving-novel-oral-anticoagulants
#19
Tomoyuki Nagao, Hiroshi Hunakubo, Mayu Suzuki, Takashi Kataoka, Satoshi Okumura, Norihiro Shinoda, Ken Harada, Bunichi Kato, Masataka Kato, Nobuyuki Marui, Shinichi Sakai, Tetsuya Amano, Toyoaki Murohara
BACKGROUND: Little is known about physiological anticoagulation effects via antithrombin III (AT III) and protein C/S (PC/PS) in patients using new oral anticoagulants (NOACs). METHODS: We evaluated 120 consecutive patients with non-valvular atrial fibrillation (AF) receiving NOACs. Patients were randomly divided into three groups: a dabigatran group (DG, N=40), a rivaroxaban group (RG, N=40) or an apixaban group (AG, N=40). A warfarin group (WG, N=40) was matched with NOAC groups for age, sex and type of AF during the same time period...
April 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28412907/review-of-the-pharmacology-of-the-emerging-possibilities-of-the-direct-oral-anticoagulants-reversal
#20
Matej Samos, Lucia Stanciakova, Ingrid Skornova, Tomas Bolek, Frantisek Kovar, Jan Stasko, Peter Galajda, Marian Mokan, Peter Kubisz
BACKGROUND: Direct oral anticoagulants (DOACs) offer consistent and predictable anticoagulation, oral administration with good patient compliance and a good safety profile. Dabigatran - a direct thrombin inhibitor, apixaban and rivaroxaban - direct factor Xa inhibitors are now largely used for anticoagulation in patients with non-valvular atrial fibrillation and in patients with venous thromboembolism. These agents have emerged as an expediential clinical choice in long-term anticoagulation for an increasing number of patients...
April 13, 2017: Current Drug Metabolism
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