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https://www.readbyqxmd.com/read/29149366/prescribing-of-noacs-has-outnumbered-warfarin-exploring-how-physicians-choose-anticoagulant-treatments
#1
Anne Katrine Eek, Erik Øie, Anne Gerd Granas
PURPOSE: The development of non-vitamin K-dependent oral anticoagulants (NOACs) is a new alternative to treatment with warfarin. The purpose of this study was to explore drug prescription decisions of NOACs or warfarin from hospital physicians in cardiovascular departments. METHODS: A qualitative study with focus group interviews was conducted in three different hospitals. The interview guide explored the background of prescribing anticoagulants (warfarin, dabigatran, rivaroxaban, and apixaban) and experiences with effect and side-effects they had observed in patients...
November 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29148592/oral-anticoagulants-in-german-nursing-home-residents-drug-use-patterns-and-predictors-for-treatment-choice
#2
Kathrin Jobski, Falk Hoffmann, Stefan Herget-Rosenthal, Michael Dörks
AIMS: Information on utilization of oral anticoagulants (OACs) in nursing homes is scarce. This study aimed to (i) describe OAC use in German nursing home residents, (ii) examine factors influencing whether treatment is initiated with vitamin K antagonists (VKAs) or non-VKA oral anticoagulants (NOACs) and (iii) assess which conditions predict switching to NOAC instead of continuing VKA. METHODS: Using claims data (2010-2014), we studied a cohort of new nursing home residents aged ≥ 65 years receiving OAC...
November 17, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#3
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29146484/association-between-ischemic-and-bleeding-risk-scores-and-the-use-of-new-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome
#4
Pedro J Flores-Blanco, Francisco Cambronero-Sánchez, Sergio Raposeiras-Roubin, Emad Abu-Assi, Gunnar Leithold, Rafael Cobas-Paz, Ana I Rodríguez Serrano, Francisco Calvo-Iglesias, Mariano Valdés, James L Januzzi, Andrés Iñiguez-Romo, Sergio Manzano-Fernández
INTRODUCTION AND OBJECTIVES: Acute coronary syndrome (ACS) guidelines recommend the use of newer P2Y12 inhibitors (prasugrel and ticagrelor) over clopidogrel in patients with moderate-to-high ischemic risk, unless they have an increased bleeding risk. The aim of our study was to assess the GRACE risk score and the CRUSADE bleeding risk score relative to prescription of newer P2Y12 inhibitors at discharge in ACS patients. METHODS: Retrospective analysis of a multicenter ACS registry; 3515 consecutive patients were included...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29145948/type-of-atrial-fibrillation-and-outcomes-in%C3%A2-patients-with-heart-failure-and-reduced%C3%A2-ejection%C3%A2-fraction
#5
Ulrik M Mogensen, Pardeep S Jhund, William T Abraham, Akshay S Desai, Kenneth Dickstein, Milton Packer, Jean L Rouleau, Scott D Solomon, Karl Swedberg, Michael R Zile, Lars Køber, John J V McMurray
BACKGROUND: Atrial fibrillation (AF) is common in heart failure (HF), but the outcome by type of AF is largely unknown. OBJECTIVES: This study investigated outcomes related to type of AF (paroxysmal, persistent or permanent, or new onset) in 2 recent large trials in patients with HF with reduced ejection fraction. METHODS: The study analyzed patients in the PARADIGM-HF (Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure) and ATMOSPHERE (Aliskiren Trial to Minimize Outcomes in Patients with Heart Failure) trials...
November 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29145107/postoperative-thoracic-hemorrhage-after-right-upper-lobectomy-with-thoracic-wall-resection-during-rivaroxaban-anticoagulant-therapy-for-deep-leg-vein-thrombosis-a-case-report
#6
Taiji Kuwata, Masatoshi Kanayama, Ayako Hirai, Shuichi Shinohara, Masaru Takenaka, Soichi Oka, Yasuhiro Chikaishi, Naoko Imanishi, Koji Kuroda, Fumihiro Tanaka
INTRODUCTION: Postoperative pulmonary embolism (PE) is the one of the most important complications after thoracic surgery. This complicatin after the surgery is often treated by new anticoaglant drug, such as rivaroxaban, which dose not need to the monitoring of blood coaglation system. We experienced postoperative bleeding case during anticoaglant therapy using rivaroxaban. PRESENTATION OF CASE: The patient underwent a right upper lobectomy with lung and chest wall resection for lung cancer...
November 11, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29141274/use-of-direct-oral-anticoagulants-in-the-first-year-after-market-entry-of-edoxaban-a-danish-nationwide-drug-utilization-study
#7
Anton Pottegård, Erik L Grove, Maja Hellfritzsch
OBJECTIVES: To describe the early uptake of edoxaban; the fourth direct oral anticoagulant (DOAC) to enter the market. METHODS: Using the Danish nationwide health registries, we identified new users of edoxaban (n = 609) from June 6 (day of marketing) through June 2017. For comparison, we also identified new users of dabigatran (n = 2211), rivaroxaban (n = 19 227), and apixaban (n = 14 736). Users were described regarding indication of use, previous anticoagulant experience, comorbidity, and co-medication...
November 15, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29140870/a-retrospective-assessment-of-postoperative-bleeding-complications-in-anticoagulated-patients-following-mohs-micrographic-surgery
#8
Robert E Eilers, Alina Goldenberg, Natasha L Cowan, Pallavi Basu, Shang I Brian Jiang
BACKGROUND: A significant number of patients undergoing Mohs micrographic surgery (MMS) for skin cancer are treated with oral anticoagulants. The incidence of postoperative complications associated with new classes of oral anticoagulants remains largely unknown. OBJECTIVE: To determine the incidence of postoperative complications in patients undergoing MMS on both traditional oral anticoagulants and new novel oral anticoagulants. MATERIALS AND METHODS: A single-center retrospective chart review was performed for all patients treated with oral anticoagulants who underwent MMS between July 1, 2012 and June 30, 2015 at University of California, San Diego...
November 14, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/29140555/withdrawn-electrical-cardioversion-for-atrial-fibrillation-and-flutter
#9
REVIEW
Gillian E Mead, Andrew Elder, Andrew D Flapan, John Cordina
BACKGROUND: Atrial fibrillation increases stroke risk and adversely affects cardiovascular haemodynamics. Electrical cardioversion may, by restoring sinus rhythm, improve cardiovascular haemodynamics, reduce the risk of stroke, and obviate the need for long-term anticoagulation. OBJECTIVES: To assess the effects of electrical cardioversion of atrial fibrillation or flutter on the risk of thromboembolic events, strokes and mortality (primary outcomes), the rate of cognitive decline, quality of life, the use of anticoagulants and the risk of re-hospitalisation (secondary outcomes) in adults (>18 years)...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29138609/non-valvular-atrial-fibrillation-impact-of-apixaban-on-patient-outcomes
#10
REVIEW
Adam Ioannou, Irene Tsappa, Sofia Metaxa, Constantinos G Missouris
Atrial fibrillation is the most common arrhythmia worldwide, and carries a significantly increased risk of thromboembolic stroke. Initially, vitamin K antagonists were used as stroke prophylaxis; but more recently, a group of drugs known as novel oral anticoagulants have been developed. Apixaban belongs to this group of drugs, and is a factor Xa inhibitor that has emerged as a popular pharmacological agent worldwide. In this review, we will provide an overview of the pivotal trials in the development of apixaban, while also critically evaluating the new emerging real-world data, and discussing the effectiveness, safety, economic viability and future prospects of apixaban and how it impacts on patient outcomes in those with non-valvular atrial fibrillation...
2017: Patient related Outcome Measures
https://www.readbyqxmd.com/read/29136662/protective-effect-of-metformin-against-retinal-vein-occlusions-in-diabetes-mellitus-a-nationwide-population-based-study
#11
Tai-Chi Lin, De-Kuang Hwang, Chih-Chien Hsu, Chi-Hsien Peng, Mong-Lien Wang, Shih-Hwa Chiou, Shih-Jen Chen
Previous studies have found that metformin can reduce cardiovascular risk, but its association with retinal vein occlusion (RVO) is unknown. In this population-based cohort study using the Taiwan National Health Insurance Research Database (NHIRD), we demonstrated the protective effect of metformin against RVO in diabetes mellitus (DM) and explored the incidence rate and factors associated with RVO development in general and diabetic populations. One million patients were randomly selected from the registry files of the NHIRD, and all their claims data were collected for the 1996-2011 period...
2017: PloS One
https://www.readbyqxmd.com/read/29136331/risk-factor-management-in-a-contemporary-australian-population-at-increased-cardiovascular-disease-risk
#12
D J Campbell, J M Coller, F F Gong, M McGrady, D L Prior, U Boffa, L Shiel, D Liew, R Wolfe, A J Owen, H Krum, C M Reid
BACKGROUND: Effective management of cardiovascular and chronic kidney disease risk factors offers longer, healthier lives and savings in health care. We examined risk factor management in participants of the SCReening Evaluation of the Evolution of New Heart Failure (SCREEN-HF) study, a self-selected population at increased cardiovascular disease risk recruited from members of a health insurance fund in Melbourne and Shepparton, Australia. METHODS: Inclusion criteria were age ≥60 years with one or more of self-reported ischaemic or other heart disease, irregular or rapid heart rhythm, cerebrovascular disease, renal impairment, or treatment for hypertension or diabetes for ≥2 years...
November 14, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29132650/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#13
REVIEW
Marin Nishimura, Jonathan C Hsu
Over the past decade, there have been tremendous advancements in anticoagulation therapies for stroke prevention in patients with atrial fibrillation (AF). Although the non-vitamin K antagonist oral anticoagulants (NOACs) demonstrated favorable clinical outcomes compared with warfarin overall, the decision to anticoagulate and the choice of appropriate agent in patients with AF and concomitant chronic kidney disease (CKD) or end-stage renal disease (ESRD) are a particularly complex issue. CKD and ESRD increase both the risk of stroke and bleeding, and since all of the NOACs undergo various levels of renal clearance, renal dysfunction inevitably affects the pharmacokinetics of the drug in each patient...
October 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29131836/opportunistic-screening-for-atrial-fibrillation-in-a-real-life-setting-in-general-practice-in-denmark-the-atrial-fibrillation-found-on-routine-detection-afford-non-interventional-study
#14
Jonas Hald, Peter Bo Poulsen, Ina Qvist, Lisbeth Holm, Dorte Wedell-Wedellsborg, Lars Dybro, Lars Frost
Atrial fibrillation (AF) is a chronic disease with an incidence increasing steeply by age and affecting more than 11 million patients in Europe and the United States. Diagnosing AF is essential for the prevention of stroke by oral anticoagulation. Opportunistic screening for AF in patients ≥65 years of age is recommended by the European and Danish Societies of Cardiology. The study aim was to examine the detection rate of AF in consecutively screened patients in the primary care setting in Denmark. In an open, non-interventional, cluster, multicenter, cross-sectional, observational study patients ≥65 years of age entering consecutively into general practice clinics were invited to nurse-assisted opportunistic screening for AF...
2017: PloS One
https://www.readbyqxmd.com/read/29131431/synthesis-of-fucosylated-chondroitin-sulfate-glycoclusters-a-robust-route-to-novel-anticoagulant-agents
#15
Xiao Zhang, Wang Yao, Xiaojiang Xu, Huifang Sun, Jinhua Zhao, Xiangbao Meng, Mingyi Wu, Zhongjun Li
Fucosylated chondroitin sulfate (FuCS) is a structurally distinct glycosaminoglycan with excellent anticoagulant activity. Studies show that FuCS and its depolymerized fragments exhibit different anticoagulant mechanism from heparin derivatives, with decreased risks of adverse effects and bleeding. However, further exploitation has been hindered by the scarcity of structurally defined oligosaccharides. Herein we report a facile method to synthesize the repeating trisaccharide unit of FuCS based on the degradation of chondroitin sulfate polymers...
November 13, 2017: Chemistry: a European Journal
https://www.readbyqxmd.com/read/29129761/are-antiplatelet-and-anticoagulants-drugs-a-risk-factor-for-bleeding-in-mild-traumatic-brain-injury
#16
Laura Uccella, Cesare Zoia, Daniele Bongetta, Paolo Gaetani, Franz Martig, Christian Candrian, Raffaele Rosso
OBJECT: facing mild traumatic brain injury (mTBI) clinicians must decide whether to perform a CT scan to detect a potential intracranial hemorrhage.Many useful guidelines have been developed for general population, but there is no general consensus about the best practice to adopt when dealing with patients on antiplatelet or anticoagulation drugs. The relatively recent introduction of new anticoagulants and second generation antiplatelet drugs poses new challenges in this field. There is no data in the literature about the relative risk of intracranial bleeding in such categories...
November 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29129259/comparison-of-prevalence-and-management-of-left-atrial-appendage-thrombi-under-old-and-new-anticoagulants-prior-to-left-atrial-catheter-ablation
#17
Antoine Da Costa, Clarisse Delolme, Jean Baptiste Guichard, Antoine Gerbay, Romain Pierrard, Cécile Romeyer-Bouchard, Karl Isaaz
BACKGROUND: The prevalence and management of left atrial appendage (LAA) thrombi associated with new anticoagulants remain to be elucidated, especially prior to atrial fibrillation (AFib) ablation. This study sought to (1) compare the prevalence of LAA thrombi and/or severe LAA contrast under vitamin K antagonist (VKA) agents and novel oral anticoagulants (NOACs), (2) evaluate the rate of LAA thrombus resolution after anticoagulation modification, and (3) determine the predictive factors of LAA thrombi and severe LAA contrast in patients prior to LA AFib ablation...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29129158/practical-gastrointestinal-investigation-of-iron-deficiency-anaemia
#18
Anjan K Banerjee, Valerio Celentano, Jim Khan, Gaius Longcroft-Wheaton, Amanda Quine, Pradeep Bhandari
About 10% of oesophagogastroduodenoscopies (OGDs) and colonoscopies are done for investigation of iron deficiency anemia (IDA) . Much of the existing guidance on investigation of IDA predates CRC screening, which has driven significant improvements in colonoscopy quality and completion rates, as well as a reduction in Helicobacter pylori prevalence and increase in PPI usage, and therefore probably needs re-consideration. New investigations, e.g. CT colonography, enteroscopy and capsule endoscopy have also been introduced...
November 13, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29122724/detection-of-new-atrial-fibrillation-in-patients-with-cardiac-implanted-electronic-devices-and-factors-associated-with-transition-to-higher-device-detected-atrial-fibrillation-burden
#19
Giuseppe Boriani, Taya V Glotzer, Paul D Ziegler, Mirko De Melis, Lorenza Mangoni di S Stefano, Milan Sepsi, Maurizio Landolina, Maurizio Lunati, Thorsten Lewalter, A John Camm
BACKGROUND: In patients with cardiac implanted electronic devices (CIEDs) detection of new atrial fibrillation (AF) is associated with an increased risk of stroke. OBJECTIVE: To characterize daily AF burden at first detection and the rate of temporal transition to higher device detected AF burden. METHODS: A pooled analysis of data from three prospective studies was analyzed and 6580 patients (mean age 68±12 years, 72% male) with no history of AF and no anticoagulants at baseline were identified...
November 6, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29120920/the-growing-clinical-spectrum-of-cerebral-amyloid-angiopathy
#20
Marieke J H Wermer, Steven M Greenberg
PURPOSE OF REVIEW: Cerebral amyloid angiopathy (CAA) is diagnosed primarily as a cause of lobar intracerebral hemorrhages (ICH) in elderly patients. With improving MRI techniques, however, the role of CAA in causing other symptoms has become clear. Recognizing the full clinical spectrum of CAA is important for diagnosis and treatment. In this review we summarize recent insights in clinical CAA features, MRI biomarkers, and management. RECENT FINDINGS: The rate of ICH recurrence in CAA is among the highest of all stroke subtypes...
November 7, 2017: Current Opinion in Neurology
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