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https://www.readbyqxmd.com/read/29775297/factor-xia-inhibitors-as-new-anticoagulants
#1
Mimi L Quan, Donald J P Pinto, Joanne M Smallheer, William R Ewing, Karen A Rossi, Joseph M Luettgen, Dietmar A Seiffert, Ruth R Wexler
With the introduction of thrombin and factor Xa inhibitors to the oral anticoagulant market, significant improvements in both efficacy and safety have been achieved. Early clinical and preclinical data suggest that inhibitors of factor XIa can provide a still safer alternative, with expanded efficacy for arterial indications. This Perspective provides an overview of target rationale and details of the discovery and development of inhibitors of factor XIa as next generation antithrombotic agents.
May 18, 2018: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29775170/rationale-design-and-protocol-of-a-randomized-controlled-trial-of-the-safety-and-efficacy-of-dabigatran-etexilate-versus-dose-adjusted-warfarin-in-patients-with-cerebral-venous-thrombosis
#2
José M Ferro, Francesco Dentali, Jonathan M Coutinho, Adam Kobayashi, Jorge Caria, Marc Desch, Mandy Fraessdorf, Holger Huisman, Hans-Christoph Diener
Rationale To prevent recurrent venous thrombotic events after acute cerebral venous or dural sinus thrombosis, guidelines recommend long-term oral anticoagulation with vitamin K antagonists. Non-vitamin K oral anticoagulant experience in cerebral venous or dural sinus thrombosis is limited to case reports and series. Aim To compare dabigatran with dose-adjusted warfarin in patients with cerebral venous or dural sinus thrombosis for the prevention of recurrent venous thrombotic event. Sample size One hundred and twenty patients...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#3
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29768158/-issues-of-antithrombotic-therapy-in-acs-patients-with-atrial-fibrillation
#4
N A Kaydalova, L Y Koroleva, G V Kovaleva, N N Paykova, V P Nosov, A T Volkova, A M Koryazina
The review analyzed current ideas on prevalence and clinical significance of atrial fibrillation following acute coronary syndrome; described modern approaches to administration of antithrombotic therapy; and addressed available clinical studies on the treatment with warfarin and new oral anticoagulants as a part of combination antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome.
2018: Kardiologiia
https://www.readbyqxmd.com/read/29754652/risk-of-cardiovascular-events-and-incident-atrial-fibrillation-in-patients-without-prior-atrial-fibrillation-implications-for-expanding-the-indications-for-anticoagulation
#5
Xiaoxi Yao, Bernard J Gersh, Lindsey R Sangaralingham, Nilay D Shah, Peter A Noseworthy
BACKGROUND: There is growing interest in the role for non-vitamin K antagonist oral anticoagulants (NOACs) in patients without atrial fibrillation (AF). We aimed to provide a comprehensive assessment of the risks of ischemic stroke, myocardial infarction (MI), AF, and major bleeding in patients without previously diagnosed AF. METHODS: Using a large US administrative database, we identified 6,495,875 patients ≥50 years between January 1, 2011, and September 30, 2016, who were not diagnosed with AF and were not treated with oral anticoagulants or nonaspirin antiplatelet agents...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29754512/-stroke-prevention-in-the-elderly-effectiveness-and-safety-of-edoxaban-in-elderly-patients-according-to-the-results-of-the-engage-af-study
#6
László Márk
Atrial fibrillation is the most common clinically relevant arrhythmia frequently causing systemic thromboembolic events. Traditionally vitamin K antagonists had been used for decades to prevent these events. The emerging of the new direct anticoagulants has revolutionized this treatment and a gradual growth and extensive spread of usage is expected. The latest one approved in Hungary, edoxaban, is a factor Xa inhibitor. Once-daily administration and favourable safety profile are major benefits of this drug...
May 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29748219/frequency-reasons-and-impact-of-premature-ticagrelor-discontinuation-in-patients-undergoing-coronary-revascularization-in-routine-clinical-practice-results-from-the-bern-percutaneous-coronary-intervention-registry
#7
Thomas Zanchin, Fabrice Temperli, Alexios Karagiannis, Christian Zanchin, Markus Räsänen, Konstantinos C Koskinas, Stefan Stortecky, Lukas Hunziker, Fabien Praz, Stefan Blöchlinger, Christina Moro, Aris Moschovitis, Christian Seiler, Michael Billinger, Dik Heg, Thomas Pilgrim, Marco Valgimigli, Stephan Windecker, Lorenz Räber
BACKGROUND: Although ticagrelor has improved clinical outcomes among patients with acute coronary syndrome compared with clopidogrel, adherence to this new antiplatelet agent in real-world practice has not been fully investigated. METHODS AND RESULTS: Between November 2011 and June 2014, 1278 of 4831 consecutive patients (26.5%) undergoing percutaneous coronary intervention at a tertiary care center were treated with ticagrelor. Premature ticagrelor cessation was categorized into (1) change, when ticagrelor was replaced by prasugrel; (2) de-escalation, when ticagrelor was replaced by clopidogrel; and (3) premature discontinuation, when ticagrelor was discontinued without P2Y12 inhibitor replacement...
May 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29743994/approaches-to-left-atrial-appendage-closure-device-design-performance-and-limitations
#8
REVIEW
Amish S Dave, Miguel Valderrábano
Up to 6.1 million people in the United States have atrial fibrillation (AF), which is associated with an increased risk of stroke. Oral anticoagulants are the mainstay of stroke prevention in AF. For decades, warfarin was the only available drug, fraught with compliance limitations, a narrow therapeutic window, and a high risk of hemorrhage. Pharmacologic developments have produced new anticoagulants that have improved the rates of stroke related to AF; however, they still confer a high risk of bleeding, making them unsuitable for some patients...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29743176/warfarin-and-vitamin-k-epoxide-reductase-a-molecular-accounting-for-observed-inhibition
#9
Sangwook Wu, Xuejie Chen, Da-Yun Jin, Darrel W Stafford, Lee G Pedersen, Jian-Ke Tie
Vitamin K epoxide reductase (VKOR), an endoplasmic reticulum membrane protein, is the key enzyme for vitamin K-dependent carboxylation, a post-translational modification that is essential for the biological functions of coagulation factors. VKOR is the target of the most widely prescribed oral anticoagulant warfarin. However, the topological structure of VKOR and the mechanism of warfarin's inhibition of VKOR remain elusive. Additionally, it is not clear why warfarin-resistant VKOR mutations identified in patients significantly decrease warfarin's binding affinity, but have only a minor effect on vitamin K binding...
May 9, 2018: Blood
https://www.readbyqxmd.com/read/29742737/inadvertent-defibrillator-lead-placement-into-the-left-ventricle-after-mitraclip-implantation-a-case-report
#10
Giuseppe Santarpia, Francesco Passafaro, Eugenia Pasceri, Annalisa Mongiardo, Antonio Curcio, Ciro Indolfi
RATIONALE: Inadvertent pacemaker/defibrillator lead placement into the left ventricle is an unusual cardiac device-related complication and its diagnosis is not always easy and often misunderstood. Thromboembolic events are frequently associated with this procedural complication. Percutaneous lead extraction should be performed when diagnosis is made early after device implantation while long-life oral anticoagulation is a wise option when the diagnosis is delayed and the lead is not removed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29739915/cost-effectiveness-of-left-atrial-appendage-closure-with-the-watchman-device-compared-with-warfarin-or-non-vitamin-k-antagonist-oral-anticoagulants-for-secondary-prevention-in-nonvalvular-atrial-fibrillation
#11
Vivek Y Reddy, Ronald L Akehurst, Stacey L Amorosi, Meghan B Gavaghan, Deanna S Hertz, David R Holmes
BACKGROUND AND PURPOSE: Once a patient with atrial fibrillation experiences an embolic event, the risk of a recurrent event increases 2.6-fold. New treatments have emerged as viable treatment alternatives to warfarin for stroke risk reduction in secondary prevention populations. This analysis sought to assess the cost-effectiveness of left atrial appendage closure (LAAC) compared with warfarin and the non-vitamin K antagonist oral anticoagulants dabigatran 150 mg, apixaban and rivaroxaban in the prevention of stroke in nonvalvular atrial fibrillation patients with a prior stroke or transient ischemic attack...
May 8, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29739702/contemporary-approach-to-stroke-prevention-in-atrial-fibrillation-risks-benefits-and-new-options
#12
REVIEW
Jonathan Stock, Brian J Malm
Atrial fibrillation is a common diagnosis affecting nearly 3 million adults in the United States. Morbidity and mortality in these patients is driven largely by the associated increased risk of thromboembolic complications, especially stroke. Atrial fibrillation is a stronger risk factor than hypertension, coronary disease, or heart failure and is associated with an approximately five-fold increased risk. Mitigating stroke risk can be challenging and requires accurate assessment of stroke risk factors and careful selection of appropriate therapy...
April 4, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29735286/epistaxis-complicating-treatment-by-anti-vitamin-k-and-new-oral-anticoagulants
#13
V L'Huillier, C Badet, L Tavernier
OBJECTIVES: To assess any differences in severity and management of epistaxis when complicating treatment by anti-vitamin K (AVK) or by new oral anticoagulants (NOAC). MATERIALS AND METHOD: All patients admitted to the ENT department of a University Hospital Center for epistaxis under oral anticoagulation therapy between January 2010 and June 2015 were included in a retrospective study. Severity was assessed in terms of management and of hemoglobin level at admission...
May 4, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29733468/guidelines-for-gastroenterological-endoscopy-in-patients-undergoing-antithrombotic-treatment-2017-appendix-on-anticoagulants-including-direct-oral-anticoagulants-doacs
#14
REVIEW
Mototsugu Kato, Noriya Uedo, Seiji Hokimoto, Masahiro Ieko, Kazuhide Higuchi, Kazunari Murakami, Kazuma Fujimoto
In 2012, the Japan Gastroenterological Endoscopy Society has published "Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment" concerning thromboembolism associated with antithrombotic therapy withdrawal. Since then, physicians have started prescribing oral anticoagulants, creating a need for standards reflecting their use in clinical practice. Therefore, new findings regarding anticoagulants are included in this appendix. However, the evidence levels are low for many statements contained herein and these appended guidelines still need to be verified in clinical settings...
May 7, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29730624/optimal-thromboprophylaxis-in-elderly-chinese-patients-with-atrial-fibrillation-chioteaf-registry-protocol-for-a-prospective-observational-nationwide-cohort-study
#15
Yutao Guo, Yutang Wang, Xiaoying Li, Zaoliang Shan, Xiangmin Shi, Guorong Xi, Gregory Y H Lip
INTRODUCTION: Atrial fibrillation (AF) is a worldwide healthcare burden that is associated with the ageing population. Elderly patients with AF with multiple comorbidities usually present with a high risk of thromboembolism and bleeding. Limited prospective data are available from Asian cohorts on the epidemiology and complications of AF. The present prospective cohort study aims to explore contemporary antithrombotic strategies among the elderly Chinese population in the new era of non-vitamin K antagonist oral anticoagulants and to compare the clinical characteristics and outcomes between Chinese and European AF populations...
May 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29727507/optimal-combination-strategy-of-left-atrial-appendage-closure-plus-catheter-ablation-in-a-single-procedure-in-patients-with-nonvalvular-atrial-fibrillation
#16
Xianfeng Du, Huimin Chu, Bin He, Binhao Wang, Jing Liu, Mingjun Feng, Yibo Yu, Guohua Fu, He Jin, Fang Gao, Jingjing Zhu, Xiaomin Chen
BACKGROUND: The efficacy and safety of combining left atrial appendage closure (LAAC) plus atrial fibrillation (AF) catheter ablation (CA) in a single procedure has been established, but the optimal combination strategy has not been thoroughly elucidated to date. OBJECTIVE: We aimed to investigate the impact of different combination strategies on clinical outcomes. METHODS: Eighty-two consecutive patients with symptomatic AF (mean CHA2 DS2 -VASc score 4...
May 4, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29724279/instrument-for-assessing-knowledge-of-oral-anticoagulant-therapy-construction-and-validation
#17
Fernanda Souza E Silva Garcia, Débora Cristina Prévide Teixeira da Cunha, Rafaela de Oliveira Manzato, Fabiana Bolela, Pedro Alberto Barbetta, Rosana Spadoti Dantas
BACKGROUND AND PURPOSE: A valid and reliable assessment tool is fundamental for evaluating the knowledge of individuals about using oral anticoagulant therapy (OAT). The purpose of this study was to develop a tool to assess knowledge about OAT and provide evidence to support its use in people living in developing countries. METHODS: Construction and validation: development of items; assessment of face and content validity; pilot study; application of the instrument to a sample of 500 users of OAT to analyze dimensionality, convergent validation, and reliability...
April 1, 2018: Journal of Nursing Measurement
https://www.readbyqxmd.com/read/29723893/causes-of-death-in-patients-with-venous-thromboembolism-anticoagulated-with-direct-oral-anticoagulants-a-systematic-review-and-meta-analysis
#18
Antonio Gómez-Outes, Ana Isabel Terleira-Fernández, Ramón Lecumberri, Mª Luisa Suárez-Gea, Gonzalo Calvo-Rojas, Emilio Vargas-Castrillón
Death is more frequent than nonfatal recurrent venous thromboembolism (VTE) and major bleeding after acute VTE. The analysis of the causes of death is fundamental to explore new strategies to reduce mortality rates in these patients. The authors performed a meta-analysis to analyze mortality and independently adjudicated causes of death in anticoagulated patients due to VTE, and to evaluate potential differences between different anticoagulant schemes. They searched MEDLINE and CENTRAL, from January 1, 2000, to January 31, 2017, and performed additional searches in Web sites of regulatory agencies, clinical trial registers, and conference proceedings...
May 3, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29723207/benefit-risk-and-cost-of-new-oral-anticoagulants-and-warfarin-in-atrial-fibrillation-a-multicriteria-decision-analysis
#19
Jose Mendoza-Sanchez, Federico Silva, Lady Rangel, Linda Jaramillo, Leidy Mendoza, Jenny Garzon, Andrea Quiroga
INTRODUCTION: Warfarin and new oral anticoagulants are effective in reducing stroke in atrial fibrillation; however, the benefits and risks rates in clinical trials show heterogeneity for each anticoagulant, and is unknown the cost influence on a model considering most of the treatment consequences. We designed a benefit-risk and cost assessment of oral anticoagulants. DESIGN: We followed the roadmap proposed by IMI-PROTECT and the considerations of emerged good practice to perform Multi-Criteria Decision Analysis (MCDA)...
2018: PloS One
https://www.readbyqxmd.com/read/29715499/new-and-upcoming-treatments-in-antiphospholipid-syndrome-a-comprehensive-review
#20
REVIEW
Flavio Signorelli, Gustavo Guimarães Moreira Balbi, Vinicius Domingues, Roger Abramino Levy
Current therapeutic recommendations for thrombosis prevention in patients with antiphospholipid syndrome (APS) are limited to anticoagulation with vitamin K antagonists (VKA) or heparins and to anti-platelet aggregating agents. Maintaining optimized anticoagulation to prevent recurrent thrombosis or bleeding remains a therapeutic challenge. Although there are important ongoing trials with direct oral anticoagulants, they still aim the same target. New insights about pathophysiology in APS have revealed a myriad of potential pathways to be investigated as treatment targets...
April 28, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
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