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https://www.readbyqxmd.com/read/27931607/causes-of-death-in-anticoagulated-patients-with-atrial-fibrillation
#1
Antonio Gómez-Outes, Julián Lagunar-Ruíz, Ana-Isabel Terleira-Fernández, Gonzalo Calvo-Rojas, Maria Luisa Suárez-Gea, Emilio Vargas-Castrillón
BACKGROUND: Oral anticoagulation reduces the risk of mortality in atrial fibrillation (AF), but examination of the causes of death is essential to design new strategies to further reduce the high mortality rates observed in this population. OBJECTIVES: The authors sought to analyze and compare causes of death in patients receiving direct oral anticoagulants (DOAC) or warfarin for prevention of stroke and systemic embolism (SE) in AF. METHODS: The authors systematically searched for randomized trials of DOAC versus warfarin for prevention of stroke/SE in AF...
December 13, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27929577/a-practical-approach-to-the-new-oral-anticoagulants-used-for-stroke-prevention-in-patients-with-atrial-fibrillation
#2
S Bashir, A Al-Mohammed, S Gupta
This review evaluates the research undertaken in the last six years on the use of new oral anticoagulants for stroke prevention in atrial fibrillation and provides evidence-based answers to common clinical questions. Two types of new oral anticoagulants - direct thrombin (IIa) inhibitors, and Xa inhibitors - are currently available. These drugs have similar pharmacokinetics and pharmacodynamics. They are more predictable than, though in many respects comparable to, warfarin. They do not require frequent laboratory tests, nor do they have a narrow therapeutic window...
June 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27926465/freestyle-stentless-bioprosthesis-for-aortic-valve-therapy-17-year-clinical-results
#3
Juergen Ennker, Markus Meilwes, Joern Pons-Kuehnemann, Bernd Niemann, Philippe Grieshaber, Ina C Ennker, Andreas Boening
BACKGROUND: Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. METHODS: Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center...
November 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27918771/association-of-selective-serotonin-reuptake-inhibitors-with-the-risk-for-spontaneous-intracranial-hemorrhage
#4
Christel Renoux, Sarah Vahey, Sophie Dell'Aniello, Jean-François Boivin
Importance: Selective serotonin reuptake inhibitors (SSRIs) may increase the risk for spontaneous intracranial hemorrhage (ICH), an effect that is in theory linked to the strength of inhibition of serotonin reuptake of an antidepressant. However, whether antidepressants that are strong inhibitors of serotonin reuptake actually increase the risk for ICH and the effect of concomitant use of antithrombotics are unknown. Objectives: To assess the risk for ICH associated with the use of SSRIs compared with tricyclic antidepressants (TCAs) among new users of antidepressants and according to the relative affinity of the antidepressant for the serotonin transporter and to assess whether concomitant use of antithrombotics modifies this risk...
December 5, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27917690/pharmacological-management-of-pulmonary-embolism
#5
Bobby Gouin, Helia Robert-Ebadi, Marc Righini, Marc Blondon
Pulmonary embolism (PE) is a common and potentially severe manifestation of venous thromboembolism. Its management has relied on anticoagulation by vitamin K antagonists (VKA) for the past fifty years. Recently, new alternative drugs have been developed and dramatically modified both the treatment of acute PE and its secondary prevention. Areas covered: This review discusses the contemporary pharmacological treatment for PE, with a focus on anticoagulation options for non-high risk PE. In particular, the advent of direct oral anticoagulants (rivaroxaban, apixaban, edoxaban and dabigatran) and modalities for long-term prevention will be described...
December 3, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27911120/new-frontiers-in-anticoagulation-non-vitamin-k-oral-anticoagulants-in-stroke-prevention
#6
Valentina Arnao, Marianna Riolo, Antonino Tuttolomondo, Antonio Pinto, Brigida Fierro, Paolo Aridon
Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert Commentary: Although warfarin is effective in cardioembolic stroke prevention, easier handling and more favorable risk-benefit profile often render NOACs a more preferable therapy choice for neurologists...
December 2, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27909516/the-role-of-noacs-in-atrial-fibrillation-management-a-qualitative-study
#7
Katherine Kirley Md Ms, Goutham Rao Md, Victoria Bauer Bs, Christopher Masi Md PhD
Patients with atrial fibrillation (AF) benefit from anticoagulation to reduce stroke risk. However, 30-60% of patients with AF are not anticoagulated. This study explored physicians' reasons for under-treatment of AF, focusing on the role of the novel oral anticoagulants (NOACs). We interviewed primary care physicians and cardiologists involved in AF management in a variety of practice settings. We conducted interviews using a semi-structured format and analyzed the data using the Framework Method. Four themes emerged...
June 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909486/misleading-advertising-by-attorneys-concerning-noacs-is-adversely-costly-to-our-patients-and-our-society
#8
EDITORIAL
James A, Reiffel M D
Over the past five years, "ambulance-chasing" attorneys have aggressively advertised for patients who have bled on a new oral anticoagulant (NOAC) or their family members. It is an infrequent day when American consumers do not see a TV advertisement saying something like: "Have you or a loved-one had a serious bleeding event while taking [fill in the NOAC]? If so, you may be entitled to monetary compensation. Call XXX, attorneys at law, and we will get you the money you deserve."
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909482/the-cost-effectiveness-of-laa-exclusion
#9
REVIEW
Bahij Kreidieh, Moisés Rodríguez-Mañero, Sergio H Ibarra-Cortez, Paul Schurmann, Miguel Valderrábano
Left atrial appendage (LAA) exclusion strategies are increasingly utilized for stroke prevention in lieu of oral anticoagulants. Reductions in bleeding risk and long-term compliance issues bundled with comparable stroke prevention benefits have made these interventions increasingly attractive. Unfortunately, healthcare funding remains limited. Comparative cost economic analyses are therefore critical in optimizing resource allocation. In this review we seek to discourse the cost economics analysis of LAA exclusion over available therapeutic alternatives (warfarin and the new oral anticoagulants (NOACs))...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27906754/management-of-acute-stroke-in-patients-on-oral-anticoagulants
#10
Jan C Purrucker, Thorsten Steiner
PURPOSE OF REVIEW: An increasing number of patients are receiving oral anticoagulants. Since non-vitamin K antagonist oral anticoagulants (NOACs) were approved, primary prevention of ischemic stroke has become simpler. However, managing ischemic stroke and intracerebral hemorrhage while on oral anticoagulation (OAC) has become more complex. This review covers the latest developments in managing ischemic and hemorrhagic stroke in patients receiving vitamin K antagonists (VKA) and NOACs...
December 7, 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27903029/-lupus-erythematosus-update-2016
#11
Martin Aringer, Reinhard Edmund Voll
Meanwhile, five years have passed since the approval of the anti-BAFF antibody belimumab as a first biological for SLE, but no further SLE drug candidate is even close to approval. There are still no clinical trial data available for the use of new oral anticoagulants in antiphospholipid syndrome. In spite of convincing evidence for the use of mycophenolate mofetil (MMF) in lupus nephritis, the German "Gemeinsame Bundesausschuss" (GBA) has not yet decided on its reimbursement. However, several of the ongoing clinical trials have potential to lead to important advances in SLE treatment in the future...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27900867/-new-direct-oral-anticoagulants-actual-review
#12
Jana Michalcová, Miroslav Penka, Alena Buliková, Jiřina Zavřelová, Andrea Štěpařová
In recent years the options of anticoagulant/antithrombotic therapy have extended with new - direct oral anticoagulants, comprising direct thrombin inhibitors (dabigatran etexilate) and direct factor Xa inhibitors (rivaroxaban, apixaban). These agents represent another progress towards "the ideal antithrombotic drug", and thus towards a safe and effective antithrombotic therapy. The following article provides actual review and recommendations for clinical practice, including laboratory assessment and management of emergency situations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27899756/coagulation-testing-in-acute-ischemic-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants
#13
Jan C Purrucker, Kirsten Haas, Timolaos Rizos, Shujah Khan, Sven Poli, Peter Kraft, Christoph Kleinschnitz, Rainer Dziewas, Andreas Binder, Frederick Palm, Sebastian Jander, Hassan Soda, Peter U Heuschmann, Roland Veltkamp
BACKGROUND AND PURPOSE: In patients who present with acute ischemic stroke while on treatment with non-vitamin K antagonist oral anticoagulants (NOACs), coagulation testing is necessary to confirm the eligibility for thrombolytic therapy. We evaluated the current use of coagulation testing in routine clinical practice in patients who were on NOAC treatment at the time of acute ischemic stroke. METHODS: Prospective multicenter observational RASUNOA registry (Registry of Acute Stroke Under New Oral Anticoagulants; February 2012-2015)...
November 29, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#14
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27896543/vitamin-k-antagonists-relative-strengths-and-weaknesses-vs-direct-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation
#15
REVIEW
Andreas Zirlik, Christoph Bode
Vitamin K antagonists (VKAs) have been the mainstay of anticoagulation therapy for more than 50 years. VKAs are mainly used for the prevention of stroke in patients with atrial fibrillation (AF) and the treatment and secondary prevention of venous thromboembolism. In the past 5 years, four new agents-the direct factor Xa inhibitors apixaban, edoxaban and rivaroxaban and the direct thrombin inhibitor dabigatran [collectively known as direct oral anticoagulants (DOACs) or non-VKA oral anticoagulants]-have been approved for these and other indications...
November 28, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27895055/role-of-agents-for-reversing-the-effects-of-target-specific-oral-anticoagulants
#16
REVIEW
Tanya R Riley, Mary L Gauthier-Lewis, Chelsea K Sanchez, Janine S Douglas
PURPOSE: The available clinical data on target-specific oral anticoagulant (TSOAC) reversal agents that are currently in development or have been approved by the Food and Drug Administration (FDA) are reviewed. SUMMARY: The development of TSOACs such as dabigatran, rivaroxaban, edoxaban, and apixaban has presented benefits and new challenges. One of the main challenges associated with the use of TSOACs is the lack of suitable agent-specific reversal agents. Several treatment options for the management of life-threatening bleeding events associated with TSOAC use, such as fresh frozen plasma, prothrombin complex concentrates, and recombinant coagulation factor VIIa, have been used, with inconsistent results...
November 28, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27892890/trial-design-rivaroxaban-for-the-prevention-of-major-cardiovascular-events-after-transcatheter-aortic-valve-replacement-rationale-and-design-of-the-galileo-study
#17
Stephan Windecker, Jan Tijssen, Gennaro Giustino, Ana H C Guimarães, Roxana Mehran, Marco Valgimigli, Pascal Vranckx, Robert C Welsh, Usman Baber, Gerrit-Anne van Es, Peter Wildgoose, Albert A Volkl, Ana Zazula, Karen Thomitzek, Melanie Hemmrich, George D Dangas
BACKGROUND: Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN: GALILEO is an international, randomized, open-label, event-driven, phase III trial in more than 1,520 patients without an indication for oral anticoagulation who underwent a successful TAVR (ClinicalTrials...
October 31, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892885/vitamin-k-antagonists-for-stroke-prevention-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#18
Hans Van Der Meersch, Dirk De Bacquer, An S De Vriese
BACKGROUND: The use of vitamin K antagonists (VKAs) in hemodialysis patients with atrial fibrillation (AF) is controversial. No randomized trials are available and observational studies have yielded conflicting results, engendering a large clinical practice variability and physician uncertainty. An unresolved but highly relevant question is whether AF poses a true risk of ischemic stroke in hemodialysis and whether any form of oral anticoagulation is therefore warranted. METHODS: We conducted a systematic review of studies that compared the incidence of ischemic stroke and bleeding in hemodialysis patients with AF taking VKA and those not taking VKA...
October 4, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27891570/pragmatic-approach-to-manage-new-oral-anticoagulants-in-patients-undergoing-dental-extractions-a-prospective-case-control-study
#19
Isabel Miclotte, Maarten Vanhaverbeke, Jimoh Olubanwo Agbaje, Paul Legrand, Thomas Vanassche, Peter Verhamme, Constantinus Politis
OBJECTIVES: The aim of this study was to validate a standardized pragmatic approach to manage new oral anticoagulants (NOACs) in patients who undergo dental extractions. MATERIALS AND METHODS: This prospective case-control study in patients undergoing dental extraction included 26 patients (mean age 76 years, 57% male) treated with dabigatran, rivaroxaban, or apixaban and 26 matched controls. Regardless of timing of extraction, drug regimen, or renal function, patients were instructed to skip only the dose on the morning of the procedure...
November 28, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27890386/2016-guidelines-of-the-taiwan-heart-rhythm-society-and-the-taiwan-society-of-cardiology-for-the-management-of-atrial-fibrillation
#20
Chern-En Chiang, Tsu-Juey Wu, Kwo-Chang Ueng, Tze-Fan Chao, Kuan-Cheng Chang, Chun-Chieh Wang, Yenn-Jiang Lin, Wei-Hsian Yin, Jen-Yuan Kuo, Wei-Shiang Lin, Chia-Ti Tsai, Yen-Bin Liu, Kun-Tai Lee, Li-Jen Lin, Lian-Yu Lin, Kang-Ling Wang, Yi-Jen Chen, Mien-Cheng Chen, Chen-Chuan Cheng, Ming-Shien Wen, Wen-Jone Chen, Jyh-Hong Chen, Wen-Ter Lai, Chuen-Wang Chiou, Jiunn-Lee Lin, San-Jou Yeh, Shih-Ann Chen
Atrial fibrillation (AF) is the most common sustained arrhythmia. Both the incidence and prevalence of AF are increasing, and the burden of AF is becoming huge. Many innovative advances have emerged in the past decade for the diagnosis and management of AF, including a new scoring system for the prediction of stroke and bleeding events, the introduction of non-vitamin K antagonist oral anticoagulants and their special benefits in Asians, new rhythm- and rate-control concepts, optimal endpoints of rate control, upstream therapy, life-style modification to prevent AF recurrence, and new ablation techniques...
November 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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