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https://www.readbyqxmd.com/read/29670777/iatrogenic-spinal-subdural-hematoma-due-to-apixaban-a-case-report-and-review-of-the-literature
#1
Alba Colell, Adrià Arboix, Francesco Caiazzo, Elisenda Grivé
In the last decade, the clinical relevance for developing safer oral anticoagulants prompted the development of new classes of drugs that have shown a lower risk of life-threatening bleeding events as compared to standard warfarin. Nontraumatic spinal subdural hematoma is an uncommon urgent complication that can be associated with the use of these agents. An unusual case of spinal subdural hematoma related to apixaban treatment for nonrheumatic atrial fibrillation is reported here.
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29663354/the-management-of-livedoid-vasculopathy-focused-on-direct-oral-anticoagulants-doacs-four-case-reports-successfully-treated-with-rivaroxaban
#2
Gabriela Franco Marques, Paulo Ricardo Criado, Thâmara Cristiane Alves Batista Morita, María Salomé Cajas García
Livedoid vasculopathy (LV) is a thrombotic skin disease characterized by episodic painful ulcerations of the distal aspects of the legs. Its healing process typically leaves small porcelain-white scars called atrophie blanche as a result of the occlusion of cutaneous microcirculation. The main goals of the treatment are pain management and the prevention of ulceration and of progressive scarring in the malleolar area. The therapeutic management is still a challenge, however, and most treatments were based on anecdotal off-label protocols...
April 16, 2018: International Journal of Dermatology
https://www.readbyqxmd.com/read/29648661/anticoagulation-therapy-in-patients-with-non-valvular-atrial-fibrillation-hospitalized-in-the-department-of-medicine-in-the-noacs-era
#3
Alaa Atamna, Mohamad Suki, Hadeel Kena'any, Avishay Elis
Background: The treatment of atrial fibrillation (AF) includes anticoagulation therapy (AC) to prevent systemic emboli. Until recently, warfarin was the main anticoagulation agent, while in recent years the new oral anticoagulants (NOACs) are increasingly being used. The aim of our study was to characterize the AC treatment policy of AF patients at the department of medicine in the NOACs era. Methods: An observational study of consecutive hospitalized patients with non-valvular AF for a period of 3 months in Beilinson hospital (January - March 2017)...
April 10, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29626281/hospital-length-of-stay-in-patients-initiated-on-direct-oral-anticoagulants-versus-warfarin-for-venous-thromboembolism-a-real-world-single-center-study
#4
Hisham Badreldin
This study was conducted to describe the real-world hospital length of stay in patients treated with all of the U.S. Food and Drug Administration approved direct oral anticoagulants (DOACs) versus warfarin for new-onset venous thromboembolism (VTE) at a large, tertiary, academic medical center. A retrospective cohort analysis of all adult patients diagnosed with acute onset VTE was conducted. Of the 441 patients included, 261 (57%) patients received DOACs versus 180 (41%) patients received warfarin. In the DOAC group, a total of 92 (35%) patients received rivaroxaban, followed by 83 (32%) patients received apixaban, 50 (19%) patients received dabigatran, and 36 (14%) patients received edoxaban...
April 6, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29624137/multi-disciplinary-decision-making-in-general-practice
#5
Ann Kirby, Aileen Murphy, Colin Bradley
Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents...
April 9, 2018: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29622761/simultaneous-pancreas-kidney-transplantation-in-a-patient-with-heparin-induced-thrombocytopenia-on-dabigatran-therapy
#6
Agnieszka Jóźwik, Wojciech Lisik, Jarosław Czerwiński, Maciej Kosieradzki
BACKGROUND New oral anticoagulants like direct thrombin inhibitors are an attractive alternative to vitamin K antagonists as anticoagulation therapy and can be used in heparin-induced thrombocytopenia. They are convenient in low-risk surgery, as there is no need for bridging with heparins. Patients who need urgent major surgery are at similar risk as on warfarin therapy, which, however, is much higher than in elective procedures. Due to their elimination profiles, these drugs are generally contraindicated in patients with severe renal insufficiency...
April 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29622591/safety-and-efficacy-of-novel-oral-anticoagulants-versus-warfarin-in-medicare-beneficiaries-with-atrial-fibrillation-and-valvular-heart-disease
#7
Alexandros Briasoulis, Chakradhari Inampudi, Emmanuel Akintoye, Paulino Alvarez, Sidakpal Panaich, Mary Vaughan-Sarrazin
BACKGROUND: We examined a large community-based sample of patients with atrial fibrillation (AF) and valvular heart disease (VHD) (excluding prosthetic valves) with a goal to compare outcomes among patients with AF, with and without VHD, taking warfarin, dabigatran, and rivaroxaban. METHODS AND RESULTS: We identified Medicare beneficiaries enrolled in Medicare Part D benefit plan from 2011 to 2013 with newly diagnosed AF (18 137 patients with VHD [dabigatran, 1979; rivaroxaban, 2027; warfarin, 14 131] and 85 596 patients without VHD [dabigatran, 13 522; rivaroxaban, 14 257; warfarin, 57 817])...
April 5, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29611427/impact-of-known-or-new-onset-atrial-fibrillation-on-2-year-cardiovascular-event-rate-in-patients-with-acute-coronary-syndromes-results-from-the-prospective-epicor-registry
#8
Uwe Zeymer, Lieven Annemans, Nicolas Danchin, Stuart Pocock, Simon Newsome, Frans Van de Werf, Jesús Medina, Héctor Bueno
BACKGROUND: Atrial fibrillation (AF) is associated with increased morbidity in acute coronary syndrome patients, but impact on outcomes beyond 1 year is unclear. METHODS: This was a post-hoc analysis from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) registry (NCT01171404), a prospective, observational study conducted in Europe and Latin America, which enrolled acute coronary syndrome survivors at discharge...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29602837/trends-in-initiation-of-direct-oral-anticoagulant-therapies-for-atrial-fibrillation-in-a-national-population-based-cross-sectional-study-in-the-french-health-insurance-databases
#9
Laetitia Huiart, Cyril Ferdynus, Christel Renoux, Amélie Beaugrand, Sophie Lafarge, Léa Bruneau, Samy Suissa, Olivier Maillard, Xavier Ranouil
OBJECTIVE: Unlike several other national health agencies, French health authorities recommended that the newer direct oral anticoagulant (DOAC) agents only be prescribed as second choice for the treatment of newly diagnosed non-valvular atrial fibrillation (NVAF), with vitamin K antagonists (VKA) remaining the first choice. We investigated the patterns of use of DOACs versus VKA in the treatment of NVAF in France over the first 5 years of DOAC availability. We also identified the changes in patient characteristics of those who initiated DOAC treatment over this time period...
March 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29599284/correlation-of-non-vitamin-k-antagonist-oral-anticoagulant-exposure-and-cerebral-microbleeds-in-chinese-patients-with-atrial-fibrillation
#10
Yannie Soo, Jill Abrigo, Kam Tat Leung, Wenyan Liu, Bonnie Lam, Suk Fung Tsang, Vincent Ip, Karen Ma, Bonaventure Ip, Sze Ho Ma, Florence Fan, Winnie Chu, Lawrence Wong, Vincent Mok, Thomas W Leung
BACKGROUND AND PURPOSE: Cerebral microbleeds (CMBs) are radiological markers which predict future intracerebral haemorrhage. Researchers are exploring how CMBs can guide anticoagulation decisions in atrial fibrillation (AF). The purpose of this study is to evaluate the correlation of non-vitamin K antagonist oral anticoagulants (NOAC) exposure and prevalence of CMBs in Chinese patients with AF. METHODS: We prospectively recruited Chinese patients with AF on NOAC therapy of ≥30 days for 3T MRI brain for evaluation of CMBs and white matter hyperintensities...
March 29, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29599096/antithrombotic-therapy-trends-in-non-valvular-atrial-fibrillation-patients-undergoing-percutaneous-coronary-stent-implantation-results-from-a-survey-among-fellows-at-the-japanese-college-of-cardiology
#11
Daisuke Fukamachi, Atsushi Hirayama, Katsumi Miyauchi, Satoshi Yasuda, Hisao Ogawa, Hiroshi Ito, Hiroyuki Daida
BACKGROUND: Antithrombotic therapy with oral anticoagulants (OAC) in patients with atrial fibrillation (AF) after stent implantation, where dual antiplatelet therapy (DAPT) is also recommended, is not established. Antithrombotic therapies prescribed vary widely among cardiologists and may change year by year, according to the accumulation of new evidence. METHODS: A questionnaire-based survey concerning the antithrombotic therapy prescribed for OAC-treated AF patients who underwent stent implantation was conducted from 2014 to 2016...
March 26, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29590304/long-term-thromboembolic-risk-in-patients-with-postoperative-atrial-fibrillation-after-coronary-artery-bypass-graft-surgery-and-patients-with-nonvalvular-atrial-fibrillation
#12
Jawad H Butt, Ying Xian, Eric D Peterson, Peter Skov Olsen, Rasmus Rørth, Anna Gundlund, Jonas B Olesen, Gunnar H Gislason, Christian Torp-Pedersen, Lars Køber, Emil L Fosbøl
Importance: New-onset postoperative atrial fibrillation (POAF) is a common complication of coronary artery bypass graft (CABG) surgery. However, the long-term risk of thromboembolism in patients who develop POAF after CABG surgery remains unknown. In addition, information on stroke prophylaxis in this setting is lacking. Objective: To examine stroke prophylaxis and the long-term risk of thromboembolism in patients with new-onset POAF after first-time isolated CABG surgery compared with patients with nonsurgical, nonvalvular atrial fibrillation (NVAF)...
March 28, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29589064/recent-major-advances-in-cardiovascular-pharmacotherapy
#13
REVIEW
James Milner, Andreia Cunha, Carlota Gamboa-Cruz, Julie Reis, Márcia Campos, Natália António
The field of cardiovascular pharmacotherapy remains extremely active. The aim of this review is to summarize the recent major advances in cardiovascular pharmacotherapy, with a focus on (1) the new approved drug for treatment of heart failure with reduced ejection fraction-sacubitril/valsartan; (2) proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors; (3) the novel reversal agents for non-vitamin K oral anticoagulants (NOACs); and finally, (4) new evidence on pharmacological treatment of coronary artery disease...
March 27, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29578954/health-care-costs-and-utilization-of-dabigatran-compared-with-warfarin-for-secondary-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-a-retrospective-population-study
#14
Nai-Fang Chi, Ye Wang, Li-Nien Chien, Shu-Chen Chien, Yu Ko
BACKGROUND: It remains unclear whether the use of new oral anticoagulants, compared with warfarin, is economically beneficial in Asian countries. OBJECTIVE: The objective of this study is to compare the health care costs and utilization between dabigatran and warfarin in a real-world nonvalvular atrial fibrillation (NVAF) population. RESEARCH DESIGN: Data were obtained from the Taiwan National Health Insurance Database, and patients with an NVAF diagnosis between June 1, 2012, and May 31, 2014, were identified using the International Classification of Diseases, Ninth Revision code of 427...
March 23, 2018: Medical Care
https://www.readbyqxmd.com/read/29575675/novel-oral-anticoagulant-use-in-adult-fontan-patients-a-single-center-experience
#15
Justin Georgekutty, Amir Kazerouninia, YunFei Wang, Peter R Ermis, Dhaval R Parekh, Wayne J Franklin, Wilson W Lam
OBJECTIVE: Adult Fontan patients are at increased risk for thrombosis and thromboembolic complications leading to increased morbidity and mortality. Most are prescribed antiplatelet or anticoagulant therapy for thromboprophylaxis; novel oral anticoagulants (NOACs) are uncommonly used given lack of data on their use in this population and generalized concerns regarding Fontan patients' abnormal coagulation. We report the largest single-center experience with the use of NOACs for treatment and prophylaxis of thrombosis and thromboembolism in adult Fontan patients...
March 24, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29566416/beyond-stroke-prevention-in-atrial-fibrillation-exploring-further-unmet-needs-with-rivaroxaban
#16
C M Gibson, G J Hankey, T Nafee, R C Welsh
With improved life expectancy and the aging population, the global burden of atrial fibrillation (AF) continues to increase, and with AF comes an estimated fivefold increased risk of ischaemic stroke. Prophylactic anticoagulant therapy is more effective in reducing the risk of ischaemic stroke in AF patients than acetylsalicylic acid or dual-antiplatelet therapy combining ASA with clopidogrel. Non-vitamin K antagonist oral anticoagulants are the standard of care for stroke prevention in patients with non-valvular AF...
March 22, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29566413/rivaroxaban-a-new-treatment-paradigm-in-the-setting-of-vascular-protection
#17
Rupert Bauersachs, Faiez Zannad
The pathophysiology of atherosclerosis involves a diseased endothelium, lipid accumulation and low-grade inflammation. In later stages of coronary artery disease (CAD) and peripheral arterial disease (PAD), plaque rupture may induce atherothrombosis caused by fibrin formation and platelet activation, leading to vessel occlusion with subsequent organ damage such as myocardial infarction, stroke or limb ischaemia. Because of the high disease burden associated with CAD and PAD, there is a need for continuous vascular protection beyond currently available treatments including antiplatelet agents...
March 22, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29563129/serpentine-thrombus-in-the-heart-a-rare-case-of-trapped-thrombus-in-patent-foramen-ovale
#18
Dominika M Zoltowska, Yashwant Agrawal, Jagadeesh K Kalavakunta
A 77-year-old Caucasian woman with recent abdominal surgery was diagnosed with multiple paradoxical systemic emboli in the mesenteric and renal circulation. Diagnosis was made by direct visualisation of a serpentine thrombus traversing both atria through patent foramen ovale (PFO) by transesophageal echocardiogram (TEE). Concomitantly, the patient was found to have deep venous thrombosis and pulmonary embolism. A decision was made to pursue cardiothoracic surgery preceded by inferior vena cava filter placement...
March 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29562325/the-2018-european-heart-rhythm-association-practical-guide-on-the-use-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation
#19
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the second update of the original Practical Guide, published in 2013 [Heidbuchel et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF) and have emerged as the preferred choice, particularly in patients newly started on anticoagulation...
March 17, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29558778/direct-oral-anticoagulants-and-the-paradigm-shift-in-the-management-of-venous-thromboembolism
#20
Hui Yin Lim, Harshal Nandurkar, Prahlad Ho
The advent of direct oral anticoagulants (DOACs) has revolutionized anticoagulation management in both stroke prevention and venous thromboembolism (VTE) treatment/prevention. Clinical trials and secondary real-world data have shown that DOACs have similar efficacy and, in some cases, improved bleeding safety profiles compared with vitamin K antagonists. Together with benefits of patient convenience, this has shifted the risk-benefit ratio toward long-term anticoagulation. However, current VTE risk assessment models are based on vitamin K antagonists and do not take into account the new paradigm of DOACs...
March 20, 2018: Seminars in Thrombosis and Hemostasis
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