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New oral anticoagulants

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https://www.readbyqxmd.com/read/29222248/direct-oral-anticoagulants-now-also-for-prevention-and-treatment-of-cancer-associated-venous-thromboembolism
#1
REVIEW
Ingrid Pabinger, Julia Riedl
Data on specific studies in cancer patients using direct oral anticoagulants (DOACs) for the prevention and treatment of venous thromboembolism (VTE) are still scarce. For preventing VTE with DOACs, current experience is still very limited, so definite conclusions cannot yet be drawn. However, DOACs have so far been compared with vitamin K antagonists (VKAs) in patients with acute VTE in 5 studies, and several hundreds of patients included in these studies had either active cancer, a history of cancer, or a new occurrence of cancer during the course of disease...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29214062/management-of-oral-antiplatelet-agents-and-anticoagulation-therapy-before-bronchoscopy
#2
REVIEW
Houssein A Youness, Jean Keddissi, Ilya Berim, Ahmed Awab
Although, bronchoscopy is a relatively safe procedure, small amount of bleeding in the airway can have serious consequences. Careful consideration of the risks of diagnostic and therapeutic bronchoscopic intervention can help minimize potential complications. With increasing number of patients using antiplatelet and anticoagulation therapies, strategies for minimizing thromboembolic and operative bleeding events need to be included in the risk and benefit analyses. Growing evidence suggests that aspirin is safe and does not increase bleeding during bronchoscopy...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29210752/lactobacillus-casei-beneficially-modulates-immuno-coagulative-response-in-an-endotoxemia-model
#3
Cecilia Haro, María E Mónaco, Marcela Medina
: The current study aims at evaluating the effect of the oral administration of Lactobacillus casei CERELA (CRL) 431 on parameters implicated in inflammation-coagulation interaction using a model of acute inflammation induced by lipopolysaccharide (LPS) in mice. Six-week-old Balb/c mice were treated with L. casei for 5 consecutive days. Then treated and untreated mice received an LPS injection (L. casei + LPS and LPS groups, respectively). Liver and kidney were removed, blood samples were obtained, and hemostatic and inflammatory parameters were evaluated at different times post LPS injection...
November 27, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29203044/-new-international-guidelines-for-curative-treatment-and-prophylaxis-for-venous-thromboembolism-vte-in-cancer-patients-and-the-dedicated-smartphone-application
#4
I Benzidia, J Connault, A Solanilla, U Michon-Pasturel, M Jamelot, M K Nguessan, A Hij, C Le Maignan, D Farge, C Frère
Venous thromboembolism (VTE) is a frequent and serious complication in cancer patients, and the second leading cause of death in this setting. Cancer patients are also more likely to present recurrent VTE and major bleeding while taking anticoagulants. Management of VTE in these patients is always challenging and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME) released international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis, based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale...
December 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29199852/bleeding-with-oral-anticoagulant-dabigatran-is-highly-associated-with-occult-cancers-in-atrial-fibrillation-patients
#5
Hideki Koike, Tadashi Fujino, Makiko Koike, Shintaro Yao, Katsuya Akitsu, Masaya Shinohara, Hitomi Yuzawa, Takeya Suzuki, Takanori Ikeda
AIM: The aim of this study was to examine cancer and bleeding in atrial fibrillation patients administered with dabigatran. MATERIALS & METHODS: This study enrolled 509 consecutive nonvalvular atrial fibrillation patients who received dabigatran. The mean administration period was 14.8 ± 15.7 months. We investigated the prevalence and new development of cancers. Further, the relation between cancer and adverse events was evaluated. RESULTS: In the 509 patients, major bleeding occurred in 2...
December 4, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29195844/leaflet-thrombosis-following-transcatheter-aortic-valve-implantation
#6
M Marwan, N Mekkhala, M Göller, J Röther, D Bittner, A Schuhbaeck, M Hell, G Muschiol, J Kolwelter, R Feyrer, C Schlundt, S Achenbach, M Arnold
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly being offered to high-risk patients with symptomatic aortic valve stenosis. Recent reports have suggested a high incidence of subclinical leaflet thrombosis following bioprosthestic aortic valve replacement. We report the frequency and clinical presentation of leaflet thrombosis identified by cardiac CT in patients referred for follow-up contrast enhanced CT angiography following TAVI. METHODS: 91 consecutive patients referred for follow-up contrast-enhanced CT angiography following TAVI were screened for inclusion in this analysis...
November 9, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29195825/meta-analysis-of-the-safety-and-efficacy-of-the-oral-anticoagulant-agents-apixaban-rivaroxaban-dabigatran-in-patients-with-acute-coronary-syndrome
#7
REVIEW
Safi U Khan, Adeel Arshad, Irbaz Bin Riaz, Swapna Talluri, Fahad Nasir, Edo Kaluski
The significance of adding new oral anticoagulants (NOACs) to antiplatelet therapy in patients with acute coronary syndrome (ACS) is unclear. We conducted a meta-analysis to assess the safety and efficacy of adding NOACs (apixaban, rivaroxaban, and dabigatran) to single antiplatelet agent (SAP) or dual antiplatelet therapy (DAPT) in patients with ACS. Seven randomized controlled trials were selected using PubMed or MEDLINE, Scopus, and Cochrane library (inception to August 2017). The summary measure was random effects hazard ratio (HR) with 95% confidence interval (CI)...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29188358/anticoagulation-strategies-in-patients-with-atrial-fibrillation-after-pci-or-with-acs-the-end-of-triple-therapy
#8
N Fluschnik, P M Becher, R Schnabel, S Blankenberg, D Westermann
Clinicians struggle daily with the optimal regimen for patients with an indication for antiplatelet therapy after stenting and in patients needing oral anticoagulation treatment for atrial fibrillation (AF). This is not only difficult in patients with acute coronary syndrome (ACS) but also in the large number of patients with AF undergoing elective percutaneous coronary intervention (PCI). The challenge is to strike a balance between the increasing risk of bleeding events and ischemic or thrombotic events. Until recently, guidelines were based on expert consensus and a few small, many of them retrospective, trials...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29185829/a-multi-hospital-analysis-of-predictors-of-oral-anticoagulation-prescriptions-for-patients-with-actionable-atrial-fibrillation-who-attend-the-emergency-department
#9
Joel A Scott-Herridge, Colette M Seifer, Ron Steigerwald, Glen Drobot, William F McIntyre
Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increase in the risk of ischemic stroke. The risk of stroke can be significantly decreased by oral anticoagulation (OAC). Our objective was to characterize the filling of OAC prescriptions for patients with actionable AF (new or existing AF with an indication for OAC but not prescribed) and determine the prevalence and predictors of guideline-appropriate therapy at 30 days. This is a multi-hospital, retrospective cohort study of patients who visited the Emergency Department (ED) and had a discharge diagnosis of AF...
November 29, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29181265/off-label-use-of-direct-oral-anticoagulants-for-left-ventricular-thrombus-is-it-appropriate
#10
George Degheim, Abeer Berry, Marcel Zughaib
A 57 year old gentleman with a history of non-ischemic cardiomyopathy and paroxysmal atrial fibrillation presented with worsening lower extremity edema and dyspnea on exertion. He had been compliant with his medications including rivaroxaban (Xarelto) for atrial fibrillation that he takes with the evening meal daily. His echocardiogram showed an ejection fraction of 10-15% and a new left ventricle (LV) apical thrombus. During his hospital stay, he developed right sided weakness. Magnetic Resonance Imaging showed a subacute infarct involving the left parietal lobe...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/29176437/anticoagulant-options-in-atrial-fibrillation-when-new-treatments-become-standard-practice
#11
Connie S Cole, Richard Zimmerman
Direct oral anticoagulants (DOACs) have expanded options for treating patients with atrial fibrillation (AF). However, DOACs are not warfarin substitutes, and NPs need to be aware of the difference. DOACs are first-line agents when treating AF, yet warfarin has not been replaced. Individualized patient characteristics drive current guidelines.
December 15, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/29171208/real-world-data-and-recommended-dosage-of-non-vitamin-k-oral-anticoagulants-for-korean-patients
#12
REVIEW
Boyoung Joung
Regulatory approvals of non-vitamin K antagonist oral anticoagulants (NOACs) have been based on large randomized phase III trials evaluating dabigatran, rivaroxaban, apixaban, or edoxaban relative to warfarin for atrial fibrillation (AF). The results of the trials showed that all NOACs were at least non-inferior to warfarin in the prevention of stroke/thromboembolism and showed lower rates of intracranial bleeding than those associated with warfarin. However, the trials were designed differently, varied in the inclusion/exclusion criteria, and used either one dose or a low/high dose of the NOAC drug...
October 17, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29164916/age-and-gender-differences-in-medical-adherence-after-myocardial-infarction-women-do-not-receive-optimal-treatment-the-netherlands-claims-database
#13
Daniëlle C Eindhoven, Alexander D Hilt, Thomas C Zwaan, Martin J Schalij, C Jan Willem Borleffs
Background Following myocardial infarction, medication is, besides lifestyle interventions, the cornerstone treatment to improve survival and minimize the occurrence of new cardiovascular events. Still, data on nationwide medication adherence are scarce. This study assesses medical adherence during one year following myocardial infarction, stratifying per type of infarct, age and gender. Design Retrospective cohort study. Methods In The Netherlands, all inhabitants are by law obliged to have health insurance and all claims data are centrally registered...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29161419/incidence-of-postoperative-atrial-fibrillation-recurrence-in-patients-discharged-in-sinus-rhythm-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#14
Nicole Lowres, Georgina Mulcahy, Kai Jin, Robyn Gallagher, Lis Neubeck, Ben Freedman
Postoperative atrial fibrillation (POAF) is associated with increased stroke risk and mortality post-discharge. POAF is often considered transient; however, recurrence is likely under-recognized as symptoms are an unreliable guide. Surveillance post-discharge may identify asymptomatic POAF recurrences in patients discharged in sinus rhythm. Therefore, we performed a systematic review and meta-analysis of studies investigating POAF recurrence post-discharge, in patients with new-onset POAF following cardiac surgery who reverted to sinus rhythm prior to discharge...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29153212/-new-treatments-for-heart-failure
#15
Clément Venner, Olivier Huttin, Christine Selton-Suty, Yves Juillière
New direct oral anticoagulants are recommended as first-line therapy in case of atrial fibrillation within a heart failure. In the absence of atrial fibrillation, the role for new direct oral anticoagulants would have to be confirmed in the next years. Sacubitril/valsartan, angiotansin II receptor neprilysin inhibitor, presents with an efficacy superior to that of angiotensin converting enzyme inhibitors. It is now recommended in the treatment of heart failure as a third-line therapy. Modalities of prescription are strict, and safety is good...
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29149366/prescribing-of-noacs-has-outnumbered-warfarin-exploring-how-physicians-choose-anticoagulant-treatments
#16
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
#17
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/29141274/use-of-direct-oral-anticoagulants-in-the-first-year-after-market-entry-of-edoxaban-a-danish-nationwide-drug-utilization-study
#18
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
#19
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/29138609/non-valvular-atrial-fibrillation-impact-of-apixaban-on-patient-outcomes
#20
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
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