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Rivaroxaban versus aspirin

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https://www.readbyqxmd.com/read/30274772/rivaroxaban-or-aspirin-for-patent-foramen-ovale-and-embolic-stroke-of-undetermined-source-a-prespecified-subgroup-analysis-from-the-navigate-esus-trial
#1
Scott E Kasner, Balakumar Swaminathan, Pablo Lavados, Mukul Sharma, Keith Muir, Roland Veltkamp, Sebastian F Ameriso, Matthias Endres, Helmi Lutsep, Steven R Messé, J David Spence, Krassen Nedeltechev, Kanjana Perera, Gustavo Santo, Veronica Olavarria, Arne Lindgren, Shrikant Bangdiwala, Ashkan Shoamanesh, Scott D Berkowitz, Hardi Mundl, Stuart J Connolly, Robert G Hart
BACKGROUND: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. METHODS: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS...
September 28, 2018: Lancet Neurology
https://www.readbyqxmd.com/read/30220379/cost-effectiveness-of-rivaroxaban-and-aspirin-compared-to-aspirin-alone-in-patients-with-stable-cardiovascular-disease-an-australian-perspective
#2
Zanfina Ademi, Ella Zomer, Andrew Tonkin, Danny Liew
OBJECTIVE: In light of the Cardiovascular Outcomes for People using Anticoagulation Strategies (COMPASS) trial, our objective was to assess the cost-effectiveness, from the Australian healthcare perspective, of rivaroxaban in combination with aspirin versus aspirin alone for the prevention of recurrent cardiovascular disease among patients with stable atherosclerotic vascular disease. METHODS: A Markov model was developed using input data from the COMPASS trial to predict the clinical course and costs of patients over a 20-year time-horizon...
November 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/30103248/dual-pathway-inhibition-with-low-dose-direct-factor-xa-inhibition-after-acute-coronary-syndromes-why-is-it-not-used-in-clinical-practice
#3
Uwe Zeymer, Benedikt Schrage, Dirk Westermann
The optimal anti-thrombotic therapy for secondary prevention after an acute coronary syndrome is still a matter of debate. While current guidelines recommend dual anti-platelet therapy with aspirin and a P2Y12 inhibitor over 12 months especially in patients with stent implantation, the value of prolonged anticoagulation is still controversial. In the ATLAS-TIMI 52 trial, a low-dose direct factor Xa inhibition with rivaroxaban compared with placebo reduced the combined primary endpoint of cardiovascular mortality, myocardial infraction and stroke with an increase in major bleeding complications...
September 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/30015064/safety-and-efficacy-of-non-vitamin-k-oral-anticoagulant-for-atrial-fibrillation-patients-after-percutaneous-coronary-intervention-a-bivariate-analysis-of-the-pioneer-af-pci-and-re-dual-pci-trial
#4
Gerald Chi, Mathieu Kerneis, Arzu Kalayci, Yuyin Liu, Roxana Mehran, Christoph Bode, Jonathan L Halperin, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Marc Cohen, Eric D Peterson, Keith A A Fox, C Michael Gibson
BACKGROUND: The tradeoff in safety versus efficacy in substituting a non-vitamin K antagonist oral anticoagulant for a vitamin K antagonist (VKA) in the stented atrial fibrillation patient has not been quantitatively evaluated. METHODS: Based on summary data from the PIONEER AF-PCI and RE-DUAL PCI trials, 4 antithrombotic regimens were compared with VKA-based triple therapy: (1) rivaroxaban (riva) 15 mg daily + P2Y12 inhibitor, (2) riva 2.5 mg twice daily + P2Y12 inhibitor + aspirin, (3) dabigatran (dabi) 110 mg twice daily + P2Y12 inhibitor, and (4) dabi 150 mg twice daily + P2Y12 inhibitor...
September 2018: American Heart Journal
https://www.readbyqxmd.com/read/29525076/characterization-of-patients-with-embolic-strokes-of-undetermined-source-in-the-navigate-esus-randomized-trial
#5
RANDOMIZED CONTROLLED TRIAL
Scott E Kasner, Pablo Lavados, Mukul Sharma, Yongjun Wang, Yilong Wang, Antoni Dávalos, Nikolay Shamalov, Luis Cunha, Arne Lindgren, Robert Mikulik, Antonio Arauz, Wilfried Lang, Anna Czlonkowska, Jens Eckstein, Rubens Gagliardi, Pierre Amarenco, Sebastián F Ameriso, Turgut Tatlisumak, Roland Veltkamp, Graeme J Hankey, Danilo S Toni, Daniel Bereczki, Shinichiro Uchiyama, George Ntaios, Byung-Woo Yoon, Raf Brouns, M M DeVries Basson, Matthias Endres, Keith Muir, Natan Bornstein, Serefnur Ozturk, Martin O'Donnell, Hardi Mundl, Calin Pater, Jeffrey Weitz, W Frank Peacock, Balakumar Swaminathan, Bodo Kirsch, Scott D Berkowitz, Gary Peters, Guillaume Pare, Ellison Themeles, Ashkan Shoamanesh, Stuart J Connolly, Robert G Hart
BACKGROUND: The New Approach Rivaroxaban Inhibition of Factor Xa in a Global Trial vs. ASA to Prevent Embolism in Embolic Stroke of Undetermined Source (NAVIGATE-ESUS) trial is a randomized phase-III trial comparing rivaroxaban versus aspirin in patients with recent ESUS. AIMS: We aimed to describe the baseline characteristics of this large ESUS cohort to explore relationships among key subgroups. METHODS: We enrolled 7213 patients at 459 sites in 31 countries...
June 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29509922/a-systematic-review-of-direct-oral-anticoagulant-use-in-chronic-kidney-disease-and-dialysis-patients-with-atrial-fibrillation
#6
Jordanne Feldberg, Param Patel, Ashley Farrell, Sylvia Sivarajahkumar, Karen Cameron, Jennifer Ma, Marisa Battistella
Background: There is a lack of clear benefit and a potential risk of bleeding with direct oral anticoagulant (DOAC) use in chronic kidney disease (CKD) and dialysis patients with atrial fibrillation. The objective of this study was to evaluate how treatment with DOACs affects stroke and bleeding outcomes compared with warfarin or aspirin. Methods: We conducted a systematic review of randomized controlled trials, cohort studies and case series, and searched electronic databases from 1946 to 2017...
March 2, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29244199/secondary-prevention-of-recurrent-venous-thromboembolism-after-initial-oral-anticoagulation-therapy-in-patients-with-unprovoked-venous-thromboembolism
#7
REVIEW
Lindsay Robertson, Su Ern Yeoh, Ahmad Ramli
BACKGROUND: Currently, little evidence is available on the length and type of anticoagulation used for extended treatment for prevention of recurrent venous thromboembolism (VTE) in patients with unprovoked VTE who have completed initial oral anticoagulation therapy. OBJECTIVES: To compare the efficacy and safety of available oral therapeutic options (aspirin, warfarin, direct oral anticoagulants (DOACs)) for extended thromboprophylaxis in adults with a first unprovoked VTE, to prevent VTE recurrence after completion of an acceptable initial oral anticoagulant treatment period, as defined in individual studies...
December 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29228736/bleeding-risk-with-dabigatran-rivaroxaban-warfarin-and-antiplatelet-agent-in-asians-with-non-valvular-atrial-fibrillation
#8
Yi-Hsin Chan, Yung-Hsin Yeh, Hui-Tzu Tu, Chi-Tai Kuo, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Lai-Chu See
It is not understood if dabigatran or rivaroxaban are superior to antiplatelet agents (AA) for safety outcomes in Asians with non-valvular atrial fibrillation (NVAF). In this study we evaluated the bleeding risk of dabigatran, rivaroxaban, warfarin and AA in Asians with NVAF. This national retrospective cohort study analyzed 6,600, 3,167, 5,338 and 8,238 consecutive NVAF patients taking dabigatran, rivaroxaban, warfarin or AAs (including aspirin, clopidogrel or ticlopidine), respectively, from June 1, 2012 to December 31, 2013...
November 17, 2017: Oncotarget
https://www.readbyqxmd.com/read/28397847/acute-coronary-syndromes-similar-bleeding-risks-with-low-dose-rivaroxaban-versus-aspirin
#9
Karina Huynh
No abstract text is available yet for this article.
April 11, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#10
RANDOMIZED CONTROLLED TRIAL
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
May 6, 2017: Lancet
https://www.readbyqxmd.com/read/27595682/use-of-concomitant-aspirin-in-patients-with-atrial-fibrillation-findings-from-the-rocket-af-trial
#11
Rohan Shah, Anne Hellkamp, Yuliya Lokhnygina, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Keith A A Fox, Christopher C Nessel, Kenneth W Mahaffey, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
BACKGROUND: We aimed to investigate the relationship between aspirin use and clinical outcomes in patients enrolled in Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF), in particular, those with known coronary artery disease (CAD). METHODS: Patients in ROCKET AF, comparing rivaroxaban and warfarin, were analyzed. Aspirin use was assessed at baseline...
September 2016: American Heart Journal
https://www.readbyqxmd.com/read/26610874/gastrointestinal-bleeding-in-patients-with-atrial-fibrillation-treated-with-rivaroxaban-or-warfarin-rocket-af-trial
#12
RANDOMIZED CONTROLLED TRIAL
Matthew W Sherwood, Christopher C Nessel, Anne S Hellkamp, Kenneth W Mahaffey, Jonathan P Piccini, Eun-Young Suh, Richard C Becker, Daniel E Singer, Jonathan L Halperin, Graeme J Hankey, Scott D Berkowitz, Keith A A Fox, Manesh R Patel
BACKGROUND: Gastrointestinal (GI) bleeding is a common complication of oral anticoagulation. OBJECTIVES: This study evaluated GI bleeding in patients who received at least 1 dose of the study drug in the on-treatment arm of the ROCKET AF (Rivaroxaban Once-daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation) trial. METHODS: The primary outcome was adjudicated GI bleeding reported from first to last drug dose + 2 days...
December 1, 2015: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/26458895/treatment-of-rivaroxaban-versus-aspirin-for-non-disabling-cerebrovascular-events-trace-study-protocol-for-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Fang Yang, Wenrui Jiang, Ya Bai, Junliang Han, Xuedong Liu, Guangyun Zhang, Gang Zhao
BACKGROUND: Transient ischemic attack (TIA) or minor ischemic stroke represents the largest group of cerebrovascular disease, and those patients have a high risk of early recurrent stroke. Over decades, anticoagulation therapy has been used prudently in them for likely increasing the risk of intra-/extra-cranial hemorrhagic complications. However, recently rivaroxaban, a new oral anticoagulant, is proved to be as effective as traditional anticoagulants, while carrying significantly less risk of intracranial hemorrhage...
October 12, 2015: BMC Neurology
https://www.readbyqxmd.com/read/26274538/non-vitamin-k-antagonist-oral-anticoagulants-and-antiplatelet-therapy-for-stroke-prevention-in-patients-with-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Shashi Kumar, Stephan B Danik, Robert K Altman, Conor D Barrett, Gregory Y H Lip, Saurav Chatterjee, Gary S Roubin, Andrea Natale, Jacqueline S Danik
Non-vitamin K antagonist oral anticoagulants (NOACs) are frequently used to prevent stroke in patients with atrial fibrillation. These patients are often also on aspirin or other antiplatelet agents. It is possible that treatment with both NOACs and aspirin or other antiplatelet drug may be effective in decreasing stroke, but data are sparse regarding the efficacy and safety of using both agents for stroke prevention. To address these issues, data were pooled from the 4 recent randomized, controlled trials of NOACs: apixaban, rivaroxaban, dabigatran, and edoxaban, which included 42,411 patients; 14,148 (33...
September 2016: Cardiology in Review
https://www.readbyqxmd.com/read/25994838/two-doses-of-rivaroxaban-versus-aspirin-for-prevention-of-recurrent-venous-thromboembolism-rationale-for-and-design-of-the-einstein-choice-study
#15
RANDOMIZED CONTROLLED TRIAL
Jeffrey I Weitz, Rupert Bauersachs, Jan Beyer-Westendorf, Henri Bounameaux, Timothy A Brighton, Alexander T Cohen, Bruce L Davidson, Gerlind Holberg, Ajay Kakkar, Anthonie W A Lensing, Martin Prins, Lloyd Haskell, Bonno van Bellen, Peter Verhamme, Philip S Wells, Paolo Prandoni
Patients with unprovoked venous thromboembolism (VTE) are at high risk for recurrence. Although rivaroxaban is effective for extended VTE treatment at a dose of 20 mg once daily, use of the 10 mg dose may further improve its benefit-to-risk ratio. Low-dose aspirin also reduces rates of recurrent VTE, but has not been compared with anticoagulant therapy. The EINSTEIN CHOICE study is a multicentre, randomised, double-blind, active-controlled, event-driven study comparing the efficacy and safety of two once daily doses of rivaroxaban (20 and 10 mg) with aspirin (100 mg daily) for the prevention of recurrent VTE in patients who completed 6-12 months of anticoagulant therapy for their index acute VTE event...
August 31, 2015: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/25964962/rivaroxaban-2-5-mg-no-justification-for-using-this-anticoagulant-after-an-acute-coronary-syndrome
#16
(no author information available yet)
Aspirin is the antithrombotic drug of choice for preventing recurrences after a first acute coronary syndrome. The addition of clopidogrel, another antiplatelet agent, is helpful in case of angioplasty with stenting. Following the acute phase, warfarin, an anticoagulant, alone or in combination with aspirin, may be used only in specific situations, particularly for patients with a high thrombotic risk (due to atrial fibrillation for example). Rivaroxaban, an oral factor Xa inhibitor anticoagulant, has been authorised for use following an acute coronary syndrome, but at a new dose strength of 2...
October 2014: Prescrire International
https://www.readbyqxmd.com/read/25795564/comparative-efficacy-and-safety-of-anticoagulants-and-aspirin-for-extended-treatment-of-venous-thromboembolism-a-network-meta-analysis
#17
Diana M Sobieraj, Craig I Coleman, Vinay Pasupuleti, Abhishek Deshpande, Roop Kaw, Adrian V Hernandez
OBJECTIVE: To systematically review the literature and to quantitatively evaluate the efficacy and safety of extended pharmacologic treatment of venous thromboembolism (VTE) through network meta-analysis (NMA). METHODS: A systematic literature search (MEDLINE, Embase, Cochrane CENTRAL, through September 2014) and searching of reference lists of included studies and relevant reviews was conducted to identify randomized controlled trials of patients who completed initial anticoagulant treatment for VTE and then randomized for the extension study; compared extension of anticoagulant treatment to placebo or active control; and reported at least one outcome of interest (VTE or a composite of major bleeding or clinically relevant non-major bleeding)...
May 2015: Thrombosis Research
https://www.readbyqxmd.com/read/25577431/-managing-antithrombotic-therapy-in-vitreoretinal-surgery
#18
REVIEW
M Gallice, F Rouberol, P Albaladejo, E Brillat Zaratzian, K Palombi, F Aptel, J-P Romanet, C Chiquet
Given the growing number of patients on antithrombotic therapy we are increasingly confronted with the management of this therapy before, during and after vitreoretinal surgery. In the absence of a consensus, the decision to withdraw antithrombotic therapy is based on the cardiovascular thromboembolism risk versus the theoretical risk of bleeding if the antithrombotic treatment is continued. As suggested by the literature, antiplatelet therapy (acetylsalicylic acid or clopidogrel) may be safely continued for vitreoretinal surgery, including retinal detachment repair...
January 2015: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/24826310/bleeding-complication-of-triple-therapy-of-rivaroxaban-prasugrel-and-aspirin-a-case-report-and-general-discussion
#19
Dane D Gruenebaum, Ahmad Alsarah, Osama Alsara, Heather Laird-Fick
Hemorrhagic side effects are the bane of oral anticoagulation. Despite careful selection of medications and close monitoring, some adverse events are unavoidable. The available literature about the risks of triple oral anticoagulation therapy versus dual antiplatelet therapy does not address all of the medication combinations currently available. This report describes a patient with atrial fibrillation and recent stent placement who developed severe, recurrent epistaxis on aspirin, prosugrel, and rivaroxaban...
2014: Case Reports in Cardiology
https://www.readbyqxmd.com/read/24026260/comparative-effectiveness-of-new-oral-anticoagulants-and-standard-thromboprophylaxis-in-patients-having-total-hip-or-knee-replacement-a-systematic-review
#20
REVIEW
Soheir S Adam, Jennifer R McDuffie, Paul F Lachiewicz, Thomas L Ortel, John W Williams
BACKGROUND: Pharmacologic thromboprophylaxis reduces the risk for venous thromboembolism after total hip replacement (THR) or total knee replacement (TKR). New oral anticoagulants (NOACs), including direct thrombin inhibitors and factor Xa inhibitors, are emerging options for thromboprophylaxis after these procedures. PURPOSE: To compare the benefits and risks of NOACs versus standard thromboprophylaxis for adults having THR or TKR. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from January 2009 through March 2013...
August 20, 2013: Annals of Internal Medicine
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