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https://www.readbyqxmd.com/read/28619189/antithrombotic-therapy-and-first%C3%A2-myocardial%C3%A2-infarction-in-patients%C3%A2-with%C3%A2-atrial%C3%A2-fibrillation
#1
Christina J-Y Lee, Jannik L Pallisgaard, Jonas Bjerring Olesen, Nicholas Carlson, Morten Lamberts, Gunnar H Gislason, Christian Torp-Pedersen, Axel Brandes, Steen E Husted, Søren P Johnsen, Morten L Hansen
BACKGROUND: Patients with atrial fibrillation (AF) have increased risk of thromboembolic events such as stroke and myocardial infarction (MI). Although it has been established that the efficacy of anticoagulation is superior to that of antiplatelet agents for stroke prophylaxis in AF, the optimal antithrombotic treatment remains uncertain for primary protection against MI. OBJECTIVES: The authors investigated the incidence of first-time MI in patients with AF according to antithrombotic treatment and estimated the risk of stroke and bleeding...
June 20, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28616216/warfarin-related-nephropathy-induced-by-three-different-vitamin-k-antagonists-analysis-of-13-biopsy-proven-cases
#2
Léonard Golbin, Cécile Vigneau, Guy Touchard, Eric Thervet, Jean-Michel Halimi, Théophile Sawadogo, Nathan Lagoutte, Pascale Siohan, Elie Zagdoun, Alexandre Hertig, Nathalie Rioux-Leclercq, Thierry Frouget
Background: Acute kidney injury (AKI) with renal tubular obstruction by red blood cell casts (RBCC) has been described in patients treated with warfarin and is known as warfarin-related nephropathy (WRN). Methods: To determine whether other vitamin K antagonists (VKA) cause WRN, we retrospectively collected and analyzed the clinical and histological data of 13 patients treated with different VKA (seven with fluindione, four with warfarin and two with acenocoumarol) in seven French hospitals. Results: They all developed gross hematuria following overanticoagulation complicated by severe AKI (median serum creatinine concentration = 693 μmol/L)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28612237/assessment-of-the-impact-of-l-thyroxine-therapy-on-bleeding-risk-in-patients-receiving-vitamin-k-antagonists
#3
Farès Moustafa, Rémi Malhomme, Bruno Pereira, Alain Barres, Jennifer Saint-Denis, Frederic Dutheil, Marie Batisse, Jeannot Schmidt
BACKGROUND: Several studies have suggested a link exists between L-thyroxine and the coagulation system, and, according to some drug interaction studies, L-thyroxine can potentiate the effect of warfarin. This study sought to assess whether thyroid hormone therapy could impact the risk of bleeding in patients receiving vitamin K antagonists (VKAs). METHODS: We conducted a monocentric, retrospective study on prospectively collected data from consecutive patients enrolled in the Registry of patient with AntiThrombotic agents admitted to an Emergency Department (RATED) database, and compared the hemorrhage rates (both major and nonmajor) of patients receiving treatment with and without L-thyroxine...
June 13, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28611403/temporal-trends-in-initiation-of-vka-rivaroxaban-apixaban-and-dabigatran-for-the-treatment-of-venous-thromboembolism-a-danish-nationwide-cohort-study
#4
Caroline Sindet-Pedersen, Jannik Langtved Pallisgaard, Laila Staerk, Jeffrey S Berger, Morten Lamberts, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
Danish nationwide registries were used to investigate temporal trends in initiation of rivaroxaban or apixaban or dabigatran versus vitamin K antagonists (VKA) in patients with venous thromboembolism (VTE). Patients treated with one of the NOACs (rivaroxaban, dabigatran, apixaban) or VKA were identified between February 2012 and September 2016. A total of 19,578 patients were included of which 10,844 (55.4%) were treated with VKA and 8,734 (44.6%) were treated with NOACs (rivaroxaban 7,572, apixaban 1,066, and dabigatran 96)...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28608277/-oral-anticoagulation-using-coumarins-an-update
#5
REVIEW
Christoph Sucker, Jens Litmathe
Vitamin K antagonists (VKA) are used for the prophylaxis and treatment of thrombotic and thromboembolic events. Most important indications are venous thrombosis and pulmonary embolism, atrial fibrillation, and mechanical heart-valve replacement. Hence they are from high relevance for the neurologist and his daily praxis in cardio-neurological routine. Here, we give an overview about VKA with focus on mode of action, indications and efficacy, practical aspects of treatment, side effects, and monitoring.
June 12, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28606886/early-anticoagulation-drug-regimens-after-watchman-left-atrial-appendage-closure-safety-and-efficacy
#6
Martin W Bergmann, Timothy R Betts, Horst Sievert, Boris Schmidt, Evgeny Pokushalov, Stephan Kische, Thomas Schmitz, Felix Meincke, Kenneth M Stein, Lucas V Boersma, Hüseyin Ince
AIMS: While LAA closure has recently been incorporated in both European and US guidelines for stroke prevention, uncertainties regarding post-procedural drug therapy so far limit its adoption. METHODS AND RESULTS: 1005 patients were implanted with a WATCHMAN device in the prospective EWOLUTION study at 47 centers. 73.5% of the patients were deemed contraindicated for long-term OAC therapy. Here we report on 3-months data including the first follow-up TOE exam for 94% of the study population...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28590907/real-practice-thromboprophylaxis-in-atrial-fibrillation
#7
Paola Deambrosis, Alessandra Bettiol, Jenny Bolcato, Roberta Pirolo, Giulia Franchin, Sakis Themistoclakis, Michele Pellizzari, Alessandro Chinellato, Pietro Giusti
This retrospective observational study was based on databases of the Local Health Authority of Treviso, Italy. It evaluated the prevalence and the effectiveness of oral anticoagulation treatment (OAT) for the management of nonvalvular atrial fibrillation (NVAF) in everyday clinical practice. Out of 6,138 NVAF patients, only 3,024 received vitamin K antagonist (VKA). Potential barriers decreasing the probability of being treated with VKA were female sex, older age, antiplatelet treatment and history of bleeding...
June 27, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28584203/current-use-of-oral-anticoagulants-and-prognostic-analysis-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#8
Heng-Bo Zhai, Jun Liu, Zhi-Chao Dong, Dong-Xia Wang, Bo Zhang
BACKGROUND: It is currently believed that triple oral antithrombotic therapy in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) should be recommended if there are no contraindications. However, selecting triple therapy for AF patients undergoing PCI is still challenging when bleeding risk is considered. This study aimed to investigate the current use of oral anticoagulants (Vitamin K antagonists [VKA]) and perform prognostic analysis in real-world patients with AF undergoing coronary stenting...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28577840/efficacy-and-safety-of-left-atrial-appendage-closure-with-watchman-in-patients-with-or-without-contraindication-to-oral-anticoagulation-1-year-follow-up-outcome-data-of-the-ewolution-trial
#9
Lucas V Boersma, Hueseyin Ince, Stephan Kische, Evgeny Pokushalov, Thomas Schmitz, Boris Schmidt, Tommaso Gori, Felix Meincke, Alexey Vladimir Protopopov, Timothy Betts, David Foley, Horst Sievert, Patrizio Mazzone, Tom De Potter, Elisa Vireca, Kenneth Stein, Martin W Bergmann
BACKGROUND: LAA occlusion with Watchman has emerged as viable alternative to Vit.K antagonists in randomized controlled trials. OBJECTIVE: EWOLUTION was designed to provide data in routine practice from a prospective multicentre registry. METHODS: 1025 pts scheduled for a WATCHMAN implant were prospectively and sequentially enrolled at 47 centers. Indication for LAAC was based on ESC guidelines. Follow-up and TEE were performed per local practice...
May 31, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28571631/maternal-and-fetal-outcomes-of-anticoagulation-in-pregnant-women-with%C3%A2-mechanical-heart%C3%A2-valves
#10
Zachary L Steinberg, Clara P Dominguez-Islas, Catherine M Otto, Karen K Stout, Eric V Krieger
BACKGROUND: Anticoagulation for mechanical heart valves during pregnancy is essential to prevent thromboembolic events. Each regimen has drawbacks with regard to maternal or fetal risk. OBJECTIVES: This meta-analysis sought to estimate and compare the risk of adverse maternal and fetal outcomes in pregnant women with mechanical heart valves who received different methods of anticoagulation. METHODS: Studies were identified using a Medline search including all publications up to June 5, 2016...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28558081/stroke-prevention-in-atrial-fibrillation-focus-on-latin-america
#11
Ayrton R Massaro, Gregory Y H Lip
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with an estimated prevalence of 1-2% in North America and Europe. The increased prevalence of AF in Latin America is associated with an ageing general population, along with poor control of key risk factors, including hypertension. As a result, stroke prevalence and associated mortality have increased dramatically in the region. Therefore, the need for effective anticoagulation strategies in Latin America is clear. The aim of this review is to provide a contemporary overview of anticoagulants for stroke prevention...
December 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28544489/thromboembolic-and-bleeding-complications-during-oral-anticoagulation-therapy-in-cancer-patients-with-atrial-fibrillation-a-danish-nationwide-population-based-cohort-study
#12
Anne G Ording, Erzsébet Horváth-Puhó, Kasper Adelborg, Lars Pedersen, Paolo Prandoni, Henrik T Sørensen
Coexisting cancer in patients with atrial fibrillation (AF) has been associated with thromboembolism and bleeding. We used Danish population-based medical databases to conduct a population-based cohort study that included all AF patients who redeemed a prescription for vitamin K antagonists (VKA) or non-VKA oral anticoagulant (NOAC) between July 2004 and December 2013. We characterized these patients according to the presence (N = 11,855) or absence (N = 56,264) of a cancer diagnosis before redemption of their oral anticoagulant prescription, and then examined their 1-year risk of thromboembolic or bleeding complications or death...
June 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28540468/benefits-and-harms-of-4-factor-prothrombin-complex-concentrate-for-reversal-of-vitamin-k-antagonist-associated-bleeding-a-systematic-review-and-meta-analysis
#13
REVIEW
Marjolein P A Brekelmans, Kim van Ginkel, Joost G Daams, Barbara A Hutten, Saskia Middeldorp, Michiel Coppens
Prothrombin complex concentrate (PCC) is used for reversal of vitamin K antagonists (VKA) in patients with bleeding complications. This study aims to assess benefits and harms of 4-factor PCC compared to fresh frozen plasma (FFP) or no treatment in VKA associated bleeding. PubMed, EMBASE and CENTRAL were searched from 1945 to August 2015. Studies reporting 4-factor PCC use for VKA associated bleeding and providing data on INR normalization, mortality or thromboembolic (TE) complications were eligible. Two authors screened titles and full articles for inclusion, extracted data, and assessed risk of bias...
May 24, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28532773/comparison-of-the-incidences-of-complications-after-second-generation-cryoballoon-ablation-of-atrial-fibrillation-using-vitamin-k-antagonists-versus-novel-oral-anticoagulants
#14
Giacomo Mugnai, Carlo de Asmundis, Saverio Iacopino, Erwin Stroker, Massimo Longobardi, Valentina De Regibus, Hugo Enrique Coutino-Moreno, Ken Takarada, Rajin Choudhury, Juan Pablo Abugattas de Torres, Cesare Storti, Pedro Brugada, Gian-Battista Chierchia
Data evaluating the impact of the periprocedural administration of novel oral anticoagulants (NOACs) on complications in the setting of pulmonary vein (PV) isolation using cryoballoon (CB) is limited. In the present study, our aim was to analyze procedural characteristics and incidence of complications in those patients who underwent CB ablation for atrial fibrillation and the impact of NOACs on adverse events compared with vitamin K antagonists (VKAs). Consecutive patients with drug resistant atrial fibrillation who underwent PV isolation by CB as index procedure were retrospectively included in our analysis...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28528780/comparative-effectiveness-and-safety-of-apixaban-and-vitamin-k-antagonist-therapy-in-patients-with-nonvalvular-atrial-fibrillation-treated-in-routine-german-practice
#15
Craig I Coleman, W Frank Peacock, Matthias Antz
BACKGROUND: Scarce data comparing real-world outcomes between apixaban and vitamin K antagonist (VKA) users with nonvalvular atrial fibrillation (NVAF) are available. We sought to assess the effectiveness and safety of newly-initiated apixaban vs. VKA in German NVAF patients. MATERIALS AND METHODS: We performed a retrospective analysis in German outpatients using IMS Disease Analyzer data. Adults newly-initiated on apixaban or a VKA from January 2013 to March 2015 with a diagnosis of NVAF on the day of the first qualifying oral anticoagulant (OAC) prescription (index date) or any time during one year prior, and at least one year of follow-up were included...
May 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28526929/analytical-management-of-patients-undergoing-oral-anticoagulant-therapy-could-have-a-strong-impact-on-clinical-outcomes-a-follow-up-study
#16
Vincenzo De Iuliis, Sebastiano Ursi, Gianfranco Vitullo, Irma Griffo, Antonio Marino, Marika Caruso, Francesco Cipollone, Sabrina Capodifoglio, Veronica Breda, Elena Toniato, Alfonso Pennelli, Pio Conti, Stefano Martinotti
INTRODUCTION: Oral anticoagulant therapy, such as vitamin K antagonists (VKAs), is prominent for the prevention of cerebral ischemic stroke or systemic embolism and all-cause mortality in patients with atrial fibrillation, venous thromboembolism, and mechanical or biological valve. VKA treatment requires monitoring of the international normalized ratio (INR) in order to maintain it in a therapeutic range, avoiding side effects, the main and most significant of which is bleeding. The aim of the present study was to evaluate the event rates of several clinical composite outcomes, such as bleeding, thromboembolic events, and all-cause death...
May 19, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28521540/cost-effectiveness-analysis-of-rivaroxaban-for-treatment-and-secondary-prevention-of-venous-thromboembolism-in-the-netherlands
#17
Marieke Heisen, Maarten J Treur, Harald E Heemstra, Eric B W Giesen, Maarten J Postma
BACKGROUND: Until recently, standard treatment of venous thromboembolism (VTE) concerned a combination of short-term low-molecular-weight heparin (LMWH) and long-term vitamin-K antagonist (VKA). Risk of bleeding and the requirement for regular anticoagulation monitoring are, however, limiting their use. Rivaroxaban is a novel oral anticoagulant associated with a significantly lower risk of major bleeds (hazard ratio 0.54, 95% confidence interval 0.37-0.79) compared to LMWH/VKA therapy and does not require regular anticoagulation monitoring...
May 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28508916/direct-oral-anticoagulants-for-the-treatment-of-cancer-associated-venous-thromboembolism-what-do-we-know-so-far
#18
Minna Voigtlaender, Florian Langer
Cancer patients with venous thromboembolism (VTE) are at increased risk for both bleeding and VTE recurrence. Anticoagulation with low-molecular-weight heparin (LMWH) is the standard of care during the initial and long-term treatment phase (i.e. during the first 3 - 6 months of therapy) based on its overall beneficial safety and efficacy profile compared to vitamin K antagonists (VKAs). The direct oral anticoagulants (DOACs) rivaroxaban, apixaban, edoxaban, and dabigatran are approved for the treatment of acute VTE, and the combined six phase-3 trials have included > 1500 patients with active cancer, as defined by variable selection criteria...
May 16, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28501909/vitamin-k-antagonist-therapy-changes-in-the-treated-populations-and-in-management-results-in-italian-anticoagulation-clinics-compared-with-those-recorded-20%C3%A2-years-ago
#19
Gualtiero Palareti, Emilia Antonucci, Ludovica Migliaccio, Nicoletta Erba, Francesco Marongiu, Vittorio Pengo, Daniela Poli, Sophie Testa, Alberto Tosetto, Armando Tripodi, Marco Moia
Vitamin K antagonists (VKA) are the most widely used anticoagulants in the world. An appropriate management of treated patients is crucial for their efficacy and safety. The prospective, observational, multicenter, inception-cohort FCSA-START Register, a branch of START Register (NCT02219984) included VKA-treated patients managed by centers of Italian Federation of anticoagulation clinics (AC). Baseline patient characteristics and data during treatment were analyzed and compared with those of ISCOAT study, performed by the Federation and published in 1996/7...
May 13, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28500649/a-comparative-study-using-thrombin-generation-and-three-different-inr-methods-in-patients-on-vitamin-k-antagonist-treatment
#20
N Riva, K Vella, S Meli, K Hickey, D Zammit, C Calamatta, M Makris, S Kitchen, W Ageno, A Gatt
INTRODUCTION: Vitamin K antagonist (VKA) treatment requires routine monitoring using the international normalized ratio (INR). However, different INR assays may vary in their results. The aim of this study was to assess the agreement of three different INR methods, compared with thrombin generation, in patients on VKA treatment. METHODS: Sixty patients attending the Anticoagulation Clinic at Mater Dei Hospital (Msida, Malta) for VKA monitoring between August and September 2015 were enrolled...
May 12, 2017: International Journal of Laboratory Hematology
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