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https://www.readbyqxmd.com/read/28727359/-stroke-prevention-in-patients-with-atrial-fibrillation
#1
Gaia Sirimarco, Lorenz Hirt, Roman Sztajzel, Fabienne Perren
Oral anticoagulation with vitamin K antagonists (VKA) was the cornerstone of stroke prevention in atrial fibrillation (AF). This review article presents the state of the art, with regard to the treatment options developed over the past few years, the new oral anticoagulants (NOAC). A search in PubMed for relevant published studies has been performed. Dabigatran and apixaban were superior to warfarin to reduce stroke risk or systemic embolism ; dabigatran, rivaroxaban and edoxaban were non-inferior. All NOAC are globally non-inferior to warfarin for stroke prevention in non-valvular AF and they have a superior safety profile, with a reduced intracranial bleeding risk...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28725983/dabigatran-and-vitamin-k-antagonists-use-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-a-cross-sectional-study-of-primary-care-based-electronic-health-records
#2
Bogdan Vlacho, Maria Giner-Soriano, Edurne Zabaleta-Del-Olmo, Albert Roso-Llorach, Ana García-Sangenís, Rosa Morros-Pedrós
PURPOSE: The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs). METHODS: We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed...
July 19, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28724879/infectious-complications-in-patients-with-cardiac-implantable-electronic-devices-risk-factors-prevention-and-prognosis
#3
Anna Polewczyk, Wojciech Jacheć, Aneta Maria Polewczyk, Andrzej Tomasik, Marianna Janion, Andrzej Kutarski
INTRODUCTION    Cardiac device infections (CDI) are still a significant problem. The knowledge of risk factors for CDI is crucial both for preventing infections and reducing mortality. OBJECTIVES    The assesment of the risk factors and long term survival of patients with CDI. PATIENTS AND METHODS    The clinical data of 1837 patients (40.9% CDI) undergoing transvenous leads extraction (TLE) at a single institution from 2006 to 2015 was analyzed. We compared the clinical and procedure-related factors for all types of CDI: isolated pocket infection (IPI), isolated lead-related infective endocarditis (ILRIE) and PI+LRIE...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28724836/prothrombin-complex-concentrate-for-vitamin-k-antagonist-associated-intracranial-hemorrhage%C3%A3-global-evidence-and-the-japanese-perspective
#4
Masahiro Yasaka, Andres Brainsky, Kazunori Toyoda
Patients receiving vitamin K antagonists (VKAs) are at increased risk of bleeding. Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality in this population, and is a particular concern among Japanese clinicians, given reports of an elevated risk of this bleeding type in patients of Asian ethnicity. Patients with VKA-associated ICH require rapid international normalized ratio (INR) reversal, and treatment guidelines suggest the use of prothrombin complex concentrates (PCCs) or plasma for this purpose...
July 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28724590/long-term-antithrombotic-treatment-in-intracranial-hemorrhage-survivors-with-atrial-fibrillation
#5
Eleni Korompoki, Filippos T Filippidis, Peter B Nielsen, Angela Del Giudice, Gregory Y H Lip, Joji B Kuramatsu, Hagen B Huttner, Jiming Fang, Sam Schulman, Joan Martí-Fàbregas, Celine S Gathier, Anand Viswanathan, Alessandro Biffi, Daniela Poli, Christian Weimar, Uwe Malzahn, Peter Heuschmann, Roland Veltkamp
OBJECTIVE: To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. METHODS: A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM)...
July 19, 2017: Neurology
https://www.readbyqxmd.com/read/28722795/influence-of-renal-function-on-anticoagulation-control-in-patients-with-non-valvular-atrial-fibrillation-taking-vitamin-k-antagonists
#6
José M Lobos-Bejarano, Angel Castellanos Rodríguez, Vivencio Barrios, Carlos Escobar, José Polo-García, José Carlos Del Castillo-Rodríguez, Diego Vargas-Ortega, Adriana Lopez-Pineda, Luis Prieto-Valiente, Gregory Y H Lip
BACKGROUND AND PURPOSE: Chronic kidney disease (CKD) has been related to poor anticoagulation control and an increased risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60 mL/min/1.73 m(2) ) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy. We also assessed whether the predictive value of the SAMe-TT2 R2 score prevailed for subgroups both with and without CKD...
July 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28720315/-evaluation-of-the-antithrombotic-strategy-in-low-thrombotic-risk-patients-who-underwent-aortic-valve-replacement-wth-bioprosthesis
#7
Eduardo Aceves-Velázquez, Gerardo Vieyra-Herrera, Laura Rodríguez-Chávez, Valentín Herrera-Alarcón
According to current guidelines, in patients without additional risk factors who underwent aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). We compared the incidence of thrombotic and hemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico...
July 15, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28716241/low-risk-of-ich-after-reperfusion-therapy-in-acute-stroke-patients-treated-with-direct-oral-anti-coagulant
#8
Kentaro Suzuki, Junya Aoki, Yuki Sakamoto, Arata Abe, Satoshi Suda, Seiji Okubo, Takehiko Nagao, Kazumi Kimura
BACKGROUND: The safety of intravenous thrombolysis (IVT) and endovascular therapy (EVT) in patients treated with DOAC is unclear. We investigated whether recanalization therapy in patients treated with DOAC is safe. METHODS: A nationwide, multicenter, retrospective cohort questionnaire survey was conducted to investigate the: (1) frequency of intracerebral hemorrhage (ICH) after recanalization therapy in patients treated with DOAC; (2) independent factors related to ICH; (3) relationship between last intake time of DOAC and ICH; and (4) comparison of ICH frequency between patients treated with DOAC, vitamin K antagonist (VKA), and no-anticoagulation (no-ACT) (control)...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28713563/recent-advances-in-the-treatment-of-venous-thromboembolism-in-the-era-of-the-direct-oral-anticoagulants
#9
REVIEW
Jeffrey I Weitz, Iqbal H Jaffer, James C Fredenburgh
The direct oral anticoagulants (DOACs) have now supplanted vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE). The DOACs include dabigatran, which inhibits thrombin, and rivaroxaban, apixaban, and edoxaban, which inhibit factor Xa. The DOACs are as effective for the prevention of recurrence as conventional VTE treatment, consisting of a parenteral anticoagulant followed by a VKA, and are associated with less bleeding. Because of these properties and the convenience of fixed dosing without the need for routine coagulation monitoring, guidelines now recommend DOACs over VKAs for VTE treatment in patients without active cancer...
2017: F1000Research
https://www.readbyqxmd.com/read/28705401/-are-general-practitioners-in-paris-and-surrounding-areas-reticent-about-direct-oral-anticoagulants
#10
C Caucanas, D Sfeir, C Blas-Châtelain, P Priollet
OBJECTIVE: Determine how familiar general practitioners (GPs) working in Paris and surrounding areas are with prescriptions for direct oral anticoagulants (DOACs). MATERIAL AND METHOD: A questionnaire sent to 189 GP working in Paris and surrounding areas yielded 100 responses. Data collected included a brief summary of sociodemographic items, comparative knowledge about DOACs and vitamin K antagonists (VKAs), and responses to two clinical situations for DOAC prescriptions (renewal of a first prescription)...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28703931/rationale-and-design-of-a-randomized-trial-of-apixaban-vs-warfarin-to-evaluate-atherosclerotic-calcification-and-vulnerable-plaque-progression
#11
Kazuhiro Osawa, Rine Nakanishi, Theingi Tiffany Win, Dong Li, Sina Rahmani, Negin Nezarat, Nasim Sheidaee, Matthew J Budoff
Vitamin K antagonists (VKAs) are known to increase vascular calcification, suggesting increased cardiovascular disease events. Apixaban is an oral direct factor Xa inhibitor superior to warfarin at preventing stroke or systemic embolism and may stabilize coronary atherosclerosis. The potential benefits of avoiding VKA therapy and the favorable effects of factor Xa inhibitors could contribute to cardiovascular disease event reduction. We hypothesized that apixaban inhibits vascular calcification and coronary atherosclerosis progression compared with warfarin in patients with atrial fibrillation (AF)...
July 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28692826/efficacy-of-non-vitamin-k-antagonist-oral-anticoagulants-for-intracardiac-thrombi-resolution-in-nonvalvular-atrial-fibrillation
#12
Esteban Orenes-Piñero, María A Esteve-Pastor, Mariano Valdés, Gregory Y H Lip, Francisco Marín
Intracardiac thrombus is a potentially life-threatening condition associated with atrial fibrillation (AF), with a high risk of embolic complications. Oral anticoagulation (OAC) therapy is the first-line treatment for its prevention or resolution. For many patients, traditional OAC treatment using vitamin K antagonists (VKAs; e.g., warfarin) is limited by several factors and the advent of non-VKA oral anticoagulants (NOACs), with improved efficacy and safety profiles, has provided additional treatment options...
July 7, 2017: Drug Discovery Today
https://www.readbyqxmd.com/read/28692742/vitamin-k-antagonists-with-or-without-long-term-antiplatelet-therapy-in-outpatients-with-stable-coronary-artery-disease-and-atrial-fibrillation-association-with-ischemic-and-bleeding-events
#13
Gilles Lemesle, Gregory Ducrocq, Yedid Elbez, Eric Van Belle, Shinya Goto, Christopher P Cannon, Christophe Bauters, Deepak L Bhatt, Philippe Gabriel Steg
BACKGROUND: It remains uncertain whether patients with atrial fibrillation (AF) requiring long-term oral anticoagulation (OAC) and with stable coronary artery disease (CAD) should receive antiplatelet therapy (APT) in addition to OAC. HYPOTHESIS: APT in addition to OAC would be more effective than OAC alone in preventing ischaemic events in such patients. METHODS: In the international REduction of Atherothrombosis for Continued Health (REACH) Registry including 68 236 outpatients with or at risk for atherothrombosis, we identified 2347 patients with stable CAD and AF receiving vitamin K antagonists (VKA)...
July 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28686914/an-optimized-drvvt-based-assay-to-estimate-the-intensity-of-anticoagulation-in-patients-treated-with-direct-oral-anticoagulants
#14
Anne-Laure Sennesael, Thomas Exner, Bernard Chatelain, Sarah Lessire, Anne-Sophie Larock, Christelle Vancraeynest, Lionel Pochet, Jean-Michel Dogné, Anne Spinewine, François Mullier, Jonathan Douxfils
BACKGROUND: The dilute Russell's viper venom time (dRVVT) has been suggested for the assessment of the intensity of anticoagulation of all direct oral anticoagulants (DOACs). This study aimed to compare the performance of an optimized liquid-stable dRVVT-based DOAC assay (DRVV-DOAC) on clinical samples before and after mixing these with normal pooled plasma (NPP). METHODS: Forty-one apixaban, 25 dabigatran, 56 rivaroxaban and 49 vitamin K antagonists (VKAs) plasma samples were included for retrospective analysis...
June 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28682153/real-life-cost-of-vitamin-k-antagonist-treatment-in-patients-with-non-valvular-atrial-fibrillation-in-france-in-2013
#15
Jean Dallongeville, Xavier Ansolabehere, Noëlla Karusisi, Maurel Frédérique, Eric Van Ganse, Jean-Yves Le Heuzey
AIMS: Data highlighting the cost drivers for non-valvular atrial fibrillation (NVAF) patients in terms of vitamin K antagonist (VKA) treatment and monitoring are lacking in France. This study aimed to evaluate the real-life daily cost of VKA treatment in 2013, in French patients suffering from NVAF. METHODS: This longitudinal observational study was performed using the EGB (Echantillon Généraliste des Bénéficiaires) database, a random sample of the French national insurance (NHI) database which covers 80% of the population...
July 6, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28679480/non-vitamin-k-antagonist-oral-anticoagulants-compared-with-warfarin-at-different-levels-of-inr-control-in-atrial-fibrillation-a-meta-analysis-of-randomized-trials
#16
João Carmo, Jorge Ferreira, Francisco Costa, Pedro Carmo, Diogo Cavaco, Salomé Carvalho, Francisco Morgado, Pedro Adragão, Miguel Mendes
BACKGROUND: The efficacy and safety of warfarin for stroke prevention in atrial fibrillation (AF) depend on the time in the therapeutic range (TTR) with an international normalised ratio (INR) of 2.0-3.0. This meta-analysis focused the relative efficacy and safety of non-VKA oral anticoagulants (NOAC) compared with warfarin at different thresholds of centre's TTR (cTTR). METHODS: We searched PubMed, Embase, CENTRAL and websites of regulatory agencies, limiting searches to randomized phase 3 trials...
June 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28668628/effectiveness-and-safety-of-non-vitamin-k-antagonist-oral-anticoagulants-for-atrial-fibrillation-and-venous-thromboembolism-a-systematic-review-and-meta-analyses
#17
REVIEW
Abdulaali R Almutairi, Lili Zhou, Walid F Gellad, Jeannie K Lee, Marion K Slack, Jennifer R Martin, Wei-Hsuan Lo-Ciganic
PURPOSE: The findings from the observational studies comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) for atrial fibrillation (AF) and venous thromboembolism (VTE) are inconsistent. We conducted separate meta-analyses examining the efficacy/effectiveness and safety of NOACs versus VKAs by disease (AF vs VTE), study design (randomized controlled trials [RCTs] vs observational studies), and NOAC (dabigatran, rivaroxaban, apixaban, and edoxaban)...
June 28, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28666358/shifting-to-a-non-vitamin-k-antagonist-oral-anticoagulation-agent-from-vitamin-k-antagonist-in-atrial-fibrillation
#18
Emil L Fosbøl, Naja Emborg Vinding, Morten Lamberts, Laila Staerk, Anna Gundlund, Kasper Gadsbøll, Lars Køber, Gunnar H Gislason, Jonas Bjerring Olesen
Aims: After non-vitamin K antagonist (VKA) oral anticoagulation agents (NOAC) have been approved for thrombo-embolic prophylaxis in non-valvular atrial fibrillation (NVAF), utilization of oral anticoagulants (OAC) in NVAF has changed. Contemporary shifting from a VKA to a NOAC (dabigatran, rivaroxaban, or apixaban) has not been quantified, and could help assess whether these drugs are used according to recommendations. Methods and results: Using Danish nationwide registries, we identified all VKA-experienced NVAF patients initiating a NOAC from 22 August 2011 to 31 December 2015 (shifters) and all VKA-experienced NVAF patients who were not switched to NOACs (non-shifters)...
June 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28665208/association-between-rivaroxaban-use-and-length-of-hospital-stay-treatment-costs-and-early-outcomes-in-patients-with-pulmonary-embolism-a-systematic-review-of-real-world-studies
#19
Christine G Kohn, Gregory J Fermann, W Frank Peacock, Phil S Wells, Christopher W Baugh, Veronica Ashton, Concetta Crivera, Jeff R Schein, Peter Wildgoose, Craig I Coleman
BACKGROUND: In the EINSTEIN-Pulmonary Embolism (PE) trial, subjects randomized to rivaroxaban versus enoxaparin bridging to vitamin K antagonist (VKA) therapy experienced a reduced index hospital length of stay (LOS). We sought to conduct a systematic review of real-world studies comparing LOS, costs and early outcomes among patients treated with rivaroxaban or parenterally bridged VKA in routine practice. METHODS: We searched Medline and Scopus from 1 January 2011 to 30 November 2016 to identify observational studies comparing acute PE patients anticoagulated with rivaroxaban or parenterally bridged VKA and reporting data on index hospital LOS, costs and/or early post-PE outcomes...
July 17, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28641379/clinical-events-preceding-switching-and-discontinuation-of-oral-anticoagulant-treatment-in-patients-with-atrial-fibrillation
#20
Maja Hellfritzsch, Erik Lerkevang Grove, Steen Elkjær Husted, Lotte Rasmussen, Birgitte Klindt Poulsen, Søren Paaske Johnsen, Jesper Hallas, Anton Pottegård
Aims: Switching between oral anticoagulants and treatment discontinuation are common events related to therapy with non-vitamin K antagonist oral anticoagulants (NOACs). However, knowledge on the reasons leading to these treatment changes is scarce. The aim of this study was to identify clinical events preceding anticoagulant switching and NOAC discontinuation during oral anticoagulant therapy in patients with atrial fibrillation. Methods and results: We performed a nationwide register-based study including Danish atrial fibrillation patients initiating a NOAC between August 2011 and February 2016 (n = 50 623)...
October 17, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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