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https://www.readbyqxmd.com/read/28423431/-treatment-and-secondary-prevention-of-venous-thromboembolism-change-in-oral-anticoagulation
#1
Thomas-Maria Helms, Dietrich Gulba, Ingo Ahrens, Andreas Schäfer, Johannes Hankowitz, Peter Kuhlencordt, Hans-Peter Lipp, Sigrid Nikol, Hanno Riess, Tom Stargardt, Peter Bramlage
With the recent approval of the fourth direct non vitamin K dependent oral anticoagulant (NOAC) edoxaban the range of available NOACs for the treatment of venous thromboembolism (VTE) has expanded. Shortly thereafter, two updated guidelines for the prevention and treatment of VTE have been published. In these NOACs are listed as equal anticoagulants to low-molecular weight heparin (LMWH), or fondaparinux (FDX), and VKA for the initial or maintenance treatment of VTE. All NOACs are approved for the maintenance therapy after VTE and two NOACs (rivaroxaban and apixaban) for the initial treatment in addition in an increased dose...
April 19, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28418370/-current-study-aimed-to-highlight-extent-of-clot-resolution-in-deep-veins-and-its-association-with-anticoagulation-pattern-in-vte-patients
#2
E A Shcheglov, N N Alontzeva
MATERIAL AND METHODS: Data of 70 patients with acute VTE of lower extremities (iliofemoral level) was analyzed. There were 42 patients in the study group which were treated with rivaroxaban (15 mg BID for 21 days, 20 mg od from day 22); 28 patients were in control group treated with conventional therapy (LMWH/VKA). Extent of clot resolution was assessed on ultrasound. Data was collected at a day of VTE diagnosis and further at 1, 3, 6 month. RESULTS: The results of the study demonstrated, that patients treated with rivaroxaban had earlier recanalization and extent of clot resolution was higher than in patients treated with conventional therapy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28416008/a-guide-to-acquired-vitamin-k-coagulophathy-diagnosis-and-treatment-the-russian-perspective
#3
REVIEW
Valery V Wojciechowski, Daniela Calina, Konstantinos Tsarouhas, Alexander V Pivnik, Alexander A Sergievich, Vladimir V Kodintsev, Ekaterina A Filatova, Eren Ozcagli, Anca Oana Docea, Andreea Letitia Arsene, Eliza Gofita, Christina Tsitsimpikou, Aristidis M Tsatsakis, Kirill S Golokhvast
Physicians often come across with cases of vitamin K antagonists-dependent coagulopathy for reasons such as accidental use of the vitamin K antagonists (VKA), excessive administration of prescribed anticoagulants of indirect action or not reported administration of vitamin K antagonists due to memory impairment and/or other mental disorders, even deliberate use thereof (attempt to murder or suicide). Rodenticide-poisoning (coumarins, warfarins) via food or occupational accidents are difficult to diagnose. This article discusses different types of acquired vitamin K-dependent coagulopathy...
April 17, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
https://www.readbyqxmd.com/read/28408116/-prevalence-of-oral-anticoagulation-and-quality-of-its-management-in-primary-healthcare-a-study-by-the-health-sentinel-network-of-the-region-of-valencia-spain
#4
Ana Boned-Ombuena, Jordi Pérez-Panadés, Aurora López-Maside, Maite Miralles-Espí, Sandra Guardiola Vilarroig, Desamparados Adam Ruiz, Oscar Zurriaga
OBJECTIVE: To estimate the prevalence of patients with oral anticoagulant therapy (OAT) in the Region of Valencia and to evaluate the quality of management of OAT with vitaminK antagonists (VKA) carried out in primary healthcare. DESIGN: Observational cross-sectional study conducted through the Health Sentinel Network of the Region of Valencia, which includes a survey and the retrospective analysis of OAT monitoring. SETTING: Primary healthcare, Region of Valencia, Spain...
April 10, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28405671/predictors-of-oral-cavity-bleeding-and-clinical-outcome-after-dental-procedures-in-patients-on-vitamin-k-antagonists-a-cohort-study
#5
Joseph S Biedermann, Willem M H Rademacher, Hendrika C A M Hazendonk, Denise E van Diermen, Frank W G Leebeek, Frederik Rozema, Marieke J H A Kruip
Patients on vitamin K antagonists (VKA) often undergo invasive dental procedures. International guidelines consider all dental procedures as low-risk procedures, while bleeding risk may differ between standard low-risk (e. g. extraction 1-3 elements) and extensive high-risk (e. g. extraction of >3 elements) procedures. Therefore current guidelines may need refinement. In this cohort study, we identified predictors of oral cavity bleeding (OCB) and evaluated clinical outcome after low-risk and high-risk dental procedures in patients on VKA...
April 13, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28400068/intracranial-complications-after-minor-head-injury-mhi-in-patients-taking-vitamin-k-antagonists-vka-or-direct-oral-anticoagulants-doacs
#6
Alessandro Riccardi, Beatrice Spinola, Pierangela Minuto, Maria Ghinatti, Grazia Guiddo, Michele Malerba, Roberto Lerza
INTRODUCTION: The correlation between chronic direct oral anticoagulants (DOACs) intake and the incidence of intracranial complications after minor head injury (MHI) is still not well defined. This study examined the incidence of complications in patients receiving vitamin K antagonists (VKA) or DOACs observed in the emergency department (ED) for MHI. METHODS: Two hundred twenty-five patients affected by MHI and receiving oral anticoagulants were recorded between January and December 2016, distinguishing those treated with VKA (118) from those receiving DOACs (107)...
April 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28390065/trends-in-the-prescription-of-novel-oral-anticoagulants-in-uk-primary-care
#7
S Y Loo, S Dell'Aniello, L Huiart, C Renoux
AIMS: Novel oral anticoagulants (NOAC) are alternatives to vitamin-K antagonists (VKA) for the prevention of thromboembolism. It is unclear how NOAC have been adopted in the UK since first introduced in 2008. This study was conducted to describe the trends in the prescription of NOAC, including dabigatran, rivaroxaban, and apixaban. METHODS: Using the UK's Clinical Practice Research Datalink, the rates of new users of NOAC and VKA from 2009 to 2015 were calculated with Poisson regression...
April 7, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28384199/areas-of-improvement-in-anticoagulant-safety-data-from-the-cacao-study-a-cohort-in-general-practice
#8
Paul Frappé, Joël Cogneau, Yoann Gaboreau, Nathan Abenhaïm, Marc Bayen, Matthieu Calafiore, Claude Guichard, Jean-Pierre Jacquet, François Lacoin, Laurent Bertoletti
BACKGROUND: Real-world studies on anticoagulants are mostly performed on health insurance databases, limited to reported events, and sometimes far from every-day issues in family practice. We assess the presence of data for safe monitoring of oral anticoagulants in general practice, and compare patients' knowledge of taking an anticoagulant between vitamin K antagonists (VKA) and direct anticoagulants (DOAC), and the general practitioner's perception of their adherence to anticoagulation...
2017: PloS One
https://www.readbyqxmd.com/read/28381513/outcome-of-intracerebral-hemorrhage-associated-with-different-oral-anticoagulants
#9
Duncan Wilson, David J Seiffge, Christopher Traenka, Ghazala Basir, Jan C Purrucker, Timolaos Rizos, Oluwaseun A Sobowale, Hanne Sallinen, Shin-Joe Yeh, Teddy Y Wu, Marc Ferrigno, Rik Houben, Floris H B M Schreuder, Luke A Perry, Jun Tanaka, Marion Boulanger, Rustam Al-Shahi Salman, Hans R Jäger, Gareth Ambler, Clare Shakeshaft, Yusuke Yakushiji, Philip M C Choi, Julie Staals, Charlotte Cordonnier, Jiann-Shing Jeng, Roland Veltkamp, Dar Dowlatshahi, Stefan T Engelter, Adrian R Parry-Jones, Atte Meretoja, David J Werring
OBJECTIVE: In an international collaborative multicenter pooled analysis, we compared mortality, functional outcome, intracerebral hemorrhage (ICH) volume, and hematoma expansion (HE) between non-vitamin K antagonist oral anticoagulation-related ICH (NOAC-ICH) and vitamin K antagonist-associated ICH (VKA-ICH). METHODS: We compared all-cause mortality within 90 days for NOAC-ICH and VKA-ICH using a Cox proportional hazards model adjusted for age; sex; baseline Glasgow Coma Scale score, ICH location, and log volume; intraventricular hemorrhage volume; and intracranial surgery...
April 5, 2017: Neurology
https://www.readbyqxmd.com/read/28353372/satisfaction-quality-of-life-and-perception-of-patients-regarding-burdens-and-benefits-of-vitamin-k-antagonists-compared-with-direct-oral-anticoagulants-in-patients-with-nonvalvular-atrial-fibrillation
#10
Mª Del Mar Contreras Muruaga, José Vivancos, Gemma Reig, Ayoze González, Pere Cardona, José Mª Ramírez-Moreno, Joan Martí, Carmen Suárez Fernández
AIM: To compare the satisfaction of patients treated with vitamin K antagonists (VKA) with that of patients treated with direct oral anticoagulants (DOACs) and to determine the impact on quality of life of both treatments in patients with nonvalvular atrial fibrillation (NVAF). METHODS: Cross-sectional multicenter study in which outpatients with NVAF completed the ACTS (Anti-Clot Treatment Scale), SAT-Q (Satisfaction Questionnaire) and EQ-5D-3L (EuroQol 5 dimensions questionnaire, 3 level version) questionnaires...
March 29, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28329309/changes-in-oral-anticoagulation-for-elective-cardioversion-results-from-a-european-cardioversion-registry
#11
Judit Papp, Endre Zima, Ramon Bover, Rasa Karaliute, Andrea Rossi, Catherine Szymanski, Rossella Troccoli, Jonas Schneider, Morten Wang Fagerland, A John Camm, Dan Atar
Aims: In patients with atrial fibrillation (AF) pharmacological or electrical cardioversion may be performed to restore sinus rhythm. The procedure is associated with an increased risk of thromboembolic events, which can be significantly reduced by adequate anticoagulation (OAC). Our aim was to create a partly prospective, partly retrospective cardioversion registry, particularly focusing on OAC strategies in different European countries, and on emerging choice of OAC over time. Methods: From September 2014 to October 2015, cardioversions due to AF performed in six European city hospitals in five European countries (Hungary: Budapest-1 and -2; Italy: Bari and Pisa; France: Amiens; Spain: Madrid; and Lithuania: Kaunas) were recorded in the registry...
March 17, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28326589/risk-of-myocardial-infarction-in-patients-with-atrial-fibrillation-using-vitamin-k-antagonists-aspirin-or-direct-acting-oral-anticoagulants
#12
Leo M Stolk, Frank de Vries, Chiel Ebbelaar, Anthonius de Boer, Tom Schalekamp, Patrick Souverein, Arina Ten Cate-Hoek, Andrea M Burden
AIM: Direct-acting oral anticoagulants (DOACs) have become available for the prevention of stroke in patients with atrial fibrillation (AF). Conflicting results have been published on the risk of acute myocardial infarction (AMI) with the use of DOACs in comparison with vitamin K antagonists (VKAs). The objective of the present study was to evaluate the risk of AMI in patients with AF who are exposed to either VKAs, DOACs or low-dose (< 325 mg) aspirin. METHODS: We conducted a population-based cohort study using data from the Clinical Practice Research Datalink (2008-2014)...
March 22, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28322423/uptake-of-non-vitamin-k-antagonist-oral-anti-coagulants-in-patients-with-atrial-fibrillation-a-prospective-cohort-study
#13
Matylda Zimny, Steffen Blum, Peter Ammann, Paul Erne, Giorgio Moschovitis, Marcello Di Valentino, Dipen Shah, Jürg Schläpfer, Cyrill Vogt, Alexandra Tabord, Michael Kühne, Christian Sticherling, Stefan Osswald, David Conen
AIMS: We aimed to assess the uptake of non-vitamin K antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation between 2010 and 2015 in Switzerland. METHODS: We performed a prospective observational cohort study. At the baseline examination and during yearly follow-ups, we used questionnaires to obtain information about clinical characteristics and antithrombotic treatment. Stroke risk was assessed using the CHA2DS2-VASc score. RESULTS: 1545 patients were enrolled across seven centres in Switzerland...
March 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28320118/prothrombin-complex-concentrate-administration-for-bleeding-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-the-samurai-nvaf-study
#14
Sohei Yoshimura, Shoichiro Sato, Kenichi Todo, Yasushi Okada, Eisuke Furui, Takayuki Matsuki, Hiroshi Yamagami, Masatoshi Koga, Jun C Takahashi, Kazuyuki Nagatsuka, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: Antidotes appropriate for non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) are not yet in widespread clinical use. Efficacy of prothrombin complex concentrate (PCC) in NOAC-associated bleeding remains unclarified. METHODS: Ten NOAC users (4 women, median 74years old) who developed major bleeding and received PCC were prospectively enrolled. Eight single-center NOAC users (0 women, median 74years old) with intracerebral hemorrhage, who over the same period did not receive PCC, were studied for comparison...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28300865/comparative-safety-and-effectiveness-of-rivaroxaban-versus-vkas-in-patients-with-venous-thromboembolism-a-danish-nationwide-registry-based-study
#15
Caroline Sindet-Pedersen, Jannik Langtved Pallisgaard, Laila Staerk, Thomas Alexander Gerds, Emil Loldrup Fosbøl, Christian Torp-Pedersen, Gunnar Gislason, Jonas Bjerring Olesen
The approval of rivaroxaban has changed the landscape of treatment of venous thromboembolism (VTE). Little is known about the effect of rivaroxaban compared with vitamin K antagonists (VKA), when used in the everyday clinical practice. The aim of this study was to investigate the safety and effectiveness of rivaroxaban compared with VKAs among patients with VTE, using the Danish nationwide registries. All patients diagnosed with VTE and treated with either rivaroxaban or VKAs between 2013 and 2015 were included...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28296129/comparing-thrombin-generation-in-patients-with-hemophilia-a-and-patients-on-vitamin-k-antagonists
#16
M L Y de Koning, K Fischer, B de Laat, A Huisman, M Ninivaggi, R E G Schutgens
Essentials It is unknown if hemophilia patients with atrial fibrillation need anticoagulation. Endogenous thrombin potentials (ETP) in hemophilia patients and patients on coumarins were compared. Severe hemophilia patients had comparable ETP to therapeutic international normalized ratio (INR). In non-severe hemophilia, 33% had higher ETP than therapeutic INR and may need anticoagulation. Click to hear Dr Negrier's perspective on global assays for assessing coagulation SUMMARY: Background It is unknown whether patients with hemophilia A with atrial fibrillation require treatment with vitamin K antagonists (VKAs) to the same extent as the normal population...
March 15, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28284562/the-vkorc1-and-cyp2c9-genotypes-significantly-effect-vitamin-k-antagonist-dosing-only-in-patients-over-the-age-of-20years
#17
U Nowak-Göttl, K Dietrich, A Kruempel, C Geisen, L G Mitchell
INTRODUCTION: Given the qualitative differences in the role of VKORC1 and CYP2C9 polymorphisms in Vitamin K antagonists (VKA) dosing variation between adults and children, we were interested in determining at what age these polymorphism begin to play a more significant role. METHODS: A prospective cohort study of 190 patients aged 1-86years receiving VKA for treatment of venous thromboembolism. Blood samples were collected beyond the acute thrombotic event when patients were on stable targeted INR (2-3) for plasma testing and VKORC1/CYP2C9 genotyping...
December 30, 2016: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/28276323/preference-for-direct-oral-anticoagulants-in-patients-treated-with-vitamin-k-antagonists-for-venous-thromboembolism
#18
M P A Brekelmans, M Kappelhof, P T Nieuwkerk, M Nierman, H R Buller, M Coppens
BACKGROUND: Direct oral anticoagulants (DOACs) are an alternative for vitamin K antagonists (VKA) in the treatment and prevention of venous thromboembolism (VTE). Patient preferences for treatment options have not been extensively explored. METHODS: A random sample of 200 patients was obtained from those treated with VKA for deep vein thrombosis, pulmonary embolism or both at the Thrombosis Service Amsterdam. Preference for DOACs relative to VKA was assessed using a treatment trade-off technique administered as a questionnaire sent to all patients...
March 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28265683/-recurrent-thromboembolisms-despite-full-anticoagulation-in-a-patient-with-antiphospholipid-syndrome
#19
S Wernicke, K Selleng, S B Felix, A Greinacher, F Hammer
We report on a female patient with confirmed secondary antiphospholipid syndrome (APS) due to underlying systemic lupus erythematosus (SLE). Despite a thromboplastin time within the normal range (international normalized ratio, INR) under treatment with a vitamin K antagonist (VKA), a recurrent thrombotic event occurred, this time as pulmonary embolism due to bilateral deep vein thrombosis. Despite an INR value in the therapeutic range, clotting factors II, VII, IX and X were found to be insufficiently decreased suggesting inefficient anticoagulation...
March 6, 2017: Der Internist
https://www.readbyqxmd.com/read/28261098/oral-anticoagulants-initiation-in-patients-with-atrial-fibrillation-real-world-data-from-a-population-based-cohort
#20
Clara L Rodríguez-Bernal, Isabel Hurtado, Aníbal García-Sempere, Salvador Peiró, Gabriel Sanfélix-Gimeno
Objective: Little is known about initial prescription of currently used oral anticoagulants (OAC), and correlated characteristics in real-world practice. We aimed to assess patterns of initiation of Vitamin K antagonists (VKA) and non-VKA oral anticoagulants (NOAC) in naive patients with non-valvular atrial fibrillation and the factors associated with starting treatment with NOAC. Methods: Population-based retrospective cohort study of all patients with NVAF who had a first prescription of OAC from November 2011 to February 2014 in the Valencia region, Spain (n = 21,881)...
2017: Frontiers in Pharmacology
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