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https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#1
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29776574/incidence-of-bleeding-in-patients-with-atrial-fibrillation-and-advanced-liver-fibrosis-on-treatment-with-vitamin-k-or-non-vitamin-k-antagonist-oral-anticoagulants
#2
Daniele Pastori, Gregory Y H Lip, Alessio Farcomeni, Francesco Del Sole, Angela Sciacqua, Francesco Perticone, Rossella Marcucci, Elisa Grifoni, Pasquale Pignatelli, Francesco Violi
OBJECTIVES: To investigate the incidence of bleeding events in atrial fibrillation (AF) patients treated with vitamin K (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) screened for the presence of liver fibrosis (LF). BACKGROUND: Previous studies provided conflicting results on bleeding risk in AF patients with liver disease on VKAs, and no data on NOACs in this setting are available. METHODS: Post-hoc analysis of a prospective, observational multicentre study including 2330 AF outpatients treated with VKAs (n = 1297) or NOACs (n = 1033)...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29761512/oral-anticoagulation-and-left-atrial-thrombi-resolution-in-non-rheumatic-atrial-fibrillation-or-flutter-a-systematic-review-and-meta-analysis
#3
Norman C Wang, Matthew D Sather, Aliza Hussain, Andrew D Althouse, Evan C Adelstein, Sandeep K Jain, William E Katz, Alaa A Shalaby, Andrew H Voigt, Samir Saba
BACKGROUND: Oral anticoagulation (OAC) is prescribed for left atrial thrombi (LAT) in non-rheumatic atrial fibrillation (AF) and/or atrial flutter (AFL). The study objective was to review the existing evidence regarding LAT resolution in non-rheumatic AF and/or AFL with OAC agents. METHODS: Data sources included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) between January 1, 1991 and February 1, 2017. English-language studies that assessed LAT resolution with OAC agents in subjects with non-rheumatic AF and/or AFL, by serial transesophageal echocardiography (TEE), and with follow-up times ≥3 weeks and < 1 year were selected...
May 14, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29754725/-time-in-therapeutic-range-ttr-and-follow-up-of-patients-on-vitamin-k-antagonist-a-cohort-analysis
#4
E Valdelièvre, I Quéré, B Caré, J P Laroche, J F Schved
INTRODUCTION: Despite the increasing utilization of direct oral anticoagulant (DOAC) prescriptions, vitamin K antagonists (VKAs) remain the treatment of choice for treating and preventing thromboembolic events. The morbidity and mortality of VKAs are partly due to the difficulty of keeping the patient within the therapeutic range. For patients treated by VKA, time in therapeutic range (TTR) is a quality parameter of treatment, widely used in clinical trials but rarely by prescribers. It is well established that its use correlates with the risk of hemorrhage, thrombosis or mortality...
May 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29753603/direct-oral-anticoagulant-agents-pharmacologic-profile-indications-coagulation-monitoring-and-reversal-agents
#5
REVIEW
Deborah K Rose, Barak Bar
Vitamin K antagonists (VKAs), such as warfarin, have been used for thromboprophylaxis and for the treatment of thromboembolic events in patients with nonvalvular atrial fibrillation for over 60 years. The increasing use of direct oral anticoagulants (DOACs) in recent years has shown greater advantages and safer use over VKA, including reduced bleeding, fewer drug interactions, no food interactions, a quick onset and offset of activity, and predictable dose-response properties. Despite their advantages, there are a couple of major limitations that raise concerns among clinicians, including the need for more coagulation assays to monitor their effects and more specific reversal antidotes in life-threatening circumstances of bleeding...
May 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29750067/real-world-effectiveness-and-safety-of-oral-anticoagulation-strategies-in-atrial-fibrillation-a-cohort-study-based-on-a-german-claims-dataset
#6
Sabrina Mueller, Antje Groth, Stefan G Spitzer, Anja Schramm, Andreas Pfaff, Ulf Maywald
Objective: To compare the real-world effectiveness and safety of non-vitamin-K-antagonist oral anticoagulant (NOAC) treatment in atrial fibrillation (AF) patients with a vitamin-K-antagonist (VKA)-based treatment. Methods: This was a retrospective analysis of an anonymized claims dataset from 3 German health insurance funds covering the period from January 01, 2010 to June 30, 2014, with a minimum observation time of 12 months. All continuously insured patients with at least 2 outpatient AF diagnoses and/or 1 inpatient respective diagnosis who received at least 1 outpatient prescription of a NOAC or VKA were included...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29730090/a-propensity-score-matched-comparison-of-clinical-outcomes-in-atrial-fibrillation-patients-taking-vitamin-k-antagonists-comparing-the-real-world-vs-clinical-trials
#7
José Miguel Rivera-Caravaca, María Asunción Esteve-Pastor, Francisco Marín, Mariano Valdés, Vicente Vicente, Vanessa Roldán, Gregory Y H Lip
OBJECTIVE: To investigate the incidence and risk of adverse clinical outcomes in a "real- world" cohort of patients with atrial fibrillation (AF) anticoagulated with vitamin K antagonists (VKAs) from the Murcia AF Project in comparison with the warfarin arm of the randomized clinical trial (RCT) AMADEUS (Evaluating the Use of SR34006 Compared to Warfarin or Acenocoumarol in Patients With Atrial Fibrillation). PATIENTS AND METHODS: We included 1361 patients with AF from the Murcia AF Project (recruitment from May 1, 2007, to December 1, 2007) and 2293 from the AMADEUS trial (started in September 2003 and primary completed in March 2006), all taking VKA treatment...
May 2, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29729202/non-hemorrhagic-joint-disorders-and-vitamin-k-antagonists-an-under-recognized-adverse-drug-reaction
#8
Johana Béné, Clémentine Rousselin, Haleh Bagheri, Thierry Vial, Sophie Gautier, Marc Lambert
Isolated arthralgia, without hemorrhagic side effect exists and is considered as a very rare adverse drug reaction according to vitamin K antagonists' (VKAs) summary of product characteristics. Up to now, there are no literature reports of isolated, non-hemorrhagic joint complications in patients receiving VKAs. Hence, the objective of this study was to describe cases of VKA-related non-hemorrhagic joint disorders (fluindione, warfarin, and acenocoumarol) reported in the French Pharmacovigilance Database (FPVD)...
May 5, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29723895/anticancer-drug-related-nonvalvular-atrial-fibrillation-challenges-in-management-and-antithrombotic-strategies
#9
Antonella Tufano, Maurizio Galderisi, Luca Esposito, Valentina Trimarco, Daniela Sorriento, Guy Gerusalem, Marco Picardi, Patrizio Lancellotti, Fabrizio Pane
Cancer patients may experience nonvalvular atrial fibrillation (AF) as a manifestation of cardiotoxicity. AF may be a direct effect of a neoplasm or, more often, appear as a postsurgical complication, especially after thoracic surgery. AF may also develop as a consequence of anticancer therapy (chemotherapy or radiotherapy), a condition probably underestimated. Cancer patients with AF require a multidisciplinary approach involving oncologists/hematologists, cardiologists, and coagulation experts. An echocardiogram should be performed to detect possible abnormalities of left ventricular systolic and diastolic function, as well as left atrial dilation and the existence of valvular heart disease, to determine pretest probability of sinus rhythm restoration, and identify the best treatment...
May 3, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29715499/new-and-upcoming-treatments-in-antiphospholipid-syndrome-a-comprehensive-review
#10
REVIEW
Flavio Signorelli, Gustavo Guimarães Moreira Balbi, Vinicius Domingues, Roger Abramino Levy
Current therapeutic recommendations for thrombosis prevention in patients with antiphospholipid syndrome (APS) are limited to anticoagulation with vitamin K antagonists (VKA) or heparins and to anti-platelet aggregating agents. Maintaining optimized anticoagulation to prevent recurrent thrombosis or bleeding remains a therapeutic challenge. Although there are important ongoing trials with direct oral anticoagulants, they still aim the same target. New insights about pathophysiology in APS have revealed a myriad of potential pathways to be investigated as treatment targets...
April 28, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29714004/non-bleeding-adverse-events-with-the-use-of-direct-oral-anticoagulants-a-sequence-symmetry-analysis
#11
Géric Maura, Cécile Billionnet, Joël Coste, Alain Weill, Anke Neumann, Antoine Pariente
INTRODUCTION: Postmarketing pharmacovigilance reports have raised concerns about non-bleeding adverse events associated with direct oral anticoagulants (DOACs), but only limited results are available from large claims databases. OBJECTIVE: The aim of this study was to assess the potential association between DOAC initiation and the onset of four types of non-bleeding adverse events by sequence symmetry analysis (SSA). METHODS: SSA was performed using nationwide data from the French National Healthcare databases (Régime Général, 50 million beneficiaries) to assess a cohort of 386,081 DOAC new users for the first occurrence of four types of non-bleeding outcomes: renal, hepatic, skin outcomes identified by using hospitalization discharge diagnoses, and gastrointestinal outcomes by using medication reimbursement...
April 30, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29706468/-assessing-post-hospitalization-therapeutic-ranges-in-elderly-patients-treated-for-atrial-fibrillation-with-vitamin-k-antagonists
#12
D Bureau, C Laget, J-P Cambus, J Constans, A Trinh-Duc
BACKGROUND: In France, anticoagulants are among the most recommended treatments for serious accidents, particularly among the elderly. OBJECTIVES: The purpose of this study was to evaluate the impact of practical and validated tools designed to reduce the negative effects of vitamin K antagonist (VKA) treatments by assessing patients before and after the tools were implemented. METHODS: An exhaustive before and after multi-centric cohort study was performed in the Agen territory...
April 26, 2018: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29703158/periprocedural-anticoagulation-during-left-atrial-ablation-interrupted-and-uninterrupted-vitamin-k-antagonists-or-uninterrupted-novel-anticoagulants
#13
Maria Brinkmeier-Theofanopoulou, Panagiotis Tzamalis, Susan Wehrkamp-Richter, Andrea Radzewitz, Matthias Merkel, Gerhard Schymik, Gesine van Mark, Peter Bramlage, Claus Schmitt, Armin Luik
BACKGROUND: There is a lack of data on anticoagulation requirements during ablation of atrial fibrillation (AF). This study compares different oral anticoagulation (OAC) strategies to evaluate risk of bleeding and thromboembolic complications. METHODS: We conducted a single-centre study in patients undergoing left atrial ablation of AF. Three groups were defined: 1) bridging: interrupted vitamin-K-antagonists (VKA), INR ≤2, and bridging with heparin; 2) VKA: uninterrupted VKA and INR of > 2; 3) DOAC: uninterrupted direct oral anticoagulants...
April 27, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29694286/primary-nonadherence-to-oral-anticoagulants-in-patients-with-atrial-fibrillation-real-world-data-from-a-population-based-cohort
#14
Clara L Rodriguez-Bernal, Salvador Peiró, Isabel Hurtado, Aníbal García-Sempere, Gabriel Sanfélix-Gimeno
BACKGROUND: Primary nonadherence (not filling a first prescription) is an important yet unstudied aspect of adherence to oral anticoagulant (OAC) therapy. OBJECTIVE: To estimate the rates of primary nonadherence to OACs and determine associated factors in real-world practice. METHODS: This population-based retrospective cohort study set in the Valencia region of Spain (about 5 million inhabitants) included all patients with atrial fibrillation who were newly prescribed OACs during 2011-2014 (N = 18,715)...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29692686/noacs-replace-vka-as-preferred-oral-anticoagulant-among-new-patients-a-drug-utilization-study-in-560-pharmacies-in-the-netherlands
#15
J M van den Heuvel, A M Hövels, H R Büller, A K Mantel-Teeuwisse, A de Boer, A H Maitland-van der Zee
Background: In 2012, around 400.000 patients in the Netherlands were treated with Vitamin K Antagonists (VKA) for thromboembolic diseases. Since 2011, non-VKA oral anticoagulants (NOACs) are available. NOACs do not require frequent INR monitoring which benefits patients, but also imposes a risk of reduced therapy adherence. The objective of this study is to describe uptake and patient adherence of NOACs in The Netherlands until October 2016. Methods: Prescription data for 247...
2018: Thrombosis Journal
https://www.readbyqxmd.com/read/29687299/anticoagulation-reversal-in-vitamin-k-antagonist-associated-intracerebral-hemorrhage-a-systematic-review
#16
Darae Ko, Zayd Razouki, James Otis, Erika Marulanda-Londoño, Elaine M Hylek
The effect of rapid anticoagulation reversal on mortality and functional outcome in vitamin K antagonist-associated intracerebral hemorrhage (VKA-ICH) is uncertain. Given the approval of idarucizumab for dabigatran reversal and pending approval for andexanet alfa for reversal of factor Xa inhibitors, a systematic appraisal of the effectiveness of reversal for VKA-ICH would provide a bench mark for current practice. We performed PubMed searches and reviewed current guidelines. Using pre-specified inclusion and exclusion criteria, studies were reviewed by two physicians independently...
April 23, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29679301/contemporary-antithrombotic-treatment-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-rationale-and-design-of-the-greek-antiplatelet-atrial-fibrillation-grape-af-registry
#17
Ioanna Xanthopoulou, Vasiliki-Maria Dragona, Periklis Davlouros, Costas Tsioufis, Efstathios Iliodromitis, Dimitrios Alexopoulos
BACKGROUND: Approximately 5 to 7% of patients undergoing percutaneous coronary intervention (PCI) for the treatment of coronary artery disease require chronic oral anticoagulation (OAC) on top of aspirin and a P2Y12 receptor antagonist, mainly due to non-valvular atrial fibrillation (AF). The advent of non-vitamin K antagonist oral anticoagulants (NOACs) increased treatment options, while there is cumulative evidence that dual combination of a NOAC and a P2Y12 receptor antagonist attenuates risk of bleeding, compared to traditional triple therapy, consisting of a vitamin K antagonist (VKA), aspirin, and a P2Y12 receptor antagonist, without significantly compromising efficacy...
April 20, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29679144/antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-should-we-change-our-practice-after-the-pioneer-af-pci-and-re-dual-pci-trials
#18
D Duerschmied, J Brachmann, H Darius, N Frey, H A Katus, W Rottbauer, A Schäfer, H Thiele, C Bode, Uwe Zeymer
The number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2 DS2 -VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known...
April 20, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29670522/dabigatran-added-to-dual-antiplatelet-therapy-to-treat-a-left-ventricular-thrombus-in-an-87-year-old-patient-with-myocardial-infarction-and-very-high-bleeding-risk
#19
Maria Noflatscher, Nicolas Moes, Eva-Maria Gassner, Peter Marschang
Background: A left ventricular (LV) thrombus is detected in approximately 5-10% of patients after myocardial infarction (MI). If left untreated, these LV thrombi carry a significant risk of complications including embolic stroke. According to current guidelines, anticoagulation with vitamin K antagonists (VKA) is recommended to treat a LV thrombus. Case presentation: An 87 year old patient was referred to our department with non ST-elevation MI. Five months before, he had been diagnosed with a subacute ST elevation MI, which had been treated conservatively...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29663464/uninterrupted-administration-of-edoxaban-vs-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation-rationale-and-design-of-the-eliminate-af-study
#20
Stefan H Hohnloser, John Camm, Riccardo Cappato, Hans-Christoph Diener, Hein Heidbuchel, Hans-Joachim Lanz, Lluís Mont, Carlos A Morillo, Rüdiger Smolnik, Ophelia Q P Yin, Josef Kautzner
Patients with atrial fibrillation (AF) are at an approximately 0.5% to 3% increased risk of thromboembolism during and immediately after catheter ablation. Treatment guidelines recommend periprocedural oral anticoagulation plus unfractionated heparin during ablation. Rivaroxaban and dabigatran are the only non-vitamin K oral anticoagulants for which there are randomized controlled trials assessing uninterrupted anticoagulation in patients undergoing catheter ablation of AF. Edoxaban, a direct factor Xa inhibitor, is noninferior vs warfarin for the prevention of stroke or systemic embolism with less major bleeding in patients with nonvalvular AF...
April 17, 2018: Clinical Cardiology
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