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https://www.readbyqxmd.com/read/28210867/management-and-outcome-of-gastrointestinal-bleeding-in-patients-taking-oral-anticoagulants-or-antiplatelet-drugs
#1
Sven Pannach, Julia Goetze, Sandra Marten, Thomas Schreier, Luise Tittl, Jan Beyer-Westendorf
BACKGROUND: Non-vitamin K dependent oral anticoagulants (NOACs) significantly decrease overall major bleeding rates compared with vitamin K antagonists (VKAs) but there is conflicting evidence regarding the relative risk of gastrointestinal bleeding. Since data regarding the types, the management, and the outcome of NOAC-associated gastrointestinal bleeding are scarce, we aimed to fill this gap by comparing cases of gastrointestinal bleeding associated with NOAC, VKA, or antiplatelet therapy...
February 16, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28209218/the-changing-landscape-for-stroke%C3%A2-prevention-in-af-findings-from-the-gloria-af-registry-phase-2
#2
Menno V Huisman, Kenneth J Rothman, Miney Paquette, Christine Teutsch, Hans-Christoph Diener, Sergio J Dubner, Jonathan L Halperin, Chang Sheng Ma, Kristina Zint, Amelie Elsaesser, Dorothee B Bartels, Gregory Y H Lip
BACKGROUND: GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non-vitamin K antagonist oral anticoagulant (NOAC), became available. OBJECTIVES: This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1...
February 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28205318/risk-of-major-bleeding-and-stroke-associated-with-the-use-of-vkas-noacs-and-aspirin-in-patients-with-atrial-fibrillation-a-cohort-study
#3
Emilie Gieling, Hendrika A van den Ham, Hein van Onzenoort, Jacqueline Bos, Cornelis Kramers, Anthonius de Boer, Frank de Vries, Andrea M Burden
INTRODUCTION: Non-vitamin K antagonist oral anticoagulants (NOACs) are now available for the prevention of stroke in patients with atrial fibrillation (AF) as an alternative to vitamin K antagonists (VKA) and aspirin. The comparative effectiveness and safety in daily practice of these different drug classes is still unclear. The objective of this study was to evaluate the risk of major bleeding and stroke in AF patients using NOACs, VKAs or aspirin. METHODS: A retrospective cohort study was conducted among AF patients using the UK Clinical Practice Research Datalink (March 2008-October 2014)...
February 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28204995/dalteparin-or-vitamin-k-antagonists-to-prevent-recurrent-venous-thromboembolism-in-cancer-patients-a-patient-level-economic-analysis-for-france-and-austria
#4
George Dranitsaris, Lesley G Shane, Jean-Philippe Galanaud, Gunar Stemer, Philippe Debourdeau, Seth Woodruff
BACKGROUND: International guidelines recommend extended duration secondary prophylaxis in cancer patients who develop primary venous thromboembolism (VTE). Agent selection is guided in part by one large randomized trial (i.e., CLOT; Lee et al., N Engl J Med 349:146-53, 2003) which demonstrated that dalteparin reduced the relative risk of recurrence by 52% compared with oral vitamin K antagonists (VKA; HR = 0.48, 95% CI, 0.30 to 0.77). In a subgroup analysis from that same trial, patients with renal impairment also derived benefit with dalteparin (VTE rates = 3% vs...
February 15, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28198064/real-life-practices-for-preventing-venous-thromboembolism-in-multiple-myeloma-patients-a-cohort-study-from-the-french-health-insurance-database
#5
Aurore Palmaro, Marie-Eve Rougé-Bugat, Martin Gauthier, Fabien Despas, Guillaume Moulis, Maryse Lapeyre-Mestre
PURPOSE: The risk of venous thromboembolic event (VTE) in multiple myeloma is particularly increased. Current guidelines recommend systematic VTE prophylaxis with vitamin K antagonists (VKA) or low weight molecular heparin (LWMH) or unfractionated heparin (UFH) in high-risk patients, based on treatment received [e.g. use of IMiDs (thalidomide, lenalidomide and pomalidomide), alkylating agents or erythropoietin] and individual risk factors (e.g. history of VTE). The aim of this study was to describe strategy of VTE prophylaxis and prescribing of other antithrombotic agents during the first 6 months of multiple myeloma therapy, with stratification on IMiD-based regimens and drug and disease-related risk factors...
February 15, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28180234/pharmacokinetics-and-pharmacodynamics-of-tecarfarin-a-novel-vitamin-k-antagonist-oral-anticoagulant
#6
Detlef Albrecht, David Ellis, Daniel M Canafax, Daniel Combs, Pascal Druzgala, Peter G Milner, Mark G Midei
Tecarfarin is a vitamin K antagonist (VKA) with reduced propensity for drug interactions. To evaluate the pharmacokinetic (PK), pharmacodynamic (PD), and safety of tecarfarin, we performed single ascending dose (SAD) (n=66), multiple ascending dose (MAD) (n=43), and tecarfarin versus warfarin (n=28) studies in human volunteers. In the SAD, tecarfarin was administered to 5 of 6 subjects (1 received placebo) in each of 11 cohorts. AUC0-∞ exhibited linearity and dose proportionality. Elimination T1/2 ranged from 87-136 hours (h) across all doses...
February 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28151036/the-cost-of-warfarin-treatment-for-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-in-russia-from-a-collective-perspective
#7
J B Briere, K Bowrin, R Wood, J Roberts, B Tatarsky
AIMS: Vitamin K antagonists (VKAs) are used for stroke prevention in patients with non-valvular atrial fibrillation (NVAF) but necessitate regular monitoring of prothrombin time via international normalized ratio (INR) testing. This study explores the economic burden of VKA therapy for Russian patients with NVAF. METHOD: Cardiologists provided clinical characteristics and healthcare resource use data relating to the patient's first year of treatment. Data were used to quantify direct medical costs (INR testing, consultations, drug costs)...
February 2, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28148636/antithrombotic-pretreatment-increases-very-early-mortality-in-primary-intracerebral-hemorrhage
#8
Jaume Roquer, Rosa María Vivanco Hidalgo, Angel Ois, Ana Rodríguez Campello, Elisa Cuadrado Godia, Eva Giralt Steinhauer, Alejandra Gómez González, Carolina Soriano-Tarraga, Jordi Jiménez Conde
OBJECTIVE: To analyze the effect of previous antiplatelet (AP) and vitamin K antagonist (VKA) treatments on outcome in patients with primary intracerebral hemorrhage (ICH). METHODS: In this prospective observational study, we analyzed 529 patients according to antithrombotic pretreatment: none, AP, or VKA. Very-early (24-hour) death, 3-month mortality, and functional independence were analyzed. RESULTS: Of 236 (44.6%) pretreated patients, 147 (27...
February 1, 2017: Neurology
https://www.readbyqxmd.com/read/28144725/-noac-real-life-data-and-the-role-of-antidotes-for-the-treatment-of-bleeding
#9
H Darius
The non-vitamin K antagonists (NOAC) are an integral component of our antithrombotic prevention and therapy. For four of the NOAC, their non-inferiority or even superiority versus vitamin K antagonists (VKA) has been proven. Thus, the management of special patient cohorts or the management of active bleeding complications is a focus of current discussion.In addition to prospective trials, numerous retrospective analyses of health insurers or public health provider data have been analyzed and published as "real life" or "real-world evidence" data...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28139289/cost-effectiveness-analysis-for-apixaban-in-the-acute-treatment-and-prevention-of-venous-thromboembolism-in-the-netherlands
#10
Lisa A de Jong, Evgeni Dvortsin, Kristel J Janssen, Maarten J Postma
PURPOSE: Low-molecular weight heparin (LMWH) followed by vitamin K antagonists (VKAs) are the current standard treatment of acute venous thromboembolism (VTE) and prevention of recurrent VTE. The direct oral anticoagulant apixaban was recently found noninferior in efficacy and superior in preventing major bleeding compared with LMWH/VKAs in the AMPLIFY (Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-Line Therapy) trial. The objective of this study was to calculate the cost-effectiveness of apixaban compared with LMWH/VKA in the treatment of acute VTE and prevention of recurrent VTE in the Netherlands...
January 27, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28138260/dalteparin-versus-vitamin-k-antagonists-for-the-prevention-of-recurrent-venous-thromboembolism-in-patients-with-cancer-and-renal-impairment-a-canadian-pharmacoeconomic-analysis
#11
George Dranitsaris, Lesley G Shane, Mark Crowther, Guillaume Feugere, Seth Woodruff
BACKGROUND: Patients with cancer are at increased risk of venous thromboembolism (VTE) and the risk is further elevated after a primary VTE. To reduce the risk of recurrent events, extended prophylaxis with vitamin K antagonists (VKA) is available for use. However, in a large randomized trial (Comparison of Low-Molecular-Weight Heparin versus Oral Anticoagulant Therapy for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer [CLOT]; Lee et al), extended duration dalteparin reduced the relative risk of recurrent VTE by 52% compared to VKA (p=0...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28132418/switching-adverse-effects-and-use-of-over-the-counter-analgesics-among-users-of-oral-anticoagulants-a-pharmacy-based-survey
#12
Maja Hellfritzsch, Lea Maria Rønneberg Hyllested, Line Meegaard, Alexander Wiberg-Hansen, Erik Lerkevang Grove, Anton Pottegård
Oral anticoagulants are widely used but information on important aspects in that respect is not available from medical registers or clinical databases. Therefore, we conducted a survey including patients filling a prescription for oral anticoagulants at two large Danish community pharmacies. We collected information concerning the patients' knowledge of their anticoagulant treatment including prior drug switching. Further, patients were asked about use of over-the-counter analgesics, adverse effects, and how the treatment affected their everyday life...
January 28, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28130378/rationale-and-design-of-axafa-afnet-5-an-investigator-initiated-randomized-open-blinded-outcome-assessment-multi-centre-trial-to-comparing-continuous-apixaban-to-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation
#13
REVIEW
Luigi Di Biase, David Callans, Karl Georg Hæusler, Gerhard Hindricks, Hussein Al-Khalidi, Lluis Mont, Jens Cosedis Nielsen, Jonathan P Piccini, Ulrich Schotten, Paulus Kirchhof
AIMS: Catheter ablation is the most efficacious rhythm control therapy in atrial fibrillation (AF) patients. There is growing evidence that catheter ablation procedures are best performed during continuous oral anticoagulation, but outcomes are variable depending on the anticoagulation strategy or agent chosen. Specifically, there is a need to evaluate the peri-procedural use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients undergoing catheter ablation of AF. The AXAFA-AFNET 5 trial will test whether peri-procedural anticoagulation therapy using apixaban is a safe alternative to vitamin K antagonist (VKA) therapy for patients undergoing catheter ablation of AF...
January 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28124061/microfluidic-coagulation-assay-for-monitoring-anticoagulant-therapy-in-acute-stroke-patients
#14
Annemarie Bluecher, Sascha Meyer Dos Santos, Nerea Ferreirós, Sandra Labocha, Isabel Maria Rodrigues Meyer Dos Santos, Bettina Picard-Willems, Sebastian Harder, Oliver C Singer
Reliable detection of anticoagulation status in patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) is challenging but of importance especially in the emergency setting. This study evaluated the potential of a whole-blood clotting time assay based on Surface Acoustic Waves (SAW-CT) in stroke-patients. The SAW-technology was used for quick and homogenous recalcification of whole blood inducing a surface-activated clotting reaction quantified and visualised by real-time fluorescence microscopy with automatic imaging processing...
January 26, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28123163/overview-of-current-evidence-on-the-impact-of-the-initial-high-dose-of-the-direct-factor-xa-inhibitor-rivaroxaban-on-thrombus-resolution-in-the-treatment-of-venous-thromboembolism
#15
Rupert Bauersachs, Norimichi Koitabashi
Incomplete thrombus resolution in patients with venous thromboembolism (VTE) may increase the risk of recurrent thromboembolic events and other complications, such as post-thrombotic syndrome. Various options exist for thrombus resolution, including systemic thrombolytic agents, catheter-directed thrombolysis, and traditional anticoagulants such as heparins or vitamin K antagonists (VKAs). Data are accumulating on the use of non-VKA oral anticoagulants, such as rivaroxaban, and these may provide greater thrombus resolution compared with VKAs...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28114939/cost-effectiveness-of-apixaban-versus-low-molecular-weight-heparin-vitamin-k-antagonist-for-the-treatment-of-venous-thromboembolism-and-the-prevention-of-recurrences
#16
Tereza Lanitis, Robert Leipold, Melissa Hamilton, Dale Rublee, Peter Quon, Chantelle Browne, Alexander T Cohen
BACKGROUND: Prior analyses beyond clinical trials are yet to evaluate the projected lifetime benefit of apixaban treatment compared to low-molecular-weight heparin (LMWH)/vitamin K antagonist (VKA) for treatment of venous thromboembolism (VTE) and prevention of recurrences. The objective of this study is to assess the cost-effectiveness of initial plus extended treatment with apixaban versus LMWH/VKA for either initial treatment only or initial plus extended treatment. METHODS: A Markov cohort model was developed to evaluate the lifetime clinical and economic impact of treatment of VTE and prevention of recurrences with apixaban (starting at 10 mg BID for 1 week, then 5 mg BID for 6 months, then 2...
January 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28109541/anaemia-as-an-independent-key-risk-factor-for-major-haemorrhage-in-patients-treated-with-vitamin-k-antagonists-results-of-the-score-prospective-cohort
#17
Nora Zenati, Yoann Gaboreau, Cynthia Brousseau Provencher, Pierre Albaladejo, Jean Luc Bosson, Gilles Pernod
INTRODUCTION: Risk scores for the prediction of haemorrhage are poorly predictive of major bleeding. The aim of this study was to refine the estimation of bleeding risk by identifying one or several parameters of prognostic significance among these algorithms. MATERIALS AND METHODS: The SCORE study was a prospective, multicentre cohort study conducted in France in 2009-2010. Patients were eligible if they had received vitamin K antagonist (VKA) for any therapeutic indication for at least 3months...
October 28, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28074293/-management-of-noak-administration-during-invasive-or-surgical-interventions-when-and-how-to-pause-and-when-to-restart
#18
M Buerke, H M Hoffmeister
Many patients under oral anticoagulation therapy need percutaneous or surgical interventions/operations. For vitamin K antagonists (VKA), there are recommendations regarding preoperative or postoperative administration. Management of the new oral anticoagulants (NOAC) was supposed to be easier - but some aspects must be considered. Due to the different pharmacokinetic profiles of substances such as dabigatran, rivaroxaban, apixaban, and edoxaban, different recommendations are given.Upon periprocedural management, thromboembolic risk has to be considered in patients treated with NOACs...
January 10, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28064150/a-novel-risk-prediction-score-in-atrial-fibrillation-for-a-net-clinical-outcome-from-the-engage-af-timi-48-randomized-clinical-trial
#19
Christina L Fanola, Robert P Giugliano, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott M Antman, Eugene Braunwald
AIMS: The choice between initiating a non-vitamin K antagonist oral anticoagulant (NOAC) and a vitamin K antagonist (VKA) in patients with atrial fibrillation (AF) may be challenging. To assist in this decision, we developed a risk score to identify patients for whom a therapeutic benefit of NOACs over VKA is predicted. METHODS AND RESULTS: ENGAGE AF-TIMI 48 was a randomized clinical trial of edoxaban vs. warfarin in 21 105 patients with AF. Cox proportional hazard models identified factors associated with a serious net clinical outcome (NCO) of disabling stroke, life-threatening bleeding, and all-cause mortality in VKA naïve patients from the warfarin arm...
January 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28063671/meta-analysis-of-major-bleeding-events-on-aspirin-versus-vitamin-k-antagonists-in-randomized-trials
#20
P Ambrosi, A Daumas, P Villani, R Giorgi
BACKGROUND AND OBJECTIVES: The relative bleeding risk of aspirin versus vitamin K antagonists (VKA) is unclear. Most of previous meta-analyses included trials with target INR for VKA therapy far beyond usually recommended range (2-3). The aim of this study was to compare the bleeding risk of aspirin and VKA, as indicated by the aggregate body of clinical evidence including data from the recently published WARCEF trial. METHODS: In this meta-analysis we included randomized controlled trials that compared aspirin to VKA (1...
March 1, 2017: International Journal of Cardiology
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