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Novel anticoagulants

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https://www.readbyqxmd.com/read/28820554/warfarin-therapy-after-mechanical-valve-replacement-a-tool-for-predicting-bleeding-events
#1
Insil Jang, Sukjung Choo, Kyunghee Kim
BACKGROUND: Mechanical valve replacement is associated with positive outcomes, but patients must undergo life-long anticoagulation therapy with warfarin, which carries a significant risk of bleeding complications. Therefore, a systematic and continuous assessment and supervision of warfarin treatment is essential in such patients, and approaches that can predict the risk of bleeding in advance are required. The study aim was to develop a classification tool to predict bleeding events in South Korean patients with mechanical valve replacement undergoing oral warfarin therapy...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28808959/deaths-from-medicines-a-systematic-analysis-of-coroners-reports-to-prevent-future-deaths
#2
Robin E Ferner, Craig Easton, Anthony R Cox
INTRODUCTION: Since legislation in 2009, coroners in England and Wales must make reports in cases where they believe it is possible to prevent future deaths. We categorised the reports and examined whether they could reveal preventable medication errors or novel adverse drug reactions. METHODS: We examined 500 coroners' reports by pre-defined criteria to identify those in which medicines played a part, and to collect information on coroners' concerns. RESULTS: We identified 99 reports (100 deaths) in which medicines or a part of the medication process or both were mentioned...
August 14, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28807511/prevalence-and-predictors-of-inappropriate-anticoagulation-in-patients-with-a-cha2ds2-vasc-score-of-0-and-atrial-fibrillation
#3
Sepehr Saberian, Auroa Badin, Vince Siebert, Ashish Roy, Sandeep Banga, Harshavardhan R Ghadiam, Rebecca R Wigant, Ashim Aggarwal, Timir S Baman
BACKGROUND: Previous studies have shown underutilization of anticoagulation therapy in patients with atrial fibrillation and a CHA2DS2-VASc score ≥2; however there exists little data regarding the inappropriate use of anticoagulation in patients with a CHA2DS2-VASc score of 0. We aimed to determine the true prevalence and predictors of inappropriate anticoagulation therapy in patients with atrial fibrillation and a CHA2DS2-VASc score of 0. METHODS: A retrospective chart review was performed on all patients with atrial fibrillation and a CHA2DS2-VASc score of 0 in our institution from January 2009 to January 2016...
August 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28803520/probable-rivaroxaban-induced-full-body-rash-a-case-report
#4
Evan Sasson, Marian James, Mark Russell, Darko Todorov, Henry Cohen
INTRODUCTION: Rivaroxaban is a novel oral anticoagulant with several indications, one of which is for stroke prevention in nonvalvular atrial fibrillation. We present a case of probable rivaroxaban-induced rash. CASE SUMMARY: A 79-year-old female with a medical history of atrial fibrillation experienced a stroke, after which she was prescribed rivaroxaban 20 mg. After several days, she developed a rash requiring admission to the emergency department and several days of treatment...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28802808/novel-oral-anticoagulants-in-direct-current-cardioversion-for-atrial-fibrillation
#5
Giuseppe Femia, Taufik Fetahovic, Pratap Shetty, Astin Lee
BACKGROUND: For some patients with atrial fibrillation, direct current cardioversion (DCCV) is one strategy that can be used to establish sinus rhythm but appropriate anticoagulation is mandatory to prevent thromboembolic events. Historically, patients were anticoagulated with warfarin with bridging with unfractionated or low molecular weight heparin, however, recently novel oral anticoagulants (NOACs), apixaban, dabigatran and rivaroxaban have become more popular. Despite the increase in use, real world data on safety and efficacy is limited...
July 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28801633/evaluation-of-novel-factor-xa-inhibitors-from-oxya-chinensis-sinuosa-with-anti-platelet-aggregation-activity
#6
Wonhwa Lee, HeeSeung Lee, Mi-Ae Kim, Joonhyeok Choi, Kyung-Min Kim, Jae Sam Hwang, MinKyun Na, Jong-Sup Bae
The edible grasshopper Oxya chinensis sinuosa is consumed worldwide for its various medicinal effects. The purpose of this study was to investigate potential bioactive antithrombotic and antiplatelet compounds from O. chinensis sinuosa. Five N-acetyldopamine dimers (1-5) were isolated from O. chinensis sinuosa and compounds 1 and 2 were identified as new chemicals with chiral centers at H-2 and H-3 of the benzo-1,4-dioxane structure. Compounds 1-4 were found to have both FXa and platelet aggregation inhibitory activities...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28800389/silicon-micropore-based-parallel-plate-membrane-oxygenator
#7
Ajay Dharia, Emily Abada, Benjamin Feinberg, Torin Yeager, Willieford Moses, Jaehyun Park, Charles Blaha, Nathan Wright, Benjamin Padilla, Shuvo Roy
Extracorporeal membrane oxygenation (ECMO) is a life support system that circulates the blood through an oxygenating system to temporarily (days to months) support heart or lung function during cardiopulmonary failure until organ recovery or replacement. Currently, the need for high levels of systemic anticoagulation and the risk for bleeding are main drawbacks of ECMO that can be addressed with a redesigned ECMO system. Our lab has developed an approach using microelectromechanical systems (MEMS) fabrication techniques to create novel gas exchange membranes consisting of a rigid silicon micropore membrane (SμM) support structure bonded to a thin film of gas-permeable polydimethylsiloxane (PDMS)...
August 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28797879/using-a-non-invasive-secure-skin-closure-following-total-knee-arthroplasty-leads-to-fewer-wound-complications-and-no-patient-home-care-visits-compared-to-surgical-staples
#8
Alberto V Carli, Sara Spiro, Brian T Barlow, Steven B Haas
BACKGROUND: Superficial wound complications occur in up to 10% of total knee arthroplasty (TKA) procedures and have been associated with periprosthetic joint infection. The ideal material for TKA closure should offer: 1) fast intraoperative application, 2) minimal wound complications and 3) removable by patients without assistance. We evaluated a novel, non-invasive, removable skin closure system for TKA to determine its effect on wound complications. METHODS: We prospectively evaluated 221 consecutive TKA patients who received skin closure using a non-invasive zipper-like system ('Zip'; Zip 16 Surgical Skin Closure System; Zipline Medical)...
August 7, 2017: Knee
https://www.readbyqxmd.com/read/28792914/reply-pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#9
Petros Ioannou
In their recent work published in the Romanian Journal of Internal Medicine, Balahura et al. reviewed the cases of pulmonary embolism (PE) diagnosed in an emergency hospital in Bucharest during a 3 year period from January 2014 to December 2016 [1]. Among their observations was that novel oral anticoagulants (NOACs) were administered in 26.3% of patients diagnosed with PE, while vitamin K antagonists (VKA) were administered in 71.7% of them [1]. The authors state that their study was performed at a time when NOACs were just becoming available in the hospitals of Romania, and they imply that more patients with PE could be treated nowadays with NOACs...
August 5, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28790282/-arrhythmia-perioperative-management-and-the-prevention
#10
Masayoshi Inoue
Perioperative/postoperative atrial fibrillation and flutter( POAF) is one of the common complications after pulmonary resection and the frequency is reported as 12.6% according to Society of Thoracic Surgeons general thoracic surgery database. We usually observed POAF 2~3 day after operation. While the etiology remains uncertain, the left atrial overload by the refilling from the 3rd space or systemic inflammation after surgery could raise this complication in addition to the right atrial overload following pulmonary resection and postoperative hypoxia status...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28777854/-a-novel-double-heterozygote-of-hbb-c-219t-a-220g-t-gene-diagnosis-and-pedigree-analysis
#11
Jiezhong Lv, Zhaofan Luo, Jianpei Fang, Tao Du, Hongman Xue, Yong Liu, Jianping Zhang
OBJECTIVE: To identify a novel hemoglobinopathy applied by direct sequencing and clone sequencing. METHODS: EDTA anticoagulated blood of proband and his parents were analyzed by hematology analyzers and Capillarys hemoglobin electrophoresis (CE). Then thalassemia genetypes were screened by gap-PCR and reverse dot blot (RDB). Proband was suspected with abnormal hemoglobin combine alpha beta compound thalassemia. The mutation of beta-globin was identified by direct sequencing and clone sequencing...
August 10, 2017: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
https://www.readbyqxmd.com/read/28771671/assessment-of-the-efficacy-of-a-novel-tailored-vitamin-k-dosing-regimen-in-lowering-the-international-normalised-ratio-in-over-anticoagulated-patients-a-randomised-clinical-trial
#12
Emmanouela Kampouraki, Peter J Avery, Hilary Wynne, Tina Biss, John Hanley, Kate Talks, Farhad Kamali
Current guidelines advocate using fixed-doses of oral vitamin K to reverse excessive anticoagulation in warfarinised patients who are either asymptomatic or have minor bleeds. Over-anticoagulated patients present with a wide range of International Normalised Ratio (INR) values and response to fixed doses of vitamin K varies. Consequently a significant proportion of patients remain outside their target INR after vitamin K administration, making them prone to either haemorrhage or thromboembolism. We compared the performance of a novel tailored vitamin K dosing regimen to that of a fixed-dose regimen with the primary measure being the proportion of over-anticoagulated patients returning to their target INR within 24 h...
August 2, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28771571/optical-sensing-of-anticoagulation-status-towards-point-of-care-coagulation-testing
#13
Diane M Tshikudi, Markandey M Tripathi, Zeinab Hajjarian, Elizabeth M Van Cott, Seemantini K Nadkarni
Anticoagulant overdose is associated with major bleeding complications. Rapid coagulation sensing may ensure safe and accurate anticoagulant dosing and reduce bleeding risk. Here, we report the novel use of Laser Speckle Rheology (LSR) for measuring anticoagulation and haemodilution status in whole blood. In the LSR approach, blood from 12 patients and 4 swine was placed in disposable cartridges and time-varying intensity fluctuations of laser speckle patterns were measured to quantify the viscoelastic modulus during clotting...
2017: PloS One
https://www.readbyqxmd.com/read/28769114/diagnosing-antiphospholipid-syndrome-extra-criteria-manifestations-and-technical-advances
#14
REVIEW
Savino Sciascia, Mary-Carmen Amigo, Dario Roccatello, Munther Khamashta
First described in the early 1980s, antiphospholipid syndrome (APS) is a unique form of acquired autoimmune thrombophilia in which patients present with clinical features of recurrent thrombosis and pregnancy morbidity and persistently test positive for the presence of antiphospholipid antibodies (aPL). At least one clinical (vascular thrombosis or pregnancy morbidity) and one lab-based (positive test result for lupus anticoagulant, anticardiolipin antibodies and/or anti-β2-glycoprotein 1 antibodies) criterion have to be met for a patient to be classified as having APS...
August 3, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28762624/chronic-complications-of-venous-thromboembolism
#15
M-P Winter, G H Schernthaner, I M Lang
Venous thromboembolism (VTE) is a common disease (~700 per 100 000) that is associated with significant risk of recurrence, chronic complications, and substantial mortality, with reported death rates of up to 40% at 10 years. The development of novel anticoagulants has revolutionized the treatment of acute VTE, while strategies for prevention and treatment of chronic complications still seek for such a landmark change. Impaired thrombus resolution is the common denominator behind VTE complications, which are postthrombotic syndrome (PTS) and chronic thromboembolic pulmonary hypertension (CTEPH)...
August 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28752228/the-dx-af-study-a-prospective-multicenter-randomized-controlled-trial-comparing-vdd-icd-to-vvi-icd-in-detecting-sub-clinical-atrial-fibrillation-in-defibrillator-patients
#16
Mohammed Shurrab, Amir Janmohamed, Jean-François Sarrazin, Felix Ayala-Paredes, Marcio Sturmer, Randall Williams, Satish Toal, Chris Lane, Kevin E Thorpe, Jeff S Healey, Eugene Crystal
PURPOSE: Atrial fibrillation (AF) is the most common cardiac dysrhythmia. Appropriate detection of AF and early initiation of oral anticoagulation therapy are critical to reduce the risk of stroke. Patients with implantable cardioverter defibrillators (ICD) are at high risk of developing AF. The purpose of the Dx-AF study is to demonstrate that a novel single-lead VDD-ICD system (Linox smart S DX) will facilitate adequate recognition of sub-clinical AF and ultimately stroke prevention with a comparable safety profile in comparison to VVI-ICD...
July 27, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28751848/anmco-position-paper-long-term-follow-up-of-patients-with-pulmonary-thromboembolism
#17
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28740586/mechanical-valve-thrombosis-on-rivaroxaban-are-novel-anticoagulants-really-an-option
#18
Vishesh Kumar, Shawn Kelly, Amol Raizada, Jimmy Yee, Amornpol Anuwatworn, Adam Stys, Maria Stys
This is a case of a 54-year-old female with a history of mechanical aortic valve replacement who presented in cardiogenic shock. Her primary care provider started her on rivaroxaban for anticoagulation therapy. An urgent transesophageal echocardiogram revealed a significant gradient and thrombosis on one leaflet of the valve that was immobile. Given that she was not a surgical candidate, she underwent thrombolysis. However, she later died due to complications from the thrombotic valve. The utility of target-specific oral anticoagulants has yet to be established in clinical practice...
April 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28740162/nomogram-predicted-risk-of-peripherally-inserted-central-catheter-related-thrombosis
#19
Nan Hao, Xin Xie, Zhangjian Zhou, Jieqiong Li, Li Kang, Huili Wu, Pingli Guo, Chengxue Dang, Hao Zhang
The use of peripherally inserted central catheters (PICCs) is increasing rapidly worldwide. A number of patient-related, clinical-related and device-related characteristics might be risk factors for PICC-related thrombosis. We retrospectively reviewed a database of 320 consecutive patients who underwent PICC insertion between December 2014 and December 2015 at the First Affiliated Hospital of Xi'an Jiaotong University to explore the potential associations between risk factors and PICC-associated thrombosis...
July 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28736561/recent-advances-in-stroke-prevention-in-patients-with-atrial-fibrillation-and-end-stage-renal-disease
#20
REVIEW
Federico Ronco, Patrizio Mazzone, Leila Hosseinian, Simonetta Genovesi
BACKGROUND: Chronic kidney disease (CKD) is associated with a high prevalence of atrial fibrillation (AF), but in this population the risk/benefit ratio of anticoagulant therapy with vitamin K antagonists (VKA) for thromboprophylaxis is uncertain. SUMMARY: In end-stage renal disease (ESRD) patients undergoing hemodialysis, VKA seem less effective in stroke prevention than in the general population, with an increased risk of major bleeding. Recently, novel oral anticoagulant agents (NOACs) have proven to be effective for stroke prevention in AF and have demonstrated an improved safety profile compared to VKA...
June 2017: Cardiorenal Medicine
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