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https://www.readbyqxmd.com/read/28821169/predictors-of-pre-procedural-concentrations-of-direct-oral-anticoagulants-a-prospective-multicentre-study
#1
Anne Godier, Anne-Sophie Dincq, Anne-Céline Martin, Adrian Radu, Isabelle Leblanc, Marion Antona, Marc Vasse, Jean-Louis Golmard, François Mullier, Isabelle Gouin-Thibault
Aims: Patients receiving direct oral anticoagulants (DOACs) frequently undergo elective invasive procedures. Their management is challenging. We aimed to determine the optimal duration of DOAC discontinuation that ensures a minimal anticoagulant effect during the procedure. Methods and results: This prospective multicentre study included 422 DOAC-treated patients requiring an invasive procedure. Pre-procedural DOAC concentration ([DOAC]) and routine haemostasis assays were performed to determine i/the proportion of patients who achieved a minimal pre-procedural [DOAC] (≤30 ng/mL) according to the duration of DOAC discontinuation, ii/the predictors of minimal [DOAC] and, iii/the ability of routine assays to predict minimal [DOAC]...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28819709/use-of-direct-oral-anticoagulants-in-patients-on-immunomodulatory-agents
#2
L Man, A Morris, J Brown, S Palkimas, K Davidson
Immunomodulatory agents (IMiDs) are used to treat multiple hematologic malignancies. Their use is also associated with increased risk of venous thromboembolism (VTE). Direct oral anticoagulants (DOACs) have been increasingly utilized but due to their relative novelty, their role in malignancy has only been recently investigated. The objective of this study was to assess the safety and efficacy of DOACs in patients receiving IMiDs. This was a retrospective study of patients at our institution treated with an IMiD and concomitant warfarin or DOAC between January 1, 2010 and December 31, 2015...
August 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28814457/direct-oral-anticoagulant-vs-vitamin-k-antagonist-related-nontraumatic-intracerebral-hemorrhage
#3
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Panayiotis Varelas, Aristeidis H Katsanos, Nitin Goyal, Robert Mikulik, Kristian Barlinn, Christos Krogias, Vijay K Sharma, Konstantinos Vadikolias, Efthymios Dardiotis, Theodore Karapanayiotides, Alexandra Pappa, Christina Zompola, Sokratis Triantafyllou, Odysseas Kargiotis, Michael Ioakeimidis, Sotirios Giannopoulos, Ali Kerro, Argyrios Tsantes, Chandan Mehta, Mathew Jones, Christoph Schroeder, Casey Norton, Anastasios Bonakis, Jason Chang, Anne W Alexandrov, Panayiotis Mitsias, Andrei V Alexandrov
OBJECTIVE: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF). METHODS: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH...
August 16, 2017: Neurology
https://www.readbyqxmd.com/read/28806802/in-nonvalvular-af-doac-related-risk-for-gi-bleeding-was-lower-with-apixaban-than-dabigatran-or-rivaroxaban
#4
Ronald L Koretz
No abstract text is available yet for this article.
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#5
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28804832/measuring-direct-oral-anticoagulants
#6
Robert C Gosselin, Jonathan Douxfils
Direct oral anticoagulants (DOACs) can be quantified using methods that can be performed in any clinical or research laboratory using manual or automated instrument platforms. Dabigatran etexilate, the oral direct thrombin inhibitor, can be quantified by drug-calibrated clot or chromogenic-based assays using either thrombin or ecarin as substrates. Oral direct anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban, can be quantified with drug-calibrated anti-Xa kits or reagents as typically used for measuring heparins (unfractionated, low molecular weight, or pentasaccharides)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803521/evaluation-of-direct-acting-oral-anticoagulant-use-in-patients-with-cancer
#7
Daphne O Davis, Kyle A Davis
PURPOSE: To evaluate the use of direct-acting oral anticoagulants in patients with cancer and venous thromboembolism (VTE) treated at Ochsner Medical Center with the intent of determining the efficacy and safety of these agents. METHODS: Patients were identified by a retrospective data extraction of patients treated at Ochsner Medical Center from January 1, 2013, through December 31, 2015. Patients were included for review if they were ≥18 years of age, with a confirmed diagnosis of VTE and active or history of cancer, and if they received dabigatran, apixaban, rivaroxaban, or edoxaban for at least 6 months...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28799998/use-of-direct-oral-anticoagulants-for-treatment-of-atrial-fibrillation-in-patients-with-hiv-a-review
#8
Timothy A West, Jacinta Perram, Cameron J Holloway
PURPOSE OF REVIEW: Atrial fibrillation is increasingly common in the ageing population. Patients with atrial fibrillation and HIV have a higher stroke risk, with guidelines recommending anticoagulation in the majority. Whilst anticoagulation options have diversified in the last decade for the general population, there is limited evidence for the safety and efficacy of these medications when used concurrently with antiretroviral therapy. We review the potential for patients with HIV on antiretroviral therapy to have direct-acting oral anticoagulations (DOACs)...
August 10, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28799408/assessment-of-apixaban-prescribing-patterns-for-nonvalvular-atrial-fibrillation-in-hospitalized-patients
#9
Caitlin M Gibson, Carmen B Smith, Sondra Davis, Michael J Scalese
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). Other DOACs require renal dose adjustments based solely on creatinine clearance. Apixaban differs in that its dose adjustments are more complex, potentially leading to prescribing errors. OBJECTIVE: To determine if adherence to Food and Drug Administration (FDA)-approved dosing for apixaban is maintained in hospitalized patients with NVAF...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28799181/the-relationship-between-stroke-severity-and-prior-direct-oral-anticoagulant-therapy-in-patients-with-acute-ischemic-stroke-and-non-valvular-atrial-fibrillation
#10
Yuki Sakamoto, Seiji Okubo, Chikako Nito, Satoshi Suda, Noriko Matsumoto, Arata Abe, Junya Aoki, Takashi Shimoyama, Yohei Takayama, Kentaro Suzuki, Masahiro Mishina, Kazumi Kimura
BACKGROUND: Anticoagulant treatment with a vitamin K antagonist (VKA) has been reported to reduce stroke severity when patients with atrial fibrillation (AF) suffer acute ischemic stroke (AIS). Direct oral anticoagulant (DOAC) therapy also has a potential to reduce the initial severity of AIS. However, the effect of DOAC therapy on the severity of AIS is not well known. The aims of the present study were to investigate the effect of DOACs on initial stroke severity in patients with AIS and non-valvular AF (NVAF)...
August 11, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28790169/disease-understanding-in-patients-newly-diagnosed-with-atrial-fibrillation
#11
Brystana G Kaufman, Sunghee Kim, Karen Pieper, Larry A Allen, Bernard J Gersh, Gerald V Naccarelli, Michael D Ezekowitz, Gregg C Fonarow, Kenneth W Mahaffey, Daniel E Singer, Paul S Chan, James V Freeman, Jack Ansell, Peter R Kowey, James A Rieffel, Jonathan Piccini, Eric Peterson, Emily C O'Brien
OBJECTIVE: To describe self-reported disease understanding for newly diagnosed patients with atrial fibrillation (AF) and assess (1) how disease understanding changes over the first 6 months after diagnosis and (2) the relationship between patient understanding of therapies at baseline and treatment receipt at 6 months among treatment-naïve patients. METHODS: We analysed survey data from SATELLITE (Survey of Patient Knowledge and Personal Priorities for Treatment), a substudy of patients with new-onset AF enrolled in the national Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT) II registry across 56 US sites...
August 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28781025/changes-in-oral-anticoagulant-prescribing-for-stroke-prevention-in-patients-with-atrial-fibrillation
#12
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28780634/holmium-laser-enucleation-of-the-prostate-in-patients-requiring-anticoagulation
#13
REVIEW
Marcelino Rivera, Amy Krambeck, James Lingeman
PURPOSE OF REVIEW: This is to evaluate and discuss the literature surrounding holmium laser enucleation of the prostate (HoLEP) in patients on anticoagulation. RECENT FINDINGS: The relationship of benign prostatic hyperplasia (BPH) to bothersome lower urinary tract symptoms (LUTS) is well established with a majority of men over the age of 60 having significant symptoms. Patients with severe enough symptoms often require surgery and with cardiovascular disease ranking as the primary cause of death in the USA, a growing number will be taking antiplatelet (AP) or anticoagulation (AC) for primary or secondary prevention of disease...
October 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28780343/the-role-of-heparin-lead-in-in-the-real-world-management-of-acute-venous-thromboembolism-the-prefer-in-vte-registry
#14
Rupert Bauersachs, Giancarlo Agnelli, Anselm K Gitt, Manuel Monreal, Patrick Mismetti, Stefan N Willich, Petra Laeis, Eva-Maria Fronk, Peter Bramlage, Alexander T Cohen
INTRODUCTION: The appropriate strategy for initiating oral anticoagulant (OAC) therapy after an acute venous thromboembolism (VTE) depends on the intermediate-term anticoagulant to be used. While heparin bridging to vitamin K antagonists (VKA) is required, the direct oral anticoagulants (DOAC) rivaroxaban (30mg/day) and apixaban (10mg/day) can be initiated directly without parenteral anticoagulation. The objective was to evaluate OAC initiation patterns in clinical practice. MATERIALS AND METHODS: PREFER in VTE was an international, non-interventional registry conducted between January 2013 and August 2015...
July 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28775134/emergency-coagulation-assessment-during-treatment-with-direct-oral-anticoagulants-limitations-and-solutions
#15
Matthias Ebner, Ingvild Birschmann, Andreas Peter, Florian Härtig, Charlotte Spencer, Joachim Kuhn, Gunnar Blumenstock, Christine S Zuern, Ulf Ziemann, Sven Poli
BACKGROUND AND PURPOSE: In patients receiving direct oral anticoagulants (DOACs), emergency treatment like thrombolysis for acute ischemic stroke is complicated by insufficient availability of DOAC-specific coagulation tests. Conflicting recommendations have been published concerning the use of global coagulation assays for ruling out relevant DOAC-induced anticoagulation. METHODS: Four hundred eighty-one samples from 96 DOAC-treated patients were tested using prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT), DOAC-specific assays (anti-Xa activity, diluted TT), and liquid chromatography-tandem mass spectrometry...
August 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28771049/direct-oral-anticoagulants-in-the-treatment-of-pulmonary-embolism
#16
Joanna B Eldredge, Alex C Spyropoulos
OBJECTIVE: The objective of this review is to examine the management strategies for pulmonary embolism (PE) with an emphasis of the role of direct oral anticoagulants (DOACs). METHODS: PubMed was searched to identify relevant journal articles published through April 2017. Additional references were obtained from articles discovered during the database search. RESULTS: Initial heparinization followed by long-term anticoagulation with vitamin K antagonists (VKAs) has been considered the mainstay for the treatment of PE...
August 3, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28769570/reversal-of-direct-oral-anticoagulants
#17
REVIEW
Mosaad Almegren
Reversal agents for direct oral anticoagulants (DOACs), including factor X inhibitors and direct thrombin inhibitors, are a major concern in clinical practice. After DOACs were introduced and became widely used as an alternative for vitamin K antagonists in the management of venous thromboembolism and nonvalvular atrial fibrillation, the need for effective reversal agents has increased, particularly for life-threatening bleeding episodes related to DOACs or to reverse medication effects during urgent interventions...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28768967/dabigatran-therapy-resulting-in-the-resolution-of-rivaroxaban-resistant-left-atrial-appendage-thrombi-in-patients-with-atrial-fibrillation
#18
Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Shiro Hoshida
Patients with persistent atrial fibrillation (AF) and a large left atrium are at a high risk for thromboembolisms. Recently, direct oral anticoagulants (DOACs) have mainly been used for the prevention of cardiac embolisms caused by AF. Transesophageal echocardiography (TEE) is performed in order to exclude any left atrial appendage (LAA) thrombi. We herein report two cases of persistent AF, both of which were treated with rivaroxaban for more than two years. Since TEE identified mobile LAA thrombi with this treatment, we switched from rivaroxaban to the direct thrombin inhibitor dabigatran...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28768548/the-anticoagulated-trauma-patient-in-the-age-of-the-direct-oral-anticoagulants-a-canadian-perspective
#19
Brendan Wood, Barto Nascimento, Sandro Rizoli, Michelle Sholzberg, Amanda McFarlan, Andrea Phillips, Alun D Ackery
BACKGROUND: The anticoagulated trauma patient presents a particular challenge to the critical care physician. Our understanding of these patients is defined and extrapolated by experience with patients on warfarin pre-injury. Today, many patients who would have been on warfarin are now prescribed the Direct Oral Anticoagulants (DOACs) a class of anticoagulants with entirely different mechanisms of action, effects on routine coagulation assays and approach to reversal. METHODS: Trauma registry data from Toronto's (Ontario, Canada) two Level 1 trauma centres were used to identify patients on oral anticoagulation pre-injury from June 1, 2014 to June 1, 2015...
August 2, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28765760/study-design-of-general-general-practitioners-and-embolism-prevention-in-nvaf-patients-treated-with-rivaroxaban-real-life-evidence-a-multicenter-prospective-cohort-study-in-primary-care-physicians-to-investigate-the-effectiveness-and-safety-of-rivaroxaban-in
#20
Kengo Kusano, Masaharu Akao, Hikari Tsuji, Kunihiko Matsui, Shinya Hiramitsu, Yutaka Hatori, Hironori Odakura
BACKGROUND: Rivaroxaban, a direct oral anticoagulant (DOAC), has become available for stroke prevention in patients with non-valular atrial fibrillation (NVAF). However, little is known about its effectiveness and safety when prescribed by general practitioners in real-life settings. METHODS: GENERAL is a multicenter, prospective, non-interventional observational study of patients receiving rivaroxaban for NVAF in daily clinical practice prescribed specifically by general practitioners...
August 2017: Journal of Arrhythmia
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