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https://www.readbyqxmd.com/read/29094912/recurrent-ischemic-stroke-strategies-for-prevention
#1
Rupal Oza, Kristen Rundell, Miriam Garcellano
Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke...
October 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#2
RANDOMIZED CONTROLLED TRIAL
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28709650/anticoagulation-control-in-warfarin-treated-patients-undergoing-cardioversion-of-atrial-fibrillation-from-the-edoxaban-versus-enoxaparin-warfarin-in-patients-undergoing-cardioversion-of-atrial-fibrillation-trial
#3
RANDOMIZED CONTROLLED TRIAL
Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette
In the Edoxaban Versus Enoxaparin-Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin-warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open blinded end-point trial, we analyzed patients randomized to enoxaparin-warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; and impact on primary end points (composite of stroke, systemic embolic event[SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant nonmajor bleeding)...
September 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28646078/stereospecific-metabolism-of-r-and-s-warfarin-by-human-hepatic-cytosolic-reductases
#4
Dustyn A Barnette, Bryce P Johnson, Dakota L Pouncey, Robert Nshimiyimana, Linda P Desrochers, Thomas E Goodwin, Grover P Miller
Coumadin (rac-warfarin) is the most commonly used anticoagulant in the world; however, its clinical use is often challenging because of its narrow therapeutic range and interindividual variations in response. A critical contributor to the uncertainty is variability in warfarin metabolism, which includes mostly oxidative but also reductive pathways. Reduction of each warfarin enantiomer yields two warfarin alcohol isomers, and the corresponding four alcohols retain varying levels of anticoagulant activity. Studies on the kinetics of warfarin reduction have often lacked resolution of parent-drug enantiomers and have suffered from coelution of pairs of alcohol metabolites; thus, those studies have not established the importance of individual stereospecific reductive pathways...
September 2017: Drug Metabolism and Disposition: the Biological Fate of Chemicals
https://www.readbyqxmd.com/read/28520719/sex-differences-in-management-and-outcomes-of-patients-with-atrial-fibrillation-in-the-middle-east-gulf-survey-of-atrial-fibrillation-events-gulf-safe
#5
Abdulla Shehab, Mohammad Zubaid, Akshaya Srikanth Bhagavathula, Wafa A Rashed, Alawi A Alsheikh-Ali, Wal AlMahmeed, Kadhim Sulaiman, Ibrahim Al-Zakwani, Ahmed AlQudaimi, Nidal Asaad, Haitham Amin
Differences in the management of atrial fibrillation (AF) between men and women were investigated by using Gulf SAFE data in the Middle East. The study included 2,043 patients presenting with AF to emergency room (ER) were prospectively enrolled and followed for one-year. Women were older, have higher body mass index (BMI), comorbidities, and health complications than men. With regard to management of AF, cardioversion was recommended more often for men (16.7% vs. 9.3%), and underwent electrical cardioversion (2...
2017: PloS One
https://www.readbyqxmd.com/read/28470980/aprepitant-and-fosaprepitant-drug-interactions-a-systematic-review
#6
Priya Patel, J Steven Leeder, Micheline Piquette-Miller, L Lee Dupuis
AIMS: Aprepitant and fosaprepitant, commonly used for the prevention of chemotherapy-induced nausea and vomiting, alter cytochrome P450 activity. This systematic review evaluates clinically significant pharmacokinetic drug interactions with aprepitant and fosaprepitant and describes adverse events ascribed to drug interactions with aprepitant or fosaprepitant. METHODS: We systematically reviewed the literature to September 11, 2016, to identify articles evaluating drug interactions involving aprepitant/fosaprepitant...
October 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#7
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28426737/incidence-and-predictors-of-excessive-warfarin-anticoagulation-in-patients-with-atrial-fibrillation-the-ewa-study
#8
Samuli Jaakkola, Ilpo Nuotio, Tuomas O Kiviniemi, Raine Virtanen, Melina Issakoff, K E Juhani Airaksinen
Vitamin K antagonist warfarin is widely used in clinical practice and excessive anticoagulation is a well-known complication of this therapy. Little is known about permanent and temporary predictors for severe overanticoagulation. The aim of this study was to investigate the occurrence and predicting factors for episodes with very high (≥9) international normalized ratio (INR) values in warfarin treated patients with atrial fibrillation (AF). Excessive Warfarin Anticoagulation (EWA) study screened all patients (n = 13618) in the Turku University Hospital region with an INR ≥2 between years 2003-2015...
2017: PloS One
https://www.readbyqxmd.com/read/28394435/real-world-clinical-characteristics-and-treatment-patterns-of-individuals-aged-80-and-older-with-nonvalvular-atrial-fibrillation-results-from-the-real-life-multicenter-survey-evaluating-stroke-study
#9
MULTICENTER STUDY
Murat Biteker, Özcan Başaran, Volkan Doğan, İbrahim Altun, Fatma Özpamuk Karadeniz, Ahmet İlker Tekkesin, Yasin Çakıllı, Ceyhan Türkkan, Mehmet Hamidi, Vahit Demir, Mustafa Ozan Gürsoy, Müjgan Tek Öztürk, Gökhan Aksan, Sabri Seyis, Mehmet Ballı, Mehmet Hayri Alıcı, Serdar Bozyel
OBJECTIVES: To compare the clinical characteristics of and use of oral anticoagulant (OAC) therapy in individuals aged 80 and older with atrial fibrillation (AF) with those of individuals younger than 80 with AF in clinical practice. DESIGN: Observational study. SETTING: The ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey trial (NCT02344901), a national observational registry. PARTICIPANTS: Turkish adults with nonvalvular AF (NVAF)...
August 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28379643/integrating-in-vitro-modeling-and-in-vivo-approaches-to-investigate-warfarin-bioequivalence
#10
X Zhang, H Wen, J Fan, B Vince, T Li, W Gao, M Kinjo, J Brown, W Sun, W Jiang, R Lionberger
We demonstrate the use of modeling and simulation to investigate bioequivalence (BE) concerns raised about generic warfarin products. To test the hypothesis that the loss of isopropyl alcohol and slow dissolution in acidic pH has significant impact on the pharmacokinetics of warfarin sodium tablets, we conducted physiologically based pharmacokinetic absorption modeling and simulation using formulation factors or in vitro dissolution profiles as input parameters. Sensitivity analyses indicated that warfarin pharmacokinetics was not sensitive to solubility, particle size, density, or dissolution rate in pH 4...
August 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28296671/the-use-of-thrombolytic-therapy-in-the-treatment-of-frostbite-injury
#11
Allyson Wexler, Sarah Zavala
Frostbite can lead to severe consequences including loss of digits and limbs. One of the mechanisms of frostbite includes vascular thrombosis. The use of tissue plasminogen activator (tPA) in frostbite has been shown to be effective in case reports and small prospective studies. A retrospective chart review was performed on all patients admitted for frostbite between January 2008 and April 2015, and six patients were identified as having received treatment with intravenous tPA. Patients received an initial bolus dose followed by a 6-hour infusion of tPA...
September 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28283218/long-term-performance-evaluation-of-small-diameter-vascular-grafts-based-on-polyvinyl-alcohol-hydrogel-and-dextran-and-mscs-based-therapies-using-the-ovine-pre-clinical-animal-model
#12
Nuno Alexandre, Irina Amorim, Ana Rita Caseiro, Tiago Pereira, Rui Alvites, Alexandra Rêma, Ana Gonçalves, Guilherme Valadares, Elísio Costa, Alice Santos-Silva, Miguel Rodrigues, Maria Ascensão Lopes, André Almeida, José Domingos Santos, Ana Colette Maurício, Ana Lúcia Luís
The functional and structural performance of a 5cm synthetic small diameter vascular graft (SDVG) produced by the copolymerization of polyvinyl alcohol hydrogel with low molecular weight dextran (PVA/Dx graft) associated to mesenchymal stem cells (MSCs)-based therapies and anticoagulant treatment with heparin, clopidogrel and warfarin was tested using the ovine model during the healing period of 24 weeks. The results were compared to the ones obtained with standard expanded polyetetrafluoroethylene grafts (ePTFE graft)...
March 7, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28178408/epidemiology-risk-factors-and-clinical-features-of-intracerebral-hemorrhage-an-update
#13
REVIEW
Sang Joon An, Tae Jung Kim, Byung-Woo Yoon
Intracerebral hemorrhage (ICH) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. ICH is more common in Asians, advanced age, male sex, and low- and middle-income countries. The case fatality rate of ICH is high (40% at 1 month and 54% at 1 year), and only 12% to 39% of survivors can achieve long-term functional independence. Risk factors of ICH are hypertension, current smoking, excessive alcohol consumption, hypocholesterolemia, and drugs. Old age, male sex, Asian ethnicity, chronic kidney disease, cerebral amyloid angiopathy (CAA), and cerebral microbleeds (CMBs) increase the risk of ICH...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28160742/determination-of-rodenticides-and-related-metabolites-in-rabbit-liver-and-biological-matrices-by-liquid-chromatography-coupled-to-orbitrap-high-resolution-mass-spectrometry
#14
Marina López-García, Roberto Romero-González, Antonia Garrido Frenich
An analytical method based on ultra-high performance liquid chromatography (UHPLC) coupled to Orbitrap high resolution mass spectrometry was developed for the determination of rodenticides (bromadiolone, brodifacoum, difenacoum, chlorophacinone, diphacinone, coumachlor and warfarin) in liver matrix. Different extraction conditions were tested, obtaining the best results when the "dilute and shoot" method (acidified acetonitrile as extraction solvent) and a clean-up step with primary secondary amine (PSA) were used...
April 15, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28119762/synthesis-spectroscopic-dielectric-molecular-docking-and-dft-studies-of-3e-3-4-methylbenzylidene-3-4-dihydro-2h-chromen-2-one-an-anticancer-agent
#15
T Beena, L Sudha, A Nataraj, V Balachandran, D Kannan, M N Ponnuswamy
BACKGROUND: Coumarin (2H-chromen-2-one) and its derivatives have a wide range of biological and pharmaceutical activities. They possess antitumor, anti-HIV, anticoagulant, antimicrobial, antioxidant, and anti-inflammatory activities. Synthesis and isolation of coumarins from different species have attracted the attention of medicinal chemists. Herein, we report the synthesis, molecular structure, dielectric, anticancer activity and docking studies with the potential target protein tankyrase...
2017: Chemistry Central Journal
https://www.readbyqxmd.com/read/28057799/prospective-study-of-oral-anticoagulants-and-risk-of-liver-injury-in-patients-with-atrial-fibrillation
#16
MULTICENTER STUDY
Alvaro Alonso, Richard F MacLehose, Lin Y Chen, Lindsay Gs Bengtson, Alanna M Chamberlain, Faye L Norby, Pamela L Lutsey
OBJECTIVE: To assess the risk of liver injury hospitalisation in patients with atrial fibrillation (AF) after initiation of direct oral anticoagulants (DOACs) or warfarin and to determine predictors of liver injury hospitalisation in this population. METHODS: We studied 113 717 patients (mean age 70, 39% women) with AF included in the MarketScan Commercial and Medicare Supplemental databases with a first prescription for oral anticoagulation after 4 November 2011, followed through 31 December 2014...
June 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28049362/warfarin-dose-model-for-the-prediction-of-stable-maintenance-dose-in-indian-patients
#17
Tejasvita Gaikwad, Kanjaksha Ghosh, Peter Avery, Farhad Kamali, Shrimati Shetty
The main aim of this study was to screen various genetic and nongenetic factors that are known to alter warfarin response and to generate a model to predict stable warfarin maintenance dose for Indian patients. The study comprised of 300 warfarin-treated patients. Followed by extensive literature review, 10 single-nucleotide polymorphisms, that is, VKORC1-1639 G>A (rs9923231), CYP2C9*2 (rs1799853), CYP2C9*3 (rs1057910), FVII R353Q (rs6046), GGCX 12970 C>G (rs11676382), CALU c.*4A>G (rs1043550), EPHX1 c...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27884245/acute-kidney-injury-in-asians%C3%A2-with%C3%A2-atrial%C3%A2-fibrillation-treated%C3%A2-with%C3%A2-dabigatran%C3%A2-or-warfarin
#18
Yi-Hsin Chan, Yung-Hsin Yeh, Lai-Chu See, Chun-Li Wang, Shang-Hung Chang, Hsin-Fu Lee, Lung-Sheng Wu, Hui-Tzu Tu, Chi-Tai Kuo
BACKGROUND: Whether dabigatran is associated with a lower risk of acute kidney injury (AKI) in patients with nonvalvular atrial fibrillation (NVAF) remains unknown. OBJECTIVES: The authors compared the risk of AKI in Asians with NVAF who were prescribed dabigatran versus warfarin. METHODS: The authors analyzed patients enrolled in the Taiwan nationwide retrospective cohort study from June 1, 2012, to December 31, 2013. Dabigatran and warfarin were taken by 7,702 and 7,885 NVAF patients without a history of chronic kidney disease (CKD) and 2,256 and 2,089 NVAF patients with a history of CKD, respectively...
November 29, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27698722/analysis-of-the-first-therapeutic-target-achieving-time-of-warfarin-therapy-and-associated-factors-in-patients-with-pulmonary-embolism
#19
Xiaowei Gong, Haiyan Wang, Yadong Yuan
The present study aimed to investigate the factors affecting the first therapeutic-target-achieving (TTA) time of warfarin therapy in patients with acute pulmonary embolism (PTE). Between January 2008 and June 2013, patients with PTE confirmed by transpulmonary arterial enhanced computed tomographic pulmonary angiography or pulmonary ventilation perfusion scanning were included in the present study. Data collected included demographic information, history of tobacco and alcohol intake, basic diseases (stable and unstable hypertension, diabetes, heart failure, cancer/cerebral infarction, old myocardial infarction and atrial fibrillation), liver and kidney function, the haemoglobin and platelet count of the blood, international normalized ratio monitoring, warfarin dosage adjustment and medication combinations...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27688985/cardiovascular-disease-death-before-age-65-in-168-countries-correlated-statistically-with-biometrics-socioeconomic-status-tobacco-gender-exercise-macronutrients-and-vitamin-k
#20
David K Cundiff, Paul S Agutter
BACKGROUND: Nutrition researchers recently recognized that deficiency of vitamin K2 (menaquinone: MK-4-MK-13) is widespread and contributes to cardiovascular disease (CVD). The deficiency of vitamin K2 or vitamin K inhibition with warfarin leads to calcium deposition in the arterial blood vessels. METHODS: Using publicly available sources, we collected food commodity availability data and derived nutrient profiles including vitamin K2 for people from 168 countries...
August 24, 2016: Curēus
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