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https://www.readbyqxmd.com/read/29909576/comparative-risks-of-bleeding-ischemic-stroke-and-mortality-with-direct-oral-anticoagulants-versus-phenprocoumon-in-patients-with-atrial-fibrillation
#1
Mariam Ujeyl, Ingrid Köster, Hans Wille, Thomas Stammschulte, Rebecca Hein, Sebastian Harder, Ursula Gundert-Remy, Julian Bleek, Peter Ihle, Helmut Schröder, Gerhard Schillinger, Anette Zawinell, Ingrid Schubert
PURPOSE: The pivotal trials for stroke prevention in non-valvular atrial fibrillation (NVAF) compared rivaroxaban, dabigatran, and apixaban with warfarin, as did most claims-based studies. Comparisons with phenprocoumon, the most frequently used vitamin K antagonist (VKA) in Germany, are scarce. METHODS: Risk of bleeding, ischemic stroke, and all-cause mortality in patients with NVAF were analyzed using data for 2010 to 2014 from a large German claims database. New users of oral anticoagulants from January 2012 to December 2013 were included and observed over 1 year...
June 16, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29903344/anticoagulation-and-antiplatelet-strategies-after-on-x-mechanical-aortic-valve-replacement
#2
John D Puskas, Marc Gerdisch, Dennis Nichols, Lilibeth Fermin, Birger Rhenman, Divya Kapoor, Jack Copeland, Reed Quinn, G Chad Hughes, Hormoz Azar, Michael McGrath, Michael Wait, Bobby Kong, Tomas Martin, E Charles Douville, Steven Meyer, Jian Ye, W R Eric Jamieson, Lance Landvater, Robert Hagberg, Timothy Trotter, John Armitage, Jeffrey Askew, Kevin Accola, Paul Levy, David Duncan, Bobby Yanagawa, John Ely, Allen Graeve
BACKGROUND: The burden oral anticoagulation is a limitation of mechanical valve prostheses. OBJECTIVES: The aim of this study was to test whether patients could be safely managed with dual-antiplatelet therapy (DAPT) (aspirin 325 mg and clopidogrel 75 mg) or lower warfarin after On-X mechanical aortic valve replacement (mAVR). METHODS: PROACT (Prospective Randomized On-X Anticoagulation Trial) (n = 576) is a multicenter (41 sites) noninferiority trial...
June 19, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29898863/assessment-of-the-bleeding-risk-of-anticoagulant-treatment-in-non-severe-frail-octogenarians-with-atrial-fibrillation
#3
Masaya Shinohara, Tadashi Fujino, Shinntaro Yao, Kensuke Yano, Katsuya Akitsu, Hideki Koike, Toshio Kinoshita, Hitomi Yuzawa, Takeya Suzuki, Kenzaburo Kobayashi, Takanori Ikeda
BACKGROUND: Physicians estimate the frailty in elderly patients with atrial fibrillation (AF) to aid in the decision making with respect to oral anticoagulant (OAC) therapy. There are limited data on the safety of OAC therapy in non-severe frail elderly patients. We evaluated the risk factors of bleeding among non-severe frail octogenarians with AF taking OACs. METHODS: Among 430 consecutive AF patients aged 80 years and over with non-severe frailty, we enrolled 346 patients [167 men, 83...
June 10, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29898845/predictors-of-oral-anticoagulant-non-prescription-in-patients-with-atrial-fibrillation-and-elevated-stroke-risk
#4
Steven A Lubitz, Shaan Khurshid, Lu-Chen Weng, Gheorghe Doros, Joseph Walker Keach, Qi Gao, Anil K Gehi, Jonathan C Hsu, Matthew R Reynolds, Mintu P Turakhia, Thomas M Maddox
BACKGROUND: Many patients with atrial fibrillation (AF) and elevated stroke risk are not prescribed oral anticoagulation (OAC) despite evidence of benefit. Identification of factors associated with OAC non-prescription could lead to improvements in care. METHODS AND RESULTS: Using NCDR PINNACLE, a United States-based ambulatory cardiology registry, we examined factors associated with OAC non-prescription in patients with non-valvular AF at elevated stroke risk (CHA2 DS2 -VASc ≥2) between January 5, 2008 and December 31, 2014...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898836/impact-of-polyvascular-disease-on-patients-with-atrial-fibrillation-insights-from-rocket-af
#5
Sean T Chen, Anne S Hellkamp, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Keith A A Fox, Werner Hacke, Jonathan L Halperin, Graeme J Hankey, Kenneth W Mahaffey, Christopher C Nessel, Jonathan P Piccini, Daniel E Singer, Manesh R Patel
BACKGROUND: We investigated the impact of polyvascular disease in patients enrolled in ROCKET AF. METHODS: Cox regression models were used to assess clinical outcomes and treatment effects of rivaroxaban compared with warfarin in patients with atrial fibrillation and coronary, peripheral, or carotid artery disease, or any combination of the 3. RESULTS: A total of 655 (4.6%) patients had polyvascular disease (≥2 disease locations), and 3,391 (23...
June 2018: American Heart Journal
https://www.readbyqxmd.com/read/29898023/immediate-laser-induced-hemostasis-in-anticoagulated-rats-subjected-to-oral-soft-tissue-surgery-a-double-blind-study
#6
Flavio Halak de Oliveira Campos, Lorraine Braga Ferreira, Marcelo Munhoes Romano, Maria Stella Moreira, Carlos de Paula Eduardo, Karen Müller Ramalho
Given the growing trend towards medical indications for continuous use of anticoagulants, the number of patients on these medications continues to rise. The management of patients on oral anticoagulants requiring oral surgical procedures has aroused much controversy. Changes in an anticoagulation regimen are associated with an increased risk of thromboembolism. However, it seems logical and advantageous for the patients' health if surgery could be performed without any change to the anticoagulation therapy...
June 7, 2018: Brazilian Oral Research
https://www.readbyqxmd.com/read/29886103/randomized-controlled-trial-of-rivaroxaban-versus-warfarin-in-the-management-of-acute-non-neoplastic-portal-vein-thrombosis
#7
Amr Shaaban Hanafy, Sherief Abd-Elsalam, Mohammed M Dawoud
BACKGROUND AND AIM: Anticoagulation therapy is the main line of treatment for acute portal vein thrombosis (PVT) in the absence of cirrhosis. However, the use of this therapy in cirrhotic PVT is still with doubtful evidence. We aimed to evaluate the efficacy and safety of rivaroxaban compared to warfarin for the management of acute non-neoplastic PVT in Hepatitis C virus (HCV)-related compensated cirrhosis. METHODS: Out of 578 patients with chronic HCV infection, 80 patients with acute PVT who had undergone splenectomy due to hypersplenism and 4 patients with acute PVT due to portal pyemia were selected...
June 7, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29883907/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-in-patients-with-unprovoked-venous-thromboembolism-a-propensity-score-weighted-administrative-claims-cohort-study
#8
Craig I Coleman, W Frank Peacock, Thomas J Bunz, Jan Beyer-Westendorf
BACKGROUND: In phase III trials, rivaroxaban demonstrated non-inferiority over enoxaparin/warfarin to prevent recurrent venous thromboembolism (VTE), with a reduction of major bleeding. However, compared to provoked VTE, the risk-benefit ratio of rivaroxaban may be different for patients with unprovoked VTE. METHODS: In a retrospective claims data analysis using US MarketScan claims from 1/2012 to 12/2016, we included adults with a primary diagnosis of VTE newly-initiated on rivaroxaban or warfarin within 30-days of the incident VTE and with ≥12-months of continuous insurance benefits prior to the VTE (baseline)...
May 30, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29883037/the-perils-of-inhibiting-deficient-factors
#9
Zara Sayar, Victoria Speed, Jignesh P Patel, Raj K Patel, Roopen Arya
We report a case of a previously undiagnosed factor X deficiency in an 83-year old man, who had no previous bleeding history despite multiple haemostatic challenges. He was anticoagulated with warfarin for atrial fibrillation (AF) without bleeding complications; however, major haemorrhage occurred soon after a switch to rivaroxaban. This article is protected by copyright. All rights reserved.
June 8, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29882198/safety-and-effectiveness-of-rivaroxaban-and-warfarin-in-moderate-to-advanced-ckd-real-world-data
#10
Luca Di Lullo, Giovanni Tripepi, Claudio Ronco, Antonio De Pascalis, Vincenzo Barbera, Antonio Granata, Domenico Russo, Biagio Raffaele Di Iorio, Ernesto Paoletti, Maura Ravera, Maria Fusaro, Antonio Bellasi
BACKGROUND: In recent years, novel anticoagulant drugs have been introduced in the clinical armamentarium and have progressively gained momentum. Although their use is increasing among CKD patients, some skepticism about their risk-benefit ratio still persists. We sought to investigate the safety and effectiveness of rivaroxaban in a cohort of moderate-to-advanced CKD patients. METHODS: This observational, retrospective, longitudinal study involved 347 consecutive CKD stage 3b-4 (according to NKF-KDOQI guidelines) patients enrolled from 8 cardiac outpatient clinics between March 2015 and October 2017...
June 7, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29881958/effectiveness-and-safety-of-rivaroxaban-versus-warfarin-in-patients-with-provoked-venous-thromboembolism
#11
Craig I Coleman, Alexander G G Turpie, Thomas J Bunz, Jan Beyer-Westendorf
A paucity of real-world data evaluating rivaroxaban in provoked venous thromboembolism (VTE) exists. We assessed the effectiveness and safety of rivaroxaban versus warfarin in provoked VTE patients treated in routine practice. Using MarketScan claims data from 1/2012 to 12/2016, we identified adults who had ≥ 1 primary hospitalization/emergency department discharge diagnosis code for VTE (index event) and a provoking factor, received rivaroxaban or warfarin as their first outpatient oral anticoagulant within 30-days of the index event and had ≥ 12-month of insurance coverage prior the index VTE...
June 7, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29880089/assessment-of-oral-anticoagulation-control-at-pharmacist-managed-clinics-a-retrospective-cohort-study
#12
E Kose, T An, A Kikkawa
In chronic kidney disease (CKD) patients, the ratio of warfarin enantiomers is changed and becomes unstable due to a reduction of cytochrome P450 (CYP) 2C9 activity of, which contributes to the development of hemorrhagic complications. The aim of this study was to investigate the influence of interventions by clinical pharmacists in addition to guidance by physicians on time in therapeutic range (TTR) control of warfarin therapy for CKD patients with non-valvular atrial fibrillation (NVAF). This retrospective cohort study included NVAF patients with CKD admitted and discharged from a cardiovascular internal medicine ward between March 2011 and July 2013 in Yokosuka Kyousai Hospital...
June 1, 2018: Die Pharmazie
https://www.readbyqxmd.com/read/29879466/a-paradoxical-thrombogenic-mutation-in-factor-ii-at-the-target-site-of-arthropod-bleeding-toxin
#13
Toshiki Takenouchi, Hiroyuki Shimada, Tomoko Uehara, Yae Kanai, Takao Takahashi, Kenjiro Kosaki
Loss-of-function mutations in coagulation cascade proteins lead to bleeding diasthesis. In contrast, gain-of-function mutations in these proteins, which are exceptionally rare, lead to hereditary thrombosis. This is best exemplified by Factor V (i.e., Factor V Leiden) and Factor II (i.e., p.Arg596Leu). Here, we report a family with hereditary thrombosis. The proposita presented with cerebral venous thrombosis accompanied by infarction at the age of 12 years. Despite anticoagulation therapy with oral warfarin, she later developed deep venous thrombosis in her hepatic portal veins at the age of 27 years...
June 4, 2018: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/29878693/abnormal-vaginal-bleeding-in-the-doac-era
#14
Bethan Myers
Women of child-bearing potential are increasingly treated with direct oral anticoagulants (DOACs) for venous thrombo-embolism, and so the impact on abnormal vaginal bleeding is an important topic to consider. This adverse event in women taking anticoagulants may result in discontinuation, leading to recurrent venous thrombosis. This issue includes an important study highlighting this topic, reporting post-hoc analysis of abnormal vaginal bleeding in women receiving edoxaban or warfarin for treatment of venous thrombosis (Scheres et al BJOG 2018)...
June 7, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29877660/efficacy-and-safety-of-oral-anticoagulant-therapy-in-frail-patients-with-atrial-fibrillation
#15
Giuseppe Patti, Ludmilla Mantione, Edoardo Bressi, Antonio Bisignani
Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation  (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile...
June 7, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29876128/aspirin-provides-adequate-vte-prophylaxis-for-patients-undergoing-hip-preservation-surgery-including-periacetabular-osteotomy
#16
Ibrahim Azboy, Michael M Kheir, Ronald Huang, Javad Parvizi
There are no clear guidelines regarding optimal venous thromboembolism (VTE) prophylaxis for patients undergoing hip preservation surgery (HPS), in particular pelvic osteotomy, which is considered to be a major orthopaedic procedure. The aim of this study was to determine the efficacy of aspirin for VTE prophylaxis in a large cohort of patients undergoing femoroacetabular osteoplasty (FAO) and periacetabular osteotomy (PAO). This was a retrospective study of prospectively collected data on patients undergoing HPS...
July 2018: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/29871978/the-use-of-biomarkers-to-predict-specific-causes-of-death-in-patients-with-atrial-fibrillation-insights-from-the-aristotle-trial
#17
Abhinav Sharma, Ziad Hijazi, Ulrika Andersson, Sana M Al-Khatib, Renato D Lopes, John H Alexander, Claes Held, Elaine M Hylek, Sergio Leonardi, Michael Hanna, Justin A Ezekowitz, Agneta Siegbahn, Christopher B Granger, Lars Wallentin
Background -Atrial fibrillation (AF) is associated with an increased risk of death. High-sensitivity troponin-T, growth differentiation factor-15 (GDF-15), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and interleukin-6 levels are predictive of cardiovascular (CV) events and total and CV death in anticoagulated AF patients. The prognostic utility of these biomarkers for cause-specific death is unknown. Methods -The ARISTOTLE trial randomized 18,201 patients with AF to apixaban or warfarin. Biomarkers were measured at randomization in 14,798 patients (1...
June 5, 2018: Circulation
https://www.readbyqxmd.com/read/29871510/safety-and-efficacy-of-apixaban-versus-warfarin-in-patients-with-advanced-chronic-kidney-disease
#18
Joseph H Schafer, Ashley L Casey, Kristina A Dupre, Britta A Staubes
BACKGROUND: Because of a lack of comparative data on anticoagulant use in the advanced chronic kidney disease (CKD) population, guidelines recommend warfarin for atrial fibrillation and venous thromboembolism (VTE) treatment in these patients. However, apixaban has specific dosing recommendations in CKD leading to use in clinical practice. OBJECTIVE: To evaluate major bleeding, stroke, and thromboembolism rates in patients with CKD stage 4, stage 5, and dialysis on apixaban or warfarin therapy...
June 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29864777/new-anticoagulant-agents-incidence-of-adverse-drug-reactions-and-new-signals-thereof
#19
Carlos Treceño-Lobato, María-Isabel Jiménez-Serranía, Raquel Martínez-García, Francisco Corzo-Delibes, Luis H Martín Arias
The aim of this study was to evaluate the adverse drug reaction (ADR) incidence rate and new signals thereof for classic compared with new anticoagulants in real-life ambulatory settings. The authors performed an observational cross-sectional study in two cohorts of surveyed patients treated with vitamin K antagonists (VKAs; acenocoumarol or warfarin) or nonvitamin K antagonist oral anticoagulants (NOACs; apixaban, edoxaban, rivaroxaban, dabigatran etexilate). Descriptive, clinical, and ADRs data were reported and analyzed through a bivariate analysis (odds ratio [OR]) to compare the ADRs incidence rate and an adaptation of Bayesian methodology (false discovery rate [FDR] < 0...
June 4, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29863095/two-year-outcomes-of-anticoagulation-for-acute-ischemic-stroke-with-nonvalvular-atrial-fibrillation-samurai-nvaf-study
#20
Sohei Yoshimura, Masatoshi Koga, Shoichiro Sato, Kenichi Todo, Hiroshi Yamagami, Masaya Kumamoto, Ryo Itabashi, Tadashi Terasaki, Kazumi Kimura, Yoshiki Yagita, Yoshiaki Shiokawa, Kenji Kamiyama, Satoshi Okuda, Yasushi Okada, Shunya Takizawa, Yasuhiro Hasegawa, Tomoaki Kameda, Satoshi Shibuya, Yoshinari Nagakane, Yasuhiro Ito, Hideki Matsuoka, Kazuhiro Takamatsu, Kazutoshi Nishiyama, Kyohei Fujita, Teppei Kamimura, Daisuke Ando, Toshihiro Ide, Takeshi Yoshimoto, Masayuki Shiozawa, Soichiro Matsubara, Yoshitaka Yamaguchi, Naoto Kinoshita, Takayuki Matsuki, Junji Takasugi, Keisuke Tokunaga, Kyoko Higashida, Kazunari Homma, Kazuomi Kario, Shoji Arihiro, Kazunori Toyoda
BACKGROUND: We determined the 2-year long-term risk-benefit profile in patients with stroke or transient ischemic attack (TIA) receiving warfarin or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF) using a prospective, multicenter, observational registry in Japan.Methods and Results:NVAF patients within 7 days after onset of ischemic stroke/TIA were enrolled in 18 stroke centers. Outcome measures included ischemic and bleeding events and death in the 2-year follow-up period...
June 1, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
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