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https://www.readbyqxmd.com/read/28635338/risk-of-stroke-systemic-embolism-major-bleeding-and-associated-costs-in-non-valvular-atrial-fibrillation-patients-who-initiated-apixaban-dabigatran-or-rivaroxaban-compared-with-warfarin-in-the-united-states-medicare-population
#1
Alpesh Amin, Allison Keshishian, Jeffrey Trocio, Oluwaseyi Dina, Hannah Le, Lisa Rosenblatt, Xianchen Liu, Jack Mardekian, Qisu Zhang, Onur Baser, Lien Vo
OBJECTIVE: To compare the risk and cost of stroke/systemic embolism (SE) and major bleeding between each direct oral anticoagulant (DOAC) and warfarin among non-valvular atrial fibrillation (NVAF) patients. METHODS: Patients (≥65 years) initiating warfarin or DOACs (apixaban, rivaroxaban, and dabigatran) were selected from the Medicare database from 01/01/2013-12/31/2014. Patients initiating each DOAC were matched 1:1 to warfarin patients using propensity score matching to balance demographics and clinical characteristics...
June 21, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28635328/dietary-implications-for-patients-receiving-long-term-oral-anticoagulation-therapy-for-treatment-and-prevention-of-thromboembolic-disease
#2
Emmanouela Kampouraki, Farhad Kamali
The effectiveness of oral anticoagulation therapy with warfarin (a vitamin K antagonist) in the treatment of thromboembolic disease, including stroke prophylaxis in patients with atrial fibrillation is well recognised. However, warfarin has a narrow therapeutic window and an unpredictable anticoagulation response, which make it difficult to achieve and maintain optimal anticoagulation. Various dietary factors, including sudden changes in eating patterns, can significantly alter anticoagulation control, thereby potentially exposing patients to the risk of bleeding or thromboembolic complications...
June 21, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#3
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28630388/spontaneous-liver-rupture-associated-with-anticoagulant-therapy-a-case-report
#4
Marco Clementi, Sara Colozzi, Stefano Guadagni, Beatrice Pessia, Federico Sista, Mario Schietroma, Andrea Della Penna, Gianfranco Amicucci
Spontaneous hepatic rupture without underlying liver diseases is uncommon entity. We report a rare case of spontaneous rupture of liver hematoma in patient treated with warfarin end enoxaparin sodium because of pulmonary embolism. Two day after admission the patient complained generalized abdominal pain and hemodynamic instability. The abdominal US and TC scan revealed free fluid and lesion at right liver lobe. The patient, despite intravenous fluid support and blood transfusion, was hemodinamically instable and urgent laparotomy was needed...
January 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28625512/first-experience-with-edoxaban-and-atrial-fibrillation-ablation-insights-from-the-engage-af-timi-48-trial
#5
Jan Steffel, Christian T Ruff, Rose A Hamershock, Sabina A Murphy, Roxy Senior, Denis Roy, Hans-Joachim Lanz, Michele F Mercuri, Elliott M Antman, Robert P Giugliano
BACKGROUND: Atrial fibrillation (AF) ablation procedures are increasingly being performed in patients receiving direct oral anticoagulants (DOACs). Experience regarding the safety of edoxaban in this context is limited. In an exploratory analysis we therefore investigated the outcome of patients undergoing transcatheter AF ablation in the ENGAGE AF-TIMI 48 trial. METHODS & RESULTS: During the trial, 193 transcatheter AF ablation procedures were performed in 169 patients...
June 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28625380/factors-associated-with-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-new-onset-atrial-fibrillation-results-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-ii-orbit-af-ii
#6
Benjamin A Steinberg, Peter Shrader, Laine Thomas, Jack Ansell, Gregg C Fonarow, Bernard J Gersh, Elaine Hylek, Peter R Kowey, Kenneth W Mahaffey, Emily C O'Brien, Daniel E Singer, Eric D Peterson, Jonathan P Piccini
BACKGROUND: Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS: The ORBIT-AF II study is a national, US, prospective, observational, cohort study of anticoagulation treatment in patients with AF receiving NOACs or warfarin in the United States from 2013 to 2016...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28619293/efficacy-and-safety-of-traditional-chinese-medicine-on-thromboembolic-events-in-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#7
REVIEW
Zhangsheng Wang, Zeng Tang, Wenqing Zhu, Lei Ge, Junbo Ge
OBJECTIVES: Traditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF). METHODS: Potential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included...
June 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28615887/an-unusual-cause-of-chest-discomfort-case-report-of-oesophageal-hirudiniasis
#8
Cristóvão Figueiredo, Joana Alves, Cláudia Carvalho, António Sarmento
Hirudiniasis is caused by sanguivorous leeches feeding on mucous membranes with possible severe obstructive or haemorrhagic manifestations. Few cases have been reported in humans, and most occur in tropical countries. A seventy-year-old female patient presented to our Emergency Department (ED) with retrosternal discomfort. She was taking warfarin for a mechanical prosthetic heart valve. While in the ED, a leech was spontaneously extruded from her mouth, with symptomatic resolution. Endoscopy revealed an area of previous leech attachment in the distal oesophageal, without severe bleeding...
June 2017: Journal of Parasitic Diseases: Official Organ of the Indian Society for Parasitology
https://www.readbyqxmd.com/read/28615214/safety-and-efficacy-of-rivaroxaban-in-patients-with-cardiac-implantable-electronic-devices-observations-from-the-rocket-af-trial
#9
George C Leef, Anne S Hellkamp, Manesh R Patel, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Jonathan L Halperin, Graeme J Hankey, Werner Hacke, Christopher C Nessel, Daniel E Singer, Keith A A Fox, Kenneth W Mahaffey, Jonathan P Piccini
BACKGROUND: Although implantation of cardiac implantable electronic devices (CIEDs) in patients receiving warfarin is well studied, limited data are available on the use of oral factor Xa inhibitors in this setting. METHODS AND RESULTS: Using data from Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) (n=14 264), we compared baseline characteristics and clinical outcomes in patients with atrial fibrillation randomized to rivaroxaban versus warfarin who did and did not undergo CIED implantation or revision...
June 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#10
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 10, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28614582/effectiveness-and-safety-of-standard-dose-nonvitamin-k-antagonist-oral-anticoagulants-and-warfarin-among-patients-with-atrial-fibrillation-with-a-single-stroke-risk-factor-a-nationwide-cohort-study
#11
Gregory Y H Lip, Flemming Skjøth, Peter Brønnum Nielsen, Jette Nordstrøm Kjældgaard, Torben Bjerregaard Larsen
Importance: The randomized clinical trials comparing nonvitamin K antagonist oral anticoagulants (NOACs) vs warfarin largely focused on recruiting high-risk patients with atrial fibrillation with more than 2 stroke risk factors, with only the trials testing dabigatran or apixaban including few patients with 1 stroke risk factor. Despite this, regulatory approvals of all NOACs have been based on stroke prevention for patients with atrial fibrillation with 1 or more stroke risk factors...
June 14, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28612237/assessment-of-the-impact-of-l-thyroxine-therapy-on-bleeding-risk-in-patients-receiving-vitamin-k-antagonists
#12
Farès Moustafa, Rémi Malhomme, Bruno Pereira, Alain Barres, Jennifer Saint-Denis, Frederic Dutheil, Marie Batisse, Jeannot Schmidt
BACKGROUND: Several studies have suggested a link exists between L-thyroxine and the coagulation system, and, according to some drug interaction studies, L-thyroxine can potentiate the effect of warfarin. This study sought to assess whether thyroid hormone therapy could impact the risk of bleeding in patients receiving vitamin K antagonists (VKAs). METHODS: We conducted a monocentric, retrospective study on prospectively collected data from consecutive patients enrolled in the Registry of patient with AntiThrombotic agents admitted to an Emergency Department (RATED) database, and compared the hemorrhage rates (both major and nonmajor) of patients receiving treatment with and without L-thyroxine...
June 13, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28607611/report-of-periprocedural-oral-anticoagulants-in-catheter-ablation-for-atrial-fibrillation-the-japanese-catheter-ablation-registry-of-atrial-fibrillation-j-caraf
#13
Yuji Murakawa, Akihiko Nogami, Morio Shoda, Koichi Inoue, Shigeto Naito, Koichiro Kumagai, Yasushi Miyauchi, Teiichi Yamane, Norishige Morita, Hideo Mitamura, Ken Okumura, Kenzo Hirao
BACKGROUND: To obtain a perspective of the current status of catheter ablation for the cure of atrial fibrillation, the Japanese Heart Rhythm Society conducted a nationwide survey: the Japanese Catheter Ablation Registry of Atrial Fibrillation. In this report, we aimed to evaluate the periprocedural use of direct oral anticoagulants with respect to thromboembolic or bleeding complications. METHODS: Using an online questionnaire, the Japanese Heart Rhythm Society requested electrophysiology centers in Japan to register the relevant data of patients who underwent atrial fibrillation ablation over selected five-months from 2011 to 2014...
June 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28604566/novel-oral-anticoagulants-in-the-peri-endoscopic-period
#14
Michael Genualdi, William H Frishman
Millions of patients in the United States are currently prescribed some form of anticoagulation therapy. Recently, novel oral anticoagulants (NOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, have begun to replace warfarin as the drugs of choice for anticoagulation. As the use of these medications becomes more widespread, it is increasingly important for gastroenterologists to understand the risks associated with performing endoscopic procedures on patients who are taking NOACs. In this review, we provide an overview of the NOACs, as well as current guidelines from international societies regarding the management of patients scheduled to undergo endoscopic procedures who are prescribed these medications...
April 6, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28604280/express-the-anticoagulant-effects-of-warfarin-and-the-bleeding-risk-associated-with-its-use-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-at-a-specialist-center-in-japan-a-retrospective-cohort-study
#15
Takayuki Sanada Jujo, Nobuhiro Tanabe, Seiichiro Sakao, Toshihiko Sugiura, Ayumi Sekine, Rintaro Nishimura, Rika Suda, Akira Naito, Hideki Miwa, Keiko Yamamoto, Akane Sasaki, Akane Matsumura, Ryogo Ema, Hajime Kasai, Fumiaki Kato, Koichiro Tatsumi
No abstract text is available yet for this article.
January 1, 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28604139/major-bleeding-risk-and-healthcare-economic-outcomes-of-nonvalvular-atrial-fibrillation-patients-newly-initiated-with-oral-anticoagulant-therapy-in-the-real-world-setting
#16
Jay Lin, Jeffrey Trocio, Kiran Gupta, Jack Mardekian, Melissa Lingohr-Smith, Brandy Menges, Min You, Anagha Nadkarni
AIMS: This study compared the risk for major bleeding (MB) and healthcare economic outcomes of patients with nonvalvular atrial fibrillation (NVAF) after initiating treatment with apixaban versus rivaroxaban, dabigatran, or warfarin. METHODS: NVAF patients who initiated apixaban, rivaroxaban, dabigatran, or warfarin were identified from the IMS Pharmetrics Plus database (1/1/2013-9/30/2015). Propensity score matching (PSM) was used to balance differences in patient characteristics between study cohorts: patients treated with apixaban versus rivaroxaban, apixaban versus dabigatran, and apixaban versus warfarin...
June 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28597740/pocket-haematoma-after-cardiac-electronic-device-implantation-in-patients-receiving-antiplatelet-and-anticoagulant-treatment-a-single-centre-experience
#17
Gültekin Gunhan Demir, Gamze Babur Guler, Ekrem Guler, HacıMurat Güneş, Filiz Kizilirmak, İbrahim Oğuz Karaca, Mehmet Onur Omaygenç, Beytullah Çakal, Erkam Olgun, Umeyr Savur, Ersın Ibisoglu, Irfan Barutçu, Fethi Kiliçaslan
Objective In modern cardiology practice, implantation of cardiac electronic devices in patients taking anticoagulant or antiplatelet therapy is a common clinical scenario. Bleeding complications are of particular concern in this patient population and pocket haematoma is one of the most frequent complications. We sought to determine the relationship between periprocedural antiplatelet/anticoagulant therapy and pocket haematoma formation in patients undergoing cardiac implantable electronic device (CIED) implantation...
February 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28595862/safety-and-efficacy-of-uninterrupted-apixaban-therapy-versus-warfarin-during-atrial-fibrillation-ablation
#18
Ruchit R Shah, Ajay Pillai, Pascha Schafer, David Meggo, Tom McElderry, Vance Plumb, Takumi Yamada, Vineet Kumar, Harish Doppalapudi, Alicia Gunter, Emily Pentecost, William R Maddox
Thromboembolic cerebrovascular accident remains a rare but potentially devastating complication of catheter-based atrial fibrillation (AF) ablation. Uninterrupted oral anticoagulant therapy with warfarin has become the standard of care when performing catheter-based AF ablation. Compared with warfarin, apixaban, a factor Xa inhibitor, has been shown to reduce the risk of stroke and major bleeding in nonvalvular AF. With an increase in apixaban use for stroke prophylaxis in patients with AF, there is an increased interest in the safety and efficacy of uninterrupted apixaban therapy during AF ablation...
May 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28594478/what-influences-the-cost-effectiveness-of-dabigatran-versus-warfarin-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#19
Jathishinie Jegathisawaran, Anne Holbrook, James M Bowen, Natasha Burke, Kaitryn Campbell, Jean-Eric Tarride
OBJECTIVES: The introduction of new oral anticoagulants for the prevention of stroke in atrial fibrillation (AF) has changed the clinical management of AF. To inform decision making around dabigatran by identifying factors influencing cost-effectiveness results, we undertook a systematic review of economic evaluations of dabigatran versus warfarin for the prevention of stroke in AF patients. METHODS: A systematic literature search of Ovid Medline and Embase, Wiley's Cochrane Library, HEED, PubMed databases and grey literature was carried out for primary economic evaluations comparing dabigatran versus warfarin in patients with AF...
May 2, 2017: Journal of Population Therapeutics and Clinical Pharmacology
https://www.readbyqxmd.com/read/28590785/impact-of-renal-function-on-ischemic-stroke-and-major-bleeding-rates-in-nonvalvular-atrial-fibrillation-patients-treated-with-warfarin-or-rivaroxaban-a-retrospective-cohort-study-using-real-world-evidence
#20
Matthew R Weir, Jeffrey S Berger, Veronica Ashton, François Laliberté, Kip Brown, Patrick Lefebvre, Jeffrey Schein
OBJECTIVES: Renal dysfunction is associated with increased risk of cardiovascular disease, and is an independent predictor of stroke and systemic embolism. Nonvalvular atrial fibrillation (NVAF) patients with renal dysfunction may face particularly high risk of thromboembolism and bleeding. The current retrospective cohort study was designed to assess the impact of renal function on ischemic stroke and major bleeding rates in NVAF patients in the real-world setting (outside a clinical trial)...
June 7, 2017: Current Medical Research and Opinion
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