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https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#1
REVIEW
Christopher Goshgarian, Philip B Gorelick
PURPOSE OF REVIEW: The purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention. RECENT FINDINGS: Warfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades...
September 18, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28917562/an-updated-meta-analysis-of-novel-oral-anticoagulants-versus-vitamin-k-antagonists-for-uninterrupted-anticoagulation-in-atrial-fibrillation-catheter-ablation
#2
Rhanderson Cardoso, Leonardo Knijnik, Aditya Bhonsale, Guilherme Nasi, Manuel Rivera, Vanessa Blumer, Hugh Calkins
BACKGROUND: Catheter ablation is recommended as a first or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation for patients undergoing AF ablation. OBJECTIVE: We aimed to perform an updated meta-analysis of novel oral anticoagulants (NOACs) vs. vitamin K antagonists (VKAs) as uninterrupted anticoagulation for patients undergoing AF ablation. METHODS: Databases and conference abstracts were searched...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28916305/unusual-causes-of-venous-thrombosis-bladder-distension-and-uterine-mass
#3
Michael L Caparelli, Sepehr Lalezari, Steven Perlman
Thrombosis of the inferior vena cava (IVC) continues to be a rare event and there is a scarcity of evidence with regard to its etiology. One source for IVC thrombosis is external compression from adjacent structures. In this case series we present one case of IVC thrombosis caused by a severely distended bladder and a case of external iliac thrombosis caused by external compression from an abnormally enlarged uterus. The treatment of each case is varied and included novel oral anticoagulation (NOAC), catheter-directed thrombolysis in conjunction with mechanical thrombectomy, or a combination of these...
September 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28911138/resetting-the-abnormal-circadian-cortisol-rhythm-in-adrenal-incidentaloma-patients-with-mild-autonomous-cortisol-secretion
#4
Miguel Debono, Robert F Harrison, Rita Chadarevian, Carole Gueroult, Jean-Louis Abitbol, John Newell-Price
Context: Adrenal incidentalomas (AIs) are found commonly on axial imaging. Around 30% exhibit autonomous cortisol secretion (ACS) associated with increased cardiovascular events and death. Objective: We hypothesized that AI/ACS patients have an abnormal cortisol rhythm that could be reversed by use of carefully timed short-acting cortisol synthesis blockade, with improvement in cardiovascular disease markers. Design, Setting, and Participants: In a phase 1/2a, prospective study (Eudract no...
September 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28902651/anticoagulant-therapy-for-acute-venous-thromboembolism
#5
Hilal Ermiş, Necip Ermiş
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are currently defined as venous thromboembolism (VTE) since they share pathophysiological features and the treatment is similar in many respects. It has been determined that more than 90% of PE cases originate from DVT in the legs. PE, which is difficult to diagnose, has a mortality rate of 12% when untreated. The worldwide increase in obesity, cancer diseases, and average survival time also contribute to the increase in the incidence of VTE. Traditional treatment of VTE includes heparin, low-molecular-weight heparin, and warfarin...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28901221/direct-oral-anticoagulant-reversal-how-when-and-issues-faced
#6
Mikhail S Dzeshka, Daniele Pastori, Gregory Y H Lip
The number of atrial fibrillation (AF) patients requiring thrombo-prophylaxis with oral anticoagulation is greatly increasing. The introduction of non-vitamin K oral anticoagulants (NOACs) in addition to standard therapy with dose-adjusted warfarin has increased the therapeutic options for AF patients. Despite a generally better safety profile of the NOACs, the risk of major bleedings still persists, and the management of serious bleeding is a clinical challenge. Areas covered: In the current review, risk of major bleeding in patients taking NOACs and general approaches to manage bleeding depending on severity, with a particular focus on specific reversal agents, are discussed...
September 13, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28891412/a-novel-prothrombin-time-method-to-measure-all-non-vitamin-k-dependent-oral-anticoagulants-noacs
#7
Tomas L Lindahl, Kerstin Arbring, Maria Wallstedt, Mats Rånby
BACKGROUND: There is a clinical need for point-of-care (POC) methods for non-vitamin K-dependent oral anticoagulants (NOACs). We modified a routine POC procedure: Zafena's Simple Simon™ PT-INR, a room-temperature, wet-chemistry prothrombin time method of the Owren-type. METHODS: To either increase or decrease NOAC interference, two assay variants were devised by replacing the standard 10 µL end-to-end capillary used to add the citrated plasma sample to 200 µL of prothrombin time (PT) reagent by either a 20 µL or a 5 µL capillary...
September 11, 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28887903/catalytic-asymmetric-mannich-reaction-with-n-carbamoyl-imine-surrogates-of-formaldehyde-and-glyoxylate
#8
Yang'en You, Long Zhang, Linfeng Cui, Xueling Mi, Sanzhong Luo
N, O-acetals (NOAcs) have been developed as bench stable surrogates for N-carbamoyl (Boc, Cbz and Fmoc) formaldehyde and glyoxylate imines in asymmetric Mannich reactions. The NOAcs can be directly utilized in the chiral primary amine catalyzed Mannich reactions of both acyclic and cyclic β-ketocarbonyls with high yields and excellent stereoselectivity. The current reaction offers a straightforward approach in the asymmetric synthesis of α- or β-amino carbonyls bearing chiral quaternary centers in a practical and highly stereocontrolled manner...
September 9, 2017: Angewandte Chemie
https://www.readbyqxmd.com/read/28884054/the-role-of-apixaban-in-the-treatment-of-heparin-induced-thrombocytopenia
#9
Sidra Khalid, Hamed Daw
Heparin-induced thrombocytopenia (HIT) can present as arterial and venous thrombosis in adults who are treated with heparin. We present a case of a patient who developed HIT when she was treated for deep venous thrombosis (DVT) and pulmonary embolism with heparin. During the treatment with heparin and while being transitioned to warfarin, she developed arterial thrombosis. A work-up for HIT was sent, and it was positive. She was started on the argatroban drip and her platelet counts stabilized. Since her platelet counts remained stable and were not increasing for three weeks, we decided to transition the patient to an oral anticoagulant...
July 5, 2017: Curēus
https://www.readbyqxmd.com/read/28882334/meta-analysis-of-safety-and-efficacy-of-uninterrupted-non-vitamin-k-antagonist-oral-anticoagulants-versus-vitamin-k-antagonists-for-catheter-ablation-of-atrial-fibrillation
#10
Akram Y Elgendy, Dhruv Mahtta, Amr F Barakat, Ahmed Abuzaid, Ahmad Mahmoud, Amgad Mentias, Ahmed N Mahmoud, Islam Y Elgendy
This meta-analysis sought to assess the safety and efficacy of uninterrupted non-vitamin K antagonist oral anticoagulants (NOACs) versus uninterrupted vitamin K antagonists in atrial fibrillation (AF) patients undergoing catheter ablation. Electronic databases were searched for randomized trials (RCTs) and observational studies that compared uninterrupted NOACs versus uninterrupted vitamin K antagonists in the catheter ablation of AF. Safety outcomes included major bleeding, total bleeding, minor bleeding, and cardiac tamponade...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882323/left-atrial-appendage-closure-for-prevention-of-death-stroke-and-bleeding-in-patients-with-nonvalvular-atrial-fibrillation
#11
Steffen Gloekler, Jacqueline Saw, Konstantinos C Koskinas, Caroline Kleinecke, Werner Jung, Fabian Nietlispach, Bernhard Meier
Nonvalvular atrial fibrillation (AF) is the most frequent arrhythmia with a prevalence of 1%-2% in the general population. Its prevalence increases with age and its diagnosis benefits of improvement and simplification of technologies for its detection. Today, AF affects approximately 7% of individuals age>65years and 15%-20% of octogenarians. Due to stasis and activation of coagulation in a fibrillating atrium, patients are at increased risk of thromboembolism, in particular ischemic stroke, with an overall stroke risk of 5% per year...
August 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28879343/delayed-bleeding-after-implant-surgery-in-patients-taking-novel-oral-anticoagulants-a-case-report
#12
Chihun Kim, Chugeum Dam, Jieun Jeong, Eun-Jung Kwak, Wonse Park
The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28875370/how-prepared-are-pharmacists-to-support-atrial-fibrillation-patients-in-adhering-to-newly-prescribed-oral-anticoagulants
#13
Nadya Hamedi, Filipa Alves da Costa, Robert Horne, Michael Levitan, Amanda Begley, Sotiris Antoniou
Background The New Medicines Service (NMS) was implemented in the United Kingdom in 2011 and first evaluated in 2014, showing 10% increase on adherence. Objective To assess community pharmacists' current practice, knowledge and confidence in supporting patients' adherence as part of the NMS for patients on Oral Anti-Coagulants (OACs) for stroke prevention in Atrial Fibrillation. Setting Community pharmacists in London. Method An online cross-sectional survey was sent to pharmacists from their Local Pharmaceutical Committees and advertised by the Royal Pharmaceutical Society...
September 5, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28864318/comparison-of-the-effectiveness-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-newly-diagnosed-atrial-fibrillation
#14
Inmaculada Hernandez, Yuting Zhang, Samir Saba
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862063/the-safety-of-edoxaban-for-treating-atrial-fibrillation
#15
Matthias Hammwoehner, Andreas Goette
Atrial Fibrillation (AF) has a worldwide increasing incidence and prevalence, putting patients at risk for atrial thrombus formation and consecutive thromboembolic events. Morbidity and mortality have become a significant global public health care burden. Thus, there is increasing need for safe and effective medical prophylaxis of thromboembolic events. Edoxaban is the fourth approved non-vitamin K oral anticoagulant (NOAC) that has been introduced into the market for the prophylaxis of stroke or systemic embolism in non valvulär AF patients after dabigatran, rivaroxaban, and apixaban...
September 1, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28861925/standard-and-reduced-doses-of-dabigatran-rivaroxaban-and-apixaban-for-stroke-prevention-in-atrial-fibrillation-a-nationwide-cohort-study
#16
Laila Staerk, Thomas A Gerds, Gregory Y H Lip, Brice Ozenne, Anders N Bonde, Morten Lamberts, Emil L Fosbøl, Christian Torp-Pedersen, Gunnar H Gislason, Jonas B Olesen
BACKGROUND: Comparative data of non-vitamin K antagonist oral anticoagulants (NOAC) are lacking in patients with atrial fibrillation (AF). OBJECTIVE: We compared effectiveness and safety of standard and reduced dose NOAC in AF patients. METHODS: Using Danish nationwide registries, we included all oral anticoagulant-naïve AF patients who initiated NOAC treatment (2012-2016). Outcome-specific and mortality-specific multiple Cox regressions were combined to compute average treatment effects as 1-year standardized differences in stroke and bleeding risks (g-formula)...
September 1, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28861455/baseline-characteristics-and-event-rates-among-anticoagulated-patients-with-atrial-fibrillation-in-practice-and-pivotal-noac-trials
#17
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
The data report details the baseline characteristics and observed outcomes among patients included in a large US administrative claims database (Optum Labs Data Warehouse) and those enrolled in the pivotal phase III clinical trials examining apixaban, dabigratan, edoxaban and rivaroxaban versus warfarin for the prevention of cardio embolism (Granger et al., 2011; Cannolly et al., 2009; Patel et al., 2011; Giugliano et al., 2013) [1], [2], [3], [4]. These data are to be interpreted in the context of the linked publication (Noseworthy et al...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28858833/influence-of-novel-oral-anticoagulants-on-anticoagulation-care-management
#18
Andrej Janzic, Mitja Kos
Anticoagulation treatment was recently improved by the introduction of novel oral anticoagulants (NOACs). Using a combination of qualitative and quantitative methods, this study explores the effects of the introduction of NOACs on anticoagulation care in Slovenia. Face-to-face interviews with key stakeholders revealed evolvement and challenges of anticoagulation care from different perspectives. Obtained information was further explored through the analysis of nationwide data of drug prescriptions and realization of health care services...
September 1, 2017: Acta Pharmaceutica
https://www.readbyqxmd.com/read/28857611/bleeding-risk-of-apixaban-dabigatran-and-low-dose-rivaroxaban-compared-with-warfarin-in-japanese-patients-with-non-valvular-atrial-fibrillation-a-propensity-matched-analysis-of-administrative-claims-data
#19
Shun Kohsaka, Tatsunori Murata, Naoko Izumi, Jun Katada, Feng Wang, Yasuo Terayama
OBJECTIVES: There is scarce evidence comparing novel oral anticoagulants (NOACs) with warfarin in real-world settings in Japan. This study compared the risk of bleeding events among patients with non-valvular atrial fibrillation (NVAF) initiating treatment with NOACs versus warfarin. METHODS: A retrospective cohort study was conducted using de-identified electronic health records-based database of health claims and Diagnosis Procedure Combination data from 275 consenting hospitals in Japan...
August 31, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28854077/adherence-to-rivaroxaban-dabigatran-and-apixaban-for-stroke-prevention-for-newly-diagnosed-and-treatment-naive-atrial-fibrillation-patients-an-update-using-2013-2014-data
#20
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Few studies have assessed adherence to non-vitamin K antagonist oral anticoagulants (NOACs), especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To compare adherence and treatment patterns among NOACs for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). METHODS: Incident and treatment-naive NVAF patients were identified during 2013-2014 from a large claims database in this retrospective cohort study...
September 2017: Journal of Managed Care & Specialty Pharmacy
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