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rivaroxaban pulmonary embolism

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https://www.readbyqxmd.com/read/29576872/pfo-closure-in-high-risk-patient-with-paradoxical-arterial-embolism-deep-vein-thrombosis-pulmonary-embolism-and-factor-v-leiden-genetic-mutation
#1
A Parikh, T P Vacek
Occurrence of paradoxical arterial embolism may cause the first symptoms in patients with a coexisting hypercoagulable state and patent foramen ovale (PFO). This can result in significant morbidity and mortality depending on the location of the embolism. The risks and benefits of closure of small PFOs have not been well elucidated in prior studies. We describe a patient with a history of Factor V Leiden heterozygosity who presented with left arm pain secondary to arterial embolism. The patient was a 51-year-old male who initially presented to the emergency department after awaking from sleep with progressive, severe, burning left arm pain...
March 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29542359/non-vitamin-k-antagonist-oral-anticoagulants-for-pulmonary-embolism-who-where-and-for-how-long
#2
Luke S Howard
Acute pulmonary embolism (PE) is a relatively common cardiopulmonary emergency that is a major cause of hospitalization and morbidity and is the primary cause of mortality associated with venous thromboembolism (VTE). During the last decade, one of the biggest changes in the management of PE has been the approval of four non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) for the treatment of PE and deep vein thrombosis and secondary prevention of VTE. Areas covered: This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; whether patients should be treated as inpatients or outpatients; and how long patients should be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing...
March 15, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29525891/a-review-of-the-role-of-non-vitamin-k-oral-anticoagulants-in-the-acute-and-long-term-treatment-of-venous-thromboembolism
#3
REVIEW
Andrew Bromley, Anna Plitt
Venous thromboembolism (VTE), which includes both deep vein thrombosis and pulmonary embolism (PE), is a very common disorder with high risk for recurrence and is associated with significant morbidity and mortality. The non-vitamin K oral anticoagulants (NOACs), which include dabigatran, rivaroxaban, apixaban, and edoxaban, have been shown to be noninferior to conventional anticoagulant therapy for the prevention of recurrent VTE and are associated with more favorable bleeding risk. Evidence from the treatment of VTE with traditional therapy (low molecular weight heparin and vitamin K antagonists) implies that extended or indefinite treatment reduces risk of recurrence...
March 10, 2018: Cardiology and Therapy
https://www.readbyqxmd.com/read/29520700/multidisciplinary-approach-to-the-management-of-patients-with-pulmonary-embolism-and-deep-vein-thrombosis-a-consensus-on-diagnosis-traditional-therapy-and-therapy-with-rivaroxaban
#4
Davide Imberti, Cecilia Becattini, Enrico Bernardi, Giuseppe Camporese, Claudio Cuccia, Francesco Dentali, Damiano Paretti
Despite the availability of updated guidelines for the diagnosis and treatment of venous thromboembolism (VTE), the management of this disorder in clinical practice is often not standardized, given the different degree of compliance with official recommendations by the various involved specialists. The aim of this consensus paper, as a result of a board of experts in thromboembolism, is to define strategies to improve the quality of patients' care and the efficiency of healthcare resources utilization, by means of: (a) analysis of the guidelines for diagnosis and treatment of VTE; (b) analysis of diagnostic and therapeutic algorithms currently used in clinical practice by different specialists; (c) agreement on a common algorithm for diagnosis and treatment of VTE in different clinical settings; (d) definition of the possible role of the new oral anticoagulant agents (NOAC), such as rivaroxaban, based on their potential benefits for both acute and chronic therapy...
March 8, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29506708/venous-thromboembolism-therapy-with-rivaroxaban-in-daily-care-patients-results-from-the-dresden-noac-registry
#5
Loretta Keller, Sandra Marten, Judith Hecker, Kurtulus Sahin, Luise Tittl, Jan Beyer-Westendorf
The effectiveness and safety of acute venous thromboembolism (VTE) treatment with rivaroxaban, demonstrated in phase-III trials, needs to be confirmed in daily care. To confirm the positive results of phase-III VTE treatment trials with rivaroxaban in daily care, we used data from the ongoing, prospective, non-interventional Dresden NOAC Registry. For this analysis, only patients with acute VTE who started rivaroxaban within 14days after diagnosis of VTE and who were enrolled within these 14days were evaluated with regard to patient characteristics, treatment persistence and clinical outcomes...
April 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29492367/isolated-homocysteinemia-leading-to-thromboembolism-in-young-male-with-normal-vitamin-b12-and-folate-levels
#6
Waleed Sadiq, Madeeha Subhan
Pulmonary embolism (PE) with isolated homocysteinemia is a rare disease. The diagnosis demands a proper clinical workup. Timely diagnosis can prevent complications and provide a better quality of life for the patient. We present a young man with homocysteinemia with deep vein thrombosis (DVT), pulmonary embolism, and normal vitamin B12 and folate levels despite being treated with rivaroxaban.
December 22, 2017: Curēus
https://www.readbyqxmd.com/read/29476744/rivaroxaban-vs-warfarin-and-risk-of-post-thrombotic-syndrome-among-patients-with-venous-thromboembolism
#7
Mette Søgaard, Peter Brønnum Nielsen, Flemming Skjøth, Jette Nordstrøm Kjældgaard, Craig I Coleman, Torben Bjerregaard Larsen
BACKGROUND: The effectiveness of rivaroxaban to reduce post-thrombotic syndrome in patients with venous thromboembolism is largely unknown. We compared rates of post-thrombotic syndrome in patients given rivaroxaban versus warfarin in a cohort of routine clinical care patients with incident venous thromboembolism. METHODS: We linked Danish nationwide registries to identify all patients with incident venous thromboembolism who were new users of rivaroxaban or warfarin and compared rates of post-thrombotic syndrome using an inverse probability of treatment weighting approach to account for baseline confounding...
February 21, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29469638/cost-comparison-of-continued-anticoagulation-with-rivaroxaban-versus-placebo-based-on-the-one-year-einstein-extension-trial-efficacy-and-safety-results
#8
Philip S Wells, Anthonie W A Lensing, Lloyd Haskell, Bennett Levitan, François Laliberté, Michael Durkin, Veronica Ashton, Yongling Xiao, Concetta Crivera, Dominique Lejeune, Jeff Schein, Patrick Lefebvre
AIMS: The EINSTEIN-Extension trial (EINSTEIN-EXT) found that continued treatment with rivaroxaban for an additional 6 or 12 months (versus placebo) after 6-12 months of initial anticoagulation significantly reduced the risk of recurrent venous thromboembolism (VTE) with a small non-significant increased risk of major bleeding (none fatal or in critical site). This study aimed to compare total healthcare cost between rivaroxaban and placebo based on the EINSTEIN-EXT event rates. METHODS: Total healthcare cost was calculated as sum of treatment and clinical event costs from a US managed care perspective...
February 22, 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29466159/aspirin-or-rivaroxaban-for-vte-prophylaxis-after-hip-or-knee-arthroplasty
#9
RANDOMIZED CONTROLLED TRIAL
David R Anderson, Michael Dunbar, John Murnaghan, Susan R Kahn, Peter Gross, Michael Forsythe, Stephane Pelet, William Fisher, Etienne Belzile, Sean Dolan, Mark Crowther, Eric Bohm, Steven J MacDonald, Wade Gofton, Paul Kim, David Zukor, Susan Pleasance, Pantelis Andreou, Steve Doucette, Chris Theriault, Abongnwen Abianui, Marc Carrier, Michael J Kovacs, Marc A Rodger, Doug Coyle, Philip S Wells, Pascal-Andre Vendittoli
BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty...
February 22, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29455567/apixaban-or-rivaroxaban-versus-warfarin-for-treatment-of-submassive-pulmonary-embolism-after-catheter-directed-thrombolysis
#10
Lara M Groetzinger, Taylor J Miller, Ryan M Rivosecchi, Roy E Smith, Mark T Gladwin, Belinda N Rivera-Lebron
BACKGROUND: Little data exist on the use of direct oral anticoagulant (DOAC) factor Xa inhibitors for submassive pulmonary embolism (PE) after catheter-directed thrombolysis (CDT). The objective of this evaluation was to determine whether the transition from parenteral anticoagulation to DOACs for submassive PE after CDT would decrease hospital length of stay (LOS) compared to warfarin. METHODS: A retrospective review of patients diagnosed with submassive PE who underwent CDT was conducted from January 1, 2012, to February 28, 2017...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29437738/an-unusual-presentation-of-pulmonary-embolism-leading-to-infarction-cavitation-abscess-formation-and-bronchopleural-fistulation
#11
Eva Teng, Luke Bennett, Tommaso Morelli, Anindo Banerjee
We report an unusual presentation of pulmonary embolism (PE) where a 58-year-old man first developed symptoms of community-acquired pneumonia. Despite antibiotic therapy, he remained unwell with rising inflammatory markers, general malaise and persistent cough. He developed stony dull percussion and absent breath sounds to his left mid to lower zones. Serial chest x-rays showed progression from lobar consolidation to a large loculated left-sided pleural collection. CT chest showed left-sided lung abscess, empyema and bronchopleural fistulation...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29436450/lesson-of-the-month-2-pulmonary-embolism-in-a-patient-on-rivaroxaban-and-concurrent-carbamazepine
#12
Thomas Burden, Charlotte Thompson, Efstathios Bonanos, Andrew Rl Medford
A 71-year-old female with a history of pulmonary embolism treated with rivaroxaban presented with acute onset shortness of breath, chest pain and palpitations. Computed tomographic pulmonary angiography (CTPA) revealed multiple bilateral pulmonary emboli. The patient was concurrently prescribed carbamazepine and was later diagnosed with recurrence of breast cancer during the admission. We discuss common drug interactions pertinent to direct oral anticoagulants (DOACs) that can increase the risk of further venous thromboembolism...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29373226/multiple-cerebral-infarctions-due-to-patent-foramen-ovale-in-a-patient-with-eosinophilic-granulomatosis-with-polyangiitis
#13
Kota Maekawa, Masunari Shibata, Masaru Seguchi, Kazuto Kobayashi, Yutaka Naito, Fumitaka Miya
A 51-year-old man was diagnosed with eosinophilic granulomatosis with polyangiitis 6 years ago due to asthma, sinusitis, hypereosinophilia, and peripheral neuropathy based on the diagnostic criteria of American College of Rheumatology, and corticosteroid therapy achieved a remission. One year ago, he was hospitalized due to deep venous thrombosis (DVT) and pulmonary embolism, and rivaroxaban was administrated. He was admitted to our hospital for acute onset of diplopia and right hemiparesis. Peripheral blood examinations disclosed leukocytosis with hypereosinophilia...
January 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29348123/rash-associated-with-rivaroxaban-use
#14
Kelly M Rudd, Narmadha Panneerselvam, Anush Patel
PURPOSE: A case of a patient who developed a hypersensitivity reaction to rivaroxaban in the form of a diffuse, exanthematous rash is reported. SUMMARY: After starting rivaroxaban for treatment of cancer-associated deep vein thrombosis (DVT) with pulmonary embolism (PE), a 69-year-old Caucasian woman arrived at an oncology clinic with a diffuse, exanthematous (morbilliform) rash on her neck and torso, spreading to her upper and lower extremities. She reported that the symptoms started to develop about 48 hours after transitioning from subcutaneous enoxaparin to oral rivaroxaban...
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29337837/accidental-rivaroxaban-intoxication-in-a-boy-some-lessons-in-managing-new-oral-anticoagulants-in-children
#15
Julieta Weirthein, Dennis Scolnik, Nili Yanai Milshtein, Tali Capua, Miguel Glatstein
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29334815/impact-of-medication-adherence-on-risk-of-ischemic-stroke-major-bleeding-and-deep-vein-thrombosis-in-atrial-fibrillation-patients-using-novel-oral-anticoagulants
#16
Chinmay G Deshpande, Stephen Kogut, Robert Laforge, Cynthia Willey
OBJECTIVES: Our study examined the impact of adherence to novel oral anticoagulants [NOACs - dabigatran and rivaroxaban] on ischemic-stroke (IS), major-bleeding (MB), deep-vein-thrombosis and pulmonary-embolism (DVTPE) risk in a large, nationwide, propensity-matched sample. METHODS: A retrospective cohort study utilized data from a US commercial managed-care database (2010-2012). Adult patients with ≥1 diagnosis of atrial fibrillation/flutter (ICD-9 427.31/32), >1 prescription of NOACs and CHA2 DS2 -VASc score ≥1 were included...
February 15, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29299477/novel-venous-thromboembolic-disease-vted-prophylaxis-for-total-knee-arthroplasty-aspirin-and-fish-oil
#17
Peter M Bonutti, Nipun Sodhi, Yatindra H Patel, Assem A Sultan, Anton Khlopas, Morad Chughtai, Frank R Kolisek, Nick Williams, Michael A Mont
Background: Despite the demonstrated success of multiple anticoagulation therapies for post-operative prophylaxis of thromboembolic disease in lower extremity arthroplasties, each modality comes with a unique set of limitations. Thus, the ideal anticoagulation medication which provides adequate therapy with minimal cost, complications, or added patient work is yet to be defined. One promising novel thrombophylactic supplement is fish oil, as many preliminary clinical trials have demonstrated a protective effect of fish oil against thrombosis in multiple clinical settings...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29275595/-clinical-efficacy-of-rivaroxaban-in-prevention-and-treatment-of-postoperative-deep-vein-thrombosis-for-severe-traumatic-brain-injury
#18
Z L Zhang, W M Liu, Y Zhang, G H Wang, C Yan, H Q Wang, Q B Huang
Objective: To explore the clinical efficacy of rivaroxaban in the prevention and treatment of postoperative deep vein thrombosis (DVT) for severe traumatic brain injury (sTBI). Methods: Patients with sTBI who met the inclusion criteria were enrolled in this study, including 119 males (75.8%) and 38 females (24.2%), aged (38.75 ± 11.98) years old. DVT was prevented and treated according to the DVT screening and anticoagulation regimen. Intermittent venous compression was used on all of the patients to prevent DVT, and D-dimer dynamic monitoring and regular ultrasound were performed to screen for DVT...
December 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29217335/rivaroxaban-and-apixaban-for-initial-treatment-of-acute-venous-thromboembolism-of-atypical-location
#19
Dawid T Janczak, Malgorzata K Mimier, Robert D McBane, Patrick S Kamath, Benjamin S Simmons, Dalene M Bott-Kitslaar, Charles J Lenz, Emily R Vargas, David O Hodge, Waldemar E Wysokinski
OBJECTIVES: To assess the outcome of direct oral anticoagulants (DOACs), specifically Xa inhibitors: rivaroxaban and apixaban, for the treatment of venous thromboembolism (VTE) of atypical location (VTE-AL), portal, mesenteric, hepatic, splenic, gonadal, renal, and cerebral veins, prospectively collected data of Mayo Thrombophilia Clinic Registry were used. METHODS: Patients with acute VTE-AL treated with DOACs, enrolled between March 1, 2013, and February 1, 2017, were compared with patients with VTE of typical location (VTE-TL: deep vein thrombosis of extremities and/or pulmonary embolism) receiving DOACs and with patients with VTE-AL treated with enoxaparin...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29202213/rivaroxaban-for-preventing-venous-thromboembolism-in-high-risk-ambulatory-patients-with-cancer-rationale-and-design-of-the-cassini-trial
#20
Alok A Khorana, Saroj Vadhan-Raj, Nicole M Kuderer, Ted Wun, Howard Liebman, Gerald Soff, Chandra Belani, Eileen M O'Reilly, Robert McBane, John Eikelboom, C V Damaraju, Karen Beyers, Flavia Dietrich, Ajay K Kakkar, Hanno Riess, Renata D'Alpino Peixoto, Gary H Lyman
Venous thromboembolism (VTE) is a frequent complication of cancer associated with morbidity, mortality, increased hospitalizations and higher health care costs. Cancer patients at increased risk for VTE can be identified using a validated risk assessment score, and the incidence of VTE can be reduced in high-risk settings using anticoagulation. Rivaroxaban is a potent, oral, direct, factor Xa inhibitor approved for the prevention and treatment of thromboembolic events, including VTE. CASSINI is a double-blind, randomized, parallel-group, multicentre study comparing rivaroxaban with placebo in adult ambulatory patients with various cancers who are initiating systemic cancer therapy and are at high risk of VTE (Khorana score ≥ 2)...
November 2017: Thrombosis and Haemostasis
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