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https://www.readbyqxmd.com/read/27637305/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation
#1
REVIEW
Anna Plitt, Christian T Ruff, Robert P Giugliano
For more than 50 years, vitamin K antagonists (VKAs) have been the standard of care for treatment of atrial fibrillation (AF). However, the numerous limitations of VKAs have led to the development of non-VKA oral anticoagulants (NOACs). There are 4 NOACs currently approved for prevention of thromboembolism in patients with nonvalvular AF. This article provides an overview of AF, summarizes basic properties of NOACs, and reviews the landmark trials. Current data on use of NOACs in special populations and specific clinical scenarios are also presented...
October 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27436881/management-of-bleeding-with-non-vitamin-k-antagonist-oral-anticoagulants-in-the-era-of-specific-reversal-agents
#2
Christian T Ruff, Robert P Giugliano, Elliott M Antman
Vitamin K antagonists are commonly used by clinicians to provide anticoagulation to patients who have or are at risk of having thrombotic events. In addition to familiarity with the dosing and monitoring of vitamin K antagonists, clinicians are accustomed to using vitamin K if there is a need to reverse the anticoagulant effect of vitamin K antagonists. There are now 4 new non-vitamin K antagonist oral anticoagulants (NOACs) that are attractive alternatives to vitamin K antagonists. Despite similar or lower rates of serious bleeding with NOACs in comparison with warfarin, there is a pressing need for strategies to manage bleeding when it does occur with NOACs and to reverse the pharmacological effect of these agents if needed...
July 19, 2016: Circulation
https://www.readbyqxmd.com/read/26386790/systemic-noncerebral-arterial-embolism-in-21-105-patients-with-atrial-fibrillation-randomized-to-edoxaban-or-warfarin-results-from-the-effective-anticoagulation-with-factor-xa-next-generation-in-atrial-fibrillation-thrombolysis-in-myocardial-infarction-study
#3
RANDOMIZED CONTROLLED TRIAL
Bram J Geller, Robert P Giugliano, Eugene Braunwald, Sabina A Murphy, James J Hanyok, Jianqing Jin, Michele Mercuri, Elliott M Antman, Christian T Ruff
BACKGROUND: Atrial fibrillation (AF) is a major risk factor for stroke and systemic embolism. Trials comparing warfarin with non-vitamin K oral anticoagulants (NOACs) have demonstrated that, when compared with warfarin, the NOACs are at least as effective in preventing stroke, although detailed analyses characterizing systemic embolic events (SEEs) are lacking. METHODS AND RESULTS: We performed a prespecified analysis in 21,105 patients with AF enrolled in the ENGAGE AF-TIMI 48 trial, which compared 2 once-daily regimens of edoxaban with warfarin for the prevention of stroke and SEE...
October 2015: American Heart Journal
https://www.readbyqxmd.com/read/25495417/new-oral-anticoagulants-for-nonvalvular-atrial-fibrillation-in-the-elderly-limited-applicability-in-primary-care
#4
REVIEW
Wim Opstelten, Maureen van den Donk, Ton Kuijpers, Jako Burgers
BACKGROUND: Based on the results from randomized controlled trials (RCTs), new oral anticoagulants (NOACs) seem attractive alternatives to vitamin K antagonists (VKAs) because of their effectiveness, safety, and ease of use. However, the use of NOACs in unselected elderly patients with atrial fibrillation (AF) in primary care is arguable. OBJECTIVES: To assess the evidence for the effectiveness and safety of NOACs compared with VKAs in elderly patients with nonvalvular AF in primary care...
June 2015: European Journal of General Practice
https://www.readbyqxmd.com/read/25104527/transition-of-patients-from-blinded-study-drug-to-open-label-anticoagulation-the-engage-af-timi-48-trial
#5
RANDOMIZED CONTROLLED TRIAL
Christian T Ruff, Robert P Giugliano, Eugene Braunwald, Michele Mercuri, Valentin Curt, Joshua Betcher, Laura Grip, Abby L Cange, Andrea E Crompton, Sabina A Murphy, Naveen Deenadayalu, Elliott M Antman
BACKGROUND: At the end of 2 previous trials, an excess of stroke and bleeding was observed in patients with AF randomized to a new oral anticoagulant (NOAC) who transitioned to a vitamin K antagonist (VKA). OBJECTIVES: The ENGAGE AF-TIMI 48 (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48) trial compared once-daily edoxaban to warfarin for stroke prevention in patients with AF. An end-of-trial transition plan was developed to minimize the risks of stroke due to inadequate anticoagulation and bleeding from excessive anticoagulation during this critical period...
August 12, 2014: Journal of the American College of Cardiology
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