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https://www.readbyqxmd.com/read/29723874/peri-operative-adverse-outcomes-in-patients-with-atrial-fibrillation-taking-warfarin-or-edoxaban-analysis-of-the-engage-af-timi-48-trial
#1
James D Douketis, Sabina A Murphy, Elliott M Antman, Laura T Grip, Michele F Mercuri, Christian T Ruff, Jeffrey I Weitz, Eugene Braunwald, Robert P Giugliano
BACKGROUND:  Peri-operative management of anticoagulated patients with atrial fibrillation (AF) is challenging. To gain information on the peri-operative management of edoxaban, we compared outcomes in patients on warfarin or edoxaban enrolled in ENGAGE AF-TIMI 48 who underwent a surgery or invasive procedure. METHODS:  Data from patients undergoing their first surgery/procedure were analysed and results compared by anticoagulant (warfarin vs. higher- or lower-dose edoxaban regimen [HDER and LDER, respectively])...
May 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29687454/interventions-for-implementation-of-thromboprophylaxis-in-hospitalized-patients-at-risk-for-venous-thromboembolism
#2
REVIEW
Susan R Kahn, David R Morrison, Gisèle Diendéré, Alexandre Piché, Kristian B Filion, Adi J Klil-Drori, James D Douketis, Jessica Emed, André Roussin, Vicky Tagalakis, Martin Morris, William Geerts
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in hospitalized patients. While numerous randomized controlled trials (RCTs) have shown that the appropriate use of thromboprophylaxis in hospitalized patients at risk for VTE is safe, effective, and cost-effective, thromboprophylaxis remains underused or inappropriately used. Our previous review suggested that system-wide interventions, such as education, alerts, and multifaceted interventions were more effective at improving the prescribing of thromboprophylaxis than relying on individual providers' behaviors...
April 24, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29549777/an-opinion-on-the-benefits-of-concomitant-oral-contraceptive-therapy-in-premenopausal-women-treated-with-oral-anticoagulants
#3
REVIEW
Richard Godin, Geneviève Roy, James Douketis
Women who are receiving an oral anticoagulant appear to be at higher risk of developing bleeding-related adverse events than men. Physiological bleeding related to the ovulatory cycle poses an ongoing risk for bleeding complications during anticoagulant therapy. Abnormal uterine bleeding and hemorrhagic ovarian cysts are risks specific to women of reproductive age who are treated with anticoagulants. The use of combined oral contraceptives can help minimize such adverse events and would also mitigate the risks of obstetrical complications related to thrombosis and anticoagulation, in addition to avoiding fetal exposure to potentially teratogenic anticoagulants...
March 8, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29534986/peri-procedural-management-of-oral-anticoagulants-in-the-doac-era
#4
REVIEW
Geoffrey D Barnes, Erin Mouland
Peri-procedural management of oral anticoagulants can be complex and confusing for many providers. It involves a careful balance of a patient's thromboembolic risk and bleeding risk. For every patient chronically taking an oral anticoagulant who will be undergoing an elective procedure, a four step approach may be considered when creating a plan for the oral anticoagulant.(Writing Group M, 20161 ) Does the oral anticoagulant need to stop for the procedure?(Periprocedural Management of Anticoagulation Writing C, Doherty JU, Gluckman TJ, et al...
March 10, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29531627/a-pharmacist-checklist-for-direct-oral-anticoagulant-management-raising-the-bar
#5
Kori Leblanc, William M Semchuk, John Papastergiou, Blair Snow, Leilany Mandlsohn, Vinay Kapoor, Lisa M Guirguis, James D Douketis, William Geerts, David J Gladstone
No abstract text is available yet for this article.
March 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/29490924/antiphospholipid-antibodies-and-recurrent-thrombosis-after-a-first-unprovoked-venous-thromboembolism
#6
Clive Kearon, Sameer Parpia, Frederick A Spencer, Trevor Baglin, Scott M Stevens, Kenneth A Bauer, Steven R Lentz, Craig M Kessler, James D Douketis, Stephan Moll, Scott Kaatz, Sam Schulman, Jean M Connors, Jeffrey S Ginsberg, Luciana Spadafora, Vinai Bhagirath, Patricia C Liaw, Jeffrey I Weitz, Jim A Julian
It is uncertain whether antiphospholipid antibodies (APAs) increase the risk of recurrence after a first unprovoked venous thromboembolism (VTE). We tested for anticardiolipin antibodies, anti-β2 glycoprotein 1 antibodies, and lupus anticoagulant on 2 occasions ∼6 months apart in 307 patients with a first unprovoked VTE who were part of a prospective cohort study. We then determined if APAs were associated with recurrent thrombosis in the 290 patients who stopped anticoagulant therapy in response to negative D-dimer results...
May 10, 2018: Blood
https://www.readbyqxmd.com/read/29475527/2018-canadian-cardiovascular-society-canadian-association-of-interventional-cardiology-focused-update-of-the-guidelines-for-the-use-of-antiplatelet-therapy
#7
Shamir R Mehta, Kevin R Bainey, Warren J Cantor, Marie Lordkipanidzé, Guillaume Marquis-Gravel, Simon D Robinson, Matthew Sibbald, Derek Y So, Graham C Wong, Joseph G Abunassar, Margaret L Ackman, Alan D Bell, Raymond Cartier, James D Douketis, Patrick R Lawler, Michael S McMurtry, Jacob A Udell, Sean van Diepen, Subodh Verma, G B John Mancini, John A Cairns, Jean-François Tanguay
Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29345686/reversal-agents-for-non-vitamin-k-antagonist-oral-anticoagulants
#8
REVIEW
Jerrold H Levy, James Douketis, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban, and rivaroxaban, which inhibit coagulation factor Xa. Although clinical studies of NOACs were conducted without antidotes, patient outcomes with major bleeding when receiving NOACs were no worse than those in patients treated with a vitamin K antagonist. Nonetheless, in patients with life-threatening bleeding or requiring urgent surgery, the capacity for rapid NOAC reversal is likely to increase patient safety...
January 18, 2018: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/29224638/predictors-of-perioperative-major-bleeding-in-patients-who-interrupt-warfarin-for-an-elective-surgery-or-procedure-analysis-of-the-bridge-trial
#9
RANDOMIZED CONTROLLED TRIAL
Nathan P Clark, James D Douketis, Vic Hasselblad, Sam Schulman, Andrei L Kindzelski, Thomas L Ortel
BACKGROUND: The use of low-molecular weight heparin bridge therapy during warfarin interruption for elective surgery/procedures increases bleeding. Other predictors of bleeding in this setting are not well described. METHODS: BRIDGE was a randomized, double-blind, placebo-controlled trial of bridge therapy with dalteparin 100 IU/kg twice daily in patients with atrial fibrillation requiring warfarin interruption. Bleeding outcomes were documented from the time of warfarin interruption until up to 37 days postprocedure...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29217632/perioperative-management-of-anticoagulant-and-antiplatelet-therapy
#10
Alfonso Tafur, James Douketis
No abstract text is available yet for this article.
December 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29212129/the-perioperative-anticoagulant-use-for-surgery-evaluation-pause-study-for-patients-on-a-direct-oral-anticoagulant-who-need-an-elective-surgery-or-procedure-design-and-rationale
#11
James D Douketis, Alex C Spyropoulos, Julia M Anderson, Donald M Arnold, Shannon M Bates, Mark Blostein, Marc Carrier, Joseph A Caprini, Nathan P Clark, Michiel Coppens, Francesco Dentali, Joanne Duncan, Peter L Gross, Jeannine Kassis, Stephen Kowalski, Agnes Y Lee, Gregoire Le Gal, Geneviève Le Templier, Na Li, Elizabeth MacKay, Vinay Shah, Sudeep Shivakumar, Susan Solymoss, Frederick A Spencer, Summer Syed, Alfonso J Tafur, Thomas Vanassche, Thomas Thiele, Cynthia Wu, Erik Yeo, Sam Schulman
Background The perioperative management of patients who take a direct oral anticoagulant (DOAC) for atrial fibrillation and require treatment interruption for an elective surgery/procedure is a common clinical scenario for which best practices are uncertain. The Perioperative Anticoagulant Use for Surgery Evaluation (PAUSE) study is designed to address this unmet clinical need. We discuss the rationale for the PAUSE design and analysis plan as well as the rationale supporting the perioperative DOAC protocol...
December 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29171361/canadian-stroke-best-practice-recommendations-secondary-prevention-of-stroke-sixth-edition-practice-guidelines-update-2017
#12
Theodore Wein, M Patrice Lindsay, Robert Côté, Norine Foley, Joseph Berlingieri, Sanjit Bhogal, Aline Bourgoin, Brian H Buck, Jafna Cox, Dion Davidson, Dar Dowlatshahi, Jim Douketis, John Falconer, Thalia Field, Laura Gioia, Gord Gubitz, Jeffrey Habert, Sharon Jaspers, Cheemun Lum, Dana McNamara Morse, Paul Pageau, Mubeen Rafay, Amanda Rodgerson, Bill Semchuk, Mukul Sharma, Ashkan Shoamanesh, Arturo Tamayo, Elisabeth Smitko, David J Gladstone
The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29125695/age-adjusted-d-dimer-to-rule-out-deep-vein-thrombosis-findings-from-the-palladio-algorithm
#13
N Riva, G Camporese, M Iotti, E Bucherini, M Righini, P W Kamphuisen, P Verhamme, J D Douketis, C Tonello, P Prandoni, W Ageno
Essentials The accuracy of the age-adjusted D-dimer in suspected venous thromboembolism is still debated. We assessed the performance of age-adjusted D-dimer combined with the PALLADIO algorithm. The age-adjusted threshold can reduce the need for imaging tests compared to the fixed cut-off. The safety of this approach should be confirmed in large management studies. SUMMARY: Background Age-adjusted D-dimer has been proposed to increase specificity for the diagnosis of venous thromboembolism (VTE)...
February 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28985175/navigating-the-anticoagulant-landscape-in-2017
#14
REVIEW
James D Douketis
Several questions remain regarding anticoagulant management: What is the best strategy for managing acute venous thromboembolism? How should patients on a direct oral anticoagulant or on warfarin be managed when they need elective surgery? When is heparin bridging necessary?
October 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28339794/short-term-dabigatran-interruption-before-cardiac-rhythm-device-implantation-multi-centre-experience-from-the-re-ly-trial
#15
Vidal Essebag, Riccardo Proietti, David H Birnie, Jia Wang, James Douketis, Benoit Coutu, Ratika Parkash, Gregory Y H Lip, Stefan H Hohnloser, Andrew Moriarty, Jonas Oldgren, Stuart J Connolly, Michael Ezekowitz, Jeff S Healey
Aims: Cardiac implantable electronic device (CIED) surgery is commonly performed in patients with atrial fibrillation (AF). The current analysis was undertaken to compare peri-operative anticoagulation management, bleeding, and thrombotic events in AF patients treated with dabigatran vs. warfarin. Methods and results: This study included 611 patients treated with dabigatran vs. warfarin who underwent CIED surgery during the RE-LY trial. Among 201 warfarin-treated patients, warfarin was interrupted a median of 144 (inter-quartile range, IQR: 120-216) h, and 37 (18...
October 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28203409/practice-patterns-in-venous-thromboembolism-vte-prophylaxis-in-thoracic-surgery-a-comprehensive-canadian-delphi-survey
#16
John Agzarian, Lori-Ann Linkins, Laura Schneider, Waël C Hanna, Christian J Finley, Colin Schieman, Marc De Perrot, Mark Crowther, James Douketis, Yaron Shargall
BACKGROUND: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. METHODS: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28160670/cost-effectiveness-of-the-addition-of-a-comprehensive-ct-scan-to-the-abdomen-and-pelvis-for-the-detection-of-cancer-after-unprovoked-venous-thromboembolism
#17
Kathryn Coyle, Marc Carrier, Alejandro Lazo-Langner, Sudeep Shivakumar, Ryan Zarychanski, Vicky Tagalakis, Susan Solymoss, Nathalie Routhier, James Douketis, Douglas Coyle
IMPORTANCE: Unprovoked venous thromboembolism (VTE) can be the first manifestation of cancer. It is unclear if extensive screening for occult cancer including a comprehensive computed tomography (CT) scan of the abdomen/pelvis is cost-effective in this patient population. OBJECTIVE: To assess the health care related costs, number of missed cancer cases and health related utility values of a limited screening strategy with and without the addition of a comprehensive CT scan of the abdomen/pelvis and to identify to what extent testing should be done in these circumstances to allow early detection of occult cancers...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28075424/managing-challenging-patients-with-venous-thromboembolism-a-practical-case-based-approach
#18
REVIEW
James Douketis, Walter Ageno, Marc Carrier, Clive Kearon
The management of patients with venous thromboembolism (VTE) is a common clinical scenario that, for the most part, involves well‑established, evidence‑based treatment pathways. However, important unanswered clinical questions remain that are the focus of ongoing research. The aim of this narrative review is to provide a practical, case‑based approach to the following clinical scenarios in which therapeutic management pathways are less well established: How long to administer anticoagulation to patients with a first unprovoked VTE? How to manage complex patients with cancer‑associated VTE? When and how to treat patients with splanchnic vein thrombosis? When to use thrombolytic therapy for deep vein thrombosis?...
January 4, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
REVIEW
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
April 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27872458/periprocedural-risk-of-bleeding-and-thrombosis-to-bridge-or-not-to-bridge-dr-james-douketis-in-an-interview-with-dr-roman-jaeschke-part-2
#20
James Douketis, Roman Jaeschke
No abstract text is available yet for this article.
October 28, 2016: Polskie Archiwum Medycyny Wewnętrznej
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