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https://www.readbyqxmd.com/read/29791257/the-use-of-direct-oral-anticoagulants-in-the-treatment-of-acute-venous-thromboembolism-in-cancer-patients
#1
Hikmat Abdel-Razeq, Antoine Finianos, Ali T Taher
Introduction - After the CLOT study, LMWHs (low-molecular weight heparins) have gradually replaced warfarin as the treatment of choice for VTE (venous thromboembolism) in cancer patients. Randomized controlled studies comparing DOACs (direct oral anticoagulants) to LMWHs in cancer patients are still limited. However, new emerging data are supporting the use of DOACs in cancer-associated thrombosis. Areas Covered - This review will discuss the recent studies that addressed the utilization of such agents in the treatment of VTE in cancer patients...
May 23, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29790645/fibrinogen-prothrombin-time-derived-method-is-not-useful-in-patients-anticoagulated-with-low-molecular-weight-heparins-or-rivaroxaban
#2
C Duboscq, M Martinuzzo, J M Ceresetto, M Lopez, L Barrera, J Oyhamburu, G Stemmelin
BACKGROUND: Fibrinogen prothrombin time derived method (FIBPT-d) with photo-optical coagulometers is easy and economical. However, there are few reports on the behavior of this test on samples from patients anticoagulated with direct oral anticoagulants (DOACs) or low molecular weight heparin (LMWH). OBJECTIVE: To compare fibrinogen results obtained by Clauss method (FIB C) and FIBPT-d with two thromboplastins in anticoagulated patients. POPULATION: 295 consecutive anticoagulated patients: 99 vitamin K antagonist (VKA), 49 unfractionated heparin (UFH), 47 LMWH, 50 rivaroxaban and 50 dabigatran; and 100 healthy controls (NC)...
May 23, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29790125/management-of-major-bleeding-and-outcomes-in-patients-treated-with-direct-oral-anticoagulants-results-from-the-start-event-registry
#3
Sophie Testa, Walter Ageno, Emilia Antonucci, Rossella Morandini, Jan Beyer-Westendorf, Maurizio Paciaroni, Marc Righini, Piera Sivera, Peter Verhamme, Vittorio Pengo, Daniela Poli, Gualtiero Palareti
The management of major bleeding in patients treated with direct oral anticoagulants (DOACs) is still not well established. START-Events, a branch of the START registry (Survey on anTicoagulated pAtients RegisTer) (NCT02219984), aims to describe the actual management of bleeding or recurrent thrombotic events in routine clinical practice. We here present the results of the management of bleeding patients. The START-Event registry is a prospective, observational, multicenter, international study. Baseline characteristics (demographic, clinical, risk factors) of patients, laboratory data at admission and during follow-up, site of bleeding, therapeutic strategies, and outcomes at the time of hospital discharge and after 6 months were recorded on a web-based case report form...
May 22, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29789047/concerns-for-bleeding-in-the-elderly-with-the-use-of-direct-oral-anticoagulants
#4
Michelle Min, Stephanie Sibicky
Since Food and Drug Administration approval of dabigatran in 2010, direct oral anticoagulants (DOACs) have been alternatives to warfarin for patients who are at risk for cardioembolic complications of nonvalvular atrial fibrillation. Unfortunately, there are limited safety data available on the use of these newer agents in older adults, particularly risks of gastrointestinal, intracranial, and major bleeding (as defined by the International Society on Thrombosis and Haemostasis) in those 75 years of age and older...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29784753/use-of-direct-oral-anticoagulants-for-treating-venous-thromboembolism-in-patients-with-cancer
#5
Gerald A Soff
For patients with cancer who experience venous thromboembolism (VTE), low-molecular-weight heparin (LMWH) remains the standard of care in the NCCN Guidelines for VTE, but under certain conditions direct oral anticoagulants (DOACs) are acceptable alternatives. A growing body of literature suggests that DOACs may more effective than LMWHs in preventing recurrences, but they do carry some increased risk of bleeding. Most of this risk is seen in patients with gastrointestinal or urinary pathology or implanted devices...
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29782270/-tactics-of-selection-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-ischemic-heart-disease
#6
Y N Belenkov, G A SHakaryants, N V Khabarova
In the clinical practice a physician quite often is at a loss due to "freedom of choice" granted by availability of direct oral anticoagulants (DOAC). If a patient with nonvalvular atrial fibrillation (AF) has indications for therapy with anticoagulants which DOAC should be preferred? What are benefits for a patient with ischemic heart disease and AF when definite NOAC is chosen and what are risks inherent of this choice? Answers to such questions are given in this paper.
March 2018: Kardiologiia
https://www.readbyqxmd.com/read/29779882/antithrombotic-therapy-strategy-for-cancer-associated-ischemic-stroke-a-case-series-of-26-patients
#7
Hiroyuki Naito, Tomohisa Nezu, Naohisa Hosomi, Shiro Aoki, Hiroki Ueno, Kazuhide Ochi, Hirofumi Maruyama
BACKGROUND: The risk of complications from thromboembolism is increased for patients with malignancy. Cancer-associated stroke is also a serious issue with regard to the management of patients with cancer because stroke incidence often causes disabilities that affect daily life and cancer treatment strategy. METHODS: Between March 2011 and September 2017, 328 patients with acute ischemic stroke were registered to our hospital. RESULTS: Of these patients, 26 (7...
May 17, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#8
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29775794/rebleeding-vs-thromboembolism-after-hospitalization-for-gastrointestinal-bleeding-in-patients-on-direct-oral-anticoagulants
#9
Neil Sengupta, Ariela L Marshall, Blake A Jones, Sandra Ham, Elliot B Tapper
BACKGROUND AND AIMS: Little is known about outcomes of patients hospitalized for gastrointestinal bleeding (GIB) while they are taking direct oral anticoagulants (DOAC). We aimed to determine the frequency at which patients resume DOAC therapy following hospitalization for GIB in a real-world setting, and the risks and benefits. METHODS: We conducted a retrospective analysis of medical claims data from the Truven Health Marketscan Commercial Claims and Encounters Database, from January 1, 2010 through December 31, 2014...
May 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29772108/reduced-dose-direct-oral-anticoagulants-in-the-extended-treatment-of-venous-thromboembolism-a-systematic-review-and-meta-analysis
#10
Lakshman Vasanthamohan, Kochawan Boonyawat, Chatree Chai-Adisakopha, Mark Crowther
BACKGROUND: Extended duration anticoagulation is beneficial for preventing recurrent venous thromboembolism (VTE). Reduced dose direct oral anticoagulants (DOACs) may be preferable if they preserve efficacy and cause less bleeding. We conducted a systematic review and meta-analysis of trials comparing reduced dose DOACs with full dose DOACs and aspirin or placebo in the extended phase of VTE treatment. METHODS: A literature search was conducted using the MEDLINE, EMBASE and CINAHL databases supplemented by hand-searching...
May 17, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#11
V Sawhney, M Shaukat, E Volkova, N Jones, R Providencia, S Honarbakhsh, G Dhillon, A Chow, M Lowe, P Lambiase, M Dhinoja, S Sporton, M J Earley, R J Schilling, R J Hunter
BACKGROUND: Current consensus guidelines suggest DOACs are interrupted peri-procedurally for catheter ablation (CA) of AF. However, this may predispose patients to thromboembolic complications. This study investigates the safety of CA for AF on uninterrupted DOACs compared to uninterrupted warfarin. METHODS: Single centre, retrospective study of consecutive patients undergoing CA for AF. All patients were heparinised prior to trans-septal puncture with a target activated clotting time (ACT) of 300-350 seconds...
May 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29768369/pembrolizumab-induced-acute-thrombosis-a-case-report
#12
Kei Kunimasa, Kazumi Nishino, Madoka Kimura, Takako Inoue, Motohiro Tamiya, Toru Kumagai, Fumio Imamura
RATIONALE: Acute thrombosis has not been reported in the literature so far in lung cancer patients as an immune-related adverse event (irAE) associated with PD-1 pathway inhibitors. PATIENTS CONCERNS: Here, we for the first time present two NSCLC (non-small cell lung cancer) patients suffering from acute thrombosis as a pembrolizumab-induced irAE. Immediate treatment with continuous heparin infusion improved their symptoms and enabled them to continue pembrolizumab administration...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766734/-more-safe-anticoagulant-treatment-use-of-idarucizumab-praxbind%C3%A2-case-reports-from-re-verse-ad-study-and-clinical-practice
#13
David Tuček, Tomáš Veleta, Martin Havrda
RE-VERSE AD, a prospective multicentric cohort study, examined the effect of idarucizumab on 2 cohorts of patients anticoagulated with dabigatran - in cohort A in patients with uncontrollable or life threatening bleeding, in cohort B in patients who undergo acute surgery. Within the study patients were intravenously administered 5 g antidote divided into 2 doses per 2.5 g within 15 min to eliminate the anticoagulation effect of dabigatran. A series of case studies is presented to describe the use of idarucizumab within the RE-VERSE AD study and in clinical practice in the period of 2015-2016 at the University Hospital Hradec Králové...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29765398/epidemiology-of-intracranial-hemorrhage-associated-with-oral-anticoagulants-in-spain-trends-in-anticoagulation-complications-registry-the-tac-2-study
#14
Gustavo Zapata-Wainberg, Sonia Quintas, Álvaro Ximénez-Carrillo Rico, Jaime Masjuán Vallejo, Pere Cardona, Mar Castellanos Rodrigo, Lorena Benavente Fernández, Andrés García Pastor, José Egido, José Maciñeiras, Joaquín Serena, María Del Mar Freijo Guerrero, Francisco Moniche, José Vivancos
Objective: Patients receiving treatment with oral anticoagulants (OACs) are at risk of intracranial hemorrhage (ICH). In this study, we describe the epidemiological and clinical characteristics of patients receiving OACs who experience ICH and compare those receiving vitamin K antagonists (ICH-VKAs) with those receiving direct OACs (ICH-DOACs). Methods: We performed a national, multicenter, descriptive, observational, retrospective study of all adult patients receiving OACs who were admitted to the neurology department with ICH over a 1-year period...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29761512/oral-anticoagulation-and-left-atrial-thrombi-resolution-in-non-rheumatic-atrial-fibrillation-or-flutter-a-systematic-review-and-meta-analysis
#15
Norman C Wang, Matthew D Sather, Aliza Hussain, Andrew D Althouse, Evan C Adelstein, Sandeep K Jain, William E Katz, Alaa A Shalaby, Andrew H Voigt, Samir Saba
BACKGROUND: Oral anticoagulation (OAC) is prescribed for left atrial thrombi (LAT) in non-rheumatic atrial fibrillation (AF) and/or atrial flutter (AFL). The study objective was to review the existing evidence regarding LAT resolution in non-rheumatic AF and/or AFL with OAC agents. METHODS: Data sources included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) between January 1, 1991 and February 1, 2017. English-language studies that assessed LAT resolution with OAC agents in subjects with non-rheumatic AF and/or AFL, by serial transesophageal echocardiography (TEE), and with follow-up times ≥3 weeks and < 1 year were selected...
May 14, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29761426/predictors-of-self-reported-adherence-to-direct-oral-anticoagulation-in-a-population-of-elderly-men-and-women-with-non-valvular-atrial-fibrillation
#16
Andrea P Rossi, Roberto Facchinetti, Elena Ferrari, Nicole Nori, Selena Sant, Elena Masciocchi, Elena Zoico, Francesco Fantin, Gloria Mazzali, Mauro Zamboni
There is a general lack of studies evaluating medication adherence with self-report scales for elderly patients in treatment with direct oral anticoagulants (DOACs). The aim of the study was to assess the degree of adherence to DOAC therapy in a population of elderly outpatients aged 65 years or older affected by non-valvular atrial fibrillation (NVAF), using the 4-item Morisky Medication Adherence Scale, and to identify potential factors, including the geriatric multidimensional evaluation, which can affect adherence in the study population...
May 14, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29757137/reversal-of-apixaban-induced-alterations-in-haemostasis-by-different-coagulation-factor-concentrates-in-patients-after-hip-or-knee-replacement-surgery
#17
Katrin Schmidt, Kerstin Krüger, Elisabeth Langer, Martin Schmutzler, Elke Johnen, Klaus D Wernecke, Christian Von Heymann, Mareike K Körber
BACKGROUND: Apixaban is a direct oral anticoagulant (DOAC) with a specific inhibition of activated factor X (FXa). In case of bleeding or need of urgent surgery a direct antidote is not yet available. Off-label application of non-specific haemostatic agents, such as prothrombin complex concentrate (PCC) and recombinant FVIIa (rFVIIa), has been reported to reverse the effects of apixaban in in vitro and animal studies. The aim of this study is to measure the reversal potential of PCC and rFVIIa in patients with prophylactic apixaban concentrations...
May 11, 2018: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/29754730/-direct-oral-anticoagulants-doacs-a-necessary-focus
#18
J P Laroche, F Becker, J F Schved
In 2008, we decided to enter the era of direct oral anticoagulants (DOACS). Was that the right decision to make? The answer will depend on how well we meet the conditions of proper use. This means avoiding underdosing and overdosing as well as understanding how DOACS were validated so that our prescriptions fulfill their role in the management of thrombotic disease.
May 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29754725/-time-in-therapeutic-range-ttr-and-follow-up-of-patients-on-vitamin-k-antagonist-a-cohort-analysis
#19
E Valdelièvre, I Quéré, B Caré, J P Laroche, J F Schved
INTRODUCTION: Despite the increasing utilization of direct oral anticoagulant (DOAC) prescriptions, vitamin K antagonists (VKAs) remain the treatment of choice for treating and preventing thromboembolic events. The morbidity and mortality of VKAs are partly due to the difficulty of keeping the patient within the therapeutic range. For patients treated by VKA, time in therapeutic range (TTR) is a quality parameter of treatment, widely used in clinical trials but rarely by prescribers. It is well established that its use correlates with the risk of hemorrhage, thrombosis or mortality...
May 2018: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/29753603/direct-oral-anticoagulant-agents-pharmacologic-profile-indications-coagulation-monitoring-and-reversal-agents
#20
REVIEW
Deborah K Rose, Barak Bar
Vitamin K antagonists (VKAs), such as warfarin, have been used for thromboprophylaxis and for the treatment of thromboembolic events in patients with nonvalvular atrial fibrillation for over 60 years. The increasing use of direct oral anticoagulants (DOACs) in recent years has shown greater advantages and safer use over VKA, including reduced bleeding, fewer drug interactions, no food interactions, a quick onset and offset of activity, and predictable dose-response properties. Despite their advantages, there are a couple of major limitations that raise concerns among clinicians, including the need for more coagulation assays to monitor their effects and more specific reversal antidotes in life-threatening circumstances of bleeding...
May 9, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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