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https://www.readbyqxmd.com/read/28799998/use-of-direct-oral-anticoagulants-for-treatment-of-atrial-fibrillation-in-patients-with-hiv-a-review
#1
Timothy A West, Jacinta Perram, Cameron J Holloway
PURPOSE OF REVIEW: Atrial fibrillation is increasingly common in the ageing population. Patients with atrial fibrillation and HIV have a higher stroke risk, with guidelines recommending anticoagulation in the majority. Whilst anticoagulation options have diversified in the last decade for the general population, there is limited evidence for the safety and efficacy of these medications when used concurrently with antiretroviral therapy. We review the potential for patients with HIV on antiretroviral therapy to have direct-acting oral anticoagulations (DOACs)...
August 10, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28781025/changes-in-oral-anticoagulant-prescribing-for-stroke-prevention-in-patients-with-atrial-fibrillation
#2
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
Suboptimal guideline adherence and underuse of anticoagulants in patients with atrial fibrillation (AF) have been reported worldwide. This study aimed to compare anticoagulation practice in Australia during the pre- and postdirect oral anticoagulant (DOAC) eras. Between January 2011 and July 2015, patients with nonvalvular AF (NVAF) admitted to the Royal Hobart Hospital, Tasmania, Australia, were retrospectively reviewed. The pre- and post-DOAC era cohorts included admissions from January 2011 to July 2013 and August 2013 to July 2015, respectively...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28780343/the-role-of-heparin-lead-in-in-the-real-world-management-of-acute-venous-thromboembolism-the-prefer-in-vte-registry
#3
Rupert Bauersachs, Giancarlo Agnelli, Anselm K Gitt, Manuel Monreal, Patrick Mismetti, Stefan N Willich, Petra Laeis, Eva-Maria Fronk, Peter Bramlage, Alexander T Cohen
INTRODUCTION: The appropriate strategy for initiating oral anticoagulant (OAC) therapy after an acute venous thromboembolism (VTE) depends on the intermediate-term anticoagulant to be used. While heparin bridging to vitamin K antagonists (VKA) is required, the direct oral anticoagulants (DOAC) rivaroxaban (30mg/day) and apixaban (10mg/day) can be initiated directly without parenteral anticoagulation. The objective was to evaluate OAC initiation patterns in clinical practice. MATERIALS AND METHODS: PREFER in VTE was an international, non-interventional registry conducted between January 2013 and August 2015...
July 28, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28765760/study-design-of-general-general-practitioners-and-embolism-prevention-in-nvaf-patients-treated-with-rivaroxaban-real-life-evidence-a-multicenter-prospective-cohort-study-in-primary-care-physicians-to-investigate-the-effectiveness-and-safety-of-rivaroxaban-in
#4
Kengo Kusano, Masaharu Akao, Hikari Tsuji, Kunihiko Matsui, Shinya Hiramitsu, Yutaka Hatori, Hironori Odakura
BACKGROUND: Rivaroxaban, a direct oral anticoagulant (DOAC), has become available for stroke prevention in patients with non-valular atrial fibrillation (NVAF). However, little is known about its effectiveness and safety when prescribed by general practitioners in real-life settings. METHODS: GENERAL is a multicenter, prospective, non-interventional observational study of patients receiving rivaroxaban for NVAF in daily clinical practice prescribed specifically by general practitioners...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28713563/recent-advances-in-the-treatment-of-venous-thromboembolism-in-the-era-of-the-direct-oral-anticoagulants
#5
REVIEW
Jeffrey I Weitz, Iqbal H Jaffer, James C Fredenburgh
The direct oral anticoagulants (DOACs) have now supplanted vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE). The DOACs include dabigatran, which inhibits thrombin, and rivaroxaban, apixaban, and edoxaban, which inhibit factor Xa. The DOACs are as effective for the prevention of recurrence as conventional VTE treatment, consisting of a parenteral anticoagulant followed by a VKA, and are associated with less bleeding. Because of these properties and the convenience of fixed dosing without the need for routine coagulation monitoring, guidelines now recommend DOACs over VKAs for VTE treatment in patients without active cancer...
2017: F1000Research
https://www.readbyqxmd.com/read/28656545/is-it-reasonable-to-use-a-lower-doac-dose-in-some-patients-with-vte-no
#6
Francesco Dentali, Chiara Fantoni
The international guidelines recommend the use of direct oral anticoagulants (DOACs) over vitamin K antagonists for anticoagulation long-term therapy in patients diagnosed with venous thromboembolism (VTE), and for stroke prevention in patients with non-valvular atrial fibrillation (AF). Efficacy and safety of DOACS have been extensively evaluated in large phase III trials. According to the product label, dose reductions of DOACs are recommended for patients with AF and renal impairment, low body weight and concomitant use of interfering medications...
August 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28635085/venous-thromboembolism-management-in-northeast-melbourne-how-does-it-compare-to-international-guidelines-and-data
#7
Hui Yin Lim, Chong Chyn Chua, Mark Tacey, Matthew Sleeman, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
BACKGROUND: Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and international guidelines. AIMS: To provide a holistic evaluation of "real-world" Australian experience in the warfarin era, including how we compare to international guidelines. METHODS: Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia...
June 21, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28596467/-embolic-stroke-of-undetermined-source
#8
Teruyuki Hirano
A new clinical construct, embolic stroke of undetermined source (ESUS) was established as a therapeutically relevant entity, which are defined as a non-lacunar infarction without proximal arterial stenosis or cardioembolic sources, with a clear indication for anticoagulation, especially with direct oral anticoagulant (DOAC). The possible embolic sources include covert atrial fibrillation, arterial stenosis with <50%, low-risk emboligenic cardiac sources, aortic plaque, cancer-associated, and paradoxical embolism...
June 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28587584/strategies-to-optimize-dual-antiplatelet-therapy-after-coronary-artery-stenting-in-acute-coronary-syndrome
#9
Bridget Paravattil, Hazem Elewa
The use of aspirin and a P2Y12 receptor antagonist as dual antiplatelet therapy (DAPT) has become the treatment of choice in patients with acute coronary syndrome (ACS) and percutaneous coronary intervention to prevent recurrent thrombotic events. Although DAPT is beneficial for most patients, few patients still experience recurrent thrombotic events and increased bleeding episodes. This article reviews current literature to identify various approaches that may enhance the DAPT benefit-risk ratio in patients with ACS...
July 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28540489/endoscopy-in-patients-on-antiplatelet-agents-and-anticoagulants
#10
REVIEW
Andrew M Veitch
Management of patients on anticoagulant or antiplatelet therapy undergoing endoscopy presents a balance of risks between haemorrhage due to the procedure, and thrombosis due to discontinuation of antithrombotic therapy. Haemorrhage is usually controllable endoscopically, but thrombosis could, on occasion, result in myocardial infarction or stroke, with permanent disability or death. For elective procedures, there is adequate time to plan best management of antithrombotic therapy. International guidelines have been published, but recommendations are based on limited evidence and consultation with appropriate medical specialists, and the patient is important...
June 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28515674/perioperative-management-of-patients-on-direct-oral-anticoagulants
#11
REVIEW
Virginie Dubois, Anne-Sophie Dincq, Jonathan Douxfils, Brigitte Ickx, Charles-Marc Samama, Jean-Michel Dogné, Maximilien Gourdin, Bernard Chatelain, François Mullier, Sarah Lessire
Direct oral anticoagulants (DOACs) have been licensed worldwide for several years for various indications. Each year, 10-15% of patients on oral anticoagulants will undergo an invasive procedure and expert groups have issued several guidelines on perioperative management in such situations. The perioperative guidelines have undergone numerous updates as clinical experience of emergency management has increased and perioperative studies including measurement of residual anticoagulant levels have been published...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28508916/direct-oral-anticoagulants-for-the-treatment-of-cancer-associated-venous-thromboembolism-what-do-we-know-so-far
#12
Minna Voigtlaender, Florian Langer
Cancer patients with venous thromboembolism (VTE) are at increased risk for both bleeding and VTE recurrence. Anticoagulation with low-molecular-weight heparin (LMWH) is the standard of care during the initial and long-term treatment phase (i.e. during the first 3 - 6 months of therapy) based on its overall beneficial safety and efficacy profile compared to vitamin K antagonists (VKAs). The direct oral anticoagulants (DOACs) rivaroxaban, apixaban, edoxaban, and dabigatran are approved for the treatment of acute VTE, and the combined six phase-3 trials have included > 1500 patients with active cancer, as defined by variable selection criteria...
May 16, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28475278/anticoagulation-bridge-therapy-in-patients-with-atrial-fibrillation-recent-updates-providing-a-rebalance-of-risk-and-benefit
#13
Candice L Garwood, Bianca Korkis, Domenico Grande, Claudia Hanni, Amy Morin, Lynette R Moser
In 2011 we reviewed clinical updates and controversies surrounding anticoagulation bridge therapy in patients with atrial fibrillation (AF). Since then, options for oral anticoagulation have expanded with the addition of four direct oral anticoagulant (DOAC) agents available in the United States. Nonetheless, vitamin K antagonist (VKA) therapy continues to be the treatment of choice for patients who are poor candidates for a DOAC and for whom bridge therapy remains a therapeutic dilemma. This literature review identifies evidence and guideline and consensus statements from the last 5 years to provide updated recommendations and insight into bridge therapy for patients using a VKA for AF...
June 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28455651/-management-of-hemorrhage-in-patients-treated-with-direct-oral-anticoagulants
#14
REVIEW
O Grottke, H Lier, S Hofer
The introduction of nonvitamin K antagonistic, direct oral anticoagulants (DOAC) made thromboembolic prophylaxis easier for patients. For many physicians, however, there is still uncertainty about monitoring, preoperative discontinuation, and restarting of DOAC therapy. Guidelines for the management of bleeding are provided, but require specific therapeutic skills in the management of diagnostics and therapy of acute hemorrhage. Small clinical studies and case reports indicate that unspecific therapy with prothrombin complex concentrates (PCC) and activated PCC (aPCC) concentrate may reverse DOAC-induced anticoagulation...
April 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28412908/news-in-the-indications-of-non-vitamin-k-oral-anticoagulants-according-to-the-guidelines-of-the-american-college-of-chest-physicians-2016
#15
Gabriela Cesarman-Maus, Guillermo J. Ruiz-Argüelles
Antithrombotic guidelines published by the Chest Journal, the official publication of the American College of Chest Physicians (ACCP), are continuously updated as clinically relevant information accumulates. The Evidence-Based Clinical Practice Guidelines on antithrombotic therapy and prevention of thrombosis were published in 2012. This year, the topic that has been updated pertains to antithrombotic therapy, specifically addressing prophylaxis and treatment of venous thromboembolic (VTE) disease. In this paper, I focus on these guidelines regarding the indications or lack thereof for the use of Non-vitamin K-antagonist Oral Anticoagulants (NOACS), also referred to as Direct-acting Oral Anticoagulants (DOACS)...
April 13, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/28400546/management-of-bleeding-or-urgent-interventions-in-patients-treated-with-direct-oral-anticoagulants-2017-recommendations-for-poland
#16
Piotr Pruszczyk, Anna Tomaszuk-Kazberuk, Agnieszka Słowik, Rafał Drwiła, Grażyna Rydzewska, Krzysztof J Filipiak, Zbigniew Gaciong, Jarosław Kaźmierczak, Wojciech Marczyński, Jerzy Windyga, Adam Kobayashi, Janina Stepińska
Direct oral anticoagulants (DOACs) such as apixaban, dabigatran, edoxaban, and rivaroxaban are mainly used in the prevention of thromboembolic complications in patients with atrial fibrillation (AF) and in the treatment of venous thromboembolism. As compared with vitamin K antagonists (VKAs), they are characterized by at least similar efficacy and better safety profiles, especially with respect to intracranial hemorrhages. Moreover, they are more convenient therapeutic agents. The 2016 European Society of Cardiology guidelines clearly favor DOACs over VKAs in patients with AF...
May 31, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28328524/paramagnetic-micro-particles-as-a-tool-for-rapid-quantification-of-apixaban-dabigatran-edoxaban-and-rivaroxaban-in-human-plasma-by-uhplc-ms-ms
#17
Martin H J Wiesen, Cornelia Blaich, Thomas Streichert, Guido Michels, Carsten Müller
BACKGROUND: Assessment of the anticoagulant activity of direct oral anticoagulants (DOACs) is justified in special clinical situations. Here, we evaluated two independent extraction methods and developed a multi-analyte ultra-high performance liquid chromatography tandem mass (UHPLC-MS/MS) method for the quantification of apixaban, dabigatran, edoxaban and rivaroxaban in human plasma. METHODS: Routine extraction based on protein precipitation with acetonitrile and subsequent centrifugation was compared to sample clean-up using commercial paramagnetic micro-particles and subsequent magnetic depletion...
August 28, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28222250/long-term-treatment-of-cancer-associated-thrombosis-the-choice-of-the-optimal-anticoagulant
#18
REVIEW
I Elalamy, I Mahé, W Ageno, G Meyer
Patients with cancer-associated thrombosis (CAT) carry a higher risk of recurrence, bleeding and mortality as compared with non-cancer patients. The specific profiles of cancer patients, combining frequent co-morbidities, the use of anti-tumoral therapies and the cancer progression itself, represent a major therapeutic challenge for choosing a long-term anticoagulant treatment. This review discusses the practical basis of making a choice between the available drugs for a long-term antithrombotic strategy, linked to their pharmacology, mechanism of action, evidence of clinical benefits, and advantages and limitations in such a complex clinical context...
May 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28208196/the-novel-oral-anticoagulants-for-acute-venous-thromboembolism-is-warfarin-dead
#19
Alexander T Cohen, Serena Granziera, Nicola Veronese, Giacomo Zoppellaro
The direct oral anticoagulants (DOACs) have been compared with parenteral anticoagulants and vitamin K antagonists (VKAs) for the treatment of venous thromboembolism (VTE) in several robust studies. DOACs have shown similar efficacy in preventing recurrent VTE and significant reductions in critical site (intracranial) bleeding, fatal bleeding, major and nonmajor bleeding. Warfarin and other VKAs are not dead as treatment modalities for VTE. A better way to describe the current situation is to use a boxing expression, "down but not out...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28050712/optimizing-the-use-of-oral-anticoagulant-therapy-for-atrial-fibrilation-in-primary-care-a-pharmacist-led-intervention
#20
Mandeep S Virdee, Derek Stewart
Background Updated evidence-based guidelines for the management of atrial fibrillation (AF) necessitate patient review, particularly with respect to oral anticoagulants, to ensure maximum health gain around stroke prophylaxis. Objective To quantify the level of anticoagulation utilisation in patients with a CHA2DS2-VASc ≥1/≥2 (male/female) according to evidence-based guidelines and to assess the impact of a pharmacist-led intervention to optimise therapy. Setting Fifteen general medical practices in Liverpool, North-West England with a practice population of 99,129...
February 2017: International Journal of Clinical Pharmacy
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