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direct oral anticoagulants guidelines

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https://www.readbyqxmd.com/read/29768672/catheter-ablation-for-atrial-fibrillation-on-uninterrupted-direct-oral-anticoagulants-a-safe-approach
#1
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/29733468/guidelines-for-gastroenterological-endoscopy-in-patients-undergoing-antithrombotic-treatment-2017-appendix-on-anticoagulants-including-direct-oral-anticoagulants-doacs
#2
REVIEW
Mototsugu Kato, Noriya Uedo, Seiji Hokimoto, Masahiro Ieko, Kazuhide Higuchi, Kazunari Murakami, Kazuma Fujimoto
In 2012, the Japan Gastroenterological Endoscopy Society has published "Guidelines for Gastroenterological Endoscopy in Patients Undergoing Antithrombotic Treatment" concerning thromboembolism associated with antithrombotic therapy withdrawal. Since then, physicians have started prescribing oral anticoagulants, creating a need for standards reflecting their use in clinical practice. Therefore, new findings regarding anticoagulants are included in this appendix. However, the evidence levels are low for many statements contained herein and these appended guidelines still need to be verified in clinical settings...
May 7, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/29703477/treatment-of-venous-thromboembolism-in-patients-with-cancer-what-news-from-clinical-trials
#3
Melina Verso, Laura Franco, Michela Giustozzi, Cecilia Becattini, Giancarlo Agnelli
About 15% of patients with cancer experience one or more episodes of venous thromboembolism (VTE) during the course of their disease. In patients with cancer, VTE has a substantial impact on the quality of life and care. Current guidelines recommend low-molecular-weight heparin (LMWH) as first choice therapy for long-term anticoagulation in cancer patients with VTE. However, there are several practical issues concerning the long-term use of these anticoagulants. In the last years, several direct oral anticoagulants (DOACs) have emerged as alternatives to heparins and vitamin K antagonists for the treatment of VTE, but data regarding both efficacy and safety of DOACs in the subgroup of patients with cancer treatments were limited...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29703470/apixaban-for-the-prevention-of-venous-thromboembolism-in-high-risk-ambulatory-cancer-patients-receiving-chemotherapy-rational-and-design-of-the-avert-trial
#4
Miriam Kimpton, Philip S Wells, Marc Carrier
Patients with active cancer have a heightened risk of venous thromboembolism (VTE). This risk is further increased by the initiation of chemotherapy. Although previous studies have suggested that the use of parenteral thromboprophylaxis in all ambulatory cancer patients receiving chemotherapy significantly decreases the rate of VTE, current clinical practice guidelines do not recommend routine use of thromboprophylaxis in this patient population. A major criticism of these studies has been the inclusion of patients at lower risk for VTE, which may have diluted the potential beneficial effect of the parenteral thromboprophylaxis...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29700696/the-vexed-question-of-whether-or-not-to-measure-levels-of-direct-oral-anticoagulants-before-surgery-or-invasive-procedures
#5
REVIEW
Armando Tripodi, Francesco Marongiu, Marco Moia, Gualtiero Palareti, Vittorio Pengo, Daniela Poli, Domenico Prisco, Sophie Testa, Maria Zanazzi
Direct oral anticoagulants (DOAC) possess high bioavailability, and their anticoagulant effect is more predictable than that of vitamin K antagonists, hence they do not require routine dose adjustment based on laboratory testing. However, there are circumstances when laboratory testing may be useful, including patients who need to undergo surgery or invasive procedures. Most guidelines state that patients on DOAC may safely undergo surgery/invasive procedures by stopping anticoagulation for a few days before intervention without testing if renal function is within normal limits...
April 26, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29691276/asia-pacific-working-group-consensus-on-non-variceal-upper-gastrointestinal-bleeding-an-update-2018
#6
Joseph Jy Sung, Philip Cy Chiu, Francis K L Chan, James Yw Lau, Khean-Lee Goh, Lawrence Hy Ho, Hwoon-Young Jung, Jose D Sollano, Takuji Gotoda, Nageshwar Reddy, Rajvinder Singh, Kentaro Sugano, Kai-Chun Wu, Chun-Yin Wu, David J Bjorkman, Dennis M Jensen, Ernst J Kuipers, Angel Lanas
Non-variceal upper gastrointestinal bleeding remains an important emergency condition, leading to significant morbidity and mortality. As endoscopic therapy is the 'gold standard' of management, treatment of these patients can be considered in three stages: pre-endoscopic treatment, endoscopic haemostasis and post-endoscopic management. Since publication of the Asia-Pacific consensus on non-variceal upper gastrointestinal bleeding (NVUGIB) 7 years ago, there have been significant advancements in the clinical management of patients in all three stages...
April 24, 2018: Gut
https://www.readbyqxmd.com/read/29663464/uninterrupted-administration-of-edoxaban-vs-vitamin-k-antagonists-in-patients-undergoing-atrial-fibrillation-catheter-ablation-rationale-and-design-of-the-eliminate-af-study
#7
Stefan H Hohnloser, John Camm, Riccardo Cappato, Hans-Christoph Diener, Hein Heidbuchel, Hans-Joachim Lanz, Lluís Mont, Carlos A Morillo, Rüdiger Smolnik, Ophelia Q P Yin, Josef Kautzner
Patients with atrial fibrillation (AF) are at an approximately 0.5% to 3% increased risk of thromboembolism during and immediately after catheter ablation. Treatment guidelines recommend periprocedural oral anticoagulation plus unfractionated heparin during ablation. Rivaroxaban and dabigatran are the only non-vitamin K oral anticoagulants for which there are randomized controlled trials assessing uninterrupted anticoagulation in patients undergoing catheter ablation of AF. Edoxaban, a direct factor Xa inhibitor, is noninferior vs warfarin for the prevention of stroke or systemic embolism with less major bleeding in patients with nonvalvular AF...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29662292/post-polypectomy-bleeding-and-thromboembolism-risks-associated-with-warfarin-vs-direct-oral-anticoagulants
#8
Naohiro Yanagisawa, Naoyoshi Nagata, Kazuhiro Watanabe, Tatsuhiro Iida, Mariko Hamada, Sakurako Kobayashi, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
AIM: To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants (DOAC). METHODS: We collected data from 218 patients receiving oral anticoagulants (73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics (age- and sex-matched controls) who underwent polypectomy. (1) We evaluated post-polypectomy bleeding (PPB) risk in patients receiving warfarin or DOAC compared with controls; (2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge (HPB) (endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29661489/comparison-of-the-effects-of-edoxaban-an-oral-direct-factor-xa-inhibitor-on-venous-thromboembolism-between-patients-with-and-without-cancer
#9
Satoshi Ikeda, Seiji Koga, Yuki Yamagata, Masamichi Eguchi, Daisuke Sato, Takahiro Muroya, Tsuyoshi Yonekura, Akira Tsuneto, Tsuyoshi Yoshimuta, Yuji Koide, Hiroaki Kawano, Koji Maemura
BACKGROUND: Venous thromboembolism (VTE) is a frequent and serious complication of cancer. The current guidelines in the USA and Europe recommend low-molecular weight heparin (LMWH) for the treatment of cancer-associated VTE. In Japan, LMWH is not given for the treatment of VTE; instead edoxaban, an oral direct factor Xa inhibitor, was approved for the treatment of VTE in September 2014. However, the efficacy and safety of the factor Xa inhibitor in cancer patients have not been fully elucidated...
April 13, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29650686/use-of-direct-oral-anticoagulants-in-patients-with-cancer-practical-considerations-for-the-management-of-patients-with-nausea-or-vomiting
#10
REVIEW
Hanno Riess, Cihan Ay, Rupert Bauersachs, Cecilia Becattini, Jan Beyer-Westendorf, Francis Cajfinger, Ian Chau, Alexander T Cohen, Alok A Khorana, Anthony Maraveyas, Marcos Renni, Annie M Young
Direct oral anticoagulants (DOACs) have proven efficacy and safety and are approved for use in the prevention and treatment of thromboembolic events in patients with venous thromboembolism (VTE) and those with atrial fibrillation (AF). There is no clear guidance on the use of DOACs in the significant proportion of these patients who have or will develop concomitant cancer. The occurrence of nausea and vomiting in these patients, despite implementation of guideline-recommended antiemetic strategies, is a particular concern because it may affect oral drug intake and consequently outcomes with anticoagulation therapy...
April 12, 2018: Oncologist
https://www.readbyqxmd.com/read/29617053/efficacy-and-safety-of-rivaroxaban-compared-to-enoxaparin-in-treatment-of-cancer-associated-venous-thromboembolism
#11
Benjamin Simmons, Waldemar Wysokinski, Rayya A Saadiq, Dalene Bott-Kitslaar, Stanislav Henkin, Ana Casanegra, Charles Lenz, Paul Daniels, Haraldur Bjarnason, Emily Vargas, David Hodge, Sara J Holton, James R Cerhan, Charles Loprinzi, Robert McBane
BACKGROUND: Low molecular weight heparin (LMWH) is the guideline endorsed treatment for cancer associated venous thromboembolism (cVTE). Study objectives were to compare the efficacy and safety of rivaroxaban and enoxaparin in cVTE. METHODS: Using a cohort study design, consecutive patients with cVTE (3/1/2013-7/31/2016), enrolled in the Mayo Thrombophilia Clinic Direct Oral Anticoagulants Registry were compared to contemporary cancer patients receiving enoxaparin...
April 4, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29602444/tromboc-t-working-group-recommendations-for-management-in-patients-receiving-direct-oral-anticoagulants
#12
Pável Olivera, Miren Gabilondo, Mireia Constans, Dolors Tàssies, Esther Plensa, Verónica Pons, Germán Las Heras, Carmen Jiménez, Desirée Campoy, Anna Bustins, Artur Oliver, Cristina Marzo, Tania Canals, Anna Varela, Marc Sorigue, Eva Sánchez, Gabriela Ene, Granada Perea, Laura Vicente, Meritxell López, María Cerdá, Erik Johansson, M Reyes Aguinaco, Nazly Santos, José Mateo, Joan Carles Reverter, Ángel Moya, Amparo Santamaría
BACKGROUND AND OBJECTIVES: In recent years, direct oral anticoagulants (DOACs) have become an alternative to vitamin K antagonists (VKA) for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF) as well as for prevention and treatment of deep venous thrombosis. Pivotal trials have demonstrated non-inferiority and potential superiority compared to warfarin, which increases the options of anticoagulant treatment. In our setting, the Anticoagulant Treatment Units (ATUs) and Primary Care Centres (PCCs) play an important role in the education, follow-up, adherence control and management in special situations of anticoagulated patients...
March 27, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29593860/potential-drug-drug-interactions-with-direct-oral-anticoagulants-in-elderly-hospitalized-patients
#13
Heather L Forbes, Thomas M Polasek
Background: To determine the prevalence and nature of potential drug-drug interactions (DDIs) with direct oral anticoagulants (DOACs) in elderly hospitalized patients. Methods: This was a retrospective observational study. Inclusion criteria were: aged over 65 years; taking apixaban, rivaroxaban or dabigatran; and admitted to the Repatriation General Hospital between April 2014 and July 2015. A list of clinically relevant 'perpetrator' drugs was compiled from product information, the Australian Medicines Handbook, the Australian National Prescribing Service resources, and local health network guidelines...
October 2017: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/29589063/patterns-of-direct-oral-anticoagulant-drug-prescription-in-france-in-2010-2013-a-study-in-the-midi-pyr%C3%A3-n%C3%A3-es-area
#14
Hugo Diaz, Haleh Bagheri, Aurore Palmaro, Vanessa Rousseau, Robert Bourrel, Jean-Louis Montastruc, Jordan Birebent
AIM: The aim of our study was to study the pattern of prescription of direct-acting oral anticoagulants (DOACs) according to the French recommendations. METHODS: We performed a cross-sectional study using anonymous data of patients covered by the French National Health Insurance information system (SNIIRAM) from 1 January 2010 to 31 December 2013 in the area of Midi-Pyrénées (southwest of France). RESULTS: Of the 355,608 patients identified, 325,216 (91...
March 27, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29588359/antiphospholipid-syndrome-presenting-as-acute-mesenteric-venous-thrombosis-involving-a-variant-inferior-mesenteric-vein-and-successful-treatment-with-rivaroxaban
#15
Kevin Singh, Gulam Khan
Acute mesenteric venous thrombosis (MVT) is the rarest cause of acute mesenteric ischaemia, so thrombosis of a variant inferior mesenteric vein (IMV) is especially uncommon in the setting of antiphospholipid syndrome (APS). Here, we present such a case of seronegative APS initially manifesting as an anomalous IMV thrombosis in a 76-year-old woman. Although guidelines support anticoagulation with vitamin K antagonists in these patients, we anticoagulated with rivaroxaban (a direct oral anticoagulant (DOAC)) due to patient preference, which resulted in complete clinical and endoscopic resolution...
March 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29578847/development-of-quality-indicators-to-assess-oral-anticoagulant-management-in-community-pharmacies-for-patients-with-atrial-fibrillation
#16
Mylène Chartrand, Line Guénette, Denis Brouillette, Stéphane Côté, Roger Huot, Jérôme Landry, Josée Martineau, Sylvie Perreault, Brian White-Guay, David Williamson, Élisabeth Martin, Marie-Mireille Gagnon, Lyne Lalonde
BACKGROUND: Few studies have evaluated the quality of oral anticoagulant management by community pharmacists. There is no complete set of quality indicators available for this purpose. OBJECTIVE: To develop a set of specific quality indicators to assess oral anticoagulant management by community pharmacists for patients with atrial fibrillation (AF). METHODS: Quality indicators were developed in 3 phases. In phase 1, potential quality indicators were generated based on clinical guidelines and a literature review...
April 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29570900/temporal-trends-in-safety-and-complication-rates-of-catheter-ablation-for-atrial-fibrillation
#17
Rahul G Muthalaly, Roy M John, Benjamin Schaeffer, Shinichi Tanigawa, Tomofumi Nakamura, Sunil Kapur, Paul C Zei, Laurence M Epstein, Usha B Tedrow, Gregory F Michaud, William G Stevenson, Bruce A Koplan
INTRODUCTION: Atrial fibrillation (AF) ablation is increasingly common, but is associated with potential major complications. Technology, experience and protocols have evolved significantly in recent times, and may have impacted procedural safety. We sought to compare AF ablation safety profiles, including complication rates and fluoroscopy times in a 'modern' versus 'historical' cohort. METHODS AND RESULTS: We evaluated consecutive patients undergoing AF ablation from a modern cohort (MC) from 2014 to 2015 and a historic cohort (HC) from 2009 to 2011 for complications...
March 23, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29570366/therapeutic-approach-for-patients-with-venous-thromboembolism-attended-in-emergency-departments-during-routine-clinical-practice-the-edith-study
#18
Pedro Ruiz-Artacho, Pascual Piñera, Albert Antolin, José Ramón Casal, Marta Sanchez, Coral Suero, Marta Merlo, Jorge Carriel, Mar Genis, Sonia Jimenez
AIM: To analyze treatment at discharge/follow-up of patients diagnosed with venous thromboembolism (VTE) in the emergency department (ED). MATERIALS & METHODS: Ambispective study (50 Spanish centers) of consecutive patients (October-December 2014) with VTE diagnosed in ED. RESULTS: VTE was diagnosed in 775 patients (295 pulmonary embolism [PE] without deep vein thrombosis [DVT], 389 DVT without PE and 91 PE + DVT); 95.5% received anticoagulants (90...
April 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29537161/management-of-antithrombotic-agents-in-dermatologic-surgery-before-and-after-publication-of-the-corresponding-german-evidence-based-guideline
#19
Matthew Gaskins, Martin Dittmann, Lisa Eisert, Ricardo Niklas Werner, Corinna Dressler, Christoph Löser, Alexander Nast
BACKGROUND: A survey in 2012 revealed marked heterogeneity in the management of antithrombotic agents in dermatologic surgery in Germany. An evidence-based guideline on this topic was published for the first time in 2014. METHODS: Using the same study sample, we conducted an anonymous survey on the management of antithrombotic agents and familiarity with the guideline. We reported the results as relative frequencies and compared them with those from 2012. RESULTS: We analyzed a total of 208 questionnaires (response rate: 36...
March 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29532536/peri-procedural-management-of-anticoagulation-for-atrial-fibrillation-catheter-ablation-in-direct-oral-anticoagulant-treated-patients
#20
Anne-Céline Martin, Sarah Lessire, Isabelle Leblanc, Anne-Sophie Dincq, Ivan Philip, Isabelle Gouin-Thibault, Anne Godier
BACKGROUND: Guidelines recommend to perform atrial fibrillation (AF) catheter ablation without interruption of direct oral anticoagulant (DOAC) and to administer unfractionated heparin (UFH) for an activated clotting time (ACT) ≥300 seconds, by analogy with vitamin K antagonist (VKA). Nevertheless, pharmacological differences between DOAC and VKA, especially regarding ACT sensitivity and UFH response, prevent extrapolation from VKA to DOAC. HYPOTHESIS: The level of anticoagulation at the time of the procedure in uninterrupted DOAC-treated patients is unpredictable, and would complicate intra-procedural UFH administration and monitoring...
March 13, 2018: Clinical Cardiology
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