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direct oral anticoagulants guidelines

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https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#1
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28042443/differences-between-warfarin-and-new-oral-anticoagulants-in-dental-clinical-practice
#2
REVIEW
M Miranda, L S Martinez, R Franco, V Forte, A Barlattani, P Bollero
The oral anticoagulant therapy is used for the cure and the prevention of thromboembolic diseases. In the last fifty years the warfarin has been considered the oral anticoagulant of choice. However, its use is limited by a narrow therapeutic index and by a complex pharmacodynamics, which requires regular adjustments and monitoring of the dose. Recently, three new oral anticoagulant - dabigatran etexilato (direct thrombin inhibitor), rivaroxaban and apixaban (Xa factor direct inhibitor) - have been approved for use in europe...
July 2016: Oral & Implantology
https://www.readbyqxmd.com/read/28029563/-use-of-non-vitamin-k-antagonist-oral-anticoagulants-in-primary-care-actua-study
#3
V Barrios, C Escobar, J M Lobos, J Polo, D Vargas
OBJECTIVES: Approximately 40% of patients with non-valvular auricular fibrillation (NVAF) who receive vitamin K antagonists (VKA) in Primary Care in Spain have poor anticoagulation control. The objective of the study Actuación en antiCoagulación, Tratamiento y Uso de anticoagulantes orales de acción directa (ACOD) en Atención primaria (ACTUA) (Action in Coagulation, Treatment and Use of direct oral anticoagulants [DOACs]) in Primary Care) was to analyse the current situation regarding the use of VKA and non-vitamin K antagonist oral anticoagulants (NOACs) in patients with NVAF in Primary Care in Spain and the possible issues arising from it...
October 28, 2016: Semergen
https://www.readbyqxmd.com/read/28012224/continuation-of-low-molecular-weight-heparin-treatment-for-cancer-related-venous-thromboembolism-a-prospective-cohort-study-in-daily-clinical-practice
#4
S J van der Wall, F A Klok, P L den Exter, D Barrios, R Morillo, S C Cannegieter, D Jimenez, M V Huisman
: Essentials Low-molecular-weight heparin (LMWH) injections for venous thromboembolism (VTE) may be burdensome. Patients with active cancer and confirmed VTE were included to evaluate LMWH continuation. The cumulative incidence of discontinuation was 21% after a median period of 90 days. One out of five patients discontinued LMWH injections because of side effects. SUMMARY: Background Current guidelines recommend low -molecular -weight heparin (LMWH) monotherapy for 3-6 months as the first-line treatment for cancer-associated venous thromboembolism (VTE)...
November 5, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28004413/direct-oral-anticoagulant-use-in-nonvalvular-atrial-fibrillation-with-valvular-heart-disease-a-systematic-review
#5
REVIEW
Ryan E Owens, Rajesh Kabra, Carrie S Oliphant
Direct oral anticoagulants (DOACs) are indicated for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), which, according to the American College of Cardiology/American Heart Association/Heart Rhythm Society atrial fibrillation (AF) guidelines, excludes patients with rheumatic mitral stenosis, a mechanical or bioprosthetic heart valve, or mitral valve repair. However, the data regarding use of DOACs in AF patients with other types of valvular heart disease (VHD) are unclear. We aimed to summarize and evaluate the literature regarding the safety and efficacy of DOAC use in NVAF patients with other types of VHD...
December 22, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27995007/direct-new-oral-anticoagulants-follow-up-guidelines-and-bleeding-complications-in-general-practice-a-survey-of-swiss-general-internal-medicine-practitioners
#6
Thomas C Sauter, Carlo Melis, Wolf E Hautz, Meret E Ricklin, Aristomenis K Exadaktylos
BACKGROUND: The present study investigated how much Swiss general internal medicine practitioners (GPs) know about new direct oral anticoagulants (NOACs), particularly the relevant guidelines, follow-up tests, dosing adjustments, indications and complications. We conducted a paper-based survey of GPs, performed in Bern, Switzerland. Our questionnaire assessed the physicians' preference for NOACs rather than vitamin K antagonists (VKA), prevalence and choice of NOAC, clinical follow-up including follow-up blood testing, and bleeding complications...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27909544/reducing-the-risk-of-stroke-in-patients-with-nonvalvular-atrial-fibrillation-with-direct-oral-anticoagulants-is-one-of-these-not-like-the-others
#7
REVIEW
Paul P Dobesh Pharm D, John Fanikos Mba R Ph
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and increases risk of stroke by nearly 5-fold. While warfarin has been employed successfully to reduce the risk of stroke in these patients, there are a number of challenges with therapy. These include the need for therapeutic monitoring due to variability in patient response, frequent dose adjustments, numerous drug-drug, drug-food, and drug-disease interactions, and a heightened risk of thrombosis and bleeding due to these issues. Current guidelines recommend that the vitamin K antagonists (VKA) or direct oral anticoagulants (DOACs) should be used for thromboprophylaxis in patients with nonvalvular AF at risk for stroke or systemic embolic events...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27869893/-anmco-position-paper-recommendations-for-the-follow-up-of-patients-with-pulmonary-thromboembolism
#8
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is the third most common cause of cardiovascular death. The management of the acute phase of VTE is well described in several papers and guidelines, whereas the management of the follow-up of the patients affected from VTE is less defined. This position paper of the Italian Association of Hospital Cardiologists (ANMCO) tries to fill the gap using currently available evidence and the opinion of the experts to suggest the most useful way to manage patients in the chronic phase...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27836786/non-vitamin-k-antagonist-oral-anticoagulants-and-heart-failure
#9
REVIEW
Richard Isnard, Fabrice Bauer, Alain Cohen-Solal, Thibaud Damy, Erwan Donal, Michel Galinier, Albert Hagège, Patrick Jourdain, Christophe Leclercq, Rémi Sabatier, Jean-Noël Trochu, Ariel Cohen
Thromboembolism contributes to morbidity and mortality in patients with heart failure (HF), and atrial fibrillation (AF) is one of the main factors promoting this complication. As they share many risk factors, HF and AF frequently coexist, and patients with both conditions are at a particularly high risk of thromboembolism. Non-vitamin K antagonist oral anticoagulants (NOACs) are direct antagonists of thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban and edoxaban), and were designed to overcome the limitations of vitamin K antagonists...
November 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27780804/how-i-use-anticoagulation-in-atrial-fibrillation
#10
REVIEW
Benjamin A Steinberg
Atrial fibrillation is the most common cardiac arrhythmia and conveys a significant risk of morbidity and mortality due to related stroke and systemic embolism. Oral anticoagulation (OAC) is the mainstay of thromboembolism prevention, and management of anticoagulation can be challenging. For patients without significant valvular disease, decisions around anticoagulation therapy are first based on the presence of additional stroke risk factors, as measured by the CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75, diabetes, prior stroke or transient ischemic attack, vascular disease, age 65-74, and sex category [female]) score...
December 22, 2016: Blood
https://www.readbyqxmd.com/read/27766052/cancer-associated-thrombosis-in-asia
#11
Pantep Angchaisuksiri
Thrombosis is a common complication in cancer patients. Although the major inherited risk factors for thrombophilia are different between Asians and Caucasians, the main acquired risk factors that are associated with the development of venous thromboembolism (VTE) in Asians appear to be similar to those for Caucasians. Malignancy is the most important acquired risk factor for VTE in Asians. Recent studies have shown that the incidence of VTE is significant in Asian patients with cancer, particularly those in an advanced stage...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27766049/management-of-venous-thromboembolism-an-update
#12
REVIEW
Siavash Piran, Sam Schulman
Venous thromboembolism (VTE), which constitutes pulmonary embolism and deep vein thrombosis, is a common disorder associated with significant morbidity and mortality. Landmark trials have shown that direct oral anticoagulants (DOACs) are as effective as conventional anticoagulation with vitamin K antagonists (VKA) in prevention of VTE recurrence and associated with less bleeding. This has paved the way for the recently published guidelines to change their recommendations in favor of DOACs in acute and long-term treatment of VTE in patients without cancer...
2016: Thrombosis Journal
https://www.readbyqxmd.com/read/27746290/registries-in-atrial-fibrillation-from-trials-to-real-life-clinical-practice
#13
REVIEW
Michał Mazurek, Menno V Huisman, Gregory Y H Lip
BACKGROUND: Recent improvements in atrial fibrillation diagnosis and management have prompted the initiation of various registries, predominantly to assess adherence to new guidelines but also to address the pending questions of safety and effectiveness of newly introduced management options in "real-world" clinical practice settings. In this review, we appraise antithrombotic treatment patterns for stroke prevention in atrial fibrillation registries. METHODS: We searched PubMed, Science Direct, and the Cochrane databases for registries focusing on stroke thromboprophylaxis in atrial fibrillation...
October 13, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27740860/management-of-idiopathic-venous-thromboembolism
#14
Benilde Cosmi
Idiopathic or unprovoked venous thromboembolism is an event occurring in the absence of any apparent provoking or triggering environmental risk factors, such as surgery, trauma, and immobilization. Areas covered: Unprovoked VTE can be associated with occult cancer, but only limited, and not extensive cancer screening, may be warranted, as the rate of occult cancer is low in such patients. Routine thrombophilia testing is not currently recommended as it does not influence the management of the disease. The duration of anticoagulation for unprovoked VTE after the first three months is still debated as the disease tends to recur regardless of treatment duration...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27733271/international-clinical-practice-guidelines-including-guidance-for-direct-oral-anticoagulants-in-the-treatment-and-prophylaxis-of-venous-thromboembolism-in-patients-with-cancer
#15
REVIEW
Dominique Farge, Henri Bounameaux, Benjamin Brenner, Francis Cajfinger, Philippe Debourdeau, Alok A Khorana, Ingrid Pabinger, Susan Solymoss, James Douketis, Ajay Kakkar
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at an increased risk of developing VTE and are more likely to have a recurrence of VTE and bleeding while taking anticoagulants. Management of VTE in patients with cancer is a major therapeutic challenge and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME), established to reduce the global burden of VTE in patients with cancer, published international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis...
October 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27706224/comparison-of-approaches-for-stroke-prophylaxis-in-patients-with-non-valvular-atrial-fibrillation-network-meta-analyses-of-randomized-controlled-trials
#16
Navkaranbir S Bajaj, Rajat Kalra, Nirav Patel, Taimoor Hashim, Hemant Godara, Sameer Ather, Garima Arora, Tilak Pasala, Thomas T Whitfield, David C McGiffin, Mustafa I Ahmed, Steven G Lloyd, Nita A Limdi, Pankaj Arora
BACKGROUND: Multiple novel oral anticoagulants and left atrial appendage closure devices (WATCHMAN) have been tested against dose-adjusted vitamin K antagonists in randomized controlled trials for stroke prophylaxis in non-valvular atrial fibrillation. No direct comparisons of these strategies are available from randomized controlled trials. We conducted the current analyses by combining efficacy and safety characteristics of all FDA approved stroke prophylaxis treatment strategies for patients with non-valvular atrial fibrillation...
2016: PloS One
https://www.readbyqxmd.com/read/27697438/idarucizumab-and-factor-xa-reversal-agents-role-in-hospital-guidelines-and-protocols
#17
REVIEW
Menno V Huisman, John Fanikos
As expected with all antithrombotic agents, there is a risk of bleeding complications in patients receiving direct oral anticoagulants (DOACs) because of the DOAC itself, acute trauma, invasive procedures, or underlying comorbidities. For many bleeding events, a prudent course of action will be to withdraw the DOAC, then "wait and support" the patient, with the expectation that the bleeding event should resolve with time. Likewise, DOAC therapy may be interrupted ahead of a planned procedure, the stopping time being dependent on the agent involved and the patient's renal function...
November 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27696300/risk-benefit-profile-of-direct-acting-oral-anticoagulants-in-established-therapeutic-indications-an-overview-of-systematic-reviews-and-observational-studies
#18
REVIEW
Emanuel Raschi, Matteo Bianchin, Walter Ageno, Roberto De Ponti, Fabrizio De Ponti
Since 2008, the direct-acting oral anticoagulants (DOACs) have expanded the therapeutic options of cardiovascular diseases with recognized clinical and epidemiological impact, such as non-valvular atrial fibrillation (NVAF) and venous thromboembolism (VTE), and also in the preventive setting of orthopedic surgical patients. The large body of evidence, not only from pivotal clinical trials but also from 'real-world' postmarketing observational findings (e.g. analytical epidemiological studies and registry data) gathered to date allow for a first attempt at verifying a posteriori whether or not the pharmacological advantages of the DOACs actually translate into therapeutic innovation, with relevant implications for clinicians, regulators and patients...
December 2016: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/27694780/dabigatran-a-new-oral-anticoagulant-guidelines-to-follow-in-oral-surgery-procedures-a-systematic-review-of-the-literature
#19
M Muñoz-Corcuera, L Ramírez-Martínez-Acitores, R-M López-Pintor, E Casañas-Gil, G Hernández-Vallejo
BACKGROUND: Dabigatran is a newly commercialized drug that is replacing other anticoagulants in the prevention of venous thromboembolism, stroke and systemic arterial valve embolism. It acts directly on thrombin presenting in a dynamic and predictable way, which does not require monitoring these patients. Therefore, we consider the need to assess whether their use increases the risk of bleeding involved before any dental treatment. MATERIAL AND METHODS: We performed a systematic review with a bibliographic search in PubMed/Medline along with the Cochrane Library...
November 1, 2016: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/27659969/management-of-direct-oral-anticoagulants-in-patients-undergoing-elective-surgeries-and-invasive-procedures-updated-guidelines-from-the-french-working-group-on-perioperative-hemostasis-gihp-%C3%A2-%C3%A2-september-2015
#20
Pierre Albaladejo, Fanny Bonhomme, Normand Blais, Jean-Philippe Collet, David Faraoni, Pierre Fontana, Anne Godier, Juan Llau, Dan Longrois, Emmanuel Marret, Patrick Mismetti, Nadia Rosencher, Stéphanie Roullet, Charles-Marc Samama, Jean-François Schved, Pierre Sié, Annick Steib, Sophie Susen
Since 2011, data on patients exposed to direct oral anticoagulants (DOAs) while undergoing invasive procedures have accumulated. At the same time, an increased hemorrhagic risk during perioperative bridging anticoagulation without thrombotic risk reduction has been demonstrated. This has led the GIHP to update their guidelines published in 2011. For scheduled procedures at low bleeding risk, it is suggested that patients interrupt DOAs the night before irrespective of type of drug and to resume therapy six hours or more after the end of the invasive procedure...
September 20, 2016: Anaesthesia, Critical Care & Pain Medicine
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