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https://www.readbyqxmd.com/read/28727707/continuing-anti-thrombotic-medication-during-low-to-intermediate-risk-spinal-procedures-a-retrospective-evaluation
#1
Noud van Helmond, Wesley Day, Kenneth B Chapman
BACKGROUND: The current American Society of Regional Anesthesia (ASRA) guidelines recommend discontinuing anti-thrombotic therapy prior to any interventional spine procedures to decrease the incidence of bleeding complications. However, discontinuing anti-thrombotics may pose considerable danger in terms of cerebrovascular and cardiovascular events. Recent evidence suggests that some spinal interventions may still be performed safely with anti-thrombotics on board and some practitioners thus elect to continue certain anti-thrombotics for these procedures...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28720743/-usefulness-of-edoxaban-for-deep-cerebral-venous-sinus-thrombosis-with-hemorrhagic-infarction-a-case-report
#2
Takeo Amemiya, Toshio Uesaka, Katsuharu Kameda, Junji Uno, Shintaro Nagaoka, Yoshiaki Ikai, Hidefuku Gi
We describe a case of deep cerebral venous sinus thrombosis(DCVST)that was successfully treated by oral administration of the Xa inhibitor edoxaban. A 53-year-old man was admitted to our hospital because of a headache and undifferentiated dizziness. Computed tomography(CT)demonstrated a low-density area in the bilateral thalamus and high-density lesions in the internal cerebral veins(ICVs)and vein of Galen. Magnetic resonance imaging with diffusion-weighted images detected areas of hyperintensity in the bilateral thalamus...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28717005/lipid-oxidation-inactivates-the-anticoagulant-function-of-protein-z-dependent-protease-inhibitor-zpi
#3
Xin Huang, Baoxin Liu, Yidong Wei, Ryan Beyea, Han Yan, Steven T Olson
Lipid oxidation due to oxidative stress plays an important role in the pathogenesis of inflammatory and thrombotic cardiovascular diseases. Several findings suggest that lipid peroxidation can alter the function of coagulation proteins and contribute to a hypercoagulable state, but the molecular mechanisms are unclear. Here, we report that oxidized phospholipids suppress the anticoagulant function of the serpin, protein Z-dependent protease inhibitor (ZPI), a specific inhibitor of membrane-associated factor Xa (FXa) that requires protein Z (PZ), phospholipid and calcium as cofactors...
July 17, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28714376/retrospective-comparison-of-low-molecular-weight-heparin-vs-warfarin-vs-oral-xa-inhibitors-for-the-prevention-of-recurrent-venous-thromboembolism-in-oncology-patients-the-re-clot-study
#4
Saeed K Alzghari, Susan E Seago, Jessica E Garza, Yasmeen F Hashimie, Kimberly A Baty, Martha F Evans, Courtney Shaver, Jon D Herrington
Background There is increasing evidence indicating oral factor Xa inhibitors can be used for secondary prevention of venous thromboembolism. Studies are needed to compare oral factor Xa inhibitors, low molecular weight heparins, and warfarin in the oncology population. The purpose of this study is to evaluate the recurrent venous thromboembolism incidence in oncology patients utilizing oral Xa inhibitors, low molecular weight heparins, or warfarin. Methods Using retrospectively collected data, we compared the recurrent venous thromboembolism incidence in oncology patients taking rivaroxaban/apixaban, enoxaparin, or warfarin with at least three months of follow-up...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28708713/platelet-aggregation-in-direct-oral-factor-xa-inhibitors-treated-patients-with-atrial-fibrillation-a-pilot-study
#5
Peter Bánovčin, Ingrid Škorňová, Matej Samoš, Martin Schnierer, Tomáš Bolek, František Kovář, Ján Staško, Peter Kubisz, Marián Mokáň
BACKGROUND: Activated factor X (factor Xa) plays an important role in regulation of platelets. The aim of this study was to test the effect of direct oral factor Xa inhibitors - rivaroxaban and apixaban - on platelet aggregation in patients with non-valvular atrial fibrillation (NV-AF). PATIENTS AND METHODS: This single-centre pilot study enrolled 21 factor Xa inhibitors-treated (9 rivaroxaban-treated and 12 apixaban-treated) patients with NV-AF. The trough and peak samples of these patients were tested for adenosinediphosphate-induced (ADP), epinephrine-induced, and collagen-induced platelet aggregation with light transmission aggregometry (LTA), and with factor Xa-calibrated anti-Xa chromogenic analysis...
July 13, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28703931/rationale-and-design-of-a-randomized-trial-of-apixaban-vs-warfarin-to-evaluate-atherosclerotic-calcification-and-vulnerable-plaque-progression
#6
Kazuhiro Osawa, Rine Nakanishi, Theingi Tiffany Win, Dong Li, Sina Rahmani, Negin Nezarat, Nasim Sheidaee, Matthew J Budoff
Vitamin K antagonists (VKAs) are known to increase vascular calcification, suggesting increased cardiovascular disease events. Apixaban is an oral direct factor Xa inhibitor superior to warfarin at preventing stroke or systemic embolism and may stabilize coronary atherosclerosis. The potential benefits of avoiding VKA therapy and the favorable effects of factor Xa inhibitors could contribute to cardiovascular disease event reduction. We hypothesized that apixaban inhibits vascular calcification and coronary atherosclerosis progression compared with warfarin in patients with atrial fibrillation (AF)...
July 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28692575/rendering-factor-xa-zymogen-like-as-a-therapeutic-strategy-to-treat-bleeding
#7
Nabil K Thalji, Rodney M Camire
PURPOSE OF REVIEW: New therapies are needed to control bleeding in a range of clinical conditions. This review will discuss the biochemical properties of zymogen-like factor Xa, its preclinical assessment in different model systems, and future development prospects. RECENT FINDINGS: Underlying many procoagulant therapeutic approaches is the rapid generation of thrombin to promote robust clot formation. Clinically tested prohemostatic agents (e.g., factor VIIa) can provide effective hemostasis to mitigate bleeding in hemophilia and other clinical situations...
July 7, 2017: Current Opinion in Hematology
https://www.readbyqxmd.com/read/28689334/safety-and-interactions-of-direct-oral-anticoagulants-with-antiarrhythmic-drugs
#8
REVIEW
Ipek Celikyurt, Christoph R Meier, Michael Kühne, Beat Schaer
Direct oral anticoagulants (DOACs) are novel direct-acting medications that are selective for either thrombin or activated factor X. Due to their obvious benefits for patients (fewer interactions, broader therapeutic window, etc.), they are increasingly used as an alternative to warfarin, phenprocoumon, or acenocoumarol. One of the major indications for use of DOACs is stroke prevention in patients with atrial fibrillation (AF). However, interactions still exist, especially in combination with antiarrhythmic drugs (AADs), which are frequently given to AF patients for rhythm or rate control...
July 8, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28682477/preclinical-safety-and-efficacy-of-andexanet-alfa-in-animal-models
#9
G Lu, S J Hollenbach, D C Baker, S Tan, A Hutchaleelaha, J T Curnutte, P B Conley
BACKGROUND: Andexanet is a recombinant modified form of factor Xa (FXa), designed to bind to and reverse the anticoagulant activity of FXa inhibitors. OBJECTIVES: To evaluate the ability of andexanet to reverse the anticoagulant activity of rivaroxaban, and assess its pharmacokinetics (PK) and toxicity in animal models. METHODS: The effects of andexanet on blood loss, anti-FXa activity, rivaroxaban unbound plasma concentrations, and other coagulation parameters were assessed in a rabbit liver laceration 'treatment' model...
July 6, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28674871/real-life-use-of-rivaroxaban-in-the-netherlands-data-from-the%C3%A2-xarelto-for-prevention-of-stroke-in-patients-with-atrial-fibrillation%C3%A2-xantus-registry
#10
R Pisters, S P G van Vugt, M A Brouwer, A Elvan, W L Ten Holt, P A G Zwart, P Kirchhof, H J G M Crijns, M E W Hemels
BACKGROUND: The Xarelto for Prevention of Stroke in Patients with Atrial Fibrillation (XANTUS) registry investigated the safety and efficacy of the factor Xa inhibitor rivaroxaban. We studied the Dutch XANTUS cohort to a ssess drug safety and prescription patterns in the Netherlands. METHODS: The XANTUS registry was designed as a European prospective, observational study among patients with non-valvular atrial fibrillation. Major bleeding and all-cause mortality were assessed every three months during a 1-year follow-up period...
July 3, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28671072/anticoagulant-activity-of-oral-rivaroxaban-in-healthy-dogs
#11
B Conversy, M C Blais, M Dunn, C Gara-Boivin, J R E Del Castillo
Rivaroxaban is an oral, direct factor Xa inhibitor used in human thrombotic disorders. In view of the in vitro concentration dependent anticoagulant effects of rivaroxaban in dogs, the time course of its anticoagulant effects was characterized in healthy dogs. Twenty-four healthy Beagles were randomized into three groups (n = 8 per group) and received orally either a placebo or 20 mg rivaroxaban once or twice at an 8 h interval. Fifteen blood samples were collected over a 30 h period, and blindly assayed for prothrombin time (PT), activated partial thromboplastin time (aPTT), tissue factor induced thrombin generation (TG) and anti-factor Xa activity...
May 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28656493/corr-insights-%C3%A2-venous-thromboembolism-prophylaxis-after-tka-aspirin-warfarin-enoxaparin-or-factor-xa-inhibitors
#12
Daniel R Whiting
No abstract text is available yet for this article.
June 27, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28652799/direct-oral-anticoagulants-in-patients-with-chronic-kidney-disease-patient-selection-and-special-considerations
#13
REVIEW
Jens Lutz, Kerstin Jurk, Helmut Schinzel
Many patients with chronic kidney disease (CKD) receive anticoagulation or antiplatelet therapy due to atrial fibrillation, coronary artery disease, thromboembolic disease, or peripheral artery disease. The treatment usually includes vitamin K antagonists (VKAs) and/or platelet aggregation inhibitors. The direct oral anticoagulants (DOAC) inhibiting factor Xa or thrombin represent an alternative for VKAs. In patients with acute and chronic kidney disease, caution is warranted, as DOACs can accumulate as they are partly eliminated by the kidneys...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28650000/andexanet-alfa-a-recombinant-mimetic-of-human-factor-xa-for-the-reversal-of-anticoagulant-therapies
#14
G Escolar, M Diaz-Ricart, E Arellano-Rodrigo
Activated coagulation factor X (FXa) is a common target for classic and newer anticoagulants. Parenteral anticoagulants with an indirect inhibitory action on FXa (low-molecular-weight heparins) have a well-established clinical efficacy in the prophylaxis and therapy of thromboembolic conditions. More recently developed direct oral anticoagulants (DOACs) have emerged as a new class of antithrombotic drugs. Rivaroxaban, apixaban and edoxaban are direct inhibitors of FXa approved for the management of venous thromboembolism and stroke prevention in atrial fibrillation...
May 2017: Drugs of Today
https://www.readbyqxmd.com/read/28648320/cost-effectiveness-of-edoxaban-vs-warfarin-in-patients-with-atrial-fibrillation-based-on-results-of-the-engage-af-timi-48-trial-taiwanese-perspective
#15
Katherine A Vilain, Ming Chin Yang, Elise Chia Hui Tan, Kaijun Wang, Haiyan Li, Wan Hsuan Hsu, Robert P Giugliano, David J Cohen, Elizabeth A Magnuson
BACKGROUND: Novel anticoagulants, such as factor Xa inhibitors, have entered clinical practice as alternatives to warfarin for the prevention of stroke and systemic embolic event (SEE) in patients with atrial fibrillation (AF). It is not known whether edoxaban, the fourth-to-market factor Xa inhibitor approved for this indication, will be cost-effective in Taiwan, where the cost of warfarin monitoring is prohibitive. METHODS: A Markov model projecting lifetime results of edoxaban 60 mg/30 mg dose-reduced versus warfarin in patients with nonvalvular AF, based on the ENGAGE AF - TIMI 48 trial, found edoxaban to be of high value relative to warfarin, from the perspective of the US health care system...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28643538/do-methodological-differences-account-for-the-current-controversy-on-tissue-factor-expression-in-platelets
#16
Marta Brambilla, Laura Rossetti, Chiara Zara, Paola Canzano, Peter L A Giesen, Elena Tremoli, Marina Camera
Tissue factor (TF), the key activator of the blood coagulation cascade and of thrombus formation, is also expressed by circulating human platelets. Despite the documented in-depth characterization of platelet TF carried out in the past 15 years, some authors still fail to identify TF in platelets, especially when assessment in platelet-rich plasma (PRP) or washed platelets is carried out. This study aims to extend the characterization of the subset of TF-positive platelets in PRP from healthy subjects and to verify how different centrifugation forces, used to prepare the PRP, could affect the analysis of TF-positive platelets...
June 23, 2017: Platelets
https://www.readbyqxmd.com/read/28639463/adverse-drug-reactions-and-cutaneous-manifestations-associated-with-anticoagulation
#17
Trang T Vu, Melinda Gooderham
Anticoagulants are amongst the most commonly prescribed medications worldwide. Although rare, localised and systemic drug reactions have been reported with anticoagulants that can lead to significant morbidity and mortality. Some of the first signs of drug reactions to anticoagulants are cutaneous changes that, when recognised early, can prevent significant complications. Dermatologists should be aware of these changes to make an early and accurate diagnosis. This is particularly important in instances of skin-induced necrosis caused by systemic toxicity to anticoagulants...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#18
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28615214/safety-and-efficacy-of-rivaroxaban-in-patients-with-cardiac-implantable-electronic-devices-observations-from-the-rocket-af-trial
#19
George C Leef, Anne S Hellkamp, Manesh R Patel, Richard C Becker, Scott D Berkowitz, Günter Breithardt, Jonathan L Halperin, Graeme J Hankey, Werner Hacke, Christopher C Nessel, Daniel E Singer, Keith A A Fox, Kenneth W Mahaffey, Jonathan P Piccini
BACKGROUND: Although implantation of cardiac implantable electronic devices (CIEDs) in patients receiving warfarin is well studied, limited data are available on the use of oral factor Xa inhibitors in this setting. METHODS AND RESULTS: Using data from Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) (n=14 264), we compared baseline characteristics and clinical outcomes in patients with atrial fibrillation randomized to rivaroxaban versus warfarin who did and did not undergo CIED implantation or revision...
June 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28604566/novel-oral-anticoagulants-in-the-peri-endoscopic-period
#20
Michael Genualdi, William H Frishman
Millions of patients in the United States are currently prescribed some form of anticoagulation therapy. Recently, novel oral anticoagulants (NOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, have begun to replace warfarin as the drugs of choice for anticoagulation. As the use of these medications becomes more widespread, it is increasingly important for gastroenterologists to understand the risks associated with performing endoscopic procedures on patients who are taking NOACs. In this review, we provide an overview of the NOACs, as well as current guidelines from international societies regarding the management of patients scheduled to undergo endoscopic procedures who are prescribed these medications...
April 6, 2017: Cardiology in Review
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