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https://www.readbyqxmd.com/read/28821888/risk-factors-for-epistaxis-in-patients-followed-in-general-practices-in-germany
#1
D U Seidel, L Jacob, K Kostev, A M Sesterhenn
<p>BACKGROUND: The goal of the present study was to analyze the risk factors for epistaxis in patients followed in general practices in Germany.</p> <p>METHODS: The current study sample included patients aged 18 years or older who received a first epistaxis diagnosis between January 2012 and December 2016 (index date). Epistaxis patients and controls without epistaxis were matched (1:1) on the basis of age, gender, insurance status and physician. </p> <p>RESULTS: A total of 16,801 patients with epistaxis and 16,801 control subjects were included in this study...
August 19, 2017: Rhinology
https://www.readbyqxmd.com/read/28818570/prevalence-and-risk-factors-of-deep-vein-thrombosis-in-patients-undergoing-lumbar-spine-surgery
#2
Koji Yamasaki, Masahiro Hoshino, Keita Omori, Hidetoshi Igarashi, Takashi Tsuruta, Hiroyuki Miyakata, Yasuhiro Nemoto, Hiromi Matsuzaki, Takanori Iriuchishima
BACKGROUND: Spinal surgery is classified as a moderate risk for DVT. The occurrence of DVT after various spinal surgical procedures was reviewed retrospectively, and the perioperative risk factors in the high-risk group were identified. In addition, the administration of the factor Xa inhibitor to DVT subjects with unstable thrombosis was evaluated to reveal its effectiveness in the prevention of PTE and postoperative complications. METHODS: This study included 588 subjects who underwent lumbar spine surgery...
August 14, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28816341/clinical-impact-of-major-bleeding-in-patients-with-venous-thromboembolism-treated-with-factor-xa-inhibitors-or-vitamin-k-antagonists-an-individual-patient-data-meta-analysis
#3
Suzanne M Bleker, Marjolein P A Brekelmans, Elise S Eerenberg, Alexander T Cohen, Saskia Middeldorp, Gary Raskob, Harry R Büller
Factor Xa (fXa)-inhibitors are as effective and safer than vitamin-K-antagonists (VKA) in the treatment of venous thromboembolism (VTE). We previously classified the severity of clinical presentation and course of all major bleeding events from the EINSTEIN, AMPLIFY and HOKUSAI-VTE trials separately. The current aim was to combine these findings in order to increase precision, assess a class effect and analyse presentation and course for different types of bleeding, i. e. intracranial, gastro-intestinal, and other...
August 17, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28808888/has-time-come-for-the-use-of-direct-oral-anticoagulants-in-the-extended-prophylaxis-of-venous-thromboembolism-in-acutely-ill-medical-patients-yes
#4
Walter Ageno
Betrixaban is a direct factor Xa inhibitor with a renal excretion of only approximately 5-7%. On June 23rd 2017, it became the first direct oral anticoagulant to receive Food and Drug Administration approval for the prevention of venous thromboembolism in acutely ill medical patients, and the first anticoagulant agent to be approved for extended-duration thromboprophylaxis after hospital discharge in this setting. Approval followed the results of the APEX trial, a phase III clinical trial comparing betrixaban (80 mg) administered for 35-42 days with enoxaparin (40 mg) administered for 10 ± 4 days...
August 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28808596/the-severity-of-intracranial-hemorrhages-measured-by-free-hemoglobin-in-the-brain-depends-on-the-anticoagulant-class-experimental-data
#5
Kyle M Ware, Douglas L Feinstein, Israel Rubinstein, Prudhvi Battula, Jose Otero, Lee Hebert, Tzu-Fei Wang, Alexandra Ivanova, Shweta Chaudhary, Jessica Hemminger, Sergey V Brodsky
Background and Purpose. Anticoagulant therapy is broadly used to prevent thromboembolic events. Intracranial hemorrhages are serious complications of anticoagulation, especially with warfarin. Direct oral anticoagulants reduce but do not eliminate the risk of intracranial hemorrhages. The aim of this study is to determine the degree of intracranial hemorrhage after application of anticoagulants without additional triggers. Methods. Rats were treated with different anticoagulant classes (vitamin K antagonists, heparin, direct thrombin inhibitor, and factor Xa inhibitor)...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#6
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28805299/dissociation-between-the-pharmacokinetics-and-pharmacodynamics-of-once-daily-rivaroxaban-and-twice-daily-apixaban-a-randomized-crossover-study
#7
Reinhold Kreutz, Pontus B Persson, Dagmar Kubitza, Kirstin Thelen, Stefan Heitmeier, Stephan Schwers, Michael Becka, Melanie Hemmrich
BACKGROUND: The anticoagulant actions of the oral direct factor Xa inhibitors, rivaroxaban and apixaban, have not previously been directly compared. OBJECTIVES: To compare directly the steady-state pharmacokinetics and anticoagulant effects of rivaroxaban and apixaban at doses approved for stroke prevention in nonvalvular atrial fibrillation. METHODS: Twenty-four healthy Caucasian male volunteers were included in this open-label, two-period crossover, phase 1 study (EudraCT number: 2015-002612-32)...
August 14, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28804832/measuring-direct-oral-anticoagulants
#8
Robert C Gosselin, Jonathan Douxfils
Direct oral anticoagulants (DOACs) can be quantified using methods that can be performed in any clinical or research laboratory using manual or automated instrument platforms. Dabigatran etexilate, the oral direct thrombin inhibitor, can be quantified by drug-calibrated clot or chromogenic-based assays using either thrombin or ecarin as substrates. Oral direct anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban, can be quantified with drug-calibrated anti-Xa kits or reagents as typically used for measuring heparins (unfractionated, low molecular weight, or pentasaccharides)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28804827/assessment-of-hereditary-thrombophilia-performance-of-antithrombin-at-testing
#9
Jana N Gausman, Richard A Marlar
Antithrombin (AT) is a naturally occurring plasma inhibitor of coagulation, which is a synthesized in the liver. AT inhibits coagulation serine proteases (the enzymatically activated forms of the clotting factors), mainly thrombin (factor IIa) and factor Xa, but also to a lesser extent factors IXa, XIa, and XIIa. Acting alone, AT inhibits coagulation factors, but does this very slowly; however, when coupled with heparin as a cofactor, the speed of inhibition is increased many fold. The AT/Heparin complex is the most powerful naturally occurring anticoagulant in blood...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803520/probable-rivaroxaban-induced-full-body-rash-a-case-report
#10
Evan Sasson, Marian James, Mark Russell, Darko Todorov, Henry Cohen
INTRODUCTION: Rivaroxaban is a novel oral anticoagulant with several indications, one of which is for stroke prevention in nonvalvular atrial fibrillation. We present a case of probable rivaroxaban-induced rash. CASE SUMMARY: A 79-year-old female with a medical history of atrial fibrillation experienced a stroke, after which she was prescribed rivaroxaban 20 mg. After several days, she developed a rash requiring admission to the emergency department and several days of treatment...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28801633/evaluation-of-novel-factor-xa-inhibitors-from-oxya-chinensis-sinuosa-with-anti-platelet-aggregation-activity
#11
Wonhwa Lee, HeeSeung Lee, Mi-Ae Kim, Joonhyeok Choi, Kyung-Min Kim, Jae Sam Hwang, MinKyun Na, Jong-Sup Bae
The edible grasshopper Oxya chinensis sinuosa is consumed worldwide for its various medicinal effects. The purpose of this study was to investigate potential bioactive antithrombotic and antiplatelet compounds from O. chinensis sinuosa. Five N-acetyldopamine dimers (1-5) were isolated from O. chinensis sinuosa and compounds 1 and 2 were identified as new chemicals with chiral centers at H-2 and H-3 of the benzo-1,4-dioxane structure. Compounds 1-4 were found to have both FXa and platelet aggregation inhibitory activities...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28794370/the-successful-prevention-of-thromboembolism-using-rivaroxaban-in-a-patient-with-antithrombin-deficiency-during-the-perioperative-period
#12
Hidetsugu Kawai, Hiromichi Matsushita, Hiroshi Kawada, Yoshiaki Ogawa, Kiyoshi Ando
Antithrombin (AT) deficiency, a rare disorder of the coagulation system, is a serious risk factor for thromboembolism. Approximately 50-90% of patients with AT deficiency develop thromboembolism during their lifetime. In addition, surgery is a major risk factor for thromboembolism in these patients. We herein report the case of a 90-year-old woman with AT deficiency who was safely and successfully managed using rivaroxaban (a direct oral factor Xa inhibitor) during the perioperative period of surgery for right femur fracture...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28790786/direct-acting-oral-anticoagulant-bench-to-bedside
#13
REVIEW
D S Chadha, P Bharadwaj
Vitamin K antagonists are an effective group of oral anticoagulants. However because of genetic variability in their metabolism and multiple food and drug interactions, these drugs have narrow therapeutic window with unpredictable anticoagulant effects requiring constant monitoring. Several newer direct acting oral anticoagulants have been approved for prevention of stroke in patients with nonvalvular atrial fibrillation and treatment or prevention of venous thromboembolism. The direct acting oral anticoagulants include the direct thrombin inhibitor (dabigatran) and the factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban)...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28782047/characterization-of-protein-z-dependent-protease-inhibitor-antithrombin-chimeras-provides-insight-into-the-serpin-specificity-of-coagulation-proteases
#14
Likui Yang, Alireza R Rezaie
Protein Z (PZ)-dependent protease inhibitor (ZPI) and antithrombin (AT) are two physiological serpin inhibitors involved in the regulation of proteolytic activities of the blood coagulation cascade. ZPI has restricted protease specificity capable of inhibiting factors Xa (FXa) and XIa (FXIa) but exhibiting no reactivity with other coagulation proteases. Unlike ZPI, AT is a general inhibitor of all coagulation proteases and the only physiological inhibitor of factor IXa (FIXa). To understand the molecular determinants of protease specificity of the two serpins, we engineered two ZPI mutants in which the P12-P3' residues of the reactive center loop of ZPI were replaced with either P12-P3' or P12-P7' residues of AT (ZPI-AT(P12-P3') and ZPI-AT(P12-P7'))...
July 31, 2017: ACS Omega
https://www.readbyqxmd.com/read/28771049/direct-oral-anticoagulants-in-the-treatment-of-pulmonary-embolism
#15
Joanna B Eldredge, Alex C Spyropoulos
OBJECTIVE: The objective of this review is to examine the management strategies for pulmonary embolism (PE) with an emphasis of the role of direct oral anticoagulants (DOACs). METHODS: PubMed was searched to identify relevant journal articles published through April 2017. Additional references were obtained from articles discovered during the database search. RESULTS: Initial heparinization followed by long-term anticoagulation with vitamin K antagonists (VKAs) has been considered the mainstay for the treatment of PE...
August 3, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28766070/prothrombin-time-international-normalized-ratio-is-a-useful-marker-for-edoxaban-efficacy-in-preventing-venous-thromboembolism-after-total-knee-arthroplasty
#16
Kazuki Kodato, Kazunari Ishida, Nao Shibanuma, Akihiko Toda, Koji Takayama, Shinya Oka, Shinya Hayashi, Shingo Hashimoto, Masahiro Kurosaka, Ryosuke Kuroda, Tomoyuki Matsumoto
BACKGROUND: Deep vein thrombosis (DVT) is one of the main complications following total knee arthroplasty (TKA). In this study, oral administration of 15 mg edoxaban (a factor Xa inhibitor) once daily for 14 days efficiently prevented the incidence of DVT. Our hypothesis was that prothrombin time-international normalized ratio (PT-INR) on the third postoperative day could predict the incidence of DVT following TKA. METHODS: In this study, 286 subjects were enrolled and divided into two groups according to the presence or absence of DVT...
August 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28761683/mortality-and-oral-anticoagulants-in-the-food-and-drug-administration-adverse-event-reporting-system
#17
Victor Serebruany, Vasily Cherepanov, Seth Fortmann, Moo Hyun Kim
OBJECTIVE: The comparative crude death rates (CDR) among non-vitamin K antagonist oral anticoagulants (NOACs) are unknown. Further, whether NOACs improve survival when compared with warfarin is also unclear. We compared CDR co-reported for four NOACs combined or separately versus warfarin within the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database. METHODS: We selected CDR from the FAERS database linked to four NOACs and warfarin...
2017: Open Heart
https://www.readbyqxmd.com/read/28760063/incremental-economic-burden-associated-with-major-bleeding-among-atrial-fibrillation-patients-treated-with-factor-xa-inhibitors
#18
Steven Deitelzweig, W Richey Neuman, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
OBJECTIVE: To evaluate healthcare resource use and costs incurred during, as well as following hospitalization for major bleeding (MB), among atrial fibrillation (AF) patients treated with factor Xa inhibitors Methods: Patients with an AF diagnosis and MB hospitalization (index event) were identified from the MarketScan Commercial and Medicare databases (1/1/2011-12/31/2014). Patients were required to have ≥1 prescription for rivaroxaban or apixaban within 3 months prior to MB hospitalization...
August 1, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28744136/quick-reference-guide-to-apixaban
#19
REVIEW
Katherine Victoria Hurst, John Matthew O'Callaghan, Ashok Handa
Direct oral anticoagulants (DOACs) are being increasingly used in the clinical setting for patients at risk of venous thromboembolism (VTE) and/or stroke. These medications offer valued benefits for long-term use, including a fast onset of anticoagulation, fixed anticoagulation profile (and consequent prescription of specified doses) and no requirement for routine monitoring. Apixaban is a selective factor Xa inhibitor, approved for use in the prevention of stroke in patients with nonvalvular atrial fibrillation and in the prevention and treatment of acute VTE...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28743742/disease-causing-mutations-in-the-serpin-antithrombin-reveal-a-key-domain-critical-for-inhibiting-protease-activities
#20
Sonia Águila, Gonzalo Izaguirre, Irene Martinez-Martinez, Vicente Vicente, Steven T Olson, Javier Corral
Antithrombin mainly inhibits factor Xa, and thrombin. The reactive center loop (RCL) is crucial for its interactions with its protease targets and is fully inserted into the A-sheet after its cleavage, causing translocation of the covalently linked protease to the opposite end of the A-sheet. Antithrombin variants with altered RCL hinge residues behave as substrates rather than inhibitors, resulting in stoichiometries of inhibition greater than one. Other antithrombin residues have been suggested to interfere with RCL insertion or the stability of the antithrombin-protease complex, but available crystal structures or mutagenesis studies have failed to identify such residues...
July 25, 2017: Journal of Biological Chemistry
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