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https://www.readbyqxmd.com/read/29679301/contemporary-antithrombotic-treatment-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-rationale-and-design-of-the-greek-antiplatelet-atrial-fibrillation-grape-af-registry
#1
Ioanna Xanthopoulou, Vasiliki-Maria Dragona, Periklis Davlouros, Costas Tsioufis, Efstathios Iliodromitis, Dimitrios Alexopoulos
BACKGROUND: Approximately 5 to 7% of patients undergoing percutaneous coronary intervention (PCI) for the treatment of coronary artery disease require chronic oral anticoagulation (OAC) on top of aspirin and a P2Y12 receptor antagonist, mainly due to non-valvular atrial fibrillation (AF). The advent of non-vitamin K antagonist oral anticoagulants (NOACs) increased treatment options, while there is cumulative evidence that dual combination of a NOAC and a P2Y12 receptor antagonist attenuates risk of bleeding, compared to traditional triple therapy, consisting of a vitamin K antagonist (VKA), aspirin, and a P2Y12 receptor antagonist, without significantly compromising efficacy...
April 20, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29679144/antithrombotic-therapy-in-patients-with-non-valvular-atrial-fibrillation-undergoing-percutaneous-coronary-intervention-should-we-change-our-practice-after-the-pioneer-af-pci-and-re-dual-pci-trials
#2
D Duerschmied, J Brachmann, H Darius, N Frey, H A Katus, W Rottbauer, A Schäfer, H Thiele, C Bode, Uwe Zeymer
The number of patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) is increasing. Since these patients have a CHA2 DS2 -VASc score of 1 or higher, they should be treated with oral anticoagulation to prevent stroke. However, combination therapy with oral anticoagulation for prevention of embolic stroke and dual platelet inhibition for prevention of coronary thrombosis significantly increases bleeding complications. The optimal combination, intensity and duration of antithrombotic combination therapy is still not known...
April 20, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29672182/oral-anticoagulant-use-in-cardiovascular-disorders-a-perspective-on-present-and-potential-indications-for-rivaroxaban
#3
A John Camm, Keith A A Fox
BACKGROUND: Four nonvitamin K antagonist oral anticoagulants (NOACs) have been approved for use in various cardiovascular indications. The direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors apixaban, edoxaban, and rivaroxaban are now increasingly used in clinical practice. For some of these agents, available data from real-world studies support the efficacy and safety data in phase III clinical trials. OBJECTIVES: This review aims to summarize the current status of trials and observational studies of oral anticoagulant use over the spectrum of cardiovascular disorders (excluding venous thrombosis), provide a reference source beyond stroke prevention for atrial fibrillation (AF) and examine the potential for novel applications in the cardiovascular field...
April 19, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29671285/effect-of-non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-newly-diagnosed-cancer
#4
Kyu Kim, Yong Joon Lee, Tae Hoon Kim, Jae Sun Uhm, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung
BACKGROUND AND OBJECTIVES: There are limited data on the use of non-vitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with cancer. We aimed to assess the efficacy and safety of NOACs in AF patients with cancer in this study. METHODS: In 2,568 consecutive non-valvular AF patients with newly diagnosed cancer, we analyzed ischemic stroke/systemic embolism (SE), major bleeding, and all-cause death. Based on propensity score matching, 388 matched pairs were included in the NOAC and warfarin groups...
February 26, 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29671011/-rectal-bleeding-in-a-60-year-old-woman-under-anticoagulation-and-platelet-aggregation-inhibition
#5
J Pohlan, N Willamowski, C Jürgensen, E Zimmermann, M Möckel
CASE REPORT: We report on a woman with lower gastrointestinal bleeding under effective oral anticoagulation with both phenprocoumon and apixaban (with intention to switch to the latter) as well as the antiplatelet agent acetylsalicylic acid for aortic bifurcation kissing stents after stent thrombosis. Our patient presented with weakness and rectal bleeding. Upon examination, she looked anemic and had sinus tachycardia (104 beats per minute). The digital rectal examination revealed bright red blood mixed with clots...
April 18, 2018: Der Internist
https://www.readbyqxmd.com/read/29670522/dabigatran-added-to-dual-antiplatelet-therapy-to-treat-a-left-ventricular-thrombus-in-an-87-year-old-patient-with-myocardial-infarction-and-very-high-bleeding-risk
#6
Maria Noflatscher, Nicolas Moes, Eva-Maria Gassner, Peter Marschang
Background: A left ventricular (LV) thrombus is detected in approximately 5-10% of patients after myocardial infarction (MI). If left untreated, these LV thrombi carry a significant risk of complications including embolic stroke. According to current guidelines, anticoagulation with vitamin K antagonists (VKA) is recommended to treat a LV thrombus. Case presentation: An 87 year old patient was referred to our department with non ST-elevation MI. Five months before, he had been diagnosed with a subacute ST elevation MI, which had been treated conservatively...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29664236/use-of-non-vitamin-k-antagonist-oral-anticoagulants-2008-2016-a-danish-nationwide-cohort-study
#7
Simone Haastrup, Maja Hellfritzsch, Lotte Rasmussen, Anton Pottegård, Erik Lerkevang Grove
We aimed to provide detailed utilization data on the total use of non-vitamin K antagonist oral anticoagulants (NOACs) since their introduction in 2008. Using the nationwide Danish National Prescription Registry, we identified all individuals filling prescriptions for NOACs 2008-2016. We reported the development in incident and prevalent users and explored baseline characteristics and treatment persistence according to treatment indication. A total of 126,691 NOAC users were identified within the Danish population of 5...
April 17, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29663443/time-trends-in-antithrombotic-management-of-patients-with-atrial-fibrillation-treated-with-coronary-stents-results-from-talent-af-the-international-stent-atrial-fibrillation-study-multicenter-registry
#8
Brian J Potter, Giuseppe Andò, Giovanni Cimmino, Ricardo Ladeiras-Lopes, Zied Frikah, Xin Yue Chen, Vittorio Virga, Joao Goncalves-Almeida, A John Camm, Keith A A Fox
BACKGROUND: Antithrombotic management of patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI) is highly variable; limited evidence-based guidelines exist to influence practice. HYPOTHESIS: Patient characteristics and availability of novel drugs may have contributed to practice variability. METHODS: We undertook an international multicenter retrospective registry of AF patients treated with PCI. The primary measures of interest were antiplatelet and OAC prescriptions at discharge...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29663313/microbleeds-in-ischemic-vs-hemorrhagic-strokes-on-novel-oral-anticoagulants
#9
J C Purrucker, M Wolf, K Haas, T Siedler, T Rizos, S Khan, P U Heuschmann, R Veltkamp
OBJECTIVES: To identify differences in clinical characteristics and severity of cerebral small vessel disease (CSVD) including cerebral microbleeds (CMBs), between patients suffering ischemic stroke (IS) or intracerebral hemorrhage (ICH) while taking novel (non-vitamin K antagonists) oral anticoagulants (NOACs). METHODS: Multicenter, prospective, observational cohort study performed at 38 centers between 2012 and 2015. We compared demographics, comorbidity, and functional status (before and after stroke) between NOAC-IS and NOAC-ICH patients...
April 16, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29656119/state-of-play-and-future-direction-with-noacs-an-expert-consensus
#10
REVIEW
A T Cohen, G Y Lip, R De Caterina, H Heidbuchel, J L Zamorano, G Agnelli, F Verheugt, A J Camm
Atrial fibrillation (AF) and venous thromboembolism (VTE) are cardiovascular conditions significant in contemporary practice. In both, the use of anticoagulation with vitamin K antagonists (VKAs) has been traditionally used to prevent adverse events. However, VKA therapy is associated with challenges relating to dose maintenance, the need to monitor anticoagulation, and bleeding risks. The non-vitamin K oral anticoagulants (NOACs) are becoming accepted as a clear alternative to VKA therapy for both AF and VTE management...
April 12, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29648661/anticoagulation-therapy-in-patients-with-non-valvular-atrial-fibrillation-hospitalized-in-the-department-of-medicine-in-the-noacs-era
#11
Alaa Atamna, Mohamad Suki, Hadeel Kena'any, Avishay Elis
Background: The treatment of atrial fibrillation (AF) includes anticoagulation therapy (AC) to prevent systemic emboli. Until recently, warfarin was the main anticoagulation agent, while in recent years the new oral anticoagulants (NOACs) are increasingly being used. The aim of our study was to characterize the AC treatment policy of AF patients at the department of medicine in the NOACs era. Methods: An observational study of consecutive hospitalized patients with non-valvular AF for a period of 3 months in Beilinson hospital (January - March 2017)...
April 10, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29644411/noac-monotherapy-in-patients-with-concomitant-indications-for-oral-anticoagulation-undergoing-transcatheter-aortic-valve-implantation
#12
Nicolas A Geis, Christina Kiriakou, Emmanuel Chorianopoulos, Lorenz Uhlmann, Hugo A Katus, Raffi Bekeredjian
AIMS: Antithrombotic therapy after transcatheter aortic valve implantation (TAVI) is highly controversial and guideline recommendations are not evidence based. We assessed efficacy and safety of non-vitamin K antagonist oral anticoagulant (NOAC) monotherapy in patients with concomitant indications for OAC undergoing TAVI. METHODS: Among more than 1300 TAVI patients since 2008, 154 patients were identified who received postinterventional NOAC monotherapy. Outcomes were compared to 172 patients treated with vitamin K antagonist (VKA) monotherapy...
April 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29628941/early-outcome-after-intracranial-hemorrhage-related-to-non-vitamin-k-oral-anticoagulants
#13
Senta Frol, Janja Pretnar Oblak
Background: Intracranial hemorrhage (ICH) is a serious, life-threatening, but fortunately rare complication of non-vitamin K oral anticoagulant (NOAC) therapy. There are limited data on NOAC-related ICH prognosis. Methods: All consecutive patients admitted to a single center due to acute NOAC-related ICH from September 2012 until the beginning of 2017 were included. Risk factors, type of NOAC, and location of ICH were evaluated. Risk for ischemic and bleeding events and clinical status upon admission and at discharge were evaluated using standard scales...
February 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29622761/simultaneous-pancreas-kidney-transplantation-in-a-patient-with-heparin-induced-thrombocytopenia-on-dabigatran-therapy
#14
Agnieszka Jóźwik, Wojciech Lisik, Jarosław Czerwiński, Maciej Kosieradzki
BACKGROUND New oral anticoagulants like direct thrombin inhibitors are an attractive alternative to vitamin K antagonists as anticoagulation therapy and can be used in heparin-induced thrombocytopenia. They are convenient in low-risk surgery, as there is no need for bridging with heparins. Patients who need urgent major surgery are at similar risk as on warfarin therapy, which, however, is much higher than in elective procedures. Due to their elimination profiles, these drugs are generally contraindicated in patients with severe renal insufficiency...
April 6, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29622587/efficacy-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-asians-with-nonvalvular-atrial-fibrillation
#15
Yi-Hsin Chan, Lai-Chu See, Hui-Tzu Tu, Yung-Hsin Yeh, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Chun-Li Wang, Chang-Fu Kuo, Chi-Tai Kuo
BACKGROUND: Whether non-vitamin K antagonist oral anticoagulants (NOACs) are superior to warfarin among Asians with nonvalvular atrial fibrillation remains unclear. METHODS AND RESULTS: In this nationwide retrospective cohort study collected from Taiwan National Health Insurance Research Database, there were 5843, 20 079, 27 777, and 19 375 nonvalvular atrial fibrillation patients taking apixaban, dabigatran, rivaroxaban and warfarin, respectively, from June 1, 2012 to December 31, 2016...
April 5, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29622509/impact-of-bmi-on-clinical-outcomes-of-noac-therapy-in-daily-care-results-of-the-prospective-dresden-noac-registry-nct01588119
#16
L Tittl, S Endig, S Marten, A Reitter, I Beyer-Westendorf, J Beyer-Westendorf
Direct acting non-Vitamin K antagonist oral anticoagulants (NOAC) are characterized by a fixed dosing regimen. Despite the potential for relative underdosing due to large distribution volumes, dose adjustments for patients with high body mass index (BMI) are not recommended. Since efficacy and safety data in obese patients are scarce, we evaluated the impact of BMI on clinical outcomes in daily care patients treated with NOAC for stroke prevention in atrial fibrillation or venous thromboembolism. Using prospectively collected data from a non-interventional registry, cardiovascular (CV), major bleeding events (MB) and all-cause mortality were evaluated according to BMI classes...
March 14, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29621248/adherence-to-rivaroxaban-versus-apixaban-among-patients-with-non-valvular-atrial-fibrillation-analysis-of-overall-population-and-subgroups-of-prior-oral-anticoagulant-users
#17
Colleen A McHorney, Concetta Crivera, François Laliberté, Guillaume Germain, Willy Wynant, Patrick Lefebvre
BACKGROUND: Medication non-adherence can result in poor health outcomes. Understanding differences in adherence rates to non-vitamin K oral anticoagulants (NOACs) could guide treatment decisions and improve clinical outcomes among patients with non-valvular atrial fibrillation (NVAF). OBJECTIVE: To compare adherence to rivaroxaban and apixaban among the overall NVAF population and subgroups of prior oral anticoagulant (OAC) users (e.g., multiple comorbidities, non-adherence risk factors)...
2018: PloS One
https://www.readbyqxmd.com/read/29618160/comparing-non-vitamin-k-antagonist-oral-anticoagulants-noacs-to-different-coumadins-the-win-win-scenarios
#18
Tatjana S Potpara
No abstract text is available yet for this article.
April 4, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29616407/a-meta-summary-of-case-reports-of-non-vitamin-k-antagonist-oral-anticoagulant-use-in-patients-with-left-ventricular-thrombus
#19
Aloysius Sheng-Ting Leow, Ching-Hui Sia, Benjamin Yong-Qiang Tan, Joshua Ping-Yun Loh
Left ventricular (LV) thrombus is commonly seen in patients with extensive anterior ST-elevation myocardial infarction. The standard of care for LV thrombus is anticoagulation with warfarin. However, there has been an increasing trend of case reports using non-vitamin K antagonist oral anticoagulants (NOAC) for the treatment of LV thrombus. This study aimed to perform a meta-summary of the literature to characterise and evaluate the safety and feasibility of using NOAC in patients with LV thrombus. We searched for articles published in four electronic databases: PubMed, EMBASE, Scopus and Google Scholar using an appropriate keyword/MeSH term search strategy...
April 3, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29608110/fitting-the-right-non-vitamin-k-antagonist-oral-anticoagulant-to-the-right-patient-with-non-valvular-atrial-fibrillation-an-evidence-based-choice
#20
Yanguang Li, Daniele Pastori, Gregory Yh Lip
Atrial fibrillation (AF) is the most prevalent arrhythmia and is associated with an increased risk of ischemic stroke (IS) and systemic embolism (SE). Stroke prevention is a key element for the overall management of AF patients. The non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, rivaroxaban, apixaban and edoxaban, are at least as effective as warfarin in reducing IS/SE with a lower rate of major bleeding. Various analyses from the large Phase III randomised trials demonstrated different efficacy and safety of NOACs in specific subgroups of patients...
April 2, 2018: Annals of Medicine
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