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Oral anticoagulation

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https://www.readbyqxmd.com/read/28938240/atrial-fibrillation-bleeding-and-coronary-intervention-current-recommendations
#1
Serdar Farhan, Roxana Mehran
The patient population with the need for oral anticoagulation to reduce stroke risk associated with atrial fibrillation (AF) and dual antiplatelet therapy to prevent stent thrombosis and myocardial infarction after percutaneous coronary intervention is increasing. However, patients treated with a triple therapy consisting of oral anticoagulation, aspirin, and a P2Y12 inhibitor have been demonstrated to be at high bleeding risk. The best combination of these agents and the duration of the different therapies are still uncertain...
September 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28937581/thrombosis-on-a-left-atrial-appendage-occluder-device-the-double-edged-sword-of-stroke-prevention-strategies-in-atrial-fibrillation
#2
Giuseppe Ciconte, Manuel Conti, Mario Baldi, Massimo Saviano, Gabriele Vicedomini, Carlo Pappone
: A huge thrombus, developing after percutaneous left atrial appendage occlusion, has been successfully treated with dabigatran and aspirin as combination therapy.Although novel oral anticoagulants alone may be effective in thrombus dissolution, the association of an antiplatelet drug may safely enhance this process.
September 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28936148/the-potential-anticoagulant-property-of-caulerpa-lentillifera-crude-extract
#3
Althea R Arenajo, Adrian P Ybañez, Maria Maichol P Ababan, Charlotte E Villajuan, May Rose M Lasam, Chiqui P Young, Julie Lynn A Reyes
BACKGROUND: Anticoagulants have been used in the treatment of several circulatory diseases and thrombotic disorders, and in the blood sampling for hematologic analysis. Sulfated polysaccharides (SP), which have anticoagulant properties, are found in most seaweeds, including Caulerpa spp. OBJECTIVE: The study generally aimed to evaluate the potential anticoagulant property of Caulerpa lentillifera. METHODOLOGY: The whole plant of fresh C. lentillifera was washed thoroughly with distilled water and manually expressed to obtain the extract...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28936083/unilateral-papilledema-in-cerebral-venous-sinus-thrombosis
#4
Girish Baburao Kulkarni, Ravinder Jeet Singh, Veeranna Gadad, Subasree Ramakrishnan, Veerendrakumar Mustare
In the majority of patients with raised intracranial pressure, the papilledema is bilateral. Unilateral papilledema is rare in conditions causing intracranial hypertension, and it has been described in Foster-Kennedy syndrome and in some cases of idiopathic intracranial hypertension. It has never been reported in cerebral venous thrombosis. We report a young lady presenting with features of subacute onset of headache with seizures, on evaluation she had superior sagittal and bilateral lateral sinus thrombosis...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28935464/effectiveness-and-safety-of-oral-anticoagulation-with-non-vitamin-k-antagonists-compared-to-well-managed-vitamin-k-antagonists-in-na%C3%A3-ve-patients-with-non-valvular-atrial-fibrillation-propensity-score-matched-cohort-study
#5
Gentian Denas, Nicola Gennaro, Eliana Ferroni, Ugo Fedeli, Mario Saugo, Giacomo Zoppellaro, Seena Padayattil Jose, Giorgio Costa, Maria Chiara Corti, Margherita Andretta, Vittorio Pengo
BACKGROUND: The global real-life impact of non-vitamin K antagonist oral anticoagulants (NOACs) introduction in the healthcare system in a setting of well-managed vitamin K antagonist (VKA) therapy has not been specifically addressed. METHODS: We did a population-based retrospective cohort study in naïve patients initiating oral anticoagulants for stroke prevention in atrial fibrillation in a region with a well-managed VKA therapy. NOAC and VKA cohorts were identified using Anatomical Therapeutic Chemical (ATC) codes, while excluding other indications for anticoagulation therapy using ICD-9CM codes...
September 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28935034/persistence-with-dabigatran-therapy-at-2%C3%A2-years-in-patients-with-atrial-fibrillation
#6
Miney Paquette, Lionel Riou França, Christine Teutsch, Hans-Christoph Diener, Shihai Lu, Sergio J Dubner, Chang Sheng Ma, Kenneth J Rothman, Kristina Zint, Jonathan L Halperin, Menno V Huisman, Gregory Y H Lip, Robby Nieuwlaat
BACKGROUND: Guidelines recommend long-term oral anticoagulation therapy for stroke prevention in patients with atrial fibrillation (AF). Treatment discontinuation rates in vitamin K antagonist (VKA)-treated patients are high but may be lower with non-VKA oral anticoagulant agents. OBJECTIVES: The goal of this study was to describe and explore predictors of dabigatran etexilate persistence in patients with newly diagnosed AF over 2 years of follow-up. METHODS: Consecutive patients newly diagnosed with AF and ≥1 stroke risk factor were followed up for 2 years...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28933799/rivaroxaban-for-preventing-venous-thromboembolism-in-high-risk-ambulatory-patients-with-cancer-rationale-and-design-of-the-cassini-trial-rationale-and-design-of-the-cassini-trial
#7
Alok Khorana, Saroj Vadhan-Raj, Nicole M Kuderer, Ted Wun, Howard Liebman, Gerald Soff, Chandra Belani, Eileen M O'Reilly, Robert McBane, John Eikelboom, C V Damaraju, Karen Beyers, Flavia Dietrich, Ajay Kakkar, Hanno Riess, Renata D'Alpino Peixoto, Gary H Lyman
Venous thromboembolism (VTE) is a frequent complication of cancer associated with morbidity, mortality, increased hospitalizations and higher health care costs. Cancer patients at increased risk for VTE can be identified using a validated risk assessment score, and the incidence of VTE can be reduced in high-risk settings using anticoagulation. Rivaroxaban is a potent, oral, direct, factor Xa inhibitor approved for the prevention and treatment of thromboembolic events, including VTE. CASSINI is a double-blind, randomized, parallel-group, multicentre study comparing rivaroxaban with placebo in adult ambulatory patients with various cancers who are initiating systemic cancer therapy and are at high risk of VTE (Khorana score ≥ 2)...
September 21, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28933640/the-impact-of-antithrombin-deficiency-on-women-s-reproductive-health-experiences-and-healthcare-decision-making
#8
Ariela L Marshall, Juliana Perez Botero, Aneel A Ashrani, Rajiv K Pruthi, John A Heit, Ashish Chintakuntlawar, Jennifer C Guenther, Mrinal M Patnaik
BACKGROUND: Women with inherited antithrombin (AT) deficiency are at high risk for venous thromboembolism (VTE), especially during times of estrogen exposure, but little is known about patient-oriented reproductive decision-making in this population. MATERIALS AND METHODS: Provider-administered survey of women with AT deficiency. Participants were asked to discuss their diagnosis of AT deficiency and questioned about (1) contraception, (2) pregnancies, and (3) menorrhagia, and the impact of their AT deficiency on each reproductive health experience...
September 21, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28932938/assessment-of-oral-anticoagulation-control-at-two-pharmacist-managed-clinics-in-brazil
#9
Rogério Guimarães de Lima Silva, Caryne Margotto Bertollo, Isadora Gonçalves Ferreira, Luisa Caldeira Brant, Maria Auxiliadora Parreiras Martins
Background Warfarin remains widely used by patients with cardiovascular diseases. When using warfarin, the quality of oral anticoagulation control is a critical determinant to minimize the risk of bleeding and thromboembolic events. Pharmacist engagement in patient care is relevant towards improving the quality of warfarin therapy. Objective To assess the quality of oral anticoagulation control measured by time in therapeutic range (TTR) at two pharmacist-managed anticoagulation clinics (AC). Method This study included adults with indication of continuous warfarin use...
September 20, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28932314/cost-effectiveness-analysis-of-treatment-acute-deep-vein-thrombosis-in-clinic-of-vascular-surgery-sarajevo
#10
Haris Vukas, Samra Kadić-Vukas, Adis Salihbegović, Muhamed Djedović, Dragan Totić, Haris Vranić, Amel Hadžimehmedagić
AIM: To compare hospital costs of acute deep vein thrombosis (ADVT) treatment in two periods of time. Evidence of repercussions on reducing costs during successful treatment. Attention was given to the necessity, costs and effectiveness of diagnostic procedures, treatment and complications. METHODS: A retrospective analysis of data obtained from patients medical history in a period from 2000 to 2016. Model management and safe practice of ADVT care consisted of clinical examination, laboratory, colour Doppler and invasive diagnostics...
August 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#11
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
September 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28930849/analysis-of-risk-factors-for-colonic-diverticular-bleeding-and-recurrence
#12
Masato Taki, Tadayuki Oshima, Katsuyuki Tozawa, Yukako Taniguchi, Toshihiko Tomita, Yoshio Ohda, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
The increase in incidence of colonic diverticular bleeding is relative to an age-related rise in the incidence of colonic diverticulosis and use of antithrombotic medication. However, risk factors related to the onset, recurrence, and prophylaxis have not been established. Therefore, we aimed to determine risk factors for the onset and recurrence of colonic diverticular bleeding.An age- and sex-matched case-control study was performed to assess the risk factors for the onset of colonic diverticular bleeding...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930804/venous-thromboembolism-in-gynecological-malignancy
#13
Abigail Cohen, Chung Sim Lim, Alun Huw Davies
OBJECTIVE: Venous thromboembolism (VTE) is a recognized complication of gynecological malignancy and represents a leading cause of morbidity and mortality in these patients. The review aimed to discuss the incidence, risk factors, and clinical presentation of VTE before examining the literature on the diagnosis, prevention, and management in the context of uterine, cervical, ovarian, and vulval cancers. METHODS/MATERIALS: A literature search was performed using Ovid Medline and Embase with the following words: "gynecological malignancy," "pelvic tumor," "venous thromboembolism," "deep vein thrombosis" and "pulmonary embolism...
September 19, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28929298/chronic-kidney-disease-and-anticoagulation-from-vitamin-k-antagonists-and-heparins-to-direct-oral-anticoagulant-agents
#14
REVIEW
Savino Sciascia, Massimo Radin, Karen Schreiber, Roberta Fenoglio, Simone Baldovino, Dario Roccatello
Anticoagulation in patients with impaired kidney function can be challenging since drugs' pharmacokinetics and bioavailability are altered in this setting. Patients with chronic kidney disease (CKD) treated with conventional anticoagulant agents [vitamin K antagonist (VKA), low-molecular weight heparin (LMWH) or unfractionated heparin (UFH)] are at high risk of bleeding events (both non-major and major clinically relevant bleeding). While anticoagulation reduces the risk of thromboembolic events, the co-existing bleeding risk and the fact that the most commonly used anticoagulation agents are eliminated via the kidneys pose additional challenges...
September 19, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28921890/phase-ii-study-of-dabigatran-in-children-with-venous-thrombosis-pharmacokinetics-safety-and-tolerabilty
#15
J M L Halton, M Albisetti, B Biss, L Bomgaars, M Brueckmann, S Gropper, R Harper, F Huang, M Luciani, H Maas, I Tartakovsky, L G Mitchell
BACKGROUND: The current standard-of-care treatments for pediatric venous thromboembolism (VTE) have limitations. Dabigatran etexilate (DE), a direct thrombin inhibitor, may offer an alternative therapeutic option. OBJECTIVES: To assess the pharmacokinetics (PK), pharmacodynamics (PD), safety and tolerability of DE oral liquid formulation (OLF) in pediatric patients with VTE. PATIENTS/METHODS: Patients who had completed planned treatment with low-molecular-weight heparin or oral anticoagulants for VTE were enrolled in two age groups (2-<12 and 1-<2 years) and received DE OLF based on an age- and weight-adjusted nomogram...
September 16, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28921408/catheter-ablation-for-af-improves-global-thrombotic-profile-and-enhances-fibrinolysis
#16
Maria Niespialowska-Steuden, Vias Markides, Mohamed Farag, David Jones, Wajid Hussain, Tom Wong, Diana A Gorog
Patients with atrial fibrillation (AF) are at increased risk of thrombotic events despite oral anticoagulation (OAC). Radiofrequency catheter ablation (RFCA) can restore and maintain sinus rhythm (SR) in patients with AF. To assess whether RFCA improves thrombotic status. 80 patients (71% male, 64 ± 12y) with recently diagnosed AF, on OAC and scheduled to undergo RFCA or DC cardioversion (DCCV) were recruited. Thrombotic status was assessed using the point-of-care global thrombosis test (GTT), before, and 4-6 weeks after DCCV and 3 months after RFCA...
September 18, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#17
REVIEW
Christopher Goshgarian, Philip B Gorelick
PURPOSE OF REVIEW: The purpose of this review is to discuss the prevention of venous thromboembolism (VTE) in stroke patients. We discuss use of oral anticoagulation and other interventions for the prevention of VTE. A new class of medications, non-vitamin K antagonist oral anticoagulants (NOACs), have been successfully trialed for the prevention of VTE. We review the data and guidance statements for VTE prevention. RECENT FINDINGS: Warfarin and vitamin K antagonist drugs have been the mainstay of VTE prevention for decades...
September 18, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28919457/patterns-of-botulinum-toxin-treatment-for-spasticity-and-bleeding-complications-in-patients-with-thrombotic-risk
#18
Chetan P Phadke, Vivekanand Thanikachalam, Farooq Ismail, Chris Boulias
The purpose of this study was to assess the prevalence of compartment syndrome or major bleeding episodes and compare compartment syndrome, patient and intervention characteristics in 110 patients with stroke (treated with Warfarin, new oral anticoagulants, antiplatelet, or no anticoagulants) treated for spasticity in deep leg compartment muscles with botulinum toxin injections [onabotulinumtoxinA (n = 77); incobotulinumtoxinA (n = 33)]. We reviewed 674 injection cycles (range 1-25 cycles per patient) and found no cases of compartment syndrome in any patient groups...
September 15, 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28918657/direct-oral-anticoagulant-use-in-atypical-thrombosis-related-conditions
#19
Clement Chang, Mario Hoyos, Yaw Owusu, Hazem Elewa
OBJECTIVE: To review the published literature for evidence of the efficacy and safety of direct oral anticoagulants (DOACs) when used in the management of atypical thrombosis-related conditions. DATA SOURCES: A comprehensive MEDLINE database search (1948 to July 2017) and EMBASE search (1980 to July 2017) were conducted using the search terms direct oral anticoagulant in combination with acute coronary syndrome (ACS), antiphospholipid antibody syndrome (APLAS), and cancer-associated thrombosis (CAT)...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28918087/left-atrial-enlargement-and-anticoagulation-status-in-patients-with-acute-ischemic-stroke-and-atrial-fibrillation
#20
Katarina Dakay, Andrew D Chang, Morgan Hemendinger, Shawna Cutting, Ryan A McTaggart, Mahesh V Jayaraman, Antony Chu, Nikhil Panda, Christopher Song, Alexander Merkler, Gino Gialdini, Benjamin Kummer, Michael P Lerario, Hooman Kamel, Mitchell S V Elkind, Karen L Furie, Shadi Yaghi
BACKGROUND: Despite anticoagulation therapy, ischemic stroke risk in atrial fibrillation (AF) remains substantial. We hypothesize that left atrial enlargement (LAE) is more prevalent in AF patients admitted with ischemic stroke who are therapeutic, as opposed to nontherapeutic, on anticoagulation. METHODS: We included consecutive patients with AF admitted with ischemic stroke between April 1, 2015, and December 31, 2016. Patients were divided into two groups based on whether they were therapeutic (warfarin with an international normalized ratio ≥ 2...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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