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warfarin understanding

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https://www.readbyqxmd.com/read/29753636/coronary-arterial-calcification-a-review-of-mechanisms-promoters-and-imaging
#1
REVIEW
Jordan Andrews, Peter J Psaltis, Belinda A Di Bartolo, Stephen J Nicholls, Rishi Puri
Coronary artery calcification (CAC) was once thought to be a passive, degenerative, and quiescent development of disease. However, it has now been shown to be an active process associated with atherosclerosis that is stimulated by inflammatory pathways. Calcification forms within the intimal and medial layers of the vessel wall by way of mechanisms similar to bone development. A variety of imaging modalities have been used to identify and characterize CAC, from early microcalcifications to well-developed fibroatheromas that have calcified...
May 2, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29743994/approaches-to-left-atrial-appendage-closure-device-design-performance-and-limitations
#2
REVIEW
Amish S Dave, Miguel Valderrábano
Up to 6.1 million people in the United States have atrial fibrillation (AF), which is associated with an increased risk of stroke. Oral anticoagulants are the mainstay of stroke prevention in AF. For decades, warfarin was the only available drug, fraught with compliance limitations, a narrow therapeutic window, and a high risk of hemorrhage. Pharmacologic developments have produced new anticoagulants that have improved the rates of stroke related to AF; however, they still confer a high risk of bleeding, making them unsuitable for some patients...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29728318/non-vitamin-k-dependent-oral-anticoagulants-for-nonvalvular-atrial-fibrillation-in-patients-with-ckd-pragmatic-considerations-for-the-clinician
#3
Gautam R Shroff, Rachel Stoecker, Allyson Hart
Management of atrial fibrillation (AF) in patients with advanced chronic kidney disease (CKD) poses a complex conundrum because of higher risks for both thromboembolic and bleeding complications compared to the general population. This makes it particularly important for clinicians to carefully weigh the risks versus benefits of anticoagulation therapy to determine the individualized net clinical benefit for every patient. During the past few years, 4 non-vitamin K-dependent oral anticoagulant (NOAC) agents have supplemented warfarin in the therapeutic armamentarium for the prevention of systemic thromboembolism in nonvalvular AF...
May 2, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29724296/identification-of-gene-modules-associated-with-warfarin-dosage-by-a-genome-wide-dna-methylation-study
#4
Zhiying Luo, Rong Liu, Bao Sun, Xinming Zhou, Zhaoqian Liu, Honghao Zhou, Heng Xu, Xi Li, Wei Zhang
OBJECTIVE: To identify warfarin dose-associated DNA methylation changes, we conducted the first genomewide DNA methylation association study. METHOD: A total of 22 patients who required an extreme warfarin dosage from VKORC1 -1639AA & CYP2C9*1*1 genotype group were enrolled in this study. The Illumina Infinium HumanMethylation450 platform was used to perform genome-scale DNA methylation profiling, identifying differentially methylated CpG sites by a nonparametric test...
May 1, 2018: Die Pharmazie
https://www.readbyqxmd.com/read/29710221/what-surgeons-should-know-about-non-vitamin-k-oral-anticoagulants-a-review
#5
Atul Verma, Andrew C T Ha, James T Rutka, Subodh Verma
Importance: Non-vitamin K oral anticoagulants (NOACs) are increasingly prescribed for patients to treat or prevent arterial or venous thromboembolism. The following 4 NOAC agents are approved by the US Food and Drug Administration for clinical use: dabigatran etexilate, apixaban, edoxaban tosylate, and rivaroxaban. A good understanding of these agents' pharmacologic properties is important for surgeons given their marked differences compared with warfarin sodium. This review highlights key practical issues surrounding the use of NOACs in the perioperative setting...
April 18, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29703388/update-of-green-tea-interactions-with-cardiovascular-drugs-and-putative-mechanisms
#6
REVIEW
José Pablo Werba, Shingen Misaka, Monica Gianna Giroli, Kenju Shimomura, Manuela Amato, Niccolò Simonelli, Lorenzo Vigo, Elena Tremoli
Many patients treated with cardiovascular (CV) drugs drink green tea (GT), either as a cultural tradition or persuaded of its putative beneficial effects for health. Yet, GT may affect the pharmacokinetics and pharmacodynamics of CV compounds. Novel GT-CV drug interactions were reported for rosuvastatin, sildenafil and tacrolimus. Putative mechanisms involve inhibitory effects of GT catechins at the intestinal level on influx transporters OATP1A2 or OATP2B1 for rosuvastatin, on CYP3A for sildenafil and on both CYP3A and the efflux transporter p-glycoprotein for tacrolimus...
April 2018: Journal of Food and Drug Analysis
https://www.readbyqxmd.com/read/29696409/valvular-heart-disease-and-pregnancy
#7
REVIEW
Emily S Lau, Nandita S Scott
With improving reproductive assistive technologies, advancing maternal age, and improved survival of patients with congenital heart disease, valvular heart disease has become an important cause of morbidity and mortality in pregnant women. In general, stenotic lesions, even those in the moderate range, are poorly tolerated in the face of hemodynamic changes of pregnancy. Regurgitant lesions, however, fare better due to the physiologic afterload reduction that occurs. Intervention on regurgitant valve preconception follows the same principles as a non-pregnant population...
April 26, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29665197/stabilization-of-warfarin-binding-pocket-of-vkorc1-and-vkorl1-by-a-peripheral-region-determines-their-different-sensitivity-to-warfarin-inhibition
#8
G Shen, S Li, W Cui, S Liu, Q Liu, Y Yang, M Gross, W Li
The human genome encodes two paralogs of vitamin-K-epoxide reductase, VKORC1 and VKORL1, that support blood coagulation and other vitamin-K-dependent processes. Warfarin inhibits both enzymes, but VKORL1 is relatively resistant to warfarin OBJECTIVES: To understand the difference between VKORL1 and VKORC1, and the cause of warfarin-resistant (WR) mutations in VKORC1 METHODS: We performed systematic mutagenesis and analyzed warfarin responses with a cell-based activity assay. Mass spectrometry analyses were used to detect cellular redox state RESULTS: VKORC1 and VKORL1 adopt a similar intracellular redox state with four-transmembrane-helix topology...
April 17, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29605836/structure-and-function-of-anticoagulation-clinics-in-the-united-states-an-ac-forum-membership-survey
#9
Geoffrey D Barnes, Eva Kline-Rogers, Christopher Graves, Eric Puroll, Xiaokui Gu, Kevin Townsend, Ellen McMahon, Terri Craig, James B Froehlich
Many anticoagulation clinics have adapted their services to provide care for patients taking direct oral anticoagulants (DOAC) in addition to traditional warfarin management. Anticoagulation clinic scope of service and operations in this transitional environment have not been well described in the literature. A survey was conducted of United States-based Anticoagulation Forum members to inquire about anticoagulation clinic structure, function, and services provided. Survey responses are reported using summary or non-parametric statistics, when appropriate...
March 31, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29512220/study-on-the-molecular-recognition-action-of-lamivudine-by-human-serum-albumin
#10
Hua-Xin Zhang, Dan Zhou, Qing-Hua Xia
In this work, the interaction of an anti-HIV drug lamivudine and human serum albumin (HSA) was studied by multispectroscopic and molecular modeling methods. The fluorescence emission spectra showed that the fluorescence of HSA was quenched by lamivudine through static mechanism with HSA-lamivudine complex produced at ground state. According to the binding equilibriums observed at 4 different temperatures, the number of binding site, binding constant, enthalpy change, entropy change, and Gibbs free energy change of the interaction were calculated...
March 7, 2018: Journal of Molecular Recognition: JMR
https://www.readbyqxmd.com/read/29501323/antithrombotic-therapies-in-children-on-durable-ventricular-assist-devices-a-literature-review
#11
Joanna Y Huang, Paul Monagle, M Patricia Massicotte, Christina J VanderPluym
INTRODUCTION: Ventricular Assist Devices (VADs) are increasingly utilised in children with end-stage heart failure, and experience high bleeding and clotting rates. In particular, pediatric VAD patients are more challenging than adults to anticoagulate due to developmental hemostasis, lack of suitable drug preparations, and difficult anticoagulation monitoring often due to poor vascular access; in addition to difficulties of VAD design in smaller children. This review aims to summarize the current evidence related to antithrombotic therapy in pediatric VAD patients...
February 28, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29447084/binding-site-identification-of-anticancer-drug-gefitinib-to-hsa-and-dna-in-the-presence-of-five-different-probes
#12
Hamid Tanzadehpanah, Hanie Mahaki, Neda Hosseinpour Moghadam, Sadegh Salehzadeh, Omid Rajabi, Rezvan Najafi, Razieh Amini, Massoud Saidijam
This study was carried out to evaluate the binding interaction of gefitinib (GEF) with human serum albumin (HSA) and calf thymus DNA (ct-DNA) using fluorescence, UV-Visible, zeta potential measurements and molecular docking methods in order to understand its pharmacokinetic mechanism. By increasing the temperature, a steady decrease in Stern-Volmer quenching constants was observed for HSA binding properties; this indicates a static type of fluorescence quenching. Negative values were calculated for Gibbs free energy (ΔG), enthalpy (ΔH), and entropy (ΔS) changes, indicating that the reaction is spontaneous and enthalpy-driven...
February 22, 2018: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/29444357/safety-of-direct-oral-anticoagulants-vs-warfarin-in-patients-with-chronic-liver-disease-and-atrial-fibrillation
#13
Pavel Goriacko, Keith T Veltri
BACKGROUND: A complication of chronic liver disease (CLD) is the abnormality of coagulation. In clinical practice, this increased risk of bleeding has not been identified as a protective factor against stroke or systemic embolism associated with atrial fibrillation (AF). The objective of this study was to assess the safety of direct oral anticoagulant (DOAC) agents vs warfarin in CLD patients with AF. METHODS: This was a retrospective cohort study of patients with CLD and AF initiated on oral anticoagulants...
May 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29423559/mind-the-gap-results-of-a-multispecialty-survey-on-coordination-of-care-for-peri-procedural-anticoagulation
#14
Jacob E Kurlander, Geoffrey D Barnes, Michelle A Anderson, Brian Haymart, Eva Kline-Rogers, Scott Kaatz, Sameer D Saini, Sarah L Krein, Caroline R Richardson, James B Froehlich
To understand how physicians from various specialties perceive coordination of care when managing peri-procedural anticoagulation. Cross-sectional survey of cardiologists, gastroenterologists, and primary care physicians (PCPs) in an integrated health system (N = 251). The survey began with a vignette of a patient with atrial fibrillation co-managed by his PCP, cardiologist, and an anticoagulation clinic who must hold warfarin for a colonoscopy. Respondents' experiences and opinions around responsibilities and institutional support for managing peri-procedural anticoagulation were elicited using multiple choice questions...
April 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29384289/principles-and-nursing-management-of-anticoagulation
#15
Emma Gee
Anticoagulant drugs are widely used in hospital and community settings. Anticoagulation is the first-line treatment for venous thromboembolism, and anticoagulant drugs have an important role in the treatment and prevention of blood clots. However, maintaining the equilibrium between clotting and bleeding can be challenging and anticoagulants have been identified as a class of drug associated with preventable patient harm. Direct oral anticoagulants (DOACs) have become the first-line treatment for many patients requiring an anticoagulant, removing the burden of frequent tests and the many food and drug interactions associated with vitamin K antagonists such as warfarin sodium...
January 31, 2018: Nursing Standard
https://www.readbyqxmd.com/read/29283063/antiplatelet-potential-of-plant-derived-glycosides-as-possible-lead-compounds
#16
Haroon Khan, Aini Pervaiz, Mohammad A Kamal, Seema Patel
Blood platelets are crucial for maintaining hemostasis and several events in the wound-healing. However, platelet up-regulation leads to the development and the complications of several cardiovascular diseases. For the effective management of these complications, several synthetic drugs are in clinical practice such as aspirin and warfarin. since a long time. But some adverse reactions like aspirin resistance and bleed disorders cause patient in compliance and reduce their therapeutic potential. Thus, the search for potent and safer antiplatelet agents is of great interest...
December 27, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/29280698/haematological-factors-in-the-management-of-adult-epistaxis-systematic-review
#17
REVIEW
A Williams, A Biffen, N Pilkington, L Arrick, R J Williams, M E Smith, M Smith, J Birchall
BACKGROUND: The management of epistaxis requires an understanding of haematological factors that may complicate its treatment. This systematic review includes six distinct reviews examining the evidence supporting epistaxis-specific management strategies relating to warfarin, direct oral anticoagulants, heparin, antiplatelet agents, tranexamic acid and transfusion. METHOD: A systematic review of the literature was performed using a standardised methodology and search strategy...
December 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29277691/genetic-polymorphisms-of-drug-metabolizing-cytochrome-p450-enzymes-in-cynomolgus-and-rhesus-monkeys-and-common-marmosets-in-preclinical-studies-for-humans
#18
REVIEW
Yasuhiro Uno, Shotaro Uehara, Hiroshi Yamazaki
Cynomolgus monkeys (Macaca fascicularis, Old World Monkeys) and common marmosets (Callithrix jacchus, New World Monkeys) have been widely, and expectedly, used as non-human primate models in drug development studies. Major drug-metabolizing cytochrome P450 (P450) enzymes information is now available that supports these primate species as animal models, and it is established that multiple forms of cynomolgus monkey and common marmoset P450 enzymes have generally similar substrate recognition functionality to human P450 enzymes...
December 23, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/29250280/time-to-revisit-the-time-in-the-therapeutic-range
#19
REVIEW
James A Reiffel
In recent clinical trials, the \"quality\" of warfarin management has been characterized by the time in therapeutic range (TTR) -- with the therapeutic range being an INR between 2.0 and 3.0. In many reviews of recent clinical trials, differences in the TTR have been used comparatively to critique and contrast the trials. However, TTR is a more complex measurement than is commonly appreciated, and many factors that underlie the TTR calculation, which can differ from trial to trial, have not been adequately addressed...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29238798/association-between-hypercoagulable-conditions-and-calciphylaxis-in-patients-with-renal-disease-a-case-control-study
#20
Allison S Dobry, Lauren N Ko, Jessica St John, J Mark Sloan, Sagar Nigwekar, Daniela Kroshinsky
Importance: Calciphylaxis is a rare skin disease with high morbidity and mortality that frequently affects patients with renal disease. Hypercoagulable conditions are frequently observed in both patients with calciphylaxis and those with chronic kidney disease (CKD), complicating our understanding of which hypercoagulable conditions are specific to calciphylaxis. Objective: To identify hypercoagulable conditions that are risk factors for developing calciphylaxis while controlling for CKD...
February 1, 2018: JAMA Dermatology
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