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https://www.readbyqxmd.com/read/29871510/safety-and-efficacy-of-apixaban-versus-warfarin-in-patients-with-advanced-chronic-kidney-disease
#1
Joseph H Schafer, Ashley L Casey, Kristina A Dupre, Britta A Staubes
BACKGROUND: Because of a lack of comparative data on anticoagulant use in the advanced chronic kidney disease (CKD) population, guidelines recommend warfarin for atrial fibrillation and venous thromboembolism (VTE) treatment in these patients. However, apixaban has specific dosing recommendations in CKD leading to use in clinical practice. OBJECTIVE: To evaluate major bleeding, stroke, and thromboembolism rates in patients with CKD stage 4, stage 5, and dialysis on apixaban or warfarin therapy...
June 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29858511/cytochrome-p450-genotype-guided-drug-therapies-an-update-on-current-states
#2
REVIEW
Amelia Nathania Dong, Boon Hooi Tan, Yan Pan, Chin Eng Ong
Over the past two decades, knowledge of the role and clinical value of pharmacogenetic markers has expanded so that individualized pre-emptive therapy based on genetic background of patients could be within reach for clinical implementation. This is evidenced from the frequent updating of drug labels that incorporates pharmacogenetic information (where compelling data become available) by the regulatory agencies (such as FDA), and the periodical publication of guidelines of specific therapeutic recommendations based on the results of pharmacogenetic tests by the pharmacogenetics working groups or consortiums of professional bodies...
June 2, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29805387/effects-of-structured-patient-education-on-knowledge-level-and-inr-control-of-patients-receiving-warfarin-randomized-controlled-trial
#3
Ebru Baysal, Tulay Sagkal Midilli
Objective: To determine the effects of patient education about the safety of warfarin therapy on related-knowledge levels and on International Normalized Ratio (INR) control. Methods: In the study, randomized controlled experimental study design was used. It was conducted between September 2014-March 2015 with 63 patients who use warfarin at least two months at cardiology and cardiovascular surgery outpatient departments of two different hospitals in Manisa. Participants in the intervention group received one-to-one education about the safety of warfarin therapy and a booklet...
March 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29802125/clinical-pharmacology-of-oral-anticoagulants-in-patients-with-kidney-disease
#4
Nishank Jain, Robert F Reilly
Oral anticoagulants are commonly used drugs in patients with CKD and patients with ESKD to treat atrial fibrillation to reduce stroke and systemic embolism. Some of these drugs are used to treat or prevent deep venous thrombosis and pulmonary embolism in patients with CKD who undergo knee and hip replacement surgeries. Warfarin is the only anticoagulant that is approved for use by the Food and Drug Administration in individuals with mechanical heart valves. Each oral anticoagulant affects the coagulation profile in the laboratory uniquely...
May 25, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29798785/uninterrupted-direct-oral-anticoagulant-and-warfarin-administration-in-elderly-patients-undergoing-catheter-ablation-for-atrial-fibrillation-a-comparison-with-younger-patients
#5
Satoshi Yanagisawa, Yasuya Inden, Aya Fujii, Monami Ando, Junya Funabiki, Yosuke Murase, Masaki Takenaka, Noriaki Otake, Yoshihiro Ikai, Yusuke Sakamoto, Rei Shibata, Toyoaki Murohara
OBJECTIVES: The goal of this study was to evaluate the efficacy and safety of uninterrupted direct oral anticoagulant (DOAC) use and uninterrupted warfarin administration in elderly patients undergoing catheter ablation for atrial fibrillation (AF). BACKGROUND: There is limited knowledge regarding the uninterrupted use of oral anticoagulant agents in elderly patients undergoing catheter ablation for AF. METHODS: This retrospective study included 2,164 patients (n = 325 ≥75 years of age and n = 1,839 <75 years of age) who underwent catheter ablation for AF...
May 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29794812/genetic-causes-of-resistance-to-vitamin-k-antagonists-in-polish-patients-a-novel-p-ile123met-mutation-in-vkorc1-gene
#6
Joanna Wzorek, Ewa Wypasek, Magdalena Awsiuk, Daniel P Potaczek, Anetta Undas
: Mutations in the genes encoding vitamin K epoxide reductase complex subunit 1 (VKORC1) and cytochrome P450 2C9 (CYP2C9) largely contribute to the inter-individual variations in vitamin K antagonists (VKAs) dose requirements. Up to 50% of the dosage variability can be explained by genetic polymorphisms in these genes. We sought to identify the mutations responsible for VKA resistance in a series of Polish patients. Of the 607 patients treated with VKA, 35 (6%) individuals with the VKA resistance defined as a daily dose of acenocoumarol more than 8 mg (n = 15, 43%) or warfarin more than 10 mg (n = 20, 57%) were selected for further mutational analysis using Sanger sequencing (VKORC1) or real-time PCR genotyping (CYP2C9)...
May 22, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29785093/assessment-of-patients-warfarin-knowledge-and-anticoagulation-control-at-a-joint-physician-and-pharmacist-managed-clinic-in-china
#7
Xingang Li, Shusen Sun, Qiaoyu Wang, Buxing Chen, Zhigang Zhao, Xiaowei Xu
Purpose: Warfarin is a widely used anticoagulant with a narrow therapeutic index, and it requires close monitoring and adequate patient education. We aimed to assess the knowledge level regarding warfarin therapy among its users and to identify the factors that significantly influence anticoagulation control. Patients and methods: Patients attending the Warfarin Clinic at the Beijing Tiantan Hospital were enrolled in this study. Patients' knowledge on warfarin was assessed using a validated Anticoagulation Knowledge Assessment (AKA) questionnaire...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29705388/the-translation-of-knowledge-into-practice-in-the-management-of-atrial-fibrillation-in-singapore
#8
Fong Yeong Brigitte Woo, Toon Wei Lim, Wai San Wilson Tam
BACKGROUND: Atrial fibrillation (AF) is a clinically significant cardiac arrhythmia known to increase the risk of stroke by at least four times. Stroke-risk assessment and thromboprophylaxis are vital components in AF management. Guidelines are available to standardise AF management, but physicians' adherence to the recommended guidelines has been low. The aims were to: 1. Examine and compare the level of knowledge and current practice in AF management between cardiologists and non-cardiologist physicians in Singapore; 2...
March 12, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29701078/genotype-guided-warfarin-therapy-current-status
#9
Letícia C Tavares, Leiliane R Marcatto, Paulo Cjl Santos
Warfarin pharmacogenomics has been an extensively studied field in the last decades as it is focused on personalized therapy to overcome the wide interpatient warfarin response variability and decrease the risk of side effects. In this expert review, besides briefly summarizing the current knowledge about warfarin pharmacogenetics, we also present an overview of recent studies that aimed to assess the efficacy, safety and economic issues related to genotype-based dosing algorithms used to guide warfarin therapy, including randomized and controlled clinical trials, meta-analyses and cost-effectiveness studies...
May 2018: Pharmacogenomics
https://www.readbyqxmd.com/read/29699776/communication-networks-of-medication-management-in-an-ambulatory-care-setting
#10
Andrea L Kjos, Ginelle A Bryant
BACKGROUND: Systems approaches in healthcare address complexities of care related to medication safety. Adverse drug events can be prevented by communication between providers. Thus, methods that depict the structures and processes of communications are foundational for prevention efforts. Social network analysis is a methodology applied in healthcare settings to describe and quantify communication patterns. Knowledge of the structures and processes surrounding medication management communications will be useful to explain and intervene on related quality or safety outcomes...
April 12, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29619136/health-literacy-and-knowledge-in-a-cohort-of-australian-patients-taking-warfarin
#11
Angela W Yiu, Beata V Bajorek
Objectives: To 1) characterise older patients taking warfarin, 2) assess these patients' level of warfarin knowledge, and 3) describe their strengths and limitations in health literacy, and 4) explore relationships between participants' characteristics, warfarin knowledge and health literacy. Methods: A warfarin knowledge questionnaire and Health Literacy Questionnaire (HLQ) were administered to older patients (aged >65 years, N=34) taking warfarin in an Australian general practice setting...
January 2018: Pharmacy Practice
https://www.readbyqxmd.com/read/29590159/motivations-of-women-in-uganda-living-with-rheumatic-heart-disease-a-mixed-methods-study-of-experiences-in-stigma-childbearing-anticoagulation-and-contraception
#12
Andrew Y Chang, Juliet Nabbaale, Haddy Nalubwama, Emmy Okello, Isaac Ssinabulya, Christopher T Longenecker, Allison R Webel
BACKGROUND: Rheumatic heart disease (RHD) is a leading cause of premature mortality in low- and middle-income countries (LMICs). Women of reproductive age are a unique and vulnerable group of RHD patients, due to increased risk of cardiovascular complications and death during pregnancy. Yet, less than 5% of women of childbearing age with RHD in LMICs use contraceptives, and one in five pregnant women with RHD take warfarin despite known teratogenicity. It is unclear whether this suboptimal contraception and anticoagulant use during pregnancy is due to lack of health system resources, limited health literacy, or social pressure to bear children...
2018: PloS One
https://www.readbyqxmd.com/read/29569402/use-of-neutrophil-lymphocyte-ratio-for-risk-stratification-and-relationship-with-time-in-therapeutic-range-in-patients-with-nonvalvular-atrial-fibrillation-a-pilot-study
#13
Kahraman Cosansu, Mehmet Bulent Vatan, Huseyin Gunduz, Ramazan Akdemir
BACKGROUND: Atrial fibrillation is one of the most common abnormal heart rhythms. Neutrophil-lymphocyte ratio (NLR) has emerged as a potential marker for the level of inflammation in cardiac disorders. HYPOTHESIS: NLR might be associated with thrombosis and bleeding risk scores and might predict cardioembolic risk in nonvalvular atrial fibrillation (NVAF) patients within the therapeutic international normalized ratio (INR). METHODS: We enrolled 272 patients taking warfarin for NVAF and classified them into 2 groups: Group A consisted of patients (n = 132) whose time in therapeutic range (TTR) was ≥65%, and Group B comprised patients (n = 139) whose TTR was <65%...
March 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29484682/efficacy-and-safety-of-uninterrupted-low-intensity-warfarin-for-cryoballoon-ablation-of-atrial-fibrillation-in-the-elderly-a-pilot-study
#14
Y Xing, B Xu, X Sheng, C Xu, F Peng, Y Sun, S Wang, H Guo
WHAT IS KNOWN AND OBJECTIVE: Uninterrupted warfarin during cryoballoon ablation (CB-A) of atrial fibrillation (AF) has been widely accepted. However, to our knowledge, no previous studies exist investigating the optimal intensity of anticoagulation with warfarin for CB-A. This study aimed to evaluate the efficacy and safety of uninterrupted low-intensity warfarin for CB-A of AF in the elderly. METHODS: Paroxysmal AF patients (age ≥ 70 years) who underwent CB-A were enrolled prospectively...
June 2018: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29457323/anticoagulation-knowledge-in-patients-with-atrial-fibrillation-an-australian-survey
#15
Kehinde O Obamiro, Leanne Chalmers, Kenneth Lee, Bonnie J Bereznicki, Luke R E Bereznicki
BACKGROUND: Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia in clinical practice, and is associated with a significant medical and economic burden. Anticoagulants reduce the risk of stroke and systemic embolism by approximately two-thirds compared with no therapy. Knowledge regarding anticoagulant therapy can influence treatment outcomes in patients with AF. OBJECTIVE: To measure the level of anticoagulation knowledge in patients with AF taking oral anticoagulants (OACs), investigate the association between patient-related factors and anticoagulation knowledge, and compare these results in patients taking warfarin and direct-acting oral anticoagulant (DOACs)...
March 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29450643/variants-in-fix-propeptide-associated-with-vitamin-k-antagonist-hypersensitivity-functional-analysis-and-additional-data-confirming-the-common-founder-mutations
#16
Behnaz Pezeshkpoor, Katrin J Czogalla, Michael Caspers, Ann-Cristin Berkemeier, Kerstin Liphardt, Suvoshree Ghosh, Marco Kellner, Silvia Ulrich, Anna Pavlova, Johannes Oldenburg
One of the most common and unwanted side effects during oral anticoagulant therapy (OAT) is bleeding complications. In rare cases, vitamin K antagonist (VKA)-related bleeding events are associated with mutations affecting the F9 propeptide at amino acid position 37 due to a substitution of alanine to either valine or threonine. Based on our actual cohort of 18 patients, we update the knowledge on this rare phenotype and its origin. A founder mutation for both variants was reconfirmed by haplotype analysis of intronic and extragenic short tandem repeat (STR) polymorphisms with a higher prevalence in Switzerland than in other regions of Europe...
June 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29400612/the-pharmacoepigenomics-informatics-pipeline-defines-a-pathway-of-novel-and-known-warfarin-pharmacogenomics-variants
#17
Ari Allyn-Feuer, Alex Ade, Jasmine A Luzum, Gerald A Higgins, Brian D Athey
AIM: 'Pharmacoepigenomics' methods informed by omics datasets and pre-existing knowledge have yielded discoveries in neuropsychiatric pharmacogenomics. Now we evaluate the generality of these methods by discovering an extended warfarin pharmacogenomics pathway. MATERIALS & METHODS: We developed the pharmacoepigenomics informatics pipeline, a scalable multi-omics variant screening pipeline for pharmacogenomics, and conducted an experiment in the genomics of warfarin...
April 2018: Pharmacogenomics
https://www.readbyqxmd.com/read/29391010/a-multicenter-prospective-study-evaluating-the-impact-of-the-clinical-pharmacist-physician-counselling-on-warfarin-therapy-management-in-lebanon
#18
Nermine S Choumane, Diana N Malaeb, Bassem Malaeb, Souheil Hallit
BACKGROUND: Health care professionals (HCP) are known key elements of effective patient's counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evaluate the patients' knowledge about warfarin and assess the impact of the health care professionals' counselling in enhancing patients' knowledge in achieving warfarin therapeutic outcomes...
February 1, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29374418/fast-apixaban-related-resolution-of-left-ventricular-thrombi-in-a-patient-with-dilated-cardiomyopathy
#19
Waldemar Elikowski, Magorzata Małek-Elikowska, Natalia Fertała, Magdalena Zawodna, Kamila Kruzel
Left ventricular thrombi (LVTs) develop most often in patients with post-myocardial left ventricular dysfunction and in cardiomyopathies, particularly in dilated cardiomyopathy (DCM). They constitute a danger of systemic embolization. So far, direct-acting oral anticoagulants (DOACs), including apixaban - a selective inhibitor of active Factor X, have not been systematically investigated in patients with LVTs; study comparing the efficacy of apixaban and warfarin has been undertaken only recently. A few case reports or case series presenting patients with LVTs treated with DOACs are available in the literature...
January 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29368193/periprocedural-anticoagulation-management-for-atrial-fibrillation-ablation-current-knowledge-and-future-directions
#20
REVIEW
Alan Sugrue, Konstantinos C Siontis, Jonathan P Piccini, Peter A Noseworthy
Catheter ablation (CA) for atrial fibrillation (AF) is an established first-line approach to the management of drug-refractory AF. Although, advancements in procedural techniques and technology have improved the efficacy and safety of CA, thromboembolism (TE) remains one of the most feared periprocedural complications. Minimizing the risk of TE during and after CA requires a multifaceted approach, in which periprocedural anticoagulation plays a central role. The goal of anticoagulation before, during, and after CA is to minimize TE risk without excessively increasing the risk of adverse bleeding...
January 25, 2018: Current Treatment Options in Cardiovascular Medicine
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