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Oral anticoagulants

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https://www.readbyqxmd.com/read/29792215/adding-left-atrial-appendage-closure-to-open-heart-surgery-provides-protection-from-ischemic-brain-injury-six-years-after-surgery-independently-of-atrial-fibrillation-history-the-laacs-randomized-study
#1
Jesper Park-Hansen, Susanne J V Holme, Akhmadjon Irmukhamedov, Christian L Carranza, Anders M Greve, Gina Al-Farra, Robert G C Riis, Brian Nilsson, Johan S R Clausen, Anne S Nørskov, Christina R Kruuse, Egill Rostrup, Helena Dominguez
BACKGROUND: Open heart surgery is associated with high occurrence of atrial fibrillation (AF), subsequently increasing the risk of post-operative ischemic stroke. Concomitant with open heart surgery, a cardiac ablation procedure is commonly performed in patients with known AF, often followed by left atrial appendage closure with surgery (LAACS). However, the protective effect of LAACS on the risk of cerebral ischemia following cardiac surgery remains controversial. We have studied whether LAACS in addition to open heart surgery protects against post-operative ischemic brain injury regardless of a previous AF diagnosis...
May 23, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29792125/characteristics-of-apixaban-treated-patients-evaluation-of-the-dose-prescribed-and-the-persistence-of-treatment-a-cohort-study-in-catalonia
#2
Ainhoa Gomez-Lumbreras, Jordi Cortes, Maria Giner-Soriano, M Angeles Quijada-Manuitt, Rosa Morros
BACKGROUND: Apixaban is a direct oral anticoagulant, which inhibits factor Xa. It has demonstrated clinical efficacy in prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation and a better safety profile compared to warfarin. OBJECTIVES: (1) To describe the characteristics of patients with nonvalvular atrial fibrillation beginning treatment with apixaban, (2) to analyze concomitant prescriptions of medications that could potentially interact with apixaban, (3) to evaluate the level of appropriate usage according to the recommended dosage, and (4) to estimate the level of apixaban persistence among naive and non-naive patients...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29792060/warfarin-monitoring-with-viscoelastic-haemostatic-assays-thrombin-generation-coagulation-factors-and-correlations-to-owren-and-quick-prothrombin-time
#3
Caroline U Nilsson, Karin Strandberg, Peter Reinstrup
The anticoagulant warfarin is commonly monitored with prothrombin time (PT). Viscoelastic haemostatic assays (VHA) are primarily used in situations of acute bleeding to guide haemostatic therapy. Much research has focused on VHA monitoring of new oral anticoagulants. However, many patients are still anticoagulated with warfarin and effect of warfarin anticoagulation on VHA is uncertain. The aim of this study was to assess warfarin anticoagulation on three different VHA and compare these findings with prothrombin time (PT), coagulation factor analyses and a thrombin generation assay (TGA)...
May 23, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29791520/use-of-direct-oral-anticoagulants-for-chronic-thromboembolic-pulmonary-hypertension
#4
Francisca Alexandra Gavilanes-Oleas, Jose Leonidas Alves, Caio Julio Cesar Fernandes, Luis Felipe Lopes Prada, William Salibe Filho, Mario Terra Filho, Luciana Morinaga, Susana Hoette, Carlos Jardim, Rogerio Souza
OBJECTIVES: Chronic thromboembolic pulmonary hypertension is one of the most prevalent forms of pulmonary hypertension and is a major complication of acute pulmonary embolism. One mainstay of chronic thromboembolic pulmonary hypertension treatment is lifelong anticoagulation. The recent advent of direct oral anticoagulants for acute pulmonary embolism treatment has provided a viable and effective alternative for treating this condition. However, little is known about the efficacy of this new class of drugs for treating chronic thromboembolic pulmonary hypertension...
May 17, 2018: Clinics
https://www.readbyqxmd.com/read/29791257/the-use-of-direct-oral-anticoagulants-in-the-treatment-of-acute-venous-thromboembolism-in-cancer-patients
#5
Hikmat Abdel-Razeq, Antoine Finianos, Ali T Taher
Introduction - After the CLOT study, LMWHs (low-molecular weight heparins) have gradually replaced warfarin as the treatment of choice for VTE (venous thromboembolism) in cancer patients. Randomized controlled studies comparing DOACs (direct oral anticoagulants) to LMWHs in cancer patients are still limited. However, new emerging data are supporting the use of DOACs in cancer-associated thrombosis. Areas Covered - This review will discuss the recent studies that addressed the utilization of such agents in the treatment of VTE in cancer patients...
May 23, 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29790645/fibrinogen-prothrombin-time-derived-method-is-not-useful-in-patients-anticoagulated-with-low-molecular-weight-heparins-or-rivaroxaban
#6
C Duboscq, M Martinuzzo, J M Ceresetto, M Lopez, L Barrera, J Oyhamburu, G Stemmelin
BACKGROUND: Fibrinogen prothrombin time derived method (FIBPT-d) with photo-optical coagulometers is easy and economical. However, there are few reports on the behavior of this test on samples from patients anticoagulated with direct oral anticoagulants (DOACs) or low molecular weight heparin (LMWH). OBJECTIVE: To compare fibrinogen results obtained by Clauss method (FIB C) and FIBPT-d with two thromboplastins in anticoagulated patients. POPULATION: 295 consecutive anticoagulated patients: 99 vitamin K antagonist (VKA), 49 unfractionated heparin (UFH), 47 LMWH, 50 rivaroxaban and 50 dabigatran; and 100 healthy controls (NC)...
May 23, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29790596/rivaroxaban-for-stroke-prevention-in-people-with-atrial-fibrillation-and-diabetes-mellitus
#7
Y-G Li, Daniele Pastori, G Y H Lip
Atrial fibrillation (AF) is associated with various cardiovascular comorbidities, such as hypertension, heart failure and diabetes mellitus, which increases not only the risk of ischaemic stroke but also of myocardial infarction and mortality. Oral anticoagulation for stroke prevention is the cornerstone of management for people with AF, both with vitamin K antagonists, or with non-vitamin K antagonist oral anticoagulants (NOACs), which show efficacy, safety and convenience compared with vitamin K antagonists [1]...
May 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29790365/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-bioprosthetic-valves
#8
Jason G Andrade, Elena Meseguer, Romain Didier, Charles Dussault, Jeffrey I Weitz
The non-vitamin K antagonist oral anticoagulants (NOACs), which include dabigatran, apixaban, edoxaban and rivaroxaban, are preferred over vitamin K antagonists for stoke prevention in most patients with non-valvular atrial fibrillation. The NOACs are contraindicated in atrial fibrillation patients with rheumatic mitral stenosis or mechanical heart valves. There is evidence that bioprosthetic heart valves are less thrombogenic than mechanical heart valves, but it is unknown whether the risk of thromboembolism in atrial fibrillation patients with bioprosthetic valves differs from that in patients without such valves...
May 23, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29790252/should-we-still-be-utilizing-warfarin-in-the-type-2-diabetic-patient
#9
REVIEW
David S H Bell, Edison Goncalves
The frequency of non-valvular atrial fibrillation is increased by 40% in type 2 diabetic subjects and the thromboembolic risk associated with atrial fibrillation is increased by 79% compared with the non-diabetic individual with atrial fibrillation. Warfarin, the traditional anticoagulant used to prevent thromboembolism, is non-specific and affects several proteins outside the coagulation system. By decreasing the levels of matrix Gla protein there is an increase in coronary and renal artery calcification which has the potential to increase cardiovascular events and accelerate decline in renal function...
May 22, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29790125/management-of-major-bleeding-and-outcomes-in-patients-treated-with-direct-oral-anticoagulants-results-from-the-start-event-registry
#10
Sophie Testa, Walter Ageno, Emilia Antonucci, Rossella Morandini, Jan Beyer-Westendorf, Maurizio Paciaroni, Marc Righini, Piera Sivera, Peter Verhamme, Vittorio Pengo, Daniela Poli, Gualtiero Palareti
The management of major bleeding in patients treated with direct oral anticoagulants (DOACs) is still not well established. START-Events, a branch of the START registry (Survey on anTicoagulated pAtients RegisTer) (NCT02219984), aims to describe the actual management of bleeding or recurrent thrombotic events in routine clinical practice. We here present the results of the management of bleeding patients. The START-Event registry is a prospective, observational, multicenter, international study. Baseline characteristics (demographic, clinical, risk factors) of patients, laboratory data at admission and during follow-up, site of bleeding, therapeutic strategies, and outcomes at the time of hospital discharge and after 6 months were recorded on a web-based case report form...
May 22, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29789105/oral-anticoagulation-in-chronic-kidney-disease-and-atrial-fibrillation
#11
Gunnar H Heine, Vincent Brandenburg, Stephan H Schirmer
BACKGROUND: Cardiological societies recommend, in their guidelines, that patients with atrial fibrillation and an intermediate (or higher) risk of stroke and systemic embolization should be treated with oral anticoagulant drugs. For patients who do not have mitral valve stenosis or a mechanical valve prosthesis, non-vitamin-K dependent oral anticoagulants (NOAC) are preferred over vitamin K antagonists (VKA) for this purpose. It is unclear, however, whether patients with chronic kidney disease and atrial fibrillation benefit from oral anticoagulation to the same extent as those with normal kidney function...
April 27, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29789047/concerns-for-bleeding-in-the-elderly-with-the-use-of-direct-oral-anticoagulants
#12
Michelle Min, Stephanie Sibicky
Since Food and Drug Administration approval of dabigatran in 2010, direct oral anticoagulants (DOACs) have been alternatives to warfarin for patients who are at risk for cardioembolic complications of nonvalvular atrial fibrillation. Unfortunately, there are limited safety data available on the use of these newer agents in older adults, particularly risks of gastrointestinal, intracranial, and major bleeding (as defined by the International Society on Thrombosis and Haemostasis) in those 75 years of age and older...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29789046/management-of-venous-thromboembolism-in-the-elderly-a-review-of-the-non-vitamin-k-oral-anticoagulants
#13
Laressa Bethishou, Tania Gregorian, Kimberly Won, Kristina Lopez, Laura V Tsu
Objective To provide an up-to-date review of the available evidence regarding pharmacotherapeutic management of venous thromboembolic events in the geriatric population. Data Sources A PubMed search of articles published through August 2017 was performed using a combination of the following words: apixaban, betrixaban, dabigatran, edoxaban, enoxaparin, geriatric, heparin, idaricizumab, rivaroxaban, and venous thromboembolism. Study Selection/data Extraction Relevant original research, review articles, and guidelines were assessed for the management of elderly patients with venous thromboembolism (VTE)...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29788853/-cme-answers-%C3%A2-periinterventional-management-of-direct-oral-anticoagulants-balancing-benefits-and-risks%C3%A2-praxis-no-9-10
#14
Jacqueline Dülgeroglu, Dörthe Schmidt
No abstract text is available yet for this article.
2018: Praxis
https://www.readbyqxmd.com/read/29788810/clinical-and-immunological-pattern-and-outcome-of-egyptian-systemic-lupus-erythematosus-patients-a-single-center-experience
#15
G A Mahmoud, A A Shahin, H S Zayed, A Moghazy, B M Eissa
Objective The objective of this study was to describe the clinical and immunological pattern and disease outcome in Egyptian systemic lupus erythematosus patients. Patients and methods The medical records of 770 systemic lupus erythematosus patients who were followed from 2002-2015 at Kasr Alainy Hospital, Cairo University, were retrospectively reviewed. Results There were 707 (91.8%) females. The mean age at disease onset was 22.1 ± 8.6 and the disease duration was 6.1 ± 4.5 years. The main clinical manifestations were mucocutaneous (90...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29788021/predictors-of-cardioembolic-stroke-in-japanese-patients-with-atrial-fibrillation-in-the-fushimi-af-registry
#16
Ken Yasuda, Shunichi Fukuda, Michikazu Nakamura, Ryo Ohtani, Yasuhiro Kuwata, Masaki Takata, Makoto Sainouchi, Masahiro Gotou, Yuichi Masuda, Satoru Kawarazaki, Yasuhiro Kawabata, Nagako Murase, Tomokazu Aoki, Naohiro Yonemoto, Masaharu Akao, Tetsuya Tsukahara
BACKGROUND: Large-scale clinical trials have analyzed risk factors for any ischemic stroke in patients with atrial fibrillation (AF). However, the risk factors for cardioembolic stroke (CES), specifically, have not been reported. To clarify the risk factors for CES and clinically significant cardioembolic infarction, we examined the incidence of CES and larger infarct volume (IV) (> 30 mL) CES, employing the Fushimi AF Registry, a community-based prospective cohort of AF patients in the Fushimi ward, Kyoto, Japan...
May 22, 2018: Cerebrovascular Diseases Extra
https://www.readbyqxmd.com/read/29786530/meta-analysis-of-safety-and-efficacy-of-oral-anti-coagulants-in-patients-requiring-catheter-ablation-for-atrial-fibrillation
#17
Hammad Rahman, Safi U Khan, Michael DePersis, Tehseen Hammad, Fahad Nasir, Edo Kaluski
BACKGROUND: The ideal oral anticoagulant agent during catheter ablation (CA) for atrial fibrillation (AF) remained unclear. HYPOTHESIS: Novel oral anticoagulants (NOACs) are safer and effective compared to uninterrupted vitamin K antagonists (U-VKA) among patients requiring CA for AF. METHODS: Four randomized controlled trials (RCTs) and 9 observational studies (OS) were selected using PubMed/Medline, EMBASE and the CENTRAL data bases (Inception-December-2017)...
May 9, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29786189/-renal-infarction-multicentric-cases-in-piedmont
#18
Daria Motta, Andrea Airoldi, Serena Bainotti, Manuel Burdese, Andrea Campo, Luigia Costantini, Raffaella Cravero, Paola Mesiano, Giorgina B Piccoli, Olga Randone, Andrea Serra, Patrizia Vio, Roberto Boero
We describe factors associated to renal infarction, clinical, instrumental and laboratoristic features, and therapeutic strategies too. This is an observational, review and polycentric study of cases in Nephrologic Units in Piedmont during 2013-2015, with diagnosis of renal infarction by Computed Tomography Angiography (CTA). We collected 48 cases (25 M, age 57±16i; 23 F age 70±18, p = 0.007), subdivided in 3 groups based on etiology: group 1: cardio-embolic (n=19) ; group 2: coagulation abnormalities (n= 9); group 3: other causes or idiopathic (n=20)...
May 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29785752/skin-lesions-over-the-pocket-area-that-may-mimic-cardiac-implantable-electronic-device-infection-a-case-series
#19
Panagiotis Korantzopoulos, Sofia Plakoutsi, Elizabeth Florou, Aris Bechlioulis
BACKGROUND: The early and correct diagnosis of cardiac implantable electronic device (CIED) infections is critical given that early aggressive treatment with complete removal of the system along with antimicrobial therapy dramatically improves outcomes. Pocket infection manifested by local signs of inflammation is the most common form of CIED infections. Conditions mimicking pocket infection have been described in the literature. These include various types of malignancy and rarely allergic reactions/contact dermatitis to pacemaker compounds...
May 21, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29785661/atrial-fibrillation-in-dialysis-patients-is-there-a-place-for-non-vitamin-k-antagonist-oral-anticoagulants
#20
REVIEW
Elzbieta Mlodawska, Paulina Lopatowska, Jolanta Malyszko, Maciej Banach, Bożena Sobkowicz, Adrian Covic, Anna Tomaszuk-Kazberuk
Atrial fibrillation (AF) occurs approximately in 3% of general population, with greater prevalence in elderly. Non-vitamin K-dependent oral anticoagulant agents (NOACs) according to the current European guidelines are recommended for patients with AF at high risk for stroke as a first-choice treatment. NOACs are not inferior to warfarin or some of them are better than warfarin in reducing the rate of ischemic stroke. Moreover, they significantly reduce the rate of intracranial hemorrhages, major bleedings, and mortality compared with warfarin...
May 21, 2018: International Urology and Nephrology
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