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https://www.readbyqxmd.com/read/28298191/bleeding-events-associated-with-a-low-dose-110%C3%A2-mg-versus-a-high-dose-150%C3%A2-mg-of-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#1
Pravesh Kumar Bundhun, Nabin Chaudhary, Jun Yuan
BACKGROUND: The newer oral anticoagulant dabigatran is considered to be more beneficial in patients with non-valvular Atrial Fibrillation (AF) when compared to warfarin. However, because bleeding events which are associated with a low dose (110 mg) versus a high dose (150 mg) of dabigatran have seldom been compared, we aimed to systematically solve this important issue through this meta-analysis. METHODS: English publications comparing 110 mg with 150 mg dabigatran in patients who were treated for AF were electronically searched through medical databases...
March 15, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28279076/triple-antithrombotic-therapy-with-aspirin-p2y12-inhibitor-and-warfarin-after-percutaneous-coronary-intervention
#2
Nathan J Verlinden, James C Coons, Carlo J Iasella, Sandra L Kane-Gill
BACKGROUND: Triple antithrombotic therapy is used in patients who require systemic anticoagulation and undergo percutaneous coronary intervention (PCI) requiring dual antiplatelet therapy. Bleeding with this combination is significant; however, few studies have described outcomes with the use of newer oral P2Y12 inhibitors in this setting. OBJECTIVES: We aimed to compare outcomes among patients prescribed triple therapy with prasugrel or ticagrelor compared to triple therapy with clopidogrel in patients who underwent PCI and required warfarin...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28258727/comparison-of-baseline-characteristics-and-inhospital-outcomes-of-patients-and-use-of-bare-metal-versus-drug-eluting-stents-during-percutaneous-coronary-intervention-2005-to-2015-at-a-single-tertiary-hospital
#3
Romain Didier, Michael A Gaglia, Michael J Lipinski, Edward Koifman, Sarkis Kiramijyan, Smita Negi, Jiaxiang Gai, Rebecca Torguson, Augusto D Pichard, Ron Waksman
With steady growth in the use of drug-eluting stents (DES), the indications for bare metal stents (BMS) have significantly changed over the last decade. This study aims to describe trends in the use of BMS and the evolution of the population receiving them over the past 10 years and determine patient characteristics associated with using BMS. Consecutive patients who underwent percutaneous coronary intervention (PCI) at the Washington Hospital Center from January 2005 through March 2015 were included. Baseline characteristics and inhospital outcomes of patients who underwent PCI with BMS versus DES were compared during 2 different time periods: from 2005 to 2010 and from 2011 to 2015...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28225876/anticoagulation-in-acute-ischemic-stroke-a-systematic-search
#4
Nayara L Froio, Richard Murdoch Montgomery, Elias David-Neto, Ivan Aprahamian
INTRODUCTION: Stroke is one of the most important diseases worldwide. Several clinical scenarios demand full dose of anticoagulants primary to stroke etiology or to the treatment of comorbidity. However, controversy exists over many issues regarding anticoagulation treatment in stroke such as time for initiation, efficacy according to stroke etiology, the ideal dose of anticoagulants, and whether novel anticoagulants should be used. METHOD: Computerized search for clinical trials and randomized controlled clinical trials was done to the present date at Medline, Scielo, Embase, PsychInfo, and Cochrane Library using MeSH terms and the keywords stroke, ischemic stroke, anticoagulation, anticoagulants, heparin, low-molecular-weight heparin, warfarin, dabigatran, rivaroxaban, apixaban...
January 1, 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28185693/advances-in-oral-anticoagulation-therapy-what-s-in-the-pipeline
#5
REVIEW
P S S Rao, T Burkart
Approximately 900,000 people are affected by some sort of venous thromboembolic (VTE) event every year in the United States. VTE diagnosis used to mean treatment with medications that required routine lab monitoring for safety and efficacy. Activated factor X (FXa) inhibition has emerged as a convenient pathway for management of VTE and currently three FXa inhibitors are available for anticoagulation management - rivaroxaban, apixaban, and edoxaban. Continued development of medications utilizing this pathway may offer advantages via novel pharmacokinetic or pharmacodynamic properties that may minimize the adverse effects associated with traditional anticoagulant therapy...
February 5, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#6
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28039855/use-of-oral-anticoagulant-therapy-in-older-adults-with-atrial-fibrillation-after-acute-ischemic-stroke
#7
Emer R McGrath, Alan S Go, Yuchiao Chang, Leila H Borowsky, Margaret C Fang, Kristi Reynolds, Daniel E Singer
OBJECTIVES: To explore barriers to anticoagulation in older adults with atrial fibrillation (AF) at high risk of stroke and to identify opportunities for interventions that might increase use of oral anticoagulants (OACs). DESIGN: Retrospective cohort study. SETTING: Two large community-based AF cohorts. PARTICIPANTS: Individuals with ischemic stroke surviving hospitalization (N = 1,405, mean age 79). MEASUREMENTS: Using structured chart review, reasons for nonuse of OAC were identified, and 1-year poststroke survival was assessed...
February 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28025962/the-cost-savings-of-newer-oral-anticoagulants-in-atrial-fibrillation-related-stroke-prevention%C3%A2
#8
Norliana Masbah, Mary Joan Macleod
BACKGROUND: Newer oral anticoagulants (NOACs) are considered as better alternatives compared to warfarin for stroke prevention in atrial fibrillation (AF) in terms of clinical effectiveness although the drug acquisition cost is more substantial. AIM: This study determined the direct stroke costs based on inpatient hospitalization in a subgroup of the National Health Service (NHS) Grampian, Scotland, stroke patients, to evaluate the differences in costs related to AF stroke, and to ascertain whether the use of NOACs within this study population would produce greater cost savings...
March 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28024166/an-east-asian-perspective-on-the-interaction-between-proton-pump-inhibitors-and-clopidogrel
#9
Duowu Zou, Khean-Lee Goh
Both proton pump inhibitors (PPIs) and clopidogrel are widely prescribed in the Asia-Pacific population. PPIs are the mainstay therapeutic agents for prophylaxis against aspirin gastropathy and for ARDs (Acid Related Disorders) including gastroesophageal reflux disease (GERD). They are also co-prescribed with oral anticoagulant agents (OAAs)and with dual-antiplatelet therapy (DAPT) for the treatment and prevention of gastrointestinal (GI) bleeding. Clopidogrel belongs to the drug class of thienopyridines, and is currently the most widely prescribed OAA either alone or in combination with aspirin...
December 26, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28000318/dawn-of-the-direct-acting-oral-anticoagulants-trends-in-oral-anticoagulant-prescribing-in-wales-2009-2015
#10
M B Protty, J Hayes
WHAT IS KNOWN AND OBJECTIVE: Oral anticoagulants (OACs) have been used for decades for the long-term prevention of arterial and venous thromboembolic disease. These include warfarin and the newer direct-acting OACs (DOACs). Data on 'real-life' prescribing patterns for DOACs are limited. In this commentary, we report the prescribing patterns for OACs in Wales, as a representative country within the UK. COMMENT: A retrospective analysis of anonymized OAC prescribing data in Wales from June 2009 to December 2015...
December 21, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27843361/pulmonary-embolism-new-treatments-for-an-old-problem
#11
REVIEW
John Ryan
Nonvitamin K antagonist oral anticoagulants, previously referred to as novel oral anticoagulants, have emerged in recent years as attractive treatment options for acute pulmonary embolism (PE). However, despite the widespread anticipation by physicians and the approval of rivaroxaban, apixaban, dabigatran, and more recently edoxaban, there is still some reluctance to choose these newer agents over conventional treatment with heparin/vitamin K antagonists. Acute PE puts a considerable strain on emergency departments, and medical staff rely on efficient diagnosis and risk assessment to manage the condition appropriately and economically...
2016: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/27842767/drug-hepatotoxicity-newer-agents
#12
REVIEW
Chalermrat Bunchorntavakul, K Rajender Reddy
Idiosyncratic hepatotoxicity is one of the most common reasons for an approved drug being restricted. This article focuses on hepatotoxicity of selected and recently introduced agents, such as, tyrosine kinase inhibitors, monoclonal antibodies, novel oral anticoagulants, newer antiplatelets, antibiotics, anti-diabetics, anti-epileptics, anti-depressants, anti-psychotics and anti-retrovirals. Overall, the incidence of clinically relevant hepatotoxicity from newer agents seems to be lower than that of the older agents...
February 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/27723533/new-oral-anticoagulants-and-dual-antiplatelet-therapy-focus-on-apixaban
#13
REVIEW
Francesco Pelliccia, Fabiana Rollini, Giuseppe Marazzi, Cesare Greco, Carlo Gaudio, Dominick J Angiolillo, Giuseppe Rosano
The combination of AF and coronary artery disease not only is a common clinical setting, it is also a complex setting to deal with anticoagulation and antiplatelet therapy, and it is associated with significantly higher mortality rates. Unfortunately, there are no sufficient data available to optimally guide clinical practice in such settings. This review focuses specifically on newer oral anticoagulants (NOACs) associated with dual antiplatelet therapy (DAPT) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI)...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27692605/anti-xa-bioassays-for-the-laboratory-measurement-of-direct-factor-xa-inhibitors-in-plasma-in-selected-patients
#14
REVIEW
Jean Amiral, Claire Dunois, Cédric Amiral, Jerard Seghatchian
In the past decade Direct Oral Anti-Coagulants (DOACs), targeting Thrombin or Factor Xa, have enormously facilitated the daily treatment of all relevant patients, including those requiring lifelong therapy. These DOACs have considerable advantages over the use of oral Vitamin K Antagonist (VKA) treatments, in view of having little interferences with food and other medications and also not requiring adjustment for age, gender or weight, with some well-defined exceptions. In this current What's Happening Section we focus on measurements of DiXaIs in plasma using anti-Xa assays, with the objective of providing a tribute to Professor Michel Meyer Samama, who was not only a real leader in this field but, in the past, both authors benefited from his wisdom, as a teacher who dedicated his scientific and professional life (among many other interests in hemostasis, thrombosis and fibrinolysis) to develop and promote methods and strategies for laboratory monitoring of anticoagulants...
October 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27685458/an-update-on-the-pharmaceutical-management-of-thrombosis
#15
Benilde Cosmi
Anticoagulants such as heparins and vitamin K antagonists (VKA) are effective for thrombosis prevention and treatment, but are associated with the risk of bleeding and other limitations, spurring the search for improved drugs. Areas covered: to evaluate the newer anticoagulants, focusing on those tested in phase III clinical trials such as direct oral anticoagulants (DOACs), antisense oligonucleotides (ASO) and warfarin analogues. DOACs such as dabigatran, rivaroxaban, apixaban and edoxaban are licensed for stroke prevention in atrial fibrillation and treatment of venous thromboembolism, dabigatran, rivaroxaban and apixaban for postoperative thromboprophylaxis in patients undergoing elective hip or knee arthroplasty and rivaroxaban for secondary prevention of acute coronary syndromes...
October 12, 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27659886/ischemic-and-bleeding-events-in-patients-with-myocardial-infarction-undergoing-percutaneous-coronary-intervention-who-require-oral-anticoagulation-insights-from-the-canadian-observational-antiplatelet-study
#16
Steven Sra, Mary K Tan, Shamir R Mehta, Harold N Fisher, Jean-Pierre Déry, Robert C Welsh, Mark J Eisenberg, Christopher B Overgaard, Barry F Rose, Anthony J Della Siega, Asim N Cheema, Brian Y L Wong, Mark A Henderson, Sohrab Lutchmedial, Shahar Lavi, Shaun G Goodman, Andrew T Yan
BACKGROUND: Since the introduction of newer, more potent P2Y12 receptor inhibitors (P2Y12ris), practice patterns and associated clinical outcomes in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) and also requiring oral anticoagulation (OAC) have not been fully characterized. METHODS: The Canadian Observational Antiplatelet Study was a prospective, multicenter, longitudinal, observational study (26 hospitals, December 2011 to May 2013) describing P2Y12ri treatment patterns and outcomes in patients with ST-elevation and non-ST-elevation MI undergoing PCI...
October 2016: American Heart Journal
https://www.readbyqxmd.com/read/27640616/-direct-oral-anticoagulants-in-cardiology
#17
Róbert Gábor Kiss
Antithrombotic drug therapy is a main cornerstone - sometimes a fairly uneven cornerstone - of today's clinical practice. Patients treated with antithrombotic drugs appear sometimes unawaited at those of our colleagues, who are not necessarily experts of this narrow field. Furthermore, new and newer molecules of antiplatelet and anticoagulant medicines have come into practice, frequently in combination. This dramatic development has been important to patients; pharmacological - and recently nonpharmacological - antithrombotic treatment has paved the way to improve current modalities in cardiology...
September 2016: Orvosi Hetilap
https://www.readbyqxmd.com/read/27640182/the-critical-care-management-of-spontaneous-intracranial-hemorrhage-a-contemporary-review
#18
REVIEW
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
September 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27624772/warfarin-and-newer-agents-what-the-oral-surgeon-needs-to-know
#19
REVIEW
Martin B Steed, Matthew T Swanson
The new direct oral anticoagulants-dabigatran etexilate, rivaroxaban, and apixaban- have predictable pharmacokinetic and pharmacodynamic profiles and are alternatives to warfarin. However, many surgeons are wary of these drugs, as there is limited evidence on how to manage bleeding in patients taking them, and only recently has a specific antidote been developed to reverse their anticoagulant effect. Management of the newer agents requires careful adherence to primary measures of bleeding care, knowledge of their mechanism of action, and familiarity with the unapproved and untested reversal strategies that may be required in patients with life-threatening bleeding...
November 2016: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/27621674/percutaneous-left-atrial-appendage-closure-devices-safety-efficacy-and-clinical-utility
#20
REVIEW
Martin J Swaans, Lisette Is Wintgens, Arash Alipour, Benno Jwm Rensing, Lucas Va Boersma
Atrial fibrillation (AF) is the most common arrhythmia treated in the clinical practice. One of the major complications of AF is a thromboembolic cerebral ischemic event. Up to 20% of all strokes are caused by AF. Thromboembolic cerebral ischemic event in patients with AF occurs due to atrial thrombi, mainly from the left atrial appendage (LAA). Prevention of clot formation with antiplatelet agents and especially oral anticoagulants (vitamin K antagonists or newer oral anticoagulants) has been shown to be effective in reducing the stroke risk in patients with AF but has several drawbacks with (major) bleedings as the most important disadvantage...
2016: Medical Devices: Evidence and Research
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