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https://www.readbyqxmd.com/read/28921057/dvt-prevention-in-stroke
#1
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/28917562/an-updated-meta-analysis-of-novel-oral-anticoagulants-versus-vitamin-k-antagonists-for-uninterrupted-anticoagulation-in-atrial-fibrillation-catheter-ablation
#2
Rhanderson Cardoso, Leonardo Knijnik, Aditya Bhonsale, Guilherme Nasi, Manuel Rivera, Vanessa Blumer, Hugh Calkins
BACKGROUND: Catheter ablation is recommended as a first or second-line rhythm control therapy for selected patients with atrial fibrillation (AF). There is a wide variability in the periprocedural management of oral anticoagulation for patients undergoing AF ablation. OBJECTIVE: We aimed to perform an updated meta-analysis of novel oral anticoagulants (NOACs) vs. vitamin K antagonists (VKAs) as uninterrupted anticoagulation for patients undergoing AF ablation. METHODS: Databases and conference abstracts were searched...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28901221/direct-oral-anticoagulant-reversal-how-when-and-issues-faced
#3
Mikhail S Dzeshka, Daniele Pastori, Gregory Y H Lip
The number of atrial fibrillation (AF) patients requiring thrombo-prophylaxis with oral anticoagulation is greatly increasing. The introduction of non-vitamin K oral anticoagulants (NOACs) in addition to standard therapy with dose-adjusted warfarin has increased the therapeutic options for AF patients. Despite a generally better safety profile of the NOACs, the risk of major bleedings still persists, and the management of serious bleeding is a clinical challenge. Areas covered: In the current review, risk of major bleeding in patients taking NOACs and general approaches to manage bleeding depending on severity, with a particular focus on specific reversal agents, are discussed...
September 13, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28882334/meta-analysis-of-safety-and-efficacy-of-uninterrupted-non-vitamin-k-antagonist-oral-anticoagulants-versus-vitamin-k-antagonists-for-catheter-ablation-of-atrial-fibrillation
#4
Akram Y Elgendy, Dhruv Mahtta, Amr F Barakat, Ahmed Abuzaid, Ahmad Mahmoud, Amgad Mentias, Ahmed N Mahmoud, Islam Y Elgendy
This meta-analysis sought to assess the safety and efficacy of uninterrupted non-vitamin K antagonist oral anticoagulants (NOACs) versus uninterrupted vitamin K antagonists in atrial fibrillation (AF) patients undergoing catheter ablation. Electronic databases were searched for randomized trials (RCTs) and observational studies that compared uninterrupted NOACs versus uninterrupted vitamin K antagonists in the catheter ablation of AF. Safety outcomes included major bleeding, total bleeding, minor bleeding, and cardiac tamponade...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28882323/left-atrial-appendage-closure-for-prevention-of-death-stroke-and-bleeding-in-patients-with-nonvalvular-atrial-fibrillation
#5
Steffen Gloekler, Jacqueline Saw, Konstantinos C Koskinas, Caroline Kleinecke, Werner Jung, Fabian Nietlispach, Bernhard Meier
Nonvalvular atrial fibrillation (AF) is the most frequent arrhythmia with a prevalence of 1%-2% in the general population. Its prevalence increases with age and its diagnosis benefits of improvement and simplification of technologies for its detection. Today, AF affects approximately 7% of individuals age>65years and 15%-20% of octogenarians. Due to stasis and activation of coagulation in a fibrillating atrium, patients are at increased risk of thromboembolism, in particular ischemic stroke, with an overall stroke risk of 5% per year...
August 26, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28879343/delayed-bleeding-after-implant-surgery-in-patients-taking-novel-oral-anticoagulants-a-case-report
#6
Chihun Kim, Chugeum Dam, Jieun Jeong, Eun-Jung Kwak, Wonse Park
The use of novel oral anticoagulants (NOACs) has increased in recent times in an effort to overcome the shortcomings of warfarin. They are being used primarily for the prevention of thrombosis caused by atrial fibrillation and offer the advantages of having fewer drug interactions than warfarin, no dietary restrictions, and no requirement for regular blood tests. Although there is reportedly less postoperative bleeding even if the drug is not discontinued during procedures that can cause local bleeding, such as dental procedures, no well-designed clinical studies have assessed postoperative bleeding associated with the use of these drugs...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28875370/how-prepared-are-pharmacists-to-support-atrial-fibrillation-patients-in-adhering-to-newly-prescribed-oral-anticoagulants
#7
Nadya Hamedi, Filipa Alves da Costa, Robert Horne, Michael Levitan, Amanda Begley, Sotiris Antoniou
Background The New Medicines Service (NMS) was implemented in the United Kingdom in 2011 and first evaluated in 2014, showing 10% increase on adherence. Objective To assess community pharmacists' current practice, knowledge and confidence in supporting patients' adherence as part of the NMS for patients on Oral Anti-Coagulants (OACs) for stroke prevention in Atrial Fibrillation. Setting Community pharmacists in London. Method An online cross-sectional survey was sent to pharmacists from their Local Pharmaceutical Committees and advertised by the Royal Pharmaceutical Society...
September 5, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28864318/comparison-of-the-effectiveness-and-safety-of-apixaban-dabigatran-rivaroxaban-and-warfarin-in-newly-diagnosed-atrial-fibrillation
#8
Inmaculada Hernandez, Yuting Zhang, Samir Saba
No studies have performed direct pairwise comparisons of the effectiveness and safety of warfarin and the new oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban. Using 2013 to 2014 claims from a 5% random sample of Medicare beneficiaries, we identified patients newly diagnosed with atrial fibrillation who initiated apixaban, dabigatran, rivaroxaban, warfarin, or no oral anticoagulation therapy in 2013 to 2014. Outcomes included the composite of ischemic stroke, systemic embolism (SE) and death, any bleeding event, gastrointestinal bleeding, intracranial bleeding, and treatment persistence...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862063/the-safety-of-edoxaban-for-treating-atrial-fibrillation
#9
Matthias Hammwoehner, Andreas Goette
Atrial Fibrillation (AF) has a worldwide increasing incidence and prevalence, putting patients at risk for atrial thrombus formation and consecutive thromboembolic events. Morbidity and mortality have become a significant global public health care burden. Thus, there is increasing need for safe and effective medical prophylaxis of thromboembolic events. Edoxaban is the fourth approved non-vitamin K oral anticoagulant (NOAC) that has been introduced into the market for the prophylaxis of stroke or systemic embolism in non valvulär AF patients after dabigatran, rivaroxaban, and apixaban...
September 1, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28861925/standard-and-reduced-doses-of-dabigatran-rivaroxaban-and-apixaban-for-stroke-prevention-in-atrial-fibrillation-a-nationwide-cohort-study
#10
Laila Staerk, Thomas A Gerds, Gregory Y H Lip, Brice Ozenne, Anders N Bonde, Morten Lamberts, Emil L Fosbøl, Christian Torp-Pedersen, Gunnar H Gislason, Jonas B Olesen
BACKGROUND: Comparative data of non-vitamin K antagonist oral anticoagulants (NOAC) are lacking in patients with atrial fibrillation (AF). OBJECTIVE: We compared effectiveness and safety of standard and reduced dose NOAC in AF patients. METHODS: Using Danish nationwide registries, we included all oral anticoagulant-naïve AF patients who initiated NOAC treatment (2012-2016). Outcome-specific and mortality-specific multiple Cox regressions were combined to compute average treatment effects as 1-year standardized differences in stroke and bleeding risks (g-formula)...
September 1, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/28861455/baseline-characteristics-and-event-rates-among-anticoagulated-patients-with-atrial-fibrillation-in-practice-and-pivotal-noac-trials
#11
Peter A Noseworthy, Xiaoxi Yao, Bernard J Gersh, Ian Hargraves, Nilay D Shah, Victor M Montori
The data report details the baseline characteristics and observed outcomes among patients included in a large US administrative claims database (Optum Labs Data Warehouse) and those enrolled in the pivotal phase III clinical trials examining apixaban, dabigratan, edoxaban and rivaroxaban versus warfarin for the prevention of cardio embolism (Granger et al., 2011; Cannolly et al., 2009; Patel et al., 2011; Giugliano et al., 2013) [1], [2], [3], [4]. These data are to be interpreted in the context of the linked publication (Noseworthy et al...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28857611/bleeding-risk-of-apixaban-dabigatran-and-low-dose-rivaroxaban-compared-with-warfarin-in-japanese-patients-with-non-valvular-atrial-fibrillation-a-propensity-matched-analysis-of-administrative-claims-data
#12
Shun Kohsaka, Tatsunori Murata, Naoko Izumi, Jun Katada, Feng Wang, Yasuo Terayama
OBJECTIVES: There is scarce evidence comparing novel oral anticoagulants (NOACs) with warfarin in real-world settings in Japan. This study compared the risk of bleeding events among patients with non-valvular atrial fibrillation (NVAF) initiating treatment with NOACs versus warfarin. METHODS: A retrospective cohort study was conducted using de-identified electronic health records-based database of health claims and Diagnosis Procedure Combination data from 275 consenting hospitals in Japan...
August 31, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28854077/adherence-to-rivaroxaban-dabigatran-and-apixaban-for-stroke-prevention-for-newly-diagnosed-and-treatment-naive-atrial-fibrillation-patients-an-update-using-2013-2014-data
#13
Joshua D Brown, Anand R Shewale, Jeffery C Talbert
BACKGROUND: Few studies have assessed adherence to non-vitamin K antagonist oral anticoagulants (NOACs), especially using contemporary data now that multiple NOACs are available. OBJECTIVE: To compare adherence and treatment patterns among NOACs for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). METHODS: Incident and treatment-naive NVAF patients were identified during 2013-2014 from a large claims database in this retrospective cohort study...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28854073/major-bleeding-risk-during-anticoagulation-with-warfarin-dabigatran-apixaban-or-rivaroxaban-in-patients-with-nonvalvular-atrial-fibrillation
#14
Gboyega Adeboyeje, Gosia Sylwestrzak, John J Barron, Jeff White, Alan Rosenberg, Jacob Abarca, Geoffrey Crawford, Rita Redberg
BACKGROUND: The use of non-vitamin K oral anticoagulants (NOACs) has increased steadily following marketing approval; however, their relative safety in nonvalvular atrial fibrillation (NVAF) patients in real-world clinical practice remains unclear. OBJECTIVE: To compare the risk of major bleeding during anticoagulation therapy between warfarin and NOACs. METHODS: This retrospective cohort study analyzed administrative claims data on new NVAF users of warfarin, dabigatran, apixaban, or rivaroxaban in routine clinical care from November 2010 to February 2015 in a commercially insured population in the United States...
September 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28853765/pulmonary-embolism-four-days-after-interruption-of-therapy-with-rivaroxaban
#15
Claudia Stöllberger, Gabor Göndör
Thrombosis after cessation of anticoagulation, also named rebound thrombosis, is a matter of concern and controversy. There are only few published data about occurrence of rebound thrombosis associated with non-vitamin K-antagonist oral anticoagulant drugs (NOACs). We report on a 58-year-old male with paroxysmal atrial fibrillation (AF) with a CHA2DS2VASC score of 4 who developed central pulmonary embolism four days after interruption of rivaroxaban because of parotid surgery. He had received 40 mg enoxaparin/d...
August 24, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28846806/apixaban-rivaroxaban-and-dabigatran-use-in-patients-undergoing-catheter-ablation-for-atrial-fibrillation-using-the-second-generation-cryoballoon
#16
Verena Tscholl, Abdullah Khaled-A Lsharaf, Tina Lin, Barbara Bellmann, Patrick Nagel, Klaus Lenz, Ulf Landmesser, Mattias Roser, Andreas Rillig
BACKGROUND: Data are limited on the safety of periprocedural anticoagulation with novel oral anticoagulants (NOACs) in patients undergoing pulmonary vein isolation (PVI) using the second-generation cryoballoon (CB) for the treatment of atrial fibrillation. HYPOTHESIS: We hypothesized that the incidence of acute periprocedural complications in patients undergoing PVI do not differ between patients treated with VKA compared to NOACs. METHODS: In 200 consecutive patients (mean age, 64...
August 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28845374/noacs-vs-warfarin-for-stroke-prevention-in-nonvalvular-atrial-fibrillation
#17
REVIEW
Priya Patel, Jheel Pandya, Madeline Goldberg
Atrial fibrillation is a heart arrhythmia associated with increased risk for ischemic stroke. Vitamin K antagonists were developed to decrease a patient's clotting risk; however, these medications require therapeutic monitoring and have several drug interactions. Novel oral anticoagulants (NOACs) were developed as an alternative to vitamin K antagonists and several studies have evaluated the ability of NOAC to decrease clotting as well as the risk of major bleeding in comparison to vitamin K antagonists, such as warfarin...
June 26, 2017: Curēus
https://www.readbyqxmd.com/read/28844514/comparison-of-the-cha2ds2-vasc-chads2-has-bled-orbit-and-atria-risk-scores-in-predicting-non-vitamin-k-antagonist-oral-anticoagulants-associated-bleeding-in-patients-with-atrial-fibrillation
#18
Xiaoxi Yao, Bernard J Gersh, Lindsey R Sangaralingham, David M Kent, Nilay D Shah, Neena S Abraham, Peter A Noseworthy
The increasing adoption of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF) necessitates a reassessment of bleeding risk scores. Because known risk factors for bleeding are largely the same as for stroke, we hypothesize that stroke risk scores could also be used to identify patients with high bleeding risks. We aimed to compare the performance of 2 stroke risk scores (Congestive Heart failure, hypertension, Age ≥75 [doubled], Diabetes, Stroke [doubled], Vascular disease, Age 65-74, and Sex [female] [CHA2DS2-VASc] and Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] [CHADS2]) and 3 bleeding risk scores (hypertension, abnormal renal/liver function [1 point each], stroke, bleeding history or predisposition, labile INR, elderly [...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28832920/effect-of-new-oral-anticoagulants-on-prescribing-practices-for-atrial-fibrillation-in-older-adults
#19
Raymond B Fohtung, Eric Novak, Michael W Rich
OBJECTIVES: To determine the effect of new oral anticoagulants (NOACs) on prescribing practices in older adults with atrial fibrillation (AF). DESIGN: Retrospective observational cohort study. SETTING: Academic medical center in St. Louis, Missouri. PARTICIPANTS: Individuals aged 75 and older with AF admitted to the hospital from October 2010 through September 2015 (N = 6,568, 50% female, 15% non-white). MEASUREMENTS: Information on NOACs and warfarin prescribed at discharge was obtained from hospital discharge summaries, and linear regression was used to examine quarterly trends in their use...
August 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28822583/-misuse-and-adverse-effects-of-new-direct-oral-anticoagulants-a-prospective-observational-study-in-patients-admitted-to-an-emergency-unit-of-a-french-university-hospital
#20
Thomas Lafon, Christine Vallejo, Mathilde Hadj, Marie-Laure Laroche, Hélène Geniaux
INTRODUCTION: The use of direct oral anticoagulants (NOAC) is complex: indications, dosage adjustments and precautions. Emergency departments (ED) are increasingly faced with patients receiving NOAC. The aim of this study was to evaluate the misuse and the adverse effects (AE) of NOAC. METHODS: All subjects with NOAC admitted to the Limoges University Hospital ED from 1/8/2013 to 1/4/2014 were included in a prospective observational study. Misuse was identified from the NOAC summary of product characteristics and from the 2014 ANSM guideline (indication, dose, co-medications, age, hepatic and renal function); adverse effects were recorded...
July 19, 2017: Thérapie
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