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rivaroxaban versus warfarin

Mathieu Kerneis, C Michael Gibson, Gerald Chi, Roxana Mehran, Fahad AlKhalfan, Usama Talib, Seyedmahdi Pahlavani, Mahshid Mir, Christoph Bode, Jonathan L Halperin, Tarek Nafee, Eric D Peterson, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Keith A A Fox, Marc Cohen
OBJECTIVES: This study sought to assess whether there were significant interactions of procedural access strategies and lesion characteristics with bleeding and ischemic events among atrial fibrillation (AF) patients anticoagulated with rivaroxaban or warfarin following a percutaneous coronary intervention. BACKGROUND: Among stented AF patients, the impact of procedural access strategies or lesion characteristics on antithrombotic safety and efficacy outcomes is unclear...
March 8, 2018: JACC. Cardiovascular Interventions
John Burn, Munir Pirmohamed
About 1.4 British million people are at risk of strokes due to non-valvular atrial fibrillation (AF) necessitating long-term anticoagulation. The vitamin K antagonist, warfarin, has a long half-life and narrow therapeutic range necessitating regular monitoring and is a common cause of iatrogenic hospital admission. Direct-acting oral anticoagulants (DOACs), dabigatran, rivaroxaban, apixaban and edoxaban are not required to have monitoring but are sensitive to changes in renal function and are associated with poorer adherence...
2018: Open Heart
Craig I Coleman, Alexander G G Turpie, Thomas J Bunz, Jan Beyer-Westendorf
PURPOSE: Frailty predicts poorer outcomes in patients receiving anticoagulation. We sought to assess the effectiveness and safety of rivaroxaban versus warfarin in frail patients experiencing venous thromboembolism in routine practice. METHODS: Using United States MarketScan claims data from 1/2012-12/2016, we identified frail patients (using the Johns Hopkins Claims-Based Frailty Indicator score) who had ≥1 primary hospitalization/emergency department visit discharge diagnosis code for venous thromboembolism (index event), received rivaroxaban or warfarin as their first outpatient oral anticoagulant (OAC) within 30-days of the index event and had ≥12-month of insurance coverage prior the index venous thromboembolism (baseline)...
March 8, 2018: American Journal of Medicine
Craig I Coleman, Jan Beyer-Westendorf, Thomas J Bunz, Charles E Mahan, Alex C Spyropoulos
Postthrombotic syndrome (PTS) is a frequent complication of venous thromboembolism (VTE). Using MarketScan claims data from January 2012 to June 2015, we identified adults with a primary diagnosis code for VTE during a hospitalization/emergency department visit, ≥6 months of insurance coverage prior to the index event and newly started on rivaroxaban or warfarin within 30 days of the index VTE. Patients with <4-month follow-up postindex event or a claim for any anticoagulant during 6-month baseline period were excluded...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
Karsten Mh Bruins Slot, Eivind Berge
BACKGROUND: Factor Xa inhibitors and vitamin K antagonists (VKAs) are now recommended in treatment guidelines for preventing stroke and systemic embolic events in people with atrial fibrillation (AF). This is an update of a Cochrane review previously published in 2013. OBJECTIVES: To assess the effectiveness and safety of treatment with factor Xa inhibitors versus VKAs for preventing cerebral or systemic embolic events in people with AF. SEARCH METHODS: We searched the trials registers of the Cochrane Stroke Group and the Cochrane Heart Group (September 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (August 2017), MEDLINE (1950 to April 2017), and Embase (1980 to April 2017)...
March 6, 2018: Cochrane Database of Systematic Reviews
Jordanne Feldberg, Param Patel, Ashley Farrell, Sylvia Sivarajahkumar, Karen Cameron, Jennifer Ma, Marisa Battistella
Background: There is a lack of clear benefit and a potential risk of bleeding with direct oral anticoagulant (DOAC) use in chronic kidney disease (CKD) and dialysis patients with atrial fibrillation. The objective of this study was to evaluate how treatment with DOACs affects stroke and bleeding outcomes compared with warfarin or aspirin. Methods: We conducted a systematic review of randomized controlled trials, cohort studies and case series, and searched electronic databases from 1946 to 2017...
March 2, 2018: Nephrology, Dialysis, Transplantation
Mette Søgaard, Peter Brønnum Nielsen, Flemming Skjøth, Jette Nordstrøm Kjældgaard, Craig I Coleman, Torben Bjerregaard Larsen
BACKGROUND: The effectiveness of rivaroxaban to reduce post-thrombotic syndrome in patients with venous thromboembolism is largely unknown. We compared rates of post-thrombotic syndrome in patients given rivaroxaban versus warfarin in a cohort of routine clinical care patients with incident venous thromboembolism. METHODS: We linked Danish nationwide registries to identify all patients with incident venous thromboembolism who were new users of rivaroxaban or warfarin and compared rates of post-thrombotic syndrome using an inverse probability of treatment weighting approach to account for baseline confounding...
February 21, 2018: American Journal of Medicine
Lara M Groetzinger, Taylor J Miller, Ryan M Rivosecchi, Roy E Smith, Mark T Gladwin, Belinda N Rivera-Lebron
BACKGROUND: Little data exist on the use of direct oral anticoagulant (DOAC) factor Xa inhibitors for submassive pulmonary embolism (PE) after catheter-directed thrombolysis (CDT). The objective of this evaluation was to determine whether the transition from parenteral anticoagulation to DOACs for submassive PE after CDT would decrease hospital length of stay (LOS) compared to warfarin. METHODS: A retrospective review of patients diagnosed with submassive PE who underwent CDT was conducted from January 1, 2012, to February 28, 2017...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
Craig I Coleman, Alexander G G Turpie, Thomas J Bunz, William L Baker, Jan Beyer-Westendorf
INTRODUCTION: Screening for primary hypercoagulable states (PHSs) in venous thromboembolism (VTE) patients was not mandated in the EINSTEIN trials; and therefore, few patients with a known PHS were available for analysis. We sought to assess the effectiveness and safety of rivaroxaban versus warfarin for treatment of VTE in patients with a known PHS. METHODS: Using MarketScan claims data from 1/2012-9/2015, we identified adults with a primary diagnosis of VTE during a hospitalization/emergency department visit (the index event), with ≥180-days of continuous insurance coverage prior to the index event, a documented diagnosis for a PHS and newly-initiated as an outpatient on rivaroxaban or warfarin within 30-days of the index VTE...
January 31, 2018: Thrombosis Research
Ekta Yogeshkumar Pandya, Elizabeth Anderson, Clara Chow, Yishen Wang, Beata Bajorek
Background: To document antithrombotic utilization in patients with nonvalvular atrial fibrillation (NVAF), particularly, recently approved NOACs (nonvitamin K antagonist oral anticoagulants) and warfarin; and identify factors predicting the use of NOACs versus warfarin. Methods: A retrospective audit was conducted in an Australian hospital. Data pertaining to inpatients diagnosed with atrial fibrillation (AF) admitted between January and December 2014 were extracted...
February 2018: Therapeutic Advances in Drug Safety
Sean T Chen, Manesh R Patel
In patients with non-valvular atrial fibrillation (NVAF), oral anticoagulation is important for prevention of stroke and systemic embolism (SE). While Vitamin K antagonists (VKAs) have historically been the standard of care, these medications are limited by numerous food and drug interactions with onerous requirements for frequent monitoring and dose adjustments. Over the past decade, several novel oral anticoagulants (NOACs) have been developed to directly inhibit factor IIa/thrombin (dabigatran) or activated factor X (apixaban, rivaroxaban, edoxaban)...
January 13, 2018: Progress in Cardiovascular Diseases
K K Utne, A Dahm, H S Wik, L P Jelsness-Jørgensen, P M Sandset, W Ghanima
INTRODUCTION: Despite treatment of acute deep vein thrombosis (DVT) with low molecular weight heparin and warfarin, up to 50% of patients develop post-thrombotic syndrome (PTS). Our aims were to assess whether treatment of DVT with rivaroxaban would reduce the rate of subsequent PTS and improve health-related quality of life (HRQoL) as compared to conventional anticoagulation with low molecular weight heparin (LMWH)/warfarin. MATERIALS AND METHODS: Consecutive patients with an objectively confirmed DVT diagnosed between 2011 and 2014 and treated with either rivaroxaban or warfarin were included in this study 24 (±6) months after DVT...
January 8, 2018: Thrombosis Research
Elizabeth A Chrischilles, Joshua J Gagne, Bruce Fireman, Jennifer Nelson, Sengwee Toh, Azadeh Shoaibi, Marsha E Reichman, Shirley Wang, Michael Nguyen, Rongmei Zhang, Rima Izem, Margie R Goulding, Mary Ross Southworth, David J Graham, Candace Fuller, Hannah Katcoff, Tiffany Woodworth, Catherine Rogers, Ryan Saliga, Nancy D Lin, Cheryl N McMahill-Walraven, Vinit P Nair, Kevin Haynes, Ryan M Carnahan
PURPOSE: The US Food and Drug Administration's Sentinel system developed tools for sequential surveillance. METHODS: In patients with non-valvular atrial fibrillation, we sequentially compared outcomes for new users of rivaroxaban versus warfarin, employing propensity score matching and Cox regression. A total of 36 173 rivaroxaban and 79 520 warfarin initiators were variable-ratio matched within 2 monitoring periods. RESULTS: Statistically significant signals were observed for ischemic stroke (IS) (first period) and intracranial hemorrhage (ICH) (second period) favoring rivaroxaban, and gastrointestinal bleeding (GIB) (second period) favoring warfarin...
January 10, 2018: Pharmacoepidemiology and Drug Safety
Lindsay Robertson, Su Ern Yeoh, Ahmad Ramli
BACKGROUND: Currently, little evidence is available on the length and type of anticoagulation used for extended treatment for prevention of recurrent venous thromboembolism (VTE) in patients with unprovoked VTE who have completed initial oral anticoagulation therapy. OBJECTIVES: To compare the efficacy and safety of available oral therapeutic options (aspirin, warfarin, direct oral anticoagulants (DOACs)) for extended thromboprophylaxis in adults with a first unprovoked VTE, to prevent VTE recurrence after completion of an acceptable initial oral anticoagulant treatment period, as defined in individual studies...
December 15, 2017: Cochrane Database of Systematic Reviews
Yi-Hsin Chan, Yung-Hsin Yeh, Hui-Tzu Tu, Chi-Tai Kuo, Shang-Hung Chang, Lung-Sheng Wu, Hsin-Fu Lee, Lai-Chu See
It is not understood if dabigatran or rivaroxaban are superior to antiplatelet agents (AA) for safety outcomes in Asians with non-valvular atrial fibrillation (NVAF). In this study we evaluated the bleeding risk of dabigatran, rivaroxaban, warfarin and AA in Asians with NVAF. This national retrospective cohort study analyzed 6,600, 3,167, 5,338 and 8,238 consecutive NVAF patients taking dabigatran, rivaroxaban, warfarin or AAs (including aspirin, clopidogrel or ticlopidine), respectively, from June 1, 2012 to December 31, 2013...
November 17, 2017: Oncotarget
Adrienne M Gilligan, Jessica Franchino-Elder, Xue Song, Cheng Wang, Caroline Henriques, Amy Sainski-Nguyen, Kathleen Wilson, David M Smith, Stephen Sander
OBJECTIVES: Compare costs and healthcare resource utilization (HCRU) among newly-diagnosed non-valvular atrial fibrillation (NVAF) patients newly treated with dabigatran vs apixaban, rivaroxaban, or warfarin. METHODS: Newly-diagnosed adult NVAF patients initiating dabigatran, apixaban, rivaroxaban, or warfarin (index event) between October 1, 2010-December 31, 2014 were identified using MarketScan claims data, and followed until medication discontinuation, switch, inpatient death, enrollment end, or study end (December 31, 2015)...
February 2018: Current Medical Research and Opinion
Craig I Coleman, Erin R Weeda, Elaine Nguyen, Thomas J Bunz, Nitesh A Sood
No abstract text is available yet for this article.
November 7, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
Jun Zhu, Rong-Jun Gao, Qiang Liu, Ru-Hong Jiang, Lu Yu, Ya-Xun Sun, Pei Zhang, Jian-Wei Lin, Yang Ye, Zu-Wen Zhang, Shi-Quan Chen, Hui Cheng, Xia Sheng, Chen-Yang Jiang
BACKGROUND AND OBJECTIVE: Rivaroxaban is a new oral anticoagulant for stroke prevention in patients with non-valvular atrial fibrillation (NVAF), which has less drug-food interaction than warfarin. We conducted this prospective randomized study to evaluate the metabolic benefits as well as the safety and efficacy with rivaroxaban versus warfarin in patients with NVAF following radiofrequency catheter ablation (RFCA). METHODS: From April to July 2014, 60 patients with NVAF undergoing RFCA were prospectively enrolled in our study...
2017: Journal of Zhejiang University. Science. B
Miho Kimachi, Toshi A Furukawa, Kimihiko Kimachi, Yoshihito Goto, Shingo Fukuma, Shunichi Fukuhara
BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for atrial fibrillation (AF), which is more prevalent among CKD patients than the general population. AF causes stroke or systemic embolism, leading to increased mortality. The conventional antithrombotic prophylaxis agent warfarin is often prescribed for the prevention of stroke, but risk of bleeding necessitates regular therapeutic monitoring. Recently developed direct oral anticoagulants (DOAC) are expected to be useful as alternatives to warfarin...
November 6, 2017: Cochrane Database of Systematic Reviews
Beenish S Manzoor, Surrey M Walton, Lisa K Sharp, William L Galanter, Todd A Lee, Edith A Nutescu
Real-world evidence focusing on medication switching patterns amongst direct oral anticoagulant (DOACs) has not been well studied. The objective of this study is to evaluate patterns of prescription switching in non-valvular atrial fibrillation (NVAF) patients initiated on a DOAC and previously naïve to anticoagulation (AC) therapy. Data was obtained from Truven Health MarketScan(®) Commercial and Medicare Supplemental database (2009-2013). AC naïve (those without prior anticoagulant use) NVAF patients initiated on a DOAC, with 6 months of continuous health plan enrollment before and after treatment initiation and maintained on continuous therapy for a minimum of 6 months were included...
November 2017: Journal of Thrombosis and Thrombolysis
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