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https://www.readbyqxmd.com/read/28210988/real-life-experience-with-the-specific-reversal-agent-idarucizumab-for-the-management-of-emergency-situations-in-dabigatran-treated-patients-a-series-of-11-cases
#1
Milan R Vosko, Christof Bocksrucker, Rafał Drwiła, Petr Dulíček, Tomas Hauer, Johannes Mutzenbach, Christoph J Schlimp, David Špinler, Thomas Wolf, Daša Zugwitz
Non-vitamin K antagonist oral anticoagulants (NOACs) have a favorable benefit-risk profile compared with vitamin K antagonists. However, the lack of specific reversal agents has made the management of some patients receiving long-term treatment with NOACs problematic in emergency situations such as major bleeding events or urgent procedures. Idarucizumab, a fully humanized Fab antibody fragment that binds specifically and with high affinity to dabigatran, was recently approved for use in adult patients treated with dabigatran when rapid reversal of its anticoagulant effect is required...
February 16, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28188509/anticoagulation-in-atrial-fibrillation-noac-prescribing-in-primary-health-care
#2
Carla Bastida, Núria Corominas, José Miguel Sotoca, Marina Rovira
Background Few studies assess the use of non-vitamin K antagonist oral anticoagulants (NOACs) in daily practice for the prevention of thromboembolic complications associated to nonvalvular atrial fibrillation (AF). Objectives Describe NOACs' use and analyze its prescribing pattern. Evaluate possible factors associated to adverse events (AEs) and the applicability of prescription support forms. Methods We included patients with AF treated with a NOAC during 2014 in three primary healthcare centers in Barcelona, Spain...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28178408/epidemiology-risk-factors-and-clinical-features-of-intracerebral-hemorrhage-an-update
#3
REVIEW
Sang Joon An, Tae Jung Kim, Byung-Woo Yoon
Intracerebral hemorrhage (ICH) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. ICH is more common in Asians, advanced age, male sex, and low- and middle-income countries. The case fatality rate of ICH is high (40% at 1 month and 54% at 1 year), and only 12% to 39% of survivors can achieve long-term functional independence. Risk factors of ICH are hypertension, current smoking, excessive alcohol consumption, hypocholesterolemia, and drugs. Old age, male sex, Asian ethnicity, chronic kidney disease, cerebral amyloid angiopathy (CAA), and cerebral microbleeds (CMBs) increase the risk of ICH...
January 2017: Journal of Stroke
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#4
D C Gulba, L Broscaru
Since first used in 2009, non-vitamin K oral anticoagulants (NOAC) have gained world-wide acceptance. Two groups of NOAC are currently used: the direct thrombin antagonist dabigatran and three direct factor  Xa antagonists apixaban, edoxaban, and ricaroxaban. With their increasing use for prevention of thromboembolism, the probability increases that NOAC-pretreated patients are admitted to emergency departments or intensive care units.The clinical challenge in NOAC preanticoagulated patients is to adequately cope with the given anticoagulated status of such patients...
January 31, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28119380/use-of-intravenous-recombinant-tissue-plasminogen-activator-in-acute-ischemic-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-noacs-before-stroke
#5
Ying Xian, Jerome J Federspiel, Adrian F Hernandez, Daniel Laskowitz, Lee H Schwamm, Deepak L Bhatt, Eric E Smith, Gregg C Fonarow, Eric D Peterson
BACKGROUND: -Intravenous recombinant tissue plasminogen activator (rt-PA) is effective in improving outcomes in ischemic stroke; however, there are few data on use of rt-PA in patients who are receiving a non-vitamin K antagonist oral anticoagulant (NOAC). METHODS: -Using data from the American Heart Association Get With The Guidelines-Stroke Registry, we examined the outcomes of use of thrombolytic therapy in ischemic stroke patients receiving anticoagulation with NOACs versus those on warfarin (international normalized ratio <1...
January 24, 2017: Circulation
https://www.readbyqxmd.com/read/28009346/risk-of-intraocular-hemorrhage-with-new-oral-anticoagulants
#6
G Talany, M Guo, M Etminan
PurposeTo assess the risk of intraocular hemorrhage with warfarin and new oral anticoagulants (NOACs).MethodsWe ascertained all reported cases of intraocular hemorrhage (vitreous, choroidal, or retinal) with warfarin and NOACs (including dabigatran, rivaroxaban, apixaban) from the World Health Organizations's Vigibase database from 1968-2015. We used a disproportionality analysis to compute reported odds ratios (RORs) and corresponding 95% confidence by comparing the number of events with the study outcomes and study drugs compared with all other drugs reported to Vigibase...
December 23, 2016: Eye
https://www.readbyqxmd.com/read/27933569/decision-making-in-clinical-practice-oral-anticoagulant-therapy-in-patients-with-non-valvular-atrial-fibrillation-and-a-single-additional-stroke-risk-factor
#7
REVIEW
Tatjana S Potpara, Nikolaos Dagres, Nebojša Mujović, Dragan Vasić, Milika Ašanin, Milan Nedeljkovic, Francisco Marin, Laurent Fauchier, Carina Blomstrom-Lundqvist, Gregory Y H Lip
Approximately 1 in 3-4 patients presenting with an ischemic stroke will also have atrial fibrillation (AF), and AF-related strokes can be effectively prevented using oral anticoagulant therapy (OAC), either with well-controlled vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs). In addition, OAC use (both VKAs and NOACs) is associated with a 26% reduction in all-cause mortality (VKAs) or an additional 10% mortality reduction with NOACs relative to VKAs. The decision to use OAC in individual AF patient is based on the estimated balance of the benefit from ischemic stroke reduction against the risk of major OAC-related bleeding [essentially intracranial hemorrhage (ICH)]...
December 8, 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27928459/intracranial-hemorrhage-during-administration-of-a-novel-oral-anticoagulant
#8
Akira Tempaku
Objective: Oral anticoagulants are widely administered to patients with atrial fibrillation in order to prevent the onset of cardiogenic embolisms. However, intracranial bleeding during anticoagulant therapy often leads to fatal outcomes. Accordingly, the use of novel oral anticoagulants (NOACs), which less frequently have intracranial bleeding as a complication, is expanding. A nationwide survey of intracranial bleeding and its prognosis in Japan reported that intracranial bleeding of advanced severity was not common after NOAC administration...
2016: Journal of Rural Medicine: JRM
https://www.readbyqxmd.com/read/27893153/efficacy-and-safety-of-dabigatran-rivaroxaban-and-warfarin-for-stroke-prevention-in-chinese-patients-with-atrial-fibrillation-the-hong-kong-atrial-fibrillation-project
#9
Wen-Hua Li, Duo Huang, Chern-En Chiang, Chu-Pak Lau, Hung-Fat Tse, Esther W Chan, Ian C K Wong, Gregory Y H Lip, Pak-Hei Chan, Chung-Wah Siu
BACKGROUND: Little is known about the comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOAC) compared to warfarin in Chinese atrial fibrillation (AF) patients. Our aim was to compare the ischemic stroke risk reduction and incidence of intracranial hemorrhage (ICH) of warfarin in relation to quality of anticoagulation control (as reflected by time in therapeutic range [TTR]), and to dabigatran and rivaroxaban in a real-world cohort of Chinese AF patients...
November 28, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27777713/medication-error-when-switching-from-warfarin-to-rivaroxaban-leading-to-spontaneous-large-ecchymosis-of-the-abdominal-and-chest-wall
#10
Flavio Egger, Federica Targa, Ivan Unterholzner, Russell P Grant, Markus Herrmann, Christian J Wiedermann
Non-vitamin K oral anticoagulant (NOAC) therapy may be inappropriate if prescription was incorrect, the patient's physiological parameters change, or interacting concomitant medications are erroneously added. The aim of this report was to illustrate inappropriate NOAC prescription in a 78-year-old woman with non-valvular atrial fibrillation and borderline renal dysfunction who was switched from warfarin to rivaroxaban and subsequently developed bruising with hemorrhagic shock and acute on chronic renal failure...
August 8, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27659468/atrial-fibrillation-and-thromboembolism-in%C3%A2-patients-with-chronic-kidney-disease
#11
REVIEW
Yee C Lau, Marco Proietti, Elisa Guiducci, Andrew D Blann, Gregory Y H Lip
A bidirectional relationship exists between atrial fibrillation (AF) and chronic renal disease. Patients with AF have a higher incidence of renal dysfunction, and the latter predisposes to incident AF. The coexistence of both conditions results in a higher risk for thromboembolic-related adverse events but a paradoxical increased hemorrhagic risk. Oral anticoagulants (both vitamin K antagonists [VKAs] and non-VKA oral anticoagulants [NOACs]) have been demonstrated to be effective in mild to moderate renal dysfunction...
September 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27614940/efficacy-and-safety-of-novel-oral-anticoagulants-in-patients-with-atrial%C3%A2-fibrillation-and-heart-failure-a-meta-analysis
#12
Gianluigi Savarese, Robert P Giugliano, Giuseppe M C Rosano, John McMurray, Giulia Magnani, Gerasimos Filippatos, Santo Dellegrottaglie, Lars H Lund, Bruno Trimarco, Pasquale Perrone-Filardi
OBJECTIVES: This study investigated the efficacy and safety of novel oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) and heart failure (HF) by a meta-analysis. BACKGROUND: AF is quite prevalent in patients with HF. METHODS: Four phase III clinical trials comparing NOACs to warfarin in patients with AF were included. Each patient was defined as affected by HF according to the criteria of the trial in which the patient was enrolled...
November 2016: JACC. Heart Failure
https://www.readbyqxmd.com/read/27582891/novel-oral-anticoagulants-for-the-secondary-prevention-of-cerebral-ischemia-a-network-meta-analysis
#13
Aristeidis H Katsanos, Dimitris Mavridis, John Parissis, Spyridon Deftereos, Alexandra Frogoudaki, Agathi-Rosa Vrettou, Ignatios Ikonomidis, Maria Chondrogianni, Apostolos Safouris, Angeliki Filippatou, Konstantinos Voumvourakis, Nikos Triantafyllou, John Ellul, Theodore Karapanayiotides, Sotirios Giannopoulos, Anne W Alexandrov, Andrei V Alexandrov, Georgios Tsivgoulis
BACKGROUND: Novel oral anticoagulants (NOACs) have shown to be both safe and effective for ischemic stroke prevention in patients with nonvalvular atrial fibrillation (NVAF). We conducted a network meta-analysis (NMA) using published data from secondary prevention subgroups of different phase III randomized clinical trials (RCTs) comparing individual NOACs with warfarin. METHODS: Eligible studies were identified by searching MEDLINE and SCOPUS and the Cochrane Central Register of Controlled Trials databases...
September 2016: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/27556937/pathogenesis-diagnosis-and-treatment-of-venous-thromboembolism-in-older-adults
#14
Stacy A Johnson, G Paul Eleazer, Matthew T Rondina
Older adults have a significantly greater risk of venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, than younger adults. The cause of this greater risk is thought to be multifactorial, including age-related changes in hemostatic factors and greater comorbid conditions and hospitalizations, but is not completely understood. Moreover, VTE remains underrecognized in older adults and may present atypically. Thus, a low index of clinical suspicion is essential when evaluating older adults with possible VTE...
September 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27545637/-new-oral-anticoagulants-noac-in-nephrology
#15
Antonio Bellasi, Luca Di Lullo, Gianvincenzo Melfa, Claudio Minoretti, Carlo Ratti, Carlo Campana, Maurizio Volpi, Stefano Mangano, Biagio Di Iorio, Mario Cozzolino
The new or direct oral anticoagulants [new oral anticoagulants (NOAC) or direct oral anticoagulants (DOAC)] were launched in the Italian market in 2013. Although these compounds share common pharmacological indications with vitamin K antagonists (warfarin or acenocumarol), they have different mechanisms of action, do not require a constant anticoagulant monitoring but are more efficacious and safer than vitamin K antagonists. The use of these molecules (Dabigatran, Apixaban, Rivaroxaban, Betrixaban, Edoxaban) is constantly rising in daily practice...
July 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/27533256/stroke-prevention-in-atrial-fibrillation-focus-on-latin-america
#16
Ayrton R Massaro, Gregory Y H Lip
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, with an estimated prevalence of 1-2% in North America and Europe. The increased prevalence of AF in Latin America is associated with an ageing general population, along with poor control of key risk factors, including hypertension. As a result, stroke prevalence and associated mortality have increased dramatically in the region. Therefore, the need for effective anticoagulation strategies in Latin America is clear. The aim of this review is to provide a contemporary overview of anticoagulants for stroke prevention...
11, 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27477399/the-efficacy-and-safety-of-oral-rivaroxaban-in-patients-with-non-valvular-atrial-fibrillation-scheduled-for-electrical-cardioversion
#17
Yoshinari Enomoto, Naoshi Ito, Tadashi Fujino, Mahito Noro, Takanori Ikeda, Kaoru Sugi
Objective Electrical cardioversion (EC) is associated with an increased risk of thrombotic events in patients with non-valvular atrial fibrillation (NVAF). Patients who experience AF for a period of >48 hours therefore require adequate anticoagulation therapy for at least 3 weeks before and 4 weeks after EC. While the guidelines address the management of vitamin K antagonists (VKAs), there are limited data on the use of novel oral anticoagulants (NOAC). One NOAC, rivaroxaban, has a rapid onset of action and might therefore shorten the time for which anti-coagulant treatment is required before a patient undergoes EC...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27394924/vitamin-k-and-non-vitamin-k-antagonist-oral-anticoagulants-for-non-valvular-atrial-fibrillation-in-real-life
#18
Michela Giustozzi, Maria Cristina Vedovati, Paolo Verdecchia, Lucia Pierpaoli, Melina Verso, Serenella Conti, Federica Cianella, Emanuela Marchesini, Esmeralda Filippucci, Giancarlo Agnelli, Cecilia Becattini
BACKGROUND: Current guidelines recommend vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with non-valvular atrial fibrillation (AF). METHODS: We compared the clinical features of consecutive in- and out-patients with non-valvular AF newly-treated with NOACs or on treatment with VKAs. RESULTS: Overall, 1314 patients newly-treated with NOACs and 1024 on treatment with VKAs were included in the study...
September 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27311528/nonvitamin-k-anticoagulant-agents-in%C3%A2-patients-with-advanced-chronic-kidney%C3%A2-disease-or-on-dialysis-with-af
#19
REVIEW
Kevin E Chan, Robert P Giugliano, Manesh R Patel, Stuart Abramson, Meg Jardine, Sophia Zhao, Vlado Perkovic, Franklin W Maddux, Jonathan P Piccini
Nonvitamin K-dependent oral anticoagulant agents (NOACs) are currently recommended for patients with atrial fibrillation at risk for stroke. As a group, NOACs significantly reduce stroke, intracranial hemorrhage, and mortality, with lower to similar major bleeding rates compared with warfarin. All NOACs are dependent on the kidney for elimination, such that patients with creatinine clearance <25 ml/min were excluded from all the pivotal phase 3 NOAC trials. It therefore remains unclear how or if NOACs should be prescribed to patients with advanced chronic kidney disease and those on dialysis...
June 21, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27292781/developments-of-anticoagulants-and-new-agents-with-anti-coagulant-effects-in-deep-vein-thrombosis
#20
Yi-Ping Dang, Yun-Fei Chen, Yi-Qing Li, Lei Zhao
Deep Vein Thrombosis (DVT) has been known as a common medical problem all over the world. Thrombus traveling in blood vessels may lead to pulmonary embolism (PE), associated with high rates of mortality. Anticoagulant therapy is the mainstay treatment of DVT. Common anticoagulants, Vitamin K antagonists (VKAs), unfractionated heparin (UFH) and Low-molecular-weight heparin (LMWH) have been used in clinical application over decades, but can increase the risk of hemorrhage. Thereby, several new oral anticoagulants (NOACs) have been developed, which includes direct thrombin inhibitors (DTI) and direct factor Xa inhibitors...
2017: Mini Reviews in Medicinal Chemistry
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