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https://www.readbyqxmd.com/read/29250278/the-nonvitamin-k-antagonist-oral-anticoagulants-and-atrial-fibrillation-challenges-and-considerations
#1
REVIEW
Anna Plitt, Sameer Bansilal
The nonvitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban are used for the reduction of the risk of stroke or systemic embolism (SEE) in patients with nonvalvular atrial fibrillation (NVAF). The purpose of this review is to highlight the safety and efficacy results of the pivotal NOAC clinical trials for use in NVAF, discuss some of the unique management challenges in the use of NOACs in special populations, summarize data on emerging and novel indications, and address potential future directions...
February 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29235900/treatment-and-discharge-patterns-among-patients-hospitalized-with-non-valvular-atrial-fibrillation-transitioning-from-the-inpatient-to-outpatient-setting
#2
Henry J Henk, Feng Cao, Kenneth Tuell, Kwanza Price, Prianka Singh, Jack Mardekian, Kevin Odell, Chad Patel, Wilson Tan, George H Sands, Shalabh Singhal, Jeffrey Trocio, Lien Vo
OBJECTIVE: To evaluate inpatient oral anticoagulant (OAC) treatment, discharge location, and post-discharge OAC treatment for patients hospitalized with non-valvular atrial fibrillation (NVAF). RESEARCH DESIGN AND METHODS: Retrospective study using claims data linked to hospital electronic health records (EHR). Patients (N = 2,484) were hospitalized with a primary (38%) or secondary (62%) diagnosis of AF without evidence of mitral valvular heart disease or valve replacement between January 2009 and September 2013...
December 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29231162/evaluation-of-clinical-outcomes-among-nonvalvular-atrial-fibrillation-patients-treated-with-rivaroxaban-or-warfarin-stratified-by-renal%C3%A2-function%C3%A2
#3
Matthew R Weir, Lloyd Haskell, Jeffrey S Berger, Veronica Ashton, François Laliberté, Concetta Crivera, Kip Brown, Patrick Lefebvre, Jeffrey Schein
BACKGROUND: Renal dysfunction increases the risk of thromboembolic and bleeding events in patients with nonvalvular atrial fibrillation (NVAF). MATERIALS AND METHODS: Adult NVAF patients with ≥ 6 months prior to first warfarin or rivaroxaban dispensing were selected from the IMS Health Real-World Data Adjudicated Claims database (05/2011 - 06/2015) with electronic medical records. Ischemic stroke events, thromboembolic events (venous thromboembolism, myocardial infarction, or ischemic stroke), and major bleeding events were compared between patients by renal function identified by 1) relevant ICD-9-CM diagnosis codes and 2) estimated creatinine clearance (eCrCl)...
December 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29228736/bleeding-risk-with-dabigatran-rivaroxaban-warfarin-and-antiplatelet-agent-in-asians-with-non-valvular-atrial-fibrillation
#4
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
https://www.readbyqxmd.com/read/29188721/comparison-of-major-bleeding-risk-in-patients-with-non-valvular-atrial-fibrillation-receiving-direct-oral-anticoagulants-in-the-real-world-setting-a-network-meta-analysis
#5
S Deitelzweig, C Farmer, X Luo, X Li, L Vo, J Mardekian, K Fahrbach, A Ashaye
OBJECTIVE: To conduct a systematic literature review (SLR) and network meta-analysis (NMA) of real-world studies comparing major bleeding risk among patients with non-valvular atrial fibrillation (NVAF) on direct oral anticoagulants (DOACs) or warfarin. METHODS: Systematic searches were conducted in MEDLINE and Embase for full-text articles published between January 1, 2003 and March 18, 2017. Eligible studies compared at least two of the following in a real-world setting: warfarin, apixaban, dabigatran, rivaroxaban, or edoxaban...
November 30, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29166800/comparison-of-all-cause-costs-and-healthcare-resource-use-among-patients-with-newly-diagnosed-non-valvular-atrial-fibrillation-newly-treated-with-oral-anticoagulants
#6
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)...
November 30, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29127745/-medication-adherence-to-non-vitamin-k%C3%A2-antagonist-oral-anticoagulants-at-non-valvular-atrial-fibrillation-the-literature-review
#7
Simona Dvořáčková, Kateřina Ládová, Josef Malý, Jozef Kolář, Miroslav Penka
Medication adherence is a complex problem reflecting variations in terms of medication taking behavior. It is essential in maximizing of the effect and risk minimization of the therapy and health care costs reduction, even in the case of oral anticoagulants (non-vitamin K antagonist oral anticoagulants - NOACs). The aim of this paper was to review the published literature and to discuss results in the field of medication adherence to NOACs in patients with non-valvular atrial fibrillation (NVAF). Based on the searching in databases Embase and PubMed 25 studies were identified, of which conclusions were summarized in this paper...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29125269/direct-oral-anticoagulants-use-in-elderly-patients-with-non-valvular-atrial-fibrillation-state-of-evidence
#8
Giulia Benedetti, Matteo Neccia, Luciano Agati
Non-valvular atrial fibrillation (NVAF) increases the risk of stroke by three- to five-fold, especially in elderly patients, creating a huge burden on medical system as well as a negative impact on patients lives. Balancing efficacy and bleeding risk is a challenge when considering anticoagulation therapy in elderly patients, because of their frequent high risk of both stroke and bleeding. Real world data reveal the underuse of anticoagulation in the elderly, especially due to physicians' fear of bleeding, often neglecting the thromboembolic risk...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29119732/metabolic-benefits-of-rivaroxaban-in-non-valvular-atrial-fibrillation-patients-after-radiofrequency-catheter-ablation
#9
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
https://www.readbyqxmd.com/read/29105666/-low-or-reduced-semantics-of-the-doses-of-new-oral-anticoagulants
#10
Andrea Rubboli
The four new oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban and edoxaban are marketed in two doses each for the prevention of stroke and/or systemic thromboembolism in non-valvular atrial fibrillation (NVAF). The meaning and indications for use of the lower dose compared with the higher dose are, however, different between the thrombin-inhibitor dabigatran on the one hand and the activated factor X (Xa) inhibitors on the other. These differences stem from the different design of the registration studies where NOACs were compared with warfarin for the prevention of stroke and/or systemic thromboembolism in patients with NVAF...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29066923/setting-priorities-in-the-health-care-sector-the-case-of-oral-anticoagulants-in-nonvalvular-atrial-fibrillation-in-denmark
#11
Peter Bo Poulsen, Søren Paaske Johnsen, Morten Lock Hansen, Axel Brandes, Steen Husted, Louise Harboe, Lars Dybro
AIM: Resources devoted to health care are limited, therefore setting priorities is required. It differs between countries whether decision-making concerning health care technologies focus on broad economic perspectives or whether focus is narrow on single budgets ("silo mentality"). The cost perspective as one part of the full health economic analysis is important for decision-making. With the case of oral anticoagulants in patients with nonvalvular atrial fibrillation (NVAF), the aim is to discuss the implication of the use of different cost perspectives for decision-making and priority setting...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29047304/real-world-comparison-of-all-cause-hospitalizations-hospitalizations-due-to-stroke-and-major-bleeding-and-costs-for-nonvalvular-atrial-fibrillation-patients-prescribed-oral-anticoagulants-in-a-us-health-plan
#12
Alpesh Amin, Allison Keshishian, Lien Vo, Qisu Zhang, Oluwaseyi Dina, Chad Patel, Kevin Odell, Jeffrey Trocio
AIMS: Compare the risk of all-cause hospitalization and hospitalizations due to stroke/systemic embolism (SE) and major bleeding as well as associated health care costs for nonvalvular atrial fibrillation (NVAF) patients initiating apixaban, dabigatran, rivaroxaban, or warfarin. MATERIALS AND METHODS: NVAF patients initiating apixaban, dabigatran, rivaroxaban, or warfarin were selected from the OptumInsight Research Database from 01JAN2013-30SEP2015. Propensity score matching (PSM) was performed between apixaban and each oral anticoagulant...
October 19, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29033229/analysis-of-recurrent-stroke-volume-and-prognosis-between-warfarin-and-four-non-vitamin-k-antagonist-oral-anticoagulants-administration-for-secondary-prevention-of-stroke
#13
Yukie Kanai, Hiroaki Oguro, Nao Tahara, Hanako Matsuda, Hiroyuki Takayoshi, Shingo Mitaki, Keiichi Onoda, Shuhei Yamaguchi
OBJECTIVE: We investigated recurrent stroke volume with nonvalvular atrial fibrillation (NVAF) patients treated with non-vitamin K antagonist oral anticoagulants (NOACs) about clinical backgrounds and number of recurrent stroke. METHODS: We administered 4 NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban in 101 postcardioembolic strokes with NVAF. In a retrospective study, we measured recurrent stroke volume with magnetic resonance imaging volumetric software and compared them between 10 vitamin K anticoagulant (VKA: warfarin) cases and 13 NOAC cases under anticoagulant therapy...
October 12, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29030869/evaluation-of-the-predictive-performance-of-bleeding-risk-scores-in-patients-with-non-valvular-atrial-fibrillation-on-oral-anticoagulants
#14
S A Beshir, Z Aziz, L B Yap, K H Chee, Y L Lo
WHAT IS KNOWN AND OBJECTIVE: Bleeding risk scores (BRSs) aid in the assessment of oral anticoagulant-related bleeding risk in patients with atrial fibrillation. Ideally, the applicability of a BRS needs to be assessed, prior to its routine use in a population other than the original derivation cohort. Therefore, we evaluated the performance of 6 established BRSs to predict major or clinically relevant bleeding (CRB) events associated with the use of oral anticoagulant (OAC) among Malaysian patients...
October 13, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29027097/high-number-of-newly-initiated-direct-oral-anticoagulant-users-switch-to-alternate-anticoagulant-therapy
#15
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
https://www.readbyqxmd.com/read/29021853/indications-for-suboptimal-low-dose-direct-oral-anticoagulants-for-non-valvular-atrial-fibrillation-patients
#16
Masahiko Umei, Mikio Kishi, Takahiro Sato, Akito Shindo, Masayuki Toyoda, Masaaki Yokoyama, Masashiro Matsushita, Satoshi Ohnishi, Masao Yamasaki
BACKGROUND: Direct oral anticoagulants (DOACs) have been developed for stroke prevention in patients with non-valvular atrial fibrillation (NVAF). We conducted a retrospective cohort study of patients with NVAF who were newly treated with DOACs in a real-world clinical setting. METHODS: We retrospectively analyzed patients with NVAF newly treated with one of three DOACs-dabigatran, rivaroxaban, or apixaban-between January 1, 2013, and December 31, 2015. RESULTS: A total of 670 patients with NVAF who were newly prescribed one of the three DOACs were analyzed; 74 patients (10...
October 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29016695/oral-anticoagulant-persistence-in-patients-with-non-valvular-atrial-fibrillation-a-cohort-study-using-primary-care-data-in-germany
#17
Shuk-Li Collings, Cinira Lefèvre, Michelle E Johnson, David Evans, Guido Hack, Gillian Stynes, Andrew Maguire
This study examined characteristics and treatment persistence among patients prescribed oral anticoagulants (OACs) for stroke prevention in non-valvular atrial fibrillation (NVAF). We identified 15,244 patients (51.8% male, 72.7% aged ≥70) with NVAF and no prior OAC therapy who were prescribed apixaban (n = 1,303), rivaroxaban (n = 5,742), dabigatran (n = 1,622) or vitamin-K antagonists (VKAs, n = 6,577) between 1-Dec-2012 and 31-Oct-2014 in German primary care (IMS® Disease Analyzer). We compared OAC persistence using Cox regression over patients' entire follow-up and using a data-driven time-partitioned approach (before/after 100 days) to handle non-proportional hazards...
2017: PloS One
https://www.readbyqxmd.com/read/28948752/budget-impact-analysis-of-rivaroxaban-vs-warfarin-anticoagulation-strategy-for-direct-current-cardioversion-in-non-valvular-atrial-fibrillation-patients-the-monaldivert-economic-study
#18
Vincenzo Russo, Anna Rago, Andrea A Papa, Valter Bianchi, Vincenzo Tavoletta, Stefano DE Vivo, Ciro Cavallaro, Gerardo Nigro, Antonio D'Onofrio
BACKGROUND: Rivaroxaban is the first novel oral anticoagulant to receive regulatory approval for non-valvular atrial fibrillation (NVAF) patients who require cardioversion. The MonaldiVert real life experience showed positive benefit-risk profile of short term rivaroxaban administration for transesophageal echocardiogram guided cardioversion in patients who had not achieved adequate pre-procedural vitamin k antagonist (VKA) anticoagulation. METHODS: Aim of our study was to perform a budget impact analysis of MonaldiVert anticoagulation strategy for direct current cardioversion in NVAF patients and to compare the following costs borne by the Regional Healthcare System (RHS) with those for a hypothetical cohort of identical patients underwent from the beginning to early rivaroxaban treatment before direct current cardioversion...
September 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28874129/comparative-effectiveness-of-rivaroxaban-versus-warfarin-or-dabigatran-for-the-treatment-of-patients-with-non-valvular-atrial-fibrillation
#19
Faye L Norby, Lindsay G S Bengtson, Pamela L Lutsey, Lin Y Chen, Richard F MacLehose, Alanna M Chamberlain, Ian Rapson, Alvaro Alonso
BACKGROUND: Rivaroxaban is an oral anticoagulant approved in the US for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). We determined the effectiveness and associated risks of rivaroxaban versus other oral anticoagulants in a large real-world population. METHODS: We selected NVAF patients initiating oral anticoagulant use in 2010-2014 enrolled in MarketScan databases. Rivaroxaban users were matched with warfarin and dabigatran users by age, sex, enrolment date, anticoagulant initiation date, and high-dimensional propensity score...
September 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28862479/cost-effectiveness-analysis-of-dabigatran-versus-rivaroxaban-for-stroke-prevention-in-patients-with-non-valvular-atrial-fibrillation-using-real-world-evidence-in-elderly-us-medicare-beneficiaries
#20
Siyang Peng, Kristen A Deger, Anastasia Ustyugova, Pranav Gandhi, Nan Qiao, Cheng Wang, Anuraag R Kansal
OBJECTIVE: Dabigatran and rivaroxaban have been approved by the US FDA to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients. Newly published real-world evidence based on the US population found that elderly Medicare patients with NVAF treated with rivaroxaban experienced statistically significant increases in intracranial hemorrhage (ICH) and major extracranial bleeding, and statistically nonsignificant decreases in thromboembolic stroke and acute myocardial infarction (AMI) compared with dabigatran...
January 2018: Current Medical Research and Opinion
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