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https://www.readbyqxmd.com/read/27914497/acute-management-of-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-addressing-real-world-anticoagulant-management-issues-in-stroke-aramis-registry-design-and-rationale
#1
Ying Xian, Adrian F Hernandez, Tina Harding, Gregg C Fonarow, Deepak L Bhatt, Robert E Suter, Yosef Khan, Lee H Schwamm, Eric D Peterson
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial lack of information on how patients on NOACs are currently treated when they have an acute ischemic stroke and the best strategies for treating intracerebral hemorrhage for those on chronic anticoagulation with warfarin or a NOAC. These are critical unmet needs for real world clinical decision making in these emergent patients...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27911120/new-frontiers-in-anticoagulation-non-vitamin-k-oral-anticoagulants-in-stroke-prevention
#2
Valentina Arnao, Marianna Riolo, Antonino Tuttolomondo, Antonio Pinto, Brigida Fierro, Paolo Aridon
Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert Commentary: Although warfarin is effective in cardioembolic stroke prevention, easier handling and more favorable risk-benefit profile often render NOACs a more preferable therapy choice for neurologists...
December 2, 2016: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/27909544/reducing-the-risk-of-stroke-in-patients-with-nonvalvular-atrial-fibrillation-with-direct-oral-anticoagulants-is-one-of-these-not-like-the-others
#3
REVIEW
Paul P Dobesh Pharm D, John Fanikos Mba R Ph
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and increases risk of stroke by nearly 5-fold. While warfarin has been employed successfully to reduce the risk of stroke in these patients, there are a number of challenges with therapy. These include the need for therapeutic monitoring due to variability in patient response, frequent dose adjustments, numerous drug-drug, drug-food, and drug-disease interactions, and a heightened risk of thrombosis and bleeding due to these issues. Current guidelines recommend that the vitamin K antagonists (VKA) or direct oral anticoagulants (DOACs) should be used for thromboprophylaxis in patients with nonvalvular AF at risk for stroke or systemic embolic events...
August 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27909496/safety-and-efficacy-of-uninterrupted-periprocedural-apixaban-in-patients-undergoing-atrial-fibrillation-catheter-ablation-a-metaanalysis-of-1-057-patients
#4
REVIEW
Jalaj Garg Md Fesc, Rahul Chaudhary Md, Parasuram Krishnamoorthy Md, Neeraj Shah Md, Babak Bozorgnia Md, Andrea Natale Md
Apixaban (factor Xa inhibitor) is a novel anticoagulant and may be beneficial during atrial fibrillation (AF) ablation for prevention of thromboembolic events. However, the adverse effects of periprocedural apixaban therapy have not been thoroughly evaluated. A meta-analysis was performed to evaluate the safety of apixaban for anticoagulation in AF ablation. We searched the online databases till October 2015 for studies comparing Apixaban with Vitamin K antagonists in atrial fibrillation patients undergoing catheter ablation...
April 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27906452/primary-prophylaxis-for-venous-thromboembolism-in-ambulatory-cancer-patients-receiving-chemotherapy
#5
REVIEW
Marcello Di Nisio, Ettore Porreca, Matteo Candeloro, Michele De Tursi, Ilaria Russi, Anne Ws Rutjes
BACKGROUND: Venous thromboembolism (VTE) often complicates the clinical course of cancer. The risk is further increased by chemotherapy, but the trade-off between safety and efficacy of primary thromboprophylaxis in cancer patients treated with chemotherapy is uncertain. This is the second update of a review first published in February 2012. OBJECTIVES: To assess the efficacy and safety of primary thromboprophylaxis for VTE in ambulatory cancer patients receiving chemotherapy compared with placebo or no thromboprophylaxis...
December 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27900867/-new-direct-oral-anticoagulants-actual-review
#6
Jana Michalcová, Miroslav Penka, Alena Buliková, Jiřina Zavřelová, Andrea Štěpařová
In recent years the options of anticoagulant/antithrombotic therapy have extended with new - direct oral anticoagulants, comprising direct thrombin inhibitors (dabigatran etexilate) and direct factor Xa inhibitors (rivaroxaban, apixaban). These agents represent another progress towards "the ideal antithrombotic drug", and thus towards a safe and effective antithrombotic therapy. The following article provides actual review and recommendations for clinical practice, including laboratory assessment and management of emergency situations...
2016: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
November 30, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27900231/efficacy-and-safety-of-direct-oral-anticoagulants-compared-to-warfarin-in-prevention-of-thromboembolic-events-among-elderly-patients-with-atrial-fibrillation
#8
REVIEW
Shilpa D Kailas, Sirisha Reddy Thambuluru
Direct oral anticoagulants (DOACs), previously also known as novel oral anticoagulants (NOACs), have increased the therapeutic options for stroke prevention in atrial fibrillation (AF). Previous studies comparing their relative efficacy and safety do not address age-related differences, such as comorbidities and physical and social boundaries. This review aimed to summarize and compare the clinical and safety outcomes of DOACs and warfarin for stroke prevention in AF in the elderly population (≥ 65 years)...
October 18, 2016: Curēus
https://www.readbyqxmd.com/read/27896543/vitamin-k-antagonists-relative-strengths-and-weaknesses-vs-direct-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation
#9
REVIEW
Andreas Zirlik, Christoph Bode
Vitamin K antagonists (VKAs) have been the mainstay of anticoagulation therapy for more than 50 years. VKAs are mainly used for the prevention of stroke in patients with atrial fibrillation (AF) and the treatment and secondary prevention of venous thromboembolism. In the past 5 years, four new agents-the direct factor Xa inhibitors apixaban, edoxaban and rivaroxaban and the direct thrombin inhibitor dabigatran [collectively known as direct oral anticoagulants (DOACs) or non-VKA oral anticoagulants]-have been approved for these and other indications...
November 28, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27896061/successful-retreatment-with-osimertinib-after-osimertinib-induced-acute-pulmonary-embolism-in-a-patient-with-lung-adenocarcinoma-a-case-report
#10
Takayuki Shiroyama, Manabu Hayama, Shingo Satoh, Shingo Nasu, Ayako Tanaka, Satomu Morita, Naoko Morishita, Hidekazu Suzuki, Norio Okamoto, Tomonori Hirashima
Pulmonary embolism (PE) can be life-threatening, and it is challenging to diagnose because of its nonspecific signs and symptoms. PE is also an important potential risk of osimertinib treatment, however, clinical courses regarding retreatment after osimertinib-induced acute pulmonary embolism remain unclear. We described a 77-year-old woman with postoperative recurrent lung adenocarcinoma who developed osimertinib-induced acute PE. She received apixaban and was later successfully retreated with osimertinib...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27895055/role-of-agents-for-reversing-the-effects-of-target-specific-oral-anticoagulants
#11
REVIEW
Tanya R Riley, Mary L Gauthier-Lewis, Chelsea K Sanchez, Janine S Douglas
PURPOSE: The available clinical data on target-specific oral anticoagulant (TSOAC) reversal agents that are currently in development or have been approved by the Food and Drug Administration (FDA) are reviewed. SUMMARY: The development of TSOACs such as dabigatran, rivaroxaban, edoxaban, and apixaban has presented benefits and new challenges. One of the main challenges associated with the use of TSOACs is the lack of suitable agent-specific reversal agents. Several treatment options for the management of life-threatening bleeding events associated with TSOAC use, such as fresh frozen plasma, prothrombin complex concentrates, and recombinant coagulation factor VIIa, have been used, with inconsistent results...
November 28, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27891570/pragmatic-approach-to-manage-new-oral-anticoagulants-in-patients-undergoing-dental-extractions-a-prospective-case-control-study
#12
Isabel Miclotte, Maarten Vanhaverbeke, Jimoh Olubanwo Agbaje, Paul Legrand, Thomas Vanassche, Peter Verhamme, Constantinus Politis
OBJECTIVES: The aim of this study was to validate a standardized pragmatic approach to manage new oral anticoagulants (NOACs) in patients who undergo dental extractions. MATERIALS AND METHODS: This prospective case-control study in patients undergoing dental extraction included 26 patients (mean age 76 years, 57% male) treated with dabigatran, rivaroxaban, or apixaban and 26 matched controls. Regardless of timing of extraction, drug regimen, or renal function, patients were instructed to skip only the dose on the morning of the procedure...
November 28, 2016: Clinical Oral Investigations
https://www.readbyqxmd.com/read/27888865/advances-in-gastrointestinal-bleeding
#13
Ángel Lanas
The main innovations of the latest meeting of the Gastroenterological Association (2016) concerning upper gastrointestinal bleeding from the clinician's perspective can be summarised as follows: a) The Glasgow-Blatchford scale has the best accuracy in predicting the need for surgical intervention and hospital mortality; b) Prognostic scales for non-variceal upper gastrointestinal bleeding are also useful for lower gastrointestinal bleeding; c) Preliminary data suggest that treatment with hemospray does not seem to be superior to current standard treatment in controlling active peptic ulcer bleeding; d) Either famotidine or a proton pump inhibitor may be effective in preventing haemorrhagic recurrence in patients taking aspirin, but this finding needs to be confirmed in further studies; e) There was confirmation of the need to re-introduce antiplatelet therapy as early as possible in patients with antiplatelet-associated gastrointestinal bleeding in order to prevent cardiovascular mortality; f) Routine clinical practice suggests that gastrointestinal or cardiovascular complications with celecoxib or traditional NSAIDs are very low; g) Dabigatran is associated with an increased incidence of gastrointestinal bleeding compared with apixaban or warfarin...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27886530/choosing-wisely-the-impact-of-patient-selection-on-efficacy-and-safety-outcomes-in-the-einstein-dvt-pe-and-amplify-trials
#14
Jan Beyer-Westendorf, Anthonie W A Lensing, Roopen Arya, Henri Bounameaux, Alexander T Cohen, Philip S Wells, Saskia Middeldorp, Peter Verhamme, Rodney Hughes, Nils Kucher, Akos F Pap, Mila Trajanovic, Martin H Prins, Paolo Prandoni, Jeffrey I Weitz
BACKGROUND: The results of the EINSTEIN-DVT/PE and AMPLIFY trials, which compared rivaroxaban and apixaban with conventional anticoagulation therapy for acute venous thromboembolism (VTE), respectively, are often compared. However, the trials differed in duration of therapy (3-12 and 6months, respectively) and in patient selection (few exclusion criteria and more stringent exclusion criteria, respectively). METHODS: To determine the effect of these methodological differences on outcomes, the patients enrolled in EINSTEIN-DVT/PE were divided into 2 cohorts; the 5253 patients that matched the exclusion criteria for AMPLIFY and were treated for at least 6months (cohort 1) and the 2368 patients who would have been ineligible for AMPLIFY (cohort 2)...
November 21, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27884586/the-x-factor-lack-of-bleeding-after-an-acute-apixaban-overdose
#15
Scott M Leikin, Hina Patel, Katherine L Welker, Jerrold B Leikin
No abstract text is available yet for this article.
November 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27882517/cost-effectiveness-of-apixaban-versus-warfarin-or-aspirin-for-stroke-prevention-in-patients-with-atrial-fibrillation-a-greek-perspective
#16
Kostas Athanasakis, Nadia Boubouchairopoulou, Eleftheria Karampli, Filippos Tarantilis, Paraskevi Savvari, Aikaterini Bilitou, John Kyriopoulos
BACKGROUND: Strokes attributed to atrial fibrillation (AF) represent a major cause of adult disability and a great burden to society and healthcare systems. OBJECTIVES: Our objective was to assess the cost effectiveness of apixaban, a direct acting oral anticoagulant (DOAC), versus warfarin or aspirin for patients with AF in the Greek healthcare setting. METHODS: We used a previously published Markov model to simulate clinical events for patients with AF treated with apixaban, the vitamin K antagonist (VKA) warfarin, or aspirin...
November 23, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27881833/apixaban-for-treatment-of-embolic-stroke-of-undetermined-source-atticus-randomized-trial-rationale-and-study-design
#17
Tobias Geisler, Sven Poli, Christoph Meisner, Juergen Schreieck, Christine S Zuern, Thomas Nägele, Johannes Brachmann, Werner Jung, Georg Gahn, Elisabeth Schmid, Hansjörg Bäezner, Timea Keller, Gabor C Petzold, Jan-Wilko Schrickel, Jan Liman, Rolf Wachter, Frauke Schön, Martin Schabet, Alfred Lindner, Albert C Ludolph, Hubert Kimmig, Sebastian Jander, Uwe Schlegel, Meinrad Gawaz, Ulf Ziemann
RATIONALE: Optimal secondary prevention of embolic stroke of undetermined source is not established. The current standard in these patients is acetylsalicylic acid, despite high prevalence of yet undetected paroxysmal atrial fibrillation. AIM: The ATTICUS randomized trial is designed to determine whether the factor Xa inhibitor apixaban administered within 7 days after embolic stroke of undetermined source, is superior to acetylsalicylic acid for prevention of new ischemic lesions documented by brain magnetic resonance imaging within 12 months after index stroke...
November 23, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27870603/indirect-comparison-of-novel-oral-anticoagulants-in-women-with-nonvalvular-atrial-fibrillation
#18
Alex Moseley, Rami Doukky, Kim Allan Williams, Amir K Jaffer, Annabelle Santos Volgman
BACKGROUND: For nonvalvular atrial fibrillation (NVAF), novel oral anticoagulants (NOACs) have been found noninferior to warfarin for stroke/systemic embolization prevention, and major bleeding events. Recent meta-analysis of NOACs versus warfarin in atrial fibrillation (AF) showed that women on warfarin have greater risk of stroke/embolism than men, and when both are treated with NOACs, differences disappear. METHODS: NOACs differ in pharmacologic properties, thus they may differ from one another in their effects on women with AF...
November 21, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27862233/transesophageal-echocardiographic-diagnosis-of-a-watchman-left-atrial-appendage-closure-device-thrombus-10%C3%A2-years-following-implantation
#19
Shariq Shamim, Anthony Magalski, Adnan C Chhatriwalla, Keith B Allen, Kenneth C Huber, Michael L Main
Left atrial appendage closure with the WATCHMAN device is an alternative to chronic oral anticoagulation for thromboembolic prophylaxis in atrial fibrillation patients. Left atrial device-related thrombus (DRT) has been described in the first year after implant with an incidence of ~6%. A 79-year-old man underwent WATCHMAN device placement in 2006. Routine protocol specified follow-up transesophageal echocardiograms (TEE) at 6 weeks, 6 months, and 1 year following implant showed no evidence for DRT or peri-device flow...
November 16, 2016: Echocardiography
https://www.readbyqxmd.com/read/27861316/development-of-an-uhplc-uv-method-for-quantification-of-direct-oral-anticoagulants-apixaban-rivaroxaban-dabigatran-and-its-prodrug-dabigatran-etexilate-in-human-serum
#20
Sebastian Boehr, Ekkehard Haen
BACKGROUND: Direct oral anticoagulants (DOACs) currently have no indication for monitoring even though there are data that imply that individual dosing can improve and add safety to the therapy. METHODS: An ultra-high performance liquid chromatography (UHPLC) method with ultra violet (UV) detection has been developed and validated for apixaban, dabigatran, dabigatran etexilate, and rivaroxaban. Protein precipitation with methanol (1:3 vol/vol) was used as sample preparation...
November 16, 2016: Therapeutic Drug Monitoring
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