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https://www.readbyqxmd.com/read/28809374/new-horizons-in-anticoagulation-direct-oral-anticoagulants-and-their-implications-in-oral-surgery
#1
V Serrano-Sánchez, J Ripollés-de Ramón, L Collado-Yurrita, I Vaello-Checa, C Colmenero-Ruiz, A Helm, M Ciudad-Cabañas, V Serrano-Cuenca
Thrombotic disorders remain a leading cause of death in the Western World. For decades, vitamin K antagonists used in the prevention of this pathology, such as warfarin or sintrom, were the only oral agents available for long-term anticoagulation, in spite of their disadvantages. Therefore, in recent years, the so-called "new oral anticoagulants" have been introduced in clinical practice to treat those patients whose medical conditions require long-term anticoagulant treatment, replacing traditional oral anticoagulants...
August 15, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28808918/idarucizumab-in-dabigatran-treated-patients-with-acute-ischemic-stroke-receiving-alteplase-a-systematic-review-of-the-available-evidence
#2
REVIEW
Slaven Pikija, Laszlo K Sztriha, J Sebastian Mutzenbach, Stefan M Golaszewski, Johann Sellner
BACKGROUND AND PURPOSE: Current guidelines do not recommend the use of intravenous recombinant tissue plasminogen activator in patients with acute ischemic stroke who receive direct oral anticoagulants. While the humanized monoclonal antibody idarucizumab can quickly reverse the anticoagulant effects of the thrombin inhibitor dabigatran, safety data for subsequent tissue plasminogen activator treatment are sparse. Here, we review current knowledge about dabigatran reversal prior to systemic reperfusion treatment in acute ischemic stroke...
August 14, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28808596/the-severity-of-intracranial-hemorrhages-measured-by-free-hemoglobin-in-the-brain-depends-on-the-anticoagulant-class-experimental-data
#3
Kyle M Ware, Douglas L Feinstein, Israel Rubinstein, Prudhvi Battula, Jose Otero, Lee Hebert, Tzu-Fei Wang, Alexandra Ivanova, Shweta Chaudhary, Jessica Hemminger, Sergey V Brodsky
Background and Purpose. Anticoagulant therapy is broadly used to prevent thromboembolic events. Intracranial hemorrhages are serious complications of anticoagulation, especially with warfarin. Direct oral anticoagulants reduce but do not eliminate the risk of intracranial hemorrhages. The aim of this study is to determine the degree of intracranial hemorrhage after application of anticoagulants without additional triggers. Methods. Rats were treated with different anticoagulant classes (vitamin K antagonists, heparin, direct thrombin inhibitor, and factor Xa inhibitor)...
2017: Stroke Research and Treatment
https://www.readbyqxmd.com/read/28806993/successful-intravenous-thrombolysis-for-ischemic-stroke-after-reversal-of-dabigatran-anticoagulation-with-idarucizumab-a-case-report
#4
Sergio Agosti, Laura Casalino, Enrico Rocci, Gabriele Zaccone, Eugenia Rota
BACKGROUND: Non-vitamin K antagonist oral anticoagulants, including dabigatran, are currently widely used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. Recently, idarucizumab, a monoclonal antibody fragment for immediate reversal of dabigatran-induced anticoagulation, has been introduced into the market to be used in life-threatening bleeding or urgent surgery, allowing for rapid normalization of clotting parameters. The use of idarucizumab is not yet well established in patients presenting with acute ischemic stroke on dabigatran who are candidates for thrombolytic therapy...
August 15, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28806802/in-nonvalvular-af-doac-related-risk-for-gi-bleeding-was-lower-with-apixaban-than-dabigatran-or-rivaroxaban
#5
Ronald L Koretz
No abstract text is available yet for this article.
August 15, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28805310/use-of-direct-oral-anticoagulants-for-stroke-prevention-in-elderly-patients-with-nonvalvular-atrial-fibrillation
#6
Lynn B Oertel, Annemarie E Fogerty
BACKGROUND AND PURPOSE: Four direct oral anticoagulants (DOACs) are available for the prevention of stroke in nonvalvular atrial fibrillation (NVAF): dabigatran (a direct thrombin inhibitor); and rivaroxaban, apixaban, and edoxaban (factor Xa inhibitors). This article summarizes the safety and efficacy of DOACs for the prevention of stroke in elderly NVAF patients. METHODS: PubMed was searched to identify published results of randomized, controlled trials evaluating DOACs for stroke prevention in elderly NVAF patients...
August 14, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28804832/measuring-direct-oral-anticoagulants
#7
Robert C Gosselin, Jonathan Douxfils
Direct oral anticoagulants (DOACs) can be quantified using methods that can be performed in any clinical or research laboratory using manual or automated instrument platforms. Dabigatran etexilate, the oral direct thrombin inhibitor, can be quantified by drug-calibrated clot or chromogenic-based assays using either thrombin or ecarin as substrates. Oral direct anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban, can be quantified with drug-calibrated anti-Xa kits or reagents as typically used for measuring heparins (unfractionated, low molecular weight, or pentasaccharides)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28803521/evaluation-of-direct-acting-oral-anticoagulant-use-in-patients-with-cancer
#8
Daphne O Davis, Kyle A Davis
PURPOSE: To evaluate the use of direct-acting oral anticoagulants in patients with cancer and venous thromboembolism (VTE) treated at Ochsner Medical Center with the intent of determining the efficacy and safety of these agents. METHODS: Patients were identified by a retrospective data extraction of patients treated at Ochsner Medical Center from January 1, 2013, through December 31, 2015. Patients were included for review if they were ≥18 years of age, with a confirmed diagnosis of VTE and active or history of cancer, and if they received dabigatran, apixaban, rivaroxaban, or edoxaban for at least 6 months...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28802808/novel-oral-anticoagulants-in-direct-current-cardioversion-for-atrial-fibrillation
#9
Giuseppe Femia, Taufik Fetahovic, Pratap Shetty, Astin Lee
BACKGROUND: For some patients with atrial fibrillation, direct current cardioversion (DCCV) is one strategy that can be used to establish sinus rhythm but appropriate anticoagulation is mandatory to prevent thromboembolic events. Historically, patients were anticoagulated with warfarin with bridging with unfractionated or low molecular weight heparin, however, recently novel oral anticoagulants (NOACs), apixaban, dabigatran and rivaroxaban have become more popular. Despite the increase in use, real world data on safety and efficacy is limited...
July 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28795348/all-cause-stroke-and-bleed-specific-healthcare-costs-comparison-among-patients-with-non-valvular-atrial-fibrillation-nvaf-newly-treated-with-dabigatran-or-warfarin
#10
Adrienne M Gilligan, Pranav Gandhi, Xue Song, Cheng Wang, Caroline Henriques, Stephen Sander, David M Smith
OBJECTIVE: Our objective was to compare all-cause and stroke- and bleed-specific healthcare costs among patients with non-valvular atrial fibrillation (NVAF) treated with dabigatran or warfarin. METHODS: Administrative claims data from the MarketScan(®) Databases for 2009-2014 were used. Patients with NVAF newly treated with dabigatran were matched 1:1 to those treated with warfarin. All-cause and stroke- and bleed-specific costs per patient per month (PPPM) ($US, year 2015 values) up to a 12-month follow-up period were analyzed...
August 9, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28790786/direct-acting-oral-anticoagulant-bench-to-bedside
#11
REVIEW
D S Chadha, P Bharadwaj
Vitamin K antagonists are an effective group of oral anticoagulants. However because of genetic variability in their metabolism and multiple food and drug interactions, these drugs have narrow therapeutic window with unpredictable anticoagulant effects requiring constant monitoring. Several newer direct acting oral anticoagulants have been approved for prevention of stroke in patients with nonvalvular atrial fibrillation and treatment or prevention of venous thromboembolism. The direct acting oral anticoagulants include the direct thrombin inhibitor (dabigatran) and the factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban)...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28775134/emergency-coagulation-assessment-during-treatment-with-direct-oral-anticoagulants-limitations-and-solutions
#12
Matthias Ebner, Ingvild Birschmann, Andreas Peter, Florian Härtig, Charlotte Spencer, Joachim Kuhn, Gunnar Blumenstock, Christine S Zuern, Ulf Ziemann, Sven Poli
BACKGROUND AND PURPOSE: In patients receiving direct oral anticoagulants (DOACs), emergency treatment like thrombolysis for acute ischemic stroke is complicated by insufficient availability of DOAC-specific coagulation tests. Conflicting recommendations have been published concerning the use of global coagulation assays for ruling out relevant DOAC-induced anticoagulation. METHODS: Four hundred eighty-one samples from 96 DOAC-treated patients were tested using prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT), DOAC-specific assays (anti-Xa activity, diluted TT), and liquid chromatography-tandem mass spectrometry...
August 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28771049/direct-oral-anticoagulants-in-the-treatment-of-pulmonary-embolism
#13
Joanna B Eldredge, Alex C Spyropoulos
OBJECTIVE: The objective of this review is to examine the management strategies for pulmonary embolism (PE) with an emphasis of the role of direct oral anticoagulants (DOACs). METHODS: PubMed was searched to identify relevant journal articles published through April 2017. Additional references were obtained from articles discovered during the database search. RESULTS: Initial heparinization followed by long-term anticoagulation with vitamin K antagonists (VKAs) has been considered the mainstay for the treatment of PE...
August 3, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28769570/reversal-of-direct-oral-anticoagulants
#14
REVIEW
Mosaad Almegren
Reversal agents for direct oral anticoagulants (DOACs), including factor X inhibitors and direct thrombin inhibitors, are a major concern in clinical practice. After DOACs were introduced and became widely used as an alternative for vitamin K antagonists in the management of venous thromboembolism and nonvalvular atrial fibrillation, the need for effective reversal agents has increased, particularly for life-threatening bleeding episodes related to DOACs or to reverse medication effects during urgent interventions...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28768967/dabigatran-therapy-resulting-in-the-resolution-of-rivaroxaban-resistant-left-atrial-appendage-thrombi-in-patients-with-atrial-fibrillation
#15
Tetsuya Watanabe, Yukinori Shinoda, Kuniyasu Ikeoka, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Shiro Hoshida
Patients with persistent atrial fibrillation (AF) and a large left atrium are at a high risk for thromboembolisms. Recently, direct oral anticoagulants (DOACs) have mainly been used for the prevention of cardiac embolisms caused by AF. Transesophageal echocardiography (TEE) is performed in order to exclude any left atrial appendage (LAA) thrombi. We herein report two cases of persistent AF, both of which were treated with rivaroxaban for more than two years. Since TEE identified mobile LAA thrombi with this treatment, we switched from rivaroxaban to the direct thrombin inhibitor dabigatran...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28767344/uninterrupted-dabigatran-versus-warfarin-for-ablation-in-atrial-fibrillation
#16
LETTER
Stephen J Seligman
New England Journal of Medicine, Volume 377, Issue 5, Page 494-496, August 2017.
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28767343/uninterrupted-dabigatran-versus-warfarin-for-ablation-in-atrial-fibrillation
#17
LETTER
Hugh Calkins, Matias Nordaby
No abstract text is available yet for this article.
August 3, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28766370/predictors-for-total-hospital-and-cardiology-cost-claims-among-patients-with-atrial-fibrillation-initiating-dabigatran-or-acenocoumarol-in-the-netherlands
#18
M S Jacobs, M W J van Leent, R G Tieleman, F G A Jansman, Q Cao, M J Postma, M van Hulst
AIMS: The prevalence of atrial fibrillation (AF) has increased over the past years due to aging of the population, and health care costs associated with AF reflect a significant financial burden. The aim of this study was to explore predictors for the real-world AF-related in-hospital costs in patients that recently initiated anticoagulation with acenocoumarol or dabigatran. METHODS: Predictors for claimed total hospital care costs and cardiology costs in AF patients were explored by using hospital financial claims data from propensity score matched patient groups in a large Dutch community hospital...
August 2, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28764897/-clinical-characteristics-of-patients-with-atrial-fibrillation-treated-with-direct-oral-anticoagulants-attended-in-primary-care-setting-the-silver-ap-study
#19
Mariano de la Figuera, Sergio Cinza, Nuria Marín, Isabel Egocheaga, Miguel Angel Prieto
OBJECTIVE: To analyse the clinical characteristics and management of patients with non-valvular atrial fibrillation (NVAF) treated with direct oral anticoagulants (DOAC). DESIGN: Observational, cross-sectional and multicentre study. LOCATION: Autonomous Communities in which the general practitioner can prescribe DOAC (n=9). PARTICIPANTS: The study included a total of 790 patients on chronic treatment with anticoagulants, and on whom therapy was changed, as well as being currently on treatment with DOAC for at least for 3 months...
July 29, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28761683/mortality-and-oral-anticoagulants-in-the-food-and-drug-administration-adverse-event-reporting-system
#20
Victor Serebruany, Vasily Cherepanov, Seth Fortmann, Moo Hyun Kim
OBJECTIVE: The comparative crude death rates (CDR) among non-vitamin K antagonist oral anticoagulants (NOACs) are unknown. Further, whether NOACs improve survival when compared with warfarin is also unclear. We compared CDR co-reported for four NOACs combined or separately versus warfarin within the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database. METHODS: We selected CDR from the FAERS database linked to four NOACs and warfarin...
2017: Open Heart
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