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Anticoagulacao

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324 papers 25 to 100 followers
By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
https://www.readbyqxmd.com/read/28300870/effectiveness-and-safety-of-apixaban-versus-warfarin-in-non-valvular-atrial-fibrillation-patients-in-real-world-clinical-practice-a-propensity-matched-analysis-of-76-940-patients
#1
Xiaoyan Li, Steve Deitelzweig, Allison Keshishian, Melissa Hamilton, Ruslan Horblyuk, Kiran Gupta, Xuemei Luo, Jack Mardekian, Keith Friend, Anagha Nadkarni, Xianying Pan, Gregory Y H Lip
The ARISTOTLE trial showed a risk reduction of stroke/systemic embolism (SE) and major bleeding in non-valvular atrial fibrillation (NVAF) patients treated with apixaban compared to warfarin. This retrospective study used four large US claims databases (MarketScan, PharMetrics, Optum, and Humana) of NVAF patients newly initiating apixaban or warfarin from January 1, 2013 to September 30, 2015. After 1:1 warfarin-apixaban propensity score matching (PSM) within each database, the resulting patient records were pooled...
March 16, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28298749/perioperative-considerations-and-management-of-patients-receiving-anticoagulants
#2
REVIEW
Safiya Imtiaz Shaikh, R Vasantha Kumari, Ganapati Hegade, M Marutheesh
Anticoagulants remain the primary strategy for the prevention and treatment of thrombosis. Unfractionated heparin, low molecular weight heparin (LMWH), fondaparinux, and warfarin have been studied and employed extensively with direct thrombin inhibitors typically reserved for patients with complications or those requiring interventions. Novel oral anticoagulants have emerged from clinical development and are expected to replace older agents with their ease to use and more favorable pharmacodynamic profiles...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28279076/triple-antithrombotic-therapy-with-aspirin-p2y12-inhibitor-and-warfarin-after-percutaneous-coronary-intervention
#3
Nathan J Verlinden, James C Coons, Carlo J Iasella, Sandra L Kane-Gill
BACKGROUND: Triple antithrombotic therapy is used in patients who require systemic anticoagulation and undergo percutaneous coronary intervention (PCI) requiring dual antiplatelet therapy. Bleeding with this combination is significant; however, few studies have described outcomes with the use of newer oral P2Y12 inhibitors in this setting. OBJECTIVES: We aimed to compare outcomes among patients prescribed triple therapy with prasugrel or ticagrelor compared to triple therapy with clopidogrel in patients who underwent PCI and required warfarin...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28232327/apixaban-versus-warfarin-for-mechanical-heart-valve-thromboprophylaxis-in-a-swine-aortic-heterotopic-valve-model
#4
Patrick A Lester, Dawn M Coleman, Jose A Diaz, Tatum O Jackson, Angela E Hawley, Angela R Mathues, Brandon T Grant, Robert M Knabb, Eduardo Ramacciotti, Charles E Frost, Yan Song, Thomas W Wakefield, Daniel D Myers
OBJECTIVE: Warfarin is the current standard for oral anticoagulation therapy in patients with mechanical heart valves, yet optimal therapy to maximize anticoagulation and minimize bleeding complications requires routine coagulation monitoring, possible dietary restrictions, and drug interaction monitoring. As alternatives to warfarin, oral direct acting factor Xa inhibitors are currently approved for the prophylaxis and treatment of venous thromboembolism and reduction of stroke and systemic embolization...
February 23, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28233091/effects-on-bone-metabolism-markers-and-arterial-stiffness-by-switching-to-rivaroxaban-from-warfarin-in-patients-with-atrial-fibrillation
#5
Sayaka Namba, Minako Yamaoka-Tojo, Ryota Kakizaki, Teruyoshi Nemoto, Kazuhiro Fujiyoshi, Takehiro Hashikata, Lisa Kitasato, Takuya Hashimoto, Ryo Kameda, Kentaro Meguro, Takao Shimohama, Taiki Tojo, Junya Ako
In recent years, direct oral anticoagulants (DOACs) of dabigatran, rivaroxaban, apixaban, edoxaban, which are all alternatives to warfarin, have been released. The use of DOACs is becoming more widespread in the clinical management of thrombotic stroke risk in patients with atrial fibrillation (AF). In large-scale clinical trials of each drug, DOACs were reported to inhibit intracranial hemorrhage, stroke, and death compared to warfarin. Warfarin is an endogenous vitamin K antagonist; therefore, patients who are taking warfarin must be prohibited from taking vitamin K...
February 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28144727/-non-vitamin-k-dependent-oral-anticoagulants-what-is-important-in-intensive-care-medicine
#6
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/20052816/regional-anesthesia-in-the-patient-receiving-antithrombotic-or-thrombolytic-therapy-american-society-of-regional-anesthesia-and-pain-medicine-evidence-based-guidelines-third-edition
#7
Terese T Horlocker, Denise J Wedel, John C Rowlingson, F Kayser Enneking, Sandra L Kopp, Honorio T Benzon, David L Brown, John A Heit, Michael F Mulroy, Richard W Rosenquist, Michael Tryba, Chun-Su Yuan
The actual incidence of neurologic dysfunction resulting from hemorrhagic complications associated with neuraxial blockade is unknown. Although the incidence cited in the literature is estimated to be less than 1 in 150,000 epidural and less than 1 in 220,000 spinal anesthetics, recent epidemiologic surveys suggest that the frequency is increasing and may be as high as 1 in 3000 in some patient populations.Overall, the risk of clinically significant bleeding increase with age,associated abnormalities of the spinal cord or vertebral column, the presence of an underlying coagulopathy, difficulty during needle placement,and an indwelling neuraxial catheter during sustained anticoagulation( particularly with standard heparin or low-molecular weight heparin)...
January 2010: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28121368/pharmacokinetics-and-pharmacodynamics-of-single-doses-of-rivaroxaban-in-obese-patients-before-and-after-bariatric-surgery
#8
Dino Kröll, Guido Stirnimann, Andreas Vogt, Desirée Lin Lee Lai, Yves Michael Borbély, Julia Altmeier, Sabine Schädelin, Daniel Candinas, Lorenzo Alberio, Philipp C Nett
AIMS: Venous thromboembolism is an important cause of postoperative morbidity and mortality in bariatric surgery. Studies of direct oral anticoagulants (DOACs) are not available in this surgical field. The objective of this phase 1 clinical trial was to investigate pharmacokinetic and pharmacodynamic (PK/PD) parameters of rivaroxaban in bariatric patients. METHODS: In this single-centre study, obese patients received single oral doses of rivaroxaban (10 mg) one day before and three days after bariatric surgery...
January 25, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28123163/overview-of-current-evidence-on-the-impact-of-the-initial-high-dose-of-the-direct-factor-xa-inhibitor-rivaroxaban-on-thrombus-resolution-in-the-treatment-of-venous-thromboembolism
#9
Rupert Bauersachs, Norimichi Koitabashi
Incomplete thrombus resolution in patients with venous thromboembolism (VTE) may increase the risk of recurrent thromboembolic events and other complications, such as post-thrombotic syndrome. Various options exist for thrombus resolution, including systemic thrombolytic agents, catheter-directed thrombolysis, and traditional anticoagulants such as heparins or vitamin K antagonists (VKAs). Data are accumulating on the use of non-VKA oral anticoagulants, such as rivaroxaban, and these may provide greater thrombus resolution compared with VKAs...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28119380/use-of-intravenous-recombinant-tissue-plasminogen-activator-in-patients-with-acute-ischemic-stroke-who-take-non-vitamin-k-antagonist-oral-anticoagulants-before-stroke
#10
Ying Xian, Jerome J Federspiel, Adrian F Hernandez, Daniel T Laskowitz, Lee H Schwamm, Deepak L Bhatt, Eric E Smith, Gregg C Fonarow, Eric D Peterson
BACKGROUND: Intravenous rt-PA (recombinant tissue-type plasminogen activator) is effective in improving outcomes in ischemic stroke; however, there are few data on the 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 patients with ischemic stroke who received anticoagulation with NOACs versus those on warfarin (international normalized ratio <1...
March 14, 2017: Circulation
https://www.readbyqxmd.com/read/28122753/edoxaban-a-direct-oral-anticoagulant
#11
REVIEW
Mara Poulakos, Jacqueline N Walker, Umima Baig, Tosin David
PURPOSE: The pharmacology, pharmacokinetics, pharmacodynamics, clinical efficacy, safety, and place in therapy of edoxaban for prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and treatment of venous thromboembolism (VTE) are reviewed. SUMMARY: Although warfarin has been an established therapy for stroke prevention in AF and VTE, the need for agents with less monitoring requirements, fewer food and drug interactions, and a lower risk of major bleeding led to the development of direct oral anticoagulants (DOACs)...
February 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28117916/comparison-of-the-safety-and-effectiveness-of-apixaban-versus-warfarin-in-patients-with-severe-renal-impairment
#12
Brooke E Stanton, Naomi S Barasch, Katie B Tellor
STUDY OBJECTIVE: The United States Food and Drug Administration approval of apixaban in patients with a creatinine clearance (CrCl) less than 15 mL/minute or those receiving dialysis is based only on pharmacokinetic data as clinical trials of apixaban excluded patients with a CrCl less than 25 mL/minute or a serum creatinine concentration (SCr) greater than 2.5 mg/dL. Thus, the objective of this study was to evaluate the safety and effectiveness of apixaban versus warfarin in patients with severe renal impairment...
January 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28097761/shortened-hospital-length-of-stay-and-lower-costs-associated-with-rivaroxaban-in-patients-with-pulmonary-embolism-managed-as-observation-status
#13
Erin R Weeda, W Frank Peacock, Gregory J Fermann, Christopher W Baugh, Philip S Wells, Veronica Ashton, Concetta Crivera, Peter Wildgoose, Jeff R Schein, Craig I Coleman
BACKGROUND: Unlike rivaroxaban, treatment of patients with pulmonary embolism (PE) with warfarin requires parenteral bridging and coagulation monitoring that may prolong length-of-stay (LOS) and increase hospital costs. AIMS: The aim of this study was to compare LOS, hospital costs and readmissions in PE patients managed through observation stays treated with rivaroxaban or parenterally bridged warfarin. METHODS: Premier Hospital claims data from November 2012 to March 2015 were used to identify patients with a primary diagnosis code for PE managed through an observation stay and with ≥1 claim for a PE-related diagnostic test on day 0-2...
January 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28081965/2017-acc-expert-consensus-decision%C3%A2-pathway-for-periprocedural-management-of-anticoagulation-in-patients-with-nonvalvular-atrial%C3%A2-fibrillation-a-report-of-the-american-college-of-cardiology-clinical-expert-consensus-document-task-force
#14
John U Doherty, Ty J Gluckman, William J Hucker, James L Januzzi, Thomas L Ortel, Sherry J Saxonhouse, Sarah A Spinler
No abstract text is available yet for this article.
January 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28056795/bleeding-outcomes-associated-with-rivaroxaban-and-dabigatran-in-patients-treated-for-atrial-fibrillation-a-systematic-review-and-meta-analysis
#15
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Abhishek Rishikesh Teeluck, Manish Pursun, Akash Bhurtu, Wei-Qiang Huang
BACKGROUND: Warfarin is commonly used as a secondary prevention of stroke in patients with atrial fibrillation (AF). However, limitations have been observed even with the use of this medication. Recently, several newer direct oral anticoagulants (DOACs) have been approved for use by the food and drug administrations. Unfortunately, these newer drugs have seldom been compared directly with each other. Therefore, this study aimed to compare the bleeding events associated with rivaroxaban and dabigatran in patients treated for non-valvular AF...
January 6, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28050755/effect-of-major-gastrointestinal-tract-surgery-on-the-absorption-and-efficacy-of-direct-acting-oral-anticoagulants-doacs
#16
REVIEW
Hakeam A Hakeam, Nasser Al-Sanea
Direct-acting oral anticoagulants (DOACs) have been introduced as alternatives to warfarin for stroke prevention in non-valvular atrial fibrillation and for treatment of venous thromboembolism. Many patients undergoing major gastrointestinal resections or bypass receive anticoagulants for various indications, including the treatment of thrombotic complication of surgery and prevention of visceral vessels events recurrence. DOACs have a wide therapeutic range that allows fixed dosing determined based on studies conducted in healthy subjects with normal absorptive capacity...
April 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28079536/non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-severe-inherited-thrombophilia-a-series-of-33-patients
#17
Anetta Undas, Tadeusz Goralczyk
The aim of the study was to investigate whether treatment with non-vitamin K antagonist oral anticoagulants (NOACs) is effective and well tolerated in real-life patients following venous thromboembolism (VTE) associated with severe inherited thrombophilia. We evaluated 33 consecutive patients with severe inherited thrombophilia, defined as the presence of deficiencies in protein C, protein S, or anti-thrombin, homozygous factor V Leiden and prothrombin G20210A mutations, or combined defects. The patients were recruited from March 2010 to December 2015 and followed till July 2016...
January 12, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28007305/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-with-chronic-kidney-disease-a-systematic-review-and-network-meta-analysis
#18
Giuseppe Andò, Piera Capranzano
BACKGROUND: Currently there is lack of head-to-head comparisons between different Non-Vitamin K Antagonist Oral Anticoagulants (NOACs), especially in more risky subgroups, as those with chronic kidney disease (CKD). METHODS: We assessed the relative efficacy and safety of the four NOACs on the market in a systematic review and network meta-analysis of patients with atrial fibrillation (AF) and moderate CKD enrolled in the phase 3 randomized trials. A Bayesian framework was used to perform the network meta-analysis...
March 15, 2017: International Journal of Cardiology
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
#19
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/27910037/effect-of-activated-charcoal-on-rivaroxaban-complex-absorption
#20
Edouard Ollier, Sophie Hodin, Julien Lanoiselée, Jean Escal, Sandrine Accassat, Elodie De Magalhaes, Thierry Basset, Laurent Bertoletti, Patrick Mismetti, Xavier Delavenne
OBJECTIVE: To quantify the impact of activated charcoal (AC) on rivaroxaban exposure in healthy volunteers. METHODS: This was an open-label study with an incomplete cross-over design of single-dose rivaroxaban (40 mg) administered alone or with AC in 12 healthy volunteers. The study comprised three treatment periods in randomised sequence, one with rivaroxaban administered alone and two with AC given at 2, 5 or 8 h post-dose. Rivaroxaban plasma concentration was measured in blood samples drawn at 16 time points...
December 2, 2016: Clinical Pharmacokinetics
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