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Anticoagulacao

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291 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/27380556/management-of-heparin-induced-thrombocytopenia
#1
Theodore E Warkentin, Andreas Greinacher
PURPOSE OF REVIEW: The purpose of this review is to summarize recent findings on heparin-induced thrombocytopenia (HIT), a prothrombotic disorder caused by platelet-activating IgG targeting platelet factor 4 (PF4)/polyanion complexes. RECENT FINDINGS: HIT can explain unusual clinical events, including adrenal hemorrhages, arterial/intracardiac thrombosis, skin necrosis, anaphylactoid reactions, and disseminated intravascular coagulation. Sometimes, HIT begins/worsens after stopping heparin ('delayed-onset' HIT)...
September 2016: Current Opinion in Hematology
https://www.readbyqxmd.com/read/27446305/fondaparinux-vs-enoxaparin-for-the-prevention-of-venous-thromboembolism-after-total-hip-replacement-a-meta-analysis
#2
Wen-Jun Dong, Hui-Juan Qian, Yan Qian, Ling Zhou, San-Lian Hu
The aim of the study was to compare the efficacy and safety profiles of fondaparinux and enoxaparin in preventing the venous thromboembolism (VTE) after total hip replacement. A systematic literature search in the PubMed, EMBASE and Cochrane library databases was performed to identify relevant articles published in English since inception up to November 16, 2014. The efficacy outcomes were all VTE, total deep vein thrombosis (DVT) and symptomatic VTE, while the safety outcome was major bleeding. Four eligible studies were included in the meta-analysis...
August 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27786333/real-life-treatment-of-venous-thromboembolism-with-direct-oral-anticoagulants-the-influence-of-recommended-dosing-and-regimens
#3
Javier Trujillo-Santos, Pierpaolo Di Micco, Francesco Dentali, James Douketis, Jose Antonio Diaz-Peromingo, Manuel Jesús Núñez, Inmaculada Cañas, Daniela Mastroiacovo, Marta Saraiva de Sousa, Manuel Monreal
In patients with venous thromboembolism (VTE), the influence on outcome of using direct oral anticoagulants (DOACs) at non-recommended doses or regimens (once vs twice daily) has not been investigated yet. We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to compare the outcomes in patients with VTE receiving DOACs according to the recommendations of the product label versus in those receiving non-recommended doses and/or regimens. The major outcomes were the rate of VTE recurrences, major bleeding and death during the course of therapy...
October 27, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27789043/comparison-of-adherence-to-rivaroxaban-versus-apixaban-among-patients-with-atrial-fibrillation
#4
Colleen A McHorney, Eric D Peterson, François Laliberté, Guillaume Germain, Winnie W Nelson, Concetta Crivera, Jeffrey Schein, Patrick Lefebvre
PURPOSE: Non-vitamin K antagonist oral anticoagulant medications are increasingly used for stroke prophylaxis in patients with nonvalvular atrial fibrillation (NVAF). This study aimed to compare adherence with rivaroxaban and apixaban among patients with NVAF in routine clinical practice. METHODS: Using pharmacy and medical claims from Truven Health Analytics MarketScan databases, we identified NVAF patients aged ≥18 years treated with rivaroxaban or apixaban...
October 24, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27823844/safety-and-efficacy-of-new-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-hip-and-knee-arthroplasty-a%C3%A2-meta-analysis
#5
REVIEW
Brett T Venker, Beejal R Ganti, Hannah Lin, Elizabeth D Lee, Ryan M Nunley, Brian F Gage
BACKGROUND: Venous thromboembolism (VTE) is a common and potentially fatal complication of arthroplasty. METHODS: We reviewed randomized trials to determine which anticoagulant has the best safety and efficacy in hip and knee arthroplasty patients. We searched PubMed, MEDLINE, and EMBASE through January 2016. RESULTS: Compared to enoxaparin (most commonly dosed 40 mg once daily), the relative risk (RR) of VTE was lowest for edoxaban 30 mg once daily (0...
October 5, 2016: Journal of Arthroplasty
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
#6
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/27896543/vitamin-k-antagonists-relative-strengths-and-weaknesses-vs-direct-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation
#7
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/27906452/primary-prophylaxis-for-venous-thromboembolism-in-ambulatory-cancer-patients-receiving-chemotherapy
#8
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/27673693/management-and-research-in-cancer-treatment-related-cardiovascular-toxicity-challenges-and-perspectives
#9
Jennifer Cautela, Nathalie Lalevée, Chloé Ammar, Stéphane Ederhy, Michael Peyrol, Philippe Debourdeau, Daniel Serin, Yvan Le Dolley, Nicolas Michel, Morgane Orabona, Jérémie Barraud, Marc Laine, Laurent Bonello, Franck Paganelli, Fabrice Barlési, Franck Thuny
Cardiovascular toxicity is a potentially serious complication that can result from the use of various cancer therapies and can impact the short- and long-term prognosis of treated patients as well as cancer survivors. In addition to their potential acute cardiovascular adverse events, new treatments can lead to late toxicity even after their completion because patients who survive longer generally have an increased exposure to the cancer therapies combined to standard cardiovascular risk factors. These complications expose the patient to the risk of cardiovascular morbi-mortality, which makes managing cardiovascular toxicity a significant challenge...
December 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27683276/direct-oral-anticoagulants-in-the-elderly-systematic-review-and-meta-analysis-of-evidence-current-and-future-directions
#10
Angelique H Sadlon, Dimitrios A Tsakiris
BACKGROUND: Concerns regarding the use of direct oral anticoagulants (DOACs: apixaban, dabigatran, edoxaban, rivaroxaban) in the elderly persist owing to the lack of randomised controlled trials targeting this age group. OBJECTIVES: The aim of this study was to assess the efficacy and safety of DOACs in elderly patients (aged 75 years or more) with atrial fibrillation or venous thromboembolism (VTE), based on already published large randomised trials. METHODS: EMBASE, MEDLINE and the Cochrane Library were searched from inception to June 2015 for phase III trials...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27693274/anti-xa-oral-anticoagulants-inhibit-in-vivo-platelet-activation-by-modulating-glycoprotein-vi-shedding
#11
Pasquale Pignatelli, Daniele Pastori, Simona Bartimoccia, Danilo Menichelli, Tommasa Vicario, Cristina Nocella, Roberto Carnevale, Francesco Violi
Anti Xa non-vitamin K oral anticoagulants (anti Xa NOACs) seem to possess antiplatelet effect in vitro, but it is unclear if this occurs also in vivo. Aim of the study was to compare the effect on platelet activation of two anti Xa NOACs, namely apixaban and rivaroxaban, to warfarin, and to investigate the potential underlying mechanism by evaluating soluble glycoprotein GPVI (sGPVI), a protein involved in platelet activation. We performed a cross-sectional including AF patients treated with warfarin (n=30), or apixaban 10mg/day (n=40), or rivaroxaban 20mg/day (n=40)...
September 28, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27723533/new-oral-anticoagulants-and-dual-antiplatelet-therapy-focus-on-apixaban
#12
REVIEW
Francesco Pelliccia, Fabiana Rollini, Giuseppe Marazzi, Cesare Greco, Carlo Gaudio, Dominick J Angiolillo, Giuseppe Rosano
The combination of AF and coronary artery disease not only is a common clinical setting, it is also a complex setting to deal with anticoagulation and antiplatelet therapy, and it is associated with significantly higher mortality rates. Unfortunately, there are no sufficient data available to optimally guide clinical practice in such settings. This review focuses specifically on newer oral anticoagulants (NOACs) associated with dual antiplatelet therapy (DAPT) in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI)...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27643979/clinical-application-and-pharmacodynamic-monitoring-of-apixaban-in-a-patient-with-end-stage-renal-disease-requiring-chronic-hemodialysis
#13
Wesley D Kufel, Adam S Zayac, David F Lehmann, Christopher D Miller
Despite prescribing guidance, limited data exist to describe the use of apixaban in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD). Current apixaban dosing recommendations for this patient population are based largely on a single-dose pharmacokinetic study of eight patients. We describe the clinical application and pharmacodynamic monitoring of apixaban in a 62-year-old 156-kg African-American woman with nonvalvular atrial fibrillation and ESRD requiring hemodialysis who developed calciphylaxis while receiving warfarin therapy...
September 19, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27632140/direct-oral-anticoagulants-in-hypercoagulable-states
#14
Paul R Kunk, Jacqueline Brown, Melissa McShane, Surabhi Palkimas, B Gail Macik
Direct oral anticoagulants have been shown safe and effective in the treatment of pulmonary emboli and deep vein thrombi. Their role in the treatment of patients with hypercoagulability is uncertain. We designed a retrospective exploratory analysis of all patients with definite heparin induced thrombocytopenia (HIT) and antiphospholipid syndrome (APS) that were treated with either apixaban or rivaroxaban from September 2011 through November 2015. Patients were reviewed for several clinico-pathologic features, including efficacy and safety...
September 8, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27617088/individualising-anticoagulant-therapy-in-atrial-fibrillation-patients
#15
Marco Alings
Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as alternatives to VKAs for the prevention of stroke in patients with non-valvular atrial fibrillation. Four NOACS: dabigatran, apixaban, rivaroxaban and edoxaban, have received regulatory approval in Europe from the European Medicines Agency. Numerous factors can influence the decision to prescribe a NOAC, the most important of which are assessment of stroke and bleeding risks. Given the variation in design of the pivotal phase III clinical trials investigating the efficacy and safety of NOACs, and in the absence of head-to-head comparative data, it is impossible to recommend one NOAC over the other...
August 2016: Arrhythmia & Electrophysiology Review
https://www.readbyqxmd.com/read/27631606/correction-comparison-of-the-non-vka-oral-anticoagulants-apixaban-dabigatran-and-rivaroxaban-in-the-extended-treatment-and-prevention-of-venous-thromboembolism-systematic-review-and-network-meta-analysis
#16
A T Cohen, M Hamilton, A Bird, S A Mitchell, X Li, R Horblyuk, S Batson
[This corrects the article DOI: 10.1371/journal.pone.0160064.].
2016: PloS One
https://www.readbyqxmd.com/read/27633045/real-world-evidence-of-stroke-prevention-in-patients-with-nonvalvular-atrial-fibrillation-in-the-united-states-the-revisit-us-study
#17
Craig I Coleman, Matthias Antz, Kevin Bowrin, Thomas Evers, Edgar P Simard, Hendrik Bonnemeier, Riccardo Cappato
BACKGROUND: Little data exists regarding the effectiveness and safety of rivaroxaban or apixaban versus warfarin in nonvalvular atrial fibrillation (NVAF) patients treated outside of clinical trials. METHODS: This was a retrospective study using MarketScan claims from January 2012 to October 2014. We included adults, newly initiated on rivaroxaban, apixaban or warfarin, with a baseline CHA2DS2-VASc score ≥2, ≥2 diagnosis codes for NVAF and ≥180 days of continuous medical and prescription benefits...
September 20, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27636529/do-ems-providers-accurately-ascertain-anticoagulant-and-antiplatelet-use-in-older-adults-with-head-trauma
#18
Daniel K Nishijima, Samuel Gaona, Trent Waechter, Ric Maloney, Troy Bair, Adam Blitz, Andrew R Elms, Roel D Farrales, Calvin Howard, James Montoya, Jeneita M Bell, Victor C Coronado, David E Sugerman, Dustin W Ballard, Kevin E Mackey, David R Vinson, James F Holmes
OBJECTIVE: Prehospital provider assessment of the use of anticoagulant or antiplatelet medications in older adults with head trauma is important. These patients are at increased risk for traumatic intracranial hemorrhage and therefore field triage guidelines recommend transporting these patients to centers capable of rapid evaluation and treatment. Our objective was to evaluate EMS ascertainment of anticoagulant and antiplatelet medication use in older adults with head trauma. METHODS: A retrospective study of older adults with head trauma was conducted throughout Sacramento County...
September 16, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27637120/diagnosis-and-treatment-of-atrial-fibrillation
#19
Cecilia Gutierrez, Daniel G Blanchard
Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, for diagnosis, and suspected atrial fibrillation should be confirmed with 12-lead electrocardiography. Because normal electrocardiographic findings do not rule out atrial fibrillation, home monitoring is recommended if there is clinical suspicion of arrhythmia despite normal test results...
September 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27637548/laboratory-assessment-of-the-anticoagulant-activity-of-direct-oral-anticoagulants-doacs-a-systematic-review
#20
Bethany T Samuelson, Adam Cuker, Deborah M Siegal, Mark Crowther, David A Garcia
BACKGROUND: The direct oral anticoagulants (DOACs) are the treatment of choice for most patients with atrial fibrillation and/or non-cancer associated venous thromboembolic disease. While routine monitoring of these agents is not required, assessment of anticoagulant effect may be desirable in special situations. The objective of this study was to systematically review and summarize current evidence regarding laboratory assessment of the anticoagulant effects of dabigatran, rivaroxaban, apixaban and edoxaban...
September 13, 2016: Chest
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