Continuation with apixaban treatment is associated with lower risk for hospitalization and medical costs among elderly patients.

Continuation with apixaban treatment is associated with lower risk for hospitalization and medical costs among elderly patients. Curr Med Res Opin. 2019 May 23;:1 Authors: Dhamane AD, Baker CL, Rajpura J, Mardekian J, Dina O, Russ C, Rosenblatt L, Lingohr-Smith M, Lin J Abstract Objective: To compare the risk of hospitalization and costs associated with major bleeding (MB) or stroke/systemic embolism (SE) among elderly patients with nonvalvular atrial fibrillation (NVAF) who initiated apixaban then switched to another oral anticoagulant (OAC) vs. those who continued with apixaban treatment. Methods: NVAF patients (≥65 years) initiating apixaban were identified from the Humana database (1/1/2013-9/30/2017) and grouped into Switcher and Continuer cohorts. For Switchers, the earliest switch from apixaban to another OAC was defined as the index event/date. A random date during apixaban treatment was selected as the index date for Continuers. Patients were followed from index date to health plan disenrollment or 12/31/2017, whichever was earlier. Multivariable regression analyses were used to examine the association of Switchers vs. Continuers with risk of MB-related or stroke/SE-related hospitalization and healthcare costs during follow-up. Results: Of 7,858 elderly NVAF patients included in the study, 14% (N = 1,110; mean age: 78 years) were Switchers; 86% (N = 6,748; mean age: 79 years) were Continuers. Apixaban Switchers vs. ...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research

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Conclusion: Age ≥75 years, body weight ≤50 kg, a history of heart failure, and initially preserved renal function appear to promote renal dysfunction in patients with AF, but a history of AF ablation seems to have a favorable effect. Worsening renal function seems to increase AF patients' risk of adverse clinical events. Renal function can decline quickly; thus, early intervention including AF ablation is warranted. PMID: 31204852 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Abstract Warfarin is the most commonly prescribed anticoagulant in hemodialysis (HD) patients with nonvalvular atrial fibrillation (NVAF). Recent trends show that Nephrologists are increasingly prescribing novel oral anticoagulants, despite the fact that no randomized clinical trials have been conducted in dialysis patients. Difficulties maintaining international normalized ratio in the therapeutic range, increased risk of intracranial hemorrhage and concerns regarding warfarin-induced vascular calcification and calciphylaxis may be responsible. Anticoagulation quality is poor in HD patients. A variety of factors ...
Source: Seminars in Dialysis - Category: Urology & Nephrology Authors: Tags: Semin Dial Source Type: research
CONCLUSIONS: Percutaneous LAAC may provide an alternative strategy to long-term OAC therapy in AF patients with a high bleeding risk. During follow-up, both ischaemic stroke and recurrent bleeding rates were lower than expected based on the CHA2DS2-VASc and HAS-BLED scores respectively. PMID: 31187455 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - Category: Cardiology Authors: Tags: Neth Heart J Source Type: research
AbstractDirect-acting oral anticoagulants (DOACs) are widely used in aged Japanese patients with atrial fibrillation (AF), but outcome data for such patients are limited. We compared outcomes between 1895 (58.5%) patients aged
Source: Heart and Vessels - Category: Cardiology Source Type: research
ConclusionsAs head-to-head trials comparing different DOACs do not exist, available evidence derives exclusively from observational studies. These data suggest that while dabigatran, rivaroxaban, and apixaban have a similar effect on the risk of ischemic stroke, apixaban may be associated with a decreased risk of major bleeding compared with either dabigatran or rivaroxaban.
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research
AbstractData on LA/LAA thrombus resolution after rivaroxaban treatment has not been established. The aim of the present study was to compare the efficacy and safety on the resolution of LA/LAA thrombus between rivaroxaban and warfarin in nonvalvular atrial fibrillation (AF) patients. 80 AF patients with LA/LAA thrombus between January 2013 and June 2016 were randomized divided into warfarin group (n  = 40) and rivaroxaban group (n = 40). Compared to warfarin group, thrombin time (TT; p 
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
This study analyzed data obtained from 103 patients with diagnosis of atrial fbrillation (AF) (39 of them had a stroke). Patients were divided into groups according to the CHADS2, CHA2DS2‑VASc, and HASBLED scores.Results:An analysis showed that anticoagulant drugs were more often prescribed to subjects
Source: International Journal of Preventive Medicine - Category: International Medicine & Public Health Source Type: research
ConclusionsCompared with VKA, DOAC is associated with a trend to a lower incidence of all major events, including death, in patients with NVAF in Spain.ResumenIntroducción y objetivosComparar los resultados a largo plazo de los anticoagulantes orales directos (ACOD) frente a los antagonistas de la vitamina K (AVK) en pacientes del mundo real con fibrilación auricular no valvular (FANV) en un estudio nacional prospectivo.MétodosEl estudio FANTASIIA incluyó consecutivamente a pacientes ambulatorios con FANV anticoagulados con ACOD o AVK desde junio de 2013 hasta octubre de 2014. Se compararon las ...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Authors: Li Y, Liu W, Liu X, Shen H, Hou F, Jin P, Xi Z, Zhou Y Abstract Objective: To evaluate warfarin use in Chinese patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) by investigating the stroke and major adverse cardiac and cerebral events (MACCEs) and bleeding events. Methods: Retrospective cohort study of the 5-year follow-up of 1134 patients with AF who underwent PCI. The patients were grouped according to whether they received warfarin or not. Baseline characteristics and the occurrence of MACCEs and bleeding events were compared between the two groups using the CHA2...
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Direct oral anticoagulants (DOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban, have become popular as equivalent to warfarin for stroke prevention in non-valvular atrial fibrillation; however, bleeding risk from DOACs, especially the difference in risks among DOACs in endoscopic treatment, has not been reported. The study aimed to evaluate delayed bleeding risk related to early resumption of DOACs and compare the bleeding risk among DOACs after endoscopic resection of colorectal polyps.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Oral abstract Source Type: research
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