Systematic review of societal costs associated with stroke, bleeding and monitoring in atrial fibrillation.
Conclusion: Limited data were available on societal costs in atrial fibrillation and further research is warranted. PMID: 31436488 [PubMed - as supplied by publisher]
ConclusionFor patients with AF at high risk of both thromboembolic and hemorrhagic events, NOACs as compared to Warfarin, seem to be safe and effective for short ‐term anticoagulation following LAAC with the WATCHMAN device. Further validation in large randomized controlled trials is required.
ConclusionThe majority of strokes occurring in anticoagulated patients are related to warfarin use. We observed an almost significant reduction in the proportion of ischaemic strokes due to under-dosing of OAC over the study period. Warfarin continues to be recommended as the first line anticoagulant for stroke prevention in atrial fibrillation by the HSE Medicines Management Programme, a decision which we would argue warrants review.
ConclusionThere has been a significant increase in primary prevention practices for AF and this is reflected in the number of stroke patients presenting with known AF on a NOAC, however more needs to be done as there are still patients who have AF that are not being anticoagulated in the community.
AbstractPurposeTo study whether polypharmacy or drug –drug interactions have differential effect on safety and efficacy in patients treated with direct oral anticoagulants (DOACs) versus warfarin.MethodsWe performed a systematic review and meta-analysis of studies that randomized patients with atrial fibrillation to DOACs or warfarin stratified by the number of concomitant drugs. Outcomes included stroke or systemic embolism (SE), all-cause mortality, major bleeding, and intracranial hemorrhage. Risk ratios (RR) were calculated and Mantel-Haenszel random effects were applied.ResultsTwo high-quality studies were eligi...
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AbstractDirect oral anticoagulants (DOACs), such as rivaroxaban, reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF). However, it is still unclear whether the stroke reduction benefit outweighs the bleeding risk in elderly Japanese patients with NVAF. The Xarelto Post-Authorization Safety and Effectiveness Study in Japanese Patients with Atrial Fibrillation (XAPASS) was a real-world, prospective observational, post-marketing surveillance study on the safety and effectiveness of rivaroxaban in Japanese clinical practice. This sub-analysis evaluated the clinical outcomes of...
ConclusionsBased on current publications, the use of NOACs is at least non-inferior to warfarin in patients with AF and liver disease.
ConclusionFor patients with Atrial Fibrillation at high risk of both thromboembolic and hemorrhagic events, NOACs as compared to Warfarin, are seem to be safe and effective for short ‐term anticoagulation following LAAC with the WATCHMAN Device. Further validation in large randomized controlled trials is required.This article is protected by copyright. All rights reserved
Direct oral anticoagulants (DOACs) are now a mainstay of anticoagulant therapy for the prevention and treatment of venous thromboembolism (VTE) and stroke prevention in non-valvular atrial fibrillation (a-fib). However, bleeding-related morbidity and mortality remains a feared complication. Bleeding in patients taking DOACs in clinical trials showed comparable, if not more favorable, outcomes compared to that of warfarin [1 –4]. However, the safety of DOAC use should also be evaluated in less selected cohorts in the real-world.
CONCLUSIONS: This case suggests that concurrent genetic polymorphisms can impair multiple apixaban elimination pathways and thus substantially increase its exposure. PMID: 31464657 [PubMed - in process]