Direct Oral Anticoagulants in Patients with Liver Disease in the Era of Non-Alcoholic Fatty Liver Disease Global Epidemic: A Narrative Review

AbstractAtrial fibrillation (AF) and venous thromboembolism (VTE) are highly prevalent and relevant healthcare issues. Direct oral anticoagulants (DOACs) are now the first-choice for anticoagulant treatment of these conditions displaying a better efficacy/safety profile than vitamin-K antagonists, mainly due to significantly reduced risk of major bleeding, especially of intracranial haemorrhage. Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in developed countries showing a continuously growing prevalence. Nonalcoholic steatohepatitis (NASH), its evolutive form, will be the leading cause for liver transplantation by 2020. NAFLD is independently associated with an increased risk of abnormalities of cardiac structure and function, including cardiac rhythm disorders (mainly AF). Moreover, data suggest an increased risk of unprovoked VTE associated with NAFLD/NASH. Therefore, a growing number of patients with chronic liver disease (CLD) will be candidate for anticoagulant therapy in the near future. Cirrhosis of any etiology is characterized by an unstable thrombosis/bleeding haemostatic balance, making anticoagulant therapy particularly challenging in this condition. Given that patients with significant active liver disease and cirrhosis were excluded from all pivotal randomized controlled trials on DOACs, this comprehensive review aims at critically discussing real-world evidence, including the latest population studies, regarding the use of DOACs in ...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research

Related Links:

Conclusion: MKTP is a safe and effective method for treating refractory vitiligo and nevus depigmentosus in Thai patients. PMID: 32643482 [PubMed - as supplied by publisher]
Source: Journal of Dermatological Treatment - Category: Dermatology Tags: J Dermatolog Treat Source Type: research
Publication date: Available online 9 July 2020Source: Thermochimica ActaAuthor(s): Kazem Lakzian, Seyedmahmoud Hosseiniallahchal, Hossein Jalaei Salmani, Abolfazl Sanjarifard
Source: Thermochimica Acta - Category: Chemistry Source Type: research
Adolescence is a developmental period characterized by fundamental transformations in parent-child communication. Although a normative shift in adolescents' secrecy seems to occur in parallel to changes in their drinking behaviors and in their perceptions ...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
OBJECTIVE: To conduct Brazil's first clinical trial employing 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder (PTSD), given its high prevalence resulting from epidemic violence. METHODS: Of 60 voluntee...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
BACKGROUND: Poor sleep quality and insomnia have been associated with the use of tobacco, alcohol, and cannabis, but it is unclear if there is a causal link. In this Mendelian Randomization (MR) study we examine if insomnia causes substance use and/or if s...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
BACKGROUND: Drug driving is an emerging global road safety problem. As the prevalence of alcohol-impaired driving decreases, and as more jurisdictions decriminalize or legalize cannabis, it is increasingly important for policy makers to have accurate infor...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
BACKGROUND: Since 1999, the rate of fatal prescription opioid overdoses and of suicides has dramatically increased in the USA. These increases, which have occurred among similar demographic groups, have led to the hypothesis that the opioid epidemic contri...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
OBJECTIVE: To analyze the temporal trend of indicators related to motor vehicle driving after alcohol consumption, in the general population and among drivers. METHODS: Temporal trend study of indicators related to driving motorized vehicles after alco...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
[Abstract unavailable] Language: en...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
Intimate Partner Violence (IPV) is a public health problem with harsh consequences for women's well-being. Social attitudes towards victims of IPV have a big impact on the perpetuation of this phenomenon. Moreover, specific problems such as the abuse of al...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
More News: Alcoholism | Bleeding | Cirrhosis | Drugs & Pharmacology | Epidemics | Epidemiology | Fatty Liver Disease (FLD) | Liver | Liver Disease | Liver Transplant | Non-alcoholic Fatty Liver Diseases (NAFLD) | Study | Thrombosis | Transplants | Urology & Nephrology | Vitamin K | Vitamins