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The risk of gastrointestinal hemorrhage with non-vitamin K antagonist oral anticoagulants: A network meta-analysis
Conclusion: Individual NOACs had varying profiles of GI bleeding risk. Results of analyses including only RCTs and those including both RCTs and population studies showed similar trends, but also showed several differences.
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report
Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage. Patient concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU). Diagnosis: Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma. Interventions: The patient was treated with Idarucizumab ...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Comparative Safety and Effectiveness of Direct-Acting Oral Anticoagulants Versus Warfarin: a National Cohort Study of Nursing Home Residents
ConclusionsAmong US nursing home residents, the DOACs were each associated with lower mortality versus warfarin. Misaligned DOAC dosing was common in nursing homes and was associated with clinical and mortality outcomes. Overall, DOAC users had lower rates of adverse outcomes including mortality compared with warfarin users.
Source: Journal of General Internal Medicine - April 5, 2020 Category: Internal Medicine Source Type: research

Comparison of dabigatran and warfarin used in patients with non-valvular atrial fibrillation: Meta-analysis of random control trial
Conclusion: No significant difference was obtained between 110 mg dabigatran and warfarin in the incidence of stroke and embolic events. However, the 110 mg dabigatran associated lower incidence of bleeding compare with warfarin. When compared with 150 mg dabigatran, warfarin associated with lower incidence of stroke and embolic events but similar in the incidence of bleeding.
Source: Medicine - November 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.
Conclusion: The available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF. The DOACs had similar benefits across several patient subgroups and seemed safe and efficacious for a wide range of patients with nonvalvular AF. Primary Funding Source: Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42017069999). PMID: 30383133 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 30, 2018 Category: Internal Medicine Authors: Lowenstern A, Al-Khatib SM, Sharan L, Chatterjee R, LaPointe NMA, Shah B, Borre ED, Raitz G, Goode A, Yapa R, Davis JK, Lallinger K, Schmidt R, Kosinski AS, Sanders GD Tags: Ann Intern Med Source Type: research

Fitting the right non-vitamin K antagonist oral anticoagulant to the right patient with non-valvular atrial fibrillation: An evidence-based choice.
Authors: Li Y, Pastori D, Lip GY Abstract Atrial fibrillation (AF) is the most prevalent arrhythmia and is associated with an increased risk of ischemic stroke (IS) and systemic embolism (SE). Stroke prevention is a key element for the overall management of AF patients. The non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, rivaroxaban, apixaban and edoxaban, are at least as effective as warfarin in reducing IS/SE with a lower rate of major bleeding. Various analyses from the large Phase III randomised trials demonstrated different efficacy and safety of NOACs in specific subgroups of patient...
Source: Annals of Medicine - April 4, 2018 Category: Internal Medicine Tags: Ann Med Source Type: research

Outcomes of Dabigatran and Warfarin for Atrial Fibrillation in Contemporary Practice: A Retrospective Cohort Study.
Conclusion: In matched adults with atrial fibrillation treated in practice, the incidences of stroke and bleeding with dabigatran versus warfarin were consistent with those seen in trials. The possible relationship between dabigatran and myocardial infarction warrants further investigation. Primary Funding Source: U.S. Food and Drug Administration. PMID: 29132153 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - November 14, 2017 Category: Internal Medicine Authors: Go AS, Singer DE, Toh S, Cheetham TC, Reichman ME, Graham DJ, Southworth MR, Zhang R, Izem R, Goulding MR, Houstoun M, Mott K, Sung SH, Gagne JJ Tags: Ann Intern Med Source Type: research

Comparison of bleeding risk scores in patients with atrial fibrillation: insights from the RE ‐LY trial
ConclusionsAmongst the current clinical bleeding risk scores, the ORBIT score demonstrated the best discrimination and calibration. All the scores demonstrated, to a variable extent, an interaction with bleeding risk associated with dabigatran or warfarin.
Source: Journal of Internal Medicine - November 7, 2017 Category: Internal Medicine Authors: M. Proietti, Z. Hijazi, U. Andersson, S. J. Connolly, J. W. Eikelboom, M. D. Ezekowitz, D. A. Lane, J. Oldgren, V. Roldan, S. Yusuf, L. Wallentin, Tags: Original Article Source Type: research

Comparison of Bleeding Risk Scores in Patients with Atrial Fibrillation:Insights from the RE ‐LY Trial
ConclusionsAmong the current clinical bleeding risk scores, the ORBIT score demonstrated the best discrimination and calibration. All the scores demonstrated, to a variable extent, an interaction with bleeding risk associated with dabigatran or warfarin.This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - October 16, 2017 Category: Internal Medicine Authors: Marco Proietti, Ziad Hijazi, Ulrika Andersson, Stuart J Connolly, John W Eikelboom, Michael D Ezekowitz, Deirdre A. Lane, Jonas Oldgren, Vanessa Roldan, Salim Yusuf, Lars Wallentin, Tags: Original Source Type: research

Standard and reduced doses of dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study
ConclusionsStandard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban.
Source: Journal of Internal Medicine - September 21, 2017 Category: Internal Medicine Authors: L. Staerk, T. A. Gerds, G. Y. H. Lip, B. Ozenne, A. N. Bonde, M. Lamberts, E. L. Fosb øl, C. Torp‐Pedersen, G. H. Gislason, J. B. Olesen Tags: Original Article Source Type: research

Important factors affecting the choice of an oral anticoagulant may be missed in database studies
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 7, 2017 Category: Internal Medicine Authors: Emma Aarnio, Risto Huupponen, Maarit Jaana Korhonen Tags: Letter to the Editor Source Type: research

Standard and reduced doses of dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study
ConclusionsStandard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban, and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban.This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 1, 2017 Category: Internal Medicine Authors: Laila Staerk, Thomas A Gerds, Gregory Y H Lip, Brice Ozenne, Anders N Bonde, Morten Lamberts, Emil L Fosb øl, Christian Torp‐Pedersen, Gunnar H Gislason, Jonas B Olesen Tags: Original Article Source Type: research

Resumption of anticoagulation after major bleeding decreases the risk of stroke in patients with atrial fibrillation
This study aimed to (1) evaluate anticoagulation use after a major bleeding event on dabigatran or warfarin and (2) compare outcomes between patients discontinuing anticoagulation and those restarting dabigatran or warfarin. Methods This was...
Source: Evidence-Based Medicine - June 9, 2017 Category: Internal Medicine Authors: Smit, M. D., Van Gelder, I. C. Tags: Therapeutics/Prevention Source Type: research

Perioperative management of new oral anticoagulants in patients undergoing elective surgery at a tertiary hospital
ConclusionConsiderable discordance exists between guideline recommendations and perioperative NOAC management. Assistive tools are required that better align decision making with current best practice.
Source: Internal Medicine Journal - June 7, 2017 Category: Internal Medicine Authors: Henry Wamala, Ian A Scott, Xenia Caney Tags: Original Article Source Type: research

Dabigatran Compared With Rivaroxaban vs Warfarin
To the Editor In a recent issue ofJAMA Internal Medicine, Graham et al reported that rivaroxaban use increased risks of major bleeding with nonsignificant reduction in thromboembolic stroke and increased mortality compared with dabigatran in elderly Medicare beneficiaries newly treated with dabigatran or rivaroxaban for nonvalvular atrial fibrillation (November 2011-June 2014). However, dabigatran event rates were lower than reported by Graham et al in a larger group of elderly Medicare beneficiaries newly treated with dabigatran or warfarin for nonvalvular atrial fibrillation with longer follow-up during a partially overl...
Source: JAMA Internal Medicine - May 1, 2017 Category: Internal Medicine Source Type: research

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