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Specialty: Internal Medicine
Condition: Bleeding
Drug: Warfarin

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Total 62 results found since Jan 2013.

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

Anticoagulation knowledge in patients with atrial fibrillation: An Australian survey
ConclusionThe study identified knowledge gaps in patients taking OACs, and these deficiencies appeared to be greater in participants taking DOACs. Knowledge assessment should be integrated into patient counselling sessions to help identify and resolve knowledge deficits.
Source: International Journal of Clinical Practice - January 1, 2018 Category: Internal Medicine Authors: Kehinde O. Obamiro, Leanne Chalmers, Kenneth Lee, Bonnie J. Bereznicki, Luke R. E. Bereznicki Tags: ORIGINAL PAPER 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

WATCHMAN device-related thrombus successfully treated with apixaban: A case report
Rationale: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. Patient concerns: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Stroke risks and patterns of warfarin therapy among atrial fibrillation patients post radiofrequency ablation: A real-world experience
In this study, we analyzed the stroke risks of patients who had undergone RFA for AF at our hospital between March 2014 and June 2016 using the CHADS2, CHADS2-VASc, and Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly (> 65 years) (HAS-BLED) scoring systems. We retrieved medications, co-morbidities, and initial warfarin dosage data. The primary outcome was the percentage of patients initiated with warfarin therapy for stroke prophylaxis in AF who had a CHADS2-VASc score of 0. Totally, 309 patients were initiated with warfarin therapy ...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study 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

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

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

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

Management of patients with atrial fibrillation and chronic kidney disease in light of the latest guidelines.
Authors: Młodawska E, Tomaszuk-Kazberuk A, Łopatowska P, Musiał WJ, Małyszko J Abstract Atrial fibrillation (AF) frequently occurs in patients with chronic kidney disease (CKD), and the rate reaches even 30% in patients with end-stage renal disease (ESRD). Patients with AF and CKD have a significantly higher risk of thrombotic complications, particularly ischemic stroke, and at the same time, a higher bleeding risk (proportionally to the grade of renal failure). In addition, AF and CKD share a number of comorbidities and risk factors, which results in increased mortality rates. Moreover, disturbances in hemosta...
Source: Polskie Archiwum Medycyny Wewnetrznej - June 2, 2016 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

A tailored treatment strategy: a modern approach for stroke prevention in patients with atrial fibrillation
The objective of this review is to provide an overview of modern AF stroke prevention with a focus on tailored treatment strategies. Biomarkers and genetic factors have been proposed to help identify ‘high‐risk’ patients to be targeted for oral anticoagulation, but ultimately their use must be balanced against that of more simple and practical considerations for everyday use. Current guidelines have directed focus on initial identification of ‘truly low‐risk’ patients with AF, that is those patients with a CHA2DS2‐VASc [congestive heart failure, hypertension, age ≥75 years (two points), diabetes mellitus, ...
Source: Journal of Internal Medicine - March 21, 2016 Category: Internal Medicine Authors: G. Y. H. Lip, T. Potpara, G. Boriani, C. Blomström‐Lundqvist Tags: Review Source Type: research

Comparison of aspirin and Naoxintong Capsule (脑心通胶囊) with adjusted-dose warfarin in elderly patients with high-risk of non-valvular atrial fibrillation and genetic variants of vitamin K epoxide reductase
Conclusions Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596)
Source: Chinese Journal of Integrative Medicine - February 26, 2016 Category: Internal Medicine Source Type: research

Effective practical management of patients with atrial fibrillation when using new oral anticoagulants.
Authors: Cox JL Abstract Practical management of stroke prevention in patients with non-valvular atrial fibrillation (AF) requires physicians to find the optimal balance between maximizing prevention of ischaemic stroke and minimizing the risk of bleeding. Vitamin K antagonists have traditionally been used for stroke prevention in patients with AF; however, they have been associated with increased risk of bleeding, particularly intracranial haemorrhage. New oral anticoagulants (OACs) have shown similar efficacy to the vitamin K antagonist warfarin but with a reduced risk of bleeding, particularly life-threatening b...
Source: Annals of Medicine - February 18, 2016 Category: Internal Medicine Tags: Ann Med Source Type: research