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Specialty: Internal Medicine
Condition: Bleeding
Nutrition: Vitamins

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Total 37 results found since Jan 2013.

Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm Source Type: research

Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin
Commentary to: Reddy VY, Sievert H, Halperin J, et al.; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation: a randomized clinical trial. JAMA 2014;312:1988–98 . Context Atrial fibrillation (AF) is a common arrhythmia in clinical practice. The major complication of AF is thromboembolic stroke. Patients with AF have a fivefold higher risk of stroke and a twofold increase in mortality.1 As complete cure for AF is never certain, the aims of AF therapy are symptom relief and prevention of thromboembolic events. The latter can be managed by vitami...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Swaans, M. J., Alipour, A., Boersma, L. V. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

Patients with atrial fibrillation and low risk of stroke - do they really need anticoagulation?
Authors: Trusz-Gluza M, Filipecki A, Urbańczyk-Świć D Abstract Atrial fibrillation (AF) significantly increases risk of thromboembolic events, in particular the risk of stroke. Anticoagulation therapy reduces this risk and the treatment should be lifelong. However, the risk in patients with non-valvular AF is not equally distributed. There are patients at low risk. Assessment of the thromboembolic risk according to guidelines is mandatory, most frequently CHA2DS2-VASc scheme is used. In the large group with the CHA2DS2-VASc-0 (females 1) the annual risk of stroke was 0.49%, ischemic stroke 0.43%, on the other si...
Source: Polskie Archiwum Medycyny Wewnetrznej - August 28, 2015 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Atrial Fibrillation had Less Impact on the Risk of Ischemic Stroke in Non-anticoagulated Patients Undergoing Hemodialysis: Insight from the RAKUEN study.
Conclusion A great impact on death, but not ischemic stroke, was observed in non-anticoagulated hemodialysis patients with AF in comparison to those without AF from the analysis of the RAKUEN study. PMID: 29607945 [PubMed - as supplied by publisher]
Source: Internal Medicine - April 4, 2018 Category: Internal Medicine Tags: Intern Med 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

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

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

Delaying clinical events among patients with non-valvular atrial fibrillation treated with oral anticoagulants: Insights from the ARISTOPHANES study
CONCLUSIONS: Over 12 months after initiation, apixaban and dabigatran conferred progressive increases in event free time for stroke/SE and MB vs warfarin, whereas rivaroxaban conferred an increase in stroke/SE-free time but a loss in MB-free time vs warfarin.PMID:36456387 | DOI:10.1016/j.ejim.2022.10.021
Source: European Journal of Internal Medicine - December 1, 2022 Category: Internal Medicine Authors: Steven Deitelzweig Allison Keshishian Amiee Kang Aaron Jenkins Nipun Atreja Patricia Schuler Jenny Jiang Huseyin Yuce Xiaoxi Sun Gregory Y H Lip Source Type: research

A Review of Oral Anticoagulants in Patients with Atrial Fibrillation
Arnold J. Greenspon, MD DOI: 10.3810/pgm.2012.11.2608 Abstract: There is a high prevalence of atrial fibrillation in the United States, particularly in the elderly population. Patients with atrial fibrillation are at an increased risk of stroke and anticoagulant therapy is recommended. However, many eligible patients are not receiving therapy due to limitations and concerns related to the use of the vitamin K antagonist warfarin, such as slow onset of action, variable drug metabolism, risk of bleeding, and requirement for monitoring. Novel oral anticoagulants (NOACs) have been developed and may be used as an alternat...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Efficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis
CONCLUSIONS: Among AF patients with ESRD on chronic hemodialysis, the risk of ischemic stroke, ischemic stroke or systemic embolism, minor bleeding, major bleeding, and all-cause mortality is similar in patients treated with DOACs compared to VKAs. Given that the meta-analysis of RCTs on gastrointestinal bleeding did not confirm the results of the meta-analysis of the observational studies, it cannot be concluded that gastrointestinal bleeding is lower among DOAC-treated patients.PROTOCOL REGISTRATION: PROSPERO CRD42023391966.PMID:37648582 | DOI:10.1016/j.ejim.2023.08.020
Source: European Journal of Internal Medicine - August 30, 2023 Category: Internal Medicine Authors: Ioannis Kyriakoulis Anastasia Adamou Iliana Stamatiou David Dimitris Chlorogiannis Ioannis Kardoutsos Despoina Koukousaki George Ntaios Source Type: research

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation
Conclusions: Our meta-analysis suggested that the use of NOACs was at least non-inferior to warfarin use for stroke prevention in Latin American patients with AF.
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Clinical outcomes with rivaroxaban in patients transitioned from vitamin k antagonist therapy: a subgroup analysis of a randomized trial.
CONCLUSION: The efficacy of rivaroxaban in VKA-experienced and VKA-naive patients was similar to that of the overall trial. There were more bleeding events within 7 days of study drug initiation with rivaroxaban, but after 30 days, rivaroxaban was associated with less bleeding in VKA-naive patients and similar bleeding in VKA-experienced patients. This information may be useful to clinicians considering a transition to rivaroxaban for patients receiving VKA therapy. PRIMARY FUNDING SOURCE: Johnson & Johnson and Bayer HealthCare. PMID: 23778903 [PubMed - in process]
Source: Annals of Internal Medicine - June 18, 2013 Category: Internal Medicine Authors: Mahaffey KW, Wojdyla D, Hankey GJ, White HD, Nessel CC, Piccini JP, Patel MR, Berkowitz SD, Becker RC, Halperin JL, Singer DE, Califf RM, Fox KA, Breithardt G, Hacke W Tags: Ann Intern Med 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

Reply to “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 28, 2017 Category: Internal Medicine Authors: Anna Gundlund, Emil Loldrup Fosb øl, Jonas Bjerring Olesen Tags: Letter to the Editor Source Type: research