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Condition: Heart Disease
Drug: Pradaxa

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Total 24 results found since Jan 2013.

Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al.. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62. Context Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabig...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Connective tissue disease, Musculoskeletal syndromes, Diabetes, Arrhythmias Therapeutics Source Type: research

Novel oral anticoagulants: too good to be true?
It is fair to say that the pharmacological therapy of cardiovascular disease has not been an area of spectacular growth in recent years. Little has happened in the treatment of hypertension and heart failure. There has been interest in the development of antiplatelet drugs in acute coronary syndromes and percutaneous interventions, but not in long-term cardiovascular prevention to compete with aspirin and clopidogrel. The one major area of intense interest has been the novel oral anticoagulants (NOACs), dabigatran, rivaroxaban and apixaban. The first of these is a direct thrombin inhibitor, while the other two are blockers...
Source: Postgraduate Medical Journal - August 18, 2014 Category: Journals (General) Authors: Schachter, M. Tags: Editor's choice, Drugs: cardiovascular system, Stroke, Hypertension, Ischaemic heart disease, Arrhythmias Editorials Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

An Aspirin a Day: Is the Benefit Worth the Risk?
Studies have shown that aspirin, the age old remedy for pain and fever, also thins the blood. Because of this property, it can also help to lower the chances of a heart attack or a stroke caused by a blood clot in the brain. And, although research has found that it only works in certain people (specifically, those with a history of heart attack or stroke) many Americans are inappropriately taking daily, low doses of aspirin as a preventative measure. In fact, researchers have found that about 12 percent of the of nearly 69,000 U.S. adults taking aspirin on a long-term basis should not have received the prescription in the ...
Source: Healthy Living - The Huffington Post - March 13, 2015 Category: Consumer Health News Source Type: news

‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

Practical Considerations for the Nonvitamin K Antagonist Oral Anticoagulants
Conclusions: Several important factors should be considered regarding the adequate use of NOACs, especially in patients with renal impairment or cardiovascular conditions other than NVAF.Cardiology 2017;136:115-124
Source: Cardiology - September 5, 2016 Category: Cardiology Source Type: research

Cardio Notes: Societies Issue Top 10 List
(MedPage Today) -- The American Heart Association and the American Stroke Association have compiled the top 10 advances in heart disease and stroke research of 2013, and the safety of dabigatran (Pradaxa) will be examined again.
Source: MedPage Today Neurology - January 6, 2014 Category: Neurology Source Type: news

Comparison of Dabigatran versus Warfarin in Patients with Atrial Fibrillation and Valvular Heart Disease: The RE-LY Trial.
CONCLUSIONS: -The presence of any VHD did not influence the comparison of dabigatran with warfarin. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique Identifier: NCT00262600. PMID: 27496855 [PubMed - as supplied by publisher]
Source: Circulation - August 4, 2016 Category: Cardiology Authors: Ezekowitz MD, Nagarakanti R, Noack H, Brueckmann M, Litherland C, Jacobs M, Clemens A, Reilly PA, Connolly SJ, Yusuf S, Wallentin L Tags: Circulation Source Type: research

Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials.
Source: Clinical Cardiology - December 21, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews Source Type: research

Direct oral anticoagulants compared to vitamin K antagonist for the management of left ventricular thrombus
ConclusionsOur data suggest that DOACs are likely to be at least as effective and safe as VKA for stroke prevention in patients with LV thrombus and, despite their lack of a licence for this indication, are therefore likely to represent a reasonable and more convenient option for this setting. The optimal timing and type of anticoagulation for LV thrombus, as well as the role of screening for high ‐risk patients, should be tested in prospective, randomized trials.
Source: ESC Heart Failure - June 24, 2020 Category: Cardiology Authors: Hansa Iqbal, Sam Straw, Thomas P. Craven, Katherine Stirling, Stephen B. Wheatcroft, Klaus K. Witte Tags: Original Research Article Source Type: research

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asian Patients with Atrial Fibrillation and Valvular Heart Disease.
CONCLUSIONS: NOACs had a comparable risk of ischemic stroke and bleeding in patients with AF and VHD, and reduced the risk of venous thromboembolism, intracranial hemorrhage, and mortality, compared to warfarin. Therefore, NOAC is an effective and safe alternative to warfarin in these patients. PMID: 33538623 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - February 6, 2021 Category: Research Tags: Curr Med Res Opin Source Type: research

Fatal Adverse Events of Dabigatran Combined With Aspirin in Elderly Patients: An Analysis Using Data From VigiBase
Conclusion: The fatal adverse events associated with the combined use of dabigatran and aspirin in elderly patients were mainly serious bleeding events, which often occurred within 1 month. Most of these cases had medication errors and most of the patients had multiple diseases, medications, or other conditions at the same time that increase the risk of bleeding. It is suggested that prescription of dabigatran and aspirin in elderly patients should go along with alertness for medication errors, care for correct dose or control of other bleeding risk factors, and the combined medication time should be as short as possible ...
Source: Frontiers in Pharmacology - December 22, 2021 Category: Drugs & Pharmacology Source Type: research

Approach to the new oral anticoagulants in family practice: Part 2: addressing frequently asked questions.
CONCLUSION: Management of "what if" scenarios for patients taking NOACs have been proposed, but additional study is needed to address these issues, especially periprocedural management and bleeding. PMID: 25392439 [PubMed - as supplied by publisher]
Source: Canadian Family Physician Medecin de Famille Canadien - November 1, 2014 Category: Primary Care Authors: Douketis J, Bell AD, Eikelboom J, Liew A Tags: Can Fam Physician Source Type: research

How to define valvular atrial fibrillation?
Abstract Atrial fibrillation (AF) confers a substantial risk of stroke. Recent trials comparing vitamin K antagonists (VKAs) with non-vitamin K antagonist oral anticoagulants (NOACs) in AF were performed among patients with so-called "non-valvular" AF. The distinction between "valvular" and "non-valvular" AF remains a matter of debate. Currently, "valvular AF" refers to patients with mitral stenosis or artificial heart valves (and valve repair in North American guidelines only), and should be treated with VKAs. Valvular heart diseases, such as mitral regurgitation, aortic stenosis (AS) and aortic insufficiency, do...
Source: Archives of Cardiovascular Diseases - July 13, 2015 Category: Cardiology Authors: Fauchier L, Philippart R, Clementy N, Bourguignon T, Angoulvant D, Ivanes F, Babuty D, Bernard A Tags: Arch Cardiovasc Dis Source Type: research

Dabigatran is Less Effective Than Warfarin at Attenuating Mechanical Heart Valve-Induced Thrombin Generation Valvular Heart Disease
Conclusions MHV induce thrombin generation via the intrinsic pathway and generate sufficient thrombin to overwhelm clinically relevant dabigatran concentrations. In contrast, warfarin is more effective than dabigatran at suppressing MHV-induced thrombin generation. These data explain why dabigatran failed in MHV patients and suggest that strategies targeting FXII or FXI may suppress the root cause of thrombosis in such patients.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Jaffer, I. H., Stafford, A. R., Fredenburgh, J. C., Whitlock, R. P., Chan, N. C., Weitz, J. I. Tags: Valvular Heart Disease Source Type: research