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Timing of Initiation of Oral Anticoagulation after Acute Ischemic Stroke in Patients with Atrial Fibrillation
AbstractPatients with atrial fibrillation (AF) who suffer an acute ischemic stroke are at risk for both hemorrhagic transformation and recurrent ischemic stroke in the acute post ‐stroke period. Oral anticoagulants are recommended for secondary stroke prevention in patients with AF. The optimal time to initiate anticoagulant therapy after acute ischemic stroke in patients with AF is uncertain. There is concern that early initiation increases the risk of hemorrhagic transfo rmation, whereas delayed initiation leaves the patient at risk for recurrent ischemic stroke. In this article, we provide a review of the risk of hemo...
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - November 6, 2019 Category: Drugs & Pharmacology Authors: Maureen A. Smythe, Dennis Parker, Candice L. Garwood, Adam Cuker, Steve R. Mess é Tags: REVIEW OF THERAPEUTICS Source Type: research

Primary Prevention of Ischaemic Stroke in Atrial Fibrillation: New Oral Anticoagulant Drugs for all?
Abstract Atrial fibrillation (AF) confers a 4.5% risk of stroke per year. The risk of stroke increases with various risk factors and until recently, warfarin has been the gold standard of thromboembolism prophylaxis in AF for many years. The dosage of warfarin requires regular adjustment dependent on the INR, to keep within a narrow therapeutic range of 2.0- 3.0. The INR can be altered by concomitant drugs, foods and alcohol and requires inconvenient blood monitoring. Underanticoagulation places patients at risk of stroke, whilst over-anticoagulation confers significant bleeding risk. Consequently approximately ha...
Source: Current Vascular Pharmacology - May 24, 2014 Category: Drugs & Pharmacology Authors: Foley J, Kirchhof P, Lip GY Tags: Curr Vasc Pharmacol Source Type: research

Edoxaban for reducing the risk of stroke and systemic embolism in patients with non-valvular atrial fibrillation.
Authors: Dzeshka MS, Lip GY Abstract INTRODUCTION: Oral anticoagulation is central to the management of patients with atrial fibrillation (AF) and at least one additional stroke risk factor. For decades, the vitamin K antagonists (e.g. warfarin) remained the only oral anticoagulant available for stroke prevention in AF. The non-vitamin K oral anticoagulants (NOACs) are now available, and these drugs include the direct thrombin inhibitors and factor Xa inhibitors. The latter class includes edoxaban, which has recently been approved for stroke prevention in AF by the United States Food and Drug Administration and the...
Source: Expert Opinion on Pharmacotherapy - February 14, 2016 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Quality of warfarin therapy and risk of stroke, bleeding, and mortality among patients with atrial fibrillation: results from the nationwide FinWAF Registry
ConclusionsThe quality of warfarin treatment was strongly associated with the risk of stroke and the prognosis of AF patients. Patient outcomes continued to improve with increasing TTR values up to a TTR ≥80%; therefore, the target for the TTR should exceed 80% instead of the traditional range of at least 60–70%. Copyright © 2017 John Wiley & Sons, Ltd.
Source: Pharmacoepidemiology and Drug Safety - February 28, 2017 Category: Drugs & Pharmacology Authors: Mika Lehto, Jussi Niiranen, Pasi Korhonen, Juha Meht älä, Houssem Khanfir, Fabian Hoti, Riitta Lassila, Pekka Raatikainen Tags: Original Report Source Type: research

Risk factors for stroke and choice of oral anticoagulant in atrial fibrillation
ConclusionsThe uptake of DOACs was rapid and spurred an increase in new users of oral anticoagulants for atrial fibrillation from 2010 to 2015 in Norway. The mean CHA2DS2-VASc score did not change substantially during this period. Vascular disease, heart failure, and diabetes were associated with initiation of warfarin, and previous stroke, age 65 –74 and female sex with initiation of DOACs.
Source: European Journal of Clinical Pharmacology - August 16, 2018 Category: Drugs & Pharmacology Source Type: research

Rivaroxaban Versus Warfarin for Stroke Prevention and Venous Thromboembolism Treatment in Extreme Obesity and High Body Weight.
Conclusion and Relevance: Although not statistically significant, rivaroxaban trended toward a lower incidence of clinical failure while demonstrating a significantly shorter LOS when compared with warfarin for VTE treatment or atrial fibrillation in morbidly obese or high-body-weight patients. PMID: 31672028 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - October 30, 2019 Category: Drugs & Pharmacology Authors: Perales IJ, San Agustin K, DeAngelo J, Campbell AM Tags: Ann Pharmacother Source Type: research

Anticoagulation Resumption in a Patient With Mechanical Heart Valves, Antithrombin Deficiency, and Hemorrhagic Transformation Following Thrombectomy After Ischemic Stroke
This study is the first report of administering argatroban and titrating to its appropriate dose in the patient with valve thrombosis, antithrombin deficiency, and HT after mechanical thrombectomy for acute ischemic stroke. Notably, the fluctuations argatroban brings to the coagulation test results might not be interpreted as increased bleeding risk. This case also suggested that the reported timing (day 6 to day 14 after hemorrhage) of anticoagulant resumption in primary intracerebral hemorrhage with mechanical valves might be late for some patients with HT.
Source: Frontiers in Pharmacology - December 16, 2020 Category: Drugs & Pharmacology Source Type: research

Selecting the right anticoagulant for stroke prevention in atrial fibrillation
CONCLUSIONS: Non-valvular AF patients on apixaban had lower rates of thromboembolic events than the patients on acenocumarol. This article will serve as a reminder of the positive health and financial outcomes of apixaban use, especially to those healthcare systems that are still oblivious to the decrease in economic burden and gain in quality-adjusted life years (QALY) by the long-term use of NOACS/ DOACS instead of the AVK anticoagulants.PMID:34286492 | DOI:10.26355/eurrev_202107_26241
Source: Pharmacological Reviews - July 21, 2021 Category: Drugs & Pharmacology Authors: N R Kundnani C I Rosca A Sharma A Tudor M S Rosca D D Nisulescu H S Branea V Mocanu D C Crisan D R Buzas S Morariu D F Lighezan Source Type: research

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