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Comparative Effectiveness and Safety Between Apixaban, Dabigatran, Edoxaban, and Rivaroxaban Among Patients With Atrial Fibrillation : A Multinational Population-Based Cohort Study
CONCLUSION: Among patients with AF, apixaban use was associated with lower risk for GIB and similar rates of ischemic stroke or systemic embolism, ICH, and all-cause mortality compared with dabigatran, edoxaban, and rivaroxaban. This finding was consistent for patients aged 80 years or older and those with chronic kidney disease, who are often underrepresented in clinical trials.PRIMARY FUNDING SOURCE: None.PMID:36315950 | DOI:10.7326/M22-0511
Source: Annals of Internal Medicine - October 31, 2022 Category: Internal Medicine Authors: Wallis C Y Lau Carmen Olga Torre Kenneth K C Man Henry Morgan Stewart Sarah Seager Mui Van Zandt Christian Reich Jing Li Jack Brewster Gregory Y H Lip Aroon D Hingorani Li Wei Ian C K Wong Source Type: research

Comparative outcomes associated with rivaroxaban versus warfarin use in elderly patients with atrial fibrillation or acute venous thromboembolism managed in the United States: a systematic review of observational studies
CONCLUSIONS: This systematic review supports findings from subgroup analyses of randomized controlled trials that, compared with warfarin, rivaroxaban is associated with generally neutral or positive effects on thrombosis and a mixed picture on bleeding outcomes in older adults with either NVAF or VTE treated in the United States.PMID:37584187 | DOI:10.1080/03007995.2023.2247988
Source: Current Medical Research and Opinion - August 16, 2023 Category: Research Authors: William L Baker Matthew S Roberts Youssef Bessada Kimberly S Caroti Veronica Ashton Brahim K Bookhart Craig I Coleman Source Type: research

Four factor prothrombin complex concentrate for warfarin reversal in patients with left ventricular assist devices
AbstractContinuous flow left ventricular assist devices (CF-LVAD) require therapeutic anticoagulation which is often interrupted for procedures or bleeding. Prior to the availability of four factor prothrombin complex concentrate (4F-PCC) in the United States, warfarin was held and its effects reversed by vitamin K or fresh frozen plasma. We evaluated the use of 4F-PCC for temporary warfarin reversal in patients with CF-LVADs and assessed outcomes. This analysis is a retrospective study of CF-LVAD patients who received 4F-PCC for warfarin reversal in the setting of bleeding or need for urgent or elective procedures. Primar...
Source: Journal of Thrombosis and Thrombolysis - May 21, 2018 Category: Hematology Source Type: research

Variation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications
Atrial fibrillation is the most common arrhythmia in the United States and affects between 2.7 million and 6.1 million adults in the United States, with a lifetime risk of up to 1 in 4 adults over age 40 and a prevalence that is projected to double over the next 25 years.1,2 Though warfarin has long been the cornerstone of therapy to reduce the risk of stroke, several new direct oral anticoagulants (DOACs) have recently become available, beginning with FDA approval of dabigatran in October 2010, and followed by rivaroxaban in 2011, apixaban in 2014, and most recently edoxaban in 2015.
Source: The American Journal of Medicine - October 3, 2018 Category: General Medicine Authors: Benjamin A. Rodwin, Joseph A. Salami, Erica S. Spatz, Javier Valero-Elizondo, Salim S. Virani, Ron Blankstein, Michael J. Blaha, Khurram Nasir, Nihar R. Desai Tags: Clinical Research Study Source Type: research

Clinical Outcome Following Reinstitution of Anticoagulation after Major Gastrointestinal Bleed: A Single Institutional Analysis
Conclusion: Given the rising national trend on the use of anticoagulants for various medical necessities, it is imperative that a safe and efficient process be devised on reinstitution of anticoagulation post MGIB to guide Clinicians. Although our study represents a single institutional analysis, it concurs with recent studies that early resumption of anticoagulant following stabilization of MGIB is associated with lower thromboembolic events. Timing for resumption depends largely on the medical reason for anticoagulation; reinstitution by day 7 appear safe for patients on mechanical valve whereas after day 12 maybe approp...
Source: Blood - November 21, 2018 Category: Hematology Authors: Ezekwudo, D. E., Gaikazian, S., Anusim, N., Konde, A. S., Zakalik, D., Huben, M. T., Stender, M., Anderson, J., Jaiyesimi, I. Tags: 332. Antithrombotic Therapy: Poster I Source Type: research

Comparison of Drug Switching and Discontinuation Rates in Patients with Nonvalvular Atrial Fibrillation Treated with Direct Oral Anticoagulants in the United States
ConclusionIn the real-world setting, patients with NVAF newly treated with apixaban were less likely to switch or discontinue treatment compared to patients treated with rivaroxaban or dabigatran.FundingPfizer and Bristol-Myers Squibb.
Source: Advances in Therapy - November 29, 2018 Category: Drugs & Pharmacology Source Type: research

Assessing patient preferences for switching from warfarin to direct oral anticoagulants
This study assessed patient preference for warfarin or DOAC based on a willingness to pay more for potential DOAC benefits. Current warfarin patients with atrial fibrillation or venous thromboembolism enrolled in the University of Utah Health Thrombosis Service were given a one-time electronic survey that assessed preferences between warfarin and DOACs using scenarios comparing effectiveness, safety, and convenience. When DOACs were preferred, patients were asked how much more they would be willing to pay monthly for the perceived advantages associated with DOACs. With 123 completed surveys, 68% of patients preferred to st...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2019 Category: Hematology Source Type: research

Correlation between intracranial vertebral artery stenosis diameter measured by digital subtraction angiography and cross-sectional area measured by optical coherence tomography
Conclusion Measurement of the narrowest diameter was not a reliable predictor of the cross-sectional area of V4 stenosis. Larger studies are therefore needed to develop a new evaluation system based on V4 stenosis.
Source: Journal of NeuroInterventional Surgery - October 15, 2021 Category: Neurosurgery Authors: Feng, Y., Wu, T., Wang, T., Li, Y., Li, M., Li, L., Yang, B., Bai, X., Zhang, X., Wang, Y., Gao, P., Chen, Y., Ma, Y., Jiao, L. Tags: Ischemic stroke Source Type: research

High rates of oral anticoagulation in atrial fibrillation patients observed in a large multi-specialty health system in the Northeast
ConclusionsWe show dramatically increased OAC usage among patients with AF and that NOACs comprise the large majority of OACs compared with previous studies. This suggests an association between widespread adoption of NOACs and increased oral anticoagulation rates. Future directions include assessing barriers to oral anticoagulation and developing interventions to reduce disparity in OAC use between clinics.
Source: Journal of Interventional Cardiac Electrophysiology - October 20, 2022 Category: Cardiology Source Type: research

Race, ethnicity, sex, and socioeconomic disparities in anticoagulation for atrial fibrillation: A narrative review of contemporary literature
J Natl Med Assoc. 2023 Mar 5:S0027-9684(23)00034-2. doi: 10.1016/j.jnma.2023.02.008. Online ahead of print.ABSTRACTAtrial fibrillation (AF) is the most prevalent arrhythmia in the United States and is responsible for 1 in 7 ischemic strokes. While anticoagulation is effective at preventing strokes, prior work has highlighted significant disparities in anticoagulation prescribing. Furthermore, racial, ethnic, sex, and socioeconomic disparities in AF outcomes have been described. As such, we aimed to review recent data on disparities with respect to anticoagulation for AF published between January 2018 and February 2021. The...
Source: Journal of the National Medical Association - March 7, 2023 Category: General Medicine Authors: Danielle J Daly Utibe R Essien Marcela G Del Carmen Benjamin Scirica Adam N Berman Jennifer Searl Como Jason H Wasfy Source Type: research

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