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Total 482 results found since Jan 2013.

Oral anticoagulant prescribing in a hyperacute stroke unit
Conclusion Currently, renal impairment is the main determinant for thromboprophylaxis choice. Local guidelines have been created with physician education underway and re-audit planned in 3 months. The authors will present the full data.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Samani, A., Kayani, M., Asokanathan, A. Tags: Stroke Thur 21, Parallel session 5: Therapeutics Source Type: research

New reversal agent for factor Xa inhibitors shows promise
Commentary on: Siegal DM, Curnette JT, Connolly SJ, et al.. Andexanet alfa for the reversal of Factor Xa inhibitor activity. N Engl J Med 2015;373:2413–24. Context Direct oral anticoagulants (DOACs) have emerged as alternatives to vitamin K-antagonists (eg, warfarin) for the long-term management of stroke prevention for non-valvular atrial fibrillation or venous thromboembolic disease. Favourable side-effect profiles and absence of therapeutic monitoring are important benefits of these newer agents. Warfarin is readily reversed with fresh frozen plasma (FFP) or prothrombin complex concentrates.1 The first reversal ag...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Ghadimi, K., Welsby, I. J. Tags: Clinical trials (epidemiology), Immunology (including allergy), Drugs: cardiovascular system, Stroke, Venous thromboembolism, Unwanted effects / adverse reactions Therapeutics/Prevention Source Type: research

Benefits of non –vitamin K antagonist oral anticoagulants in patients with atrial fibrillation go beyond stroke prevention
The last decade has produced a large body of robust randomized controlled trial (RCT) data investigating the use of non –vitamin K antagonist oral anticoagulants (NOACs) in nonvalvular atrial fibrillation (AF).1–4 Compared with warfarin, dabigatran and apixaban have been found to reduce the combined outcome of stroke and systemic embolism. In addition, apixaban and edoxaban significantly reduce major bleeding. Fu rthermore, a pooled meta-analysis has demonstrated superior efficacy and overall safety of the NOACs.
Source: Heart Rhythm - January 15, 2017 Category: Cardiology Authors: Jay A. Montgomery, Gregory F. Michaud Tags: Editorial Commentary Source Type: research

Intravenous thrombolysis for acute ischaemic stroke in patients on direct oral anticoagulants Expert opinion of the Societe Francaise de Neurologie Vasculaire (SFNV) French Vascular Neurology Society and the Groupe Francais d'etudes sur l'Hemostase et la Thrombose (GFHT) French study Group on Haemostasis and Thrombosis
ConclusionsIn this expert opinion paper, we suggest that IVT can be performed in patients selected according to the time elapsed since the drug was last taken, renal function, type of hospital where the patient is admitted and plasma concentration of DOAC.This article is protected by copyright. All rights reserved.
Source: European Journal of Neurology - January 23, 2018 Category: Neurology Authors: Emmanuel Touz é, Yves Gruel, Isabelle Gouin‐Thibault, Emmanuel De Maistre, Sophie Susen, Pierre Sie, Laurent Derex Tags: Original Article Source Type: research

Comparing the Cost Effectiveness of Non-vitamin K Antagonist Oral Anticoagulants with Well-Managed Warfarin for Stroke Prevention in Atrial Fibrillation Patients at High Risk of Bleeding
ConclusionsThe comparative cost effectiveness of edoxaban and warfarin is highly sensitive to TTR. At the $US100,000/QALY willingness-to-pay threshold, our results suggest that warfarin is the most cost-effective treatment for patients who can achieve a TTR of 70%.
Source: American Journal of Cardiovascular Drugs - May 9, 2018 Category: Cardiology Source Type: research

Pharmacological Difference Between Platelet Aggregations in Cardioembolic Stroke Patients with Direct Oral Anticoagulants: A Pilot Study
Major hemorrhagic complication incidence in patients with arterial fibrillation (AF), and treated with direct oral anticoagulants (DOACs), is lower than in vitamin K antagonist-treated patients.1 –5 Additionally, among DOACs, the direct oral thrombin inhibitor (dabigatran) and direct oral factor Xa (FXa) inhibitors (apixaban and rivaroxaban) seem to affect the coagulation system differently, which could provide distinct clinical outcomes.6,7 The results from the US6 and Denmark8 cohort stu dies suggest there is a minute, but notable difference in major bleeding complication incidence between dabigatran and FXa inhibitors.
Source: Journal of Stroke and Cerebrovascular Diseases - May 3, 2022 Category: Neurology Authors: Masahito Nakazaki, Shinichi Oka, Hirotoshi Magota, Ryo Kiyose, Rie Onodera, Ryo Ukai, Yuko Kataoka-Sasaki, Masanori Sasaki, Osamu Honmou Source Type: research

Economic evaluation of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis
Conclusions Our meta-analysis provides comprehensive economic evidence that allows policy makers to generalise cost-effectiveness data to their local context. All DOACs may be cost-effective compared with VKA in HICs with TPP perspective. The pooling results produced moderate to high heterogeneity particularly in UMICs. Further studies are required to inform UMICs with SP. PROSPERO registeration number CRD 42019146610.
Source: Evidence-Based Medicine - July 28, 2022 Category: Internal Medicine Authors: Noviyani, R., Youngkong, S., Nathisuwan, S., Bagepally, B. S., Chaikledkaew, U., Chaiyakunapruk, N., McKay, G., Sritara, P., Attia, J., Thakkinstian, A. Tags: Open access Evidence synthesis Source Type: research

Integrating Real-World Evidence in Economic Evaluation of Oral Anticoagulants for Stroke Prevention in Non-valvular Atrial Fibrillation in a Developing Country
ConclusionsIn a developing country where suboptimal anticoagulation control is common, apixaban was the cost-effective alternative to warfarin for patients with both low and intermediate TTR control.
Source: American Journal of Cardiovascular Drugs - February 3, 2023 Category: Cardiology Source Type: research

Drug-drug interactions with direct oral anticoagulants for the prevention of ischemic stroke and embolism in atrial fibrillation: a narrative review of adverse events
Expert Rev Clin Pharmacol. 2023 Mar 2. doi: 10.1080/17512433.2023.2187376. Online ahead of print.ABSTRACTINTRODUCTION: In randomized trials, direct oral anticoagulants (DOAC) were non-inferior to the vitamin-K-antagonist (VKA) warfarin in preventing stroke/embolism in patients with atrial fibrillation (AF). DOAC are substrates for P-glycoprotein (P-gp), CYP3A4 and CYP2C9. The activity of these enzymes is modulated by several drugs which might induce pharmacokinetic drug-drug interactions (DDI). Drugs affecting platelet function have the potential for pharmacodynamic DDI of DOAC.AREAS COVERED: The literature was searched fo...
Source: Expert Review of Clinical Pharmacology - March 2, 2023 Category: Drugs & Pharmacology Authors: Claudia St öllberger Birke Schneider Josef Finsterer Source Type: research