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Total 482 results found since Jan 2013.
Italian intersociety consensus on DOAC use in internal medicine
AbstractThe direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic charac...
Source: Internal and Emergency Medicine - February 12, 2017 Category: Emergency Medicine Source Type: research
Hemopericardium under dabigatran for stroke prevention in atrial fibrillation
We report a polymorbid 75-year old male under a therapy with dabigatran, valsartan, amlodipine, nicorandil, furosemide, atorvastatin, bisoprolol, metformin, tizanidine, pantoprazole, and tramadol. He suffered from chest pain for 4 months. Coronary angiography showed only ectatic coronary arteries. He started taking nonsteroidal anti-inflammatory drugs. He was hospitalized because of dyspnea starting 10 days before admission, melena, and renal failure. Hemopericardium was diagnosed and pericardiocentesis yielded 2000 ml hemorrhagic fluid. Review of previous echocardiograms showed a 4 mm echo-free space, epicardial fat o...
Source: Blood Coagulation and Fibrinolysis - February 11, 2017 Category: Hematology Tags: Case Reports Source Type: research
Effects of novel oral anticoagulants on left atrial and left atrial appendage thrombi: an appraisal
AbstractAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia and predisposes to an increased risk of thromboembolic events. Patients affected by AF exhibit an increased risk of stroke compared with those in sinus rhythm, with the most common location of thrombi in the left atrial appendage. Until 2009, warfarin and other vitamin K antagonists were the only class of oral anticoagulants available. More recently, dabigatran, rivaroxaban, apixaban, and edoxaban have been approved by regulatory authorities for prevention of stroke in patients with non-valvular AF. Few data are available about the efficacy of...
Source: Journal of Thrombosis and Thrombolysis - January 31, 2017 Category: Hematology Source Type: research
Microfluidic coagulation assay for monitoring anticoagulant therapy in acute stroke patients.
In conclusion, the SAW-CT assay is capable to monitor anticoagulant level and effect in patients receiving dabigatran, rivaroxaban and the VKA phenprocoumon. It has a limited sensitivity for apixaban-detection. If specific SAW-CT results were used as cut-offs, SAW-CT yields high diagnostic accuracy to exclude relevant rivaroxaban and dabigatran concentrations in stroke-patients.
PMID: 28124061 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 25, 2017 Category: Hematology Authors: Bluecher A, Meyer Dos Santos S, Ferreirós N, Labocha S, Meyer Dos Santos IM, Picard-Willems B, Harder S, Singer OC Tags: Thromb Haemost Source Type: research
Use of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) Before Stroke.
CONCLUSIONS: -While experience of using rt-PA in ischemic stroke patients on a NOAC is limited, these preliminary observations suggest that rt-PA appears to be reasonably well tolerated without prohibitive risks for adverse events among selected NOAC treated patients. Future study should evaluate the safety and efficacy of intravenous rt-PA in ischemic stroke patients taking NOACs.
PMID: 28119380 [PubMed - as supplied by publisher]
Source: Circulation - January 23, 2017 Category: Cardiology Authors: Xian Y, Federspiel JJ, Hernandez AF, Laskowitz D, Schwamm LH, Bhatt DL, Smith EE, Fonarow GC, Peterson ED Tags: Circulation 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
Pilot of a Computerised Antithrombotic Risk Assessment Tool Version 2 (CARATV2.0) for stroke prevention in atrial fibrillation.
CONCLUSIONS: This decision support tool can help optimise the use of antithrombotic therapy in patients with AF by considering risk versus benefit profiles and rationalising treatment selection.
PMID: 28070883 [PubMed - as supplied by publisher]
Source: Cardiology Journal - January 9, 2017 Category: Cardiology Authors: Wang Y, Bajorek B Tags: Cardiol J Source Type: research
Direct acting oral anticoagulant: Bench to bedside
Publication date: Available online 3 January 2017 Source:Medical Journal Armed Forces India Author(s): D.S. Chadha, P. Bharadwaj Vitamin K antagonists are an effective group of oral anticoagulants. However because of genetic variability in their metabolism and multiple food and drug interactions, these drugs have narrow therapeutic window with unpredictable anticoagulant effects requiring constant monitoring. Several newer direct acting oral anticoagulants have been approved for prevention of stroke in patients with nonvalvular atrial fibrillation and treatment or prevention of venous thromboembolism. The direct acting or...
Source: Medical Journal Armed Forces India - January 3, 2017 Category: Journals (General) Source Type: research
Dabigatran etexilate in a vitamin ‐K antagonist non responder patient during Heartware HVAD support
We report a case of a patient supported with a HeartWare left ventricular assist device for idiopathic cardiomyopathy who was resistance to vitamin‐K antagonists three months after implantation. The patient initially started low‐molecular‐weight heparin therapy and then, after the onset of an ischemic stroke, switched to dabigatran etexilate (DE). The patient had progressive recovery of cardiac function for which the device was explanted. No thrombotic or bleeding events occurred during DE therapy.
Source: Journal of Cardiac Surgery - December 31, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Andrea Baronetto, Paolo Centofanti, Matteo Attisani, Massimo Boffini, Davide Ricci, Erika Simonato, Mauro Rinaldi Tags: PERIOPERATIVE MANAGEMENT Source Type: research
Choosing Non-Vitamin K Antagonist Oral Anticoagulants: Practical Considerations We Need to Know.
CONCLUSION: NOACs provide a convenient and safe alternative to warfarin and may result in improved therapeutic outcomes for patients with NVAF or VTE. The use of NOACs in other indications and patient populations is under investigation, and clinical trials investigating their use in acute coronary syndrome, medically ill patients, percutaneous coronary intervention, cardioversion, catheter ablation, coronary arterial disease, and heart failure have been announced.
PMID: 27999513 [PubMed]
Source: Ochsner Journal - December 23, 2016 Category: Journals (General) Tags: Ochsner J Source Type: research
What are the effects of edoxaban in the general population and in the elderly?
Stroke and systemic embolism are common complications in patients with atrial fibrillation, and can be effectively prevented with oral anticoagulation. However, this strategy is associated with increased risk of major, sometimes fatal bleeding. Where vitamin K antagonists (VKAs) have been the standard of care in the past half century, new directly acting oral anticoagulants have been developed that, unlike VKA, have a fast onset and fast offset of action, and do not need monitoring either. These non-VKA oral anticoagulants (NOACs) have proven to be non-inferior to VKA with regards to stroke and systemic embolism and are at...
Source: European Journal of Heart Failure Supplements - December 21, 2016 Category: Cardiology Authors: Verheugt, F. W. A. Tags: Articles Source Type: research
New frontiers in anticoagulation: non vitamin-K oral anticoagulants in stroke prevention.
Authors: Arnao V, Riolo M, Tuttolomondo A, Pinto A, Fierro B, Aridon P
Abstract
INTRODUCTION: Non vitamin-K oral anticoagulants (NOACs) are direct and specific inhibitors of the coagulation factors IIa (dabigatran) and Xa (apixaban, rivaroxaban, edoxaban) which share many pharmacokinetic properties. However, indications are lacking regarding the use of NOACs during thrombolysis, surgery and bleeding events. Areas covered: In this paper, the authors retrospectively analyzed the relevant literature on the NOACs using the PubMed and Google Scholar databases. Expert Commentary: Although warfarin is effective in cardioembo...
Source: Expert Review of Neurotherapeutics - December 3, 2016 Category: Neurology Tags: Expert Rev Neurother Source Type: research
Vitamin K antagonists: relative strengths and weaknesses vs. direct oral anticoagulants for stroke prevention in patients with atrial fibrillation
This article reviews and highlights real and perceived implications of VKAs for the prevention of stroke in patients with non-valvular AF, with specific reference to their strengths and weaknesses compared with DOACs.
Source: Journal of Thrombosis and Thrombolysis - November 27, 2016 Category: Hematology Source Type: research
Practical Considerations for the Use of Direct Oral Anticoagulants in Patients With Atrial Fibrillation
Atrial fibrillation (AF) is a significant risk factor for stroke and peripheral thromboembolic events (TEs). Preventing blood clots in the heart to reduce stroke and TE risk is a key goal of AF therapy. Traditional stroke risk assessment tools for patients with nonvalvular AF include the CHADS2 and CHA(2)DS(2)-VASc scores, while long-term outcome data with the newer direct oral anticoagulants (DOACs) are emerging. The goals of this review were to assess traditional therapies and existing treatment guidelines and to discuss key pharmacologic properties of the DOACS, noting how these may benefit at-risk patients with AF. Thi...
Source: Clinical and Applied Thrombosis/Hemostasis - November 27, 2016 Category: Hematology Authors: Stacy, Z., Richter, S. Tags: Review Source Type: research
Enrollment completed for RE-DUAL PCI study of 2,700 atrial fibrillation patients
(WHITECOAT STRATEGIES, LLC) The Baim Institute announces that patient enrollment into the international Phase IIIb RE-DUAL PCI study is complete. The study evaluates the safety and efficacy of dabigatran etexilate (marketed as Pradaxa ® ) in atrial fibrillation patients undergoing a percutaneous coronary intervention with stent placement. This is the first time that two dosages of a non-vitamin K antagonist oral anticoagulant already approved for stroke prevention in AF are evaluated in a dual versus triple antithrombotic regimen after PCI.
Source: EurekAlert! - Medicine and Health - November 14, 2016 Category: Global & Universal Source Type: news
