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Specialty: General Medicine
Drug: Coumadin

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Total 209 results found since Jan 2013.

Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis.
Abstract BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009). ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Khan NA, McAlister FA, Pilote L, Palepu A, Quan H, Hill MD, Fang J, Kapral MK Tags: CMAJ Open Source Type: research

Left Atrial Appendage Closure Device With Delivery System: A Health Technology Assessment.
CONCLUSIONS: Moderate-quality evidence suggests that the LAAC device is as effective as novel oral anticoagulants in preventing stroke in people with nonvalvular atrial fibrillation. However, our results indicate that the LAAC device is cost-effective only in patients with contraindications to oral anticoagulants. People with nonvalvular atrial fibrillation with whom we spoke reported positive support for the LAAC device. PMID: 28744335 [PubMed - in process]
Source: Ontario Health Technology Assessment Series - July 28, 2017 Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research

Comparative effectiveness of rivaroxaban in the treatment of nonvalvular atrial fibrillation.
Authors: Norby FL, Alonso A Abstract Rivaroxaban is a direct oral anticoagulant (DOAC) approved for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, a common arrhythmia. In this review, we summarize the effectiveness of rivaroxaban versus warfarin and the DOACs dabigatran, apixaban and edoxaban. The primary focus is on primary evidence from clinical trials, indirect comparison studies and real-world studies. While there are gaps in the literature, the evidence thus far indicates that rivaroxaban is superior to warfarin and similar to dabigatran, apixaban and edoxaban ...
Source: Journal of Comparative Effectiveness Research - July 25, 2017 Category: General Medicine Tags: J Comp Eff Res Source Type: research

Efficacy and Safety of Apixaban Versus Warfarin in Patients with Atrial Fibrillation and a History of Cancer: Insights From the ARISTOTLE Trial
• Cancer and atrial fibrillation frequently coexist, yet there are few data to guide care in this population.• No significant associations between history of cancer and the risk of stroke/systemic embolism, major bleeding, or mortality were observed.• The safety and efficacy of apixaban versus warfarin appear to be preserved among patients with and without active cancer.
Source: The American Journal of Medicine - July 21, 2017 Category: General Medicine Authors: Chiara Melloni, Allison Dunning, Christopher B. Granger, Laine Thomas, Michel G. Khouri, David A. Garcia, Elaine M. Hylek, Michael Hanna, Lars Wallentin, Bernard J. Gersh, Pamela S. Douglas, John H. Alexander, Renato D. Lopes Tags: Clinical Research Study Source Type: research

Re-initiation of oral-anticoagulants in survivors of hemorrhagic stroke
Publication date: Available online 22 May 2017 Source:Apollo Medicine Author(s): Pushpendra Nath Renjen, Dinesh Chaudhari Intra-cerebral hemorrhage (ICH) is the most feared and the deadliest complication of oral anticoagulant therapy, i.e. warfarin (Coumadin). After such an occurrence, clinicians wonder whether their patients should resume anticoagulant therapy. The decisions to reverse and re-initiate anticoagulation hinge on the phase of stroke as the risk of thromboembolism outweighs risk of bleeding in the chronic phase. Hence in the short term, most patients with ICH will benefit from acute reversal of anticoagulatio...
Source: Apollo Medicine - July 21, 2017 Category: General Medicine Source Type: research

Comment Cerebral amyloid angiopathy and implications for atrial fibrillation management
Atrial fibrillation, the most common arrhythmia in adults, will increase in prevalence as the population ages.1 The risk of embolic stroke in atrial fibrillation also increases with age. Treatments for the prevention of embolic stroke include warfarin, direct oral anticoagulant agents, and non-anticoagulation strategies such as left atrial appendage occlusion.1 Current scores to estimate the risk of ischaemic stroke (CHA2DS2-VaSc score) or haemorrhage (HAS-BLED score) help guide intervention, but do not account for cerebral amyloid angiopathy (CAA), a prevalent, but overlooked condition.
Source: LANCET - June 29, 2017 Category: General Medicine Authors: Christopher V DeSimone, Jonathan Graff-Radford, Majd A El-Harasis, Alejandro A Rabinstein, Samuel J Asirvatham, David R Holmes Tags: Comment Source Type: research

Once- or twice-daily non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation: A  meta-analysis of randomized controlled trials
Conclusions In Asian patients with AF, NOACs, regardless of dosing regimens, have a similar feature of preserved efficacy with improved safety compared with warfarin.
Source: Journal of the Formosan Medical Association - June 21, 2017 Category: General Medicine Source Type: research

Once- or twice-daily non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation: A  meta-analysis of randomized controlled trials.
CONCLUSIONS: In Asian patients with AF, NOACs, regardless of dosing regimens, have a similar feature of preserved efficacy with improved safety compared with warfarin. PMID: 28645443 [PubMed - as supplied by publisher]
Source: J Formos Med Assoc - June 20, 2017 Category: General Medicine Authors: Wang KL, Chiu CC, Su-Yin Tan D, Lin CY, Lai EY, Goto S, Giugliano RP, Chiang CE Tags: J Formos Med Assoc Source Type: research

The anticoagulation choices of internal medicine residents for stroke prevention in non-valvular atrial fibrillation
Conclusions Canadian internal medicine residents favoured warfarin over NOACs for patients with NVAF, which is in discordance with the evidence-based CCS guidelines. This finding persisted throughout the 3 years of core internal medicine training.
Source: Postgraduate Medical Journal - May 25, 2017 Category: General Medicine Authors: Moulson, N., McIntyre, W. F., Oqab, Z., Yazdan-Ashoori, P., Quinn, K. L., van Oosten, E., Hopman, W. M., Baranchuk, A. Tags: Drugs: cardiovascular system, Stroke, Arrhythmias Original article Source Type: research

Renal function considerations for stroke prevention in atrial fibrillation
Renal impairment increases risk of stroke and systemic embolic events and bleeding in patients with atrial fibrillation. Direct oral anticoagulants have varied dependence on renal elimination, magnifying the importance of appropriate patient selection, dosing, and periodic kidney function monitoring. In randomized controlled trials of nonvalvular atrial fibrillation, direct oral anticoagulants were at least as effective and associated with less bleeding compared with warfarin. Each direct oral anticoagulant was associated with reduced risk of stroke and systemic embolic events and major bleeding compared with warfarin in n...
Source: The American Journal of Medicine - May 11, 2017 Category: General Medicine Authors: John Fanikos, Allison E. Burnett, Charles E. Mahan, Paul P. Dobesh Tags: Review Source Type: research

Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report
ConclusionsThis case raises the issue of the ineffectiveness of warfarin therapy in complex cases involving particular thrombophilic conditions and the possibility of using rivaroxaban as a safe and effective alternative.
Source: Journal of Medical Case Reports - April 9, 2017 Category: Journals (General) Source Type: research

Edoxaban: How Does the Newest Agent Fit into the DOAC Landscape?
Edoxaban is the most recently approved factor Xa inhibitor within the class of direct oral anticoagulants (DOACs). Like other DOACs, edoxaban was approved by the US Food and Drug Administration for treatment of venous thromboembolism and prevention of stroke in patients with nonvalvular atrial fibrillation. Similar to other DOACs, edoxaban has fewer drug –drug interactions than warfarin and does not require routine laboratory monitoring. Unlike other DOACs, edoxaban has yet to be approved for secondary or postoperative venous thromboembolism thromboprophylaxis.
Source: The American Journal of Medicine - April 5, 2017 Category: General Medicine Authors: Caitlin M. Gibson, Shannon W. Finks Tags: Review Source Type: research

Edoxaban: Defining place in therapy for the newest direct acting oral anticoagulant
Edoxaban is the most recently approved factor Xa inhibitor within the class of direct oral anticoagulants (DOACs). Like other DOACs, edoxaban was approved by the FDA for treatment of venous thromboembolism and prevention of stroke in patients with non-valvular atrial fibrillation. Similar to other DOACs, edoxaban has fewer drug-drug interactions than warfarin and does not require routine laboratory monitoring. Unlike other DOACs, edoxaban has yet to be approved for secondary or postoperative venous thromboembolism thromboprophylaxis.
Source: The American Journal of Medicine - April 5, 2017 Category: Journals (General) Authors: Caitlin M. Gibson, Shannon W. Finks Tags: Review Source Type: research

Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: an observational study
The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR. Methods Patients enrolled between Dec 22, 2014, and Jan 18, 2017, in the RESOLVE registry, and between June 2, 2014, and Sept 28, 2016, in the SAVORY registry, had CT imaging done with a dedicated four-dimensional volume-rendered imaging protocol at varying int...
Source: The Lancet - March 18, 2017 Category: Journals (General) Source Type: research

Atrial fibrillation patients who sustained warfarin-associated intracerebral haemorrhage have poor neurological outcomes: results from a matched case series.
CONCLUSION: Warfarin-associated intracerebral haemorrhage in patients with atrial fibrillation carried a higher stroke mortality than the non-warfarinised patients. PMID: 28232641 [PubMed - as supplied by publisher]
Source: Hong Kong Med J - February 23, 2017 Category: Journals (General) Authors: Fong MK, Sheng B, Chu YP, Wong WT, Lau PP, Wong HY, Lau KK Tags: Hong Kong Med J Source Type: research