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Use of Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention across the Stroke Spectrum: Progress and Prospects.
Abstract Multiple randomized controlled trials and many real-world evidence studies have consistently shown that non-vitamin K antagonist oral anticoagulants (NOACs) are preferable to vitamin K antagonists for thromboembolic stroke prevention in the majority of patients with atrial fibrillation (AF). However, their role in the management of patients with AF and comorbidities, as well as in other patient populations with a high risk of stroke, such as patients with prior embolic stroke of undetermined source (ESUS) and those with atherosclerosis, is less clear. There is now increasing evidence suggesting that NOACs...
Source: Thrombosis and Haemostasis - January 7, 2021 Category: Hematology Authors: Camm AJ, Atar D Tags: Thromb Haemost Source Type: research

Beyond Stroke Prevention in Atrial Fibrillation: Exploring Further Unmet Needs with Rivaroxaban.
This article provides an update on three randomized controlled trials of rivaroxaban, a direct, oral factor Xa inhibitor, that are complete or are ongoing, in these unmet areas of stroke prevention: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in patients with Atrial Fibrillation who undergo Percutaneous Coronary Intervention (PIONEER AF-PCI) trial; the New Approach riVaroxaban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE E...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Gibson CM, Hankey GJ, Nafee T, Welsh RC Tags: Thromb Haemost Source Type: research

Circulating desphospho-uncarboxylated matrix Gla protein and the risk of coronary heart disease and stroke.
CONCLUSION: The average follow-up was 11.5 years. Dp-ucMGP concentrations were not associated with CHD risk with a HR per SD of 1.00 (95% CI: 0.93-1.07) and a HR Q4 vs Q1 of 0.94 (95% CI: 0.79-1.13) after adjustment for cardiovascular risk factors. Dp-ucMGP was not associated with stroke risk (HRSD 0.98;95% CI: 0.90-1.08 and a HR Q4 vs Q1 of 1.09;95% CI: 0.78-1.51). This study could not confirm that high dp-ucMGP concentrations, reflecting a poor vitamin K status, are associated with increased CHD or stroke risk in the general population. This article is protected by copyright. All rights reserved. PMID: 24826813 [Pub...
Source: Thrombosis and Haemostasis - May 15, 2014 Category: Hematology Authors: Dalmeijer GW, van der Schouw YT, Magdeleyns EJ, Vermeer C, Verschuren WM, Boer JM, Beulens JW Tags: J Thromb Haemost Source Type: research

Spotlight on unmet needs in stroke prevention: The PIONEER AF-PCI, NAVIGATE ESUS and GALILEO trials.
This article focuses on three randomised controlled trials (RCTs) that are investigating the utility of rivaroxaban, a direct, oral, factor Xa inhibitor, in additional areas of stroke prevention where data for anticoagulants are lacking: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment (PIONEER AF-PCI); New Approach riVaroxoban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE ESUS); and Global study comparing a rivAroxaban-based antithrombo...
Source: Thrombosis and Haemostasis - September 13, 2016 Category: Hematology Authors: Hemmrich M, Peterson ED, Thomitzek K, Weitz JI Tags: Thromb Haemost 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

Anticoagulation use and the risk of stroke and major bleeding in patients on hemodialysis: From the VIVALDI, a population-based prospective cohort study
CONCLUSIONS: Although the non-randomized nature of the study is prone to bias, anticoagulation with VKA was not associated with decreased thromboembolic risk, but associated with increased risk of major bleeding and may be net-harmful to patients with AF on HD.PMID:34418291 | DOI:10.1111/jth.15508
Source: Thrombosis and Haemostasis - August 21, 2021 Category: Hematology Authors: Oliver K önigsbrügge Hannah Meisel Aljoscha Beyer Sabine Schmaldienst Renate Klauser-Braun Matthias Lorenz Martin Auinger Josef Kletzmayr Manfred Hecking Wolfgang C Winkelmayer Irene Lang Ingrid Pabinger Marcus S äemann Cihan Ay Source Type: research

Survey on APS diagnosis and antithrombotic treatment in patients with ischaemic stroke, other brain ischaemic injury or arterial thromboembolism in other sites: Communication from ISTH SSC Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibodies (LA/aPL)
CONCLUSIONS: Much of the variation in practice reflects the lack of evidence-based recommendations. The survey results should inform the development of a more uniform multidisciplinary consensus approach to diagnosis and antithrombotic treatment.PMID:37391096 | DOI:10.1016/j.jtha.2023.06.020
Source: Thrombosis and Haemostasis - June 30, 2023 Category: Hematology Authors: Hannah Cohen David J Werring Arvind Chandretheva Prabal Mittal Katrien M J Devreese David A Isenberg ISTH SSC LA/aPL Subcommittee Study Group Source Type: research

Circulating protein Z concentration, PROZ variants, and unexplained cerebral infarction in young and middle-aged adults.
Abstract Protein Z (PZ) is a vitamin K-dependent plasma protein that exhibits both pro- and anticoagulant properties. Both low and high PZ levels have been linked to ischaemic stroke. Although PZ-lowering gene variants have been found to be less common in ischaemic stroke, the relationship remains unclear. We investigated PZ levels and PROZ variants in a multi-ethnic case-control study of unexplained stroke in participants aged 18 to 64. Plasma PZ was measured in cases (≥2 months post-stroke) and controls. PZ polymorphisms G79A (rs3024735) and A13G (2273971) were genotyped. A combined genetic score (0-4 minor al...
Source: Thrombosis and Haemostasis - September 28, 2016 Category: Hematology Authors: Zhang L, Segal AZ, Leifer D, Silverstein RL, Gerber LM, Devereux RB, Kizer JR Tags: Thromb Haemost Source Type: research

Long-Term Treatment with Apixaban in Patients with Atrial Fibrillation: Outcomes during the Open-Label Extension following AVERROES.
CONCLUSION:  During the open-label extension, annual rates of stroke or systemic embolism, hemorrhagic stroke, and major bleeding remained as low as those observed during apixaban treatment in AVERROES. These data support the long-term efficacy and safety of apixaban in patients with atrial fibrillation. PMID: 33011964 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - October 3, 2020 Category: Hematology Authors: Benz AP, Eikelboom JW, Yusuf S, Hohnloser SH, Kahl A, Beresh H, Balasubramanian K, Healey JS, Connolly SJ Tags: Thromb Haemost Source Type: research

Efficacy and Safety of Nonvitamin K Oral Anticoagulants in Patients with Atrial Fibrillation and Cancer: A Study-Level Meta-Analysis.
CONCLUSION:  In AF patients with malignancy, NOACs appear at least as effective as VKAs in preventing thrombotic events and reduce intracranial bleeding. NOACs may represent a valid and more practical alternative to VKAs in this setting of high-risk patients. PMID: 31785599 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - November 29, 2019 Category: Hematology Authors: Cavallari I, Verolino G, Romano S, Patti G Tags: Thromb Haemost Source Type: research

D-dimer and risk of thromboembolic and bleeding events in patients with atrial fibrillation - observations from the ARISTOTLE trial.
CONCLUSION: In anticoagulated patients with AF the level of D-dimer is related to the risk of stroke, death and bleeding and adds to the predictive value of clinical risk scores. The benefits of apixaban were consistent regardless of the baseline D-dimer level. This article is protected by copyright. All rights reserved. PMID: 24942912 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - June 18, 2014 Category: Hematology Authors: Christersson C, Wallentin L, Andersson U, Alexander JH, Ansell J, De Caterina R, Gersh BJ, Granger CB, Hanna M, Horowitz JD, Huber K, Husted S, Hylek EM, Lopes RD, Siegbahn A Tags: J Thromb Haemost Source Type: research

Effect of Oral Anticoagulants in Atrial Fibrillation Patients with Polypharmacy: A Meta-analysis
CONCLUSION: In patients with AF and polypharmacy, NOACs showed advantages over VKAs in stroke or systemic embolism and any bleeding, and were comparable to VKAs for major bleeding, ischemic stroke, all-cause death, intracranial hemorrhage, and gastrointestinal bleeding.PMID:37399842 | DOI:10.1055/s-0043-1770724
Source: Thrombosis and Haemostasis - July 3, 2023 Category: Hematology Authors: Yuxiang Zheng Siyuan Li Xiao Liu Gregory Y H Lip Linjuan Guo Wengen Zhu Source Type: research

Oral anticoagulant use in patients with morbid obesity: A systematic review and meta-analysis
CONCLUSIONS: Patients with morbid obesity on DOACs had similar risks of stroke/systemic embolism, lower rates of recurrent VTE and major bleeding events compared to those on VKAs. However, the certainty of evidence was low given that studies were mostly observational with high risk of confounding.PMID:34399433 | DOI:10.1055/a-1588-9155
Source: Thrombosis and Haemostasis - August 16, 2021 Category: Hematology Authors: Tzu-Fei Wang Marc Carrier Karine Fournier Deborah M Siegal Gr égoire Le Gal Aur élien Delluc Source Type: research

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