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Total 1455 results found since Jan 2013.

Management of Patients with Embolic Stroke of Unknown Source: Interpreting the Evidence in the Light of Clinical Judgement
AbstractPurpose of ReviewTo assess the validity of the belief that anticoagulation is not beneficial in patients with embolic stroke of unknown source (ESUS), and to asssess the benefits and safety of direct-acting oral anticoagulants (DOACs).Recent FindingsThe failure of randomized trials to show benefit of anticoagulation in ESUS is probably due to misclassification of large artery atherosclerosis (LAA) as ESUS, as defined by a stenosis  ≥ 50%. There are important differences among DOACs. There are a number of problems with dabigatran, and rivaroxaban and edoxaban are not suitable for once-daily dosing. Recent evid...
Source: Current Neurology and Neuroscience Reports - May 7, 2022 Category: Neuroscience 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

Plasma levels of direct oral anticoagulants in atrial fibrillation patients at the time of embolic stroke: a pilot prospective multicenter study
ConclusionThis observational study showed significantly lower anti-IIa and anti-Xa plasma levels in AF patients with embolic stroke compared to those who tolerated long-term therapeutic dose DOAC therapy.
Source: European Journal of Clinical Pharmacology - March 16, 2022 Category: Drugs & Pharmacology Source Type: research

Dabigatran versus vitamin K antagonists for atrial fibrillation in clinical practice: final outcomes from Phase III of the GLORIA-AF registry
ConclusionsDabigatran was associated with a 39% reduced risk of major bleeding and 22% reduced risk for all-cause death compared with VKA. Stroke and myocardial infarction risks were similar, confirming a more favorable benefit-risk profile for dabigatran compared with VKA in clinical practice.Clinical trial registrationhttps://www.clinicaltrials.gov. NCT01468701, NCT01671007.Graphical abstract
Source: Clinical Research in Cardiology - March 16, 2022 Category: Cardiology Source Type: research

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry
ConclusionsPatients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death.RegistrationURL:https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013.Graphical abstract
Source: Clinical Research in Cardiology - March 16, 2022 Category: Cardiology Source Type: research

Dabigatran versus vitamin K antagonists for atrial fibrillation in clinical practice: final outcomes from Phase III of the GLORIA-AF registry
ConclusionsDabigatran was associated with a 39% reduced risk of major bleeding and 22% reduced risk for all-cause death compared with VKA. Stroke and myocardial infarction risks were similar, confirming a more favorable benefit-risk profile for dabigatran compared with VKA in clinical practice.Clinical trial registrationhttps://www.clinicaltrials.gov. NCT01468701, NCT01671007.Graphical abstract
Source: Clinical Research in Cardiology - March 16, 2022 Category: Cardiology Source Type: research

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry
ConclusionsPatients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death.RegistrationURL:https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013.Graphical abstract
Source: Clinical Research in Cardiology - March 16, 2022 Category: Cardiology Source Type: research

Monitoring of Direct Oral Anticoagulants Plasma Levels for Secondary Stroke Prevention
CONCLUSIONS: Monitoring of DOAC plasma levels could help to identify patients with increased risk for stroke recurrence and should be considered for certain subgroups, including patients with high GFR.PMID:35171533 | DOI:10.1111/jth.15677
Source: Thrombosis and Haemostasis - February 16, 2022 Category: Hematology Authors: Gabriela Siedler Kosmas Macha Svenja Stoll Johannes Plechschmidt Ruihao Wang Stefan T Gerner Erwin Strasser Stefan Schwab Bernd Kallm ünzer Source Type: research

Effectiveness and safety of oral anticoagulants in elderly patients with atrial fibrillation
Conclusion In this nationwide cohort study of patients ≥75 years initiating oral anticoagulation for AF, standard and reduced dose NOACs were associated with similar risks of stroke/SE as warfarin and lower or similar risks of bleeding. The NOACs seem to be a safe option also in elderly patients.
Source: Heart - February 16, 2022 Category: Cardiology Authors: Rutherford, O.-C. W., Jonasson, C., Ghanima, W., Söderdahl, F., Halvorsen, S. Tags: Open access Arrhythmias and sudden death Source Type: research

Non-Vitamin K Oral Anticoagulant After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis
Conclusion: For patients with an indication for oral anticoagulation after TAVR, NOACs seem to be associated with noninferior outcomes compared with VKA therapy. However, for patients without an indication for oral anticoagulation, NOACs appear to be associated with a higher risk of all-cause death as compared with antiplatelet treatment.Systematic Review Registration:https://clinicaltrials.gov/, identifier CRD42020155122.
Source: Frontiers in Pharmacology - February 11, 2022 Category: Drugs & Pharmacology Source Type: research

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary Source Type: research

Prothrombin complex concentrate in the management of major bleeding induced by oral anticoagulant therapy
CONCLUSION: Prothrombin complex concentrate can effectively reverse the effects of warfarin and rivaroxaban in patients with major bleeding, but only partially reverses the effect of dabigatran.PMID:35110348 | DOI:10.15537/smj.2022.43.2.20210736
Source: Saudi Medical Journal - February 3, 2022 Category: Middle East Health Authors: Mohammed AlSheef Ghaydaa Kullab Modhi Alajmi Ruba Aldhaheri Sultan Al Baqmi Haya Alajlan Abdul Rehman Z Zaidi Amani Abu-Shaheen Source Type: research