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Efficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis
CONCLUSIONS: Among AF patients with ESRD on chronic hemodialysis, the risk of ischemic stroke, ischemic stroke or systemic embolism, minor bleeding, major bleeding, and all-cause mortality is similar in patients treated with DOACs compared to VKAs. Given that the meta-analysis of RCTs on gastrointestinal bleeding did not confirm the results of the meta-analysis of the observational studies, it cannot be concluded that gastrointestinal bleeding is lower among DOAC-treated patients.PROTOCOL REGISTRATION: PROSPERO CRD42023391966.PMID:37648582 | DOI:10.1016/j.ejim.2023.08.020
Source: European Journal of Internal Medicine - August 30, 2023 Category: Internal Medicine Authors: Ioannis Kyriakoulis Anastasia Adamou Iliana Stamatiou David Dimitris Chlorogiannis Ioannis Kardoutsos Despoina Koukousaki George Ntaios Source Type: research

A new strategy for anticoagulation: The factor XI inhibitors
Eur J Intern Med. 2023 Aug 4:S0953-6205(23)00284-4. doi: 10.1016/j.ejim.2023.08.001. Online ahead of print.ABSTRACTDirect oral anticoagulants (DOACs) are currently the first-choice therapy for the prevention of cardioembolic events in patients with atrial fibrillation and for the treatment of venous thromboembolism (VTE) due to their more favorable efficacy to safety profile in comparison to vitamin K antagonists (VKA). DOACs did not show a clinical benefit when used for in stroke prevention in patients with mechanic or rheumatic valves or in those who underwent transcatheter aortic valve implantation (TAVI), in the treatm...
Source: European Journal of Internal Medicine - August 6, 2023 Category: Internal Medicine Authors: Maria Cristina Vedovati Cecilia Becattini Giancarlo Agnelli Source Type: research

Warfarin-induced isolated spontaneous subarachnoid hemorrhage: Rare case report
CONCLUSION: Warfarin is rarely associated with isolated subarachnoid hemorrhage. This case highlights a young male patient with spontaneous SAH after warfarin therapy for acute ischemic stroke. Aneurysmal rupture and trauma should be excluded before a diagnosis of warfarin-induced SAH is made.PMID:36582886 | PMC:PMC9793204 | DOI:10.1016/j.amsu.2022.104946
Source: Annals of Medicine - December 30, 2022 Category: Internal Medicine Authors: Mohamed Sheikh Hassan Ahmet Bakir Bakar Ali Adam Nor Osman Sidow Abdiwahid Ahmed Ibrahim Ishak Ahmed Abdi Mohamud Mire Waberi Source Type: research

Delaying clinical events among patients with non-valvular atrial fibrillation treated with oral anticoagulants: Insights from the ARISTOPHANES study
CONCLUSIONS: Over 12 months after initiation, apixaban and dabigatran conferred progressive increases in event free time for stroke/SE and MB vs warfarin, whereas rivaroxaban conferred an increase in stroke/SE-free time but a loss in MB-free time vs warfarin.PMID:36456387 | DOI:10.1016/j.ejim.2022.10.021
Source: European Journal of Internal Medicine - December 1, 2022 Category: Internal Medicine Authors: Steven Deitelzweig Allison Keshishian Amiee Kang Aaron Jenkins Nipun Atreja Patricia Schuler Jenny Jiang Huseyin Yuce Xiaoxi Sun Gregory Y H Lip Source Type: research

Dual therapy with an oral non-vitamin K antagonist and a P2Y12 inhibitor vs triple therapy with aspirin, a P2Y12 inhibitor and a vitamin K antagonist for the treatment of diabetes mellitus patients with co-existing atrial fibrillation following percutaneous coronary intervention: A meta-analysis
Conclusions: DT with a NOAC and a P2Y12 inhibitor was associated with significantly less bleeding events without increasing the adverse cardiovascular outcomes when compared to TT with aspirin, a P2Y12 inhibitor and a Vitamin K antagonist for the treatment of DM patients with co-existing AF following PCI. Hence, DT is comparable in efficacy, but safer compared to TT. This interesting hypothesis will have to be confirmed in future studies.
Source: Medicine - April 16, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

The risk of gastrointestinal hemorrhage with non-vitamin K antagonist oral anticoagulants: A network meta-analysis
Conclusion: Individual NOACs had varying profiles of GI bleeding risk. Results of analyses including only RCTs and those including both RCTs and population studies showed similar trends, but also showed several differences.
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Meta-analysis of the efficacy and safety of non-vitamin K antagonist oral anticoagulants with warfarin in Latin American patients with atrial fibrillation
Conclusions: Our meta-analysis suggested that the use of NOACs was at least non-inferior to warfarin use for stroke prevention in Latin American patients with AF.
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Dual Versus Triple Therapy for Atrial Fibrillation After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.
Conclusion: In adults with AF after PCI, dual therapy reduces risk for bleeding compared with triple therapy, whereas its effects on risks for death and ischemic end points are still unclear. Primary Funding Source: None. PMID: 32176890 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - March 16, 2020 Category: Internal Medicine Authors: Khan SU, Osman M, Khan MU, Khan MS, Zhao D, Mamas MA, Savji N, Al-Abdouh A, Hasan RK, Michos ED Tags: Ann Intern Med Source Type: research

Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome: A Randomized Noninferiority Trial.
Conclusion: Rivaroxaban did not show noninferiority to dose-adjusted VKAs for thrombotic APS and, in fact, showed a non-statistically significant near doubling of the risk for recurrent thrombosis. Primary Funding Source: Bayer Hispania. PMID: 31610549 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 14, 2019 Category: Internal Medicine Authors: Ordi-Ros J, Sáez-Comet L, Pérez-Conesa M, Vidal X, Riera-Mestre A, Castro-Salomó A, Cuquet-Pedragosa J, Ortiz-Santamaria V, Mauri-Plana M, Solé C, Cortés-Hernández J Tags: Ann Intern Med Source Type: research

Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis.
Conclusion: In early-stage CKD, NOACs had a benefit-risk profile superior to that of VKAs. For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs or NOACs. Primary Funding Source: None. (PROSPERO: CRD42017079709). PMID: 31307056 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - July 15, 2019 Category: Internal Medicine Authors: Ha JT, Neuen BL, Cheng LP, Jun M, Toyama T, Gallagher MP, Jardine MJ, Sood MM, Garg AX, Palmer SC, Mark PB, Wheeler DC, Jha V, Freedman B, Johnson DW, Perkovic V, Badve SV Tags: Ann Intern Med Source Type: research

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