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Condition: Hemorrhagic Stroke
Drug: Warfarin

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Total 721 results found since Jan 2013.

The Yield of Computed Tomography of the Head Among Patients Presenting With Syncope: A Systematic Review.
CONCLUSION: More than half of patients with syncope underwent CT head with a diagnostic yield of 1.1% to 3.8%. A future large prospective study is needed to develop a robust risk tool. PMID: 31006937 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - April 21, 2019 Category: Emergency Medicine Authors: Viau JA, Chaudry H, Hannigan A, Boutet M, Mukarram M, Thiruganasambandamoorthy V Tags: Acad Emerg Med Source Type: research

New Biomarkers for Atherothrombosis in Antiphospholipid Syndrome: Genomics and Epigenetics Approaches
Conclusions In recent years, there have been many advances in the understanding of the molecular basis for vascular involvement in APS, but many areas need to be further investigated, in particular the association between altered genetic/epigenetic profiles, autoantibodies and clinical manifestations, and the effectiveness of new therapeutic strategies. It would be interesting to apply next generation sequencing technologies like RNA-Seq along with GWAS to screen both, the gene profile and the whole transcriptome of large cohorts of primary APS patients, in order to reveal the mutations/polymorphisms, post-transcriptiona...
Source: Frontiers in Immunology - April 15, 2019 Category: Allergy & Immunology Source Type: research

Novel Oral Anticoagulants for the Prevention of Stroke in Patients with Atrial Fibrillation and Hypertension: A Meta-Analysis
ConclusionsOur findings suggest that NOACs can be recommended for the prevention of stroke or systemic embolism in patients with AF and hypertension.
Source: American Journal of Cardiovascular Drugs - March 31, 2019 Category: Cardiology Source Type: research

The use of anticoagulants in chronic kidney disease: Common point of view of cardiologists and nephrologists.
Abstract In patients diagnosed with chronic kidney disease (CKD), atrial fibrillation (AF) is associated with an increased risk of thromboembolism and stroke. Moreover, patients with CKD - especially those in end-stage renal disease - also present an increased risk of bleeding. Oral anticoagulation is the most effective form of thromboprophylaxis in patients with AF and an increased risk of stroke. However, the underuse of these drugs was observed, mainly due to safety reasons and restricted evidence on efficacy. Much evidence suggests that non-vitamin K-dependent oral anticoagulant agents significantly reduce the...
Source: Cardiology Journal - March 25, 2019 Category: Cardiology Authors: Domienik-Karłowicz J, Tronina O, Lisik W, Durlik M, Pruszczyk P Tags: Cardiol J Source Type: research

Novel Oral Anticoagulants in Patients with Continuous Flow Left Ventricular Assist Devices
The gold standard for anticoagulation in patients with continuous flow left ventricular assist device (CF-LVADs) is warfarin. However, many patients fail warfarin therapy due to thromboembolic and bleeding events. Warfarin requires regular monitoring and dosage adjustments, and is associated with significant patient time outside recommended therapeutic INR range. Novel oral anticoagulation (NOAC) has been shown to be non-inferior compared to warfarin in stroke prevention with less intracranial hemorrhage in patients with atrial fibrillation.
Source: The Journal of Heart and Lung Transplantation - March 16, 2019 Category: Transplant Surgery Authors: V. Parikh, U. Parikh, A.M. Ramirez, H. Lamba, J. George, S. Fedson, F. Cheema, A. Civitello, A. Nair, A. Shafii, G. Loor, T. Rosengart, O. Frazier, J. Morgan, R. Delgado Tags: 1072 Source Type: research

Percutaneous devices for left atrial appendage occlusion: A contemporary review.
Abstract Patient with atrial fibrillation (AF) are at risk of developing stroke with the left atrial appendage (LAA) being the most common site for thrombus formation. If left untreated, AF is associated with 4 to 5 folds increase in the risk of ischemic stroke in all age groups. About 5% to 15% of AF patients have atrial thrombi on transesophageal echocardiography, and 91% of those thrombi are located in the LAA in patient with nonrheumatic AF. Although oral anticoagulants are the gold-standard treatment for stroke prevention in patients with non-valvular AF, some patients are at high risk of bleeding and deemed ...
Source: World Journal of Cardiology - February 25, 2019 Category: Cardiology Authors: Moussa Pacha H, Al-Khadra Y, Soud M, Darmoch F, Moussa Pacha A, Alraies MC Tags: World J Cardiol Source Type: research

Reversal and Resumption of Antithrombotic Therapy in LVAD- Associated Intracranial Hemorrhage
ConclusionsReversal of anticoagulation appears safe following LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin±antiplatelet was associated with fewer fatal and non-fatal thrombotic events compared to antiplatelets alone, though more non-fatal hemorrhage events occurred.
Source: The Annals of Thoracic Surgery - February 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Reader response: Traumatic and spontaneous intracranial hemorrhage in patients with atrial fibrillation on warfarin
We read with interest the study by Lehtola et al.1 Anticoagulation (AC) in atrial fibrillation (AF) reduces the risk of ischemic stroke, but at the cost of increasing the risk of hemorrhagic stroke.
Source: Neurology Clinical Practice - February 12, 2019 Category: Neurology Authors: Vilanilam, G. K., Gopal, N., Agarwal, A., Badi, M. K. Tags: The Nerve! Readers Speak Source Type: research

Non-vitamin K antagonist oral anticoagulants with amiodarone, P-glycoprotein inhibitors, or polypharmacy in patients with atrial fibrillation: Systematic review and meta-analysis.
CONCLUSIONS: NOACs were equivalent to warfarin among AF patients with concomitant amiodarone use in terms of efficacy, safety, and mortality. There was no safety benefit of NOACs over warfarin in patients using polypharmacy or P-glycoprotein inhibitors. SYSTEMATIC REVIEW REGISTRATION: The protocol of this meta-analysis was registered on PROSPERO under CRD42018104808 (https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42018104808). PMID: 30770140 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - February 12, 2019 Category: Cardiology Authors: Kim IS, Kim HJ, Yu HT, Kim TH, Uhm JS, Kim JY, Joung B, Lee MH, Pak HN Tags: J Cardiol Source Type: research

Reversal and Resumption of Antithrombotic Therapy in LVAD- Associated Intracranial Hemorrhage.
CONCLUSIONS: Reversal of anticoagulation appears safe following LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin±antiplatelet was associated with fewer fatal and non-fatal thrombotic events compared to antiplatelets alone, though more non-fatal hemorrhage events occurred. PMID: 30763560 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - February 11, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Cho SM, Moazami N, Katz S, Starling R, Frontera JA Tags: Ann Thorac Surg Source Type: research

Safety of direct oral anticoagulants in real world clinical practice: translating the trials to everyday clinical management.
Authors: Fawzy AM, Yang WY, Lip GY Abstract INTRODUCTION: Direct oral anticoagulants (DOACs) may be regarded as some of the most successful innovations in recent times. These drugs which were specifically developed to overcome the challenges posed by warfarin did just that and in the process, have changed the outlook towards stroke prevention with anticoagulation. The decade of experience with these drugs that has resulted in the availability of large scale data on their safety profile has aided this. Areas covered: This review examines existing real-world studies and their interpretation to better appreciate how t...
Source: Expert Opinion on Drug Safety - February 5, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research

Low-Dose Prothrombin Complex Concentrate in Patients with Left Ventricular Assist Devices
We describe two cases of warfarin reversal with low-dose 4-factor PCC (4F-PCC) in two different LVAD patient scenarios. Low-dose 4F-PCC was administered to one patient with a Heart Mate II (HM II) LVAD, international normalized ratio (INR) of 4.7 on admission and in need of an urgent procedure. He received approximately 16 units/kg of 4F-PCC with reversal of his INR to 2.3 within 45 minutes. The second patient also had a HM II LVAD and presented with a right occipital intraparenchymal hemorrhage and subdural hematoma with an INR of 3.7. He received approximately 11 units/kg of 4F-PCC with INR reversal to 1.6 within 1 hour....
Source: ASAIO Journal - January 30, 2019 Category: Medical Devices Tags: Case Reports Source Type: research

Comparison of real-world outcomes in patients with nonvalvular atrial fibrillation treated with direct oral anticoagulant agents or warfarin.
Conclusion: The results of the study indicated that patients on DOACs had lower rates of ischemic stroke, hemorrhagic stroke, SE, and composite outcome of stroke or SE compared with patients on warfarin. No significant differences in bleeding rates between the DOAC and warfarin groups were observed, while total cost of care was lower in the DOAC group. PMID: 30698654 [PubMed - as supplied by publisher]
Source: American Journal of Health-System Pharmacy : AJHP - January 29, 2019 Category: Drugs & Pharmacology Authors: Datar M, Crivera C, Rozjabek H, Abbass IM, Xu Y, Pasquale MK, Schein JR, Andrews GA Tags: Am J Health Syst Pharm Source Type: research

Poor Quality of Warfarin Treatment Increases the Risk of All Types of Intracranial Hemorrhage in Atrial Fibrillation.
CONCLUSIONS: Poor control of warfarin treatment was associated with elevated risk of ICH. Approximately half of the ICH were traumatic, mainly subdural. PMID: 30686804 [PubMed - as supplied by publisher]
Source: Circulation Journal - January 25, 2019 Category: Cardiology Authors: Tiili P, Putaala J, Mehtälä J, Khanfir H, Niiranen J, Korhonen P, Raatikainen P, Lehto M Tags: Circ J Source Type: research

Left Atrial Appendage Closure Device Implantation in Patients with Atrial Fibrillation and Prior Intracranial Hemorrhage “No Man Left Behind”
Several LAA closure devices have been developed for patients with atrial fibrillation (AF) seeking an alternative to long-term oral anticoagulation (OAC). The PROTECT AF trial was the first multicenter randomized controlled trial (RCT) comparing LAA closure device vs. OAC with Warfarin. Primary safety events were statistically more frequent in the device group (7.4% vs. 4.4%). At a mean follow up of 3.8 years LAA closure device showed superiority for the primary efficacy endpoint (i.e., composite of stroke, cardiovascular death and systemic embolism), with a 34% relative risk reduction in total mortality1-3 However, with t...
Source: Heart Rhythm - January 14, 2019 Category: Cardiology Authors: Luigi Di Biase, Jorge Romero Source Type: research