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Condition: Hemorrhagic Stroke
Drug: Warfarin
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Total 721 results found since Jan 2013.
Rivaroxaban versus Warfarin in Patients with Mechanical Heart Valve: Rationale and Design of the RIWA Study
DiscussionWarfarin and similar VKAs are standard therapy for patients with an MHV. Even with the appropriate use of therapy, the incidence of thromboembolic events is high at 1 –4% per year. Furthermore, bleeding risk is significant, ranging from 2 to 9% per year. The new frontier to be overcome in relation to use of the new oral anticoagulants is undoubtedly in patients with MHV. A significant portion of people with MHV worldwide will benefit if noninferiority of these new agents is confirmed.Trial RegistrationClinicalTrials.gov identifier:NCT03566303. Recruitment Status: Recruiting. First Posted: 25 June 2018. Last Upd...
Source: Drugs in R&D - October 6, 2018 Category: Drugs & Pharmacology Source Type: research
Secular Trends in the Background of Intracerebral Hemorrhage from 2010 to 2015
Direct oral anticoagulants (DOACs) were recently introduced for the clinical use in stroke prevention, and they are reported to show a lower risk of intracerebral hemorrhage (ICH) compared to warfarin. We were interested to know whether there is any change in clinical backgrounds of ICH patients to date.
Source: Journal of Stroke and Cerebrovascular Diseases - October 6, 2018 Category: Neurology Authors: Taizen Nakase, Junta Moroi, Tatsuya Ishikawa Source Type: research
Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation.
Conclusion: Variation in published AF stroke rates for patients not receiving anticoagulant therapy results in multifold variation in the net clinical benefit of anticoagulation. Guidelines should better reflect the uncertainty in current thresholds of stroke risk score for recommending anticoagulation.
Primary Funding Source: None.
PMID: 30264130 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - September 25, 2018 Category: Internal Medicine Authors: Shah SJ, Eckman MH, Aspberg S, Go AS, Singer DE Tags: Ann Intern Med Source Type: research
Spontaneous choroidal hemorrhage associated with novel oral anticoagulants: A report of two cases and literature review.
We describe two clinical cases of spontaneous choroidal hemorrhage in patients treated with direct oral anticoagulants (rivaroxaban and dabigatran etexilate) for atrial fibrillation. These cases show that an ocular hemorrhagic risk exists with these drugs. Patients treated with DOAC should have the therapeutic dose adjusted based on creatinine clearance. Special monitoring should be performed in patients with age-related macular degeneration or with hypertension even though meta-analysis shows that the risk of intraocular bleeding is reduced by 22% compared with warfarin.
PMID: 30213607 [PubMed - as supplied by publisher]
Source: Journal Francais d Ophtalmologie - September 16, 2018 Category: Opthalmology Tags: J Fr Ophtalmol Source Type: research
Idarucizumab-facilitated intravenous thrombolysis in acute ischemic stroke: A therapeutic strategy requiring further investigation
Although dabigatran does a better job reducing the risk of cardioembolic stroke than warfarin in patients with non-valvular atrial fibrillation, 0.92 –1.34% of dabigatran users still develop isch emic stroke [1]. The usage of warfarin (even at a suboptimal therapeutic level) increases the risk of hemorrhagic transformation (HT) after intravenous thrombolysis (IT) [2]; therefore, current guidelines advise against performing IT in patients receiv ing any direct oral anti-coagulant (DOAC), including dabigatran [3].
Source: Journal of the Neurological Sciences - September 13, 2018 Category: Neurology Authors: Hsiao Yu-Jen, Tsai Yi-Te, Li-Kai Tsai, Fang Chen-wen Tags: Letter to the Editor Source Type: research
The efficacy and safety of Batroxobin in combination with anticoagulation on cerebral venous sinus thrombosis
This study aims to evaluate the safety and efficacy of Batroxobin in combination with anticoagulation on CVST control. In this retrospective study, a total of 61 CVST patients were enrolled and divided into Batroxobin (n = 23) and control (n = 38) groups. In addition to the same standard anticoagulation in control, patients in the treatment group received Batroxobin 5 BU intravenous infusion (10 BU for the first time) every other day, for a total of three infusions. A higher recanalization rate was found in Batroxobin group (adjusted OR [95% CI] of 2.5 [1.1–5.0],p = 0.028) compared to the control group, es...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2018 Category: Hematology Source Type: research
Real-world clinical evidence on rivaroxaban, dabigatran, and apixaban compared with vitamin K antagonists in patients with non-valvular atrial fibrillation: a systematic literature review.
Authors: Briere JB, Bowrin K, Coleman C, Fauchier L, Levy P, Folkerts K, Toumi M, Taieb V, Millier A, Wu O
Abstract
Introduction Several comparative real-world effectiveness studies on direct oral anticoagulants (DOACs) have been conducted, but an overview of the available evidence remains to be developed, which could provide a better understanding of the value of DOACs relative to vitamin K antagonists (VKAs). Areas covered A systematic literature review was conducted on the available real-world evidence (RWE) of three DOACs (rivaroxaban, dabigatran, and apixaban) compared with VKAs (e.g. warfarin), in patients wi...
Source: Expert Review of Pharmacoeconomics and Outcomes Research - September 2, 2018 Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research
Interhospital Transfer Delays Anticoagulation Reversal in Warfarin-Associated Intracranial Hemorrhage
Intracranial hemorrhage (ICH) is a complication of warfarin-associated anticoagulation resulting in significant morbidity and mortality. The purpose of this study was to assess whether interhospital transfer delays the administration of 4-factor prothrombin complex concentrate to patients with warfarin-associated ICH.
Source: Journal of Stroke and Cerebrovascular Diseases - August 30, 2018 Category: Neurology Authors: Anne Zepeski, Stacey Rewitzer, Enrique C Leira, Karisa Harland, Brett A. Faine Source Type: research
Appropriateness of non-vitamin K antagonist oral anticoagulant dose in patients with atrial fibrillation in Israel: A population-based study
The non-vitamin K oral antagonists (NOACs) are at least as effective as warfarin in the prevention of stroke in non valvular atrial fibrillation (NVAF) and are associated with less intracranial hemorrhage. Many patients with NVAF inappropriately do not receive anticoagulants often because of the inconvenience associated with warfarin administration. NOACs have the potential to increase anticoagulation use because they are safer and easier to administer than warfarin. Indeed, the use of anticoagulation in patients with newly diagnosed AF in many countries is increasing as a result of the use of NOACs in preference to warfarin [1].
Source: Thrombosis Research - July 24, 2018 Category: Hematology Authors: Martin H. Ellis, Sari Greenberg Dotan, Ariel Hammerman, Erez Battat, Estela Derazne, Orly Avnery Tags: Letter to the Editors-in-Chief Source Type: research
Prolonged Blood-Brain Barrier Injury Occurs After Experimental Intracerebral Hemorrhage and Is Not Acutely Associated with Additional Bleeding
AbstractIntracerebral hemorrhage (ICH) causes blood-brain barrier (BBB) damage along with altered element levels in the brain. BBB permeability was quantified at 3, 7, and 14 days with Evans Blue dye after collagenase-induced ICH in rat. At peak permeability (day 3), a gadolinium (Gd)-based contrast agent was injected to further characterize BBB disruption, and X-ray fluorescence imaging (XFI) was used to map Gd, Fe, Cl, and other elements. XFI revealed that Ca, Cl, Gd , and Fe concentrations were significantly elevated, whereas K was significantly decreased. Therefore, using Gd-XFI, we co-determined BBB dysfunction with...
Source: Translational Stroke Research - June 14, 2018 Category: Neurology Source Type: research
Safety and effectiveness of rivaroxaban and warfarin in moderate-to-advanced CKD: real world data.
CONCLUSION: Rivaroxaban seems a safe and effective therapeutic option in CKD stage 3b-4 patients. However, future randomized controlled trials are needed to definitively establish the role of rivaroxaban in CKD patients.
PMID: 29882198 [PubMed - as supplied by publisher]
Source: Journal of Nephrology - June 7, 2018 Category: Urology & Nephrology Authors: Di Lullo L, Tripepi G, Ronco C, De Pascalis A, Barbera V, Granata A, Russo D, Di Iorio BR, Paoletti E, Ravera M, Fusaro M, Bellasi A Tags: J Nephrol Source Type: research
Cost Analysis of Direct Oral Anticoagulants Compared with Warfarin in Patients with Blunt Traumatic Intracranial Hemorrhages.
Abstract
Direct oral anticoagulants (DOACs) are rapidly gaining popularity as alternatives to warfarin in the prevention of stroke or systemic embolic events because of the simplicity of their dosing and lack of monitoring requirement. Many physicians feared that these novel agents would be cost-prohibitive not only in their administration but also in their sequelae of bleeding, given the few reversal agents available. Whereas the medication itself is more expensive than traditional warfarin, the total cost of a hospital admission has not been compared between patients on DOACs and warfarin who have sustained a bl...
Source: The American Surgeon - June 1, 2018 Category: Surgery Authors: Lamb LC, DiFiori M, Comey C, Feeney J Tags: Am Surg Source Type: research
Two-Year Outcomes of Anticoagulation for Acute Ischemic Stroke With Nonvalvular Atrial Fibrillation - SAMURAI-NVAF Study.
CONCLUSIONS: Stroke/TIA patients receiving DOACs for secondary prevention were younger and had lower stroke severity and risk indices than those receiving warfarin. Estimated cumulative incidences of stroke and systemic embolism within 2 years were similar between warfarin and DOACs users, but those of death and intracranial hemorrhage were significantly lower among DOAC users.
PMID: 29863095 [PubMed - as supplied by publisher]
Source: Circulation Journal - June 1, 2018 Category: Cardiology Authors: Yoshimura S, Koga M, Sato S, Todo K, Yamagami H, Kumamoto M, Itabashi R, Terasaki T, Kimura K, Yagita Y, Shiokawa Y, Kamiyama K, Okuda S, Okada Y, Takizawa S, Hasegawa Y, Kameda T, Shibuya S, Nagakane Y, Ito Y, Matsuoka H, Takamatsu K, Nishiyama K, Fujita Tags: Circ J Source Type: research
Stroke Prevention with Oral Anticoagulants: Summary of the Evidence and Efficacy Measures as an Aid to Treatment Choices
AbstractAtrial fibrillation (AF) is an established risk factor for a first or recurrent stroke. Despite proven efficacy in preventing stroke in patients with AF, warfarin is underused, partly due to safety concerns. Recent randomized trials have shown that non-vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran (a direct thrombin inhibitor) and apixaban, edoxaban, and rivaroxaban (factor Xa inhibitors) are not only non-inferior or superior to warfarin but also demonstrate a decreased risk of cerebrovascular bleeding among patients with AF and moderate to high risk of stroke. Additionally, NOACs have an adva...
Source: Cardiology and Therapy - June 1, 2018 Category: Cardiology Source Type: research
Comparing the Cost Effectiveness of Non-vitamin K Antagonist Oral Anticoagulants with Well-Managed Warfarin for Stroke Prevention in Atrial Fibrillation Patients at High Risk of Bleeding
ConclusionsThe comparative cost effectiveness of edoxaban and warfarin is highly sensitive to TTR. At the $US100,000/QALY willingness-to-pay threshold, our results suggest that warfarin is the most cost-effective treatment for patients who can achieve a TTR of 70%.
Source: American Journal of Cardiovascular Drugs - May 9, 2018 Category: Cardiology Source Type: research
