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Condition: Hemorrhagic Stroke
Nutrition: Vitamin K
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Total 372 results found since Jan 2013.
Prognostic factors and analysis of mortality due to brain haemorrhages associated with vitamin K antagonist oral anticoagulants. Results from the TAC Registry
ConclusionICH in patients treated with VKA is associated with high mortality rates; mortality in these patients is mainly and independently associated with the clinical situation at stroke onset.ResumenIntroducciónLa hemorragia intracraneal (HIC) en pacientes tratados con anticoagulantes orales antagonistas de la vitamina K (AVK) es una complicación grave y frecuentemente letal; en este trabajo estudiamos las características clínicas y los factores que se relacionan con la mortalidad en este grupo de pacientes.MétodosRealizamos un estudio observacional, multicéntrico y retrospectivo, de ámbito nacional, basado en re...
Source: Neurologia - July 8, 2018 Category: Neurology Source Type: research
Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316.FindingsBetween Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0·5...
Source: The Lancet Neurology - July 5, 2018 Category: Neurology Source Type: research
Direct Oral Anticoagulants in Nonvalvular Atrial Fibrillation: Practical Considerations on the Choice of Agent and Dosing
Direct or new oral anticoagulants (NOACs), including the direct thrombin inhibitor dabigatran and the direct factor Xa inhibitors rivaroxaban, apixaban, and edoxaban, have recently revolutionized the field of antithrombotic therapy for stroke and systemic embolism prevention in nonvalvular atrial fibrillation (NVAF). Randomized controlled trials have shown that these agents have at least comparable efficacy with vitamin K antagonists along with superior safety, at least in what concerns intracranial hemorrhage. As a result, NOACs are indicated as first-line anticoagulation therapy for NVAF patients with at least one risk f...
Source: Cardiology - July 5, 2018 Category: Cardiology Source Type: research
Can an anticoagulant reduce brain hemorrhage: Invited comment on “Dabigatran reduces endothelial permeability through inhibition of thrombin-induced cytoskeleton reorganization”
During studies of anti-coagulants to prevent cardioembolic stroke, startling data emerged that patients treated with novel oral anti-coagulants (NOACs) appeared to suffer less brain hemorrhage than patients treated with traditional, vitamin-K depleting anticoagulants [1, 2]. That NOACs reduced the bleeding risk did not fit accepted dogma: clinicians imagine that hemorrhage occurs during and following ischemic stroke as the brain undergoes necrosis. In the presence of anti-coagulation, such necrotic bleeding ought to be augmented.
Source: Thrombosis Research - June 11, 2018 Category: Hematology Authors: Patrick D. Lyden Tags: Editorial Source Type: research
The safety and efficacy of non-vitamin K antagonist oral anticoagulants in atrial fibrillation in the elderly
Atrial fibrillation (AF) is the most common arrhythmia and its prevalence increases with age. Age also increases the risk of thromboembolism related to AF. As a result, elderly patients are at increased risk of AF-related stroke compared to younger patients. Age, however, also increases the risk of bleeding, including that of intracranial haemorrhage, an important cause of death and disability. Elderly patients with AF are, therefore, often undertreated due to the fear of bleeding complications, although recent data suggest an even greater net clinical benefit for anticoagulation in general in the elderly, even the very el...
Source: International Journal of Cardiology - June 7, 2018 Category: Cardiology Authors: Giuseppe Patti, Ilaria Cavallari, Olivier Hanon, Raffaele De Caterina 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
Oral Anticoagulation in Chronic Kidney Disease and Atrial Fibrillation.
CONCLUSION: The cardiological societies' recommendation that patients with atrial fibrillation should be given oral anticoagulant drugs applies to the majority of such patients who also have chronic kidney disease.
PMID: 29789105 [PubMed - in process]
Source: Deutsches Arzteblatt International - May 24, 2018 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316. Findings Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0...
Source: The Lancet Neurology - May 16, 2018 Category: Neurology 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
Different safety profiles of oral anticoagulants in very elderly non-valvular atrial fibrillation patients: A retrospective propensity score matched cohort study
Vitamin K antagonists (VKAs) have been shown to decrease the risk of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). [1] The non-VKA oral anticoagulants (NOACs) are now increasingly used as an alternative to VKAs thanks to their convenient, fixed dose and no requirement for monitoring. NOACs have shown non-inferiority to warfarin for the prevention of stroke and systemic embolism, with marked reduction in the risk of intracerebral haemorrhage [2].
Source: International Journal of Cardiology - April 25, 2018 Category: Cardiology Authors: Giacomo Zoppellaro, Luca Zanella, Gentian Denas, Nicola Gennaro, Eliana Ferroni, Ugo Fedeli, Seena Padayattil Jose, Giorgio Costa, Maria Chiara Corti, Margherita Andretta, Vittorio Pengo Source Type: research
Slow Elevation in Protein C Activity without a PROC Mutation in a Neonate with Intracranial Hemorrhage
We report a case of hemorrhagic stroke associated with neonatal asphyxia and severe PC deficiency. Plasma PC and protein S activity 7 days after birth was 12% and 43%, respectively. No PROC mutation was found. PC levels did not exceed 20% until 2 months of age, even in the absence of consumption coagulopathy or vitamin K deficiency. Neither thromboembolic nor hemorrhagic events occurred during the infusion of activated PC concentrate (twice weekly, up to 68 days after birth). The PC activity levels gradually increased to the standard value for age by 9 months of age. The present case showed that neonatal PC deficiency with...
Source: American Journal of Perinatology Reports - April 12, 2018 Category: Perinatology & Neonatology Authors: Uehara, Erika Nakao, Hiro Tsumura, Yusuke Nakadate, Hisaya Amari, Shoichiro Fujinaga, Hideshi Tsutsumi, Yoshiyuki Kang, Dongchon Ohga, Shouichi Ishiguro, Akira Tags: Case Report Source Type: research
Epidemiology of Intracranial Hemorrhage Associated with Oral Anticoagulants in Spain: Trends in Anticoagulation Complications Registry – The TAC 2 Study
Conclusion: We found that the incidence of OAC-induced ICH was greater than in previous studies. Hemorrhage volume and mortality were lower in ICH-DOACs than in ICH-VKAs. After stroke, DOACs were the most frequently indicated antithrombotic treatment.Intervent Neurol 2018;7:284 –295
Source: Interventional Neurology - April 4, 2018 Category: Neurology Source Type: research
Uninterrupted Use of Oral Anticoagulants for the Ablation of Atrial Flutter: A Single Center Cohort of 154 Patients
Conclusion: In our population there were no hemorrhag ic complications regarding the procedure of OAC use uninterruptedly, including NOACs. There was higher occurrence of stroke/TIA in the follow-up of the group of patients undergoing VKAs; however, this difference may not only be a result of the type of OAC used.Resumo Fundamento: O uso ininterrupto de anticoagula ção oral (ACO) com antagonistas da vitamina K (AVKs) para procedimentos de eletrofisiologia está sendo cada vez mais recomendado. A prática clínica em nosso serviço é de uso continuado dessas drogas para ablação de flutter atrial. Existem poucas evidên...
Source: Arquivos Brasileiros de Cardiologia - March 19, 2018 Category: Cardiology Source Type: research
Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation.
CONCLUSIONS: Treatment with factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in people with AF. The absolute effect of factor Xa inhibitors compared with warfarin treatment was, however, rather small. Factor Xa inhibitors also reduced the number of ICHs, all-cause deaths and major bleedings compared with warfarin, although the evidence for a reduction in the latter is less robust.
PMID: 29509959 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 6, 2018 Category: General Medicine Authors: Bruins Slot KM, Berge E Tags: Cochrane Database Syst Rev Source Type: research
Oral Anticoagulation in Very Elderly Patients with Atrial Fibrillation - A Nationwide Cohort Study.
Conclusions -Among AF patients age ≥90 years, warfarin was associated with a lower risk of ischemic stroke and positive NCB. Compared to warfarin, NOACs were associated with a lower risk of ICH. Thus, OACs may still be considered as thromboprophylaxis for elderly patients with NOACs being as the more favorable choice.
PMID: 29490992 [PubMed - as supplied by publisher]
Source: Circulation - February 28, 2018 Category: Cardiology Authors: Chao TF, Liu CJ, Lin YJ, Chang SL, Lo LW, Hu YF, Tuan TC, Liao JN, Chung FP, Chen TJ, Lip GYH, Chen SA Tags: Circulation Source Type: research
