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Dabigatran - the First Approved DTI for SPAF.
Authors: Trailokya A, Hiremath JS Abstract Atrial fibrillation (AF) is commonly occurring arrhythmia in clinical practice. AF is easy to recognize but difficult to treat. Stroke is the most devastating complication of AF and is associated with a huge disease burden on the society. Effective stroke prevention is a priority for patients with AF. Two-thirds of strokes due to AF are preventable with suitable anticoagulant therapy. VKA like warfarin, acenocoumarol remains the gold standard for stroke prevention in AF (SPAF). However, it is associated with numerous limitations such as a high risk of drug-drug, drug-food ...
Source: Journal of the Association of Physicians of India - October 25, 2018 Category: General Medicine Tags: J Assoc Physicians India Source Type: research

Comparison of the Ecarin Chromogenic Assay and Diluted Thrombin Time for Quantification of Dabigatran Concentrations
ConclusionsFor detection of levels below 50 ng/mL both tests have specificities of at least 96%, suggesting that they accurately detect even low levels of drug. Therefore, regardless of whether a chromogenic or clot‐based platform is preferred, the STA‐ECA‐II and dTT are useful tests for measuring dabigatran concentrations. Unfortunately, neither test is licensed by the United States Food and Drug Administration. Although approved in other jurisdictions, the dTT and STA‐ECA‐II are not widely or rapidly available in most hospitals. Therefore, cooperation between regulators and hospitals is urgently needed to rende...
Source: Journal of Thrombosis and Haemostasis - October 4, 2017 Category: Hematology Authors: Iqbal H. Jaffer, Noel Chan, Robin Roberts, James C. Fredenburgh, John W. Eikelboom, Jeffrey I. Weitz Tags: Original Article ‐ Coagulation Source Type: research

Comparison of the Ecarin Chromogenic Assay and Diluted Thrombin Time for Quantification of Dabigatran Concentrations.
CONCLUSIONS: For detection of levels below 50 ng/mL both tests have specificities of at least 96%, suggesting that they accurately detect even low levels of drug. Therefore, regardless of whether a chromogenic or clot-based platform is preferred, the STA-ECA-II and dTT are useful tests for measuring dabigatran concentrations. Unfortunately, neither test is licensed by the United States Food and Drug Administration. Although approved in other jurisdictions, the dTT and STA-ECA-II are not widely or rapidly available in most hospitals. Therefore, cooperation between regulators and hospitals is urgently needed to render these ...
Source: Thrombosis and Haemostasis - October 4, 2017 Category: Hematology Authors: Jaffer IH, Chan N, Roberts R, Fredenburgh JC, Eikelboom JW, Weitz JI Tags: J Thromb Haemost Source Type: research

Stop Bleeding! Oral  Anticoagulation and Options for Reversal
Direct oral anticoagulants (DOACs) are widely used medications for stroke prevention in nonvalvular atrial fibrillation (AF), and for deep vein thrombosis treatment and prevention. The IMS Institute for Healthcare Informatics analyzed outpatient anticoagulant use in the United States between 2009 and 2014 and found that there has been a steady increase in DOAC use following their initial approval in 2010.1 DOACs include the direct thrombin inhibitor dabigatran, and the factor Xa inhibitors rivaroxaban, apixaban, and edoxaban, and recently approved betrixaban.
Source: The Journal for Nurse Practitioners - November 29, 2017 Category: Nursing Authors: Archna Jariwala, Kori Hamman Tags: Prescription Pad Source Type: research

A Review of the Use of Direct Oral Anticoagulant Use in Orthotopic Heart Transplantation Recipients
Over 60 years ago, the vitamin K antagonist (VKA) warfarin was approved and remained the only oral anticoagulation agent until recently [1]. Currently, within North America and Europe there are four DOACs available. Dabigatran, first approved in Europe and Canada in 2008, then in the United States of America in 2010, followed by rivaroxaban, apixaban, and most recently edoxaban. The introduction of direct oral anticoagulants (DOACs) has been a major advancement and these agents are the preferred to VKAs for many indications [2 –5], including stroke prevention in nonvalvular atrial fibrillation (NVAF), acute treatment and...
Source: Transplantation Reviews - April 16, 2018 Category: Transplant Surgery Authors: Rosaleen Boswell, Glen J. Pearson Tags: Review article Source Type: research

Clinical Outcome Following Reinstitution of Anticoagulation after Major Gastrointestinal Bleed: A Single Institutional Analysis
Conclusion: Given the rising national trend on the use of anticoagulants for various medical necessities, it is imperative that a safe and efficient process be devised on reinstitution of anticoagulation post MGIB to guide Clinicians. Although our study represents a single institutional analysis, it concurs with recent studies that early resumption of anticoagulant following stabilization of MGIB is associated with lower thromboembolic events. Timing for resumption depends largely on the medical reason for anticoagulation; reinstitution by day 7 appear safe for patients on mechanical valve whereas after day 12 maybe approp...
Source: Blood - November 21, 2018 Category: Hematology Authors: Ezekwudo, D. E., Gaikazian, S., Anusim, N., Konde, A. S., Zakalik, D., Huben, M. T., Stender, M., Anderson, J., Jaiyesimi, I. Tags: 332. Antithrombotic Therapy: Poster I Source Type: research