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Condition: Thrombosis
Drug: Pradaxa

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Total 508 results found since Jan 2013.

Intravenous Thrombolysis With Recombinant Tissue-Type Plasminogen Activator in a Stroke Patient Receiving Dabigatran Anticoagulant After Antagonization With Idarucizumab Brief Reports
Conclusions— This case represents a new therapeutic paradigm. It is further supported by in vitro data showing no nonspecific interactions of idarucizumab with recombinant tissue-type plasminogen activator–induced thrombolysis. Thus, patients effectively anticoagulated with dabigatran who were previously contraindicated for thrombolytic therapy in this situation may now receive treatment because of the ability to rapidly reverse the anticoagulant activity of dabigatran with idarucizumab.
Source: Stroke - June 26, 2016 Category: Neurology Authors: Berrouschot, J., Stoll, A., Hogh, T., Eschenfelder, C. C. Tags: Cerebrovascular Procedures, Ischemic Stroke Brief Reports Source Type: research

Rivaroxaban Versus Dabigatran or Warfarin in Real-World Studies of Stroke Prevention in Atrial Fibrillation Clinical Sciences
Conclusions—In this systematic review and meta-analysis, rivaroxaban was as effective as dabigatran, but was more effective than warfarin for the prevention of stroke/thromboembolism in atrial fibrillation patients. Major bleeding risk was significantly higher with rivaroxaban than with dabigatran, as was all-cause mortality and gastrointestinal bleeding. Rivaroxaban was comparable to warfarin for major bleeding, with an increased risk in gastrointestinal bleeding and decreased risk of intracranial hemorrhage.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Ying Bai, Hai Deng, Alena Shantsila, Gregory Y.H. Lip Tags: Meta Analysis, Quality and Outcomes Original Contributions Source Type: research

Dilemma of Indication for Thrombolysis in a Patient with Acute Ischemic Stroke Treated with a Novel Oral Anticoagulant
We report the case of a patient treated with dabigatran who developed acute ischemic stroke and was considered for thrombolysis. Because of the prolonged thrombin time (TT), thrombolysis was not performed. Repeated coagulation tests 5 days after stroke, with unchanged anticoagulant (dabigatran) treatment, found 2-fold higher TT and activated partial thromboplastin time (APTT) compared with the values found in the acute stage. Routine coagulation tests (TT and APTT) do not reliably reflect the coagulation features of a patient; therefore, there is an urgent need to develop reliable biomarkers and an adequate guideline to ...
Source: Journal of Stroke and Cerebrovascular Diseases - May 30, 2013 Category: Neurology Authors: András Folyovich, Viktória Varga, Katalin A. Béres-Molnár, Károly Vadasdi, Dániel Bereczki Tags: Case Reports Source Type: research

Management of acute stroke in patients taking novel oral anticoagulants
Each year, 1·0–2·0% of individuals with atrial fibrillation and 0·1–0·2% of those with venous thromboembolism who are receiving one of the novel oral anticoagulants (dabigatran, rivaroxaban, or apixaban) can be expected to experience an acute ischemic stroke. Additionally, 0·2–0·5% of individuals with atrial fibrillation who are receiving one of the novel oral anticoagulants can be expected to experience an intracranial hemorrhage. This opinion piece addresses the current literature and offers practical approaches to the management of patients receiving novel oral anticoagulants who present with an ischemic or ...
Source: International Journal of Stroke - June 1, 2014 Category: Neurology Authors: Graeme J. Hankey, Bo Norrving, Werner Hacke, Thorsten Steiner Tags: Review Source Type: research

Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research

Intravenous Thrombolysis in Acute Ischemic Stroke After Idarucizumab Reversal of Dabigatran Effect: Analysis of the Cases From Taiwan
Background: Asians with atrial fibrillation carry a higher risk of ischemic stroke than non-Asians even under treatment of nonvitamin K antagonist oral anticoagulants. The purpose of the study was to observe the feasibility of intravenous thrombolytic therapy after administering a reversal agent, idarucizumab, in dabigatran-treated patients with acute ischemic stroke in Taiwan. Methods: Dabigatran-treated patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) after idarucizumab reversal were enrolled in the retrospective nationwide study.
Source: Journal of Stroke and Cerebrovascular Diseases - December 17, 2018 Category: Neurology Authors: Chen-Wen Fang, Yi-Te Tsai, Ping-Chen Chou, Hsi-Ming Chen, Chien-Ming Lu, Chen-Rong Tsao, Chih-Lin Chen, Mu-Chien Sun, Yu-Song Shih, Cheng-Yang Hsieh, Lu-An Chen, Po-Lin Chen, Jung-Tze Yeh, Yi-Heng Li Source Type: research

Intravenous Thrombolysis in Anticoagulated and Thrombocytopenic Ischemic Stroke Patients Does Not Increase the Risk of Intracerebral Hemorrhage (P4.271)
Conclusions:These data suggest that IV rt-PA can be safely administered in coagulopathic and thrombocytopenic patients. Although rates of sICH and mortality were similar to the NINDS cohort, caution may be needed to identify certain hemorrhagic risk factors. Routine exclusion of anticoagulated or thrombocytopenic patients is not supported and the use of IV rt-PA in these patients may increase the eligibility for acute stroke therapy, particularly at institutions where IA therapy is unavailable.Disclosure: Dr. Barazangi has received personal compensation for activities with Genentech. Dr. Sorensen has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Barazangi, N., Sorensen, S., Chen, C., Wong, C., Yee, A., Ke, M., Rose, J., Grosvenor, D., Bedenk, A., Fernandes, J., Tong, D. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research

Recurrent Ischemic Stroke in a Patient with the Trousseau Syndrome Treated with Dabigatran
A 70-year-old man with multiple ischemic strokes was diagnosed with cardiac embolism and treated with dabigatran. Three months later, he suddenly developed vertigo and vomiting. Magnetic resonance imaging, showed recurrent lesions and blood tests revealed hypercoagulability, hypoproteinemia, and elevated cytokeratin 19 fragments that serve as a tumor marker of lung cancer. Chest computed tomography showed there were small nodules in bilateral lungs and swollen mediastinal lymph nodes. A conclusive diagnosis was impossible because the patient declined invasive procedures. We suspected primary lung cancer and diagnosed conco...
Source: Journal of Stroke and Cerebrovascular Diseases - February 21, 2014 Category: Neurology Authors: Kosuke Yoshida, Takashi Kimura, Yoko Aburakawa, Yasuhiro Suzuki, Kenji Kuroda, Osamu Yahara Tags: Case Reports Source Type: research

Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation. An indirect comparison analysis.
Abstract Large Phase 3 clinical trials for stroke prevention in atrial fibrillation (AF) have compared non-vitamin K antagonist oral anticoagulants (NOACs) against warfarin, with the edoxaban trial only recently reported. In the absence of head to head trials directly comparing these NOACs against each other, we compared the efficacy and safety of edoxaban to other agents by an indirect comparison analysis. We performed an indirect comparison analysis of edoxaban (2 dose strategies) against apixaban (1 dose), dabigatran etexilate (2 doses) and rivaroxaban (1 dose), for their relative efficacy and safety against ea...
Source: Thrombosis and Haemostasis - February 28, 2014 Category: Hematology Authors: Skjøth F, Larsen TB, Rasmussen LH, Lip GY Tags: Thromb Haemost Source Type: research

Use of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) Before Stroke.
CONCLUSIONS: -While experience of using rt-PA in ischemic stroke patients on a NOAC is limited, these preliminary observations suggest that rt-PA appears to be reasonably well tolerated without prohibitive risks for adverse events among selected NOAC treated patients. Future study should evaluate the safety and efficacy of intravenous rt-PA in ischemic stroke patients taking NOACs. PMID: 28119380 [PubMed - as supplied by publisher]
Source: Circulation - January 23, 2017 Category: Cardiology Authors: Xian Y, Federspiel JJ, Hernandez AF, Laskowitz D, Schwamm LH, Bhatt DL, Smith EE, Fonarow GC, Peterson ED Tags: Circulation Source Type: research

Impact of pre-admission treatment with non-vitamin K oral anticoagulants on stroke severity in patients with acute ischemic stroke
ConclusionsWe report a positive impact of pre-admission NOAC on ischemic stroke severity, which is particularly remarkable in light of the increased prevalence of prior stroke and lower rates of thrombolysis in this patient population.
Source: Journal of Thrombosis and Thrombolysis - February 23, 2018 Category: Hematology Source Type: research

Idarucizumab in Dabigatran-Treated Patients with Acute Ischemic Stroke Receiving Alteplase: A Systematic Review of the Available Evidence
ConclusionExperience with idarucizumab administration prior to tissue plasminogen activator treatment in acute ischemic stroke is limited. Initial clinical experience in less severe stroke syndromes and short time windows seems favorable. Larger cohorts are required to confirm safety, including bleeding complications and the risk of thrombosis.
Source: CNS Drugs - August 14, 2017 Category: Neurology Source Type: research

Apixaban: A New Factor Xa Inhibitor for Stroke Prevention in Patients With Nonvalvular Atrial Fibrillation
Atrial fibrillation (AF) is an independent risk factor for ischemic stroke occurrence, severity, recurrence, and mortality. Anticoagulation therapy for the prevention of thromboembolism is critical in patients with AF who are at risk of stroke. Warfarin has been an efficacious anticoagulant for this purpose, but its use has been limited by frequent laboratory monitoring, drug interactions, unpredictable individual response, delayed onset of action, and bleeding. Apixaban is the second oral direct selective factor Xa inhibitor approved for the prevention of stroke/systemic embolism in patients with nonvalvular AF. It was si...
Source: Cardiology in Review - June 6, 2013 Category: Cardiology Tags: New Therapy Update Source Type: research