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Condition: Thrombosis
Drug: Amiodarone

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Total 21 results found since Jan 2013.

The Price of Keeping the Rhythm: Increased Bleeding Risk in Patients with Atrial Fibrillation Concurrently Prescribed Amiodarone and Factor Xa Inhibitors
Atrial fibrillation is the most common sustained cardiac arrhythmia affecting nearly 2% of the population of the United States.1 Patients with atrial fibrillation are twice as likely to have a myocardial infarction and five-times as likely to have a stroke.1 Current guidelines recommend antiarrhythmic pharmacotherapy in patients with symptomatic atrial fibrillation as first-line management.2-4 Amiodarone is a very effective, and therefore, a commonly prescribed agent for this purpose.5 Anticoagulation is a key tenet in the management of atrial fibrillation due to the increased tendency of left atrial appendage clot formati...
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 10, 2023 Category: Anesthesiology Authors: Nicolas Kumar, Manoj H. Iyer, Adam Dalia, Amit Bardia Tags: Editorial Source Type: research

Association between Use of Pharmacokinetic-Interacting Drugs and Effectiveness and Safety of Direct Acting Oral Anticoagulants: Nested Case-Control Study
Clin Pharmacol Ther. 2021 Jul 19. doi: 10.1002/cpt.2369. Online ahead of print.ABSTRACTConcomitant use of direct oral anticoagulants (DOACs) and medications with inhibition/induction effect on P-gp/CYP3A might increase risk of bleeding/treatment failure, respectively. We designed a nested case-control study within a Clalit cohort of atrial fibrillation (AF) patients and a cohort of venous thromboembolic patients, new users of a DOAC (1.1.2010-24.8.2020). Propensity scores were constructed from demographic, clinical and medications at cohort entry. Each case of: 1) serious bleeding event; 2) stroke/systemic emboli (SE) in A...
Source: Clinical Pharmacology and Therapeutics - July 21, 2021 Category: Drugs & Pharmacology Authors: Naomi Gronich Nilli Stein Mordehcai Muszkat Source Type: research

Drug interactions and pharmacogenetic factors contribute to variation in apixaban concentration in atrial fibrillation patients in routine care
In this study, we assessed the impact of interacting medication and pharmacogenetic variation to better explain apixaban concentration differences among 358 Caucasian AF patients. Genotyping (ABCG2,ABCB1,CYP3A4*22,CYP3A5*3) was performed by TaqMan assays, and apixaban quantified by mass spectrometry. The typical patient was on average 77.2  years old, 85.5 kg, and had a serum creatinine of 103.1 µmol/L. Concomitant amiodarone, an antiarrhythmic agent and moderate CYP3A/ABCB1 inhibitor, the impaired-function variantABCG2 c.421C  >  A, and sex predicted higher apixaban concentrations when controlling for age, weig...
Source: Journal of Thrombosis and Thrombolysis - January 18, 2020 Category: Hematology Source Type: research

The real world use of combined P-glycoprotein and moderate CYP3A4 inhibitors with rivaroxaban or apixaban increases bleeding
AbstractThe use of direct oral anticoagulants for stroke prevention in atrial fibrillation continues to rise. Certain populations may be at higher risk for increased drug exposure and adverse events. Pharmacokinetic studies suggest increased exposure of rivaroxaban and apixaban with combined P-gp and moderate CYP3A4 inhibitors but the clinical relevance of this is unknown. This retrospective cohort study included patients receiving rivaroxaban or apixaban from January 1, 2012 to December 31, 2016 with a moderate inhibitor (amiodarone, dronedarone, diltiazem, verapamil) for at least 3 months in the drug –drug interaction ...
Source: Journal of Thrombosis and Thrombolysis - January 9, 2020 Category: Hematology Source Type: research

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology 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

Assessment of Non-vitamin K Oral Anticoagulants Use in a Tertiary Care Center in the USA: A Chart Review of 909 Patients
ConclusionA significant number of patients received NOACs at doses inconsistent with the package labeling or had clinically significant drug –drug interactions with NOACs. Efforts are warranted to improve appropriate dosing and avoid significant drug interactions.
Source: American Journal of Cardiovascular Drugs - November 8, 2018 Category: Cardiology Source Type: research

Factors Associated with Prolonged Survival in Left Ventricular Assist Device Recipients
ConclusionsPreoperative diabetes and amiodarone use were associated with poor long-term survival in LVAD recipients. Development of early complications of stroke, gastrointestinal bleeding, hemolysis, or pump thrombosis was also associated with poor long-term survival. Early diagnosis and treatment of these complications may improve survival in LVAD recipients.
Source: The Annals of Thoracic Surgery - October 12, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Factors Associated with Prolonged Survival in Left Ventricular Assist Device Recipients.
CONCLUSIONS: Preoperative diabetes and amiodarone use were associated with poor long-term survival in LVAD recipients. Development of early complications of stroke, gastrointestinal bleeding, hemolysis, or pump thrombosis was also associated with poor long-term survival. Early diagnosis and treatment of these complications may improve survival in LVAD recipients. PMID: 30316851 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - October 11, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Xia Y, Forest S, Friedmann P, Chou LC, Patel S, Jorde U, Goldstein D Tags: Ann Thorac Surg Source Type: research

Clinical Profile and Consequences of Atrial Fibrillation in Hypertrophic Cardiomyopathy.
Conclusions -Transient symptomatic episodes of AF, although relatively uncommon in HCM, are unpredictable in frequency and timing, amenable to effective contemporary treatments, and infrequently progress to permanent AF. AF is not a major contributor to heart failure morbidity, nor a cause of arrhythmic sudden death, and when treated is associated with low-disease-related mortality, no different than for patients without AF. AF is an uncommon primary cause of death in HCM virtually limited to embolic stroke, supporting a low threshold for initiating anticoagulation therapy. PMID: 28916640 [PubMed - as supplied by publisher]
Source: Circulation - September 15, 2017 Category: Cardiology Authors: Rowin EJ, Hausvater A, Link MS, Abt P, Gionfriddo W, Wang W, Rastegar H, Estes NAM, Maron MS, Maron BJ Tags: Circulation Source Type: research

Pulmonary embolism four days after interruption of therapy with rivaroxaban.
We report on a 58-year-old male with paroxysmal atrial fibrillation (AF) with a CHA2DS2VASC score of 4 who developed central pulmonary embolism four days after interruption of rivaroxaban because of parotid surgery. He had received 40 mg enoxaparin/d. The parotid gland was partially resected within 6 hours without blood loss. Pulmonary embolism and AF occurred on the first postoperative day. He recovered with low-molecular-weight heparin in therapeutic dosages and amiodarone and was discharged with phenprocoumon. The relevance of a rivaroxaban rebound phenomenon, manifesting as arterial embolism, stroke or venous thrombo...
Source: Hamostaseologie - August 24, 2017 Category: Hematology Authors: Stöllberger C, Göndör G Tags: Hamostaseologie Source Type: research

Pharmacologic cardioversion with intravenous amiodarone is likely safe in neurocritically Ill patients
Publication date: Available online 13 February 2017 Source:Journal of Clinical Neuroscience Author(s): Michael Su, David Seki, Asma M. Moheet Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h’ duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients w...
Source: Journal of Clinical Neuroscience - February 13, 2017 Category: Neuroscience Source Type: research