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DOACs use in extreme body-weighted patients: results from the prospective START-register
ConclusionsDOACs seem to be effective and safe also for the treatment of patients with extreme body weights, both underweight and overweight. Further prospective studies are needed to support these findings.
Source: Internal and Emergency Medicine - June 10, 2023 Category: Emergency Medicine Source Type: research

Safety of antithrombotic therapy in East Asian patients
In conclusion, further investigations are necessary to clarify the specific conditions where the risk of serious bleeding events in East Asian patients differ substantially compared to the global. In addition, further understanding of the mechanisms causing the different bleeding response in specific conditions in East Asian is awaited.
Source: Internal and Emergency Medicine - March 8, 2021 Category: Emergency Medicine Source Type: research

Can echocardiography improve the prediction of thromboembolic risk in atrial fibrillation? Evidences and perspectives
AbstractAtrial fibrillation is the most common arrhythmia and its prevalence is expected to further increase. Patients with atrial fibrillation have an increased risk of stroke (fivefold increased risk), heart failure, and death. In patients with non-valvular atrial fibrillation, the most recent guidelines recommend the use of the CHA2DS2-VASc (congestive heart failure, arterial hypertension, age  >  75 years, diabetes mellitus, stroke/transient ischemic attack, vascular disease, age 65–74 years, sex category) scoring system to identify those who may benefit from oral anticoagulant treatment. Guidelines recommen...
Source: Internal and Emergency Medicine - March 1, 2020 Category: Emergency Medicine Source Type: research

The effect of management models on thromboembolic and bleeding rates in anticoagulated patients: an ecological study
AbstractThe primary  study objective is to compare the outcomes of patients taking oral anticoagulant medications in two distinct populations treated according to different management models (comprehensive vs. usual care). (Design: regional prospective cohort study; setting: hospital admission data from two regions). Eligible partecipants were patients taking oral anticoagulant drugs (vitamin K antagonist or direct oral anticoagulants), residents in the Vicenza and Cremona districts from February 1st, 2016 to June 30th, 2017. Patients were identified by accessing the administrative databases of patient drug prescripti...
Source: Internal and Emergency Medicine - July 14, 2019 Category: Emergency Medicine Source Type: research

Is it reasonable to use a lower DOAC dose in some patients with VTE? NO
AbstractThe international guidelines recommend the use of direct oral anticoagulants (DOACs) over vitamin K antagonists for anticoagulation long-term therapy in patients diagnosed with venous thromboembolism (VTE), and for stroke prevention in patients with non-valvular atrial fibrillation (AF). Efficacy and safety of DOACS have been extensively evaluated in large phase III trials. According to the product label, dose reductions of DOACs are recommended for patients with AF and renal impairment, low body weight and concomitant use of interfering medications. Except for Edoxaban, dose reductions of DOACs are not recommended...
Source: Internal and Emergency Medicine - June 27, 2017 Category: Emergency Medicine Source Type: research

Italian intersociety consensus on DOAC use in internal medicine
AbstractThe direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, apixaban and edoxaban) and one direct thrombin inhibitor (dabigatran) provide oral anticoagulation therapy alternatives to Vitamin K antagonists (VKAs). Despite their clear advantages, the DOACs require on the part of the internist a thorough knowledge of their pharmacokinetic and pharmacodynamic charac...
Source: Internal and Emergency Medicine - February 12, 2017 Category: Emergency Medicine Source Type: research

Cardiovascular risk stratification in patients with non-valvular atrial fibrillation: the 2MACE score
Abstract Recent findings suggest that patients with non-valvular atrial fibrillation (AF), in addition to having a high risk for ischemic stroke, are also at risk for myocardial infarction (MI). The aim of the study was to combine factors predicting Major Adverse Cardiovascular Events (MACE) in AF patients, including fatal/nonfatal MI, cardiac revascularization, and cardiovascular death, into a simple risk score. Predictors of MACE were obtained from a prospective observational cohort study, including 1019 AF patients taking vitamin K antagonists from the Atherothrombosis Center, of Sapienza University of Rome. Th...
Source: Internal and Emergency Medicine - October 15, 2015 Category: Emergency Medicine Source Type: research