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Dose Specific Effectiveness and Safety of DOACs in Patients with Non-valvular Atrial Fibrillation: a Canadian Retrospective Cohort Study
Direct oral anticoagulants (DOACs) have been proven to be effective and safe for prevention of ischemic stroke and systemic embolism in patients with non-valvular atrial fibrillation (NVAF). However, suboptimal adherence, variable dosing and use in patient populations that otherwise would have been excluded from clinical trials may impact the efficacy and safety profile of DOACs in a routine care setting. We compared stroke, bleeding, and mortality rates on and off therapy for standard and low-dose DOACs (apixaban, rivaroxaban, dabigatran) versus warfarin in a Canadian cohort.
Source: Thrombosis Research - May 10, 2021 Category: Hematology Authors: Elham Rahme, Richard Godin, Hacene Nedjar, Kaberi Dasgupta, Vicky Tagalakis Source Type: research

Novel antithrombotic effects of dabigatran in patients with non-valvular atrial fibrillation
Ischemic heart disease and stroke are major causes of death and morbidity worldwide. Coronary and cerebrovascular events are a consequence of thrombus formation caused by atherosclerotic plaque rupture or embolism, both of which result from platelet activation and aggregation and thrombin-mediated fibrin generation via the coagulation cascade [1]. In addition, thrombin is also one of the most effective platelet activators [2]. We focused on a novel thrombus formation mechanism called thrombin-mediated platelet stimulation and established thrombin-induced platelet aggregation [3].
Source: Thrombosis Research - February 20, 2020 Category: Hematology Authors: Keisuke Tsuda, Tatsunori Natori, Mie Shimizu, Yoko Ishigaku, Kiyotaka Oi, Shinsuke Narumi, Asami Kamada, Makiko Yoshida, Kazumasa Oura, Tetsuya Maeda, Yasuo Terayama Tags: Letter to the Editors-in-Chief Source Type: research

Direct comparisons of effectiveness and safety of treatment with Apixaban, Dabigatran and rivaroxaban in atrial fibrillation
Direct oral anticoagulants (DOACs) have been proven non-inferior or superior to warfarin in preventing stroke and systemic embolism, with a lower risk of major hemorrhage, in patients with non-valvular atrial fibrillation (NVAF). We sought to investigate whether effectiveness and safety differs among apixaban, rivaroxaban and dabigatran.
Source: Thrombosis Research - November 12, 2019 Category: Hematology Authors: M. Jansson, S. Sj älander, V. Sjögren, H. Renlund, B. Norrving, A. Själander Tags: Full Length Article Source Type: research

Oral anticoagulant-associated bleeding requiring hospitalization in Thai patients: Incidences, risk factors, and outcomes
Oral anticoagulants have been widely used in patients with atrial fibrillation (AF), mechanical valve and in the treatment of both arterial and venous thromboembolism (VTE). Warfarin is the conventional oral anticoagulant which was established its efficacy and safety profiles. Direct oral anticoagulants (DOACs) including dabigatran, rivaroxaban, and apixaban, have gained their popularity and been increasingly used since their approval in Thailand for stroke prevention in AF and VTE treatment.
Source: Thrombosis Research - September 4, 2019 Category: Hematology Authors: Kochawan Boonyawat, Patratorn Kunakorntham, Pantep Angchaisuksiri Tags: Letter to the Editors-in-Chief Source Type: research

Dabigatran, rivaroxaban and apixaban vs. high TTR warfarin in atrial fibrillation
New oral anticoagulants are non-inferior compared with warfarin regarding stroke prevention in atrial fibrillation, with similar or decreased risk of bleeding. However, it is unclear whether high TTR warfarin is as effective and safe as NOACs. Our objective was to investigate efficacy and safety of apixaban, dabigatran or rivaroxaban compared with warfarin in clinical practice.
Source: Thrombosis Research - May 17, 2018 Category: Hematology Authors: Sara Sj älander, Vilhelm Sjögren, Henrik Renlund, Bo Norrving, Anders Själander Tags: Full Length Article Source Type: research

Dabigatran reduces endothelial permeability through inhibition of thrombin-induced cytoskeleton reorganization
Dabigatran etexilate (DE), a new oral anti-coagulant, is a direct thrombin inhibitor. Clinical trials showed the favorable benefit-to-risk profile of DE compared to warfarin for the prevention of ischemic stroke in patients with atrial fibrillation. Remarkably, patients treated with dabigatran showed reduced rates of intracerebral hemorrhage compared to warfarin. As the breakdown of endothelial barrier integrity is associated with hemorrhagic events and as thrombin increases endothelial permeability, we hypothesized that dabigatran preserves the endothelial barrier by inhibiting thrombin-induced permeability.
Source: Thrombosis Research - April 25, 2018 Category: Hematology Authors: Hyun-Jung Choi, Na-Eun Kim, Jayoung Kim, Sunho An, Seung-Hee Yang, Jimin Ha, Sunghee Cho, Il Kwon, Young Dae Kim, Hyo Suk Nam, Ji Hoe Heo Tags: Full Length Article Source Type: research

The effect of dabigatran on thrombin generation and coagulation assays in rabbit and human plasma
Dabigatran etexilate is widely used for stroke prevention in the patients with atrial fibrillation. The anticoagulation activity of dabigatran is not necessary monitored in routine clinical practice. We aimed to study the effect of dabigatran on thrombin generation (TG) and coagulation assays in rabbit and human plasma.
Source: Thrombosis Research - March 14, 2018 Category: Hematology Authors: Chi Zhang, Peizhe Zhang, Hongxia Li, Lianhua Han, Lei Zhang, Lei Zhang, Xiangjun Yang Tags: Full Length Article Source Type: research

Predicted risk of stroke and bleeding and use of oral anticoagulants in atrial fibrillation: Danish nationwide temporal trends 2011 –2016
We used Danish nationwide registries to examine temporal trends in the predicted stroke and bleeding risks (mean CHA2DS2-VASc and HAS-BLED scores per year, respectively) as well as the combination of selected stroke and bleeding risk factors per year among atrial fibrillation (AF) patients initiated for the first time between 2011 and 2016 on vitamin K antagonists (VKAs), dabigatran, rivaroxaban, or apixaban.
Source: Thrombosis Research - October 16, 2017 Category: Hematology Authors: Alexandar Dukanovic, Laila Staerk, Emil Loldrup Fosb øl, Kasper Gadsbøll, Gunnar Hilmar Gislason, Jonas Bjerring Olesen Tags: Full Length Article Source Type: research

Patients' experiences of atrial fibrillation and non-vitamin K antagonist oral anticoagulants (NOACs), and their educational needs: A qualitative study
This study explores patients' experiences of dabigatran and their recommendations for development of educational materials.
Source: Thrombosis Research - March 6, 2017 Category: Hematology Authors: Danielle E Clarkesmith, Gregory Y H Lip, Deirdre A Lane Tags: Full Length Article Source Type: research

Apixaban exerts anti-inflammatory effects in mesangial cells by blocking thrombin/protease-activated receptor-1 system
Atrial fibrillation (AF) is most frequent arrhythmia in patients with chronic kidney disease (CKD) [1,2]. Since diabetes and hypertension are risk components of CHADS2 score and also risk factors for CKD, CKD could affect cardiovascular outcomes in patients with AF [2–5]. Indeed, several papers have shown that renal dysfunction increases the risk of thromboembolic events, stroke and all-cause mortality in AF patients [2–5]. In randomized trials of AF patients with stage III CKD, novel oral anticoagulant, dabigatran 150mg twice daily was superior to warfarin for stroke prevention, while apixaban was superior in regard t...
Source: Thrombosis Research - September 25, 2014 Category: Hematology Authors: Yuji Ishibashi, Takanori Matsui, Sho-ichi Yamagishi Tags: Letter to the Editor-in-Chief Source Type: research

On the monitoring of dabigatran treatment in “real life” patients with atrial fibrillation
The oral direct thrombin inhibitor dabigatran is increasingly used to prevent thromboembolic stroke in patients with atrial fibrillation (AF). Routine laboratory monitoring is currently not recommended, but measurements of dabigatran and/or its effect are desirable in certain situations. We studied dabigatran exposure and compared different tests for monitoring of dabigatran in a real-life cohort of AF patients.
Source: Thrombosis Research - July 6, 2014 Category: Hematology Authors: Mika Skeppholm, Paul Hjemdahl, Jovan P. Antovic, Josephine Muhrbeck, Jaak Eintrei, Yuko Rönquist-Nii, Anton Pohanka, Olof Beck, Rickard E. Malmström Tags: Regular Article Source Type: research

Cost-effectiveness of dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation in Taiwan
Abstract: Background: Economic evaluation of dabigatran, a new anti-antithrombotic agent, is done mostly in Western countries. It remains to be seen whether dabigatran will be cost effective in a practice environment where warfarin is significantly underused and the costs of both warfarin and international normalized ration INR monitoring are cheap.Methods: We performed a cost-effectiveness analysis with a Markov model to evaluate the value of dabigatran to prevent stroke and systemic embolism in patients with atrial fibrillation (AF) in Taiwan. Dabigatran was given through sequential dosing, where patients
Source: Thrombosis Research - March 17, 2014 Category: Hematology Authors: Chia-Hsien Chang, Yea-Huei Kao Yang, Jyh-Hong Chen, Li-Jen Lin Tags: Clinical Studies Source Type: research