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Condition: Thrombosis
Drug: Pradaxa

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Total 508 results found since Jan 2013.

Resolution (and Late Recurrence) of WATCHMAN Device–Related Thrombus Following Treatment with Dabigatran
The WATCHMAN left atrial (LA) appendage closure system is an alternative therapy for stroke prevention in patients with atrial fibrillation who are intolerant to chronic oral anticoagulation with warfarin. Infrequently, LA device–related thrombus (DRT) has been suspected. Optimal treatment of DRT is not known, and the efficacy of novel oral anticoagulants (NOAC) in this setting has not been previously described. A 69‐year‐old woman with permanent atrial fibrillation underwent WATCHMAN device placement. A transesophageal echocardiogram (TEE) performed 45 days following implant revealed a well‐seated device. A 1‐ye...
Source: Echocardiography - January 17, 2016 Category: Cardiology Authors: Abdul H. Qazi, Alan P. Wimmer, Kenneth C. Huber, George G. Latus, Michael L. Main Tags: Case Report Source Type: research

Reversing the Effect of Oral Anticoagulant Drugs: Established and Newer Options
Abstract The vitamin K antagonists (VKAs) have been the standard (and only) oral anticoagulants used for the long-term treatment or prevention of venous thromboembolism or stroke in patients with atrial fibrillation. The coagulopathy induced by VKAs can be reversed with vitamin K, and in urgent situations, the vitamin K-dependent coagulation factors can be replaced by transfusion. In the last decade, a new class of oral anticoagulants has been developed, direct oral anticoagulants that bind to a specific coagulation factor and neutralize it. These compounds were shown to be effective and safe compared with the VKA...
Source: American Journal of Cardiovascular Drugs - February 12, 2016 Category: Cardiology Source Type: research

Evaluating coagulation tests in patients with atrial fibrillation using direct oral anticoagulants.
Authors: Chan NC, Bhagirath V, Dale BJ, Eikelboom JW Abstract Four direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, edoxaban) have been shown to be at least as effective and safe as warfarin for the prevention of stroke in atrial fibrillation and the prevention and treatment of venous thromboembolism. Although they are administered in fixed doses without routine coagulation monitoring, measurement of anticoagulant effect or drug levels may be useful to determine if: anticoagulant effect is present in patients who are bleeding or require an urgent procedure or thrombolysis; levels are within usual on-t...
Source: Expert Review of Cardiovascular Therapy - February 17, 2016 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Reimagining Anticoagulation Clinics in the Era of Direct Oral Anticoagulants Cardiovascular Perspective
Anticoagulation clinics were initially developed to provide safe and effective care for warfarin-treated patients with atrial fibrillation, venous thromboembolism, and mechanical valve replacement. Traditionally, these patients required ongoing laboratory monitoring and warfarin dose adjustment by expert providers. With the introduction of direct oral anticoagulants (dabigatran, rivaroxaban, apixaban, and edoxaban), many have questioned the need for anticoagulation clinic. However, we think that the growing number of oral anticoagulant choices creates an urgent need for expanding the traditional role of the anticoagulation...
Source: Circulation: Cardiovascular Quality and Outcomes - March 15, 2016 Category: Cardiology Authors: Barnes, G. D., Nallamothu, B. K., Sales, A. E., Froehlich, J. B. Tags: Atrial Fibrillation, Ethics and Policy, Health Services, Ischemic Stroke, Thrombosis Cardiovascular Perspective Source Type: research

Medication adherence to rivaroxaban and dabigatran for stroke prevention in patients with non-valvular atrial fibrillation in the United States
The objective of this real-life study was to compare medication adherence to newly-initiated rivaroxaban or dabigatran therapy among NVAF patients in the United States (US).
Source: International Journal of Cardiology - March 17, 2016 Category: Cardiology Authors: Craig I. Coleman, Muralikrishna Tangirala, Thomas Evers Tags: Correspondence Source Type: research

Use of the Direct Oral Anticoagulants in Obese Patients: guidance from the SSC of the ISTH
This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - February 29, 2016 Category: Hematology Authors: K Martin, J Beyer‐Westendorf, BL Davidson, MV Huisman, PM Sandset, S Moll Tags: Recommendations and Guidelines Source Type: research

Management of direct oral anticoagulants in women of childbearing potential: guidance from the SSC of the ISTH
This article is protected by copyright. All rights reserved.
Source: Journal of Thrombosis and Haemostasis - April 30, 2016 Category: Hematology Authors: Hannah Cohen, Deepa Jayakody Arachchillage, Saskia Middeldorp, Jan Beyer‐Westendorf, Rezan Abdul Kadir Tags: Recommendations and Guidelines Source Type: research

Coagulation assessment with the new generation of oral anticoagulants
Long-term oral anticoagulant (OAC) therapy is used for the treatment and prevention of thrombosis and thromboembolism. As OAC use is so widespread, emergency physicians are likely to encounter patients on anticoagulant therapy in the emergency department (ED) on a regular basis, either for the same reasons as the population in general or as a result of the increased bleeding risk that OAC use entails. The vitamin K antagonist warfarin has been the standard OAC for several decades, but recently, the newer agents dabigatran etexilate, rivaroxaban and apixaban (collectively, novel OACs, non-vitamin K OACs, or simply ‘NO...
Source: Emergency Medicine Journal - May 18, 2016 Category: Emergency Medicine Authors: Pollack, C. V. Tags: Open access, Drugs: cardiovascular system, Stroke, Venous thromboembolism Review Source Type: research

Direct oral anticoagulant associated bleeding.
Abstract Direct oral anticoagulants (DOAC) are recommended for stroke prevention in atrial fibrillation and for the treatment of venous thromboembolism. However, they are associated with hemorrhagic complications. Management of DOAC-induced bleeding remains challenging. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. Therapeutic options also include antidotes: idarucizumab, antidote for dabigatran, has been approved for use whereas andexanet alpha, antidote for anti-Xa agents, and aripazine, antidote for all DOAC, are under development. Other ...
Source: Journal des Maladies Vasculaires - June 9, 2016 Category: Cardiology Authors: Godier A, Martin AC, Rosencher N, Susen S Tags: J Mal Vasc Source Type: research

Dabigatran in clinical practice: Contemporary overview of the evidence
Oral anticoagulation is the cornerstone of stroke prevention in non-valvular atrial fibrillation (AF) and management of venous thromboembolism (VTE), resulting in a reduction in thrombotic complications and mortality. Benefit of vitamin K antagonists (VKAs) in such patients has been unambiguously confirmed, but VKA use is complicated by need for regular monitoring of the international normalized ratio and multiple drug and food interactions.Dabigatran is an oral direct thrombin inhibitor that can be used with fixed doses, without the need for routine anticoagulation laboratory monitoring and the advantage of few drug or diet interactions.
Source: International Journal of Cardiology - June 22, 2016 Category: Cardiology Authors: Walter Ageno, John Eikelboom, Gregory Y.H. Lip Source Type: research

Dabigatran Versus Warfarin in Relation to Renal Function in Patients With Atrial Fibrillation
The pivotal RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial demonstrated that dabigatran (150 mg twice daily) was superior to warfarin in reducing thromboembolism with a similar risk of major bleeding (1). Because renal dysfunction increases the risk of thromboembolism and bleeding and dabigatran has significant renal clearance, establishing its comparative effectiveness versus warfarin across the range of renal function is critical in determining the optimal treatment for patients with atrial fibrillation (AF). Indeed, an interaction between renal function and major bleeding risk has been previous...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - June 27, 2016 Category: Radiology Source Type: research

Real-world comparison of major bleeding risk among non-valvular atrial fibrillation patients initiated on apixaban, dabigatran, rivaroxaban, or warfarin. A propensity score matched analysis.
Abstract In addition to warfarin, there are four non-vitamin K antagonist oral anticoagulants (NOACs) available for stroke prevention in non valvular atrial fibrillation (NVAF). There are limited data on the comparative risks of major bleeding among newly anticoagulated NVAF patients who initiate warfarin, apixaban, dabigatran, or rivaroxaban, when used in 'real world' clinical practice. The study used the Truven MarketScan® Commercial & Medicare supplemental US claims database. NVAF patients aged ≥18 years newly prescribed an oral anticoagulant 01JAN2013-31DEC2014, with a ≥1-year baseline period, were in...
Source: Thrombosis and Haemostasis - August 18, 2016 Category: Hematology Authors: Lip GY, Keshishian A, Kamble S, Pan X, Mardekian J, Horblyuk R, Hamilton M Tags: Thromb Haemost Source Type: research

Measurement and Reversal of the Direct Oral Anticoagulants
Direct oral anticoagulants (DOACs) offer non-inferior efficacy and improved safety compared to vitamin K antagonists (VKAs) for prevention and treatment of venous thromboembolism and prevention of stroke and systemic embolism in non-valvular atrial fibrillation. Unlike VKAs, DOACs do not require routine laboratory monitoring of anticoagulant effect and dose adjustment. In certain situations, however, laboratory assessment of anticoagulant effect may be desirable. Here we review the utility of currently available assays for assessment of DOAC effect and recommend an optimal assessment strategy for each drug, including calib...
Source: Blood Reviews - September 1, 2016 Category: Hematology Authors: Bethany T. Samuelson, Adam Cuker Tags: Review Source Type: research

Direct Oral Anticoagulants in Emergency Trauma Admissions.
CONCLUSION: DOACs in the setting of hemorrhage are a clinical challenge in the traumatological emergency room because of the inadequate validity of the relevant laboratory tests. An emergency antidote is now available only for dabigatran. PMID: 27658470 [PubMed - in process]
Source: Deutsches Arzteblatt International - September 24, 2016 Category: Journals (General) Tags: Dtsch Arztebl Int Source Type: research

Direct oral anticoagulants in the elderly: systematic review and meta-analysis of evidence, current and future directions.
CONCLUSION: DOACs show the same or greater efficacy than vitamin K antagonists in elderly patients with atrial fibrillation and VTE. Individual differences between DOACs in terms of safety profile cannot be excluded on the basis of current evidence. Direct head-to-head comparisons are needed to investigate possible divergence in pharmacological profiles between DOACs. Additionally, further studies conducted in real-word settings and in the frail elderly are ongoing and it would be interesting to target this particular patient group. PMID: 27683276 [PubMed - as supplied by publisher]
Source: Swiss Medical Weekly - October 1, 2016 Category: Journals (General) Authors: Sadlon AH, Tsakiris DA Tags: Swiss Med Wkly Source Type: research