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The risk of gastrointestinal hemorrhage with non-vitamin K antagonist oral anticoagulants: A network meta-analysis
Conclusion: Individual NOACs had varying profiles of GI bleeding risk. Results of analyses including only RCTs and those including both RCTs and population studies showed similar trends, but also showed several differences.
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Thrombocytopenia-Related Problems in Patients with Concomitant Atrial Fibrillation Requiring Antithrombotic Prevention: A Retrospective Cohort Study
Resumo Baixas doses de edoxabana e enoxaparina s ódica foram objeto de uma comparação retrospectiva implementada com a técnica do escore de propensão a fim de mitigar os efeitos das diferenças nas características clínicas basais de duas coortes e minimizar o risco de viés. Posteriormente, usando um modelo de riscos proporcionais de Cox, a valiou-se a associação de cada tipo de terapia com o risco do composto de morte por todas as causas, acidente vascular cerebral/ataque isquêmico transitório, hospitalizações e ocorrência de sangramentos maiores. Para essa análise, um valor de p< 0,05 foi considerado es...
Source: Arquivos Brasileiros de Cardiologia - October 23, 2020 Category: Cardiology Source Type: research

Effect of concomitant antiplatelet agents on clinical outcomes in the edoxaban vs warfarin in subjects undergoing cardioversion of atrial fibrillation (ENSURE-AF) randomized trial
ConclusionIn ENSURE-AF, thromboembolic events were rare and absolute bleeding event rates were higher with concomitant APT. These findings may be relevant for AF-patients considered for dual therapy; even for a short treatment duration of 1  month.
Source: Clinical Research in Cardiology - March 30, 2020 Category: Cardiology Source Type: research

Janssen Highlights Continued Commitment to Cardiovascular & Metabolic Healthcare Solutions with Late-Breaking Data at the First Fully Virtual American College of Cardiology Scientific Session
RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to Tweet: Jan...
Source: Johnson and Johnson - March 20, 2020 Category: Pharmaceuticals Source Type: news

Edoxaban versus warfarin in vitamin K antagonist experienced and na ïve patients from the edoxaban versus warfarin in subjects undergoing cardioversion of atrial fibrillation (ENSURE-AF) randomised trial
ConclusionsEdoxaban had comparable efficacy and safety to optimized anticoagulation with enox –warf. The primary efficacy and safety endpoint outcomes were broadly similar between VKA experienced or naïve patients.
Source: Clinical Research in Cardiology - January 7, 2020 Category: Cardiology Source Type: research

Spontaneous Retroperitoneal Hemorrhage
A 68-year-old man was admitted for pneumonia. Three months earlier he had suffered an embolic ischemic stroke related to newly diagnosed atrial fibrillation. He had residual aphasia, right hemiparesis with hemianesthesia, and was treated with subcutaneous enoxaparin 60  mg twice daily at the time of admission. Initial laboratory tests showed a white blood cell count of 12.480/mm3 and a hemoglobin level of 12.6 g/dL.
Source: The Journal of Emergency Medicine - March 13, 2019 Category: Emergency Medicine Authors: Christodoulos Dolapsakis, Vasiliki Giannopoulou, Evgenia Grivakou Tags: Visual Diagnosis in Emergency Medicine Source Type: research

Impact of Body Mass Index on Outcomes in the Edoxaban Versus Warfarin Therapy Groups in Patients Undergoing Cardioversion of Atrial Fibrillation (From ENSURE-AF)
In the EdoxabaN versus warfarin in subjectS UndeRgoing cardiovErsion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban showed similar efficacy and safety vs enoxaparin –warfarin in patients undergoing electrical cardioversion of nonvalvular atrial fibrillation. In this ancillary analysis, we compared the primary efficacy (composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular [CV] death, overall study period) and safety (composite of major and clinically relevant nonmajor [CRNM] bleeding, on-treatment) endpoints in relation to body mass index (BMI;
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: Gregory Y.H. Lip, Jose L. Merino, Maciej Banach, Joris R. de Groot, Lars S. Maier, Sakis Themistoclakis, Giuseppe Boriani, James Jin, Michael Melino, Shannon M. Winters, Andreas Goette Source Type: research

Reversal of Anticoagulation: Therapeutic Advances and Clinical Guidelines
Background: Anticoagulants are life-saving medications that prevent and treat thromboembolic disease and are of particular importance in the elderly population for prevention of stroke in atrial fibrillation. The advent of direct oral anticoagulants and reversal agents has yielded more options for patients, although complicating clinical decision-making. Areas of Uncertainty: The decision to anticoagulate in atrial fibrillation depends on the risks of stroke versus bleeding. The accompanying HAS-BLED score for predicting bleeding allows an estimation of net clinical benefit. Despite these tools, uncertainty remains. N...
Source: American Journal of Therapeutics - January 1, 2018 Category: Drugs & Pharmacology Tags: Systematic Review and Clinical Guidelines Source Type: research

Relation of Stroke and Bleeding Risk Profiles to Efficacy and Safety of Edoxaban for Cardioversion of Atrial Fibrillation (From the Edoxaban Versus Warfarin in Subjects Undergoing Cardioversion of Atrial Fibrillation ENSURE-AF Study)
In the ENSURE-AF study, edoxaban was compared to enoxaparin –warfarin in patients undergoing electrical cardioversion of nonvalvular atrial fibrillation, showing comparable low rates of bleeding and thromboembolism. This ancillary analysis investigated differences in relation to stroke and bleeding risk profiles. Secondly, we determined clinical risk profi les to quality of anticoagulation control in the warfarin arm. Primary efficacy (composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular death) and safety (composite of major and clinically relevant nonmajor bleeding) outcomes and time to...
Source: The American Journal of Cardiology - October 26, 2017 Category: Cardiology Authors: Gregory Y.H. Lip, Jose L. Merino, G. Andrei Dan, Sakis Themistoclakis, Kenneth A. Ellenbogen, Raffaele De Caterina, Assen Goudev, James Jin, Michael Melino, Shannon M. Winters, Andreas Goette Source Type: research

Anticoagulation prescribing patterns in patients with cancer
The objective of this retrospective cohort was to describe real-world anticoagulation prescribing patterns in cancer patients at a large academic medical center between January 1, 2013 and October 31, 2016. We sought to assess the safety, tolerability, and efficacy of DOACs in patients with cancer for either VTE and/or AF. Patient demographic, clinical characteristics, as well as bleeding and thrombotic events were collected. There were 214 patients in our analysis, of which 71 patients (33%) received a DOAC [apixaban (n  = 22), dabigatran (n = 17), and rivaroxaban (n = 32)]. There were fewer bleeding events an...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2017 Category: Hematology Source Type: research

Health Care Cost In Patients Undergoing Electrical Cardioversion: An Analysis From The Edoxaban Versus Warfarin In Subjects Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) Study
Electrical cardioversion (EC) restores and maintains sinus rhythm in atrial fibrillation (AF) patients. Edoxaban, a direct oral anticoagulant indicated for prevention of stroke or systemic embolic event (SEE) in patients with non-valvular atrial fibrillation (NVAF) was compared with enoxaparin –warfarin in patients undergoing EC in ENSURE-AF (NCT 02072434) study, a phase 3b open-label, multi-national open-label trial comparing edoxaban with enoxaparin/warfarin followed by warfarin alone in 2,199 NVAF patients.
Source: Value in Health - October 1, 2017 Category: International Medicine & Public Health Authors: J Rodriguez Barrrios, A Goette, J Kwong, MD Ezekowitz, M Banach, SP Hjortsh øj, D Zamoryakhin, G Lip 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

Anticoagulation Control in Warfarin-Treated Patients Undergoing Cardioversion of Atrial Fibrillation (from the Edoxaban Versus Enoxaparin –Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation Trial)
In the Edoxaban Versus Enoxaparin –Warfarin in Patients Undergoing Cardioversion of Atrial Fibrillation (ENSURE-AF) study (NCT 02072434), edoxaban was compared with enoxaparin–warfarin in 2,199 patients undergoing electrical cardioversion of nonvalvular atrial fibrillation (AF). In this multicenter prospective randomized open bl inded end-point trial, we analyzed patients randomized to enoxaparin–warfarin. We determined time to achieve therapeutic range (TtTR); time in therapeutic range (TiTR); their clinical determinants; relation to sex, age, medical history, treatment, tobacco use, race risk (SAMe-TT2R2) score; an...
Source: The American Journal of Cardiology - June 15, 2017 Category: Cardiology Authors: Gregory Y.H. Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M. Winters, Dmitry Zamoryakhin, Andreas Goette Tags: Arrhythmias and Conduction Disturbances Source Type: research

Anticoagulation Control in Warfarin Treated Patients Undergoing Cardioversion for Atrial Fibrillation (From the ENSURE-AF Trial)
In the ENSURE-AF study (NCT 02072434), edoxaban was compared to enoxaparin –warfarin in 2199 patients undergoing electrical cardioversion of non-valvular atrial fibrillation (AF). In this multicenter PROBE trial, we analyzed patients randomized to enoxaparin–warfarin. We determined time to achieve therapeutic range (TtTR), time in therapeutic range (TiTR), their clinic al determinants, relation to SAMe-TT2R2 score, and impact on primary endpoints (composite of stroke, systemic embolic event [SEE], myocardial infarction [MI], and cardiovascular death [CVD] and composite of major + clinically relevant non-major [CRNM] bleeding).
Source: The American Journal of Cardiology - June 15, 2017 Category: Cardiology Authors: Gregory Y H Lip, Naab Al-Saady, James Jin, Ming Sun, Michael Melino, Shannon M Winters, Dmitry Zamoryakhin, Andreas Goette Source Type: research

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