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Condition: Heart Valve Disease
Drug: Pradaxa

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Total 23 results found since Jan 2013.

Reduced dose direct oral anticoagulants compared with warfarin with high time in therapeutic range in nonvalvular atrial fibrillation
The objective of this study was to compare effectiveness and safety between reduced dose DOACs and high TTR warfarin treatment (TTR  ≥ 70%) in NVAF. A Swedish anticoagulation registry was used in identifying eligible patients from July 2011 to December 2017. The study cohort consisted of 40,564 patients with newly initiated DOAC (apixaban, dabigatran, or rivaroxaban) (11,083 patients) or warfarin treatment (29,481 patients ) after exclusion of 374,135 patients due to not being warfarin or DOAC naïve, not being prescribed reduced dose, having previous mechanical heart valve (MHV), or being under 18 years old. The me...
Source: Journal of Thrombosis and Thrombolysis - January 6, 2023 Category: Hematology Source Type: research

Comparison of Direct Oral Anticoagulants versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves
The objectives of this study were to evaluate the ambulatory utilization of DOACs and to compare the effectiveness and safety of DOACs versus warfarin in patients with AF and BHVs. We conducted a retrospective cohort study at a large integrated health care delivery system in California. Patients with BHVs and AF treated with warfarin, dabigatran, rivaroxaban or apixaban between September 12, 2011 and June 18, 2020 were identified.
Source: The American Journal of Cardiology - January 30, 2021 Category: Cardiology Authors: Lewei Duan, Jason N Doctor, John L Adams, John A Romley, Leigh-Anh Nguyen, Jaejin An, Ming-Sum Lee Source Type: research

Clinical Benefit of Direct Oral Anticoagulants Versus Vitamin K Antagonists in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves.
Abstract PURPOSE: The use of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) and bioprosthetic heart valve is still controversial. The aim of this study was to compare the tolerability and effectiveness of treatment with DOACs versus vitamin K antagonists (VKAs) in patients with AF and a bioprosthetic heart valve in clinical practice. METHODS: Data for this study were sourced from the multicenter, prospectively maintained AF Research Database (NCT03760874), which includes all patients with AF undergoing follow-up at participating centers through outpatient visits every 3-6 months....
Source: Clinical Therapeutics - November 13, 2019 Category: Drugs & Pharmacology Authors: Russo V, Carbone A, Attena E, Rago A, Mazzone C, Proietti R, Parisi V, Scotti A, Nigro G, Golino P, D'Onofrio A Tags: Clin Ther Source Type: research

Oral Anticoagulation.
CONCLUSION: The evidence base for anticoagulation over a time frame of several years is inadequate at present, and direct comparative data for the different types of NOAC are not yet available. PMID: 30602410 [PubMed - in process]
Source: Deutsches Arzteblatt International - January 5, 2019 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research

Non-vitamin K antagonist oral anticoagulants in atrial fibrillation patients with bioprosthetic valves.
Authors: Andrade JG, Meseguer E, Didier R, Dussault C, Weitz JI Abstract INTRODUCTION: The non-vitamin K antagonist oral anticoagulants (NOACs), which include dabigatran, apixaban, edoxaban and rivaroxaban, are preferred over vitamin K antagonists for stoke prevention in most patients with non-valvular atrial fibrillation. The NOACs are contraindicated in atrial fibrillation patients with rheumatic mitral stenosis or mechanical heart valves. There is evidence that bioprosthetic heart valves are less thrombogenic than mechanical heart valves, but it is unknown whether the risk of thromboembolism in atrial fibrillati...
Source: Expert Review of Cardiovascular Therapy - May 25, 2018 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

FDA Drug Safety Communication: Pradaxa (dabigatran etexilate mesylate) should not be used in patients with mechanical prosthetic heart valves
The U.S. Food and Drug Administration (FDA) is informing health care professionals and the public that the blood thinner (anticoagulant) Pradaxa (dabigatran etexilate mesylate) should not be used to prevent stroke or blood clots (major thromboembolic events) in patients with mechanical heart valves, also known as mechanical prosthetic heart valves.
Source: FDA Center for Drug Evaluation and Research - What's New - February 13, 2018 Category: Drugs & Pharmacology Source Type: news

Nonvitamin K Antagonist Oral Anticoagulants Use in Patients with Atrial Fibrillation and Bioprosthetic Heart Valves/Prior Surgical Valve Repair: A Multicenter Clinical Practice Experience
Semin Thromb Hemost DOI: 10.1055/s-0037-1615261This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and...
Source: Seminars in Thrombosis and Hemostasis - January 5, 2018 Category: Hematology Authors: Russo, Vincenzo Attena, Emilio Mazzone, Carmine Esposito, Francesca Parisi, Valentina Bancone, Ciro Rago, Anna Nigro, Gerardo Sangiuolo, Raffaele D' Onofrio, Antonio Tags: Original Article Source Type: research

Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials.
Source: Clinical Cardiology - December 21, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews 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

Practical Considerations for the Nonvitamin K Antagonist Oral Anticoagulants
Conclusions: Several important factors should be considered regarding the adequate use of NOACs, especially in patients with renal impairment or cardiovascular conditions other than NVAF.Cardiology 2017;136:115-124
Source: Cardiology - September 5, 2016 Category: Cardiology Source Type: research

Comparison of Dabigatran versus Warfarin in Patients with Atrial Fibrillation and Valvular Heart Disease: The RE-LY Trial.
CONCLUSIONS: -The presence of any VHD did not influence the comparison of dabigatran with warfarin. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique Identifier: NCT00262600. PMID: 27496855 [PubMed - as supplied by publisher]
Source: Circulation - August 4, 2016 Category: Cardiology Authors: Ezekowitz MD, Nagarakanti R, Noack H, Brueckmann M, Litherland C, Jacobs M, Clemens A, Reilly PA, Connolly SJ, Yusuf S, Wallentin L Tags: Circulation Source Type: research

Novel Oral Anticoagulants in Atrial Fibrillation: Update on Apixaban.
Authors: Mezue K, Obiagwu C, John J, Sharma A, Yang F, Shani J Abstract Almost 800,000 new or recurrent strokes happen every year. Atrial fibrillation, the most common cardiac arrhythmia, is a major risk factor for stroke, accounting for 15-20% of ischemic strokes. Apixaban is a direct inhibitor of Factor Xa that was approved in December 2012 by the US Food and Drug Administration (FDA) for the prevention of stroke in patients with non-valvular atrial fibrillation. It is part of a family of novel oral anticoagulants (NOACs) which have the advantage over warfarin of less dosing variability, rapid onset of action and...
Source: Current Cardiology Reviews - July 29, 2016 Category: Cardiology Tags: Curr Cardiol Rev Source Type: research

Dabigatran is Less Effective Than Warfarin at Attenuating Mechanical Heart Valve-Induced Thrombin Generation Valvular Heart Disease
Conclusions MHV induce thrombin generation via the intrinsic pathway and generate sufficient thrombin to overwhelm clinically relevant dabigatran concentrations. In contrast, warfarin is more effective than dabigatran at suppressing MHV-induced thrombin generation. These data explain why dabigatran failed in MHV patients and suggest that strategies targeting FXII or FXI may suppress the root cause of thrombosis in such patients.
Source: JAHA:Journal of the American Heart Association - August 24, 2015 Category: Cardiology Authors: Jaffer, I. H., Stafford, A. R., Fredenburgh, J. C., Whitlock, R. P., Chan, N. C., Weitz, J. I. Tags: Valvular Heart Disease Source Type: research