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Condition: Hemorrhagic Stroke
Drug: Pradaxa

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Total 307 results found since Jan 2013.

Difference of Clinical Condition of Ischemic Stroke between Warfarin and Direct Oral Anticoagulants (P6.285)
Conclusions:Ischemic lesion size may be smaller in DOACs compared with warfarin. There is a possibility that direct thrombin inhibitor may provide better outcome compared with other anticoagulants. Larger prospective study should be conducted to confirm these findings.Disclosure: Dr. Nakase has nothing to disclose. Dr. Moroi has nothing to disclose. Dr. Ishikawa has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Nakase, T., Moroi, J., Ishikawa, T. Tags: Prevention of Cerebrovascular Disease Source Type: research

Acute Stroke Despite Dabigatran Anticoagulation Treated with Idarucizumab and Intravenous Tissue Plasminogen Activator
Dabigatran is a direct thrombin inhibitor used to reduce the risk of stroke in patients with nonvalvular atrial fibrillation. For patients who present with an acute stroke despite dabigatran therapy, clinical data on the use of intravenous tissue plasminogen activator (IV-tPA) is limited. There is an anticipated increased risk of symptomatic intracranial hemorrhage (sICH) when using IV-tPA in patients on dabigatran therapy. In 2015, the humanized monoclonal antibody fragment idarucizumab was approved for rapid (minutes) reversal of anticoagulant effects of dabigatran.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2017 Category: Neurology Authors: David Bissig, Rashmi Manjunath, Brittany R. Traylor, David P. Richman, Kwan L. Ng Tags: Case Studies Source Type: research

Rivaroxaban Versus Dabigatran or Warfarin in Real-World Studies of Stroke Prevention in Atrial Fibrillation Clinical Sciences
Conclusions—In this systematic review and meta-analysis, rivaroxaban was as effective as dabigatran, but was more effective than warfarin for the prevention of stroke/thromboembolism in atrial fibrillation patients. Major bleeding risk was significantly higher with rivaroxaban than with dabigatran, as was all-cause mortality and gastrointestinal bleeding. Rivaroxaban was comparable to warfarin for major bleeding, with an increased risk in gastrointestinal bleeding and decreased risk of intracranial hemorrhage.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Ying Bai, Hai Deng, Alena Shantsila, Gregory Y.H. Lip Tags: Meta Analysis, Quality and Outcomes Original Contributions Source Type: research

Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation.
Authors: Antoniou T, Macdonald EM, Yao Z, Hollands S, Gomes T, Tadrous M, Mamdani MM, Juurlink DN, Canadian Drug Safety and Effectiveness Research Network Abstract BACKGROUND: Dabigatran etexilate is a prodrug whose absorption is opposed by intestinal P-glycoprotein and which is converted by carboxylesterase to its active form, dabigatran. Unlike other statins, simvastatin and lovastatin are potent inhibitors of P-glycoprotein and carboxylesterase, and might either increase the risk of hemorrhage with dabigatran etexilate or decrease its effectiveness. METHODS: We conducted 2 population-based, nested case-contr...
Source: Canadian Medical Association Journal - March 3, 2017 Category: Journals (General) Tags: CMAJ Source Type: research

Response to "Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation".
PMID: 28246232 [PubMed - in process]
Source: cmaj - February 26, 2017 Category: Journals (General) Authors: Antoniou T, Mamdani M, Juurlink D Tags: CMAJ Source Type: research

Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation.
PMID: 28246231 [PubMed - in process]
Source: cmaj - February 26, 2017 Category: Journals (General) Authors: Haertter S, Huang F, Franca LR Tags: CMAJ Source Type: research

Effects on bone metabolism markers and arterial stiffness by switching to rivaroxaban from warfarin in patients with atrial fibrillation
This study aimed to evaluate the effects of changing from warfarin to rivaroxaban on bone mineral metabolism, vascu lar calcification, and vascular endothelial dysfunction. We studied 21 consecutive patients with persistent or chronic AF, who were treated with warfarin at least for 12 months. Warfarin administration was changed to rivaroxaban (10 or 15 mg/day) in all patients. Osteopontin (OPN), bone alkaline ph osphatase (BAP), and under-carboxylated osteocalcin (ucOC) were measured. Pulse wave velocity (PWV) and augmentation index (AI) were also measured as atherosclerosis assessments. All measurements were done before ...
Source: Heart and Vessels - February 22, 2017 Category: Cardiology Source Type: research

Real-life experience with the specific reversal agent idarucizumab for the management of emergency situations in dabigatran-treated patients: a series of 11 cases
We report 11 real-life clinical cases in which idarucizumab was used after multidisciplinary consultation in a variety of emergency situations including severe postoperative bleeding, emergency high-bleeding-risk surgery (hip/spine surgery and neurosurgery), invasive diagnostic testing (lumbar puncture), intracranial bleeding (pre-pontine subarachnoid hemorrhage and lobar intracerebral hemorrhage) and thrombolysis with recombinant tissue plasminogen activator for acute ischemic stroke. This case series illustrates the role of idarucizumab in improving patient safety in rare emergency situations requiring rapid reversal of ...
Source: Journal of Thrombosis and Thrombolysis - February 15, 2017 Category: Hematology Source Type: research

Hemopericardium under dabigatran for stroke prevention in atrial fibrillation
We report a polymorbid 75-year old male under a therapy with dabigatran, valsartan, amlodipine, nicorandil, furosemide, atorvastatin, bisoprolol, metformin, tizanidine, pantoprazole, and tramadol. He suffered from chest pain for 4 months. Coronary angiography showed only ectatic coronary arteries. He started taking nonsteroidal anti-inflammatory drugs. He was hospitalized because of dyspnea starting 10 days before admission, melena, and renal failure. Hemopericardium was diagnosed and pericardiocentesis yielded 2000 ml hemorrhagic fluid. Review of previous echocardiograms showed a 4 mm echo-free space, epicardial fat o...
Source: Blood Coagulation and Fibrinolysis - February 11, 2017 Category: Hematology Tags: Case Reports Source Type: research

Dabigatran Etexilate: A Review in Nonvalvular Atrial Fibrillation
AbstractDabigatran etexilate (Pradaxa®) is approved in the EU for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (NVAF) and one or more risk factors. Dabigatran etexilate is a prodrug of dabigatran, a direct inhibitor of thrombin. In patients with NVAF in the phase  III RE-LY trial, dabigatran etexilate dosages of 110 and 150 mg twice daily were noninferior to warfarin with regard to the risk of stroke or systemic embolism (primary efficacy endpoint). The higher dosage was associated with a significantly lower risk of stroke or systemic embolism than warfari n, with no si...
Source: Drugs - February 8, 2017 Category: Drugs & Pharmacology Source Type: research

Anticoagulant-related nephropathy: a case report and review of the literature of an increasingly recognized entity
Abstract Treatment with oral anticoagulants has been associated with worsening kidney function in patients with chronic kidney disease (CKD) as well as among patients without underlying CKD. Thus, anticoagulant-related nephropathy (ARN) is an increasingly recognized entity nowadays, mainly associated with warfarin anticoagulation. Recent evidence indicates that patients treated with the direct anticoagulants may also be at risk of ARN. However, the true incidence of anticoagulant-related nephropathy is difficult to determine. The typical histological lesion involves renal tubular occlusion by red blood cells (RBCs), tubu...
Source: International Urology and Nephrology - February 3, 2017 Category: Urology & Nephrology Source Type: research

Use of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Taking Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) Before Stroke.
CONCLUSIONS: -While experience of using rt-PA in ischemic stroke patients on a NOAC is limited, these preliminary observations suggest that rt-PA appears to be reasonably well tolerated without prohibitive risks for adverse events among selected NOAC treated patients. Future study should evaluate the safety and efficacy of intravenous rt-PA in ischemic stroke patients taking NOACs. PMID: 28119380 [PubMed - as supplied by publisher]
Source: Circulation - January 23, 2017 Category: Cardiology Authors: Xian Y, Federspiel JJ, Hernandez AF, Laskowitz D, Schwamm LH, Bhatt DL, Smith EE, Fonarow GC, Peterson ED Tags: Circulation Source Type: research

Anticoagulation Use and Clinical Outcomes After Major Bleeding on Dabigatran or Warfarin in Atrial Fibrillation Clinical Sciences
Conclusions—Dabigatran was associated with a superior benefit/risk ratio than warfarin and anticoagulation discontinuation in the treatment of atrial fibrillation patients who have survived a major bleed.
Source: Stroke - December 22, 2016 Category: Neurology Authors: Inmaculada Hernandez, Yuting Zhang, Maria M. Brooks, Paul K.L. Chin, Samir Saba Tags: Atrial Fibrillation, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Propensity Score Weighting Compared to Matching in a Study of Dabigatran and Warfarin
ConclusionsIn this example, different applications of the same PS led to substantially different results, a finding that was particularly apparent with IPTW, and this was remedied by truncating extreme weights. If IPTW is used, information regarding the weights applied along with sensitivity analyses could avoid misrepresentation of study results, and would enhance their interpretation.
Source: Drug Safety - November 28, 2016 Category: Drugs & Pharmacology Source Type: research

Dabigatran vs Rivaroxaban for Nonvalvular Atrial Fibrillation
This cohort study compares risks of thromboembolic stroke, intracranial hemorrhage, major extracranial bleeding, and mortality in Medicare beneficiaries with nonvalvular atrial fibrillation who initiated dabigatran or rivaroxaban therapy for stroke prevention.
Source: JAMA Internal Medicine - November 1, 2016 Category: Internal Medicine Source Type: research