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Condition: Hemorrhagic Stroke
Drug: Pradaxa

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Total 307 results found since Jan 2013.

Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results From PROTECT AF Versus PREVAIL Original Article
Conclusions— Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer-term trial results and postmarketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical practice.
Source: Circulation: Arrhythmia and Electrophysiology - June 14, 2016 Category: Cardiology Authors: Freeman, J. V., Hutton, D. W., Barnes, G. D., Zhu, R. P., Owens, D. K., Garber, A. M., Go, A. S., Hlatky, M. A., Heidenreich, P. A., Wang, P. J., Al-Ahmad, A., Turakhia, M. P. Tags: Arrhythmias, Atrial Fibrillation, Anticoagulants, Treatment Original Article 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

Help Desk Answers: Do novel oral anticoagulants safely prevent stroke in patients with nonvalvular A-fib?
Abstract Yes. Dabigatran, rivaroxaban, and apixaban are safe and effective compared with warfarin for preventing stroke in patients with nonvalvular atrial fibrillation. These novel oral anticoagulants (NOACs) are noninferior in reducing the number of strokes and systemic emboli and in lowering all-cause mortality while not increasing major bleeding complications and hemorrhagic events. PMID: 27474824 [PubMed - as supplied by publisher]
Source: The Journal of Family Practice - May 31, 2016 Category: Practice Management Authors: Siewert R, Hostetter J Tags: J Fam Pract Source Type: research

Comparative Effectiveness of Interventions for Stroke Prevention in Atrial Fibrillation: A Network Meta-Analysis Arrhythmia and Electrophysiology
Conclusions The entire spectrum of therapy to prevent thromboembolism in nonvalvular AF significantly reduced stroke/systemic embolism events and mortality.
Source: JAHA:Journal of the American Heart Association - May 19, 2016 Category: Cardiology Authors: Tereshchenko, L. G., Henrikson, C. A., Cigarroa, J., Steinberg, J. S. Tags: Atrial Fibrillation, Anticoagulants, Treatment, Meta Analysis, Cerebrovascular Disease/Stroke Arrhythmia and Electrophysiology Source Type: research

Dabigatran etexilate reduces thrombin-induced inflammation and thrombus formation in experimental ischemic stroke.
Abstract Dabigatran etexilate (DE), a direct-acting, oral inhibitor of thrombin, significantly reduces the risk of stroke compared with traditional anticoagulants, without increasing the risk of major bleeding. However, studies on the fate of cerebral tissue after ischemic stroke in patients receiving DE are sparse and the role of dabigatran-mediated reduction of thrombin in this context has not yet been investigated. Here, we investigated whether pretreatment with DE reduces thrombin-mediated pro-inflammatory mechanisms and leakage of the blood-brain barrier (BBB) following ischemic stroke in rats. Male Wistar ra...
Source: Current Neurovascular Research - May 16, 2016 Category: Neurology Authors: Dittmeiera M, Wassmutha K, Schuhmanna MK, Krafta P, Kleinschnitz C, Fluri F Tags: Curr Neurovasc Res Source Type: research

From 'Sweet Clover Disease' to NOACs: A Historical Perspective on Oral Anticoagulation for Prevention of Cardioembolic Stroke (P2.397)
CONCLUSIONS: Warfarin, born from ‘sweet clover disease’ and humble beginnings as rodenticide, has been the cornerstone of cardioembolic stroke prevention. Its shortcomings inspired the development of a new generation of oral anticoagulants.Disclosure: Dr. Chiota-McCollum has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Chiota-McCollum, N. Tags: History of Neurology Source Type: research

Design and rationale of dabigatran's stroke prevention in real life in Turkey (D-SPIRIT).
CONCLUSION: Potential results of D-SPIRIT registry will add data from clinical practice to those from the RE-LY trial to expand knowledge of dabigatran etexilate treatment in patients with NVAF. PMID: 27138311 [PubMed - in process]
Source: Turk Kardiyoloji Dernegi arsivi - March 31, 2016 Category: Cardiology Authors: Türk UÖ, Alioğlu E, Tunçer E, Özpelit ME, Pekel N, Tengiz İ, Çetin N, Dalgıç O, Topaloğlu C, Bilgin N, Altın C, Özdemirkıran T, Tülüce K, Türkoğlu Eİ, Özpelit E Tags: Turk Kardiyol Dern Ars Source Type: research

Clinical and economic consequences of using dabigatran or rivaroxaban in patients with non-valvular atrial fibrillation
Conclusions The results show that dabigatran is a dominant alternative, i.e., it produces better clinical results at a lower cost. Sensitivity analysis demonstrates that the results are robust even considering the uncertainty inherent in an indirect comparison. It can thus be concluded that in clinical practice in Portugal the use of dabigatran is to be preferred to the use of rivaroxaban.
Source: Revista Portuguesa de Cardiologia - March 4, 2016 Category: Cardiology Source Type: research

Non‐vitamin K Oral Anticoagulants Versus Warfarin for Patients with Atrial Fibrillation: Absolute Benefit and Harm Assessments Yield Novel Insights
ConclusionsFor the primary outcome, the absolute benefits of NOACs were modest (NNT/year values being large). Reduced hemorrhagic stroke rates with NOACs could be due to superior embolic infarct prevention and fewer consequential hemorrhagic transformations. Among apixaban recipients, the absolute mortality benefit exceeded that for the primary outcome, indicating prevention of additional unrelated deaths. The substantially greater NOAC acquisition costs need viewing against probable greater safety and the avoidance of monitoring bleeding risks.
Source: Cardiovascular Therapeutics - March 3, 2016 Category: Cardiology Authors: Cyrus R. Kumana, Bernard M.Y. Cheung, David C.W. Siu, Hung‐Fat Tse, Ian J. Lauder Tags: Unsolicited Review Source Type: research

Challenges and Treatment for Stroke Prophylaxis in Patients with Atrial Fibrillation in Mexico: A Review
Abstract Atrial fibrillation (AF) is associated with an increased risk of stroke. AF-related strokes cause greater disability and mortality than those in patients without AF, and are associated with a significant clinical and economic burden in Mexico. Antithrombotic therapy reduces stroke risk in patients with AF and is recommended for all patients except those classified as having a low stroke risk. However, its use is suboptimal all around the world; one study showed that only 4 % of Mexican patients with AF who presented with ischemic stroke were in the therapeutic range for anticoagulation. Vitamin K antagon...
Source: American Journal of Cardiovascular Drugs - February 29, 2016 Category: Cardiology Source Type: research

Effect of Adherence to Oral Anticoagulants on Risk of Stroke and Major Bleeding Among Patients With Atrial Fibrillation Arrhythmia and Electrophysiology
Conclusions Adherence to anticoagulation is poor in practice and may be modestly improved with NOACs. Adherence to therapy appears to be most important in patients with CHA2DS2-VASc score ≥2, whereas the benefits of anticoagulation may not outweigh the harms in patients with CHA2DS2-VASc score 0 or 1.
Source: JAHA:Journal of the American Heart Association - February 23, 2016 Category: Cardiology Authors: Yao, X., Abraham, N. S., Alexander, G. C., Crown, W., Montori, V. M., Sangaralingham, L. R., Gersh, B. J., Shah, N. D., Noseworthy, P. A. Tags: Arrhythmias, Atrial Fibrillation, Secondary Prevention, Intracranial Hemorrhage, Ischemic Stroke Arrhythmia and Electrophysiology Source Type: research

Dabigatran Versus Warfarin After Bioprosthesis Valve Replacement for the Management of Atrial Fibrillation Postoperatively: DAWA Pilot Study
Conclusions The use of dabigatran appears to be similar to warfarin in preventing the formation of intracardiac thrombus. Trial Registration Clinicaltrials.gov NCT01868243.
Source: Drugs in R&D - February 18, 2016 Category: Drugs & Pharmacology Source Type: research

Dabigatran Versus Warfarin in Atrial Fibrillation: Multicenter Experience in Turkey
Safety issues have been raised about dabigatran. We aimed to investigate the occurrence of safety outcomes in patients who had atrial fibrillation and a risk of stroke. We analyzed 439 patients prescribed dabigatran (n = 220) or warfarin (n = 219). Ischemic stroke occurred in 15 (6.8%) patients in the warfarin group versus 5 (5.2%) patients in the 110-mg group versus 1 (0.8%) patient in the 150-mg dabigatran group (P = .015). Intracranial hemorrhage occurred in 6 (2.7%) patients in the warfarin group versus 3 (2.4%) patients in the 150-mg dabigatran group (P = .104). Death from any cause occurred in 10 (4.6%) patients in t...
Source: Clinical and Applied Thrombosis/Hemostasis - February 2, 2016 Category: Hematology Authors: Aslan, O., Yaylali, Y. T., Yildirim, S., Yurtdas, M., Senol, H., Ugur-Yildiz, M., Ozdemir, M. Tags: Original Articles Source Type: research

Individualized approaches to thromboprophylaxis in atrial fibrillation
Publication date: March 2016 Source:American Heart Journal, Volume 173 Author(s): Oliver J. Ziff, A. John Camm Atrial fibrillation (AF) is the most common arrhythmia worldwide. The prevalence of AF in persons older than 55 years is at least 33.5 million globally and is predicted to more than double in the next half-century. Anticoagulation, heart rate control, and heart rhythm control comprise the 3 main treatment strategies in AF. Anticoagulation is aimed at preventing debilitating stroke, systemic embolism, and associated mortality. Historically, anticoagulation in AF was achieved with a vitamin K antagonist such as ...
Source: American Heart Journal - January 30, 2016 Category: Cardiology Source Type: research

Net Clinical Benefit of Dabigatran over Warfarin in Patients with Atrial Fibrillation Stratified by CHA2DS2-VASc Score and Time in Therapeutic Range
Conclusion The combination of CHA2DS2-VASc score and TTR facilitates patient prioritization for dabigatran. The best net clinical benefit for switching warfarin to dabigatran was found in those with both high CHA2DS2-VASc score and poor TTR. Teaser Non-vitamin K antagonist oral anticoagulants (NOAC) are now preferred to warfarin for stroke prevention in atrial fibrillation. In this study, we have shown that combination of CHA2DS2-VASc score and time in therapeutic range (TTR) facilitates patient prioritization for Dabigatran – one of the NOACs. The best net clinical benefit for switching from Dabigatran to warfarin was o...
Source: Canadian Journal of Cardiology - January 26, 2016 Category: Cardiology Source Type: research