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Condition: Hemorrhagic Stroke
Drug: Pradaxa

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Total 307 results found since Jan 2013.

Direct thrombin inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in people with non-valvular atrial fibrillation.
CONCLUSIONS: DTIs were as efficacious as VKAs for the composite outcome of vascular death and ischaemic events and only the dose of dabigatran 150 mg twice daily was found to be superior to warfarin. DTIs were associated with fewer major haemorrhagic events, including haemorrhagic strokes. Adverse events that led to discontinuation of treatment occurred more frequently with the DTIs. We detected no difference in death from all causes. PMID: 24677203 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 27, 2014 Category: Journals (General) Authors: Salazar CA, Del Aguila D, Cordova EG Tags: Cochrane Database Syst Rev Source Type: research

Presentation, therapy and outcome of patients with ischemic stroke under new oral anticoagulants.
CONCLUSIONS: Little is known about ischemic strokes under NOAC. To increase the knowledge, the data of 469 ischemic strokes which occurred in NOAC-investigating trials should be analyzed. Furthermore ischemic and bleeding events under NOAC outside clinical trials should be reported. An international registry, independent from the pharmaceutical industry for collecting these informations is desirable. PMID: 24821640 [PubMed - as supplied by publisher]
Source: Neurologia i Neurochirurgia Polska - March 1, 2014 Category: Neurology Authors: Stöllberger C, Finsterer J Tags: Neurol Neurochir Pol Source Type: research

Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation. An indirect comparison analysis.
Abstract Large Phase 3 clinical trials for stroke prevention in atrial fibrillation (AF) have compared non-vitamin K antagonist oral anticoagulants (NOACs) against warfarin, with the edoxaban trial only recently reported. In the absence of head to head trials directly comparing these NOACs against each other, we compared the efficacy and safety of edoxaban to other agents by an indirect comparison analysis. We performed an indirect comparison analysis of edoxaban (2 dose strategies) against apixaban (1 dose), dabigatran etexilate (2 doses) and rivaroxaban (1 dose), for their relative efficacy and safety against ea...
Source: Thrombosis and Haemostasis - February 28, 2014 Category: Hematology Authors: Skjøth F, Larsen TB, Rasmussen LH, Lip GY Tags: Thromb Haemost Source Type: research

Summary of evidence-based guideline update: Prevention of stroke in nonvalvular atrial fibrillation: Report of the Guideline Development Subcommittee of the American Academy of Neurology
Objective: To update the 1998 American Academy of Neurology practice parameter on stroke prevention in nonvalvular atrial fibrillation (NVAF). How often do various technologies identify previously undetected NVAF? Which therapies reduce ischemic stroke risk with the least risk of hemorrhage, including intracranial hemorrhage? The complete guideline on which this summary is based is available as an online data supplement to this article. Methods: Systematic literature review; modified Delphi process recommendation formulation. Major conclusions: In patients with recent cryptogenic stroke, cardiac rhythm monitoring probabl...
Source: Neurology - February 24, 2014 Category: Neurology Authors: Culebras, A., Messe, S. R., Chaturvedi, S., Kase, C. S., Gronseth, G. Tags: All Cerebrovascular disease/Stroke SPECIAL ARTICLE Source Type: research

Response to Letter Regarding Article, "Dabigatran Versus Warfarin: Effects on Ischemic and Hemorrhagic Strokes and Bleeding in Asians and Non-Asians With Atrial Fibrillation" Letters to the Editor
Source: Stroke - February 24, 2014 Category: Neurology Authors: Hori, M., Ezekowitz, M. D., Reilly, P. A. Tags: Health policy and outcome research, Coumarins, Other anticoagulants, Acute Cerebral Hemorrhage, Acute Cerebral Infarction Letters to the Editor Source Type: research

Management of Dabigatran-associated Intracerebral and Intraventricular Hemorrhage: A Case Report
Conclusion: Due to lack of an available antidote, activated prothrombin complex concentrate was utilized as a nonspecific procoagulant to stabilize an intracerebral hemorrhage in a patient on dabigatran.
Source: The Journal of Emergency Medicine - February 10, 2014 Category: Emergency Medicine Authors: Andrew C. Faust, Evan J. Peterson Tags: Pharmacology in Emergency Medicine Source Type: research

Cost-Effectiveness of Apixaban Versus Other New Oral Anticoagulants for Stroke Prevention in Atrial Fibrillation.
CONCLUSIONS: Although our analysis was limited by the absence of head-to-head trials, based on the indirect comparison data available, our model projects that apixaban may be a cost-effective alternative to dabigatran 150 mg BID, dabigatran 110 mg BID, and rivaroxaban 20 mg once daily for stroke prevention in AF patients from the perspective of the United Kingdom National Health Services. PMID: 24508420 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - February 5, 2014 Category: Drugs & Pharmacology Authors: Lip GY, Kongnakorn T, Phatak H, Kuznik A, Lanitis T, Liu LZ, Iloeje U, Hernandez L, Dorian P Tags: Clin Ther Source Type: research

The acute management of haemorrhage, surgery and overdose in patients receiving dabigatran
Dabigatran is an oral direct thrombin inhibitor (DTI) licensed for stroke prevention in atrial fibrillation and likely to be soon approved in Europe for treatment of venous thrombosis. Predictable pharmacokinetics and a reduced risk of intracranial haemorrhage do not negate the potential risk of haemorrhage. Unlike warfarin, there is no reversal agent and measurement of the anticoagulant effect is not ‘routine’. The prothrombin time/international normalised ratio response to dabigatran is inconsistent and should not be measured when assessing a patient who is bleeding or needs emergency surgery. The activated p...
Source: Emergency Medicine Journal - January 15, 2014 Category: Emergency Medicine Authors: Alikhan, R., Rayment, R., Keeling, D., Baglin, T., Benson, G., Green, L., Marshall, S., Patel, R., Pavord, S., Rose, P., Tait, C. Tags: Poisoning/Injestion, Open access, Drugs: cardiovascular system, Stroke, Poisoning Review Source Type: research

Proposed Approach to Thrombolysis in Dabigatran-Treated Patients Presenting with Ischemic Stroke
Background: Acute ischemic stroke thrombolysis in patients taking dabigatran is controversial because of a presumed increased risk of symptomatic hemorrhagic transformation. Using data from our local hematopathology laboratory, we developed a thrombolysis protocol for acute ischemic stroke patients taking dabigatran.Methods: A local thrombin time (TT)–dabigatran concentration relationship was calculated using dabigatran calibrators. The effect of dabigatran on activated partial thromboplastin time (aPTT) and prothrombin time (PT) (international normalized ratio [INR]) was also measured. A protocol was developed, in which...
Source: Journal of Stroke and Cerebrovascular Diseases - January 9, 2014 Category: Neurology Authors: Mahesh Kate, Artur Szkotak, Adam Witt, Ashfaq Shuaib, Kenneth Butcher Tags: Original Articles Source Type: research

Dabigatran Under the FDA's Watchful EyeDabigatran Under the FDA's Watchful Eye
The FDA is requesting input from the public on a proposed study that will assess the risks of ischemic stroke, intracranial hemorrhage, and major extracranial hemorrhage with dabigatran. Heartwire
Source: Medscape Cardiology Headlines - January 6, 2014 Category: Cardiology Tags: Cardiology News Source Type: news

Physician practices regarding contraindications to oral anticoagulation in atrial fibrillation: Findings from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry
Conclusions: Contraindications to OAC therapy among patients with AF are common but subjective. Many patients with reported contraindications were receiving OAC, suggesting that the perceived benefit outweighed the potential harm posed by the relative contraindication.
Source: American Heart Journal - January 6, 2014 Category: Cardiology Authors: Emily C. O'Brien, DaJuanicia N. Holmes, Jack E. Ansell, Larry A. Allen, Elaine Hylek, Peter R. Kowey, Bernard J. Gersh, Gregg C. Fonarow, Christopher R. Koller, Michael D. Ezekowitz, Kenneth W. Mahaffey, Paul Chang, Eric D. Peterson, Jonathan P. Piccini, Tags: Electrophysiology Source Type: research

Non‐vitamin K antagonist oral anticoagulants in cardiovascular disease management: evidence and unanswered questions
This article reviews current knowledge and important unanswered questions on the use of these agents in patients with cardiovascular disease. MethodsA literature search was performed using PubMed and the search terms dabigatran, rivaroxaban, apixaban, AF and acute coronary syndrome (ACS). Peer‐reviewed, published clinical trials, review articles, relevant treatment guidelines and prescribing information documents were identified and reviewed for relevance. Results and discussionDabigatran is an oral direct thrombin inhibitor; rivaroxaban and apixaban are oral direct Factor Xa inhibitors. These agents have a quicker onset...
Source: Journal of Clinical Pharmacy and Therapeutics - January 3, 2014 Category: Drugs & Pharmacology Authors: J. W. Cheng, G. Barillari Tags: Review Article Source Type: research

Clinical Experience of Life-Threatening Dabigatran-Related Bleeding at a Large, Tertiary Care, Academic Medical Center: a Case Series.
CONCLUSION: Reversal strategies for dabigatran-related bleeding events at our institution are highly variable. Intracranial hemorrhage in patients on dabigatran was associated with 43 % mortality. Patients with severe dabigatran-related bleeding may benefit from a standardized approach to treatment. PMID: 24385325 [PubMed - as supplied by publisher]
Source: Journal of Medical Toxicology - January 3, 2014 Category: Toxicology Authors: Ross B, Miller MA, Ditch K, Tran M Tags: J Med Toxicol Source Type: research

Patient with acute renal injury presenting dabigatran overdose: Hemodialysis for surgery.
We report a case of an 80-year-old man presenting hemorrhage with dabigatran overdose caused by obstructive acute renal failure. Before nephrostomy, several hemodialysis sessions were necessary to remove dabigatran probably because of its large volume of distribution. PMID: 24378048 [PubMed - as supplied by publisher]
Source: Annales Francaises d'Anesthesie et de Reanimation - December 27, 2013 Category: Anesthesiology Authors: Bachellerie B, Ruiz S, Conil JM, Crognier L, Seguin T, Georges B, Fourcade O Tags: Ann Fr Anesth Reanim Source Type: research

Patient outcomes using the European label for dabigatran. A post-hoc analysis from the RE-LY database.
In conclusion, this post-hoc simulation of dabigatran usage based on RE-LY trial dataset indicates that "EU label simulated dabigatran treatment" may be associated with superior efficacy and safety compared to warfarin, and are in support of the EU label and the 2012 European Society of Cardiology AF guideline recommendations. Thus, adherence to European label/guideline use results in a clinically relevant benefit for dabigatran over warfarin, for both efficacy and safety. PMID: 24326736 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - December 11, 2013 Category: Hematology Authors: Lip GY, Clemens A, Noack H, Ferreira J, Connolly SJ, Yusuf S Tags: Thromb Haemost Source Type: research