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Evaluation of Prescribing Practices and Outcomes Using Direct-Acting Oral Anticoagulants After Cardiac Surgery
Clin Ther. 2021 May 30:S0149-2918(21)00203-4. doi: 10.1016/j.clinthera.2021.04.009. Online ahead of print.ABSTRACTPURPOSE: Cardiac surgery patients frequently require anticoagulation. Warfarin remains the preferred agent, and a few trials have reported negative outcomes with the use of direct-acting oral anticoagulants (DOACs) in these patients. Therefore, limited literature exists that supports the dosing, safety, and efficacy of DOACs within the cardiac surgery population.METHODS: This single-center, retrospective analysis was conducted at a tertiary academic medical center. All data were extrapolated from electronic med...
Source: Clinical Therapeutics - June 3, 2021 Category: Drugs & Pharmacology Authors: Dareen M Kanaan Bryan M Cook Julie Kelly Rhynn Malloy Source Type: research

Clinical characteristics and stratification of the cerebrovascular accident risk among patients with atrial fibrillation in Colombia, 2011-2016.
Conclusions: AF primarily affects Colombian adults >65 years old. A high burden of comorbidities and a risk of thromboembolism were found in most patients; however, lack of treatment was evident in a large percentage of cases. PMID: 33430660 [PubMed - as supplied by publisher]
Source: Expert Review of Cardiovascular Therapy - January 14, 2021 Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

Use of oral anticoagulation therapy in the first 3 months after the diagnosis of atrial fibrillation in Israel: a population ‐based study
ConclusionIn this real world, population ‐based cohort of patients with newly diagnosed AF, we found a lower than expected rate of OAC prescription within 3 months of diagnosis but an encouraging increase in OAC purchasing over time. Use of NOACs has risen exponentially in only a few years, accounting for a greater pool of AF patients be ing prescribed an OAC.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - March 25, 2020 Category: Cardiology Authors: Louise Kezerle, Meytal Avgil Tsadok, Adi Berliner Senderey, Moshe Hoshen, Maya Leventer ‐Roberts, Orna Reges, Morton Leibowitz, Moti Haim Tags: ORIGINAL ARTICLE Source Type: research

Effectiveness and safety of non-vitamin-K antagonist oral anticoagulants versus warfarin in atrial fibrillation patients with thrombocytopenia
AbstractPatients with thrombocytopenia were excluded from major clinical trials that investigated non-vitamin-K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF). The aim of this study was to evaluate the effectiveness and safety of NOAC versus warfarin in AF patients with thrombocytopenia. From 2010 to 2017, a cohort study based on electronic medical records of a multi-center healthcare provider in Taiwan and included 8239 anticoagulated AF patients (age 77.0  ± 7.3 years, 48.0% female). Patients were divided into two subgroups: 7872 patients with a normal platelet count and 36...
Source: Journal of Thrombosis and Thrombolysis - December 18, 2018 Category: Hematology Source Type: research

Clinical, Laboratory, and Genetic Risk Factors for Thrombosis in Sickle Cell Disease
In conclusion, thrombotic events are common, occurring in 18% of SCD patients over a 10-year follow-up period. HbSS/Sβ0-thalassemia, frequent hospitalizations, kidney disease, and higher systolic blood pressures and AST concentrations were risk factors for thrombosis. Genome-wide marker array analysis points to a potential role of thrombomodulin in SCD-related thrombotic events based on replicated risk variants in THBD. Future studies integrating clinical, laboratory and genetic risk factors may improve our understanding for thrombosis and guide intervention practices in SCD.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Srisuwananukorn, A., Raslan, R., Zhang, X., Shah, B. N., Han, J., Gowhari, M., Jain, S., Molokie, R. E., Gordeuk, V. R., Saraf, S. L. Tags: 114. Hemoglobinopathies, Excluding Thalassemia-Clinical: Organ Damage and Clinical Complications in Sickle Cell Disease Source Type: research

Evaluation of clinical outcomes among nonvalvular atrial fibrillation patients treated with rivaroxaban or warfarin, stratified by renal  function
.
CONCLUSION: Rivaroxaban-treated NVAF patients with diagnosed renal dysfunction had a significantly lower stroke rate compared to warfarin-treated patients. Regardless of renal dysfunction diagnoses, rivaroxaban users had lower thromboembolic event rates compared to warfarin users, and a similar rate of major bleeding. eCrCl-based analysis was limited by a small sample size. PMID: 29231162 [PubMed - as supplied by publisher]
Source: Clinical Nephrology - December 12, 2017 Category: Urology & Nephrology Authors: Weir MR, Haskell L, Berger JS, Ashton V, Laliberté F, Crivera C, Brown K, Lefebvre P, Schein J Tags: Clin Nephrol Source Type: research

Incidence of thromboembolic and bleeding events in patients with newly diagnosed nonvalvular atrial fibrillation: An Asian multicenter retrospective cohort study in Singapore
ConclusionsSAPT and DAPT are less effective than warfarin in NVAF patients. DOACs may be considered in view of lower risk of overall bleed.
Source: Clinical Cardiology - November 1, 2017 Category: Cardiology Authors: Xue Ting Wee, Lih Maan Ho, Han Kiat Ho, Joyce Yu ‐Chia Lee, Chun Wei Yap, Henry William, Linus Chong En Chan, Hooi Ching Tay, Cynthia Eei Mei Goh, Doreen Su‐Yin Tan Tags: CLINICAL INVESTIGATIONS Source Type: research

Outcomes associated with warfarin time in therapeutic range among US veterans with nonvalvular atrial fibrillation.
CONCLUSIONS: The observed quality of warfarin control in VA EMR suggests room for improvement given the association with elevated risk of adverse clinical outcomes. PMID: 28945114 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - September 27, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research

Optimizing the use of oral anticoagulant therapy for atrial fibrilation in primary care: a pharmacist-led intervention
Conclusion A pharmacist-led intervention re-aligned oral anticoagulant therapy to the latest evidence based guidelines for stroke prophylaxis, whilst simultaneously correcting the over-utilisation of antiplatelet therapy.
Source: International Journal of Clinical Pharmacy - January 2, 2017 Category: Drugs & Pharmacology Source Type: research

Pharmacological Prophylaxis for Venous Thromboembolism Among Hospitalized Patients With Acute Medical Illness: An Electronic Medical Records Study
The objectives of this study were to examine pharmacological prophylaxis against VTE among hospitalized medically ill patients and to assess demographic and clinical correlates related to VTE prophylaxis. A retrospective (1999–2010) electronic medical records study included patients aged 40 years and older hospitalized for at least 3 days, with significant medical illness or with a VTE hospitalization 30–365 days before admission. Each patient's first qualifying hospitalization was analyzed. Exclusions were if VTE treatment was started within 1 day of admission, or if warfarin (and not heparin or enoxaparin) was used. ...
Source: American Journal of Therapeutics - March 1, 2016 Category: Drugs & Pharmacology Tags: Original Articles Source Type: research

Prediction of individual combined benefit and harm for patients with atrial fibrillation considering warfarin therapy: a study protocol
This study has been approved by the KPCO Institutional Review Board and the Hamilton Integrated Research Ethics Board. Results from this study will be published in a peer-reviewed journal electronically and in print. The prediction models may aid in patient-physician shared decision-making when they are considering warfarin therapy.
Source: BMJ Open - November 5, 2015 Category: Journals (General) Authors: Li, G., Holbrook, A., Delate, T., Witt, D. M., Levine, M. A., Thabane, L. Tags: Open access, Cardiovascular medicine, Epidemiology, Pharmacology and therapeutics, Public health Protocol Source Type: research

Use of non‐vitamin K antagonist oral anticoagulants in atrial fibrillation patients: insights from a specialist atrial fibrillation clinic
ConclusionIn this specialist AF clinic, patients prescribed NOACs had a favourable adverse event profile with good efficacy for stroke prevention, with a low rate of cessation or switch to warfarin.
Source: International Journal of Clinical Practice - August 3, 2015 Category: Internal Medicine Authors: S. I. Lee, M. Sayers, G. Y. H. Lip, D. A. Lane Tags: Original Paper Source Type: research