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Dabigatran and Warfarin are Both Used for Stroke-prevention in Patients with AF but their Side effects Differ
NEW YORK (Reuters Health) – Dabigatran and warfarin offer similar stroke-prevention efficacy in patients with atrial fibrillation (AF), but their side effect profiles differ, according to a systematic review and meta-analysis of real-world clinical practice. “There could be many reasons for the differences in our findings, such as differences in the quality of evidence of... [Read More]
Source: The Hospitalist - February 19, 2016 Category: Hospital Management Authors: Will Boggs MD, Reuters Health Tags: Clinical Education Hospitalist Patient Care atrial fibrillation Dabigatran stroke warfarin Source Type: research

Selection of Warfarin or One of the New Oral Antithrombotic Agents for Long-Term Prevention of Stroke among Persons with Atrial Fibrillation
Opinion statement Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, which can potentially increases the risk of stroke by five-fold, thus, resulting in high public healthcare burden. Stroke prevention is vital in the management of AF patients. Vitamin K antagonists (VKA, eg, warfarin) have been the mainstay treatment to prevent ischemic stroke and systemic thromboembolism in AF patients for several decades. Despite the efficacy of warfarin, its limitations have recently driven the advent of some new antithrombotic agents, the non-VKA oral anticoagulant (NOACs, including dabigatran, ri...
Source: Current Treatment Options in Neurology - February 11, 2015 Category: Neurology Source Type: research

Factors associated with non –vitamin K antagonist oral anticoagulants for stroke prevention in patients with new-onset atrial fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice, up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists, and had higher socioeconomic status. Trial registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 25, 2017 Category: Cardiology Source Type: research

Factors Associated with Non-vitamin K Antagonist Oral Anticoagulants for Stroke Prevention in Patients with New-Onset Atrial Fibrillation: Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II (ORBIT-AF II)
Conclusions In contemporary clinical practice up to three-fourths of patients with new-onset AF are now initially treated with a NOAC for stroke prevention. Those selected for NOAC treatment had lower stroke and bleeding risk profiles, were more likely treated by cardiologists and had higher socioeconomic status. Trial Registration clinicaltrials.gov Identifier: NCT01701817
Source: American Heart Journal - April 4, 2017 Category: Cardiology Source Type: research

Assessment of Web ‐based education resources informing patients about stroke prevention in atrial fibrillation
This study qualitatively assessed the information presented to patients in online resources about antithrombotic therapy for stroke prevention in AF.
Source: Journal of Clinical Pharmacy and Therapeutics - September 30, 2016 Category: Drugs & Pharmacology Authors: E. Pandya, B. V. Bajorek Tags: Original Article Source Type: research

Strategies for improving dabigatran adherence for stroke prevention in patients with non-valvular atrial fibrillation: education and drug intake reminders (FACILITA study).
CONCLUSIONS: A mixed intervention, consisting of patient education and a simple calendar reminder of drug intake, is an effective strategy to improve dabigatran therapeutic adherence in patients with NVAF. The percentage of adherence with dabigatran was high. PMID: 29384410 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - February 1, 2018 Category: Research Tags: Curr Med Res Opin Source Type: research

Oral anticoagulant prescribing in a hyperacute stroke unit
Conclusion Currently, renal impairment is the main determinant for thromboprophylaxis choice. Local guidelines have been created with physician education underway and re-audit planned in 3 months. The authors will present the full data.
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 14, 2015 Category: Neurosurgery Authors: Samani, A., Kayani, M., Asokanathan, A. Tags: Stroke Thur 21, Parallel session 5: Therapeutics 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

Use of novel oral anticoagulants for patients with atrial fibrillation: Systematic review and clinical implications
Abstract: Atrial fibrillation (AF), a common arrhythmia, increases the risk of ischemic stroke. Stroke and bleeding scores for patients with AF can help to stratify risk and determine the need for antithrombotic therapy, for which warfarin has been the gold standard. Although highly effective, warfarin has several limitations that can lead to its underuse. Data from randomized, Phase III clinical trials of the novel oral anticoagulants, dabigatran, a direct thrombin inhibitor, and rivaroxaban and apixaban, both factor Xa inhibitors, indicate these drugs are at least noninferior to warfarin for the prevention of stroke and ...
Source: Heart and Lung - November 13, 2013 Category: Intensive Care Authors: Nancy M. Albert Tags: Care of Patients with Dysrhythmias Source Type: research

Dabigatran etexilate: An alternative to warfarin for patients with nonvalvular atrial fibrillation
ConclusionsSignificant evidence from the PETRO and RE‐LY trials and postmarketing analyses of dabigatran etexilate indicate that this direct thrombin inhibitor is as efficacious as warfarin in ischemic stroke prevention. In fact, the studies found that patients taking dabigatran etexilate had fewer incidences of ischemic stroke and intracranial hemorrhage than those taking warfarin. Risk for major gastrointestinal bleeding appears to be higher than that for warfarin. Implications for practicePatients taking dabigatran etexilate do not require blood work to assess international normalized ratio (INR) levels. Because this ...
Source: Journal of the American Academy of Nurse Practitioners - July 25, 2014 Category: Nursing Authors: Katie A. Scott, Karen A. Amirehsani Tags: CLINICAL PRACTICE Source Type: research

Early Adoption of Dabigatran and Its Dosing in US Patients With Atrial Fibrillation: Results From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation Health Services and Outcomes Research
Conclusions Patients receiving dabigatran were younger and at a lower risk of stroke and bleeding. Patients appeared to drive switching from warfarin, whereas clinical characteristics influenced de novo start of dabigatran. These data suggest cautious early uptake of dabigatran, and more careful attention to dosing adjustments is warranted. Clinical Trial Registration URL: Clinicaltrials.gov. Unique identifier: NCT01165710.
Source: JAHA:Journal of the American Heart Association - November 25, 2013 Category: Cardiology Authors: Steinberg, B. A., Holmes, D. N., Piccini, J. P., Ansell, J., Chang, P., Fonarow, G. C., Gersh, B., Mahaffey, K. W., Kowey, P. R., Ezekowitz, M. D., Singer, D. E., Thomas, L., Peterson, E. D., Hylek, E. M., The Outcomes Registry for Better Informed Treatme Tags: Health Services and Outcomes Research Source Type: research

Dabigatran Use in the Real World: A Multihospital System Experience
Dabigatran etexilate, an oral direct thrombin inhibitor, was approved by the Food and Drug Administration to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation based on the outcomes of the Randomized Evaluation of Long-term anticoagulant therapY (RE-LY) study. Although this study provides robust data on the efficacy and safety of dabigatran, there may be differences in the drug use and outcomes in routine clinical practice following drug approval. In this retrospective chart review study, we describe the use of dabigatran in 160 patients in 4 adult hospitals (1 academic and 3 c...
Source: Journal of Pharmacy Practice - August 4, 2014 Category: Drugs & Pharmacology Authors: Kimmons, L. A., Kabra, R., Davis, M., Segars, B. V., Oliphant, C. S. Tags: Research Articles Source Type: research

Managing reversal of direct oral anticoagulants in emergency situations. Anticoagulation Education Task Force White Paper.
This report is based on findings from the Anticoagulation Education Task Force, which brought together patient groups and professionals representing different medical specialties with an interest in patient safety and expertise in AF, VTE, stroke, anticoagulation, and reversal agents, to discuss the current status of anticoagulation reversal and fundamental changes in management of bleeding associated with DOACs occasioned by the approval of idarucizumab, a specific reversal agent for dabigatran, as well as recent clinical data on specific reversal agents for factor Xa inhibitors. Recommendations are given for when there i...
Source: Thrombosis and Haemostasis - August 3, 2016 Category: Hematology Authors: Ageno W, Büller HR, Falanga A, Hacke W, Hendriks J, Lobban T, Merino J, Milojevic IS, Moya F, van der Worp HB, Randall G, Tsioufis K, Verhamme P, Camm AJ Tags: Thromb Haemost Source Type: research

Managing New Oral Anticoagulants in the Perioperative and Intensive Care Unit Setting
Managing patients in the perioperative setting receiving novel oral anticoagulation agents for thromboprophylaxis or stroke prevention with atrial fibrillation is an important consideration for clinicians. The novel oral anticoagulation agents include direct Factor Xa inhibitors rivaroxaban and apixaban, and the direct thrombin inhibitor dabigatran. In elective surgery, discontinuing their use is important, but renal function must also be considered because elimination is highly dependent on renal elimination. If bleeding occurs in patients who have received these agents, common principles of bleeding management as with an...
Source: Anesthesiology - April 23, 2013 Category: Anesthesiology Tags: Education: Review Article Source Type: research

Appropriateness of Prescribing Dabigatran Etexilate and Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation: A Prospective Study.
CONCLUSIONS:: Inappropriate use of DE and rivaroxaban in patients with NVAF is frequent and possibly leads to AEs. Reinforcing education of health care professionals and patients is needed. Collaboration with clinical pharmacists can contribute to better use. PMID: 24982310 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - June 30, 2014 Category: Drugs & Pharmacology Authors: Larock AS, Mullier F, Sennesael AL, Douxfils J, Devalet B, Chatelain C, Dogné JM, Spinewine A Tags: Ann Pharmacother Source Type: research

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