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Total 57 results found since Jan 2013.

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

New versus Traditional Approaches to Oral Anticoagulation in Patients with Atrial Fibrillation
Abstract: For clinicians, atrial fibrillation (AFib) is not a disease that will probably be “cured” at some point during their professional lifetime. (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). AFib is a condition that occurs in association with aging, affecting as many as 1 in 10 patients by the time they reach age 85, and therefore all physicians who read The American Journal of Medicine should be aware of AFib—its etiology, how to recognize it, and with some idea of how it is treated. Perhaps the most important aspect of AFib, however, is as a risk factor for...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: James A. Reiffel Tags: CME multimedia activities Source Type: research

Untreated atrial fibrillation in the United Kingdom: Understanding the barriers and treatment options
This article reviews the barriers to anticoagulation in patients with AF in the United Kingdom and considers how those barriers may be overcome.
Source: Journal of the Saudi Heart Association - November 3, 2014 Category: Cardiology Source Type: research

Perceived Advantages and Disadvantages of Oral Anticoagulants, and the Trade-offs Patients Make in Choosing Anticoagulant Therapy and Adhering to Their Drug Regimen
Oral anticoagulant therapy (OAT) is proven to be highly effective for stroke prevention in patients suffering from atrial fibrillation (AF) [1,2]. Vitamin K antagonists (VKAs), particularly warfarin, which is the most commonly used VKA, have long been the standard of care to prevent AF-related stroke [3]. However, in recent years the European Medicines Agency has approved a number of direct oral anticoagulants (DOACs) as (possible) alternatives to VKAs. The perceived benefits of DOACs include their high efficacy and low risk of bleeding, the rapid onset/offset of action, fewer food and drug interactions, and predictable ph...
Source: Patient Education and Counseling - July 2, 2018 Category: International Medicine & Public Health Authors: Melissa C.W. Vaanholt, Marieke G.M. Weernink, Clemens von Birgelen, Catharina G.M. Groothuis-Oudshoorn, Maarten J. Ijzerman, Janine A. van Til Source Type: research

National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018.
Authors: Brieger D, Amerena J, Attia JR, Bajorek B, Chan KH, Connell C, Freedman B, Ferguson C, Hall T, Haqqani HM, Hendriks J, Hespe CM, Hung J, Kalman JM, Sanders P, Worthington J, Yan T, Zwar NA Abstract INTRODUCTION: Atrial fibrillation (AF) is increasing in prevalence and is associated with significant morbidity and mortality. The optimal diagnostic and treatment strategies for AF are continually evolving and care for patients requires confidence in integrating these new developments into practice. These clinical practice guidelines will assist Australian practitioners in the diagnosis and management of adult ...
Source: Medical Journal of Australia - August 3, 2018 Category: General Medicine Tags: Med J Aust Source Type: research

Long-Term Persistence with Newly-Initiated Warfarin or Non-VKA Oral Anticoagulant (NOAC) in Patients with Non-Valvular Atrial Fibrillation: Insights from the Prospective China-AF Registry.
CONCLUSIONS Treatment persistence of NOACs was lower than that of warfarin among Chinese patients with AF. Patients with characteristics of non-persistence predictors need special attention to maintain their therapy. PMID: 30971681 [PubMed - in process]
Source: Medical Science Monitor - April 12, 2019 Category: Research Tags: Med Sci Monit Source Type: research

Practical challenges in the conduct of pragmatic trials embedded in health plans: Lessons of IMPACT-AFib, an FDA-Catalyst trial.
Abstract IMPACT-AFib was an 80,000-patient randomized clinical trial implemented by five US insurance companies (health plans) aimed at increasing the use of oral anticoagulants by individuals with atrial fibrillation who were at high risk of stroke and not on treatment. The underlying thesis was that patients could be change agents to initiate prescribing discussions with their providers. We tested the effect of mailing information to both patients and their providers. We used administrative medical claims and pharmacy dispensing data to identify eligible patients, to randomize them to an early or delayed interve...
Source: Clinical Trials - June 25, 2020 Category: Research Authors: Garcia CJ, Haynes K, Pokorney SD, Lin ND, McMahill-Walraven C, Nair V, Parlett L, Martin D, Al-Khalidi HR, McCall D, Granger CB, Platt R, Cocoros NM Tags: Clin Trials 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

Novel Oral Anticoagulants
Abstract: Warfarin has a proven record as an oral anticoagulant; almost every study, however, has found that it is not prescribed for 40–60% of patients who are eligible and should receive it, and of those who do receive it, serum warfarin levels only achieved a time in therapeutic range (TTR) equal to INR 2–3 about 55–60% of the time (online video available at: http://education.amjmed.com/video.php?event_id=445&stage_id=5&vcs=1). This means that only about 1 in 4 patients are adequately anticoagulated with warfarin, and thus there is a large unmet need for achieving better anticoagulation in these patients. Although...
Source: The American Journal of Medicine - March 24, 2014 Category: Journals (General) Authors: James A. Reiffel Tags: CME multimedia activities Source Type: research

Pros and cons of new oral anticoagulants.
Authors: Bauer KA Abstract The availability of new oral anticoagulants (NOACs) targeting either thrombin (dabigatran etexilate) or factor Xa (rivaroxaban and apixaban) for the prevention and treatment of thrombosis has been highly anticipated. NOACs have major pharmacologic advantages over vitamin K antagonists (eg, warfarin), including rapid onset/offset of action, few drug interactions, and predictable pharmacokinetics, eliminating the requirement for regular coagulation monitoring. Regulatory agencies have approved several NOACs for specific indications based on the results of clinical trials demonstrating effic...
Source: Hematology ASH Education Program - November 11, 2014 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Reversing targeted oral anticoagulants.
Authors: Hoffman M, Monroe DM Abstract Dabigatran, rivaroxaban, and apixaban are orally active anticoagulants that are approved in many countries. Dabigatran inhibits thrombin, whereas rivaroxaban and apixaban are factor Xa inhibitors. In clinical trials, these novel oral anticoagulants were at least as effective as warfarin for preventing stroke in patients with atrial fibrillation, but with a lower rate of serious bleeding. However, the lack of true antidotes for these agents has caused concern when patients suffer life-threatening bleeding or trauma or require emergent invasive procedures. True antidotes are und...
Source: Hematology ASH Education Program - February 20, 2015 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Research to real-world application: experts weigh in on the underuse of anticoagulants.
Abstract Although numerous studies have shown that anticoagulants can reduce the risk of stroke and thromboembolic events in patients with nonvalvular atrial fibrillation, they are underprescribed in the clinical setting. While standardized risk scoring assessments are recommended in treatment guidelines to determine when anticoagulant use may be appropriate, they are not widely used in the real-world clinical setting. Many factors contribute to anticoagulant underuse, including patient characteristics and comorbidities. Reluctance to prescribe an anticoagulant may also stem from concerns about bleeding or other p...
Source: The American Journal of Managed Care - December 1, 2014 Category: Health Management Authors: Berger J, Balfour Iii DC, Biskupiak JE, Dunn J, Liotta DB, Merli GJ, Pezalla EJ, Shaya FT, Villanueva T Tags: Am J Manag Care Source Type: research

Use of newer oral anticoagulants in AF
A guide to using novel oral anticoagulants (NOACs) for stroke prevention in non-valvular atrial fibrillation, including the safety and efficacy profiles of newer anticoagulants and how to switch patients from warfarin to NOACs.
Source: GP Online Education - May 24, 2016 Category: Primary Care Tags: 15.1 Cardiovascular Problems Source Type: news

The value of F-18 FDG PET-CT scan in the diagnosis of infection of unknown origin in a patient with aortic valve replacement. in the diagnosis of infection of unknown origin in a patient with Aortic valve replacement. value of F-18 FDG PET/CT scan in the diagnosis of infection of unknown origin in a patient with Aortic valve replacement.
Conclusion: This case illustrates the value of F-18 FDG PET/CT in the diagnosis of and localization of a periaortic valve abscess in a patient with multiple valve replacements, recurrent fevers/sepsis and inconclusive imaging with transthoracic echocardiogram, transesophageal echocardiogram and Indium-111 WBC scan. The localization of the FDG activity to the posterior aspect of the valve which corresponded to the findings on transthoracic echocardiogram was key. Research Support:
Source: Journal of Nuclear Medicine - May 24, 2017 Category: Nuclear Medicine Authors: Muhleman, M., Kaur, H., Patel, M., Rydberg, J. Tags: Educational Exhibits Posters Source Type: research

Tromboc@t Working Group recommendations for management in patients receiving direct oral anticoagulants.
CONCLUSIONS: Progressive increase in the use of DOACs calls for measures to establish and homogenise clinical management guidelines for patients anticoagulated with DOACs in ATUs and PCCs. PMID: 29602444 [PubMed - as supplied by publisher]
Source: Medicina Clinica - April 1, 2018 Category: General Medicine Tags: Med Clin (Barc) Source Type: research