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Non-vitamin K antagonist oral anticoagulants (NOACs) post-percutaneous coronary intervention: a network meta-analysis.
CONCLUSIONS: Very low- to moderate-certainty evidence suggests no meaningful difference in efficacy outcomes between non-vitamin K antagonist oral anticoagulants (NOAC) and vitamin K antagonists following percutaneous coronary interventions (PCI) in people with non-valvular atrial fibrillation. NOACs probably reduce the risk of recurrent hospitalisation for adverse events compared with vitamin K antagonists. Low- to moderate-certainty evidence suggests that dabigatran may reduce the rates of major and non-major bleeding, and apixaban and rivaroxaban probably reduce the rates of non-major bleeding compared with vitamin K an...
Source: Cochrane Database of Systematic Reviews - December 18, 2019 Category: General Medicine Authors: Al Said S, Alabed S, Kaier K, Tan AR, Bode C, Meerpohl JJ, Duerschmied D Tags: Cochrane Database Syst Rev Source Type: research

Direct comparative effectiveness and safety between non-vitamin K antagonist oral anticoagulants for stroke prevention in nonvalvular atrial fibrillation: a systematic review and meta-analysis of observational studies
In this study, apixaban was found to have the most favorable safety profile amongst the three NOACs. No significant difference was observed in risk of stroke or systemic embolism be tween the NOACs. Such findings may provide some decision-making support for physicians regarding their choices amongst NOACs in patients with AF.Registration PROSPERO (identifier: CRD42016052908).
Source: European Journal of Epidemiology - June 8, 2018 Category: Epidemiology Source Type: research

Causes of Death in Patients with Venous Thromboembolism Anticoagulated with Direct Oral Anticoagulants: A Systematic Review and Meta-Analysis
Semin Thromb Hemost DOI: 10.1055/s-0038-1642644Death is more frequent than nonfatal recurrent venous thromboembolism (VTE) and major bleeding after acute VTE. The analysis of the causes of death is fundamental to explore new strategies to reduce mortality rates in these patients. The authors performed a meta-analysis to analyze mortality and independently adjudicated causes of death in anticoagulated patients due to VTE, and to evaluate potential differences between different anticoagulant schemes. They searched MEDLINE and CENTRAL, from January 1, 2000, to January 31, 2017, and performed additional searches in Web sites o...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2018 Category: Hematology Authors: G ómez-Outes, Antonio Terleira-Fern ández, Ana Isabel Lecumberri, Ram ón Su árez-Gea, Mª Luisa Calvo-Rojas, Gonzalo Vargas-Castrill ón, Emilio Tags: Review Article Source Type: research

Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease.
CONCLUSIONS: Our findings indicate that DOAC are as likely as warfarin to prevent all strokes and systemic embolic events without increasing risk of major bleeding events among AF patients with kidney impairment. These findings should encourage physicians to prescribe DOAC in AF patients with CKD without fear of bleeding. The major limitation is that the results of this study chiefly reflect CKD stage G3. Application of the results to CKD stage G4 patients requires additional investigation. Furthermore, we could not assess CKD stage G5 patients. Future reviews should assess participants at more advanced CKD stages. Additio...
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Kimachi M, Furukawa TA, Kimachi K, Goto Y, Fukuma S, Fukuhara S Tags: Cochrane Database Syst Rev Source Type: research

Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta ‐analysis by geographic region with a focus on European patients
ConclusionThe DOAC did not provide additional benefit in reducing the risk of stroke/SEE compared with warfarin in European patients with AF, but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region.
Source: British Journal of Clinical Pharmacology - June 16, 2016 Category: Drugs & Pharmacology Authors: Antonio G ómez‐Outes, Ana‐Isabel Terleira‐Fernández, Gonzalo Calvo‐Rojas, M. Luisa Suárez‐Gea, Emilio Vargas‐Castrillón Tags: Systematic Review Source Type: research

Direct oral anticoagulants for stroke prevention in patients with atrial fibrillation: meta‐analysis by geographic region with a focus on european patients
ConclusionThe DOAC did not provide additional benefit in reducing the risk of stroke/SEE compared with warfarin in European patients with AF, but were generally associated with a lower bleeding tendency than warfarin regardless of geographic region. This article is protected by copyright. All rights reserved.
Source: British Journal of Clinical Pharmacology - May 9, 2016 Category: Drugs & Pharmacology Authors: Antonio A. Gómez‐Outes, Ana‐Isabel Terleira‐Fernández, Gonzalo Calvo‐Rojas, Mª. Luisa Suárez‐Gea, Emilio Vargas‐Castrillón Tags: Systematic Review Source Type: research

New oral anticoagulants for prophylaxis of stroke : Results of an expert conference on practical use in geriatric patients.
This article highlights the outcome of an expert meeting on the practical use of NOAC in elderly patients. An interdisciplinary group of experts discussed the current situation of stroke prevention in geriatric patients and its practical management in daily clinical practice. The topic was examined through focused impulse presentations and critical analyses as the basis for the expert consensus. The key issues are summarized in this paper. The European Society of Cardiology (ESC) guidelines from 2012 for the management of patients with non-valvular AF recommend NOAC as the preferred treatment and vitamin K antagonists (VKA...
Source: Zeitschrift fur Gerontologie und Geriatrie - February 10, 2016 Category: Geriatrics Authors: Bahrmann P, Harms F, Schambeck CM, Wehling M, Flohr J Tags: Z Gerontol Geriatr Source Type: research

Case 4–2015
ATRIAL FIBRILLATION (AF) is the most common cardiac arrhythmia in the world and is estimated to affect more than 3 million people in the United States, with a projected increase to more than 5 million people in the US by the year 2050.1 AF is an independent risk factor for stroke and is associated with a four- to five-fold increased risk of embolic stroke compared with those individuals without AF. Oral anticoagulation therapy with warfarin or other agents (dabigatran, apixaban) significantly reduces the risk of stroke in this population; however, anticoagulation carries inherent risks.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2015 Category: Anesthesiology Authors: Megan J. Lanigan, Mark A. Chaney, Sandeep Nathan, Atman P. Shah, Andrew J. Feider Tags: Case Conference Source Type: research

Oral Anticoagulants and the Risk of Intracranial Hemorrhage
Conclusions and Relevance Novel oral anticoagulants are uniformly associated with an overall reduced risk of ICH when used for stroke prevention in atrial fibrillation. Any of the currently available NOACs can be considered first line for patients at high risk for ICH.JAMA Neurol. 2013;70(12):1486-1490. doi:10.1001/jamaneurol.2013.4021.
Source: JAMA - December 17, 2014 Category: Journals (General) Source Type: research

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