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Is There A Role For Pharmacokinetic/Pharmacodynamic Guided Dosing For Novel Oral Anticoagulants?
Publication date: Available online 10 October 2017 Source:American Heart Journal Author(s): Noel Chan, Philip T. Sager, Jack Lawrence, Thomas's Ortel, Paul Reilly, Scott Berkowitz, Dagmar Kubitza, John Eikelboom, Jeffry Florian, Norman Stockbridge, Martin Rose, Robert Temple, Jonathan H. Seltzer The novel direct oral anticoagulants (NOACs) represent a major advance in oral anticoagulant therapy, and are replacing vitamin K antagonists as the preferred options for many indications. Given in fixed doses without routine laboratory monitoring, they have been shown to be at least as effective in reducing thromboembolic stroke ...
Source: American Heart Journal - October 10, 2017 Category: Cardiology Source Type: research

Two-year follow-up of patients treated with dabigatran for stroke prevention in atrial fibrillation: GLORIA-AF Registry
Conclusions These global data confirm the sustained safety and effectiveness of dabigatran over 2years of follow-up, consistent with the results from clinical trials as well as contemporary real-world studies. WHAT IS KNOWN • Non- vitamin K antagonist (VKA) anticoagulants (NOACs) are the preferred therapy for prevention of ischemic stroke based on phase 3 trials, but there is insufficient information on their efficacy and safety in daily practice, based on prospectively collected data WHAT IS NEW • This study shows that in non-valvular AF patient population, with up to 2years of follow-up, the use of dabigatran led to ...
Source: American Heart Journal - September 1, 2017 Category: Cardiology Source Type: research

International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD, ORBIT-AF I, and ORBIT-AF II Registries
Conclusions Among new-onset AF patients, NOAC use has increased and antiplatelet monotherapy has decreased. However, anticoagulation is used frequently in low-risk patients and inconsistently in those at high-risk of stroke. Significant geographic variability in anticoagulation persists and represents an opportunity for improvement.
Source: American Heart Journal - August 24, 2017 Category: Cardiology Source Type: research

Probing oral anticoagulation in patients with atrial high rate episodes: Rationale and design of the Non –vitamin K antagonist Oral anticoagulants in patients with Atrial High rate episodes (NOAH–AFNET 6) trial
Conclusion NOAH–AFNET 6 will provide robust information on the effect of oral anticoagulation in patients with atrial high rate episodes detected by implanted devices. Graphical abstract
Source: American Heart Journal - May 24, 2017 Category: Cardiology Source Type: research

Probing oral anticoagulation in patients with atrial high rate episodes. Rationale and design of the Non vitamin K antagonist Oral anticoagulants in patients with Atrial High rate episodes (NOAH – AFNET 6) trial
Conclusion NOAH – AFNET 6 will provide robust information on the effect of oral anticoagulation in patients with atrial high rate episodes detected by implanted devices. Graphical abstract
Source: American Heart Journal - May 4, 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 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

Vitamin K antagonists for stroke prevention in hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis
Conclusion Our meta-analysis revealed a trend for a reduction of the risk of ischemic stroke in hemodialysis patients with AF treated with VKA. The true protective effect may have been underestimated, owing to inclusion of low-risk patients not expected to benefit from anticoagulation and to suboptimal anticoagulation. However, assessment of the overall effect of VKA in hemodialysis patients should also take into account the increased risk of bleeding, in particular of hemorrhagic stroke. Whether new oral anticoagulants provide a better benefit–risk ratio in hemodialysis patients should be the subject of future trials.
Source: American Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

Acute management of stroke patients taking non –vitamin K antagonist oral anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - September 23, 2016 Category: Cardiology Source Type: research

Acute Management of Stroke Patients Taking Non-vitamin K Antagonist Oral Anticoagulants Addressing Real-world Anticoagulant Management Issues in Stroke (ARAMIS) Registry: Design and Rationale
Conclusion The ARAMIS Registry will document the current state of management of NOAC treated patients with acute ischemic stroke as well as contemporary care and outcome of anticoagulation-related intracerebral hemorrhage. These data will be used to better understand optimal strategies to care for these complex but increasingly common emergent real world clinical challenges.
Source: American Heart Journal - August 26, 2016 Category: Cardiology Source Type: research

Rationale and design of the eXplore the efficacy and safety of once-daily oral riVaroxaban for the prEvention of caRdiovascular events in patients with nonvalvular aTrial fibrillation scheduled for cardioversion trial: A comparison of oral rivaroxaban once daily with dose-adjusted vitamin K antagonists in patients with nonvalvular atrial fibrillation undergoing elective cardioversion
The objective of this study is to explore the efficacy and safety of rivaroxaban 20 mg once daily (15 mg if creatinine clearance is 30-49 mL/min) compared with dose-adjusted vitamin K antagonists (VKAs; international normalized ratio 2.0-3.0) in patients scheduled for elective cardioversion.Methods: This is a prospective, randomized, open-label, parallel group comparison of approximately 1,500 patients from 17 countries with hemodynamically stable nonvalvular atrial fibrillation of>48 hours or unknown duration. Patients will be randomized 2:1 (rivaroxaban:VKA) using 2 cardioversion strategies: the first approach is early c...
Source: American Heart Journal - January 16, 2014 Category: Cardiology Authors: Michael D. Ezekowitz, Riccardo Cappato, Allan L. Klein, A. John Camm, Chang-Sheng Ma, Jean-Yves Le Heuzey, Mario Talajic, Maurício I. Scanavacca, Panos E. Vardas, Paulus Kirchhof, Stefan H. Hohnloser, Melanie Hemmrich, Vivian Lanius, Isabelle Ling Meng, Tags: Trial Design Source Type: research

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