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Direct Oral Anticoagulants Versus Warfarin in Morbidly Obese Patients With Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-analysis
Background: Direct oral anticoagulants (DOACs) have been increasingly preferred over warfarin; however, The International Society of Thrombosis and Hemostasis recommended avoiding the use of DOACs in morbidly obese patients (body mass index>40 or weight>120 kg) because of limited clinical data. Study Question: Are DOACs effective and safe in morbidly obese patients with nonvalvular atrial fibrillation (NVAF). Data Sources: We performed a comprehensive search for published studies indexed in PubMed/MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials that evaluated the efficacy and safet...
Source: American Journal of Therapeutics - September 1, 2021 Category: Drugs & Pharmacology Tags: Meta-analysis Source Type: research

Risk of Stroke After Transcatheter Aortic Valve Implantation: Epidemiology, Mechanism, and Management
Conclusions: The overall evidences confirm similar or lower rate of stroke in TAVI versus SAVR. Risk predictors for acute stroke after TAVI are generally related to procedural factors, whereas late stroke is mainly associated with patient characteristics, with a variable impact on cognitive function. The optimal choice for the antithrombotic treatment in TAVI for stroke prevention is yet to be determined. Current data do not support routine use of cerebral embolic protection devices during TAVI.
Source: American Journal of Therapeutics - September 1, 2021 Category: Drugs & Pharmacology Tags: Therapeutic Advances Source Type: research

Efficacy and Safety of Direct Oral Anticoagulants Versus Vitamin K Antagonists in the Treatment of Left Ventricular Thrombus: A Systematic Review and Meta-analysis
Conclusions: DOACs seem to be more efficacious in achieving LVT resolution compared with VKAs. However, there was no significant difference between the 2 groups in thromboembolic events, major bleeding, and all-cause mortality. Randomized controlled trials are needed to confirm our findings.
Source: American Journal of Therapeutics - July 1, 2021 Category: Drugs & Pharmacology Tags: Meta-analysis Source Type: research

Stroke Risk Scores as Predictors of Severe Outcomes in Atrial Fibrillation: A Comprehensive Review
Background: Atrial fibrillation (AF) is the most frequent sustained arrhythmia. It increases the risk of stroke, heart failure, death, hospitalizations, and costs. Area of uncertainty: Several scores were introduced to stratify the stroke risk and need for anticoagulation in patients (pts) with AF . CHA2DS2-VASc, the most frequently used score, as well as other stroke risk scores have been additionally applied to estimate outcomes for different other conditions, with inhomogeneous results. To date, there has been no consensus regarding the usefulness of these scores to estimate outcomes outside of thromboembolic...
Source: American Journal of Therapeutics - May 1, 2021 Category: Drugs & Pharmacology Tags: Systematic Review and Clinical Guidelines Source Type: research

Treatment Failures of Direct Oral Anticoagulants
Conclusions: Our analysis illustrates that DOACs may fail in the setting of Food and Drug Administration and non–Food and Drug Administration- approved indications. In clinical practice, it may be best to choose between available anticoagulant drugs on a case-by-case basis.
Source: American Journal of Therapeutics - December 31, 2020 Category: Drugs & Pharmacology Tags: Meta-analysis Source Type: research

Antithrombotic Therapy and Outcomes of Patients With New-Onset Transient Atrial Fibrillation After ST-Segment Elevation Myocardial Infarction
Conclusions: There is not a widely accepted treatment algorithm in patients with STEMI who complicated with new-onset AF in clinical guidelines. The current study indicated that transient form of new-onset AF might not require long-term VKA. Besides, addition of VKA to DAPT therapy may increase the rates of major and minor bleeding.
Source: American Journal of Therapeutics - December 31, 2020 Category: Drugs & Pharmacology Tags: Original Investigations Source Type: research

Use of Direct Oral Anticoagulants in the Treatment of Left Ventricular Thrombus: Systematic Review of Current Literature
Conclusions: The use of DOACs is a reasonable alternative to vitamin-K antagonists in the management of LVT.
Source: American Journal of Therapeutics - November 1, 2020 Category: Drugs & Pharmacology Tags: Systematic Review and Clinical Guidelines Source Type: research

Comparative Clinical Outcomes of Edoxaban in Adults With Nonvalvular Atrial Fibrillation
Conclusions: Edoxaban is a welcome addition to the NOAC's armamentarium. However, the comparative data with other novel NOACs are mostly nonexisting, and urgently needed for better individual patient assessment.
Source: American Journal of Therapeutics - May 1, 2020 Category: Drugs & Pharmacology Tags: Reviews Source Type: research

All-Cause Mortality and Cardiovascular Outcomes With Non-Vitamin K Oral Anticoagulants Versus Warfarin in Patients With Heart Failure in the Food and Drug Administration Adverse Event Reporting System
Background: Many patients with heart failure (HF) are treated with warfarin or non-vitamin K oral anticoagulants (NOACs). Randomized outcome-driven comparisons of different anticoagulant strategies in HF are lacking. Data from international, government-mandated registries may be useful in understanding the real-life use of various anticoagulants and how they are linked to outcomes. Study Question: To assess 2015 annual all-cause mortality, myocardial infarction, and stroke rates co-reported for warfarin and NOACs in subjects with and without HF in the US Food and Drug Administration Adverse Event Reporting System (FAE...
Source: American Journal of Therapeutics - November 1, 2019 Category: Drugs & Pharmacology Tags: Original Research Source Type: research

Comparative Effectiveness and Safety of Rivaroxaban in Adults With Nonvalvular Atrial Fibrillation
Conclusions: Research on the long-term comparative effectiveness, safety, and effects on quality of life between rivaroxaban and other novel oral anticoagulants is urgently needed.
Source: American Journal of Therapeutics - November 1, 2019 Category: Drugs & Pharmacology Tags: Review Source Type: research

Therapeutic Challenges in Patients With Noncardioembolic Acute Ischemic Stroke in Need of Double Antiplatelet Therapy for Coronary Artery Disease: Erratum
No abstract available
Source: American Journal of Therapeutics - May 1, 2019 Category: Drugs & Pharmacology Tags: Erratum Source Type: research

Benefits and Risks of Anticoagulation in Acute Coronary Syndrome
Conclusions: Many risk factors for ischemic events and bleeding overlap. The clinician's challenges include monitoring patients' adherence and global assessment of the antithrombotic effect that incorporates antiplatelet and anticoagulant effects.
Source: American Journal of Therapeutics - March 1, 2019 Category: Drugs & Pharmacology Tags: Systematic Reviews Source Type: research

Current Perspectives in Facilitated Angioplasty
Conclusions: With the current increased burden of acute coronary syndromes and the lack of immediate primary PCI facilities for all patients with STEMI, facilitated angioplasty seems a feasible therapeutic option. Another benefit of facilitated angioplasty may be represented by a major contribution of thrombolytic therapy in re-establishing microvascular myocardial blood flow.
Source: American Journal of Therapeutics - March 1, 2019 Category: Drugs & Pharmacology Tags: Systematic Reviews Source Type: research

Therapeutic Challenges in Patients With Noncardioembolic Acute Ischemic Stroke in Need of Double Antiplatelet Therapy for Coronary Artery Disease
Conclusions: In the acute phase of an IS, maintenance or initiation of DAPT therapy imposed by CHD relies, on one hand, on the risk of hemorrhagic transformation of the brain injury and, on the other hand, on the risk of stent thrombosis in the coronary arteries. The management of these patients must be carried on by a vascular team, on an individualized basis.
Source: American Journal of Therapeutics - March 1, 2019 Category: Drugs & Pharmacology Tags: Systematic Reviews Source Type: research

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