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Source: The American Journal of Medicine
Drug: Warfarin
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Total 26 results found since Jan 2013.
Racial and Ethnic Disparities in Stroke Prevention for Atrial Fibrillation
Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting around 2% of the population (1,2) and increasing the risk of stroke by 4 to 5 times (3). Anticoagulation with Vitamin K antagonists (VKAs) such as Warfarin (4) or the newer Direct Oral Anticoagulants (DOACs) (4,5) reduces this risk by up to 60%. AF-related strokes also tend to be more severe and disabling (6).
Source: The American Journal of Medicine - December 7, 2022 Category: General Medicine Authors: Peter Calvert, Kamala Tamirisa, Amin Al-Ahmad, Gregory Y H Lip, Dhiraj Gupta Tags: Review Source Type: research
Oral Anticoagulant Use for Patients with Atrial Fibrillation with Concomitant Anemia and/or Thrombocytopenia
Atrial fibrillation is the most common sustained cardiac arrhythmia in clinical practice, which is associated with an increased risk of thromboembolism, heart failure and mortality.1 Previous studies in atrial fibrillation patients have reported that abnormal hemoglobin and platelet counts may be associated with adverse events. However, these studies that specifically examined the associations between hemoglobin and platelet levels and adverse outcomes reported conflicting data.2-5 Although warfarin effectively reduces the risk of ischemic stroke by 64% compared to placebo/control,6 and non-vitamin K antagonist oral antico...
Source: The American Journal of Medicine - April 2, 2022 Category: General Medicine Authors: Yung-Hsin Yeh, Yi-Hsin Chan, Shao-Wei Chen, Shang-Hung Chang, Chun-Li Wang, Chi-Tai Kuo, Gregory Y.H. Li, Shih-Ann Chen, Tze-Fan Chao Tags: Clinical Research Study Source Type: research
Non-Vitamin K Antagonists versus Warfarin in Patients with Atrial Fibrillation and Bioprosthetic Valves: a Systematic Review and Meta-Analysis
Patients with bioprosthetic heart valves and valve repair with concomitant atrial fibrillation are at an increased risk of thromboembolic events.1-5 Until recently, there was a paucity of randomized data to guide the optimal anticoagulation strategy in this patient population. In a prior meta-analysis of 4 randomized studies in patients with atrial fibrillation and valvular heart disease, excluding significant mitral stenosis and mechanical valves, there was a significant reduction in the risk of stroke or systemic embolism with non-vitamin K antagonist oral anticoagulants (NOACs) vs.
Source: The American Journal of Medicine - October 7, 2021 Category: General Medicine Authors: Rhanderson Cardoso, Caique M.P. Ternes, Gustavo B. Justino, Amanda Fernandes, Ana Vitoria Rocha, Leonardo Knijnik, Andre d'Avila, Renato D. Lopes Tags: Clinical Research Study Source Type: research
The impact of strong inducers on direct oral anticoagulant levels
Direct oral anticoagulants (DOAC) are widely used in clinical practice. They are now recommended over warfarin in eligible patients, for stroke prevention in atrial fibrillation (SPAF) or the treatment of venous thromboembolism1,2. Given their predictable dose response, DOAC have a fixed-dose regimen and do not require routine laboratory monitoring. However, inter-individual variability in DOAC plasma concentrations has been described. In phase 3 trials and registries, low and high DOAC levels were shown to correlate with thromboembolic and bleeding events respectively3,4.
Source: The American Journal of Medicine - June 24, 2021 Category: General Medicine Authors: Anne-Laure Sennesael, Anne-Sophie Larock, Philippe Hainaut, Sarah Lessire, Michael Hardy, Jonathan Douxfils, Anne Spinewine, Fran çois Mullier Tags: Brief Observation Source Type: research
Corrigendum to “Effectiveness and Safety of Oral Anticoagulants in Adults with Non-valvular Atrial Fibrillation Patients and Concomitant Coronary/Peripheral Artery Disease” American Journal of Medicine 131:09 (2018): 1074-1085.e4
There were 33,269 apixaban-warfarin, 9,345 dabigatran-warfarin, and 42,156 rivaroxaban-warfarin matched pairs, with a median follow-up of 4-5 months. Compared with warfarin, apixaban was associated with lower rates of stroke/systemic embolism (hazard ratio [HR] 0.52; 95% confidence interval [95% CI], 0.43-0.62), major bleeding (HR 0.60; 95% CI, 0.55-0.66) and stroke/myocardial infarction/all-cause mortality (HR 0.70; 95%CI, 0.66-0.74); dabigatran was associated with lower rates of major bleeding (HR: 0.73; 95% CI, 0.62-0.85); dabigatran and rivaroxaban were associated with lower rates of stroke/myocardial infarction/all-ca...
Source: The American Journal of Medicine - August 4, 2020 Category: General Medicine Authors: Renato D. Lopes, Jan Steffel, Manuela Di Fusco, Allison Keshishian, Xuemei Luo, Xiaoyan Li, Cristina Masseria, Melissa Hamilton, Keith Friend, Kiran Gupta, Jack Mardekian, Xianying Pan, Onur Baser, W. Schuyler Jones Tags: Corrigendum Source Type: research
Oral anticoagulation in emergency department patients: high rates of off-label doses,no difference in bleeding rates
Patients with oral anticoagulation constitute an increasing proportion in the present medical routine.1 The approval of the first direct oral anticoagulant (DOAC) dabigatran by the U.S. food and drug administration in 2010 for the purpose of stroke prevention in patients with non-valvular atrial fibrillation revolutionized the therapy strategies of this entity since the Vitamin-K antagonists (VKA) warfarin, phenprocoumon and acenocoumarol had been the only available oral anticoagulants for decades.
Source: The American Journal of Medicine - October 23, 2019 Category: General Medicine Authors: Corinne M. Eschler, Bertram K. Woitok, Georg-Christian Funk, Philipp Walter, Volker Maier, Aristomenis K. Exadaktylos, Gregor Lindner Tags: Clinical Research Study Source Type: research
Etiological research using observational data, and net clinical benefit. Simplicity and practicality matter
Atrial fibrillation in an elderly patient requires oral anticoagulant (OAC) treatment, and contemporary international guidelines recommend treatment for atrial fibrillation patients at 75years or older.1,2 Substantial evidence (mostly in favour) of non-vitamin K antagonist oral anticoagulants (NOACs), in comparison with warfarin, has emerged over the past decade. In particular, the benefits from a lower risk of intracranial bleeding and the non-requirement for monitoring of anticoagulant effects have driven the uptake of NOACs as the preferred choice for stroke prevention in atrial fibrillation, although some regional differences are evident.
Source: The American Journal of Medicine - March 4, 2019 Category: General Medicine Authors: Peter Br ønnum Nielsen, Iain Buchan, Gregory Y.H. Lip Tags: Editorial Source Type: research
Comparative stroke, bleeding, and mortality risks in older Medicare patients treated with oral anticoagulants for nonvalvular atrial fibrillation
Non-vitamin K antagonist oral anticoagulants (NOACs) are alternatives to warfarin in patients with nonvalvular atrial fibrillation. Randomized trials compared NOACs to warfarin, but none have compared individual NOACs against each other for safety and effectiveness.
Source: The American Journal of Medicine - January 9, 2019 Category: General Medicine Authors: David J. Graham, Elande Baro, Rongmei Zhang, Jiemin Liao, Michael Wernecke, Marsha E. Reichman, Mao Hu, Onyekachukwu Illoh, Yuqin Wei, Margie R. Goulding, Yoganand Chillarige, Mary Ross Southworth, Thomas E. MaCurdy, Jeffrey A. Kelman Tags: Clinical Research Study Source Type: research
Variation in the Use of Warfarin and Direct Oral Anticoagulants in Atrial Fibrillation and Associated Cost Implications
Atrial fibrillation is the most common arrhythmia in the United States and affects between 2.7 million and 6.1 million adults in the United States, with a lifetime risk of up to 1 in 4 adults over age 40 and a prevalence that is projected to double over the next 25 years.1,2 Though warfarin has long been the cornerstone of therapy to reduce the risk of stroke, several new direct oral anticoagulants (DOACs) have recently become available, beginning with FDA approval of dabigatran in October 2010, and followed by rivaroxaban in 2011, apixaban in 2014, and most recently edoxaban in 2015.
Source: The American Journal of Medicine - October 3, 2018 Category: General Medicine Authors: Benjamin A. Rodwin, Joseph A. Salami, Erica S. Spatz, Javier Valero-Elizondo, Salim S. Virani, Ron Blankstein, Michael J. Blaha, Khurram Nasir, Nihar R. Desai Tags: Clinical Research Study Source Type: research
Periprocedural Bridging Anticoagulation: Measuring the Impact of a Clinical Trial on Care Delivery
Warfarin remains the most commonly prescribed oral anticoagulant in North America for patients with atrial fibrillation.1 –3 Historically, when patients underwent surgical procedures, many clinicians chose to give shorter acting “bridging” anticoagulants to help reduce the risk of stroke while the effect of warfarin was wearing off before surgery or building back up after surgery. In response to observational stu dies, the BRIDGE trial was conducted to test the safety and efficacy of short acting low-molecular-weight heparin (LMWH) as a bridge before and after surgery in patients with atrial fibrillation treated with warfarin.
Source: The American Journal of Medicine - August 1, 2018 Category: General Medicine Authors: Geoffrey D Barnes, Yun Li, Xiaokui Gu, Brian Haymart, Eva Kline-Rogers, Steven Almany, Jay Kozlowski, Gregory Krol, Michael McNamara, James B Froehlich, Scott Kaatz Tags: Clinical Research Study Source Type: research
Severity of Gastrointestinal Bleeding in Patients Treated with Direct-Acting Oral Anticoagulants
Direct-acting oral anticoagulants (DOACs), which have gained approval for stroke prevention in non-valvular atrial fibrillation and treatment of venous thromboembolism, have become increasingly preferred over warfarin given their predictable pharmacodynamics, lack of required monitoring, and superior outcomes. DOACs have been shown to be associated with an increased frequency of gastrointestinal bleeding compared to warfarin, but the severity and characteristics of gastrointestinal bleeding in these patients is poorly understood.
Source: The American Journal of Medicine - November 22, 2017 Category: General Medicine Authors: Mark M. Brodie, Jill C. Newman, Tyler Smith, Don C. Rockey Tags: Clinical Research Study Source Type: research
Clinical Outcomes and History of Fall in Patients with Atrial Fibrillation Treated with Oral Anticoagulation: Insights From the ARISTOTLE Trial
We assessed outcomes among anticoagulated patients with atrial fibrillation (AF) and a history of falling, and whether the benefits of apixaban versus warfarin are consistent in this population.
Source: The American Journal of Medicine - November 6, 2017 Category: General Medicine Authors: Meena P. Rao, Dragos Vinereanu, Daniel M. Wojdyla, John H. Alexander, Dan Atar, Elaine M. Hylek, Michael Hanna, Lars Wallentin, Renato D. Lopes, Bernard J. Gersh, Christopher B. Granger, on behalf of the Apixaban for Reduction in Stroke and Other Thromboe Tags: Clinical Research Study Source Type: research
Efficacy and Safety of Apixaban Versus Warfarin in Patients with Atrial Fibrillation and a History of Cancer: Insights From the ARISTOTLE Trial
• Cancer and atrial fibrillation frequently coexist, yet there are few data to guide care in this population.• No significant associations between history of cancer and the risk of stroke/systemic embolism, major bleeding, or mortality were observed.• The safety and efficacy of apixaban versus warfarin appear to be preserved among patients with and without active cancer.
Source: The American Journal of Medicine - July 21, 2017 Category: General Medicine Authors: Chiara Melloni, Allison Dunning, Christopher B. Granger, Laine Thomas, Michel G. Khouri, David A. Garcia, Elaine M. Hylek, Michael Hanna, Lars Wallentin, Bernard J. Gersh, Pamela S. Douglas, John H. Alexander, Renato D. Lopes Tags: Clinical Research Study Source Type: research
Renal function considerations for stroke prevention in atrial fibrillation
Renal impairment increases risk of stroke and systemic embolic events and bleeding in patients with atrial fibrillation. Direct oral anticoagulants have varied dependence on renal elimination, magnifying the importance of appropriate patient selection, dosing, and periodic kidney function monitoring. In randomized controlled trials of nonvalvular atrial fibrillation, direct oral anticoagulants were at least as effective and associated with less bleeding compared with warfarin. Each direct oral anticoagulant was associated with reduced risk of stroke and systemic embolic events and major bleeding compared with warfarin in n...
Source: The American Journal of Medicine - May 11, 2017 Category: General Medicine Authors: John Fanikos, Allison E. Burnett, Charles E. Mahan, Paul P. Dobesh Tags: Review Source Type: research
