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Reduced dose direct oral anticoagulants compared with warfarin with high time in therapeutic range in nonvalvular atrial fibrillation
The objective of this study was to compare effectiveness and safety between reduced dose DOACs and high TTR warfarin treatment (TTR  ≥ 70%) in NVAF. A Swedish anticoagulation registry was used in identifying eligible patients from July 2011 to December 2017. The study cohort consisted of 40,564 patients with newly initiated DOAC (apixaban, dabigatran, or rivaroxaban) (11,083 patients) or warfarin treatment (29,481 patients ) after exclusion of 374,135 patients due to not being warfarin or DOAC naïve, not being prescribed reduced dose, having previous mechanical heart valve (MHV), or being under 18 years old. The me...
Source: Journal of Thrombosis and Thrombolysis - January 6, 2023 Category: Hematology Source Type: research

Bleeding risk in patients with venous thromboembolic events treated with new oral anticoagulants
AbstractNew oral anticoagulants (NOACs) is the preferred treatment in secondary prophylaxis of venous thromboembolic events (VTE). The aim of this study was to investigate possible risk factors associated with major bleeding in VTE-patients treated with NOACs. In this retrospective register-based study we screened the Swedish anticoagulation registerAuricula (during 2012.01.01 –2017.12.31) to find patients and used other national registers for outcomes. Primary endpoint was major bleeding defined as bleeding leading to hospital care. Multivariate Cox-regression analysis was used to reveal risk factors. 18 219 patients wi...
Source: Journal of Thrombosis and Thrombolysis - November 2, 2020 Category: Hematology Source Type: research

Revascularization outcomes following acute ischemic stroke in patients taking direct oral anticoagulants: a single hospital cohort study
AbstractSuccessful revascularization therapy is of paramount importance in patients suffering acute ischemic stroke (AIS). However, there is currently only limited evidence on revascularization outcomes for patients suffering AIS while treated with direct oral anticoagulants (DOACs). The aim of our study was to determine the efficacy and safety of intravenous thrombolysis (IVT) and mechanical reperfusion (MeR) in AIS patients taking DOACs, and compare them to randomized clinical trials (RCTs), which included patients without DOAC treatment. In an observational cohort study, we analyzed clinical and radiological outcomes fo...
Source: Journal of Thrombosis and Thrombolysis - June 5, 2020 Category: Hematology Source Type: research

Reduction in the doses of direct oral anticoagulants and risk of ischemic stroke events: A hospital survey.
Abstract Inappropriately reduced doses (IRDs) of direct oral anticoagulants (DOACs) are common in clinical practice. We performed a retrospective review using electronic medical records of St. Marianna University School of Medicine Hospital (a 1200-bed teaching hospital in Japan) to address the prevalence of IRDs and patient-related factors that result in IRDs. We also surveyed DOAC-treated patients who were hospitalized due to a stroke during the 5-year study period to analyze the association between stroke events and IRDs. We found that one in five patients who were newly prescribed a DOAC was treated with IRDs....
Source: Biological and Pharmaceutical Bulletin - May 11, 2020 Category: Drugs & Pharmacology Authors: Ueda A, Toki S, Kitayama C, Akazawa M Tags: Biol Pharm Bull Source Type: research

The management of patients with acute ischemic stroke while on direct oral anticoagulants (DOACs): data from an Italian cohort and a proposed algorithm
This study aimed at investigating whether there is any relationship between DOAC plasma levels and the stroke occurrence, on the basis of the phenotypic classification and pathophysiology of the stroke, in a cohort of DOAC-treated patients admitted to our hospital for AIS o ver 1-year period. A total of 28 patients had DOAC plasma levels determined in emergency and were included in the study, nine patients receiving dabigatran, 11 rivaroxaban and 8 apixaban. The DOAC levels were low in 8/28 patients (28.6% of the sample), intermediate in 4 (14.3%) and high in 16 (57.1% ). The most prevalent stroke subtype was the small ves...
Source: Journal of Thrombosis and Thrombolysis - April 16, 2020 Category: Hematology Source Type: research

Treatment With Intravenous Alteplase for Acute Ischemic Stroke After Reversal of Dabigatran With Idarucizumab: A Case Study
Treatment options for anticoagulated patients presenting with ischemic stroke are limited. Off-label use of idarucizumab to rapidly reverse the anticoagulant effect of dabigatran may ensure eligibility for thrombolytic therapy with alteplase. This case describes a 77-year-old white male who presented to the hospital 89 minutes after sudden onset of right-sided hemiparesis, dysarthria, and facial palsy. Significant history included atrial fibrillation and previous right-sided cortical stroke. Medication reconciliation revealed he was taking dabigatran 150 mg twice a day, with the last dose being 179 minutes before presentat...
Source: Journal of Neuroscience Nursing - January 8, 2019 Category: Neuroscience Tags: Case Study Source Type: research

Efficacy and safety of novel oral anticoagulants in clinical practice: a report from three centers in Sweden
IntroductionIn clinical trials new oral anticoagulants (NOAC) have proved to be as effective as warfarin for thromboprophylaxis in atrial fibrillation. The aim of this study was to evaluate the efficacy and safety of these drugs in clinical practise.Methods and resultsAll patients treated with new oral anticoagulants at Sk?ne University hospital and Halland County Hospital Halmstad between 2009 and September 2013 was identified in the Swedish national quality registry for atrial fibrillation and anticoagulation (AuriculA). Medical records were reviewed to identify thromboembolism and major bleeding and compared to a warfar...
Source: Thrombosis Journal - December 2, 2014 Category: Hematology Authors: Ashkan LabafMartin CarlwePeter Svensson Source Type: research

New aspects of stroke medicine.
Abstract Systemic thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) remains the only effective and approved medical treatment of acute ischemic stroke. Several studies have demonstrated the importance of rapid recanalization. The efficacy of thrombectomy has so far not been sufficiently shown in randomized clinical trials; therefore, inclusion of suitable patients in one of the currently ongoing randomized trials is of great importance. The early treatment with magnesium after acute ischemic stroke during the pre-hospital phase did not prove to be neuroprotective. Intermittent pneumatic compr...
Source: Der Nervenarzt - June 28, 2014 Category: Neurology Authors: Diener HC, Frank B, Hajjar K, Weimar C Tags: Nervenarzt Source Type: research

Dabigatran etexilate for secondary stroke prevention: the first year experience from a multicenter short-term registry.
DISCUSSION: Our pilot data indicate that dabigatran appears to be safe for secondary stroke prevention during the first year of implementation of this therapy. However, high cost may limit the long-term treatment of AF patients with dabigatran, leading to early discontinuation. PMID: 24790645 [PubMed - as supplied by publisher]
Source: Adv Data - May 1, 2014 Category: Epidemiology Authors: Tsivgoulis G, Krogias C, Sands KA, Sharma VK, Katsanos AH, Vadikolias K, Papageorgiou SG, Heliopoulos I, Shiue H, Mitsoglou A, Liantinioti C, Athanasiadis D, Giannopoulos S, Piperidou C, Voumvourakis K, Alexandrov AV Tags: Ther Adv Neurol Disord Source Type: research

Dabigatran etexilate for secondary stroke prevention: the first year experience from a multicenter short-term registry
Discussion: Our pilot data indicate that dabigatran appears to be safe for secondary stroke prevention during the first year of implementation of this therapy. However, high cost may limit the long-term treatment of AF patients with dabigatran, leading to early discontinuation.
Source: Therapeutic Advances in Neurological Disorders - April 22, 2014 Category: Neurology Authors: Tsivgoulis, G., Krogias, C., Sands, K. A., Sharma, V. K., Katsanos, A. H., Vadikolias, K., Papageorgiou, S. G., Heliopoulos, I., Shiue, H., Mitsoglou, A., Liantinioti, C., Athanasiadis, D., Giannopoulos, S., Piperidou, C., Voumvourakis, K., Alexandrov, A. Tags: Original Research Source Type: research

Severe thrombosis of bioprosthesis mitral valve after dabigatran.
Abstract A 41-year-old female was admitted to our hospital with an unidentified source of fever, dyspnea and dizziness. Transthoracic echocardiography demonstrated severe mitral valve regurgitation, and further examination with transesophageal echocardiography (TEE) revealed a 7 mm vegetation on the anterior mitral leaflet. Blood cultures were negative, and after 45 days of empiric 12 g/day ampicillin-sulbactam therapy, the vegetation was shown to have disappeared. However, due to ongoing severe mitral regurgitation and valve deformity, a prosthetic metallic mitral valve replacement was performed. After the operat...
Source: Turk Kardiyoloji Dernegi arsivi - September 1, 2013 Category: Cardiology Authors: Akgüllü C, Eryılmaz U, Kurtoğlu T Tags: Turk Kardiyol Dern Ars Source Type: research