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Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316. Findings Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0�...
Source: The Lancet Neurology - May 16, 2018 Category: Neurology Source Type: research

Current trends in the use of anticoagulant pharmacotherapy in the United Kingdom? Are changes on the horizon?
Authors: Kotalczyk A, Gue YX, Potpara TS, Lip GYH Abstract INTRODUCTION: Effective stroke prevention with oral anticoagulation (OAC) reduces the risk of stroke and death among patients with atrial fibrillation (AF). For most patients with AF, treatment options include vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOACs). NOACs have been introduced as an alternative to VKAs, and their use has been steadily increasing in the United Kingdom and Europe over a decade. In randomised clinical trials, NOACs had a favourable risk-benefit profile as compared to warfarin. However, there is a con...
Source: Expert Opinion on Pharmacotherapy - January 27, 2021 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Oral Anticoagulants in German nursing home residents – Drug use patterns and predictors for treatment choice
ConclusionsNOACs are increasingly used in German nursing homes, both for initial anticoagulation but also in VKA pre‐treated patients. Switching from VKA to NOAC was substantially influenced by aspects such as intended higher effectiveness and safety but probably also practicability due to less blood monitoring.
Source: British Journal of Clinical Pharmacology - November 1, 2017 Category: Drugs & Pharmacology Authors: Kathrin Jobski, Falk Hoffmann, Stefan Herget ‐Rosenthal, Michael Dörks Tags: PHARMACOEPIDEMIOLOGY Source Type: research

Use of oral anticoagulants in German nursing home residents: drug use patterns and predictors for treatment choice
ConclusionsNOACs are increasingly used in German nursing homes, both for initial anticoagulation but also in VKA pre‐treated patients. Switching from VKA to NOAC was substantially influenced by aspects such as intended higher effectiveness and safety but probably also practicability due to less blood monitoring.
Source: British Journal of Clinical Pharmacology - January 11, 2018 Category: Drugs & Pharmacology Authors: Kathrin Jobski, Falk Hoffmann, Stefan Herget ‐Rosenthal, Michael Dörks Tags: PHARMACOEPIDEMIOLOGY Source Type: research

Thromboembolic and haemorrhagic events in patients with atrial fibrillation: a prospective cohort study in UK primary and secondary care.
CONCLUSION: Anticoagulants are associated with lower risk of thromboembolic and haemorrhagic events among patients with AF than antiplatelets. More research is required on the risk associated with VKAs or NOACs. PMID: 31015222 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - April 22, 2019 Category: Primary Care Authors: Robson J, Mathur R, Priebe M, Ahmed Z, Ayerbe L Tags: Br J Gen Pract Source Type: research

How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants?
Conclusion Results suggest the provision of NMS for NOACs is low. Supporting pharmacists with tailored education and adherence support might foster dissemination.
Source: International Journal of Clinical Pharmacy - September 5, 2017 Category: Drugs & Pharmacology Source Type: research

Variation in anticoagulation for atrial fibrillation between English clinical commissioning groups: an observational study.
CONCLUSION: Anticoagulation for AF has improved substantially in England in association with considerable increases in the eligible population as a result of decreased exception reporting and the use of the CHA2DS2VASc score. There is still substantial room for improvement in most CCGs because, even allowing for exceptions, nine out of 10 CCGs failed to achieve 90% anticoagulation. PMID: 29970397 [PubMed - as supplied by publisher]
Source: The British Journal of General Practice - July 2, 2018 Category: Primary Care Authors: Robson J, Homer K, Ahmed Z, Antoniou S Tags: Br J Gen Pract Source Type: research

Effectiveness and safety of 110 or 150 mg dabigatran versus vitamin K antagonists in non ‐valvular atrial fibrillation.
ConclusionIn real life D110 and D150 were at least as effective and safer than VKA.
Source: British Journal of Clinical Pharmacology - November 13, 2018 Category: Drugs & Pharmacology Authors: Patrick Blin, Caroline Dureau ‐Pournin, Yves Cottin, Jacques Bénichou, Patrick Mismetti, Abdelilah Abouelfath, Regis Lassalle, Cécile Droz, Nicholas Moore Tags: ORIGINAL ARTICLE Source Type: research

Reducing delays to administration of prothrombin complex concentrate in patients with vitamin K antagonist-related intracerebral haemorrhage.
Abstract BACKGROUND/AIMS: Four-factor prothrombin complex concentrate is the first-line treatment in vitamin K antagonist-related intracerebral haemorrhage. Early administration is associated with improved patient outcomes. A quality improvement project investigated delays in prothrombin complex concentrate administration in vitamin K antagonist-related intracerebral haemorrhage in order to reduce the time from computed tomography scan confirming intracerebral haemorrhage to prothrombin complex concentrate administration (scan-to-needle time). METHOD: Twenty patients were identified by retrospective audit ove...
Source: British Journal of Hospital Medicine - February 1, 2020 Category: Internal Medicine Authors: Marrinan E, Chen L, Werring D, Turner D Tags: Br J Hosp Med (Lond) Source Type: research

CO33 Methodological Challenges and Considerations for Decision Makers When Assessing within-Class Comparative Effectiveness and Cost-Effectiveness: The Case of Non-Vitamin K Antagonist Oral Anticoagulants
The United Kingdom National Institute of Health Care Excellence (NICE) published a draft clinical guideline for consultation on anticoagulation therapy for stroke prevention in individuals with atrial fibrillation in September 2020 that addressed which non-vitamin K antagonist oral anticoagulant (NOAC) therapy (apixaban, dabigatran, rivaroxaban, edoxaban) is most clinically and cost-effective. We aimed to elucidate methodological considerations and challenges involved in evaluating the comparative effectiveness and cost-effectiveness of within-class treatments for the  purpose of decision making by a reimbursement authority.
Source: Value in Health - June 26, 2022 Category: International Medicine & Public Health Authors: A Briggs, A Howarth, S Davies, J Schneider, G Spentzouris, F Mughal, A Fuat, M Fay Source Type: research