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Anticoagulation prescribing patterns in patients with cancer
The objective of this retrospective cohort was to describe real-world anticoagulation prescribing patterns in cancer patients at a large academic medical center between January 1, 2013 and October 31, 2016. We sought to assess the safety, tolerability, and efficacy of DOACs in patients with cancer for either VTE and/or AF. Patient demographic, clinical characteristics, as well as bleeding and thrombotic events were collected. There were 214 patients in our analysis, of which 71 patients (33%) received a DOAC [apixaban (n  = 22), dabigatran (n = 17), and rivaroxaban (n = 32)]. There were fewer bleeding events an...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2017 Category: Hematology Source Type: research

Reversal of Anticoagulation: Therapeutic Advances and Clinical Guidelines
Background: Anticoagulants are life-saving medications that prevent and treat thromboembolic disease and are of particular importance in the elderly population for prevention of stroke in atrial fibrillation. The advent of direct oral anticoagulants and reversal agents has yielded more options for patients, although complicating clinical decision-making. Areas of Uncertainty: The decision to anticoagulate in atrial fibrillation depends on the risks of stroke versus bleeding. The accompanying HAS-BLED score for predicting bleeding allows an estimation of net clinical benefit. Despite these tools, uncertainty remains. N...
Source: American Journal of Therapeutics - January 1, 2018 Category: Drugs & Pharmacology Tags: Systematic Review and Clinical Guidelines Source Type: research

Effect of concomitant antiplatelet agents on clinical outcomes in the edoxaban vs warfarin in subjects undergoing cardioversion of atrial fibrillation (ENSURE-AF) randomized trial
ConclusionIn ENSURE-AF, thromboembolic events were rare and absolute bleeding event rates were higher with concomitant APT. These findings may be relevant for AF-patients considered for dual therapy; even for a short treatment duration of 1  month.
Source: Clinical Research in Cardiology - March 30, 2020 Category: Cardiology Source Type: research

Post-operative arterial thrombosis with non-vitamin K antagonist oral anticoagulants after total hip or knee arthroplasty.
In conclusion, in RCTs of pharmacological VTE prophylaxis in patients undergoing THR or TKR, there was no difference in the incidence of post-operative AT among patients treated with NOACs, compared to those treated with enoxaparin. PMID: 25946985 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - May 7, 2015 Category: Hematology Authors: Squizzato A, Lussana F, Cattaneo M Tags: Thromb Haemost Source Type: research

Pulmonary embolism four days after interruption of therapy with rivaroxaban.
We report on a 58-year-old male with paroxysmal atrial fibrillation (AF) with a CHA2DS2VASC score of 4 who developed central pulmonary embolism four days after interruption of rivaroxaban because of parotid surgery. He had received 40 mg enoxaparin/d. The parotid gland was partially resected within 6 hours without blood loss. Pulmonary embolism and AF occurred on the first postoperative day. He recovered with low-molecular-weight heparin in therapeutic dosages and amiodarone and was discharged with phenprocoumon. The relevance of a rivaroxaban rebound phenomenon, manifesting as arterial embolism, stroke or venous thrombo...
Source: Hamostaseologie - August 24, 2017 Category: Hematology Authors: Stöllberger C, Göndör G Tags: Hamostaseologie Source Type: research

Antithrombotic treatment in peripheral artery disease.
Abstract This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke. In symptomatic PAD, dual antiplatelet therapy (DAPT) with clopidogrel and aspirin does not prov...
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - November 21, 2017 Category: Surgery Authors: Olinic DM, Tataru DA, Homorodean C, Spinu M, Olinic M Tags: Vasa Source Type: research

Edoxaban versus warfarin in vitamin K antagonist experienced and na ïve patients from the edoxaban versus warfarin in subjects undergoing cardioversion of atrial fibrillation (ENSURE-AF) randomised trial
ConclusionsEdoxaban had comparable efficacy and safety to optimized anticoagulation with enox –warf. The primary efficacy and safety endpoint outcomes were broadly similar between VKA experienced or naïve patients.
Source: Clinical Research in Cardiology - January 7, 2020 Category: Cardiology Source Type: research

The risk of gastrointestinal hemorrhage with non-vitamin K antagonist oral anticoagulants: A network meta-analysis
Conclusion: Individual NOACs had varying profiles of GI bleeding risk. Results of analyses including only RCTs and those including both RCTs and population studies showed similar trends, but also showed several differences.
Source: Medicine - March 19, 2021 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research