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Nutrition: Vitamin K

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Intravenous thrombolysis in stroke patients taking novel oral anticoagulants: experience with the low-dose 0.6  mg/kg of recombinant tissue-type plasminogen activator. Case reports
In the last decade, the novel oral anticoagulant (NOAC) dabigatran (a direct thrombin inhibitor), rivaroxaban, apixaban and edoxaban (direct factor Xa inhibitors) have been approved for primary and secondary prevention of stroke in patients with atrial fibrillation (AF) [1]. Compared with vitamin k antagonists such as warfarin, the NOACs offer benefits in terms of efficacy, safety and convenience [2]. The only currently approved treatment for acute stroke with a class I recommendation and level A evidence is intravenous recombinant tissue-type plasminogen activator alteplase (IV rt-PA) [4].
Source: Journal of the Neurological Sciences - July 7, 2018 Category: Neurology Authors: Massimiliano Plastino, Domenico Bosco, Laura Giofr è, Dario Cristiano, Franco Galati, Paolo Postorino, Arturo Consoli, Antonietta Fava, Domenico Consoli Tags: Letter to the Editor Source Type: research

Anticoagulation for Stroke Prevention in Older Adults with Atrial Fibrillation and Comorbidity: Current Evidence and Treatment Challenges.
Authors: Sabbag A, Yao X, Siontis KC, Noseworthy PA Abstract The burden of atrial fibrillation (AF) is projected to increase substantially over the next decade in parallel with the aging of the population. The increasing age, level of comorbidity, and polypharmacy will complicate the treatment of older adults with AF. For instance, advanced age and chronic kidney disease have been shown to increase the risk of both thromboembolism and bleeding in patients with AF. Frailty, recurrent falls and polypharmacy, while very common among elderly patients with AF, are often overlooked in the clinical decision making despite...
Source: Korean Circulation Journal - September 22, 2018 Category: Cardiology Tags: Korean Circ J Source Type: research

Ninety-day prognosis of patients receiving direct oral anticoagulants in the early phase of non valvular atrial fibrillation-related acute ischemic stroke: The real life evidence
Patients who receive antithrombotic therapy as secondary prevention in the early phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) have a better prognosis compared with patients who do not receive antithrombotic treatment [1]. In the VISTA registry the incidence of stroke recurrence, symptomatic intracranial bleeding, all-cause mortality and 90-day modified Rankin Scale (mRS) ≥4 in patients with NVAF-related AIS not receiving antithrombotic treatment was 19.8%, 9.3%, 40.7% and 65.3%, respectively compared with patients receiving vitamin K antagonists (VKAs) (10.6%, 2.9%, 25.5% and 46.6%...
Source: Thrombosis Research - November 3, 2018 Category: Hematology Authors: Luca Masotti, Elisa Grifoni, Alessandro Dei, Vieri Vannucchi, Federico Moroni, Stefano Spolveri, Grazia Panigada, Giancarlo Landini Tags: Letter to the Editors-in-Chief Source Type: research

Gender differences and management of stroke risk of nonvalvular atrial fibrillation in an upper middle-income country: Insights from the CARMEN-AF registry
ConclusionsCARMEN-AF Registry demonstrates that in Mexico, regardless of gender, a large proportion of patients remain undertreated. No gender differences were found in the use of VKA or DOAC.
Source: IJC Heart and Vasculature - January 18, 2019 Category: Cardiology Source Type: research

Apixaban for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation in France: The PAROS cross-sectional study of routine clinical practice.
CONCLUSIONS: Initiation of apixaban versus NOACs was more common among patients with increased age, higher bleeding risk and decreased renal function, whereas initiation of apixaban versus VKAs was more common among patients with lower bleeding risk and better renal function. PMID: 31014991 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - April 19, 2019 Category: Cardiology Authors: Falissard B, Picard F, Mahe I, Hanon O, Touzé E, Danchin N, Lamy FX, Ricci L, Steg PG Tags: Arch Cardiovasc Dis Source Type: research

Effect of direct oral anticoagulant for acute major cerebral artery occlusion in cardioembolic stroke/transient ischemic attack patients with non-valvular atrial fibrillation
Direct oral anticoagulants (DOACs) can reduce the frequency of cardioembolic stroke with non-valvular atrial fibrillation as well as or better compared to vitamin K antagonists (VKAs). However, whether taking DOACs prior to stroke can prevent acute major cerebral artery occlusion (MCAO) has not been fully elucidated.
Source: Journal of the Neurological Sciences - May 22, 2019 Category: Neurology Authors: Shinya Tomari, Junnosuke Arima, Takashi Yoshida, Hitomi Yamashita, Reiko Sata, Rikuzo Hamada, Naoaki Kanda, Hiroshi Takashima Source Type: research

Concomitant Anticoagulant and Antidepressant Therapy in Atrial Fibrillation Patients and Risk of Stroke and Bleeding.
In conclusion, concomitant use of an OAC and an AD is associated with an increased bleeding risk. PMID: 31506933 [PubMed - as supplied by publisher]
Source: Clinical Pharmacology and Therapeutics - September 9, 2019 Category: Drugs & Pharmacology Authors: Komen JJ, Hjemdahl P, Mantel-Teeuwisse AK, Klungel OH, Wettermark B, Forslund T Tags: Clin Pharmacol Ther Source Type: research

Atrial Fibrillation and Stroke. A Review on the Use of Vitamin K Antagonists and Novel Oral Anticoagulants.
Abstract Atrial fibrillation (AF) is the most common arrhythmia, ranging from 0.1% in patients <55 years to >9% in octogenarian patients. One important issue is represented by the 5-fold increased ischemic stroke risk in AF patients. Hence, the role of anticoagulation is central. Until a few years ago, vitamin K antagonists (VKAs) and low molecular weight heparin represented the only option to prevent thromboembolisms, though with risks. Novel oral anticoagulants (NOACs) have radically changed the management of AF patients, improving both life expectancy and life quality. This review aims to summarize the mo...
Source: Medicina (Kaunas) - September 19, 2019 Category: Universities & Medical Training Authors: Caturano A, Galiero R, Pafundi PC Tags: Medicina (Kaunas) Source Type: research

Idarucizumab for Intravenous Thrombolysis and Endovascular Thrombectomy in Acute Stroke: A Case Report
Non –vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran, are widely used to prevent ischemic stroke in patients with nonvalvular atrial fibrillation. Nonetheless, stroke occurs in 1–2% of patients, and the use of NOACs may increase the bleeding risk for patients who are receiving a cute treatment of intravenous thrombolysis (IVT) or endovascular thrombectomy (EVT). Idarucizumab, a monoclonal antibody developed to bind dabigatran, has been proven safe and effective for patients with uncontrolled bleeding or for patients planning to receive emergent procedures.
Source: The Journal of Emergency Medicine - November 15, 2019 Category: Emergency Medicine Authors: Yu-Ting Lin, Yen-Jun Lai, Tzu-Hsien Lai Tags: Selected Topics: Neurological Emergencies Source Type: research

708 Stroke Prevention by Non-vitamin K Oral Anticoagulant (NOAC) Agents in the Absence of Atrial Fibrillation: Meta-analysis of Randomized Controlled Trials
Anticoagulation to prevent stroke is a mainstay of atrial fibrillation (AF) management. Use of warfarin in sinus rhythm reduces stroke rates, but with an increase in bleeding. The efficacy and safety of NOACs has not been studied.
Source: Heart, Lung and Circulation - November 8, 2020 Category: Cardiology Authors: K. Lander, P. Thakeria, A. Ha, S. Nayyar Source Type: research

Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry
Conclusions: OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months.
Source: Frontiers in Neurology - November 26, 2020 Category: Neurology Source Type: research

Impact of prescription patterns of antithrombotic treatment on atrial fibrillation-related ischemic stroke.
CONCLUSIONS: The prescription of oral anticoagulants, particularly direct oral anticoagulants, has increased from 2013 to 2019 in our Health Assistance Area. This increase might partially explain the reduction in AF-related IS. PMID: 33326304 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - December 18, 2020 Category: Research Tags: Curr Med Res Opin Source Type: research

Trends in Stroke Prevention between 2014 and 2018 in Hospitalized Atrial Fibrillation Patients
Cardiol Res Pract. 2021 Feb 8;2021:6657776. doi: 10.1155/2021/6657776. eCollection 2021.ABSTRACTIn recent years, significant changes in stroke prophylaxis in patients with atrial fibrillation (AF) have been observed. Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used in the prevention of thromboembolic complications in patients with AF. The aim of the study was to evaluate recommended stroke prophylaxis in patients with AF and to identify predictors of using NOACs in patients treated with anticoagulant therapy. The present study was a retrospective, observational, single-center study which included...
Source: Cardiology Research and Practice - February 25, 2021 Category: Cardiology Authors: B Bielecka I Gorczyca O Jelonek B Wo żakowska-Kapłon Source Type: research