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Total 482 results found since Jan 2013.

Real Data on Effectiveness, Tolerability and Safety of New Oral Anticoagulant Agents: Focus on Dabigatran
Abstract Vitamin K-dependent antagonists (VKAs) are the most commonly used oral anticoagulants. Non-VKA oral anticoagulants (NOACs), directly target factor IIa (dabigatran) or Xa (rivaroxaban, apixaban, and edoxaban) have predictable pharmacological effects and relatively few drug and food interactions compared with VKA. Among NOACs, dabigatran has been extensively tested for stroke prevention in patients with non-valvular atrial fibrillation eligible for oral anticoagulation with VKA. Dabigatran is at least as effective as warfarin at preventing stroke with advantages of less serious bleeding except for gastroint...
Source: High Blood Pressure and Cardiovascular Prevention - May 19, 2016 Category: Cardiology Source Type: research

The Uptake of Non-Vitamin K Oral Anticoagulants in Ireland: Balancing Cost-Effectiveness Analysis and Budget Impact
For many years vitamin K antagonists (usually warfarin) were the only oral anticoagulants available to reduce stroke risk in Atrial fibrillation (AF). The non-vitamin K oral anticoagulants (NOACs) were first licensed in Ireland for stroke prevention in non-valvular AF with the approval of dabigatran etexilate in 2011. Rivaroxaban followed later that year, apixaban in 2013 and edoxaban in 2015. The National Centre for Pharmacoeconomics (NCPE) reviewed all the NOACs for cost-effectiveness prior to reimbursement approval in Ireland.
Source: Value in Health - April 30, 2016 Category: Global & Universal Authors: M Barry, S Clarke, N Geraghty Source Type: research

Trends in the Utilization of Warfarin and Non-Vitamin K Oral Anticoagulants in Elderly Patients with Atrial Fibrillation
Warfarin has been used for more than 60 years to decrease the risk of stroke and death in patients with atrial fibrillation (AF). In recent years, the FDA has approved four non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in AF: dabigatran, rivaroxaban, apixaban, and edoxaban.
Source: Value in Health - April 30, 2016 Category: Global & Universal Authors: A Alalwan, S Voils, A Hartzema Source Type: research

Intravenous Thrombolysis after Reversal of Dabigatran by Idarucizumab: A Case Report
We describe a 75-year-old female patient with nonvalvular atrial fibrillation who presented with acute ischemic stroke during treatment with dabigatran 2 × 110 mg per day. After informed consent, we reversed the anticoagulant effects of dabigatran using idarucizumab and applied an intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (off-label use). An intracerebral hemorrhage was excluded after systemic thrombolysis. Despite the IVT, the patient’s clinical condition deteriorated and she developed an ischemic lesion in the right pons, the right thalamus and right cerebellum. To date, the literatu...
Source: Case Reports in Neurology - June 27, 2016 Category: Neurology Source Type: research

Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life.
CONCLUSION: Patients given rivaroxaban and apixaban in clinical practice have a higher thrombotic and hemorrhagic risk in comparison with patients given dabigatran or VKAs. A considerable proportion of patients receive reduced doses of NOACs. PMID: 27394924 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 5, 2016 Category: Internal Medicine Authors: Giustozzi M, Vedovati MC, Verdecchia P, Pierpaoli L, Verso M, Conti S, Cianella F, Marchesini E, Filippucci E, Agnelli G, Becattini C Tags: Eur J Intern Med Source Type: research

Interactions between non-vitamin K oral anticoagulants and antiepileptic drugs
Atrial fibrillation (AF) is one of the most frequent causes of stroke. Secondary prophylaxis by oral anticoagulants (OACs) is recommended after stroke in patients with AF. For decades, vitamin-K antagonists (VKAs) were the only available drugs for OAC. In the last years, non-vitamin K antagonist oral anticoagulants (NOACs) like dabigatran, rivaroxaban, apixaban or edoxaban have been introduced as OAC drugs for patients with AF or venous thromboembolism, based on large randomized trials, and their use is recommended by various guidelines.
Source: Epilepsy Research - July 7, 2016 Category: Neurology Authors: Claudia St öllberger, Josef Finsterer Tags: Short communication Source Type: research

Improved persistence with non-vitamin K oral anticoagulants compared with warfarin in patients with atrial fibrillation: recent Australian experience.
CONCLUSIONS: Persistence with NOAC drugs in patients with AF appears to be superior to warfarin. If continued long-term, this alone will be of clinical importance in the prevention of stroke and death. PMID: 27463735 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - July 29, 2016 Category: Research Tags: Curr Med Res Opin Source Type: research

Dabigatran in real-world atrial fibrillation. Meta-analysis of observational comparison studies with vitamin K antagonists.
Abstract In the RE-LY clinical trial, dabigatran presented a better effectiveness/safety profile when compared to warfarin. However, clinical trials are not very representative of the real-world setting. We aimed to assess the performance of dabigatran in real-world patients with atrial fibrillation (AF) by means of a systematic review and meta-analysis of observational comparison studies with vitamin K antagonists (VKA). We searched PubMed, Embase and Scopus databases until November 2015 and selected studies according to the following criteria: observational study performed with nonvalvular AF patients; reporting...
Source: Thrombosis and Haemostasis - July 27, 2016 Category: Hematology Authors: Carmo J, Moscoso Costa F, Ferreira J, Mendes M Tags: Thromb Haemost Source Type: research

What are the effects of edoxaban in the general population and in the elderly?
Stroke and systemic embolism are common complications in patients with atrial fibrillation, and can be effectively prevented with oral anticoagulation. However, this strategy is associated with increased risk of major, sometimes fatal bleeding. Where vitamin K antagonists (VKAs) have been the standard of care in the past half century, new directly acting oral anticoagulants have been developed that, unlike VKA, have a fast onset and fast offset of action, and do not need monitoring either. These non-VKA oral anticoagulants (NOACs) have proven to be non-inferior to VKA with regards to stroke and systemic embolism and are at...
Source: European Journal of Heart Failure Supplements - December 21, 2016 Category: Cardiology Authors: Verheugt, F. W. A. Tags: Articles Source Type: research

Effects of novel oral anticoagulants on left atrial and left atrial appendage thrombi: an appraisal
AbstractAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia and predisposes to an increased risk of thromboembolic events. Patients affected by AF exhibit an increased risk of stroke compared with those in sinus rhythm, with the most common location of thrombi in the left atrial appendage. Until 2009, warfarin and other vitamin K antagonists were the only class of oral anticoagulants available. More recently, dabigatran, rivaroxaban, apixaban, and edoxaban have been approved by regulatory authorities for prevention of stroke in patients with non-valvular AF. Few data are available about the efficacy of...
Source: Journal of Thrombosis and Thrombolysis - January 31, 2017 Category: Hematology Source Type: research

Effects on bone metabolism markers and arterial stiffness by switching to rivaroxaban from warfarin in patients with atrial fibrillation
This study aimed to evaluate the effects of changing from warfarin to rivaroxaban on bone mineral metabolism, vascu lar calcification, and vascular endothelial dysfunction. We studied 21 consecutive patients with persistent or chronic AF, who were treated with warfarin at least for 12 months. Warfarin administration was changed to rivaroxaban (10 or 15 mg/day) in all patients. Osteopontin (OPN), bone alkaline ph osphatase (BAP), and under-carboxylated osteocalcin (ucOC) were measured. Pulse wave velocity (PWV) and augmentation index (AI) were also measured as atherosclerosis assessments. All measurements were done before ...
Source: Heart and Vessels - February 22, 2017 Category: Cardiology Source Type: research

Dabigatran: Important Considerations in the Elderly
We read, with keen interest, the report by Dezman et  al. regarding the severity of bleeding and mortality in trauma patients taking dabigatran (1). Stroke physicians frequently prescribe non-vitamin K antagonist oral anticoagulants (NOAC) like dabigatran for stroke prevention in the context of nonvalvular atrial fibrillation. Although the introducti on of NOAC into clinical practice has been a major advance with reduction of monitoring requirement, there remains ongoing concern about the risk of bleeding and the absence of an antidote.
Source: The Journal of Emergency Medicine - March 23, 2017 Category: Emergency Medicine Authors: Jatinder S. Minhas, Amit K. Mistri Tags: Letter to the Editor Source Type: research

Non-Vitamin K Oral Anticoagulants (NOACs) and Their Reversal
AbstractPurpose of ReviewAn 80-year-old man presents with an acute right hemiparesis and National Institutes of Health Stroke Scale (NIHSS) of 25, 14  h after taking dabigatran. Activated partial thromboplastin time (aPTT) is 42.8 s. Arteriogram demonstrates left internal carotid artery thrombosis. What is the appropriate management of this patient with acute ischemic stroke while on a NOAC?Recent FindingsIdarucizumab is a reversal agent approved for dabigatran, and two more reversal agents, andexanet alfa and aripazine, are currently in development for NOACs.SummaryIn this article, we review currently available NOACs, t...
Source: Current Neurology and Neuroscience Reports - July 22, 2017 Category: Neuroscience Source Type: research

Important factors affecting the choice of an oral anticoagulant may be missed in database studies
This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 7, 2017 Category: Internal Medicine Authors: Emma Aarnio, Risto Huupponen, Maarit Jaana Korhonen Tags: Letter to the Editor Source Type: research

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