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Total 271 results found since Jan 2013.

Current and emerging pharmacotherapy for ischemic stroke prevention in patients with atrial fibrillation.
Authors: Székely O, Miyazawa K, Lip GYH Abstract INTRODUCTION: Atrial fibrillation (AF) is associated with high morbidity and mortality rates due to thromboembolic complications, and anticoagulation is central to the management of this common arrhythmia to prevent acute thromboembolic events. The traditional anticoagulants: heparin, fondaparinux, and vitamin K antagonists (VKA, e.g. warfarin, acenocoumarol or phenprocoumin) have long served as pharmacotherapy for ischemic stroke prophylaxis. Areas covered: In this review article, the authors provide an overview on current and emerging pharmacotherapy for ischemic ...
Source: Expert Opinion on Pharmacotherapy - October 27, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Non-vitamin K oral anticoagulants (NOAC) and the risk of myocardial infarction: Differences between factor IIa and factor Xa inhibition?
Publication date: Available online 12 October 2018Source: Pharmacology & TherapeuticsAuthor(s): Amin Polzin, Lisa Dannenberg, Georg Wolff, Carolin Helten, Alina Achillles, Thomas Hohlfeld, Tobias Zeus, Malte Kelm, Steffen Massberg, Tobias PetzoldAbstractGuidelines already recommend non-vitamin K oral anticoagulants (NOAC) over vitamin-K antagonists (VKA) for stroke prevention in patients with atrial fibrillation. However, recommendations are lacking with respect to which NOAC to use. At the moment, NOACs may employ two different molecular mechanisms: Factor IIa inhibition (dabigatran) and factor Xa inhibition (apixaban, ed...
Source: Pharmacology and Therapeutics - October 12, 2018 Category: Drugs & Pharmacology Source Type: research

Rivaroxaban versus Warfarin in Patients with Mechanical Heart Valve: Rationale and Design of the RIWA Study
DiscussionWarfarin and similar VKAs are standard therapy for patients with an MHV. Even with the appropriate use of therapy, the incidence of thromboembolic events is high at 1 –4% per year. Furthermore, bleeding risk is significant, ranging from 2 to 9% per year. The new frontier to be overcome in relation to use of the new oral anticoagulants is undoubtedly in patients with MHV. A significant portion of people with MHV worldwide will benefit if noninferiority of these new agents is confirmed.Trial RegistrationClinicalTrials.gov identifier:NCT03566303. Recruitment Status: Recruiting. First Posted: 25 June 2018. Last Upd...
Source: Drugs in R&D - October 6, 2018 Category: Drugs & Pharmacology Source Type: research

Comparative risks of bleeding, ischemic stroke and mortality with direct oral anticoagulants versus phenprocoumon in patients with atrial fibrillation
ConclusionsWith rivaroxaban, no significant differences were observed compared to phenprocoumon with regard to hospitalized bleedings or ischemic strokes. Dabigatran was associated with fewer bleedings and a similar risk of ischemic strokes compared to phenprocoumon. Apixaban was also associated with fewer bleedings but was unexpectedly associated with more ischemic strokes, possibly reflecting selective prescribing. The association of rivaroxaban with higher all-cause mortality unrelated to bleedings or strokes has been described previously but remains to be explained.
Source: European Journal of Clinical Pharmacology - October 1, 2018 Category: Drugs & Pharmacology Source Type: research

Long term outcome in patients with non-valvular atrial fibrillation on dabigatran: a prospective cohort study.
CONCLUSIONS: This prospective cohort study confirms the low incidence of stroke, major bleeding and intracranial bleeding, and a 76% persistence with treatment, in NVAF patients treated with dabigatran over about two years. PMID: 30260252 [PubMed - as supplied by publisher]
Source: Expert Opinion on Drug Safety - September 29, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research

Safety of Edoxaban 30  mg in Elderly Patients with Severe Renal Impairment
ConclusionIn this explorative study analyzing patients with severe CKD treated with edoxaban 30  mg once daily, no major bleeding or thrombotic events were observed. Some minor bleedings were observed. While additional studies are necessary to confirm the results of this exploratory study, edoxaban 30 mg once daily appears to be safe in patients with severe CKD.
Source: Clinical Drug Investigation - September 6, 2018 Category: Drugs & Pharmacology Source Type: research

Non-vitamin-K oral anticoagulants (NOACs) for the prevention of secondary stroke.
Authors: Diener HC, Ntaios G, O'Donnell M, Easton JD PMID: 30152249 [PubMed - as supplied by publisher]
Source: Expert Opinion on Pharmacotherapy - August 29, 2018 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

Homocysteine and homocysteine-related compounds: an overview of the roles in the pathology of the cardiovascular and nervous systems.
HOMOCYSTEINE AND HOMOCYSTEINE-RELATED COMPOUNDS: AN OVERVIEW OF THE ROLES IN THE PATHOLOGY OF THE CARDIOVASCULAR AND NERVOUS SYSTEMS. Can J Physiol Pharmacol. 2018 Aug 21;: Authors: Djuric D, Jakovljevic V, Zivkovic VI, Srejovic IM Abstract Homocysteine, sulfhydryl group containing amino acid, is intermediate product during metabolism of the amino acids methionine and cysteine. Hyperhomocysteinema (HHcy) is used as a predictive risk factor for cardiovascular disorders, the stroke progression, screening for inborn errors of Met metabolism, and as a supplementary test for vitamin B12 deficiency. Two org...
Source: Canadian Journal of Physiology and Pharmacology - August 21, 2018 Category: Drugs & Pharmacology Authors: Djuric D, Jakovljevic V, Zivkovic VI, Srejovic IM Tags: Can J Physiol Pharmacol Source Type: research

Comparative risks of bleeding, ischemic stroke and mortality with direct oral anticoagulants versus phenprocoumon in patients with atrial fibrillation
ConclusionsWith rivaroxaban, no significant differences were observed compared to phenprocoumon with regard to hospitalized bleedings or ischemic strokes. Dabigatran was associated with fewer bleedings and a similar risk of ischemic strokes compared to phenprocoumon. Apixaban was also associated with fewer bleedings but was unexpectedly associated with more ischemic strokes, possibly reflecting selective prescribing. The association of rivaroxaban with higher all-cause mortality unrelated to bleedings or strokes has been described previously but remains to be explained.
Source: European Journal of Clinical Pharmacology - June 16, 2018 Category: Drugs & Pharmacology Source Type: research

Prognostic and therapeutic implications of vascular disease in patients with atrial fibrillation
Publication date: Available online 23 April 2018 Source:Pharmacological Research Author(s): Farhan Shahid, Daniele Pastori, Francesco Violi, Gregory YH Lip Atrial fibrillation (AF) is associated with a 5-fold increase in the risk of ischemic stroke, and AF-related stroke patients have a higher mortality and greater morbidity than patients with non-AF related stroke. AF and vascular disease share a close relationship, with the concomitant presence of both disease states leading to a dramatic rise in future cardiovascular events. Indeed, the presence of peripheral artery disease independently predicts stroke in patients wit...
Source: Pharmacological Research - April 24, 2018 Category: Drugs & Pharmacology Source Type: research

Antithrombotic therapy after TAVR.
Abstract Transvascular aortic valve replacement (TAVR) has emerged as a treatment option in patients with severe aortic stenosis who are inoperable and has recently been evaluated in patients with intermediate surgical risk. The number of procedures is increasing worldwide in parallel with the demographic changes in industrial countries. The risk for cerebral embolism is of main concern and represents a major determinant for prognosis and quality of live after TAVR. The empiric antithrombotic therapy consists of dual antiplatelet therapy (DAPT); however the risk-benefit of this approach is lacking evidence from ra...
Source: Current Vascular Pharmacology - January 17, 2018 Category: Drugs & Pharmacology Authors: Geisler T, Droppa M, Mueller K, Borst O Tags: Curr Vasc Pharmacol Source Type: research

Is there a role for oral triple therapy in patients with acute coronary syndromes without atrial fibrillation?
CONCLUSION: More potent antithrombotic regimens increase bleeding and should only be considered on an individual basis, after careful risk stratification. Accurate risk stratification of ACS patients, for both ischaemic and bleeding risk, is essential to allow individualised treatment. PMID: 29345587 [PubMed - as supplied by publisher]
Source: Current Vascular Pharmacology - January 16, 2018 Category: Drugs & Pharmacology Authors: Spinthakis N, Farag M, Akhtar Z, Gorog DA Tags: Curr Vasc Pharmacol 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

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