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Anticoagulation of Cardiovascular Conditions in the Cancer Patient: Review of Old and New Therapies
AbstractPurpose of ReviewThe anticoagulation strategies for various cardiac-specific pathologies including atrial fibrillation are changing. Applying these strategies in patients with concomitant active cancer requires additional considerations. Here, we review the most recent changes in the anticoagulation management of common cardiac diseases and their application in cancer patients.Recent FindingsThere are a range of indications for therapeutic anticoagulation in cancer patients including venous thromboembolism (VTE), atrial fibrillation/flutter (AF/AFL), prosthetic heart valves, and intracardiac thrombi. Certain cancer...
Source: Current Oncology Reports - April 3, 2019 Category: Cancer & Oncology Source Type: research

A prospective survey of the persistence of warfarin or NOAC in nonvalvular atrial fibrillation: a COmparison study of Drugs for symptom control and complication prEvention of Atrial Fibrillation (CODE-AF).
Conclusions: Nonpersistence was significantly lower with NOAC than VKA in both the maintenance and new-starter groups. In only the new-starter group, apixaban or edoxaban showed higher persistence rates than rivaroxaban. PMID: 31014064 [PubMed - as supplied by publisher]
Source: The Korean Journal of Internal Medicine - April 24, 2019 Category: Internal Medicine Authors: Kim H, Lee YS, Kim TH, Cha MJ, Lee JM, Park J, Park JK, Kang KW, Shim J, Uhm JS, Park HW, Choi EK, Kim JB, Kim C, Kim J, Joung B Tags: Korean J Intern Med Source Type: research

Use of DOACs in real-world challenging settings: a Delphi Consensus from Italian cardiologists.
CONCLUSIONS: DOACs should represent the first-line anticoagulation therapy in non-valvular AF patients in the majority of challenging settings, underexplored by literature. Caution in their prescription is needed in case of severe renal impairment. Dose choice should follow the SmPC, although this is matter of debate in borderline patients. PMID: 31343145 [PubMed - as supplied by publisher]
Source: Minerva Cardioangiologica - July 27, 2019 Category: Cardiology Tags: Minerva Cardioangiol Source Type: research

Comparative Effectiveness and Safety of Direct Oral Anticoagulants: Overview of Systematic Reviews
AbstractDirect oral anticoagulants are now recommended by major guidelines as first-choice agents for both stroke prevention in non-valvular atrial fibrillation and treatment/prevention of venous thromboembolism in non-cancer patients. Although there are no published head-to-head trials comparing different direct oral anticoagulants, a growing body of evidence from indirect comparisons and observational studies is suggesting that each direct oral anticoagulant may have a specific risk profile. This review aims to (1) synthesize and critically assess the latest evidence in comparative effectiveness and safety research in th...
Source: Drug Safety - September 23, 2019 Category: Drugs & Pharmacology Source Type: research

Is there a role for low-dose DOACs as prophylaxis?
Authors: Cohen AT, Hunt BJ Abstract The direct oral anticoagulants (DOACs) have transformed the management of thrombotic disorders. Large clinical trials have demonstrated that DOACs can replace vitamin K antagonists (VKAs) in the 2 existing major indications for anticoagulation: the prevention of stroke in atrial fibrillation and the acute treatment and secondary prevention of venous thromboembolism (VTE); this literature is widely known. In this article, we will concentrate on the less well-discussed benefits of the use of DOACs-using low doses as primary and secondary prophylaxis in both venous and arterial thro...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Drug interactions and pharmacogenetic factors contribute to variation in apixaban concentration in atrial fibrillation patients in routine care
In this study, we assessed the impact of interacting medication and pharmacogenetic variation to better explain apixaban concentration differences among 358 Caucasian AF patients. Genotyping (ABCG2,ABCB1,CYP3A4*22,CYP3A5*3) was performed by TaqMan assays, and apixaban quantified by mass spectrometry. The typical patient was on average 77.2  years old, 85.5 kg, and had a serum creatinine of 103.1 µmol/L. Concomitant amiodarone, an antiarrhythmic agent and moderate CYP3A/ABCB1 inhibitor, the impaired-function variantABCG2 c.421C  >  A, and sex predicted higher apixaban concentrations when controlling for age, weig...
Source: Journal of Thrombosis and Thrombolysis - January 18, 2020 Category: Hematology Source Type: research

Novel Oral Anticoagulant versus Warfarin in Cancer Patients with Atrial Fibrillation: An 8-Year Population-Based Cohort Study
Conclusion: In cancer patients with AF, NOAC were associated with significant reduced IS/SE, major bleeding, and ICH compared to warfarin.
Source: Journal of Cancer - July 2, 2020 Category: Cancer & Oncology Authors: Victor Chien-Chia Wu, Chun-Li Wang, Yu-Tung Huang, Wen-Ching Lan, Michael Wu, Chang-Fu Kuo, Shao-Wei Chen, Pao-Hsien Chu, Ming-Shien Wen, Chi-Ching Kuo, Shang-Hung Chang Tags: Research Paper Source Type: research

Direct oral anticoagulants: In which indications? Which one to prescribe? For or against their use in frail patients and in atypical cases? Which monitoring and management haemorrhage complications?
Authors: Hoffmann C, Leven C, Le Mao R, De Moreuil C, Lacut K Abstract Since their approval, the direct oral anticoagulants have been widely used in the management of venous thromboembolism, for stroke and systemic embolism prevention in non valvular atrial fibrillation, and in venous thromboembolism prophylaxis after surgical hip or knee replacement. Because they are easy to use, with oral fixed doses and no biological monitoring need, they are more and more prescribed. New indications are rising in cancer associated thrombosis in France beyond the 6 first months of treatment, and to prevent cardiovascular events ...
Source: Revue de Medecine Interne - July 19, 2020 Category: Internal Medicine Tags: Rev Med Interne Source Type: research

Direct oral anticoagulants in the prevention of stroke in breast cancer patients with atrial fibrillation during adjuvant endocrine therapy: A cohort study
Atrial fibrillation (AF) is a frequent comorbidity in malignant patients. Anticancer therapies complicate anticoagulant strategy. We evaluated the safety and efficacy of long-term use of direct oral anticoagulants (DOACs) in breast cancer women.
Source: International Journal of Cardiology - September 11, 2020 Category: Cardiology Authors: Renata Pacholczak-Madej, Stanis ława Bazan-Socha, Lech Zaręba, Anetta Undas, Jerzy Dropiński Source Type: research

Novel Bleeding Risk Score for Patients with Atrial Fibrillation on Oral Anticoagulants, including Direct Oral Anticoagulants.
CONCLUSION: In this prospective cohort study of AF patients and predominantly DOAC users, we successfully derived a bleeding risk prediction model with good calibration and discrimination. PMID: 33501722 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 27, 2021 Category: Hematology Authors: Adam L, Feller M, Syrogiannouli L, Del-Giovane C, Donzé J, Baumgartner C, Segna D, Floriani C, Roten L, Fischer U, Aeschbacher S, Moschovitis G, Schläpfer J, Shah D, Amman P, Kobza R, Schwenkglenks M, Kühne M, Bonati L, Beer J, Osswald S, Conen D, Auje Tags: J Thromb Haemost Source Type: research

Current status of oral anticoagulant adherence in Japanese patients with atrial fibrillation: A claims database analysis
CONCLUSION: In a real-world Japanese claim data analysis, about 70% of patients under DOAC showed persistence with anticoagulation therapy at 3 years. High adherence to DOACs assessed by PDC (over 90%) persisted to 3 years regardless of the types of DOACs.PMID:33663881 | DOI:10.1016/j.jjcc.2021.02.007
Source: Journal of Cardiology - March 5, 2021 Category: Cardiology Authors: Naoharu Yagi Shinya Suzuki Katsuhiko Nagai Takashi Tanaka Takayoshi Nagahama Takuto Arita Takayuki Otsuka Takeshi Yamashita Source Type: research

Implementation of Oral Anticoagulation Treatment Guidelines in Patients with Newly Diagnosed Atrial Fibrillation
CONCLUSION: Despite the increasing OAC treatment rates among high risk AF patients, mainly attributed to the expanding DOAC use, OAC treatment scope is still far from optimal.PMID:33982796 | DOI:10.1111/bcp.14899
Source: Clinical Colorectal Cancer - May 13, 2021 Category: Cancer & Oncology Authors: Anat Arbel Zomoroda Abu-Ful Meir Preis Shai Cohen Walid Saliba Source Type: research

Anticoagulation in special patient populations with atrial fibrillation
Herz. 2021 Jul 5. doi: 10.1007/s00059-021-05042-1. Online ahead of print.ABSTRACTAnticoagulation in patients with atrial fibrillation (AF) should be guided by considerations of the risk of thromboembolism, stroke, and bleeding as well as the patient's preference. Well-recognized scores have been developed to help the clinician in daily risk assessment, but there are several special patient populations for whom scores are not developed or validated. Furthermore, these patients were not adequately represented in the pivotal randomized trials for non-vitamin K antagonist oral anticoagulants (NOACs). In patients with cancer, t...
Source: Herz - July 5, 2021 Category: Cardiology Authors: Laura Ueberham Gerhard Hindricks Source Type: research

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