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Management of oral anticoagulation in very old patients with non valvular atrial fibrillation related acute ischemic stroke
AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - October 16, 2019 Category: Hematology Source Type: research

Anticoagulants for people hospitalised with COVID-19
CONCLUSIONS: When compared to a lower-dose regimen, higher-dose anticoagulants result in little to no difference in all-cause mortality and increase minor bleeding in people hospitalised with COVID-19 up to 30 days. Higher-dose anticoagulants possibly reduce pulmonary embolism, slightly increase major bleeding, may result in little to no difference in hospitalisation time, and may result in little to no difference in deep vein thrombosis, stroke, major adverse limb events, myocardial infarction, atrial fibrillation, or thrombocytopenia. Compared with no treatment, anticoagulants may reduce all-cause mortality but the evide...
Source: Cochrane Database of Systematic Reviews - March 4, 2022 Category: General Medicine Authors: Ronald Lg Flumignan Vinicius T Civile J éssica Dantas de Sá Tinôco Patricia If Pascoal Libnah L Areias Charbel F Matar Britta Tendal Virginia Fm Trevisani Álvaro N Atallah Luis Cu Nakano 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

Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Cost-Effectiveness of Direct Non-Vitamin K Oral Anticoagulants Versus Vitamin K Antagonists for the Management of Patients with Non-Valvular Atrial Fibrillation Based on Available “Real-World” Evidence: The Italian National Health System Perspective
ConclusionsThe beneficial effect of DOACs on containing events showed in RWE had the potential to offset drug-related costs, thus improving the sustainability of treatment for non-valvular AF in daily clinical practice.
Source: Clinical Drug Investigation - February 15, 2021 Category: Drugs & Pharmacology Source Type: research

Prescriptive behavior of non-vitamin K oral anticoagulants in patients affected by atrial fibrillation in general practice
Biomed Pharmacother. 2023 Jun 21;165:115020. doi: 10.1016/j.biopha.2023.115020. Online ahead of print.ABSTRACTAtrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and in recent years the pharmacological approach has been strongly implemented; in Italy, the prescription of the non-vitamin K oral anticoagulants (NOAC) was also extended to General Practitioners (GPs) since 2020. The aim of the present study was to investigate the GPs prescribing behaviour of NOACs. An observational study was performed by using the computerized medical record of 14 GPs in Sicily: patients affected by AF were selected and st...
Source: Atherosclerosis - June 23, 2023 Category: Cardiology Authors: M Rottura S F A Drago A Molonia N Irrera S Marino R Scoglio L Orlando M Gigliotti De Fazio F Squadrito V Arcoraci E Imbalzano on the behalf of Audit & Research Messina Primary Care Group Source Type: research

Persistence on apixaban in atrial fibrillation patients: a retrospective multicentre study
Conclusion In real-life conditions, NVAF patients treated with apixaban show rates of treatment discontinuation and major bleedings, which are comparable to those found in the ARISTOTLE pivotal study, thus supporting its external validity.
Source: Journal of Cardiovascular Medicine - January 3, 2019 Category: Cardiology Tags: Research articles: Arrhythmias Source Type: research

Non-vitamin K antagonist oral anticoagulation agents in patients with atrial fibrillation: Insights from Italian monitoring registries
ConclusionsThis study is the largest European real-world study ever published on NOACs. It includes all Italian patients treated with NOACs since 2013 accounting for about 1/3 of subjects with AF. The enrolled population consisted of very elderly patients, at high risk of ischemic adverse events. The AIFA registries are consolidated tools that guarantee the appropriateness of prescription and provide important information for the governance of National Health System by collecting real-world data.
Source: IJC Heart and Vasculature - January 24, 2020 Category: Cardiology Source Type: research

Non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and atrial thrombosis: An appraisal of current evidence.
iety of Cardiology Abstract Major thromboembolic complications in patients with atrial fibrillation, secondary to thromboembolism from the left atrium or the left atrial appendage, are a major concern because of their burden of disabling stroke and mortality. To date, non-vitamin K antagonist oral anticoagulants (NOACs) are considered the first-line strategy in most patients with atrial fibrillation receiving chronic anticoagulation, as they have major advantages compared with vitamin K antagonists, including minimization of intracranial bleeding risk. Although several studies and post-hoc analyses have provided i...
Source: Archives of Cardiovascular Diseases - July 21, 2020 Category: Cardiology Authors: Calabrò P, Gragnano F, Cesaro A, Marsico F, Pariggiano I, Patti G, Moscarella E, Cavallari I, Sardu C, Parato VM, Renda G, Niccoli G, Marcucci R, De Caterina R, Working Group of Thrombosis and, Working Group of Interventional Cardiology of the Italian So Tags: Arch Cardiovasc Dis Source Type: research

Direct oral anticoagulants and therapeutic adherence: do not let your guard down
CONCLUSIONS: Polypharmacy, patient's isolation, such as a low education level were statistically associated with a low therapeutic adherence. Therapeutic adherence remains an unsolved problem for anticoagulated patient. To identify patients at higher risk of poor compliance and therapeutic failure and establish targeted care pathways is a priority.PMID:33896375 | DOI:10.1080/00015385.2021.1908702
Source: Acta Cardiologica - April 26, 2021 Category: Cardiology Authors: Leonardo Di Gennaro Martina Monaco Claudia Riccio Erica De Candia Maria Adele Alberelli Cinzia di Martino Maria Basso Maria Antonietta Ferretti Stefano Lancellotti Raimondo De Cristofaro Source Type: research

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