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Total 1528 results found since Jan 2013.
Factors associated with antithrombotic treatment decisions for stroke prevention in atrial fibrillation in the Stockholm region after the introduction of NOACs
ConclusionsHigh stroke and bleeding risks favored choices of warfarin or ASA. Among patients receiving NOACs, apixaban was favored for elderly and high-risk patients whereas dabigatran was used in lower risk patients. The inadvertent use of ASA, especially among those with high stroke risks, should be further discouraged.
Source: European Journal of Clinical Pharmacology - June 29, 2017 Category: Drugs & Pharmacology Source Type: research
Use of direct oral anticoagulants for stroke prevention in elderly patients with nonvalvular atrial fibrillation
ConclusionsDOACs are at least as effective as warfarin for stroke prevention in elderly patients with NVAF. Compared with warfarin, DOACs were associated with reduced risk of intracranial hemorrhage, while some DOACs demonstrated an increase in other bleeding events (e.g., gastrointestinal). The faster onset and offset of action and fewer food and drug interactions of DOACs may be an advantage over warfarin for some patients.
Implications for practiceDOACs are an alternative to warfarin with overall equivalent safety and efficacy in elderly patients with NVAF, and may be preferable for some. Stroke risk must always be bala...
Source: Journal of the American Academy of Nurse Practitioners - August 14, 2017 Category: Nursing Authors: Lynn B. Oertel, Annemarie E. Fogerty Tags: REVIEW ‐ SPONSORED Source Type: research
Cost-effectiveness analysis of dabigatran versus rivaroxaban for stroke prevention in patients with non-valvular atrial fibrillation using real-world evidence in elderly US Medicare beneficiaries.
CONCLUSIONS: In this study using US Medicare real-world data, dabigatran was found to dominate rivaroxaban. The analyses were limited by the short follow-up period of the real-world data and results may not be generalizable to other patient populations.
PMID: 28862479 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - September 3, 2017 Category: Research Tags: Curr Med Res Opin Source Type: research
Real-world comparison of all-cause hospitalizations, hospitalizations due to stroke and major bleeding, and costs for nonvalvular atrial fibrillation patients prescribed oral anticoagulants in a US health plan.
CONCLUSIONS: This study demonstrated a significantly higher risk of hospitalization (all-cause, stroke/SE, and major bleeding) associated with warfarin, a significantly higher risk of major bleeding hospitalization associated with dabigatran or rivaroxaban, and a significantly higher risk of all-cause hospitalization associated with rivaroxaban compared to apixaban. Lower major bleeding-related costs were observed for apixaban patients compared to warfarin and rivaroxaban patients.
PMID: 29047304 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - October 20, 2017 Category: Health Management Tags: J Med Econ Source Type: research
Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asian Patients With Atrial Fibrillation Clinical Sciences
Conclusions—In real-world practice among a high-risk Asian atrial fibrillation population, all 3 NOACs demonstrated similar risk of ischemic stroke and lower risk of ICH compared with warfarin. All-cause mortality was significantly lower only with dabigatran and apixaban.
Source: Stroke - October 23, 2017 Category: Neurology Authors: Myung-Jin Cha, Eue-Keun Choi, Kyung-Do Han, So-Ryoung Lee, Woo-Hyun Lim, Seil Oh, Gregory Y.H. Lip Tags: Atrial Fibrillation Original Contributions Source Type: research
Direct oral anticoagulants versus warfarin for preventing stroke and systemic embolic events among atrial fibrillation patients with chronic kidney disease.
CONCLUSIONS: Our findings indicate that DOAC are as likely as warfarin to prevent all strokes and systemic embolic events without increasing risk of major bleeding events among AF patients with kidney impairment. These findings should encourage physicians to prescribe DOAC in AF patients with CKD without fear of bleeding. The major limitation is that the results of this study chiefly reflect CKD stage G3. Application of the results to CKD stage G4 patients requires additional investigation. Furthermore, we could not assess CKD stage G5 patients. Future reviews should assess participants at more advanced CKD stages. Additio...
Source: Cochrane Database of Systematic Reviews - November 6, 2017 Category: General Medicine Authors: Kimachi M, Furukawa TA, Kimachi K, Goto Y, Fukuma S, Fukuhara S Tags: Cochrane Database Syst Rev Source Type: research
Stroke Prevention with Oral Anticoagulants: Summary of the Evidence and Efficacy Measures as an Aid to Treatment Choices
AbstractAtrial fibrillation (AF) is an established risk factor for a first or recurrent stroke. Despite proven efficacy in preventing stroke in patients with AF, warfarin is underused, partly due to safety concerns. Recent randomized trials have shown that non-vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran (a direct thrombin inhibitor) and apixaban, edoxaban, and rivaroxaban (factor Xa inhibitors) are not only non-inferior or superior to warfarin but also demonstrate a decreased risk of cerebrovascular bleeding among patients with AF and moderate to high risk of stroke. Additionally, NOACs have an adva...
Source: Cardiology and Therapy - February 27, 2018 Category: Cardiology Source Type: research
Is the prescription right? A review of non-vitamin K antagonist anticoagulant (NOAC) prescriptions in patients with non-valvular atrial fibrillation. Safe prescribing in atrial fibrillation and evaluation of non-vitamin K oral anticoagulants in stroke prevention (SAFE-NOACS) group
ConclusionOur study highlights significant inaccuracies in NOAC prescribing. Patients commenced on NOACs should be assessed and followed up in a multidisciplinary AF clinic to ensure safe and effective prescribing and stroke prevention.
Source: Irish Journal of Medical Science - June 2, 2018 Category: General Medicine Source Type: research
Stroke Prevention with Oral Anticoagulants: Summary of the Evidence and Efficacy Measures as an Aid to Treatment Choices
AbstractAtrial fibrillation (AF) is an established risk factor for a first or recurrent stroke. Despite proven efficacy in preventing stroke in patients with AF, warfarin is underused, partly due to safety concerns. Recent randomized trials have shown that non-vitamin K antagonist oral anticoagulants (NOACs) such as dabigatran (a direct thrombin inhibitor) and apixaban, edoxaban, and rivaroxaban (factor Xa inhibitors) are not only non-inferior or superior to warfarin but also demonstrate a decreased risk of cerebrovascular bleeding among patients with AF and moderate to high risk of stroke. Additionally, NOACs have an adva...
Source: Cardiology and Therapy - June 1, 2018 Category: Cardiology Source Type: research
Acute reversal of dabigatran with Idarucizumab for intravenous thrombolysis as acute stroke treatment
We describe the case of a 73 year old male with AIS and active dabigatran use. Idarucizumab was administered per an approved medical center protocol and the patient was subsequently treated with IV rt-PA. The patient had a severe stroke with no other contraindications to IV rt-PA other than dabigatran use. The patient was administered Idarucizumab and IV rt-PA was given. Within 24 h of treatment, the patient had minimal stroke deficits. Imaging revealed a right middle cerebral artery patchy infarct. The patient was restarted on dabigatran therapy for his atrial fibrillation and was discharged to a skilled nursing facil...
Source: Journal of Clinical Neuroscience - October 9, 2018 Category: Neuroscience Source Type: research
Individual Treatment Effect Estimation of 2 Doses of Dabigatran on Stroke and Major Bleeding in Atrial Fibrillation: Results from the RE-LY Trial.
CONCLUSIONS: The absolute treatment benefits and harms of dabigatran in atrial fibrillation can be estimated based on readily available patient characteristics. Such treatment effect estimations can be used for shared decision-making before starting dabigatran treatment, and to determine the optimal dose.
CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov Unique identifier: NCT00262600.
PMID: 31046423 [PubMed - as supplied by publisher]
Source: Circulation - May 2, 2019 Category: Cardiology Authors: Stam-Slob MC, Connolly SJ, van der Graaf Y, van der Leeuw J, Dorresteijn JAN, Eikelboom JW, Peters RJG, Alings M, Visseren FLJ Tags: Circulation Source Type: research
122 Are We Effective Prescribers? A Retrospective Audit of DOAC Prescribing Post Embolic Stroke for Non Valvular Atrial Fibrillation
ConclusionA significant number of patients prescribed DOAC in hospital were not appropriately anticoagulated (21%), a majority of which were under-dosed. The patients who were under-dosed were older and more likely to be on 5 or more medications.
Source: Age and Ageing - September 16, 2019 Category: Geriatrics Source Type: research
Effectiveness, safety and costs of stroke prevention in non-valvular auricular fibrillation. Study of cohorts matched by Propensity score.
CONCLUSIONS: Most patients initiated VKA. We found no differences between VKA and dabigatran in the risk of stroke, haemorrhages or mortality.
PMID: 31551166 [PubMed - as supplied by publisher]
Source: Atencion Primaria - September 20, 2019 Category: Primary Care Authors: Giner-Soriano M, Casajuana M, Roso-Llorach A, Vedia C, Morros R Tags: Aten Primaria Source Type: research
Dabigatran Reversal with Idarucizumab Preceding Thrombolysis in an Octogenarian Patient with Chronic Kidney Disease and Acute Stroke: a Case Report.
CONCLUSION: Our case showed the effectiveness and safety of giving Idarucizumab followed by thrombolysis in Dabigatran-treated atrial fibrillation with ischemic stroke. Based on this case, the procedure can be performed in an elderly population with chronic kidney disease when administered close to the limit of threshold for thrombolysis.
PMID: 32778345 [PubMed - as supplied by publisher]
Source: Clinical Therapeutics - August 6, 2020 Category: Drugs & Pharmacology Authors: Laxamana LC, Co COC, Yu JRT, Mojica CV, Iboleon-Dy MAM, Domingo AMC, Ilano KCS, Macrohon-Valdez MCZ Tags: Clin Ther Source Type: research
The association between direct oral anticoagulant concentration upon acute stroke and stroke outcome
CONCLUSION: Among DOAC users who developed IS, low drug concentrations at hospital presentation predicted poor outcomes.PMID:36990874 | DOI:10.1016/j.ejim.2023.03.023
Source: European Journal of Internal Medicine - March 29, 2023 Category: Internal Medicine Authors: Shin-Yi Lin Sung-Chun Tang Ching-Hua Kuo Chih-Hao Chen Yuan-Chang Chao Chih-Fen Huang Jiann-Shing Jeng Source Type: research
