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Concentrations of dabigatran administered after acute ischemic stroke
The aim of this study was to evaluate the anticoagulation intensity of dabigatran for acute ischemic stroke patients and hemorrhagic/ischemic events after early initiation of dabigatran.
Source: Journal of the Neurological Sciences - January 21, 2020 Category: Neurology Authors: Shinichi Wada, Manabu Inoue, Takayuki Matsuki, Takuya Okata, Masaya Kumamoto, Naoki Tagawa, Sohei Yoshimura, Akira Okamoto, Toshiyuki Miyata, Masafumi Ihara, Kazunori Toyoda, Masatoshi Koga Source Type: research

Idarucizumab-facilitated intravenous thrombolysis in acute ischemic stroke: A therapeutic strategy requiring further investigation
Although dabigatran does a better job reducing the risk of cardioembolic stroke than warfarin in patients with non-valvular atrial fibrillation, 0.92 –1.34% of dabigatran users still develop isch emic stroke [1]. The usage of warfarin (even at a suboptimal therapeutic level) increases the risk of hemorrhagic transformation (HT) after intravenous thrombolysis (IT) [2]; therefore, current guidelines advise against performing IT in patients receiv ing any direct oral anti-coagulant (DOAC), including dabigatran [3].
Source: Journal of the Neurological Sciences - September 13, 2018 Category: Neurology Authors: Hsiao Yu-Jen, Tsai Yi-Te, Li-Kai Tsai, Fang Chen-wen Tags: Letter to the Editor Source Type: research

Intravenous thrombolysis in stroke patients taking novel oral anticoagulants: experience with the low-dose 0.6  mg/kg of recombinant tissue-type plasminogen activator. Case reports
In the last decade, the novel oral anticoagulant (NOAC) dabigatran (a direct thrombin inhibitor), rivaroxaban, apixaban and edoxaban (direct factor Xa inhibitors) have been approved for primary and secondary prevention of stroke in patients with atrial fibrillation (AF) [1]. Compared with vitamin k antagonists such as warfarin, the NOACs offer benefits in terms of efficacy, safety and convenience [2]. The only currently approved treatment for acute stroke with a class I recommendation and level A evidence is intravenous recombinant tissue-type plasminogen activator alteplase (IV rt-PA) [4].
Source: Journal of the Neurological Sciences - July 7, 2018 Category: Neurology Authors: Massimiliano Plastino, Domenico Bosco, Laura Giofr è, Dario Cristiano, Franco Galati, Paolo Postorino, Arturo Consoli, Antonietta Fava, Domenico Consoli Tags: Letter to the Editor Source Type: research

Idarucizumab-facilitated intravenous thrombolysis in acute stroke with dabigatran: Two cases with hemorrhagic transformation
Idarucizumab is a monoclonal antibody fragment specifically designed for counteracting the effect of a direct oral anti-coagulant (DOAC), namely dabigatran [1]. In a phase III clinical trial, idarucizumab is able to normalize the coagulation profiles in patients suffered from life-threatening bleeding or prepared for emergent intervention [2]. Idarucizumab-facilitated intravenous thrombolysis (IT) was thus considered as a reasonable therapeutic strategy for patients with acute ischemic stroke under dabigatran treatment [3].
Source: Journal of the Neurological Sciences - March 14, 2018 Category: Neurology Authors: Yi-Te Tsai, Yu-Jen Hsiao, Li-Kai Tsai, Pao-Sheng Yen, Fu-Yu Lin, Ching-Hua Lu, Chen-Wen Fang Tags: Letter to the Editor Source Type: research

Idarucizumab elimination of dabigatran minutes before systemic thrombolysis in acute ischemic stroke
We report the case of a 76-year-old woman, who received intravenous thrombolysis for acute treatment of an ischemic stroke immediately after elimination of dabigatran by intravenous application of the monoclonal antibody fragment, idarucizumab, which specifically reverses dabigatran anticoagulation. Currently, the RE-VERSE AD clinical trial is testing idarucizumab in two indications, uncontrolled bleeding and the need for urgent interventions or surgery.
Source: Journal of the Neurological Sciences - September 7, 2016 Category: Neurology Authors: Joachim G. Schulz, Bernard Kreps Tags: Letter to the Editor Source Type: research

Impact of dabigatran on platelet function and fibrinolysis
We sought to evaluate the potential enhanced fibrinolytic and antiplatelet activity of dabigatran etexilate (DE) due to decreased thrombin levels in patients with stroke or transient ischemic attack and non-valvular atrial fibrillation (NVAF).
Source: Journal of the Neurological Sciences - July 22, 2015 Category: Neurology Authors: Argirios E. Tsantes, Elias Kyriakou, Stefanos Bonovas, Maria Chondrogianni, Christina Zompola, Chrissoula Liantinioti, Athina Simitsi, Aristeidis H. Katsanos, Maria Atta, Ignatios Ikonomidis, Violetta Kapsimali, Petros Kopterides, Georgios Tsivgoulis Source Type: research

Rivaroxaban presents a better pharmacokinetic profile than dabigatran in an obese non-diabetic stroke patient
Novel oral anticoagulants (NOACs) are the recent therapeutic breakthrough in the thromboprophylaxis of non-valvular atrial fibrillation (NVAF). There are currently three different molecules approved for NVAF: dabigatran, rivaroxaban and apixaban. All three agents have demonstrated at least non-inferiority at major clinical endpoints compared to warfarin with their major advantage being the fixed-dose regimen that necessitates no regular blood tests and protects patients from the disastrous effects of infra-therapeutic (embolism) or supra-therapeutic (hemorrhage) anticoagulation.
Source: Journal of the Neurological Sciences - September 14, 2014 Category: Neurology Authors: Apostolos Safouris, Anne Demulder, Nikos Triantafyllou, Georgios Tsivgoulis Tags: Letter to the Editor Source Type: research

Cardioembolic stroke in a patient taking Dabigatran Etexilate: The first case report of clinical and pharmacologic resistance
Dabigatran Etexilate (DE) was the first oral direct thrombin inhibitor approved for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF) [1,2]. One of its main advantages relies on predictable pharmacokinetics allowing a fixed dosage for each patient. In fact, although a range of pharmacokinetic response to DE has been demonstrated, up until now no case has been described of clinical and pharmacologic resistance.
Source: Journal of the Neurological Sciences - August 29, 2014 Category: Neurology Authors: João Sargento-Freitas, Fernando Silva, João Pego, Cristina Duque, Gustavo Cordeiro, Luís Cunha Tags: Letter to the Editor Source Type: research

Reservations against new oral anticoagulants after stroke and cerebral bleeding
Abstract: Dabigatran, rivaroxaban, and apixaban are the new oral anticoagulants (NOAC) which have been investigated in patients with atrial fibrillation (AF) for primary and secondary prevention of stroke and thromboembolism. In these trials NOAC had a similar efficacy and safety profile compared to traditional vitamin-K-antagonists such as warfarin. We advise caution in the use of NOAC in patients with stroke or cerebral hemorrhage because of the following reasons:1) Patients with cerebral bleeding were excluded from the trials. 2) Stroke within 14days and severe stroke within 6months before screening were exclusion crite...
Source: Journal of the Neurological Sciences - April 29, 2013 Category: Neurology Authors: Claudia Stöllberger, Josef Finsterer Tags: Opinion Source Type: research