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Specialty: Neurology
Drug: Pradaxa

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Total 127 results found since Jan 2013.

Management of acute stroke in patients taking novel oral anticoagulants
Each year, 1·0–2·0% of individuals with atrial fibrillation and 0·1–0·2% of those with venous thromboembolism who are receiving one of the novel oral anticoagulants (dabigatran, rivaroxaban, or apixaban) can be expected to experience an acute ischemic stroke. Additionally, 0·2–0·5% of individuals with atrial fibrillation who are receiving one of the novel oral anticoagulants can be expected to experience an intracranial hemorrhage. This opinion piece addresses the current literature and offers practical approaches to the management of patients receiving novel oral anticoagulants who present with an ischemic or ...
Source: International Journal of Stroke - June 1, 2014 Category: Neurology Authors: Graeme J. Hankey, Bo Norrving, Werner Hacke, Thorsten Steiner Tags: Review Source Type: research

Ischemic Stroke in Patients with Elevated Body Mass Index while on Novel Anticoagulants: A case series report (P1.059)
CONCLUSIONS:We report and characterize the largest published case series of patients with non-valvular atrial fibrillation who had ischemic stroke while on novel oral anticoagulants. Elevated body mass index was noted among those who developed embolic strokes while on these agents.Disclosure: Dr. Kamal has nothing to disclose. Dr. Smith has nothing to disclose. Dr. Mowla has nothing to disclose. Dr. Shirani has nothing to disclose. Dr. Sawyer has nothing to disclose. Dr. Fanous has nothing to disclose. Dr. Ching has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Kamal, H., Smith, K., Mowla, A., Shirani, P., Sawyer Jr., R., Fanous, A., Ching, M. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Cardio-embolic Stroke Source Type: research

Real-World Use of Apixaban for Stroke Prevention in Atrial Fibrillation Clinical Sciences
Background and Purpose—The use of oral anticoagulant therapy for stroke prevention in atrial fibrillation has been transformed by the availability of the nonvitamin K antagonist oral anticoagulants. Real-world studies on the use of nonvitamin K antagonist oral anticoagulants would help elucidate their effectiveness and safety in daily clinical practice. Apixaban was the third nonvitamin K antagonist oral anticoagulants introduced to clinical practice, and increasing real-world studies have been published. Our aim was to summarize current evidence about real-world studies on apixaban for stroke prevention in atrial fibril...
Source: Stroke - December 22, 2017 Category: Neurology Authors: Marco Proietti, Imma Romanazzi, Giulio Francesco Romiti, Alessio Farcomeni, Gregory Y.H. Lip Tags: Atrial Fibrillation, Anticoagulants, Quality and Outcomes Original Contributions Source Type: research

A dedicated Stroke Prevention in Atrial Fibrillation (SPAF) clinic for the acute assessment and initiation of anticoagulation in patients with atrial fibrillation. (P1.056)
CONCLUSIONS: This confirms the feasibility of a dedicated AF anticoagulation clinic and it’s ability to significantly increase anticoagulation rates among patients with AF. The intention is to expand this service to primary care initially through engagement in a cluster randomized trial (see next poster).Disclosure: Dr. Jolliffe has nothing to disclose. Dr. Rosemergy has nothing to disclose. Dr. Lanford has nothing to disclose. Dr. Abernethy has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Jolliffe, E., Rosemergy, I., Lanford, J., Abernethy, D. Tags: Cerebrovascular Disease and Interventional Neurology: Atrial Fibrillation and Cardio-embolic Stroke Source Type: research

Anticoagulation Use and Clinical Outcomes After Major Bleeding on Dabigatran or Warfarin in Atrial Fibrillation Clinical Sciences
Conclusions—Dabigatran was associated with a superior benefit/risk ratio than warfarin and anticoagulation discontinuation in the treatment of atrial fibrillation patients who have survived a major bleed.
Source: Stroke - December 22, 2016 Category: Neurology Authors: Inmaculada Hernandez, Yuting Zhang, Maria M. Brooks, Paul K.L. Chin, Samir Saba Tags: Atrial Fibrillation, Quality and Outcomes, Intracranial Hemorrhage, Ischemic Stroke Original Contributions Source Type: research

Thrombolytic Therapy in Severe Cardioembolic Stroke After Reversal of Dabigatran with Idarucizumab: Case Report and Literature Review
Whether idarucizumab, an antidote of dabigatran, can be used effectively and safely before thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients with stroke undergoing treatment with dabigatran remains unknown. We herein describe a 57-year-old man who developed severe cardioembolic stroke with a National Institutes of Health Stroke Scale score of 22 in the left middle cerebral artery territory while undergoing treatment with dabigatran for nonvalvular atrial fibrillation and who was treated with rt-PA after the reversal of dabigatran with idarucizumab.
Source: Journal of Stroke and Cerebrovascular Diseases - March 16, 2018 Category: Neurology Authors: Yuichiro Ohya, Noriko Makihara, Kayo Wakisaka, Takao Morita, Tetsuro Ago, Takanari Kitazono, Hitonori Takaba Tags: Case Studies Source Type: research

Intravenous Thrombolysis in Acute Ischemic Stroke After Idarucizumab Reversal of Dabigatran Effect: Analysis of the Cases From Taiwan
Background: Asians with atrial fibrillation carry a higher risk of ischemic stroke than non-Asians even under treatment of nonvitamin K antagonist oral anticoagulants. The purpose of the study was to observe the feasibility of intravenous thrombolytic therapy after administering a reversal agent, idarucizumab, in dabigatran-treated patients with acute ischemic stroke in Taiwan. Methods: Dabigatran-treated patients with acute ischemic stroke who received intravenous recombinant tissue plasminogen activator (rt-PA) after idarucizumab reversal were enrolled in the retrospective nationwide study.
Source: Journal of Stroke and Cerebrovascular Diseases - December 17, 2018 Category: Neurology Authors: Chen-Wen Fang, Yi-Te Tsai, Ping-Chen Chou, Hsi-Ming Chen, Chien-Ming Lu, Chen-Rong Tsao, Chih-Lin Chen, Mu-Chien Sun, Yu-Song Shih, Cheng-Yang Hsieh, Lu-An Chen, Po-Lin Chen, Jung-Tze Yeh, Yi-Heng Li Source Type: research

Dabigatran for Japanese Patients with Atrial Fibrillation and Prior Stroke: A Subgroup Analysis of the J-Dabigatran Surveillance Program
Background: The study objective was to evaluate long-term safety and effectiveness of dabigatran 110 mg and 150 mg twice daily (bid) in patients with nonvalvular atrial fibrillation (NVAF) with a focus on secondary stroke prevention. Methods: In J-Dabigatran Surveillance, 6772 patients newly initiated on dabigatran to prevent ischemic stroke and systemic embolism were enrolled in Japan (1042 sites, December 2011 to November 2013). This subgroup analysis included patients with (1302) and without (5071) previous stroke/transient ischemic attack (TIA).
Source: Journal of Stroke and Cerebrovascular Diseases - February 25, 2020 Category: Neurology Authors: Masahiro Yasaka, Shinichiro Uchiyama, Hirotsugu Atarashi, Ken Okumura, Yukihiro Koretsune, Takeshi Yamashita, Atsushi Taniguchi, Taku Fukaya, Hiroshi Inoue, for the J-Dabigatran Surveillance Investigators Tags: Original article Source Type: research

Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting
Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke by about five times.1 Oral anticoagulation (OAC) with direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA) reduces ischemic stroke risk in AF patients. Currently, DOAC (apixaban, dabigatran, edoxaban and rivaroxaban) are recommended as first-line treatment for stroke prevention in AF patients.2 Despite several advantages compared to VKA, DOAC have a short half-life of about 12 h. Missing more than 5% of intakes is associated with a higher occurrence of thromboembolic events in OAC-treated AF patients.
Source: Journal of Stroke and Cerebrovascular Diseases - December 14, 2020 Category: Neurology Authors: Valerie Albert, Alexandros A. Polymeris, Fine Dietrich, Stefan T. Engelter, Kurt E. Hersberger, Sabine Schaedelin, Philippe A. Lyrer, Isabelle Arnet Source Type: research

Proposed Approach to Thrombolysis in Dabigatran-Treated Patients Presenting with Ischemic Stroke
Background: Acute ischemic stroke thrombolysis in patients taking dabigatran is controversial because of a presumed increased risk of symptomatic hemorrhagic transformation. Using data from our local hematopathology laboratory, we developed a thrombolysis protocol for acute ischemic stroke patients taking dabigatran.Methods: A local thrombin time (TT)–dabigatran concentration relationship was calculated using dabigatran calibrators. The effect of dabigatran on activated partial thromboplastin time (aPTT) and prothrombin time (PT) (international normalized ratio [INR]) was also measured. A protocol was developed, in which...
Source: Journal of Stroke and Cerebrovascular Diseases - January 9, 2014 Category: Neurology Authors: Mahesh Kate, Artur Szkotak, Adam Witt, Ashfaq Shuaib, Kenneth Butcher Tags: Original Articles Source Type: research

Point-of-Care Testing of Coagulation in Patients Treated With Non-Vitamin K Antagonist Oral Anticoagulants Clinical Sciences
Conclusions— If anti-Xa test is not available, we propose the use of the CoaguChek POCT to guide thrombolysis decisions after individual risk assessment in rivaroxaban-treated patients having acute ischemic stroke. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT02371044.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Ebner, M., Peter, A., Spencer, C., Hartig, F., Birschmann, I., Kuhn, J., Wolf, M., Winter, N., Russo, F., Zuern, C. S., Blumenstock, G., Ziemann, U., Poli, S. Tags: Coagulation, Other anticoagulants, Other diagnostic testing, Emergency treatment of Stroke, Anticoagulants, Thrombolysis, Coagulation and fibronolysis Clinical Sciences Source Type: research

Cardiovascular, Bleeding, and Mortality Risks of Dabigatran in Asians With Nonvalvular Atrial Fibrillation Clinical Sciences
Conclusions— In real-world practice, dabigatran was associated with a reduced risk of ischemic stroke, intracranial hemorrhage, all hospitalized major bleeding, and all-cause mortality compared with warfarin in Asian patients with nonvalvular atrial fibrillation. Dabigatran did not increase the risk of major gastrointestinal bleeding or myocardial infarction compared with warfarin.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Chan, Y.-H., Yen, K.-C., See, L.-C., Chang, S.-H., Wu, L.-S., Lee, H.-F., Tu, H.-T., Yeh, Y.-H., Kuo, C.-T. Tags: Atrial Fibrillation, Cardiovascular Disease, Race and Ethnicity, Intracranial Hemorrhage, Ischemic Stroke Clinical Sciences Source Type: research

Acute Stroke Despite Dabigatran Anticoagulation Treated with Idarucizumab and Intravenous Tissue Plasminogen Activator
Dabigatran is a direct thrombin inhibitor used to reduce the risk of stroke in patients with nonvalvular atrial fibrillation. For patients who present with an acute stroke despite dabigatran therapy, clinical data on the use of intravenous tissue plasminogen activator (IV-tPA) is limited. There is an anticipated increased risk of symptomatic intracranial hemorrhage (sICH) when using IV-tPA in patients on dabigatran therapy. In 2015, the humanized monoclonal antibody fragment idarucizumab was approved for rapid (minutes) reversal of anticoagulant effects of dabigatran.
Source: Journal of Stroke and Cerebrovascular Diseases - April 14, 2017 Category: Neurology Authors: David Bissig, Rashmi Manjunath, Brittany R. Traylor, David P. Richman, Kwan L. Ng Tags: Case Studies Source Type: research

Intravenous Thrombolysis in Anticoagulated and Thrombocytopenic Ischemic Stroke Patients Does Not Increase the Risk of Intracerebral Hemorrhage (P4.271)
Conclusions:These data suggest that IV rt-PA can be safely administered in coagulopathic and thrombocytopenic patients. Although rates of sICH and mortality were similar to the NINDS cohort, caution may be needed to identify certain hemorrhagic risk factors. Routine exclusion of anticoagulated or thrombocytopenic patients is not supported and the use of IV rt-PA in these patients may increase the eligibility for acute stroke therapy, particularly at institutions where IA therapy is unavailable.Disclosure: Dr. Barazangi has received personal compensation for activities with Genentech. Dr. Sorensen has nothing to disclose. D...
Source: Neurology - April 17, 2017 Category: Neurology Authors: Barazangi, N., Sorensen, S., Chen, C., Wong, C., Yee, A., Ke, M., Rose, J., Grosvenor, D., Bedenk, A., Fernandes, J., Tong, D. Tags: Thrombolysis and Acute Evaluation in Ischemic Stroke Source Type: research