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Specialty: Internal Medicine
Drug: Warfarin

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Total 131 results found since Jan 2013.

Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s
Commentary on: Asberg A, Erisksson M, Henriksson KM, et al.. Warfarin-associated intracerebral hemorrhage after ischemic stroke. Stroke 2014;45:2118–20. Context Since its isolation during the early half of the 20th century from the mouldy hay responsible for ‘sweet clover disease’ in cattle, warfarin has become the most widely used oral anticoagulant.1 Indications include atrial fibrillation (AF), mechanical prosthetic valves and venous thromboembolism treatment.2 Warfarin reduces stroke risk in patients with AF by nearly two-thirds; AF accounts for 20% of ischaemic strokes, which tend to be more severe t...
Source: Evidence-Based Medicine - January 21, 2015 Category: Internal Medicine Authors: Ruland, S., Biller, J. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Alcohol-related disorders, Drugs misuse (including addiction), Arrhythmias, Alcohol, Health education Aetiology/Harm Source Type: research

Efficacy and Safety of Oral Anticoagulants Versus Aspirin for Patients With Atrial Fibrillation: A Meta-Analysis
Abstract: The purpose of this study was to perform a meta-analysis comparing the effectiveness and safety of anticoagulation to antiplatelet therapy for the prevention of thromboembolic events in patients with atrial fibrillation (AF). MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched for studies published through May 31, 2014. Randomized controlled trials comparing anticoagulants (warfarin) and antiplatelet therapy in patients with AF were included. The primary outcomes were the rates of stroke and systemic embolism. Secondary outcomes included the rates of hemorrhage/major bleeding and death. Pooled o...
Source: Medicine - January 1, 2015 Category: Internal Medicine Tags: Article: Systematic Review and Meta-Analysis Source Type: research

Review: In AF with CKD, novel oral anticoagulants reduce stroke or systemic embolism compared with warfarin.
PMID: 25402537 [PubMed - in process]
Source: Annals of Internal Medicine - November 18, 2014 Category: Internal Medicine Authors: DeLoughery T Tags: Ann Intern Med Source Type: research

Literature Update in Hospital Medicine
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): William Southern , Bradley A. Sharpe , Romsai Tony BoonyasaiTeaser Perioperative statins reduce perioperative myocardial infarctions, atrial fibrillation, and length of stay. Statins do not increase the risk of intracranial hemorrhage. New oral anticoagulants are superior to warfarin in preventing stroke in patients with atrial fibrillation, and may have a better safety profile. In patients who have an acute gastrointestinal bleed while on warfarin, restarting warfarin after a week may lead to fewer thromboses and lower mortality ...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research

Evidence suggests dabigatran is an effective and safe treatment for patients with VTE requiring early parenteral therapy
Commentary on: Schulman S, Kakkar AK, Goldhaber SZ, et al.. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis. Circulation 2014;129:764–72. Context Until recently, an initial course of parenteral anticoagulation followed by vitamin K antagonist (VKA) was the standard of care for the treatment of venous thromboembolism (VTE). In the past few years, direct oral anticoagulants (DOAC) have been found to be non-inferior to VKA.1–3 The RE-COVER study found dabigatran to be non-inferior to warfarin, with a reduced risk for clinically relevant bleeding.4 In order to confirm these...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Granziera, S., Cohen, A. T. Tags: Drugs: cardiovascular system, Stroke, Venous thromboembolism, Radiology, Pulmonary embolism, Clinical diagnostic tests Therapeutics Source Type: research

Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al.. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62. Context Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabig...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Connective tissue disease, Musculoskeletal syndromes, Diabetes, Arrhythmias Therapeutics Source Type: research

In AF, apixaban reduced stroke or systemic embolism compared with warfarin, regardless of patient age.
PMID: 24935513 [PubMed - in process]
Source: Annals of Internal Medicine - June 17, 2014 Category: Internal Medicine Authors: Sharma M, Perera K Tags: Ann Intern Med Source Type: research

Controversies regarding the new oral anticoagulants for stroke prevention in patients with atrial fibrillation
This article raises 10 controversial issues regarding the use of NOACs for stroke prevention in patients with atrial fibrillation, and offers a review of the latest available evidence. We provide a brief overview of the mechanism and dosing of these drugs, as well as a summary of the key clinical trials that have brought them into the spotlight. Comparative considerations relative to warfarin such as NOAC safety, efficacy, bleeding risk, reversibility, drug-transitioning and use in patients well controlled on warfarin are addressed. Use in select populations such as the elderly, those with coronary disease, renal impairmen...
Source: Vascular Medicine recent issues - May 30, 2014 Category: Internal Medicine Authors: Mohanty, B. D., Looser, P. M., Gokanapudy, L. R., Handa, R., Mohanty, S., Choi, S. S., Goldman, M. E., Fuster, V., Halperin, J. L. Tags: Review Articles Source Type: research

Novel anticoagulants in patients with mechanical heart valves
Commentary on: Eikelboom JW, Connolly SJ, Brueckmann M, et al.. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med 2013;369:1206. Context Novel anticoagulants (including the direct thrombin inhibitor dabigatran etixilate) and oral factor Xa inhibitors have similar or superior efficacy and safety to warfarin for reducing thromboembolic stroke in patients with atrial fibrillation, and for prevention of deep venous thrombosis. Eikelboom and colleagues set out to examine whether these novel anticoagulants could be used as an alternative to warfarin in patients with mechanical heart valves. Method...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Stewart, R. A. H. Tags: Drugs: cardiovascular system, Stroke, Venous thromboembolism Therapeutics Source Type: research

The dangerous gamble of heparinization within two weeks of nonoperative traumatic acute subdural hematoma in patients with increased stroke risk: A case series
Conclusion: Heparinization within two weeks of aSDH may cause SDH enlargement resulting in rapidly fatal neurologic deterioration. Further study is needed to more definitively address this issue.
Source: Journal of Postgraduate Medicine - May 13, 2014 Category: Internal Medicine Authors: S McClellandSJ MackeySS Kim Source Type: research

Edoxaban was noninferior to warfarin for preventing stroke or systemic embolism in atrial fibrillation.
PMID: 24638185 [PubMed - in process]
Source: Annals of Internal Medicine - March 18, 2014 Category: Internal Medicine Authors: Johnson SA, Rondina MT Tags: Ann Intern Med Source Type: research

Left atrial appendage occlusion with the Watchman device in a patient with paroxysmal atrial fibrillation and intolerance of all forms of anticoagulation due to hereditary haemorrhagic telangiectasia
Abstract An elderly woman presented to our attention because of paroxysmal atrial fibrillation and cerebrovascular events requiring systemic anticoagulation and a concomitant, serious bleeding diathesis (the Osler‐Weber‐Rendu syndrome, or hereditary haemorrhagic telangiectasia). Her risk of suffering a major stroke was significant given a CHA2DS2VASc score of 6. However, she was unable to tolerate any form of anticoagulation because of torrential epistaxis and previous gastrointestinal haemorrhage on antiplatelet therapy. We proceeded with percutaneous occlusion of the left atrial appendage with a Watchman device. Ten ...
Source: Internal Medicine Journal - March 13, 2014 Category: Internal Medicine Authors: R. Spina, B. Gunalingam Tags: Brief Communication Source Type: research

Purple toes syndrome following stroke thrombolysis and warfarin therapy
Source: Internal Medicine Journal - January 23, 2014 Category: Internal Medicine Authors: T. Mooney, P. Joseph Tags: Letter to the Editor Source Type: research

Randomised controlled trial: extended-duration dabigatran is non-inferior to warfarin and more effective than placebo for symptomatic VTE
Commentary on: Schulman S, Kearon C, Kakkar AK, et al.. Extended use of dabigatran, warfarin, or placebo in venous thromboembolism. N Engl J Med 2013;368:709–718. RE-MEDY and RE-SONATE trials. Context In patients with idiopathic deep vein thrombosis (DVT) or pulmonary embolism (PE), extending the duration of warfarin beyond the initial 3–6 months of anticoagulation significantly reduces the risk for recurrence.1 2 Dabigatran is an oral direct-thrombin inhibitor that has been shown to be as effective as warfarin in the first 6 months after a venous thromboembolism (VTE).3 However, its efficacy and safe...
Source: Evidence-Based Medicine - January 22, 2014 Category: Internal Medicine Authors: Liem, T. K., DeLoughery, T. G. Tags: EBM Aetiology, Clinical trials (epidemiology), Drugs: cardiovascular system, Stroke, Venous thromboembolism, Pulmonary embolism Source Type: research

Dabigatran increased bleeding and stroke compared with warfarin after mechanical heart valve implantation.
PMID: 24343411 [PubMed - in process]
Source: Annals of Internal Medicine - December 17, 2013 Category: Internal Medicine Authors: Kolias TJ Tags: Ann Intern Med Source Type: research