Latest & greatest articles for anticoagulation

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Top results for anticoagulation

61. D-dimer to guide the intensity of anticoagulation in Chinese patients after mechanical heart valve replacement: a randomized controlled trial

D-dimer to guide the intensity of anticoagulation in Chinese patients after mechanical heart valve replacement: a randomized controlled trial 28762606 2017 08 01 2017 10 06 1538-7836 15 10 2017 Oct Journal of thrombosis and haemostasis : JTH J. Thromb. Haemost. D-dimer to guide the intensity of anticoagulation in Chinese patients after mechanical heart valve replacement: a randomized controlled trial. 1934-1941 10.1111/jth.13782 Essentials Low anticoagulation intensity reduces bleeding (...) but increases thrombosis during warfarin therapy. Elevated D-dimer level is associated with increased thrombosis events. D-dimer can be used to find potential thrombosis in those receiving low intensity therapy. D-dimer-guided therapy may be the optimal strategy for those with mechanical heart valve replacement. Background Controversies remain regarding the optimal anticoagulation intensity for Chinese patients after mechanical heart valve replacement despite guidelines having recommended a standard

EvidenceUpdates2017

62. Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis

Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis 28874418 2017 09 06 2017 09 06 1468-3288 2017 Sep 05 Gut Gut Therapeutic endoscopy-related GI bleeding and thromboembolic events in patients using warfarin or direct oral anticoagulants: results from a large nationwide database analysis. gutjnl-2017-313999 10.1136/gutjnl-2017-313999 To compare the risks of postendoscopy (...) outcomes associated with warfarin with direct oral anticoagulants (DOACs), taking into account heparin bridging and various types of endoscopic procedures. Using the Japanese Diagnosis Procedure Combination database, we identified 16 977 patients who underwent 13 types of high-risk endoscopic procedures and took preoperative warfarin or DOACs from 2014 to 2015. One-to-one propensity score matching was performed to compare postendoscopy GI bleeding and thromboembolism between the warfarin and DOAC

EvidenceUpdates2017

63. Effect of Genotype-Guided Warfarin Dosing on Clinical Events and Anticoagulation Control Among Patients Undergoing Hip or Knee Arthroplasty: The GIFT Randomized Clinical Trial.

Effect of Genotype-Guided Warfarin Dosing on Clinical Events and Anticoagulation Control Among Patients Undergoing Hip or Knee Arthroplasty: The GIFT Randomized Clinical Trial. Importance: Warfarin use accounts for more medication-related emergency department visits among older patients than any other drug. Whether genotype-guided warfarin dosing can prevent these adverse events is unknown. Objective: To determine whether genotype-guided dosing improves the safety of warfarin initiation. Design

JAMA2017

64. Safety, pharmacokinetics, and reversal of apixaban anticoagulation with andexanet alfa

Safety, pharmacokinetics, and reversal of apixaban anticoagulation with andexanet alfa 29296829 2018 11 13 2473-9529 1 21 2017 Sep 26 Blood advances Blood Adv Safety, pharmacokinetics, and reversal of apixaban anticoagulation with andexanet alfa. 1827-1838 10.1182/bloodadvances.2017007112 Direct factor Xa (FXa) inhibitors lack a specific reversal agent for emergencies such as major bleeding or urgent surgery. Andexanet alfa, a modified, catalytically inactive, recombinant human FXa derivative (...) , reverses anticoagulant effect by binding and sequestering FXa inhibitors. This original report of safety and dose-finding, phase 1 and 2 randomized, double-blind, placebo-controlled studies, investigated various doses of andexanet in healthy volunteers. Phase 1 evaluated the safety and pharmacokinetics of andexanet (n = 24) or placebo (n = 8). In phase 2, andexanet (n = 36) or placebo (n = 18) was administered following steady-state apixaban dosing (5 mg twice daily for 6 days); safety

Blood advances2017 Full Text: Link to full Text with Trip Pro

65. Management of anticoagulation in hip fractures: A pragmatic approach

Management of anticoagulation in hip fractures: A pragmatic approach 29071124 2018 11 13 2058-5241 2 9 2017 Sep EFORT open reviews EFORT Open Rev Management of anticoagulation in hip fractures: A pragmatic approach. 394-402 10.1302/2058-5241.2.160083 Hip fractures are common and increasing with an ageing population. In the United Kingdom, the national guidelines recommend operative intervention within 36 hours of diagnosis. However, long-term anticoagulant treatment is frequently encountered (...) not be delayed in patients on classical antiplatelet medications (aspirin or clopidogrel), but spinal or regional anaesthetic methods should be avoided for the latter. However, evidence regarding the use of more novel antiplatelet medications (e.g. ticagrelor) and direct oral anticoagulants remains a largely unexplored area in the context of hip fracture surgery. We suggest treatment protocols based on best available evidence and guidance from allied specialties.Hip fracture surgery presents a common

EFORT open reviews2017 Full Text: Link to full Text with Trip Pro

66. Complete Resolution of a Large Bicuspid Aortic Valve Thrombus with Anticoagulation in Primary Antiphospholipid Syndrome

Complete Resolution of a Large Bicuspid Aortic Valve Thrombus with Anticoagulation in Primary Antiphospholipid Syndrome 28979899 2018 11 13 2297-055X 4 2017 Frontiers in cardiovascular medicine Front Cardiovasc Med Complete Resolution of a Large Bicuspid Aortic Valve Thrombus with Anticoagulation in Primary Antiphospholipid Syndrome. 59 10.3389/fcvm.2017.00059 Native aortic valve thrombosis in primary antiphospholipid syndrome (APLS) is a rare entity. We describe a 38-year-old man who presented (...) with neurological symptoms and a cardiac murmur. Transthoracic echocardiography detected a large bicuspid aortic valve thrombus. Laboratory evaluation showed the presence of antiphospholipid antibodies. Anticoagulation was started, and serial echocardiographic studies showed complete resolution of the aortic valve vegetation after 4 months. The patient improved clinically and had no residual symptoms. This report and review of the literature suggests that vegetations in APLS can be treated successfully

Frontiers in cardiovascular medicine2017 Full Text: Link to full Text with Trip Pro

67. Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke.

Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke. BACKGROUND: Trials of patent foramen ovale (PFO) closure to prevent recurrent stroke have been inconclusive. We investigated whether patients with cryptogenic stroke and echocardiographic features representing risk of stroke would benefit from PFO closure or anticoagulation, as compared with antiplatelet therapy. METHODS: In a multicenter, randomized, open-label trial, we assigned, in a 1:1:1 ratio, patients 16 (...) to 60 years of age who had had a recent stroke attributed to PFO, with an associated atrial septal aneurysm or large interatrial shunt, to transcatheter PFO closure plus long-term antiplatelet therapy (PFO closure group), antiplatelet therapy alone (antiplatelet-only group), or oral anticoagulation (anticoagulation group) (randomization group 1). Patients with contraindications to anticoagulants or to PFO closure were randomly assigned to the alternative noncontraindicated treatment

NEJM2017

68. Comparison of the CHA2DS2-VASc, CHADS2, HAS-BLED, ORBIT, and ATRIA Risk Scores in Predicting Non-Vitamin K Antagonist Oral Anticoagulants-Associated Bleeding in Patients With Atrial Fibrillation

Comparison of the CHA2DS2-VASc, CHADS2, HAS-BLED, ORBIT, and ATRIA Risk Scores in Predicting Non-Vitamin K Antagonist Oral Anticoagulants-Associated Bleeding in Patients With Atrial Fibrillation 28844514 2017 08 28 2017 08 28 1879-1913 2017 Jul 31 The American journal of cardiology Am. J. Cardiol. Comparison of the CHA2DS2-VASc, CHADS2, HAS-BLED, ORBIT, and ATRIA Risk Scores in Predicting Non-Vitamin K Antagonist Oral Anticoagulants-Associated Bleeding in Patients With Atrial Fibrillation (...) . S0002-9149(17)31224-9 10.1016/j.amjcard.2017.07.051 The increasing adoption of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF) necessitates a reassessment of bleeding risk scores. Because known risk factors for bleeding are largely the same as for stroke, we hypothesize that stroke risk scores could also be used to identify patients with high bleeding risks. We aimed to compare the performance of 2 stroke risk scores (Congestive Heart

EvidenceUpdates2017

69. A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial.

A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation (IMPACT-AF): an international, cluster-randomised trial. BACKGROUND: Oral anticoagulation is underused in patients with atrial fibrillation. We assessed the impact of a multifaceted educational intervention, versus usual care, on oral anticoagulant use in patients with atrial fibrillation. METHODS: This study was a two-arm, prospective, international, cluster-randomised, controlled trial. Patients (...) were included who had atrial fibrillation and an indication for oral anticoagulation. Clusters were randomised (1:1) to receive a quality improvement educational intervention (intervention group) or usual care (control group). Randomisation was carried out centrally, using the eClinicalOS electronic data capture system. The intervention involved education of providers and patients, with regular monitoring and feedback. The primary outcome was the change in the proportion of patients treated

Lancet2017

70. Can I Safely Use Anticoagulants in my Patient with a Brain Tumor?

Can I Safely Use Anticoagulants in my Patient with a Brain Tumor? Can I Safely Use Anticoagulants in my Patient with a Brain Tumor? | Clinical Correlations Can I Safely Use Anticoagulants in my Patient with a Brain Tumor? August 3, 2017 By Christopher Sonne, MD Peer Reviewed It is the last admission of your admitting night shift. You are called to assess a pleasant, oriented 65-year-old man with lung cancer and metastases to the bone, liver, and brain. You review his history along with his (...) . In this case, the patient has metastatic lung adenocarcinoma. Brain metastases from melanoma, thyroid cancer, renal cell carcinoma, and choriocarcinoma are traditionally known to [7]. For your patient, rate of spontaneous intracranial hemorrhage (ICH) from metastatic lung adenocarcinoma appears to be comparatively low [8]. You breathe a little easier. You then consider alternatives to anticoagulation. Pooled data using varied patient populations with malignancy shows a statistically significant decrease

Clinical Correlations2017

71. Influence of renal function on anticoagulation control in patients with non-valvular atrial fibrillation taking vitamin K antagonists

Influence of renal function on anticoagulation control in patients with non-valvular atrial fibrillation taking vitamin K antagonists 28722795 2017 07 19 2017 07 19 1742-1241 2017 Jul 19 International journal of clinical practice Int. J. Clin. Pract. Influence of renal function on anticoagulation control in patients with non-valvular atrial fibrillation taking vitamin K antagonists. 10.1111/ijcp.12974 Chronic kidney disease (CKD) has been related to poor anticoagulation control and an increased (...) risk of bleeding. This study aims to evaluate the association between impaired renal function (eGFR <60 mL/min/1.73 m(2) ) and anticoagulation control in patients with non-valvular atrial fibrillation (AF) on vitamin K antagonists (VKA) therapy. We also assessed whether the predictive value of the SAMe-TT2 R2 score prevailed for subgroups both with and without CKD. This is an ancillary analysis of 1381 patients from the PAULA study, which was a cross-sectional, retrospective and nationwide

EvidenceUpdates2017

72. Risk Delayed Traumatic ICH in Patients on Anticoagulation

Risk Delayed Traumatic ICH in Patients on Anticoagulation Emergency Medicine > Journal Club > Archive > May 2017 Toggle navigation May 2017 Risk of Delayed Traumatic ICH in Patients on Anticoagulation Vignette You are working a moonlighting shift at a local level II trauma center when you meet Mr. X, a 68 year old gentleman with a history of atrial fibrillation, for which he takes diltiazem for rate control and warfarin for anticoagulation. He sees his primary care physician on a regular basis (...) the fall. On exam he has a GCS of 15, a super@icial abrasion to his forehead with a small 4 cm hematoma, no cervical spine pain or tenderness, and a normal neurologic examination. His INR today is 3.2. Being an astute reader of the literature, you remember that the studies on the Canadian Head CT rules excluded patients on anticoagulation, and proceed to order a head CT, which is read as normal by the attending radiologist (not a neuroradiologist). After updating the patient’s tetanus booster you

Washington University Emergency Medicine Journal Club2017

73. Management of women taking anticoagulants or antiplatelet medications who request intrauterine contraception or subdermal implants

Management of women taking anticoagulants or antiplatelet medications who request intrauterine contraception or subdermal implants

Faculty of Sexual & Reproductive Healthcare2017

75. External validation of the VTE-BLEED score for predicting major bleeding in stable anticoagulated patients with venous thromboembolism

External validation of the VTE-BLEED score for predicting major bleeding in stable anticoagulated patients with venous thromboembolism 28276566 2017 03 09 2017 03 09 0340-6245 2017 Mar 09 Thrombosis and haemostasis Thromb. Haemost. External validation of the VTE-BLEED score for predicting major bleeding in stable anticoagulated patients with venous thromboembolism. 10.1160/TH16-10-0810 One of the main determinants of establishing the optimal treatment duration of patients with venous (...) thromboembolism (VTE) is the risk of major bleeding during long-term anticoagulant therapy. The 6-variable VTE-BLEED score was recently developed to enable estimation of this bleeding risk. This study aimed at externally validating VTE-BLEED. This was a post-hoc study of the randomised, double-blind, double-dummy, Hokusai-VTE study that compared edoxaban versus warfarin for treatment of VTE. VTE-BLEED was calculated in all 8,240 study patients. The numbers of adjudicated major bleeding events during 'stable

EvidenceUpdates2017

76. Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study

Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study 28043907 2017 01 03 2017 03 27 1528-0012 152 5 2017 Apr Gastroenterology Gastroenterology Gastrointestinal Safety of Direct Oral Anticoagulants: A Large Population-Based Study. 1014-1022.e1 S0016-5085(16)35532-9 10.1053/j.gastro.2016.12.018 Direct oral anticoagulant (DOAC) agents increase the risk of gastrointestinal (GI) bleeding. We investigated which DOAC had the most favorable GI safety profile (...) Labs, Cambridge, Massachusetts. eng Journal Article 2016 12 30 United States Gastroenterology 0374630 0016-5085 Anticoagulant Atrial Fibrillation Comparative Safety Gastrointestinal Hemorrhage 2016 11 09 2016 12 15 2016 12 17 2017 1 4 6 0 2017 1 4 6 0 2017 1 4 6 0 ppublish 28043907 S0016-5085(16)35532-9 10.1053/j.gastro.2016.12.018

EvidenceUpdates2017

77. Anticoagulants for VTE Prevention in the Hospital Setting

Anticoagulants for VTE Prevention in the Hospital Setting Anticoagulants for VTE Prevention in the Hospital Setting | CADTH.ca Find the information you need Anticoagulants for VTE Prevention in the Hospital Setting Anticoagulants for VTE Prevention in the Hospital Setting Published on: April 18, 2017 Project Number: HT0004 - OP0520 Product Line: Technology Review Result type: Report Deep vein thrombosis and pulmonary embolism ― or venous thromboembolic events (VTEs) ― are a major source

CADTH - Plasma Products2017

78. Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease

Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease 28302287 2017 03 17 2017 03 17 1558-3597 69 11 2017 Mar 21 Journal of the American College of Cardiology J. Am. Coll. Cardiol. Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial Fibrillation and Valvular Heart Disease. 1363-1371 S0735-1097(17)30344-3 10.1016/j.jacc.2016.12.038 Valvular heart disease (VHD) and atrial fibrillation (AF) often coexist. Phase III trials (...) comparing non-vitamin K antagonist oral anticoagulants (NOACs) with warfarin excluded patients with moderate/severe mitral stenosis or mechanical heart valves, but variably included patients with other VHD and valve surgeries. This study aimed to determine relative safety and efficacy of NOACs in patients with VHD. We performed a meta-analysis of the 4 phase III AF trials of the currently available NOACs versus warfarin in patients with coexisting VHD to assess pooled estimates of relative risk (RR

EvidenceUpdates2017

79. Evaluating the safety and efficacy of regional citrate compared to systemic heparin as anticoagulation for continuous renal replacement therapy in critically ill patients: A service evaluation following a change in practice

Evaluating the safety and efficacy of regional citrate compared to systemic heparin as anticoagulation for continuous renal replacement therapy in critically ill patients: A service evaluation following a change in practice 29118829 2018 11 13 1751-1437 18 3 2017 Aug Journal of the Intensive Care Society J Intensive Care Soc Evaluating the safety and efficacy of regional citrate compared to systemic heparin as anticoagulation for continuous renal replacement therapy in critically ill patients (...) : A service evaluation following a change in practice. 184-192 10.1177/1751143717695835 Following the implementation of citrate anticoagulation for continuous renal replacement therapy, we evaluate its first year of use and compare it to the previously used heparin, to assess whether our patients benefit from the recently reported advantages of citrate. We retrospectively analysed 2 years of data to compare the safety and efficacy of citrate versus heparin. The results have shown that 43 patients received

Journal of the Intensive Care Society2017 Full Text: Link to full Text with Trip Pro

80. Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis

Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis Journals Library (...) An error occurred retrieving content to display, please try again. >> >> >> Page Not Found Page not found (404) Sorry - the page you requested could not be found. Please choose a page from the navigation or try a website search above to find the information you need. >> >> >> >> Issue {{metadata .Issue }} Toolkit 1)"> 0)"> {{metadata.Title}} {{metadata.Headline}} The study found that the use of novel oral anticoagulants has advantages over warfarin in patients with atrial fibrillation

NIHR HTA programme2017