Latest & greatest articles for warfarin

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Top results for warfarin

1. Blood & Clots Series: How do you stop warfarin for surgery?

Blood & Clots Series: How do you stop warfarin for surgery? Blood & Clots Series: How do you stop warfarin for surgery? - CanadiEM Blood & Clots Series: How do you stop warfarin for surgery? In , by Kerstin de Wit March 19, 2019 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Medical Expert, Scholar Case Description You are assessing a 76 year old lady who takes warfarin for stroke prevention because she had a mechanical aortic valve replacement 4 years ago (...) . She was at the preoperative clinic this morning because she will have a knee replacement surgery in a weeks time. The anesthesiologist said they would like to perform a spinal block for the surgery, and the surgeon says the patient must come off her warfarin before he can operate. She tells you she is worried about having a stroke if she stops her warfarin. You are wondering how to advise her. Can you stop the warfarin for a week before her surgery? Do you need to prescribe ‘bridging

2019 CandiEM

2. Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. (PubMed)

Effectiveness and safety of rivaroxaban vs. warfarin in patients with non-valvular atrial fibrillation and heart failure. Heart failure (HF) is a common co-morbidity in non-valvular atrial fibrillation (NVAF) patients and a potent risk factor for stroke, bleeding, and a decreased time-in-therapeutic range with warfarin. We assessed the real-world effectiveness and safety of rivaroxaban and warfarin in NVAF patients with co-morbid HF.Using US Truven MarketScan Commercial and Medicare (...) supplemental database claims data from 11/2011 to 12/2016, we identified oral anticoagulant (OAC)-naïve NVAF patients with HF (International Classification of Diseases, 10th Revision codes of I50 or I09.81) and ≥12 months of insurance coverage prior to the qualifying OAC dispensing. Rivaroxaban users (20 or 15 mg once daily) were 1:1 propensity score matched to warfarin users, with residual absolute standardized differences <0.1 being achieved for all covariates after matching. Patients were followed up

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2019 ESC heart failure

3. Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation

Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Discover Portal Discover Portal Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Published on 6 February 2018 doi: In people with atrial fibrillation needing anticoagulant treatment, deaths were fewer (...) in those who had direct acting oral anticoagulants compared with warfarin. The picture is less clear for the risk of stroke and complications such as bleeding in the brain or gut. Apixaban had the best efficacy and safety profile and was cost-effective compared with warfarin. This study pooled the data in all trials reporting efficacy, safety and cost of anticoagulant prevention of stroke events in people with atrial fibrillation. Researchers used a technique called network meta-analysis to compare

2019 NIHR Dissemination Centre

4. New generation anticoagulants may be safer than warfarin for people with chronic kidney disease

New generation anticoagulants may be safer than warfarin for people with chronic kidney disease New generation anticoagulants may be safer than warfarin for people with chronic kidney disease Discover Portal Discover Portal New generation anticoagulants may be safer than warfarin for people with chronic kidney disease Published on 26 April 2016 doi: Newer generation anticoagulants appear to reduce the risk of bleeding compared with older anticoagulants like warfarin, when used to prevent clots (...) in people who also have mild to moderate chronic kidney disease. This group of drugs, called direct oral anticoagulants, have been well researched in healthy people with atrial fibrillation or at risk of thromboembolism but this was the first review to look at their safety, in terms of bleeding and risk of bleeding within the brain, in people with kidney disease. As a group, these newer drugs appear safer than older anticoagulants such as warfarin. Evidence from the trials comparing individual new

2019 NIHR Dissemination Centre

5. The blood-thinner apixaban is less likely to cause major bleeding than warfarin

The blood-thinner apixaban is less likely to cause major bleeding than warfarin The blood-thinner apixaban is less likely to cause major bleeding than warfarin Discover Portal Discover Portal The blood-thinner apixaban is less likely to cause major bleeding than warfarin Published on 16 October 2018 doi: People who take apixaban to prevent blood clots are less likely to suffer major bleeding complications than those taking warfarin. Findings are similar in different groups of people (...) , such as those with irregular heart rhythm (atrial fibrillation) and those who have had joint replacement surgery. Warfarin has long been used as an anticoagulant but needs frequent blood test monitoring. The new class of direct-acting oral anticoagulants does not usually need monitoring and is replacing warfarin. This large NIHR-funded study examined registry data from 196,061 people taking anticoagulants for any reason. Fewer people had intracranial bleeding on the direct acting oral anticoagulants

2019 NIHR Dissemination Centre

6. Genotype-Guided Warfarin Dosing in Patients With Mechanical Valves: A Randomized Controlled Trial

Genotype-Guided Warfarin Dosing in Patients With Mechanical Valves: A Randomized Controlled Trial The clinical utility of genotype-guided warfarin dosing remains controversial. The objective of this trial was to evaluate the efficacy and safety of genotype-guided warfarin dosing in East Asians.A double-blind, randomized control trial was performed to compare a genotype-guided dosing algorithm (CYP2C9, VKORC1, and CYP4F2) with a clinical-guided one in the initiation treatment for patients (...) days, p = 0.009). The TTRs were 47.257% and 47.461% in the control and study group (p = 0.941), respectively. Patients with the CYP2C9 *1/*3 genotype had higher international normalized ratio (INR) variability than patients with the CYP2C9 *1/*1 genotype (p = 0.024). Compared with normal and sensitive responders, the highly sensitive responders were at increased risk of an INR of 4.0 or greater (p < 0.05).The genotype-guided warfarin dosing was safe and might be more efficient for the time to reach

2018 EvidenceUpdates

7. Periprocedural Outcomes of Direct Oral Anticoagulants vs. Warfarin in Non-Valvular Atrial Fibrillation: A Meta-analysis of Phase III Trials

Periprocedural Outcomes of Direct Oral Anticoagulants vs. Warfarin in Non-Valvular Atrial Fibrillation: A Meta-analysis of Phase III Trials Direct oral anticoagulants (DOACs) are surpassing warfarin as the anticoagulant of choice for stroke prevention in nonvalvular atrial fibrillation. DOAC outcomes in elective periprocedural settings have not been well elucidated and remain a source of concern for clinicians. The aim of this meta-analysis was to evaluate the periprocedural safety and efficacy (...) of DOACs versus warfarin in patients with nonvalvular atrial fibrillation.We reviewed the literature for data from phase III randomized controlled trials comparing DOACs with warfarin in the periprocedural period among patients with nonvalvular atrial fibrillation. Substudies from 4 trials (RE-LY [Randomized Evaluation of Long-Term Anticoagulation Therapy], ROCKET AF [Rivaroxaban Once Daily Oral Direct Factor Xa Inhibitor Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial

2018 EvidenceUpdates

8. Association of Genetic Variants With Warfarin-Associated Bleeding Among Patients of African Descent. (PubMed)

Association of Genetic Variants With Warfarin-Associated Bleeding Among Patients of African Descent. Major warfarin-related bleeding occurs more frequently in African Americans than in other populations. Identification of potential genetic factors related to this adverse event may help identify at-risk patients.To identify genetic factors associated with warfarin-related bleeding in patients of African descent at an international normalized ratio (INR) of less than 4.A case-control genome-wide (...) association study involving patients of African descent taking warfarin was conducted in a discovery cohort (University of Chicago [2009-2011] and the University of Illinois at Chicago [2002-2011]), and associations were confirmed in a replication cohort (University of Chicago [2015-2016]). Potential population stratification was examined in the discovery cohort by principal component analysis. Odds ratios (ORs) and 95% CIs were computed for bleeding risk by logistic regression analysis. Summary

2018 JAMA

9. Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome

Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome Rivaroxaban is an effective and safe alternative to warfarin in patients with atrial fibrillation and venous thromboembolism. We tested the efficacy and safety of rivaroxaban compared with warfarin in high-risk patients with thrombotic antiphospholipid syndrome. This is a randomized open-label multicenter noninferiority study with blinded end point adjudication. Rivaroxaban, 20 mg once daily (15 mg once daily based (...) on kidney function) was compared with warfarin (international normalized ratio target 2.5) for the prevention of thromboembolic events, major bleeding, and vascular death in patients with antiphospholipid syndrome. Only high-risk patients triple positive for lupus anticoagulant, anti-cardiolipin, and anti-β2-glycoprotein I antibodies of the same isotype (triple positivity) were included in the study. The trial was terminated prematurely after the enrollment of 120 patients (59 randomized to rivaroxaban

2018 EvidenceUpdates

10. New drugs for deep vein thrombosis may offer a safe alternative to warfarin

New drugs for deep vein thrombosis may offer a safe alternative to warfarin New drugs for deep vein thrombosis may offer a safe alternative to warfarin Discover Portal Discover Portal New drugs for deep vein thrombosis may offer a safe alternative to warfarin Published on 20 October 2015 doi: This Cochrane systematic review found that two new types of drugs taken by mouth for deep vein thrombosis were as effective as standard treatment, which most commonly involves treatment by injection (...) followed by warfarin tablets for at least three months. The new drugs have the advantage that they do not require monitoring or dose changes and were associated with a lower risk of bleeding. This high quality review was based on evidence from 11 good quality trials and can be considered reliable. This review did not look at overall cost or cost-effectiveness. NICE has conducted some assessments of individual drugs and is conducting further assessments. Each assessment has a costing tool or statement

2018 NIHR Dissemination Centre

11. Less abnormal uterine bleeding with dabigatran than warfarin in women treated for acute venous thromboembolism

Less abnormal uterine bleeding with dabigatran than warfarin in women treated for acute venous thromboembolism Essentials Factor Xa inhibitors cause more abnormal menstrual bleeding (AUB) than vitamin-K antagonists (VKA). We analyzed data of AUB in women, evaluating dabigatran versus VKA. We observed a 41% lower risk of AUB in women on dabigatran compared to those on VKA. Our findings of lower AUB risk on dabigatran should be corroborated in future studies.Introduction Although direct oral (...) anticoagulants (DOACs) are associated with a better safety profile than warfarin in patients with acute venous thromboembolism (VTE), direct factor Xa inhibitors involve a higher risk of abnormal uterine bleeding (AUB). We aimed to determine the risk of AUB during anticoagulation with dabigatran compared with warfarin. Methods Post-hoc analysis of the pooled RE-COVER studies and the RE-MEDY trial. Incidences of AUB, based on a defined preferred terms search for adverse events, in female patients aged 18-50

2018 EvidenceUpdates

12. Warfarin

Warfarin Top results for warfarin - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for warfarin The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted

2018 Trip Latest and Greatest

13. Self-monitoring of warfarin is safe and cost-effective

Self-monitoring of warfarin is safe and cost-effective Self-monitoring of warfarin is safe and cost-effective Discover Portal Discover Portal Self-monitoring of warfarin is safe and cost-effective Published on 21 August 2015 doi: This NIHR-funded systematic review investigated the clinical and cost-effectiveness of self-monitoring by people receiving long-term anticoagulation using vitamin K antagonists, most commonly, warfarin. People receiving warfarin require regular blood tests to see how (...) their blood is clotting and to adjust their dose to avoid bleeding from too high a dose or thrombosis (clots) if the dose drops too low. This is usually done at their GP practice or in hospital clinics. Self-monitoring involves two aspects of care; people self-testing their blood on a machine at home and self-managing, adjusting their warfarin dosage themselves. This review found self-monitoring halved the number of blood clots compared with standard care. Health and social costs were more equal

2018 NIHR Dissemination Centre

14. Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care. (PubMed)

Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care. To investigate the associations between direct oral anticoagulants (DOACs) and risks of bleeding, ischaemic stroke, venous thromboembolism, and all cause mortality compared with warfarin.Prospective open cohort study.UK general practices contributing to QResearch or Clinical Practice Research Datalink.132 231 warfarin, 7744 dabigatran, 37 863 rivaroxaban, and 18 223 apixaban (...) users without anticoagulant prescriptions for 12 months before study entry, subgrouped into 103 270 patients with atrial fibrillation and 92 791 without atrial fibrillation between 2011 and 2016.Major bleeding leading to hospital admission or death. Specific sites of bleeding and all cause mortality were also studied.In patients with atrial fibrillation, compared with warfarin, apixaban was associated with a decreased risk of major bleeding (adjusted hazard ratio 0.66, 95% confidence interval 0.54

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2018 BMJ

15. Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation

Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Discover Portal Discover Portal Direct acting oral anticoagulants likely to be better than warfarin for people taking them for atrial fibrillation Published on 6 February 2018 doi: In people with atrial fibrillation needing anticoagulant treatment, deaths were fewer (...) in those who had direct acting oral anticoagulants compared with warfarin. The picture is less clear for the risk of stroke and complications such as bleeding in the brain or gut. Apixaban had the best efficacy and safety profile and was cost-effective compared with warfarin. This study pooled the data in all trials reporting efficacy, safety and cost of anticoagulant prevention of stroke events in people with atrial fibrillation. Researchers used a technique called network meta-analysis to compare

2018 NIHR Dissemination Centre

16. New drugs for deep vein thrombosis may offer a safe alternative to warfarin

New drugs for deep vein thrombosis may offer a safe alternative to warfarin New drugs for deep vein thrombosis may offer a safe alternative to warfarin Discover Portal Discover Portal New drugs for deep vein thrombosis may offer a safe alternative to warfarin Published on 20 October 2015 doi: This Cochrane systematic review found that two new types of drugs taken by mouth for deep vein thrombosis were as effective as standard treatment, which most commonly involves treatment by injection (...) followed by warfarin tablets for at least three months. The new drugs have the advantage that they do not require monitoring or dose changes and were associated with a lower risk of bleeding. This high quality review was based on evidence from 11 good quality trials and can be considered reliable. This review did not look at overall cost or cost-effectiveness. NICE has conducted some assessments of individual drugs and is conducting further assessments. Each assessment has a costing tool or statement

2018 NIHR Dissemination Centre

17. New generation anticoagulants may be safer than warfarin for people with chronic kidney disease

New generation anticoagulants may be safer than warfarin for people with chronic kidney disease New generation anticoagulants may be safer than warfarin for people with chronic kidney disease Discover Portal Discover Portal New generation anticoagulants may be safer than warfarin for people with chronic kidney disease Published on 26 April 2016 doi: Newer generation anticoagulants appear to reduce the risk of bleeding compared with older anticoagulants like warfarin, when used to prevent clots (...) in people who also have mild to moderate chronic kidney disease. This group of drugs, called direct oral anticoagulants, have been well researched in healthy people with atrial fibrillation or at risk of thromboembolism but this was the first review to look at their safety, in terms of bleeding and risk of bleeding within the brain, in people with kidney disease. As a group, these newer drugs appear safer than older anticoagulants such as warfarin. Evidence from the trials comparing individual new

2018 NIHR Dissemination Centre

18. Self-monitoring of warfarin is safe and cost-effective

Self-monitoring of warfarin is safe and cost-effective Self-monitoring of warfarin is safe and cost-effective Discover Portal Discover Portal Self-monitoring of warfarin is safe and cost-effective Published on 21 August 2015 doi: This NIHR-funded systematic review investigated the clinical and cost-effectiveness of self-monitoring by people receiving long-term anticoagulation using vitamin K antagonists, most commonly, warfarin. People receiving warfarin require regular blood tests to see how (...) their blood is clotting and to adjust their dose to avoid bleeding from too high a dose or thrombosis (clots) if the dose drops too low. This is usually done at their GP practice or in hospital clinics. Self-monitoring involves two aspects of care; people self-testing their blood on a machine at home and self-managing, adjusting their warfarin dosage themselves. This review found self-monitoring halved the number of blood clots compared with standard care. Health and social costs were more equal

2018 NIHR Dissemination Centre

19. Dabigatran versus Warfarin for Acute Venous Thromboembolism in Elderly or Impaired Renal Function Patients: Pooled Analysis of RE-COVER and RE-COVER II

Dabigatran versus Warfarin for Acute Venous Thromboembolism in Elderly or Impaired Renal Function Patients: Pooled Analysis of RE-COVER and RE-COVER II Management of acute venous thromboembolism (VTE) with anticoagulants in elderly patients and those with chronic kidney disease poses special challenges. The RE-COVER and RE-COVER II trials showed that dabigatran 150 mg twice daily was as effective as warfarin over 6 months in preventing recurrent VTE, with a lower bleeding risk. We now assess (...) and moderate RI, respectively (23 patients with severe RI and 49 with missing creatinine clearance data were not included). For dabigatran, VTE/VTE-related death decreased from 3.1% (normal renal function) to 1.9% for mild RI and to 0.0% for moderate RI. For warfarin, the event rates were 2.6, 1.6 and 4.1%, respectively. Overall, major bleeding increased with increasing RI (p = 0.0037) and with age (p = 0.4350), with no apparent difference between the dabigatran and warfarin patients. Dabigatran shows

2018 EvidenceUpdates

20. Comparative effectiveness of direct oral anticoagulants and warfarin in patients with cancer and atrial fibrillation (PubMed)

Comparative effectiveness of direct oral anticoagulants and warfarin in patients with cancer and atrial fibrillation Randomized clinical trials comparing direct oral anticoagulants (DOACs) to warfarin in cancer patients have not been performed. We evaluated the effectiveness and associated risk of DOACs vs warfarin, as well as comparisons of DOACs, in a large population of cancer patients with nonvalvular atrial fibrillation (AF). Using the MarketScan databases, we identified 16 096 AF patients (...) (mean age, 74 years) initiating oral anticoagulant and being actively treated for cancer between 2010 and 2014. Anticoagulant users were matched by age, sex, enrollment date, and drug initiation date. Study end points were identified with diagnostic codes and included ischemic stroke, severe bleeding, other bleeding, and venous thromboembolism (VTE). Cox regression was used to estimate associations of anticoagulants with study end points. Compared with warfarin, rates of bleeding (hazard ratio [95

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2018 Blood advances