Latest & greatest articles for warfarin

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Top results for warfarin

61. Warfarin Therapy - Management During Invasive Procedures and Surgery

Warfarin Therapy - Management During Invasive Procedures and Surgery Guidelines & Protocols Advisory Committee Warfarin Therapy – Management During Invasive Procedures and Surgery Effective Date: April 1, 2015 Scope This guideline provides recommendations for the management of warfarin therapy in adults aged = 19 years requiring invasive procedures and surgery. Perioperative management of non-vitamin K antagonist oral anticoagulants can be found in BCGuidelines.ca – Use of NOACs in Non-Valvular (...) Atrial Fibrillation. Non-perioperative management of warfarin is covered in BCGuidelines.ca – Warfarin Therapy Management. Key Recommendations • Warfarin discontinuation prior to invasive procedures is necessary for all interventional procedures except for minor skin procedures, routine dental work, cataract surgery, endoscopies without biopsy, and percutaneous venous access. • For elective procedures, warfarin should be stopped for 5 to 6 days prior to the procedure to allow gradual normalization

2015 Clinical Practice Guidelines and Protocols in British Columbia

62. Report in Brief - Optimal Warfarin Management for Prevention of Thromboembolic Events in Patients with Atrial Fibrillation

Report in Brief - Optimal Warfarin Management for Prevention of Thromboembolic Events in Patients with Atrial Fibrillation Warfarin Management for Thromboembolic Events in Atrial Fibrillation | CADTH.ca Find the information you need Warfarin Management for Thromboembolic Events in Atrial Fibrillation Warfarin Management for Thromboembolic Events in Atrial Fibrillation Published on: August 15, 2011 Project Number: OP0508 Product Line: Result type: Report Warfarin has been the mainstay of oral (...) anticoagulant therapy for more than 60 years. The effectiveness of warfarin for the prevention of stroke in patients with atrial fibrillation is well established. In Canada, an estimated 200,000 to 250,000 people have this condition. Need for Recommendations Managing warfarin therapy is challenging because warfarin interacts with many foods and other drugs. Each patient needs an individualized warfarin dose, which takes time to determine and requires patients to go in for frequent laboratory testing

2015 CADTH - Optimal Use

63. COMPUS Expert Review Committee (CERC) – Warfarin

COMPUS Expert Review Committee (CERC) – Warfarin COMPUS Expert Review Committee (CERC) – Warfarin | CADTH.ca Find the information you need COMPUS Expert Review Committee (CERC) – Warfarin COMPUS Expert Review Committee (CERC) – Warfarin Published on: March 19, 2015 Result type: Report Chair Participating CERC Members Public Members Specialist Members (backup for Dr. Agnes Lee and sharing votes) Chair Lisa Dolovich , BScPhm, PharmD, MSc Dr. Lisa Dolovich is an academic pharmacist with a primary

2015 CADTH - Optimal Use

64. Warfarin Management for Thromboembolic Events in Atrial Fibrillation

Warfarin Management for Thromboembolic Events in Atrial Fibrillation Warfarin Management for Thromboembolic Events in Atrial Fibrillation | CADTH.ca Find the information you need Warfarin Management for Thromboembolic Events in Atrial Fibrillation Warfarin Management for Thromboembolic Events in Atrial Fibrillation Published on: August 15, 2011 Project Number: OP0508 Product Line: Result type: Report Warfarin has been the mainstay of oral anticoagulant therapy for more than 60 years (...) . The effectiveness of warfarin for the prevention of stroke in patients with atrial fibrillation is well established. In Canada, an estimated 200,000 to 250,000 people have this condition. Need for Recommendations Managing warfarin therapy is challenging because warfarin interacts with many foods and other drugs. Each patient needs an individualized warfarin dose, which takes time to determine and requires patients to go in for frequent laboratory testing of their blood to monitor their international normalized

2015 CADTH - Optimal Use

65. Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer: A Randomized Clinical Trial. Full Text available with Trip Pro

Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer: A Randomized Clinical Trial. Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous thromboembolism (VTE) in patients with active cancer largely based on results of a single, large trial.To study the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic VTE in patients with active cancer.A randomized, open-label study with blinded (...) contraindications for anticoagulation, were followed up for 180 days and for 30 days after the last study medication dose for collection of safety data.Tinzaparin (175 IU/kg) once daily for 6 months vs conventional therapy with tinzaparin (175 IU/kg) once daily for 5 to 10 days followed by warfarin at a dose adjusted to maintain the international normalized ratio within the therapeutic range (2.0-3.0) for 6 months.Primary efficacy outcome was a composite of centrally adjudicated recurrent DVT, fatal or nonfatal

2015 JAMA Controlled trial quality: predicted high

66. Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence

Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence | CADTH.ca Find the information you need Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical (...) Evidence Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence Published on: August 20, 2012 Product Line: , CADTH Technology Overviews Issue: Volume 2, Issue 3 Result type: Report Adapted from . [Optimal Use Report; Volume 1, Issue 2A]. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2011. For more information on this project, visit Introduction Atrial fibrillation (AF) is the most common

2015 CADTH - Health Technology Assessment

67. Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence

Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence | CADTH.ca Find the information you need Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical (...) Evidence Optimal Warfarin Management for the Prevention of Thromboembolic Events in Patients with Atrial Fibrillation: A Systematic Review of the Clinical Evidence Published on: August 20, 2012 Product Line: , CADTH Technology Overviews Issue: Volume 2, Issue 3 Result type: Report Adapted from . [Optimal Use Report; Volume 1, Issue 2A]. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2011. For more information on this project, visit Introduction Atrial fibrillation (AF) is the most common

2015 CADTH - Health Technology Assessment

68. Bleeding Risk and Antithrombotic Strategy in Patients With Sinus Rhythm and Heart Failure With Reduced Ejection Fraction Treated With Warfarin or Aspirin Full Text available with Trip Pro

Bleeding Risk and Antithrombotic Strategy in Patients With Sinus Rhythm and Heart Failure With Reduced Ejection Fraction Treated With Warfarin or Aspirin We sought to assess the performance of existing bleeding risk scores, such as the Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly (HAS-BLED) score or the Outpatient Bleeding Risk Index (OBRI), in patients with heart failure with reduced ejection fraction (...) (HFrEF) in sinus rhythm (SR) treated with warfarin or aspirin. We calculated HAS-BLED and OBRI risk scores for 2,305 patients with HFrEF in SR enrolled in the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction trial. Proportional hazards models were used to test whether each score predicted major bleeding, and comparison of different risk scores was performed using Harell C-statistic and net reclassification improvement index. For the warfarin arm, both scores predicted bleeding risk

2015 EvidenceUpdates Controlled trial quality: uncertain

69. Bleeding, Recurrent Venous Thromboembolism, and Mortality Risks During Warfarin Interruption for Invasive Procedures Full Text available with Trip Pro

Bleeding, Recurrent Venous Thromboembolism, and Mortality Risks During Warfarin Interruption for Invasive Procedures The risk of bleeding and recurrent venous thromboembolism (VTE) among patients receiving long-term warfarin sodium therapy for secondary VTE prevention who require temporary interruption of anticoagulant therapy for surgery or invasive diagnostic procedures has not been adequately described.To describe the rates of clinically relevant bleeding and recurrent VTE among patients (...) in whom warfarin therapy is interrupted for invasive procedures and compare these rates among patients who did and did not receive bridge therapy.A retrospective cohort study was conducted at Kaiser Permanente Colorado, an integrated health care delivery system. Patients in whom warfarin therapy was interrupted for invasive diagnostic or surgical procedures between January 1, 2006, and March 31, 2012, were identified via queries of administrative data sets. A total of 1812 procedures in 1178 patients

2015 EvidenceUpdates

70. Comparison of the Usefulness of Enoxaparin Versus Warfarin for Prevention of Left Ventricular Mural Thrombus After Anterior Wall Acute Myocardial Infarction (Abstract)

Comparison of the Usefulness of Enoxaparin Versus Warfarin for Prevention of Left Ventricular Mural Thrombus After Anterior Wall Acute Myocardial Infarction Left ventricular (LV) thrombus is one of the most common complications in patients with anterior acute myocardial infarction (AMI) and LV dysfunction. Although anticoagulation is frequently prescribed, data regarding the appropriate drug, duration, risks, and effect on echocardiographic indices of thrombus are lacking. Moreover, given (...) the difficulty in obtaining adequate anticoagulation with warfarin, it is possible that short-term treatment with a more predictable agent would be effective. We randomized 60 patients at high risk of developing LV mural thrombus (anterior acute myocardial infarction with Q waves and ejection fraction≤40%) to receive either enoxaparin 1 mg/kg (maximum 100 mg) subcutaneously every 12 hours for 30 days or traditional anticoagulation (intravenous heparin followed by oral warfarin for 3 months). Clinical

2015 EvidenceUpdates Controlled trial quality: uncertain

71. Genetics and the clinical response to warfarin and edoxaban: findings from the randomised, double-blind ENGAGE AF-TIMI 48 trial. (Abstract)

Genetics and the clinical response to warfarin and edoxaban: findings from the randomised, double-blind ENGAGE AF-TIMI 48 trial. Warfarin is the most widely used oral anticoagulant worldwide, but serious bleeding complications are common. We tested whether genetic variants can identify patients who are at increased risk of bleeding with warfarin and, consequently, those who would derive a greater safety benefit with a direct oral anticoagulant rather than warfarin.ENGAGE AF-TIMI 48 (...) was a randomised, double-blind trial in which patients with atrial fibrillation were assigned to warfarin to achieve a target international normalised ratio of 2·0-3·0, or to higher-dose (60 mg) or lower-dose (30 mg) edoxaban once daily. A subgroup of patients was included in a prespecified genetic analysis and genotyped for variants in CYP2C9 and VKORC1. The results were used to create three genotype functional bins (normal, sensitive, and highly sensitive responders to warfarin). This trial is registered

2015 Lancet Controlled trial quality: predicted high

72. Warfarin: Point-of-Care INR Monitoring

Warfarin: Point-of-Care INR Monitoring © 2015 Thrombosis Canada Page 1 of 3 WARFARIN: POINT-OF-CARE INR MONITORING OBJECTIVE: To provide an overview of point-of-care (POC) international normalized ratio (INR) monitoring. BACKGROUND: A POC device is a small portable instrument that measures clotting time from a fingerstick blood sample. Most POC devices report the result as an INR. POC INR devices vary in their ease of use due to: differences in blood sample volume required, the technique (...) of application of the blood sample to the meter, the need for external quality control testing, refrigeration of test strips, and meter portability. HOW ARE POC DEVICES USED? For both adults and children, use of a POC INR device provides a simple and convenient way to manage warfarin anticoagulation in both the office / clinic setting and at home. The POC INR device requires a drop of blood in order to produce an INR result within one minute. This enables timely warfarin dose adjustments and allows prompt

2015 Thrombosis Interest Group of Canada

73. Warfarin: Management of Out-of-Range INRs

Warfarin: Management of Out-of-Range INRs © 2015 Thrombosis Canada Page 1 of 6 WARFARIN: MANAGEMENT OF OUT-OF-RANGE INRS OBJECTIVE: To provide practical strategies supported by the best available evidence for managing out-of- range international normalized ratios (INRs) for patients on long-term warfarin therapy. BACKGROUND: ? Warfarin can be challenging to manage due to its narrow therapeutic range, variable dose- response among different patients and common interactions with drugs, diet (...) and other factors. ? In patients who are taking warfarin, thromboembolic events and bleeding are strongly related to the time in therapeutic range (TTR). This is the proportion of treatment time that the INR is within the target therapeutic range (typically 2.0 to 3.0). ? Clinicians may underdose warfarin due to a perceived greater risk of harm from bleeding associated with supratherapeutic INR values. However, subtherapeutic anticoagulation has been shown to increase the frequency and severity

2015 Thrombosis Interest Group of Canada

74. Warfarin: Common Causes and Management Strategies for High INRs

Warfarin: Common Causes and Management Strategies for High INRs © 2015 Thrombosis Canada Page 1 of 3 WARFARIN: COMMON CAUSES AND MANAGEMENT STRATEGIES FOR HIGH INRS OBJECTIVE: To provide a summary of the most common causes of and management strategies for high international normalized ratios (INRs) for patients on long-term warfarin therapy. COMMON CAUSES OF HIGH INRS MANAGEMENT STRATEGIES DRUG INTERACTIONS ? Temporary drug interaction: temporary warfarin hold or dose reduction ? Chronic drug (...) interaction: reduce maintenance dose and increase frequency of INR tests until new stable INR is acheived ? Although many drugs may interact with warfarin, avoidance of either warfarin or the interacting drug is usually not required ALTERED HEALTH STATES ? Fever, acute illness, diarrhea, reduced food intake ? Uncontrolled hyperthyroidism ? CHF exacerbation ? Temporarily reduce the dose and increase the frequency of INR testing until the patient’s health stabilizes MALNUTRITION ? (vitamin K deficiency

2015 Thrombosis Interest Group of Canada

75. Edoxaban vs. warfarin in vitamin K antagonist experienced and naive patients with atrial fibrillation Full Text available with Trip Pro

Edoxaban vs. warfarin in vitamin K antagonist experienced and naive patients with atrial fibrillation Edoxaban is an oral, once-daily factor Xa inhibitor that is non-inferior to well-managed warfarin in patients with atrial fibrillation (AF) for the prevention of stroke and systemic embolic events (SEEs). We examined the efficacy and safety of edoxaban vs. warfarin in patients who were vitamin K antagonist (VKA) naive or experienced.ENGAGE AF-TIMI 48 randomized 21 105 patients with AF (...) at moderate-to-high risk of stroke to once-daily edoxaban vs. warfarin. Subjects were followed for a median of 2.8 years. The primary efficacy endpoint was stroke or SEE. As a pre-specified subgroup, we analysed outcomes for those with or without prior VKA experience (>60 consecutive days). Higher-dose edoxaban significantly reduced the risk of stroke or SEE in patients who were VKA naive [hazard ratio (HR) 0.71, 95% confidence interval (CI) 0.56-0.90] and was similar to warfarin in the VKA experienced

2015 EvidenceUpdates Controlled trial quality: predicted high

76. The association between kidney function and major bleeding in older adults with atrial fibrillation starting warfarin treatment: population based observational study. Full Text available with Trip Pro

The association between kidney function and major bleeding in older adults with atrial fibrillation starting warfarin treatment: population based observational study. To determine rates of major bleeding by level of kidney function for older adults with atrial fibrillation starting warfarin.Retrospective cohort study.Community based, using province wide laboratory and administrative data in Alberta, Canada.12,403 adults aged 66 years or more, with atrial fibrillation who started warfarin (...) bleeding (intracranial, upper and lower gastrointestinal, or other).Of 12,403 participants, 45% had an eGFR <60 mL/min/1.73 m(2). Overall, 1443 (11.6%) experienced a major bleeding episode over a median follow-up of 2.1 (interquartile range: 1.0-3.8) years. During the first 30 days of warfarin treatment, unadjusted and adjusted rates of major bleeding were higher at lower eGFR (P for trend <0.001 and 0.001, respectively). Adjusted bleeding rates per 100 person years were 63.4 (95% confidence interval

2015 BMJ

77. Bleeding events with dabigatran or warfarin in patients with venous thromboembolism (Abstract)

Bleeding events with dabigatran or warfarin in patients with venous thromboembolism Dabigatran was as effective as warfarin for the acute treatment of venous thromboembolism in the RE-COVER and RE-COVER II trials. We compared the incidence of bleeding with dabigatran versus warfarin in pooled data from these studies. The localisation, bleeding severity, and the impact of key factors on the incidence of bleeding, were compared between the dabigatran and warfarin treatment group. Altogether, 2553 (...) patients received dabigatran and 2554 warfarin, each for a mean of 164 days. The incidence of any bleeding event was significantly lower with dabigatran (hazard ratio [HR] 0.70; 95% confidence interval [CI], 0.61-0.79), as was the incidence of the composite of MBEs and clinically relevant non-major bleeding events (HR 0.62; 95% CI, 0.50-0.76). The incidence of major bleeding events (MBEs) was also significantly lower with dabigatran in the double-dummy phase (HR, 0.60; 95%CI, 0.36-0.99

2015 EvidenceUpdates Controlled trial quality: uncertain

78. Cohort study: Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s Full Text available with Trip Pro

Cohort study: Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using (...) your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Risk of warfarin-associated intracerebral haemorrhage after ischaemic stroke is low and unchanged during the 2000s Article Text Aetiology/Harm

2015 Evidence-Based Medicine

79. Cohort study: Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin

Cohort study: Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin | BMJ Evidence (...) OR managers of institutional accounts Username * Password * your user name or password? You are here Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin Article Text Aetiology/Harm Cohort study Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin

2015 Evidence-Based Medicine

80. Randomised control trial: Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin

Randomised control trial: Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about (...) fibrillation, compared to using warfarin Article Text Therapeutics/Prevention Randomised control trial Using the Watchman device to close the left atrial appendage reduces risk of stroke in atrial fibrillation, compared to using warfarin Martin J Swaans , Arash Alipour , Lucas V Boersma Statistics from Altmetric.com Commentary to : Reddy VY , Sievert H , Halperin J , et al .; PROTECT AF Steering Committee and Investigators. Percutaneous left atrial appendage closure vs warfarin for atrial fibrillation

2015 Evidence-Based Medicine