Latest & greatest articles for warfarin

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Top results for warfarin

161. The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Full Text available with Trip Pro

The net clinical benefit of warfarin anticoagulation in atrial fibrillation. Guidelines recommend warfarin use in patients with atrial fibrillation solely on the basis of risk for ischemic stroke without antithrombotic therapy. These guidelines rely on ischemic stroke rates observed in older trials and do not explicitly account for increased risk for hemorrhage.To quantify the net clinical benefit of warfarin therapy in a cohort of patients with atrial fibrillation.Mixed retrospective (...) prevented by warfarin minus intracranial hemorrhages attributable to warfarin, multiplied by an impact weight. The base-case impact weight was 1.5, reflecting the greater clinical impact of intracranial hemorrhage versus thromboembolism.Patients accumulated more than 66 000 person-years of follow-up. The adjusted net clinical benefit of warfarin for the cohort overall was 0.68% per year (95% CI, 0.34% to 0.87%). Adjusted net clinical benefit was greatest for patients with a history of ischemic stroke

2009 Annals of Internal Medicine

162. Should we be applying warfarin pharmacogenetics to clinical practice? No, not now. (Abstract)

Should we be applying warfarin pharmacogenetics to clinical practice? No, not now. The U.S. Food and Drug Administration modified warfarin labeling in 2007 to suggest, but not mandate, pharmacogenetic testing. Genetic analysis is now commercially available. However, results predict only one third of all dosing variation, the value of testing in reducing bleeding and thrombosis rates remains unproved, and cost-effectiveness is not established. Careful consideration of clinical factors (...) that influence dosing, conscientious prothrombin time monitoring, and sage dosage adjustment remain paramount in warfarin management. Further study is required before routine warfarin pharmacogenetic testing can be recommended.

2009 Annals of Internal Medicine

163. Thrombomodulin as a marker for bleeding complications during warfarin treatment Full Text available with Trip Pro

Thrombomodulin as a marker for bleeding complications during warfarin treatment The major adverse effect of warfarin treatment is hemorrhage. Several risk factors for bleeding complications are also risk factors for thromboembolic events, making the clinical decision to initiate or withhold anticoagulant treatment difficult. Specific markers that solely identify patients at high risk of bleeding would have great clinical impact. This study aimed to test if thrombomodulin (TM) concentrations (...) were associated with bleeding complications, cardiovascular events, or mortality in long-term anticoagulant-treated patients.In a longitudinal cohort study we followed up 719 patients receiving warfarin treatment for a mean duration of 4.2 years. All bleeding complications causing hospitalization were registered and classified. Soluble TM antigen (sTM) concentration in plasma was measured with an enzyme-linked immunosorbent assay method.During the follow-up time, 113 clinically relevant bleeding

2009 EvidenceUpdates

164. Randomized Trial of Warfarin, Aspirin, and Clopidogrel in Patients With Chronic Heart Failure: The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) Trial Full Text available with Trip Pro

Randomized Trial of Warfarin, Aspirin, and Clopidogrel in Patients With Chronic Heart Failure: The Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) Trial Chronic heart failure remains a major cause of mortality and morbidity. The role of antithrombotic therapy in patients with chronic heart failure has long been debated. The objective of this study was to determine the optimal antithrombotic agent for heart failure patients with reduced ejection fractions who are in sinus (...) rhythm.This prospective, randomized clinical trial of open-label warfarin (target international normalized ratio of 2.5 to 3.0) and double-blind treatment with either aspirin (162 mg once daily) or clopidogrel (75 mg once daily) had a 30-month enrollment period and a minimum of 12 months of treatment. We enrolled 1587 men and women >/=18 years of age with symptomatic heart failure for at least 3 months who were in sinus rhythm and had left ventricular ejection fraction of

2009 EvidenceUpdates Controlled trial quality: predicted high

165. Estimation of the warfarin dose with clinical and pharmacogenetic data. Full Text available with Trip Pro

Estimation of the warfarin dose with clinical and pharmacogenetic data. Genetic variability among patients plays an important role in determining the dose of warfarin that should be used when oral anticoagulation is initiated, but practical methods of using genetic information have not been evaluated in a diverse and large population. We developed and used an algorithm for estimating the appropriate warfarin dose that is based on both clinical and genetic data from a broad population (...) base.Clinical and genetic data from 4043 patients were used to create a dose algorithm that was based on clinical variables only and an algorithm in which genetic information was added to the clinical variables. In a validation cohort of 1009 subjects, we evaluated the potential clinical value of each algorithm by calculating the percentage of patients whose predicted dose of warfarin was within 20% of the actual stable therapeutic dose; we also evaluated other clinically relevant indicators.In

2009 NEJM

166. Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation. (Abstract)

Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation. Variants in genes involved in warfarin metabolism and sensitivity affect individual warfarin requirements and the risk for bleeding. Testing for these variant alleles might allow more personalized dosing of warfarin during the induction phase. In 2007, the U.S. Food and Drug Administration changed the labeling for warfarin (Coumadin, Bristol-Myers Squibb, Princeton, New (...) Jersey), suggesting that clinicians consider genetic testing before initiating therapy.To examine the cost-effectiveness of genotype-guided dosing versus standard induction of warfarin therapy for patients with nonvalvular atrial fibrillation.Markov state transition decision model.MEDLINE searches and bibliographies from relevant articles of literature published in English.Outpatients or inpatients requiring initiation of warfarin therapy. The base case was a man age 69 years with newly diagnosed

2009 Annals of Internal Medicine

167. Dabigatran versus warfarin in patients with atrial fibrillation. Full Text available with Trip Pro

Dabigatran versus warfarin in patients with atrial fibrillation. Warfarin reduces the risk of stroke in patients with atrial fibrillation but increases the risk of hemorrhage and is difficult to use. Dabigatran is a new oral direct thrombin inhibitor.In this noninferiority trial, we randomly assigned 18,113 patients who had atrial fibrillation and a risk of stroke to receive, in a blinded fashion, fixed doses of dabigatran--110 mg or 150 mg twice daily--or, in an unblinded fashion, adjusted (...) -dose warfarin. The median duration of the follow-up period was 2.0 years. The primary outcome was stroke or systemic embolism.Rates of the primary outcome were 1.69% per year in the warfarin group, as compared with 1.53% per year in the group that received 110 mg of dabigatran (relative risk with dabigatran, 0.91; 95% confidence interval [CI], 0.74 to 1.11; P<0.001 for noninferiority) and 1.11% per year in the group that received 150 mg of dabigatran (relative risk, 0.66; 95% CI, 0.53 to 0.82; P

2009 NEJM Controlled trial quality: predicted high

168. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. (Abstract)

Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. In patients with non-valvular atrial fibrillation, embolic stroke is thought to be associated with left atrial appendage (LAA) thrombi. We assessed the efficacy and safety of percutaneous closure of the LAA for prevention of stroke compared with warfarin treatment in patients with atrial fibrillation.Adult patients with non (...) -valvular atrial fibrillation were eligible for inclusion in this multicentre, randomised non-inferiority trial if they had at least one of the following: previous stroke or transient ischaemic attack, congestive heart failure, diabetes, hypertension, or were 75 years or older. 707 eligible patients were randomly assigned in a 2:1 ratio by computer-generated randomisation sequence to percutaneous closure of the LAA and subsequent discontinuation of warfarin (intervention; n=463) or to warfarin treatment

2009 Lancet Controlled trial quality: predicted high

169. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. Full Text available with Trip Pro

Dabigatran versus warfarin in the treatment of acute venous thromboembolism. The direct oral thrombin inhibitor dabigatran has a predictable anticoagulant effect and may be an alternative therapy to warfarin for patients who have acute venous thromboembolism.In a randomized, double-blind, noninferiority trial involving patients with acute venous thromboembolism who were initially given parenteral anticoagulation therapy for a median of 9 days (interquartile range, 8 to 11), we compared oral (...) dabigatran, administered at a dose of 150 mg twice daily, with warfarin that was dose-adjusted to achieve an international normalized ratio of 2.0 to 3.0. The primary outcome was the 6-month incidence of recurrent symptomatic, objectively confirmed venous thromboembolism and related deaths. Safety end points included bleeding events, acute coronary syndromes, other adverse events, and results of liver-function tests.A total of 30 of the 1274 patients randomly assigned to receive dabigatran (2.4

2009 NEJM Controlled trial quality: predicted high

170. Oral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving warfarin

Oral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving warfarin Oral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving warfarinOral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving 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 (...) anticoagulation after receiving warfarinOral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving warfarin Article Text Therapeutics Oral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving warfarin Oral vitamin K did not reduce bleeding in patients with excessive anticoagulation after receiving warfarin Statistics from Altmetric.com STUDY DESIGN Design: randomised, placebo-controlled trial. ClinicalTrials.gov NCT00143715

2009 Evidence-Based Medicine

171. Evaluating the impact of study-level factors on warfarin control in US-based primary studies: a meta-analysis

Evaluating the impact of study-level factors on warfarin control in US-based primary studies: a meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 DARE.

172. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis

Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE CRD summary This generally well-conducted review found no apparent increase in risk of bleeding associated (...) with continued regular doses of warfarin compared to discontinued/modified warfarin doses for patients who underwent minor dental procedures. The conclusions appeared to be supported by the data, but poor quality included studies and risk of language bias suggest the findings should be interpreted with caution. Authors' objectives To determine the effects of continuing warfarin therapy on the risk of bleeding in patients undergoing elective dental surgery. Searching MEDLINE, EMBASE and Cochrane Central

2009 DARE.

173. Safety of continuing warfarin therapy during cataract surgery: a systematic review and meta-analysis

Safety of continuing warfarin therapy during cataract surgery: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2009 DARE.

174. Warfarin thromboprophylaxis in cancer patients with central venous catheters (WARP): an open-label randomised trial. Full Text available with Trip Pro

Warfarin thromboprophylaxis in cancer patients with central venous catheters (WARP): an open-label randomised trial. The role and dose of anticoagulants in thromboprophylaxis for patients with cancer receiving chemotherapy through central venous catheters (CVCs) is controversial. We therefore assessed whether warfarin reduces catheter-related thrombosis compared with no warfarin and whether the dose of warfarin determines the thromboprophylactic effect.In 68 clinical centres in the UK, we (...) randomly assigned 1590 patients aged at least 16 years with cancer who were receiving chemotherapy through CVCs to no warfarin, fixed-dose warfarin 1 mg per day, or dose-adjusted warfarin per day to maintain an international normalised ratio between 1.5 and 2.0. Clinicians who were certain of the benefit of warfarin randomly assigned patients to fixed-dose or dose-adjusted warfarin groups. The primary outcome was the rate of radiologically proven, symptomatic catheter-related thrombosis. Analysis

2009 Lancet Controlled trial quality: predicted high

175. Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation

Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation Cost-effectiveness of warfarin: trial versus "real-world" stroke prevention in atrial fibrillation Sorensen SV, Dewilde S, Singer DE, Goldhaber SZ, Monz BU, Plumb JM Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study examined the cost-effectiveness of warfarin treatment in patients with atrial fibrillation, who were at moderate-to-high risk of ischaemic stroke, and considered various scenarios for treatment adherence and discontinuation. The cost-effectiveness of warfarin and its beneficial effect deteriorated with poorer

2009 NHS Economic Evaluation Database.

176. Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Full Text available with Trip Pro

Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Cost-effectiveness of genotype-guided warfarin dosing for patients with atrial fibrillation Patrick AR, Avorn J, Choudhry NK Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results (...) and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The objective was to determine the circumstances in which genotyping before warfarin initiation could be cost-effective for patients with atrial fibrillation. Genotyping was cost-effective only if it reduced the out-of-range international normalised ratios by more than five to nine percentage points. There was uncertainty surrounding the effectiveness of genotyping and its

2009 NHS Economic Evaluation Database.

177. Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation

Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation Cost-effectiveness of using pharmacogenetic information in warfarin dosing for patients with nonvalvular atrial fibrillation Eckman MH, Rosand J, Greenberg SM, Gage BF Record Status This is a critical abstract of an economic evaluation that meets (...) the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study evaluated the cost-effectiveness of a genotype-guided dose titration strategy compared with the standard induction dosage of warfarin for patients with non-valvular atrial fibrillation. The authors concluded that genotype-guided warfarin dosage was unlikely

2009 NHS Economic Evaluation Database.

178. Anticoagulation - warfarin.

Anticoagulation - warfarin. Guidelines and Measures | Agency for Healthcare Research & Quality HHS.gov Search ahrq.gov Search ahrq.gov Menu Topics A - Z Healthcare Delivery Latest available findings on quality of and access to health care Searchable database of AHRQ Grants, Working Papers & HHS Recovery Act Projects AHRQ Projects funded by the Patient-Centered Outcomes Research Trust Fund You are here Guidelines and Measures Funding for the National Guideline Clearinghouse (NGC) has ended

2008 Singapore Ministry of Health

179. Impact of home warfarin use on the treatment and outcomes of patients undergoing percutaneous coronary intervention (Abstract)

Impact of home warfarin use on the treatment and outcomes of patients undergoing percutaneous coronary intervention The periprocedural management, bleeding risks, and outcomes of patients taking warfarin previous to percutaneous coronary intervention (PCI) have not been well characterized. All patients undergoing PCI in the National Cardiovascular Data Registry from January 1, 2004 to March 31, 2006 were analyzed (n = 307,443). Multivariable modeling was used to evaluate the association between (...) home warfarin use and in-hospital mortality and bleeding (requiring blood transfusion and/or prolonging hospital stay and/or causing hemoglobin drop >3.0 g/dl). Patients undergoing elective PCI and urgent PCI (primary/rescue/facilitated PCI with symptoms fewer than 24 hours) were analyzed separately. Overall, 11,173 patients (3.6%) were taking warfarin previous to PCI. Compared with patients not taking warfarin, patients taking warfarin were older and had greater burden of comorbidities. Patients

2008 EvidenceUpdates

180. A risk model predicted major bleeding in older patients with atrial fibrillation receiving warfarin therapy

A risk model predicted major bleeding in older patients with atrial fibrillation receiving warfarin therapy A risk model predicted major bleeding in older patients with atrial fibrillation receiving warfarin therapy | 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 A risk model predicted major bleeding in older patients with atrial fibrillation receiving warfarin therapy Article Text Clinical prediction guide A risk model predicted major

2008 Evidence-Based Medicine