2,386 results match your criteria doacs n = 20


Effectiveness and Safety of Direct Oral Anticoagulants vs. Warfarin and Recurrence After Discontinuation in Patients With Acute Venous Thromboembolism in the Real World.

Circ J 2021 Oct 12. Epub 2021 Oct 12.

Department of Cardiology, Japanese Red Cross Musashino Hospital.

Background: The efficacy of direct oral anticoagulants (DOACs) compared with warfarin for the treatment of venous thromboembolism (VTE), and the recurrence of VTE after discontinuation of anticoagulation therapy in research are limited.Methods and Results:This retrospective study enrolled 893 patients with acute VTE between 2011 and 2019. The cohort was divided into the transient risk, unprovoked, continued cancer treatment, and cancer remission groups. Read More

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October 2021

Anticoagulant prescribing for atrial fibrillation and risk of incident dementia.

Heart 2021 Oct 13. Epub 2021 Oct 13.

Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK

Objective: The aim of this study was to investigate the association between oral anticoagulant type (direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs)) and incident dementia or mild cognitive impairment (MCI) among patients with newly diagnosed atrial fibrillation (AF).

Methods: Using linked electronic health record (EHR) data from the Clinical Practice Research Datalink in the UK, we conducted a historical cohort study among first-time oral anticoagulant users with incident non-valvular AF diagnosed from 2012 to 2018. We compared the incidence of (1) clinically coded dementia and (2) MCI between patients prescribed VKAs and DOACs using Cox proportional hazards regression models, with age as the underlying timescale, accounting for calendar time and time on treatment, sociodemographic and lifestyle factors, clinical comorbidities and medications. Read More

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October 2021

A Systematic Review and Meta-analysis on the Efficacy and Safety of Direct Oral Anticoagulants in Patients with Peripheral Artery Disease.

Ann Vasc Surg 2021 Oct 10. Epub 2021 Oct 10.

Division of Vascular Surgery and Endovascular Therapy, University of Colorado, Anschutz Medical Center, Aurora, CO. Electronic address:

Background-objective: PAD is a significant cause of morbidity and mortality affecting over 200 million people worldwide. Current guidelines recommend at least a single antiplatelet or anticoagulant agent in symptomatic PAD and lifelong antithrombotic treatment after a revascularization procedure. The aim of this systematic review and meta-analysis was to investigate the efficacy and safety of direct oral anticoagulants (DOACs) in patients with peripheral artery disease (PAD). Read More

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October 2021

A Review of Current and Future Antithrombotic Strategies in Surgical Patients-Leaving the Graduated Compression Stockings Behind?

J Clin Med 2021 Sep 22;10(19). Epub 2021 Sep 22.

Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London W6 8RF, UK.

Venous thromboembolism (VTE) remains an important consideration within surgery, with recent evidence looking to refine clinical guidance. This review provides a contemporary update of existing clinical evidence for antithrombotic regimens for surgical patients, providing future directions for prophylaxis regimens and research. For moderate to high VTE risk patients, existing evidence supports the use of heparins for prophylaxis. Read More

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September 2021

Impact of centrifugation time and pneumatic tube transport on plasma concentrations of direct oral anticoagulants.

Int J Lab Hematol 2021 Oct 12. Epub 2021 Oct 12.

Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

Introduction: Rapid results are needed when plasma concentrations of direct oral anticoagulants (DOACs) are required in acute clinical settings. We evaluated the impact of centrifugation time and pneumatic tube transport on DOAC plasma concentrations with the overall aim of reducing turnaround time.

Methods: Blood samples were spiked with rivaroxaban, apixaban or dabigatran in a low and a high concentration prior to centrifugation for 25 minutes (3163 g) or 5 minutes (3000 g) (n = 20 for each DOAC). Read More

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October 2021

"I just didn't want to trust it at all": Atrial fibrillation patient's treatment experience of rivaroxaban and warfarin.

J Eval Clin Pract 2021 Oct 11. Epub 2021 Oct 11.

Haematology Department, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.

Background: In the treatment of atrial fibrillation (AF), anticoagulant medications such as warfarin and rivaroxaban are commonly prescribed to reduce the risk of ischaemic strokes, and other thromboembolic events. Research has highlighted advantages and disadvantages of each of these medications, but there remains an absence of qualitative evidence regarding the lived experiences of AF patients. The present study helps address this gap and obtain a greater understanding of the patient experience and beliefs surrounding their anticoagulant medication. Read More

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October 2021

Early versus late start of direct oral anticoagulants after acute ischaemic stroke linked to atrial fibrillation: an observational study and individual patient data pooled analysis.

J Neurol Neurosurg Psychiatry 2021 Oct 11. Epub 2021 Oct 11.

Stroke Research Center, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, London, UK.

Objective: The optimal timing to start direct oral anticoagulants (DOACs) after an acute ischaemic stroke (AIS) related to atrial fibrillation (AF) remains unclear. We aimed to compare early (≤5 days of AIS) versus late (>5 days of AIS) DOAC-start.

Methods: This is an individual patient data pooled analysis of eight prospective European and Japanese cohort studies. Read More

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October 2021

Economic evaluation of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation: a systematic review and meta-analysis.

BMJ Evid Based Med 2021 Oct 11. Epub 2021 Oct 11.

Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand.

Objectives: To assess cost-effectiveness of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF) by pooling incremental net benefits (INBs).

Design: Systematic review and meta-analysis.

Setting: We searched PubMed, Scopus and Centre for Evaluation of Value and Risks in Health Registry from inception to December 2019. Read More

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October 2021

Rivaroxaban Is Associated With Higher Rates of Gastrointestinal Bleeding Than Other Direct Oral Anticoagulants : A Nationwide Propensity Score-Weighted Study.

Ann Intern Med 2021 Oct 12. Epub 2021 Oct 12.

Faculty of Medicine, University of Iceland and Landspítali-The National University Hospital of Iceland, Reykjavík, Iceland (A.B.I., A.S.Á., P.T.Ö., E.S.B.).

Background: Gastrointestinal bleeding (GIB) rates for direct oral anticoagulants (DOACs) and warfarin have been extensively compared. However, population-based studies comparing GIB rates among different DOACs are limited.

Objective: To compare rates of GIB among apixaban, dabigatran, and rivaroxaban. Read More

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October 2021

Direct Oral Anticoagulants and Warfarin for Atrial Fibrillation Treatment: Rural and Urban Trends in Medicare Beneficiaries.

Am J Cardiovasc Drugs 2021 Oct 11. Epub 2021 Oct 11.

Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.

Background: Data are needed on the use of oral anticoagulation in patients with atrial fibrillation (AF) in rural versus urban areas, including the initiation of direct oral anticoagulants (DOACs).

Objective: We used Medicare data to examine rural/urban differences in anticoagulation use in patients with AF.

Methods: We identified incident AF in a 20% sample of fee-for-service Medicare beneficiaries (aged ≥ 65 years) from 2011 to 2016 and collected ZIP code and covariates at the time of AF. Read More

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October 2021

Comparison of the Direct Oral Anticoagulants and Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Front Cardiovasc Med 2021 22;8:712585. Epub 2021 Sep 22.

University of São Paulo Medical School, HCFMUSP, São Paulo, Brazil.

Direct oral anticoagulants (DOACS) are approved for use in non-valvular atrial fibrillation (AF). This systematic review and meta-analysis aimed to evaluate the efficacy and safety of DOACs vs. warfarin and update the evidence for treatment of AF and valvular heart disease (VHD). Read More

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September 2021

Treatment and outcomes in patients with left ventricular thrombus - experiences from the Aga Khan University Hospital, Nairobi - Kenya.

Pan Afr Med J 2021 23;39:212. Epub 2021 Jul 23.

Department of Internal Medicine, Aga Khan University, Nairobi, Kenya.

Introduction: left ventricular thrombus (LVT) may lead to thromboembolism and has been associated with increased morbidity and mortality. Little is known about the incidence, etiology and outcomes in patients with LVT in Africa. The objective was to determine the etiology, treatment practices, rate of resolution and clinical outcomes in patients with LVT in the region. Read More

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Direct oral anticoagulants versus vitamin K antagonists for patients with left ventricular thrombus.

Ann Palliat Med 2021 Sep;10(9):9427-9434

Department of Cardiovascular Medicine, Shanxi Bethune Hospital, Third Clinical Medical College of Shanxi Medical University, Taiyuan, China.

Background: A retrospective cohort study was conducted to compare the efficacy and safety of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in the treatment of patients with left ventricular thrombus (LVT).

Methods: Consecutive patients admitted to our institution with LVT between February 2009 and December 2020 and treated with either DOACs or VKAs were considered for inclusion in this study. The outcomes included stroke or systemic embolism (SSE), thrombus resolution, and bleeding events. Read More

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September 2021

Rivaroxaban versus Dalteparin in Cancer-Associated Thromboembolism: A Randomized Trial.

Chest 2021 Oct 7. Epub 2021 Oct 7.

F-CRIN INNOVTE network, Saint Etienne, France; Service de Médecine Vasculaire et Thérapeutique, CHU de St-Etienne, Saint-Etienne, France.

Background: Direct oral anticoagulants (DOACs) are an alternative to low-molecular-weight heparin for treating cancer-associated venous thromboembolism (VTE).

Research Question: Is rivaroxaban as efficient and safe as dalteparin to treat patients with cancer-associated VTE?

Study Design And Methods: In a randomized open-label non-inferiority trial, patients with active cancer who had proximal deep-vein thrombosis (DVT) and/or pulmonary embolism (PE) were randomly assigned to therapeutic doses of rivaroxaban or dalteparin for 3 months. The primary outcome was the cumulative incidence of recurrent VTE, a composite of symptomatic or incidental DVT or PE, and worsening of pulmonary vascular or venous obstruction at 3 months. Read More

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October 2021

Physicians' and pharmacists' views and experiences regarding use of direct oral anticoagulants in clinical practice.

Br J Clin Pharmacol 2021 Oct 8. Epub 2021 Oct 8.

Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.

Aim: Direct oral anticoagulants (DOACs) are increasingly used compared to vitamin K antagonists (VKAs). Guidelines advocate a structured multidisciplinary approach in the management of patients treated with DOACs. The aim of this study was to assess the views and experiences of physicians and pharmacists regarding DOAC use in clinical practice. Read More

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October 2021

Oral anticoagulation in people with cancer who have no therapeutic or prophylactic indication for anticoagulation.

Cochrane Database Syst Rev 2021 Oct 8;10:CD006466. Epub 2021 Oct 8.

Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Background: Oral anticoagulants may improve the survival of people with cancer through an antithrombotic effect, yet increase the risk of bleeding.

Objectives: To evaluate the efficacy and safety of oral anticoagulants in ambulatory people with cancer undergoing chemotherapy, targeted therapy, immunotherapy, or radiotherapy (either alone or in combination), with no standard therapeutic or prophylactic indication for anticoagulation.

Search Methods: We conducted comprehensive searches on 14 June 2021, following the original electronic searches performed in February 2016 (last major search). Read More

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October 2021

Anti-Xa Inhibitor-Induced Hemorrhagic Pruritic Rash: A Case Report on Possible Cross-Reactivity Between Apixaban and Rivaroxaban.

Clin Pharmacol 2021 29;13:181-184. Epub 2021 Sep 29.

Pharmacy Department, Northern Light Eastern Maine Medical Center, Bangor, ME, USA.

Direct oral anticoagulants (DOACs) have gained increasing popularity in clinical practice in the past decade. While DOACs have fewer associated adverse events as compared to warfarin, DOAC-induced hypersensitivity is a rare adverse event that has been reported in the literature. We describe a case of apixaban-induced hemorrhagic pruritic rash in a 62-year-old man with protein C deficiency for which he was receiving warfarin. Read More

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September 2021

Impact of clinical characteristics of colonic diverticular bleeding in extremely elderly patients treated with direct oral anti-coagulant drugs: a retrospective multi-center study.

J Clin Biochem Nutr 2021 Sep 3;69(2):222-228. Epub 2021 Apr 3.

Division of Gastroenterology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.

Since there were no available data about colonic diverticular bleeding in extremely elderly patients (>80 years old) treated with direct oral anticoagulants (DOACs), we tried to determine clinical characteristics in those with colonic diverticular bleeding taking DOACs and to compare clinical outcomes of those in DOAC-treated to those in warfarin-treated . We enrolled DOAC-treated ( = 20) and warfarin-treated ( = 23) extremely elderly patients with diverticular bleeding diagnosed by colonoscopy. We performed a retrospective review of patients' medical charts and endoscopic findings. Read More

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September 2021

Simultaneous assessment of DOACs effect on clot formation and fibrinolysis with the FibWave.

Int J Lab Hematol 2021 Oct 5. Epub 2021 Oct 5.

Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium.

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October 2021

Effectiveness and safety of the direct oral anticoagulants in non-triple positive antiphospholipid syndrome without prior arterial thromboembolism.

J Thromb Thrombolysis 2021 Oct 6. Epub 2021 Oct 6.

Division of Hematology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada.

Thrombotic antiphospholipid syndrome (TAPS) is an autoimmune disorder that manifests with venous thromboembolism (VTE) and/or arterial thromboembolism (ATE) in the presence of persistent antiphospholipid antibodies (aPLs). Recent trials have failed to demonstrate non-inferiority of the direct oral anticoagulants (DOACs) compared to vitamin K antagonists as anticoagulation in TAPS, but there is a subgroup of non-triple positive patients without prior ATE in who only limited data exists. The objective of this study was to assess the effectiveness and safety of DOACs in non-triple positive TAPS without prior ATE. Read More

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October 2021

The impact of mental health conditions on oral anticoagulation therapy and outcomes in patients with atrial fibrillation: A systematic review and meta-analysis.

Am J Prev Cardiol 2021 Sep 27;7:100221. Epub 2021 Jun 27.

Heart Center, Turku University Hospital, and University of Turku, Turku, Finland.

One third of patients with atrial fibrillation (AF) are estimated to suffer from mental health conditions (MHCs). We conducted a systematic review and meta-analysis to investigate the impact of MHCs on the prevalence and quality of oral anticoagulation (OAC) therapy and outcomes in patients with AF. Medline database was searched for studies published before March 1st 2021 evaluating AF patients with comorbid MHCs reporting on the prevalence of OAC therapy, time in therapeutic range (TTR) in warfarin-receiving patients, adherence to OAC therapy or adverse outcomes (ischemic stroke, hemorrhage or mortality). Read More

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September 2021

Anticoagulation management post-transjugular intrahepatic portosystemic shunt in portal hypertension associated with myeloproliferative neoplasms.

Blood Coagul Fibrinolysis 2021 Oct 4. Epub 2021 Oct 4.

Division of Hematology and Hematologic Malignancies, Department of Internal Medicine, The University of Utah, Salt Lake City, Utah, USA.

Portal hypertension (pHTN) complicates myeloproliferative neoplasms (MPNs), and usually occurs due to Budd-Chiari syndrome or splanchnic vein thrombosis. Current management modalities for MPN-associated pHTN include anticoagulation, transjugular intrahepatic portosystemic shunt (TIPS), and orthotopic liver transplant. Data on the thrombotic and bleeding outcomes of this practice is of poor quality, and whether direct oral anticoagulants (DOACs) are effective in this setting is unknown. Read More

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October 2021

Non-valvular Atrial Fibrillation in CKD: Role of Vitamin K Antagonists and Direct Oral Anticoagulants. A Narrative Review.

Front Med (Lausanne) 2021 17;8:654620. Epub 2021 Sep 17.

Departament de Medicina, Universitat de Valencia, Valencia, Spain.

Atrial fibrillation (AF) is the most common arrhythmia in chronic kidney disease (CKD), with a close bidirectional relationship between the two entities. The presence of CKD in AF increases the risk of thromboembolic events, mortality and bleeding. Vitamin K antagonists (VKA) have been the mainstay of treatment for the prevention of thromboembolic events in AF until recently, with confirmed benefits in AF patients with stage 3 CKD. Read More

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September 2021

Management of patients with hip fracture receiving anticoagulation: What are we doing in Canada?

Can J Surg 2021 Oct;64(5):E510-E515

From the Division of Orthopaedic Trauma, Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Alta. (White, Reitzel, Doyle-Baker, Sabo, Samuel); the McCaig Institute of Bone and Joint Health, Calgary, Alta. (White, Sabo); and the South Campus Research Unit for Bone and Soft Tissue, University of Calgary, Calgary, Alta. (Mattiello).

Background: Direct oral anticoagulants (DOACs) are rapidly replacing warfarin for therapeutic anticoagulation; however, many DOACs are irreversible and may complicate bleeding in emergent situations such as hip fracture. In this setting, there is a lack of clear guidelines for the timing of surgery. The purpose of this study was to evaluate the current practices of Canadian orthopedic surgeons who manage patients with hip fracture receiving anticoagulation. Read More

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October 2021

Medication errors associated with direct-acting oral anticoagulants: analysis of data from national pharmacovigilance and local incidents reporting databases.

J Pharm Policy Pract 2021 Oct 1;14(1):81. Epub 2021 Oct 1.

School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, B15 2TT, UK.

Background: For more than a decade, direct oral anticoagulants (DOACs) have been approved in clinical practice for multiple indications such as stroke prevention in non-valvular atrial fibrillation treatment of deep vein thrombosis and pulmonary embolism. This study aimed to explore the nature and contributory factors related to medication errors associated with DOACs in hospital settings.

Methods: Analysis of error reports using data from (a) Saudi Food and Drug Authority pharmacovigilance database and (b) local incidents reporting system from two tertiary care hospitals were included. Read More

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October 2021

Anticoagulant therapy in patients with congenital FXI deficiency.

Blood Adv 2021 Oct 1. Epub 2021 Oct 1.

Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain.

The bleeding phenotype of FXI deficiency is unpredictable. Bleeding is usually mild, and mostly occurs after injury. Although FXI deficiency renders antithrombotic protection, some patients might eventually develop thrombosis or atrial fibrillation, requiring anticoagulant therapy. Read More

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October 2021

Detection of Direct Oral Anticoagulants in Patient Urine Samples by Prototype and Commercial Test Strips for DOACs - A Systematic Review and Meta-analysis.

TH Open 2021 Jul 24;5(3):e438-e448. Epub 2021 Sep 24.

Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany.

The DOAC Dipstick accurately detects the presence or absence of factor Xa (DXI) and thrombin inhibitor (DTI) classes of direct oral anticoagulants (DOACs) in patients' urine samples on DOAC treatment. The aim of the study was to systematically review the literature and compare the performance of prototype and commercial test strips with a meta-analysis. A systematic literature search of electronic databases PubMed (MEDLINE) and Cochrane Library was performed. Read More

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Estimated Thresholds of Minimum Necessary Adherence for Effective Treatment with Direct Oral Anticoagulants - A Retrospective Cohort Study in Health Insurance Claims Data.

Patient Prefer Adherence 2021 24;15:2209-2220. Epub 2021 Sep 24.

Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, 69120, Germany.

Background: An essential contribution regarding the prevention of thromboembolic events in patients with (non-valvular) atrial fibrillation (AF) is good adherence to direct oral anticoagulants (DOACs). However, it is an open question what "good" adherence means for DOACs or below which threshold non-adherence is clinically relevant for AF patients. Ultimately, such a classification could prevent strokes and associated costs through adjusted treatment regimens or supportive measures. Read More

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September 2021

A drug utilization study of oral anticoagulants in five representative cities of China between 2015 and 2019.

J Clin Pharm Ther 2021 Sep 30. Epub 2021 Sep 30.

Department of Pharmacy, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

What Is Known And Objective: Oral anticoagulants (OACs), including warfarin and newer direct-acting OACs (DOACs), have been used for decades to prevent thromboembolic diseases. A drug utilization study was performed to determine the prescribing patterns of OACs.

Methods: Data were extracted from the Cooperation Project of Hospital Prescription Analysis in China. Read More

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September 2021

Idiopathic Portal Vein Thrombosis in a Non-cirrhotic Patient: A Discussion of Management and a Review of Literature.

Cureus 2021 Aug 25;13(8):e17445. Epub 2021 Aug 25.

Surgery, Gold Coast University Hospital, Southport, AUS.

Portal vein thrombosis (PVT) is most commonly seen in people with predisposing conditions such as cirrhosis, hepatobiliary malignancies, infectious or inflammatory abdominal disease, or haematologic disorders. However, the incidence of idiopathic portal vein thrombosis in non-cirrhotic people is low and approximately 25% of existing cases have no identifiable cause. If untreated, complications can include portal hypertension, a cavernous transformation of the portal vein, varices, septic thrombosis, or intestinal ischemia. Read More

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