29,799 results match your criteria oral anticoagulants


Oral Anticoagulation Timing in Patients with Acute Ischaemic Stroke and Atrial Fibrillation.

Thromb Haemost 2021 Oct 14. Epub 2021 Oct 14.

aGeneral Clinical Research Center, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.

Background And Purpose: Oral anticoagulants (OACs) prevent stroke recurrence and vascular embolism in patients with acute ischaemic stroke (AIS) and atrial fibrillation (AF). Current guidance recommends a "1-3-6-12 day"' rule to resume OACs after AIS, based mainly on empirical consensus. This study investigated the suitability of guideline-recommended timing for OAC initiation. Read More

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October 2021

Robotics-assisted epicardial left atrial appendage clip exclusion.

JTCVS Tech 2021 Oct 21;9:59-68. Epub 2021 Jul 21.

Department of Anesthesiology, Health First Holmes Regional Medical Center, Melbourne, Fla.

Objectives: We demonstrate the feasibility and safety of robotics-assisted left atrial appendage clip exclusion in clinical practice.

Methods: Analysis of a single center robotics-assisted left atrial appendage clip exclusion experience using an epicardial linear clip device in patients with atrial fibrillation with high-risk of thromboembolic stroke and intolerance to oral anticoagulants.

Results: During the period from December 2017 to September 2020, we performed 42 robotics-assisted left atrial appendage clip exclusions in response to increased risk of bleeding in patients with atrial fibrillation and intolerance to oral anticoagulants. Read More

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October 2021

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

Clearing the cognitive cloud: direct oral anticoagulants or vitamin K antagonists for reducing dementia risk in patients with atrial fibrillation?

Authors:
Winnie Chua

Heart 2021 Oct 13. Epub 2021 Oct 13.

Institute of Cardiovascular Sciences, University of Birmingham, Birmingham B15 2TT, UK

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October 2021

Shifting from vitamin K antagonists to non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: predictors, patterns and temporal trends.

BMC Cardiovasc Disord 2021 Oct 13;21(1):493. Epub 2021 Oct 13.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Non-Vitamin K antagonist oral anticoagulants (NOACs) emerged as an alternative with comparable or superior efficacy and safety to vitamin K antagonists (VKAs) for stroke prevention in patients with non-valvular atrial fibrillation (AF).

Objectives: The aim of the current study was to investigate the patterns, predictors, timelines and temporal trends of shifting from VKAs to NOACs.

Methods: In this retrospective observational study, the computerized database of a large healthcare provider in Israel, Maccabi Healthcare Services, was searched to identify patients with AF for whom either a VKA or NOAC was prescribed between 2012 and 2015. 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

The effect of health literacy on vaccine hesitancy among Italian anticoagulated population during COVID-19 pandemic: the moderating role of health engagement.

Hum Vaccin Immunother 2021 Oct 13:1-6. Epub 2021 Oct 13.

Health Professions Research and Development Unit, IRCCS Policlinico San Donato, Milano, Italy.

Assessing vaccine hesitancy and its determinants is pivotal to optimize vaccine acceptance in anticoagulated patients, given that this population has been described to have a higher risk of severe COVID-19-related complications. This study assessed the moderator role of patients' health engagement on the relationship between health literacy and vaccine hesitancy. A web-based survey was performed in Italy during the first wave (June-August 2020) and the second wave (October 2020-March 2021) of the COVID-19 pandemic, enrolling 288 patients. Read More

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October 2021

Why Did All Patients with Atrial Fibrillation and High Risk of Stroke Not Receive Oral Anticoagulants? Results of the Polish Atrial Fibrillation (POL-AF) Registry.

J Clin Med 2021 Oct 8;10(19). Epub 2021 Oct 8.

1st Clinic of Cardiology and Electrotherapy, Swietokrzyskie Cardiology Centre, 25-736 Kielce, Poland.

Background: Most atrial fibrillation (AF) patients are at high risk of thromboembolic, and the use of oral anticoagulants (OACs) is advised in such cases. The aim of the study was to evaluate the frequency at which OACs were used in patients with AF and high risk thromboembolic complications, and identify factors that result in OACs not being used in the researched group of patients.

Methods: The prospective, multicenter and non-interventional POL-AF registry is a study that includes AF patients from ten Polish cardiology centers. Read More

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October 2021

Effectiveness and Safety of Non-Vitamin K Oral Anticoagulants in Non-Valvular Atrial Fibrillation Patients: Results of A Real-World Study in a Metropolitan Area of Northern Italy.

J Clin Med 2021 Sep 30;10(19). Epub 2021 Sep 30.

Epidemiology Unit, Agency for Health Protection (ATS) of Milan, C.so Italia, 19, 20122 Milan, Italy.

Background: New oral anticoagulant agents (NOACs) are valid alternatives for vitamin K antagonists (VKA) in patients with non-valvular atrial fibrillation (NVAF) for stroke prevention. In clinical practice, NOACs users may differ from patients enrolled in clinical trials in age or comorbidities, and thus it is a critical issue to evaluate the effectiveness and safety of NOACs in the real-world. Accordingly, we assessed two-year overall mortality and hospital admissions for myocardial infarction, stroke or bleeding in patients with NVAF users of NOACs compared to warfarin-treated patients. Read More

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September 2021

Vascular Protective Effects of New Oral Anticoagulants in Patients with Atrial Fibrillation.

J Clin Med 2021 Sep 23;10(19). Epub 2021 Sep 23.

Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea.

This study was designed to determine the efficacy of a new oral anticoagulant (NOAC) therapy for the prevention of endothelial dysfunction and atherosclerosis progression in patients with atrial fibrillation (AF). Sixty-five AF patients with a CHA2DS2-VASc score ≥2 without previous history of cardiovascular disease were registered and randomly assigned to either an NOAC group (dabigatran or rivaroxaban) or the warfarin group. Reactive hyperemia peripheral arterial tonometry (RH-PAT) measurements reflecting endothelial function were taken using Endo-PAT2000. Read More

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September 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

Spontaneous spinal epidural haematoma: management and main risk factors in era of anticoagulant / antiplatelet treatment.

Neurol Neurochir Pol 2021 Oct 12. Epub 2021 Oct 12.

Department of Neurology, Third Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Czech Republic, Srobarova 50, 100 34 Prague 10, Czech Republic.

Aim Of The Study: Spontaneous spinal epidural haematomas (SSEH) are rare nosological units wherein acute collections of blood develop in the spinal canal. SSEH are usually manifested by sudden severe back pain accompanied by the development of neurological symptoms. In this study, we retrospectively describe management and the main risk factors of SSEH in a series of 14 cases. Read More

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October 2021

Non-vitamin K Antagonist Oral Anticoagulants (NOACs) Versus Warfarin in Patients with Atrial Fibrillation Using P-gp and/or CYP450-Interacting Drugs: a Systematic Review and Meta-analysis.

Cardiovasc Drugs Ther 2021 Oct 12. Epub 2021 Oct 12.

Department of Bioanalysis, Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.

Purpose: Non-vitamin K antagonist oral anticoagulants (NOACs) are excreted by P-glycoprotein (P-gp) and some are metabolized by CYP450 enzymes such as CYP3A4. Although fewer drug interactions are present with NOACs, it is unclear whether NOACs should also be preferred over vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) using pharmacokinetically interacting drugs. Therefore, the benefit-risk profile of NOACs versus VKAs was investigated in AF patients treated with P-gp and/or CYP450-interacting drugs. 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

The burden of undertreatment and non-treatment among patients with non-valvular atrial fibrillation and elevated stroke risk: a systematic review.

Curr Med Res Opin 2021 Oct 9:1-12. Epub 2021 Oct 9.

Pfizer Inc, New York, NY, USA.

Objective: Global treatment guidelines recommend treatment with oral anticoagulants (OACs) for patients with non-valvular atrial fibrillation (NVAF) and an elevated stroke risk. However, not all patients with NVAF and an elevated stroke risk receive guideline-recommended therapy. A literature review and synthesis of observational studies were undertaken to identify the body of evidence on untreated and undertreated NVAF and the association with clinical and economic outcomes. Read More

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October 2021

Identifying risk patterns in older adults with atrial fibrillation by hierarchical cluster analysis: A retrospective approach based on the risk probability for clinical events.

Int J Cardiol Heart Vasc 2021 Dec 28;37:100883. Epub 2021 Sep 28.

Department of Cardiovascular Medicine, The Cardiovascular Institute, Tokyo, Japan.

Background: Older adults with atrial fibrillation (AF) have highly diverse risk levels for mortality, heart failure (HF), thromboembolism (TE), and major bleeding (MB), thus an integrated risk-pattern algorithm is warranted.

Methods: We analyzed 573 AF patients aged ≥ 75 years from our single-center cohort (Shinken Database 2010-2018). The 3-year risk scores (risk probability) for mortality (M-score), HF (HF-score), TE (TE-score), and MB (MB-score) were estimated for each patient by logistic regression analysis. Read More

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December 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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Prediction of bleeding events using the VTE-BLEED risk score in patients with venous thromboembolism receiving anticoagulant therapy (Review).

Exp Ther Med 2021 Nov 22;22(5):1344. Epub 2021 Sep 22.

Department of Internal Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.

Venous thromboembolism (VTE) is a major healthcare problem due to its high incidence, significant mortality rate from pulmonary embolism, high recurrence rate and morbidity from long-term complications. After a first episode of VTE all patients must receive anticoagulant treatment for 3 months. Further anticoagulation is recommended in patients without transient risk factors for VTE or patients with active cancer, if they are not at a high risk for bleeding. Read More

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November 2021

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

Difference in left atrial D-dimer level in patients with atrial fibrillation treated with direct oral anticoagulant.

BMC Cardiovasc Disord 2021 Oct 9;21(1):487. Epub 2021 Oct 9.

Department of Cardiovascular Medicine, Yao Municipal Hospital, Yao, Japan.

Background: Atrial fibrillation (AF) may cause cerebral and systemic embolism. An increased D-dimer level indicates hyperactivation of secondary fibrinolysis, resulting in predilection for thrombosis. To clarify the differential effects of anticoagulation therapy, we compared the D-dimer levels in peripheral and left atrial (LA) blood of atrial fibrillation patients scheduled for ablation. Read More

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October 2021

Factors which influence the complications of external ventricular cerebrospinal fluid drainage.

Acta Neurochir (Wien) 2021 Oct 9. Epub 2021 Oct 9.

Department of Neurosurgery, Klinikum Nuremberg, Paracelsus Medical University, Nuremberg, Germany.

Background: External ventricular drainage (EVD) is one of the most common neurosurgical procedures in emergencies. This study aims to find out which factors influence the occurrence of EVD-related complications in a comparative investigation of metal needles and polyurethane catheters. This is the first clinical study comparing these two systems. 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

Towards personalized antithrombotic management with drugs and devices across the cardiovascular spectrum.

Eur Heart J 2021 Oct 8. Epub 2021 Oct 8.

Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany.

Intravascular thrombus formation and embolization are among the most frequent events leading to a number of cardiovascular conditions with high morbidity and mortality. The underlying causes are stasis of the circulating blood, genetic and acquired coagulation disorders, and reduced antithrombotic or prothrombotic properties of the vascular wall (Virchow's triad). In the venous system, intravascular thrombi can cause venous thrombosis and pulmonary and even peripheral embolism including ischaemic stroke [through a patent foramen ovale (PFO)]. Read More

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October 2021