Latest & greatest articles for anticoagulation

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Top results for anticoagulation

81. Direct effectiveness and safety comparison of direct-acting oral anticoagulants (DOACs): a systematic review and meta-analysis of real world studies

Direct effectiveness and safety comparison of direct-acting oral anticoagulants (DOACs): a systematic review and meta-analysis of real world studies Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

82. A systematic review of economic evaluations of service models to increase anticoagulation prescription rates for people with atrial fibrillation

A systematic review of economic evaluations of service models to increase anticoagulation prescription rates for people with atrial fibrillation Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

83. Association of Oral Anticoagulants and Proton Pump Inhibitor Cotherapy With Hospitalization for Upper Gastrointestinal Tract Bleeding. (PubMed)

Association of Oral Anticoagulants and Proton Pump Inhibitor Cotherapy With Hospitalization for Upper Gastrointestinal Tract Bleeding. Anticoagulant choice and proton pump inhibitor (PPI) cotherapy could affect the risk of upper gastrointestinal tract bleeding, a frequent and potentially serious complication of oral anticoagulant treatment.To compare the incidence of hospitalization for upper gastrointestinal tract bleeding in patients using individual anticoagulants with and without PPI (...) cotherapy, and to determine variation according to underlying gastrointestinal bleeding risk.Retrospective cohort study in Medicare beneficiaries between January 1, 2011, and September 30, 2015.Apixaban, dabigatran, rivaroxaban, or warfarin with or without PPI cotherapy.Hospitalizations for upper gastrointestinal tract bleeding: adjusted incidence and risk difference (RD) per 10 000 person-years of anticoagulant treatment, incidence rate ratios (IRRs).There were 1 643 123 patients with 1 713 183 new

2018 JAMA

84. The anticoagulant treatment for sepsis induced disseminated intravascular coagulation; network meta-analysis

The anticoagulant treatment for sepsis induced disseminated intravascular coagulation; network meta-analysis The benefits and harm caused by anticoagulant treatments for sepsis induced disseminated intravascular coagulation (DIC) remain unclear. Therefore, we performed a network meta-analysis to assess the effect of available anticoagulant treatments on patient mortality, DIC resolution and the incidence of bleeding complication in patients with septic DIC.We considered all studies from four (...) recent systematic reviews and searched the PubMed, MEDLINE, and Cochrane databases for other studies that investigated anticoagulant treatment for septic DIC using antithrombin, thrombomodulin, heparin, or protease inhibitors in adult critically ill patients. These four anticoagulants and placebo were compared. The primary outcome in this study was patient mortality, and the secondary outcomes were the DIC resolution rate and incidence of bleeding complications.The network meta-analysis included 1340

2018 EvidenceUpdates

85. American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy (PubMed)

American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy Clinicians confront numerous practical issues in optimizing the use of anticoagulants to treat venous thromboembolism (VTE).These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in their decisions about the use of anticoagulants in the management of VTE (...) . These guidelines assume the choice of anticoagulant has already been made.ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation

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2018 Blood advances

86. Who should get long-term anticoagulant therapy for venous thromboembolism and with what? (PubMed)

Who should get long-term anticoagulant therapy for venous thromboembolism and with what? After an initial 3 to 6 months of anticoagulation for venous thromboembolism (VTE), clinicians and patients face an important question: "Do we stop anticoagulants or continue them indefinitely?" The decision is easy in some scenarios (eg, stop in VTE provoked by major surgery). In most scenarios, which are faced on a day-to-day basis in routine practice, it is a challenging decision because of uncertainty (...) in estimates in the long-term risks (principally major bleeding) and benefits (reducing recurrent VTE) and the tight trade-offs between them. Once the decision is made to continue, the next question to tackle is "Which anticoagulant?" Here again, it is a difficult decision because of the uncertainty with regard to estimates of efficacy and the safety of anticoagulant options and the tight trade-offs between choices. We conclude with the approach that we take in our clinical practice.© 2018 by The American

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2018 Blood advances

87. Efficacy and safety of anticoagulant agents in patients with venous thromboembolism and cancer: A network meta-analysis

Efficacy and safety of anticoagulant agents in patients with venous thromboembolism and cancer: A network meta-analysis Low-molecular-weight heparins (LMWHs) are the recommended treatment for cancer-associated venous thrombosis (CAT). Recent evidences suggest a role for direct-acting oral anticoagulants (DOACs) in this clinical setting.To evaluate the efficacy and safety of different anticoagulants we performed a network meta-analysis of RCTs including patients with CAT treated with LMWHs (...) , indirect and network meta-analyses.In patients with CAT, DOACs showed a good efficacy and safety profile compared to other anticoagulants and is candidates to be an alternative to LMWHs.Copyright © 2018 Elsevier Ltd. All rights reserved.

2018 EvidenceUpdates

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

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

2018 EvidenceUpdates

89. Neuroimaging and clinical outcomes of oral anticoagulant-associated intracerebral hemorrhage

Neuroimaging and clinical outcomes of oral anticoagulant-associated intracerebral hemorrhage Whether intracerebral hemorrhage (ICH) associated with non-vitamin K antagonist oral anticoagulants (NOAC-ICH) has a better outcome compared to ICH associated with vitamin K antagonists (VKA-ICH) is uncertain.We performed a systematic review and individual patient data meta-analysis of cohort studies comparing clinical and radiological outcomes between NOAC-ICH and VKA-ICH patients. The primary outcome

2018 EvidenceUpdates

90. Impact of anticoagulant choice on hospitalized bleeding risk when treating cancer-associated venous thromboembolism

Impact of anticoagulant choice on hospitalized bleeding risk when treating cancer-associated venous thromboembolism Essentials Bleeding risk by anticoagulant choice for cancer-associated venous thrombosis (CA-VTE) is unknown. 26 894 people with CA-VTE were followed for bleeding in a claims database in the United States. Hospitalized bleeding risk was similar with direct acting oral anticoagulants vs. warfarin. Relative hospitalized bleeding risk varied by cancer type and anticoagulant choice (...) . SUMMARY: Background Direct acting oral anticoagulants (DOACs) are associated with less bleeding than traditional venous thromboembolism (VTE) treatments in the general population but are little studied in cancer-associated VTE (CA-VTE). Objective To determine whether different anticoagulation strategies for CA-VTE have different hospitalized bleeding rates. Patients/Methods We conducted a retrospective study of patients with CA-VTE, diagnosed between 2011 and 2015, in a large administrative database

2018 EvidenceUpdates

91. Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants?

Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? TAKE-HOME MESSAGE Older adults have a lower risk of any severity of bleeding (includes both major and minor bleeding) when treated with aspirin or clopidogrel compared to warfarin. However, if minor bleeding is excluded, only the subgroup of patients aged 80 years or older demonstrate a lower risk the of major bleeding with antiplatelet agents. Is the Risk of Bleeding (...) Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? EBEM Commentators Cameron Gettel, MD Elizabeth M. Goldberg, MD, ScM Department of Emergency Medicine Alpert Medical School of Brown University Providence, RI Results Commentary Several systematic reviews have previously shown that the risk of bleeding with long-term treatment with aspirin was lower than with warfarin. 2,3 It is common clinical practice to use antiplatelet agents as alternatives

2018 Annals of Emergency Medicine Systematic Review Snapshots

92. Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation?

Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation? Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation? - CanadiEM Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation? In , by Kerstin de Wit October 23, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed : Expert, health advocate, communicator Case (...) rule which includes the same variables as the CHADS score with a lower age cut-off of 65 (also used in CHADSVASC). There are two ways you can use these sores in the emergency setting. 1. You can use the estimated yearly risk of stroke to inform your patient about the risks and benefits of starting on anticoagulation. Clinical pearl: The simplest way to convert the CHADS2 score into a clinically meaningful concept is (CHADS2 score x 2) = yearly risk of patient having a stroke. For example

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2018 CandiEM

93. Prothrombin complex concentrate versus placebo, no intervention, or other interventions in critically bleeding patients associated with oral anticoagulant administration: a protocol for a systematic review of randomised clinical trials with meta-analysis (PubMed)

Prothrombin complex concentrate versus placebo, no intervention, or other interventions in critically bleeding patients associated with oral anticoagulant administration: a protocol for a systematic review of randomised clinical trials with meta-analysis Acute critical bleeding is one of the most feared complications during treatment with oral anticoagulating agents. As more patients undergo treatment with anticoagulating agents, critically bleeding episodes in patients with vitamin K (...) randomised clinical trials comparing prothrombin complex concentrate versus placebo, no intervention, or other interventions in critically bleeding patients with oral anticoagulant-induced coagulopathy. Data extraction and risk of bias assessment will be handled by two independent review authors. Meta-analysis will be performed as recommended by Cochrane Handbook for Systematic Reviews of Interventions, bias will be assessed with domains, and trial sequential analysis will be conducted to control random

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2018 Systematic Reviews

94. Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence (PubMed)

Patent foramen ovale closure, antiplatelet therapy or anticoagulation in patients with patent foramen ovale and cryptogenic stroke: a systematic review and network meta-analysis incorporating complementary external evidence To examine the relative impact of three management options in patients aged <60 years with cryptogenic stroke and a patent foramen ovale (PFO): PFO closure plus antiplatelet therapy, antiplatelet therapy alone and anticoagulation alone.Systematic review and network meta (...) medical therapy. Of these, three (n=1257) addressed PFO closure versus antiplatelet therapy, three (n=2303) addressed PFO closure versus mixed antiplatelet and anticoagulation therapies and one (n=353) addressed PFO closure versus anticoagulation. The remaining three RCTs (n=503) addressed anticoagulant versus antiplatelet therapy. PFO closure versus antiplatelet therapy probably results in substantial reduction in ischaemic stroke recurrence (risk difference per 1000 patients over 5 years (RD): -87

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2018 EvidenceUpdates

95. Prothrombin Complex Concentrates for Perioperative Vitamin K Antagonist and Non-vitamin K Anticoagulant Reversal

Prothrombin Complex Concentrates for Perioperative Vitamin K Antagonist and Non-vitamin K Anticoagulant Reversal Vitamin K antagonist therapy is associated with an increased bleeding risk, and clinicians often reverse anticoagulation in patients who require emergency surgical procedures. Current guidelines for rapid anticoagulation reversal for emergency surgery recommend four-factor prothrombin complex concentrate and vitamin K coadministration. The authors reviewed the current evidence

2018 EvidenceUpdates

96. Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation. (PubMed)

Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation. Stroke rates in patients with nonvalvular atrial fibrillation (AF) who are not receiving anticoagulant therapy vary widely across published studies; the resulting effect on the net clinical benefit of anticoagulation in AF is unknown.To determine the effect of variation in published AF stroke rates on the net clinical benefit of anticoagulation.Markov model decision analysis (...) . Warfarin was the base case, and non-vitamin K antagonist oral anticoagulants (NOACs) were modeled in a secondary analysis.Community-dwelling adults.33 434 adults with incident AF.Quality-adjusted life-years (QALYs).Of the 33 434 patients, 27 179 had a CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes, stroke, and vascular disease) score of 2 or more. The population benefit of warfarin anticoagulation for these patients was least using stroke rates from the ATRIA (AnTicoagulation

2018 Annals of Internal Medicine

97. "HERDOO2" clinical decision rule to guide duration of anticoagulation in women with unprovoked venous thromboembolism. Can I use any d-Dimer?

"HERDOO2" clinical decision rule to guide duration of anticoagulation in women with unprovoked venous thromboembolism. Can I use any d-Dimer? The "HERDOO2 rule" is a prospectively validated clinical decision rule used to identify low-risk women who can safely discontinue anticoagulants after completing 5-12 months of anticoagulant treatment for unprovoked venous thromboembolism. The VIDAS®d-Dimer (DD) assay, a component of the rule, was used in the derivation and validation of the rule at half (...) , -0.004-0.07)).The "HERDOO2 rule" is the only prospectively validated clinical decision rule that can be used to identify low-risk women with unprovoked venous thrombosis who can safely discontinue anticoagulants. An important implementation issue is whether any commercial DD assay can be used in the HERDOO2 rule, and at what cut-point. Our analysis shows that the HemosIL®, Innovance®, Liatest® and Tina-quant® DD assays should not be used in the "HERDOO2" rule due to poor concordance with the VIDAS®

2018 EvidenceUpdates

98. The efficacy and safety of anticoagulation in cerebral vein thrombosis: A systematic review and meta-analysis

The efficacy and safety of anticoagulation in cerebral vein thrombosis: A systematic review and meta-analysis Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is the mainstay for the treatment of patients with acute cerebral vein thrombosis (CVT) with or without intracranial hemorrhage (ICH).We conducted a systematic review and meta-analysis to determine the efficacy and safety of LMWH compared to UFH for the treatment of acute CVT.An electronic search (...) of MEDLINE, Pubmed, CENTRAL and Google Scholar was performed. Randomized controlled trials (RCT) reporting on the efficacy and safety of anticoagulation for acute treatment of CVT were included. Outcomes of interest included mortality, disability, new ICH and pulmonary embolism (PE).Overall, 4 RCTs were included in the meta-analysis. Two trials compared anticoagulation (UFH (N = 1) and LMWH (N = 1)) to placebo. The use of anticoagulation therapy was associated with an odd ratio (OR) for mortality

2018 EvidenceUpdates

99. Meta-Analysis Comparing the Efficacy, Safety, and Cost-Benefit of Direct Acting Oral Anticoagulants Versus Enoxaparin Thromboprophylaxis to Prevent Venous Thromboembolism Among Hospitalized Patients

Meta-Analysis Comparing the Efficacy, Safety, and Cost-Benefit of Direct Acting Oral Anticoagulants Versus Enoxaparin Thromboprophylaxis to Prevent Venous Thromboembolism Among Hospitalized Patients Venous thromboembolism (VTE) is a potentially fatal complication of hospitalization. Thromboprophylaxis using subcutaneous low molecular weight heparin (LMWH) can result in local irritation, pain, and ecchymoses, leading to nonadherence. Direct acting oral anticoagulants (DOACs) are an alternative

2018 EvidenceUpdates

100. Practical Guide to Ablation for Epicardial Ventricular Tachycardia: When to Get Access, How to Deal with Anticoagulation and How to Prevent Complications (PubMed)

Practical Guide to Ablation for Epicardial Ventricular Tachycardia: When to Get Access, How to Deal with Anticoagulation and How to Prevent Complications Epicardial ablation is needed to eliminate ventricular tachycardia (VT) in some patients with nonischaemic cardiomyopathy. The 12-lead electrocardiogram of VT, pre-procedural imaging and endocardial unipolar voltage maps can predict a high likelihood of epicardial substrate and VT. A septal VT substrate may preclude the need for epicardial (...) access and mapping and can be identified with imaging, pacing and voltage mapping. Pericardial access is usually obtained prior to systemic anticoagulation or after reversal of systemic anticoagulation. A unique set of complications can be encountered with epicardial access, mapping and ablation, which include haemopericardium, phrenic nerve injury, damage to major coronary arteries and pericarditis. Anticipating, preventing and, if necessary, managing these complications are paramount for patient

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2018 Arrhythmia & electrophysiology review