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Latest & greatest articles for warfarin
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on warfarin or other clinical topics then use Trip today.
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Enoxaparin followed by once-weekly idrabiotaparinux versus enoxaparin plus warfarin for patients with acute symptomatic pulmonary embolism: a randomised, double-blind, double-dummy, non-inferiority trial. Treatment of pulmonary embolism with low-molecular-weight heparin and vitamin K antagonists, such as warfarin, is not ideal. We aimed to assess non-inferiority of idrabiotaparinux, a reversible longlasting indirect inhibitor of activated factor X, to warfarin in patients with acute symptomatic (...) idrabiotaparinux (starting dose 3·0 mg) or adjusted-dose warfarin (target international normalised ratio 2·0-3·0); regimens lasted 3 months or 6 months dependent on clinical presentation. Block randomisation was done with a central interactive computerised system, stratified by study centre and intended treatment duration. The primary efficacy outcome was recurrent venous thromboembolism at 99 days after randomisation. We estimated the odds ratio and 95% CI with a Mantel-Haenzsel χ(2) analysis (non-inferiority
Meta-analysis of safety and efficacy of uninterrupted warfarin compared to heparin-based bridging therapy during implantation of cardiac rhythm devices Meta-analysis of safety and efficacy of uninterrupted warfarin compared to heparin-based bridging therapy during implantation of cardiac rhythm devices Meta-analysis of safety and efficacy of uninterrupted warfarin compared to heparin-based bridging therapy during implantation of cardiac rhythm devices Ghanbari H, Saint Phard W, Al-Ameri H (...) , Latchamsetty R, Jongnarngsin K, Crawford T, Good E, Chugh A, Oral H, Bogun F, Morady F, Pelosi F CRD summary The authors concluded that the strategy of uninterrupted warfarin therapy throughout pacemaker or implantable cardioverter-defibrillator implantation was associated with decreased risk of bleeding without increasing risk of thromboembolic events. Clinical variations between the included studies and some of the methodological limitations identified mean the authors conclusion may not be reliable
Warfarin and aspirin in patients with heart failure and sinus rhythm. It is unknown whether warfarin or aspirin therapy is superior for patients with heart failure who are in sinus rhythm.We designed this trial to determine whether warfarin (with a target international normalized ratio of 2.0 to 3.5) or aspirin (at a dose of 325 mg per day) is a better treatment for patients in sinus rhythm who have a reduced left ventricular ejection fraction (LVEF). We followed 2305 patients for up to 6 years (...) (mean [±SD], 3.5±1.8). The primary outcome was the time to the first event in a composite end point of ischemic stroke, intracerebral hemorrhage, or death from any cause.The rates of the primary outcome were 7.47 events per 100 patient-years in the warfarin group and 7.93 in the aspirin group (hazard ratio with warfarin, 0.93; 95% confidence interval [CI], 0.79 to 1.10; P=0.40). Thus, there was no significant overall difference between the two treatments. In a time-varying analysis, the hazard ratio
Efficacy and safety of apixaban compared with warfarin according to patient risk of stroke and of bleeding in atrial fibrillation: a secondary analysis of a randomised controlled trial. The Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial showed that apixaban is better than warfarin at prevention of stroke or systemic embolism, causes less bleeding, and results in lower mortality. We assessed in this trial's participants how results (...) differed according to patients' CHADS(2), CHA(2)DS(2)VASc, and HAS-BLED scores, used to predict the risk of stroke and bleeding.ARISTOTLE was a double-blind, randomised trial that enrolled 18,201 patients with atrial fibrillation in 39 countries. Patients were randomly assigned apixaban 5 mg twice daily (n=9120) or warfarin (target international normalised ratio 2·0-3·0; n=9081). The primary endpoint was stroke or systemic embolism. The primary safety outcome was major bleeding. We calculated CHADS(2
Meta-analysis of efficacy and safety of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus warfarin in patients with atrial fibrillation 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.
Effect of increased warfarin use on warfarin-related cerebral hemorrhage: a longitudinal population-based study Warfarin use has rapidly increased with the aging of the population. We investigated the temporal trends in the incidence and outcome of warfarin-related intracerebral hemorrhages (ICHs) in a defined population.We identified all subjects with first-ever primary ICH during 1993 to 2008 among the population of Northern Ostrobothnia, Finland. The number of warfarin users was obtained (...) from the national register of prescribed medicines kept by the Social Insurance Institution of Finland. We calculated the annual incidence of warfarin-related ICHs, 28-day case fatality, and deaths from the primary bleed.The proportion of warfarin users among the population increased 3.6-fold from 0.68% in 1993 to 2.28% in 2008. Of a total of 982 patients with ICH, 182 (18.5%) had warfarin-related ICH. One-year survival rate after onset of stroke was 35.2% among warfarin users and 67.9% among
Cost effectiveness of warfarin versus aspirin in patients older than 75 years with atrial fibrillation 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.
Cost effectiveness of warfarin versus aspirin in patients older than 75 years with atrial fibrillation Oral anticoagulants are effective at reducing stroke compared with aspirin in atrial fibrillation patients older than 75 years. Although the benefits of reduced stroke risk outweigh the risks of bleeding, the cost effectiveness of warfarin in this patient population has not yet been established.An economic evaluation was conducted alongside a randomized, controlled trial; 973 patients ≥75 (...) years of age with atrial fibrillation were recruited from primary care and randomly assigned to either take warfarin or aspirin. Follow-up was for a mean of 2.7 years. Costs of thrombotic and hemorrhagic events, anticoagulation clinic visits, and primary care utilization were determined. Clinical benefits were expressed in terms of a primary event avoided: fatal/nonfatal disabling stroke, intracranial hemorrhage, or systemic embolism. A cost-utility analysis was performed using quality-adjusted life
Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation Cost-effectiveness of dabigatran compared with warfarin for stroke prevention in atrial fibrillation Freeman JV, Zhu RP, Owens DK, Garber AM, Hutton DW, Go AS, Wang PJ, Turakhia MP 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 assessed the cost-effectiveness of low- or high-dose dabigatran, compared with warfarin, for the prevention of ischaemic stroke in patients aged 65 years or older, with non-valvular atrial fibrillation and risk factors for stroke. The authors concluded that dabigatran, particularly at a high
Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance? Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance? Catheter ablation for atrial fibrillation on uninterrupted warfarin: can it be done without echo guidance? Page SP, Siddiqui MS, Finlay M, Hunter RJ, Abrams DJ, Dhinoja M, Earley MJ, Sporton SC, Schilling RJ 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 costs and effectiveness of catheter ablation, without intracardiac echocardiography, for adults with atrial fibrillation, who were on uninterrupted warfarin. The authors concluded that uninterrupted warfarin was effective and safe
Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial. Dabigatran 150 and 110 mg twice a day and warfarin are effective for stroke prevention in atrial fibrillation. The purpose of this study was to compare their risks of bleeding in the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) trial.The RE-LY trial randomized 18 (...) 113 patients to receive dabigatran 110 or 150 mg twice a day or warfarin dose adjusted to an international normalized ratio of 2.0 to 3.0 for a median follow-up of 2.0 years. Compared with warfarin, dabigatran 110 mg twice a day was associated with a lower risk of major bleeding (2.87% versus 3.57%; P=0.002), whereas dabigatran 150 mg twice a day was associated with a similar risk of major bleeding (3.31% versus 3.57%; P=0.32). There was a significant treatment-by-age interaction
Brand Name versus Generic Warfarin: A Systematic Review of the Literature The use of generic drugs has become increasingly common in clinical practice. However, for drugs with a narrow therapeutic index, such as warfarin, there may be some concern regarding the definition of bioequivalence. Clinical studies that compared brand name and generic warfarin products provided conflicting results. Therefore, we performed a systematic review of the literature to better assess the characteristics (...) of each generic warfarin product. Several sources were searched, including MEDLINE and EMBASE, electronic records of meetings' abstracts, and reference lists of included articles. Articles were considered relevant if they were original studies, enrolled patients receiving oral anticoagulant treatment, and compared any approved generic warfarin with brand name warfarin in at least one clinical, laboratory, or management outcome. Eleven studies, with a total of more than 40,000 patients, were included
Aspirin, Warfarin, or Enoxaparin Thromboprophylaxis in Patients With Multiple Myeloma Treated With Thalidomide: A Phase III, Open-Label, Randomized Trial In patients with myeloma, thalidomide significantly improves outcomes but increases the risk of thromboembolic events. In this randomized, open-label, multicenter trial, we compared aspirin (ASA) or fixed low-dose warfarin (WAR) versus low molecular weight heparin (LMWH) for preventing thromboembolism in patients with myeloma treated
Genetic warfarin dosing tables versus algorithms The aim of this study was to compare the accuracy of genetic tables and formal pharmacogenetic algorithms for warfarin dosing.Pharmacogenetic algorithms based on regression equations can predict warfarin dose, but they require detailed mathematical calculations. A simpler alternative, recently added to the warfarin label by the U.S. Food and Drug Administration, is to use genotype-stratified tables to estimate warfarin dose. This table may (...) potentially increase the use of pharmacogenetic warfarin dosing in clinical practice; however, its accuracy has not been quantified.A retrospective cohort study of 1,378 patients from 3 anticoagulation centers was conducted. Inclusion criteria were stable therapeutic warfarin dose and complete genetic and clinical data. Five dose prediction methods were compared: 2 methods using only clinical information (empiric 5 mg/day dosing and a formal clinical algorithm), 2 genetic tables (the new warfarin label
Randomized Trial of a Warfarin Communication Protocol for Nursing Homes: an SBAR-based Approach More than 1.6 million Americans currently reside in nursing homes. As many as 12% of them receive long-term anticoagulant therapy with warfarin. Prior research has demonstrated compelling evidence of safety problems with warfarin therapy in this setting, often associated with suboptimal communication between nursing home staff and prescribing physicians.We conducted a randomized trial of a warfarin (...) management protocol using facilitated telephone communication between nurses and physicians in 26 nursing homes in Connecticut in 2007-2008. Intervention facilities received a warfarin management communication protocol using the approach "Situation, Background, Assessment, and Recommendation" (SBAR). The protocol included an SBAR template to standardize telephone communication about residents on warfarin by requiring information about the situation triggering the call, the background, the nurse's
Home Monitoring of Warfarin Effects. 21268733 2011 02 04 2018 05 10 1533-4406 364 4 2011 01 27 The New England journal of medicine N. Engl. J. Med. Home monitoring of warfarin effects. 378; author reply 378-9 10.1056/NEJMc1012980 Lippi Giuseppe G Franchini Massimo M eng Letter Comment United States N Engl J Med 0255562 0028-4793 0 Anticoagulants 5Q7ZVV76EI Warfarin AIM IM N Engl J Med. 2010 Oct 21;363(17):1608-20 20961244 Anticoagulants adverse effects Atrial Fibrillation drug therapy Drug (...) Monitoring economics methods Humans International Normalized Ratio economics Self Care economics Warfarin adverse effects 2011 1 28 6 0 2011 1 28 6 0 2011 2 5 6 0 ppublish 21268733 10.1056/NEJMc1012980 10.1056/NEJMc1012980#SA2
Home Monitoring of Warfarin Effects. 21268734 2011 02 04 2018 05 10 1533-4406 364 4 2011 01 27 The New England journal of medicine N. Engl. J. Med. Home monitoring of warfarin effects. 378; author reply 378-9 10.1056/NEJMc1012980 Arellano-Rodrigo Eduardo E eng Letter Comment United States N Engl J Med 0255562 0028-4793 0 Anticoagulants 5Q7ZVV76EI Warfarin AIM IM N Engl J Med. 2010 Oct 21;363(17):1608-20 20961244 Anticoagulants adverse effects Atrial Fibrillation drug therapy Drug Monitoring (...) methods Heart Valve Prosthesis Hemorrhage prevention & control Humans International Normalized Ratio Self Care Stroke prevention & control Thrombosis prevention & control Warfarin adverse effects 2011 1 28 6 0 2011 1 28 6 0 2011 2 5 6 0 ppublish 21268734 10.1056/NEJMc1012980 10.1056/NEJMc1012980#SA1
The Efficacy of Dabigatran versus Warfarin for Stroke Prevention in Patients With Atrial Fibrillation: Systematic Review "The Efficacy of Dabigatran versus Warfarin for Stroke Prevention in Pa" by Karim Bouferrache < > > > > > Title Author Date of Graduation 4-20-2011 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Patients with atrial fibrillation are at increased risk of experiencing embolic events. Anticoagulation (...) therapy is known to reduce these events. Warfarin, the only oral anticoagulant available, gives inconsistent results, and thus requires frequent laboratory monitoring and adjustment. A newly FDA approved fixed-dosage direct thrombin inhibitor, dabigatran, has shown some promising results in efficacy and safety. Method: An extensive review of the literature search was performed using the following database: Web of Science, MEDLINE and CINHAL. Two studies met the inclusion and exclusion criteria