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  1 / 3385 MEDLINE  
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PMID:29231667
Autor:Myrstad M; Vandvik I; Engebretsen EH; Tveit A
Título:Hjerneslag etter seponering av nye antikoagulasjonsmidler før kirurgi..
Fuente:Tidsskr Nor Laegeforen; 137(23-24), 2017 12 12.
ISSN:0807-7096
País de publicación:Norway
Idioma:nor
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
Nombre de substancia:0 (Anticoagulants); 0 (Antithrombins); 0 (Factor Xa Inhibitors); 0 (Pyrazoles); 0 (Pyridones); 3Z9Y7UWC1J (apixaban); I0VM4M70GC (Dabigatran)


  2 / 3385 MEDLINE  
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PMID:29466159
Autor:Anderson DR; Dunbar M; Murnaghan J; Kahn SR; Gross P; Forsythe M; Pelet S; Fisher W; Belzile E; Dolan S; Crowther M; Bohm E; MacDonald SJ; Gofton W; Kim P; Zukor D; Pleasance S; Andreou P; Doucette S; Theriault C; Abianui A; Carrier M; Kovacs MJ; Rodger MA; Coyle D; Wells PS; Vendittoli PA
Dirección:From the Departments of Medicine (D.R.A.), Surgery (M.D.), and Community Health and Epidemiology (P.A.), Dalhousie University, and the Nova Scotia Health Authority (S. Pleasance, S. Doucette, C.T., A.A.), Halifax, the Department of Surgery, University of Toronto, Toronto (J.M.), the Departments of M
Título:Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty.
Fuente:N Engl J Med; 378(8):699-707, 2018 02 22.
ISSN:1533-4406
País de publicación:United States
Idioma:eng
Resumen:BACKGROUND: Clinical trials and meta-analyses have suggested that aspirin may be effective for the prevention of venous thromboembolism (proximal deep-vein thrombosis or pulmonary embolism) after total hip or total knee arthroplasty, but comparisons with direct oral anticoagulants are lacking for prophylaxis beyond hospital discharge. METHODS: We performed a multicenter, double-blind, randomized, controlled trial involving patients who were undergoing total hip or knee arthroplasty. All the patients received once-daily oral rivaroxaban (10 mg) until postoperative day 5 and then were randomly assigned to continue rivaroxaban or switch to aspirin (81 mg daily) for an additional 9 days after total knee arthroplasty or for 30 days after total hip arthroplasty. Patients were followed for 90 days for symptomatic venous thromboembolism (the primary effectiveness outcome) and bleeding complications, including major or clinically relevant nonmajor bleeding (the primary safety outcome). RESULTS: A total of 3424 patients (1804 undergoing total hip arthroplasty and 1620 undergoing total knee arthroplasty) were enrolled in the trial. Venous thromboembolism occurred in 11 of 1707 patients (0.64%) in the aspirin group and in 12 of 1717 patients (0.70%) in the rivaroxaban group (difference, 0.06 percentage points; 95% confidence interval [CI], -0.55 to 0.66; P<0.001 for noninferiority and P=0.84 for superiority). Major bleeding complications occurred in 8 patients (0.47%) in the aspirin group and in 5 (0.29%) in the rivaroxaban group (difference, 0.18 percentage points; 95% CI, -0.65 to 0.29; P=0.42). Clinically important bleeding occurred in 22 patients (1.29%) in the aspirin group and in 17 (0.99%) in the rivaroxaban group (difference, 0.30 percentage points; 95% CI, -1.07 to 0.47; P=0.43). CONCLUSIONS: Among patients who received 5 days of rivaroxaban prophylaxis after total hip or total knee arthroplasty, extended prophylaxis with aspirin was not significantly different from rivaroxaban in the prevention of symptomatic venous thromboembolism. (Funded by the Canadian Institutes of Health Research; ClinicalTrials.gov number, NCT01720108 .).
Tipo de publicación:EQUIVALENCE TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
Nombre de substancia:0 (Factor Xa Inhibitors); 0 (Platelet Aggregation Inhibitors); 9NDF7JZ4M3 (Rivaroxaban); R16CO5Y76E (Aspirin)


  3 / 3385 MEDLINE  
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PMID:29443673
Autor:Hirsh J; Ginsberg JS
Dirección:From the Department of Medicine, McMaster University, Hamilton, ON, Canada.
Título:Edoxaban for the Treatment of Venous Thromboembolism in Patients with Cancer.
Fuente:N Engl J Med; 378(7):673-674, 2018 02 15.
ISSN:1533-4406
País de publicación:United States
Idioma:eng
Tipo de publicación:EDITORIAL; COMMENT
Nombre de substancia:0 (Anticoagulants); 0 (Factor Xa Inhibitors); 0 (Pyridines); 0 (Thiazoles); NDU3J18APO (edoxaban)


  4 / 3385 MEDLINE  
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PMID:29381951
Autor:Wong CK; Chan PH; Lam CC; Kwok OH; Lam YY; Siu CW
Dirección:Cardiology Division, Department of Medicine, The University of Hong Kong.
Título:WATCHMAN device-related thrombus successfully treated with apixaban: A case report.
Fuente:Medicine (Baltimore); 96(47):e8693, 2017 Nov.
ISSN:1536-5964
País de publicación:United States
Idioma:eng
Resumen:RATIONALE: Among atrial fibrillation patients with high risk of bleeding, left atrial appendage occlusion has emerged as an alternative to long-term oral anticoagulation therapy for stroke prevention. Device-related thrombus remains a major concern because it may result in recurrent embolic events. To date, there is no consensus on the optimal method of treating device-related-thrombus. PATIENT CONCERNS: A 78-year-old man with atrial fibrillation had an episode of intracranial hemorrhage while taking warfarin. He subsequently underwent percutaneous placement of a 30-mm Watchman device to the left atrial appendage. He was prescribed dual anti-platelet therapy with aspirin and clopidogrel. DIAGNOSIS: Reassessment echocardiography 3 months later found device-related thrombus. INTERVENTIONS: The antithrombotic regimen was switched from dual antiplatelet therapy to apixaban. OUTCOMES: Reassessment echocardiography 3 months later revealed complete resolution of the device-related thrombus. Apixaban was stopped. He had dual antiplatelet therapy for 6 more months followed by life-long aspirin. There was no bleeding complication since implantation of Watchman device. LESSONS: We demonstrated successful treatment of device-related thrombus with a short course of apixaban with complete resolution of thrombus. Further randomized controlled trials are required to determine the choice and duration of drug therapy for device-related thrombus.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
Nombre de substancia:0 (Anticoagulants); 0 (Factor Xa Inhibitors); 0 (Pyrazoles); 0 (Pyridones); 3Z9Y7UWC1J (apixaban); A74586SNO7 (clopidogrel); OM90ZUW7M1 (Ticlopidine); R16CO5Y76E (Aspirin)


  5 / 3385 MEDLINE  
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PMID:29216619
Autor:Kirkham K; Munson JM; McCluskey SV; Graner KK
Dirección:Mayo Clinic Rochester, Rochester, Minnesota. kirkham.kylian@mayo.edu.
Título:Stability of Dalteparin 1,000 Unit/mL in 0.9% Sodium Chloride for Injection in Polypropylene Syringes.
Fuente:Int J Pharm Compd; 21(5):426-429, 2017 Sep-Oct.
ISSN:1092-4221
País de publicación:United States
Idioma:eng
Resumen:The stability of dalteparin 1,000 units/mL in 0.9% sodium chloride for injection stored in polypropylene syringes under refrigeration was examined. Dalteparin 1,000-units/mL syringes were prepared by adding 9 mL of 0.9% sodium chloride for injection to 1 mL of dalteparin sodium 10,000 unit/mL from commercial single-use syringes. Compounded solutions in 0.5-mL aliquots were transferred to 1-mL polypropylene syringes and sealed with a Luer lock tip cap and stored at refrigerated temperatures (2°C to 8°C) with ambient fluorescent light exposure. Syringes from three batches of dalteparin 1,000 units/mL were potency tested in duplicate by a stability-indicating high-performance liquid chromatography assay using a 0.5-mL sample at specified intervals. Visual and pH testing were performed on each batch. Samples were visually inspected for container integrity, color, and clarity. Samples for pH testing were prepared using a 1:1 dilution of dalteparin 1,000 units/mL in sterile water for injection and underwent duplicate analysis at each time point. High-performance liquid chromatography analyses showed a remaining percent of the initial dalteparin content at day 30 of 94.88% ± 2.11%. Samples remained colorless and clear with no signs of container compromise and no visual particulate matter at each time point. Throughout the 30-day study period, pH values remained within 0.3-pH units from the initial value of 5.84. Dalteparin 1,000 unit/mL in 0.9% sodium chloride for injection, packaged in 1-mL polypropylene syringes was stable for at least 30 days while stored at refrigerated conditions with ambient fluorescent light exposure.
Tipo de publicación:JOURNAL ARTICLE
Nombre de substancia:0 (Factor Xa Inhibitors); 0 (Polypropylenes); 451W47IQ8X (Sodium Chloride); S79O08V79F (Dalteparin)


  6 / 3385 MEDLINE  
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PMID:29199435
Autor:Bereczky Z; Oláh Z; Ajzner É; Kappelmayer J
Dirección:Klinikai Laboratóriumi Kutató Tanszék, Debreceni Egyetem, Általános Orvostudományi Kar Debrecen.
Título:[Laboratory aspects of novel oral anticoagulant treatment].
Título:Az új orális antikoagulánsokkal történo kezelés laboratóriumi vonatkozásai..
Fuente:Orv Hetil; 158(49):1930-1945, 2017 Dec.
ISSN:0030-6002
País de publicación:Hungary
Idioma:hun
Resumen:The introduction of novel oral anticoagulants (NOAC) have long been expected drugs and they quickly became used widespread as their clinical effectiveness was as good as, or even better than the previously used only oral anticoagulant drug, the coumarins. Thus, the direct thrombin inhibitor dabigatran and the activated factor X inhibitors (rivaroxaban, apixaban, edoxaban) have become the part of daily therapeutic practice. Their permeation was facilitated by the guideline which suggested that no laboratory monitoring was required during NOAC treatment and this was very convenient for both patients and doctors. The clinical experience obtained in the past years, however have proved that the 'one size fits all' view is oversimplified and there are numerous situations when the determination NOAC levels is unavoidable or highly recommended. This review discusses the laboratory aspects of NOAC treatment, primarily summarizing their effect on the screening tests and special assays of hemostasis and we also describe the correct methods to determine their plasma concentrations. Orv Hetil. 2017; 158(49): 1930-1945.
Tipo de publicación:JOURNAL ARTICLE; REVIEW
Nombre de substancia:0 (Anticoagulants); 0 (Factor Xa Inhibitors); I0VM4M70GC (Dabigatran)


  7 / 3385 MEDLINE  
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PMID:29390574
Autor:Rota E; Bruzzone G; Agosti S; Pastorino R; Morelli N
Dirección:Neurology Unit.
Título:A case report of parenchymal hematoma after intravenous thrombolysis in a rivaroxaban-treated patient: Is it a true rivaroxaban hemorrhagic complication?
Fuente:Medicine (Baltimore); 96(51):e9435, 2017 Dec.
ISSN:1536-5964
País de publicación:United States
Idioma:eng
Resumen:RATIONALE: To date, the only treatment approved for acute ischemic strokes is thrombolysis. Whether intravenous thrombolysis may be safe in patients taking direct oral anticoagulants (DOACs) is currently a matter of debate. PATIENT CONCERNS: A 74-year-old woman, who was on rivaroxaban 20 mg/d for nonvalvular atrial fibrillation, was admitted to our stroke unit with left-sided hemiparesis and aphasia. The onset of neurologic deficits had occurred 5 hours after the last rivaroxaban dose. DIAGNOSIS: An acute ischemic stroke was diagnosed. INTERVENTIONS: The patient was administered thrombolytic treatment with intravenous recombinant tissue plasminogen activator (r-TPA) 3 hours and 20 minutes after symptoms onset. Seven hours post-r-TPA treatment, the neurological deficit had worsened, and a type I intraparenchymal hematoma was detected on a computed tomography brain scan. OUTCOMES: The clinical/neuroradiological picture improved significantly in the following days. The patient was discharged to a rehabilitation facility after 3 weeks. LESSONS: In this case, factor ten activated (Xa) inhibitor, rivaroxaban might have increased the risk of hemorrhagic transformation of the ischemic stroke. However, this risk was overweighed by the benefit of thrombolysis, as the patient's clinical condition had improved significantly in the following weeks. The current guidelines discourage the use of thrombolytic treatment in patients with DOACs administered within the last 24(48) hours. However, the case reported herein and other world experiences, even though limited, suggest that an ongoing DOAC medication could no longer be considered a barrier to r-TPA treatment which may be a reasonable and valuable option, at least in selected acute stroke patients taking factor Xa inhibitors.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
Nombre de substancia:0 (Factor Xa Inhibitors); 0 (Recombinant Proteins); 9NDF7JZ4M3 (Rivaroxaban); EC 3.4.21.68 (Tissue Plasminogen Activator)


  8 / 3385 MEDLINE  
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PMID:29369185
Autor:Sun H; Zhao Q; Wang Y; Lakin R; Feng H; Fan X; Luo H; Gao D; Liu L; He Y; Yang P
Dirección:Cardiology Department.
Título:Daily 10 mg rivaroxaban as a therapy for ventricular thrombus related to left ventricular non-compaction cardiomyopathy: A case report.
Fuente:Medicine (Baltimore); 97(4):e9670, 2018 Jan.
ISSN:1536-5964
País de publicación:United States
Idioma:eng
Resumen:RATIONALE: Left ventricular non-compaction cardiomyopathy (LVNC) is a rare heart disorder related to thrombosis. Anticoagulant therapy is suggested for the treatment of this disease. The success of the novel oral anticoagulant rivaroxaban as a treatment option for this disorder is unclear. PATIENT CONCERNS: A 43-year-old man who felt dizzy at rest was found to have an intraventricular thrombus. DIAGNOSES: The thrombus was confirmed by echocardiography. And LVNC was diagnosed by cardiac magnetic resonance (CMR) and echocardiography. INTERVENTIONS: He was prescribed a low dose (10 mg daily) of rivaroxaban as treatment. OUTCOMES: After 3 months, the thrombus diminished, and the manifestation disappeared. LESSONS: Low dose of rivaroxaban may serve as a viable option for anticoagulation therapy in LVNC patients, with large clinical trials needed to determine the best course of treatment.
Tipo de publicación:CASE REPORTS; JOURNAL ARTICLE
Nombre de substancia:0 (Factor Xa Inhibitors); 9NDF7JZ4M3 (Rivaroxaban)


  9 / 3385 MEDLINE  
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PMID:29279522
Autor:Wakakura S; Hara F; Fujino T; Hamai A; Ohara H; Kabuki T; Harada M; Ikeda T
Dirección:Department of Cardiovascular Medicine, Toho University Faculty of Medicine.
Título:Comparison of Direct Oral Anticoagulants and Warfarin in the Treatment of Deep Venous Thrombosis in the Chronic Phase.
Fuente:Int Heart J; 59(1):126-135, 2018 Jan 27.
ISSN:1349-3299
País de publicación:Japan
Idioma:eng
Resumen:We assessed the efficacy and safety of direct oral anticoagulants (DOACs) for the treatment of deep venous thrombosis (DVT) in the chronic phase through comparison with conventional warfarin therapy.A total of 807 consecutive patients who were diagnosed with having DVT in the chronic phase were included (484 patients to warfarin therapy and 323 patients to DOAC therapy). The condition of leg veins was assessed 3 to 6 months after starting the therapies by ultrasound examination. Major bleeding and mortality during the therapies were followed-up.There was no significant difference between the two groups in the thrombosis improvement rate (DOAC group: 91.2% versus warfarin group: 88.9%). There was no significant difference between the two groups in major bleeding (DOAC group: 1.8% versus warfarin group: 1.8%). In patients with active cancer, the DOAC group had a borderline higher thrombosis improvement rate than the warfarin group (92.1% versus 80.0%, P = 0.05). The proportion of major bleeding in the patients with active cancer was slightly higher in the warfarin group than in the DOAC group (4.3% versus 2.8%; P = 0.71). Active cancer was not an independent risk factor for major bleeding and recurrence in the DOAC group (OR 2.68, 95% CI 0.51-14.1; P = 0.24 and OR 0.65, 95% CI 0.20-2.07; P = 0.47).In treatment using oral anticoagulants for DVT in the chronic phase, DOACs exhibited equal efficacy and safety as warfarin did. Particularly DOACs appear to be an attractive therapeutic option for cancer-associated DVT in chronic phase, with relatively low anticipated rates of recurrence and major bleeding.
Tipo de publicación:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
Nombre de substancia:0 (Anticoagulants); 0 (Antithrombins); 0 (Factor Xa Inhibitors); 0 (Pyrazoles); 0 (Pyridines); 0 (Pyridones); 0 (Thiazoles); 3Z9Y7UWC1J (apixaban); 5Q7ZVV76EI (Warfarin); I0VM4M70GC (Dabigatran); NDU3J18APO (edoxaban)


  10 / 3385 MEDLINE  
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PMID:29372980
Autor:Cahill TJ; Wijesurendra RS; Casadei B
Dirección:University of Oxford, Oxford, United Kingdom
Título:Rivaroxaban in Stable Cardiovascular Disease.
Fuente:N Engl J Med; 378(4):397, 2018 01 25.
ISSN:1533-4406
País de publicación:United States
Idioma:eng
Tipo de publicación:LETTER; COMMENT
Nombre de substancia:0 (Anticoagulants); 0 (Factor Xa Inhibitors); 9NDF7JZ4M3 (Rivaroxaban)



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