35 related results for anticoagulation


NOACs confer lower bleeding risk than VKA in low-risk AF patients

Literature 21-6-2017 • Lip GYH et al., JAMA Cardiol. 2017
In AF patients with a single non-gender-related stroke risk factor, the risk of any bleeding was lower for apixaban and dabigatran compared with warfarin, while no difference in stroke prevention was seen.

FORTA classifies all DOACs and warfarin as beneficial for older AF patients

Literature 17-5-2017 • Wehling M, et al, Drugs & Aging 2017
Based on FORTA classification, all DOACs and warfarin were classified as beneficial or very beneficial for older AF patients, while there was lack of evidence for other vitamin K antagonists.

Doubled risk of acute MI in real world AF patients receiving DOACs or aspirin vs. VKA

Literature 11-4-2017 • Stolk LM et al., Br J Clin P harmacol 2017
Analysis of new users of rivaroxaban or dabigatran, aspirin and VKAs in CPRD reveals a two-fold increased risk of AMI in current users of DOAC or aspirin, as compared with VKA.

Undercoagulation was common in AF patients who suffered from stroke and impacts outcome

Literature 5-4-2017 • Xian Y et L., JAMA. 2017
In a contemporary registry, 84% of patients with a history of AF received no or subtherapeutic anticoagulation, which affected severity of stroke and in-hospital mortality.

Reduced doses NOAC show similar efficacy and bleeding risk but possibly higher mortality risk

Literature 20-2-2017 • Nielsen PB et al., BMJ. 2017
Real-world data show lower dose NOACs associated with similar risk of thromboembolic events and similar or lower rates of bleeding as compared with warfarin in AF, but mortality risk seems higher with NOACs.

Lower risk of liver injury hospitalisation with DOACs as compared to warfarin

Literature 10-1-2017 • Alonso A et al., Heart. 2017
Dabigatran, rivaroxaban and apixaban users were less often associated with liver injury hospitalisation compared to warfarin and several variables could predict this.

Frequency of off-label dosing of NOACs and its consequences

Literature 22-12-2016 • Steinberg BA et al., JACC 2016
Many AF patients on NOAC therapy do not receive recommended doses for stroke prevention, and are at increased risk for CV hospitalisation and all-cause mortality.

DOACs also beneficial for elderly AF and VTE patients

Literature 11-10-2016 • Sadlon AH, Swiss Med Wkly, 2016
Rivaroxaban, apixaban, dabigatran and edoxaban were superior to VKAs in a meta-analysis of 8 studies comprising elderly patients with atrial fibrillation or venous thromboembolism.

Real-world safety data show differences between anticoagulants in AF patients

Literature 23-8-2016 • Lip GYH et al., Thromb Haemost 2016
In a real-world observational study using propensity score matched cohorts, apixaban initiation was associated with significantly lower risk of major bleeding compared to warfarin and rivaroxaban.

Many AF patients inappropriately on aspirin monotherapy rather than on anticoagulation

Literature 1-7-2016 • Hsu JH et al., J Am Coll Cardiol 2016
Approximately one third of AF outpatients at moderate to high risk for stroke treated by a cardiovascular specialist, received aspirin monotherapy, in spite of the lack of data supporting this practice.

Using 5 or more drugs concomitantly increases risk for comorbidity and complications in AF

Literature 29-6-2016 • Jaspers Focks J et al., BMJ 2016
In the ARISTOTLE trial population, polypharmacy was common and associated with higher comorbidity, mortality, and higher event rates of thromboembolic complications and major bleeding.

EPCCS well represented at WONCA congress

News 28-6-2016
Representatives of the EPCCS board organised three well-attended sessions at WONCA Europe 2016 in Copenhagen, Denmark, covering topics ranging from heart failure to the pros and cons of statins.

Lower-risk AF patients also benefit from oral anticoagulation, new data show

Literature 9-6-2016 • Fauchier L et al., Stroke. 2016
Among AF patients with only 1 nongender-related stroke risk factor, OAC was associated with a positive net clinical benefit for the prevention of stroke and thromboembolic events.

Lower absolute number of bleeding events in the elderly with NOAC than with warfarin

Literature 1-6-2016 • Kato S et al., J Am Heart Assoc. 2016
In a pre-specified analysis from the ENGAGE AF-TIMI 48 trial, given the higher rates of bleeding in the elderly, a greater absolute reduction in safety events was seen with edoxaban as compared with warfarin than in younger patients.

Adherence to oral anticoagulation affects outcomes in AF patients at high stroke risk

Literature 29-2-2016 • Yao et al., J Am Heart Assoc. 2016
In patients with atrial fibrillation, adherence to oral anticoagulation for stroke prevention was modestly improved by the use of NOACs, which impacts mainly the outcomes of high-risk patients.

High risk elderly AF patients benefit from good quality anticoagulation control

Literature 21-10-2015 • Senoo K and Lip GYH, Stroke 2015
Elderly patients are at high risk of CV death and stroke/systemic embolism, but age does not increase risk of any clinically relevant bleeding. High TTR negatively correlated with adverse outcomes.

German AFNET and EHRA lay out roadmap to improve AF management

News 19-10-2015
Many people have undiagnosed and therefore untreated AF, associated with high risk of strokes and death. AFNET and EHRA composed recommendations aimed to improve AF diagnosis and treatment.

Preventing thrombotic events and stroke

Slides 2-10-2015
Downloadable slides prepared and presented by Prof Hans Christof Diener, at EPCSS 2015.

Next step on the way to approval of first antidote to anticoagulant effect of NOAC

News 28-9-2015
Following accelerated assessment, EMAs CHMP recommends granting a marketing authorisation for idarucizumab, a reversal agent for dabigatran, given its potential to respond to an unmet medical need.

Consensus paper on arrhythmia management from a patient preference perspective

News 25-6-2015
European and international experts reviewed the evidence on patient values and preferences in the management of cardiac tachyarrhythmias and advise on best practice.

Anticoagulant edoxaban receives positive CHMP opinion for management of atrial fibrillation and venous thromboembolism

News 26-4-2015
CHMP recommends for direct inhibitor of factor Xa edoxaban to be granted marketing authorisation for prevention of stroke and systemic embolism in AF and the prevention and treatment of VTE.

CHADS2 and CHA2DS2-VASc risk scoring tools

Curriculum slides
These risk assessment tools help to determine who should and who should not receive anticoagulation.

If anticoagulation and platelet inhibition is too strong for too long, risk of dementia increases

News 18-11-2014
AHA 2014 Patients with atrial fibrillation who had supratherapeutic INR >25% of the time, had a higher risk of dementia, possibly through brain damage due to microbleeds.

Antidote for Factor Xa inhibitor shows positive results in phase III study

News 6-10-2014
The first Phase 3 study of Factor Xa inhibitor antidote andexanet alfa, met its primary and secondary endpoints and shows well-tolerated and effective reversal of anticoagulation activity of apixaban.

Rivaroxaban also effective at reducing stroke in AF patients over 75 years

Literature 16-6-2014 • Halperin JL et al., Circulation 2014
Factor Xa inhibition is as effective as adjusted-dose warfarin to anticoagulate patients of over 75 years old with nonvalvular AF, tor the prevention of stroke and systemic embolism.

Time in therapeutic range does not affect treatment benefits of rivaroxaban vs. warfarin

Literature 28-4-2014 • Piccini JP, J Am Heart Assoc. 2014
A wide range of centre TTRs were seen in ROCKET-AF, but the relative efficacy of rivaroxaban over warfarin did not vary with cTTR, for stroke prevention in atrial fibrillation.

Higher bleeding risk even with brief use of NSAID or aspirin, when on anticoagulation

Literature 23-4-2014 • Davidson BL et al., JAMA Intern Med. 2014
A clinically important increase in bleedings was observed in patients treated for VTE, who are simultaneously using anticoagulation and NSAIDs or aspirin.

In patients with acute VTE, NOACs are equally effective, but with a more favourable bleeding profile than VKA

Literature 9-3-2014 • Van der Hulle T et al. J Thromb Haemost. 2013
Meta-analysis shows that NOACs are as effective in the prevention of recurrent VTE, and give a lower risk of most types of bleedings, in patients with acute VTE.

No increased risk of drug-induced liver injury with NOACs

Literature 5-2-2014 • Caldeira D et al. Heart. 2014
Meta-analysis of large NOAC RCTs shows that NOACs are not associated with elevations of transaminases over 3x ULN and bilirubin >2x ULN.

Antiplatelet therapy is still too often, inappropriately given in atrial fibrillation

Literature 29-1-2014 • Lip GYH et al. The American Journal of Medicine 2014
Improved use of oral anticoagulation in atrial fibrillation since last EuroHeart Survey, although antiplatelet therapy is still too often prescribed, specifically in the elderly.

Starting warfarin treatment gives a higher ischaemic stroke risk in the first 30 days

Literature 8-1-2014 • Azoulay et al. Eur Heart J. 2013
AF patients who start warfarin initially have a nearly two-fold increased risk of ischaemic stroke, but after 30 days this risk is lower than in patients not on antithrombotics.

Efficacy of dabigatran vs. warfarin in stroke prevention maintained with renal dysfunction

Literature 16-12-2013 • Hijazi et al., Circulation. Dec 2013
Generally, renal function did not affect the relative safety of dabigatran over warfarin, although estimation of eGFR with CKD-EPI showed a larger reduction of major bleeding risk when eGFR > 80 ml/min.

FDA grants investigational Factor Xa inhibitor antidote breakthrough therapy designation

News 26-11-2013
This FDA designation should expedite the development of andexanet alfa, which has been shown to quickly reverse the anticoagulant activity of Factor Xa inhibitors in phase 2 studies.

When does diagnosing heart arrhythmias matter?

Webcast EPCCS 2013, London
John Camm MD (London) discusses the risk of tromboembolism with atrial fibrillation, current scoring systems, guidelines and antitrombotic medication and anticoagulants.

HAS-BLED score better predicts major bleeding in anticoagulated AF patients

Literature 3-10-2013 • Roldán V, Marín F, Manzano-Fernández S et al.
The HAS-BLED score better predicts major bleeding than stroke stratification scores CHADS2 and CHA2DS2-VASc, in atrial fibrillation patients on anticoagulants.

Upcoming meetings

EPCCS Council Meeting December 6-7, 2017, Stratford Upon Avon, United Kingdom
10th EPCCS Annual CV Summit for Primary care March 15-16, 2018, Malaga, Spain
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Meeting reports & resources

EPCCS 2017 Report of the Cardiovascular Summit held in Dublin, Ireland
EPCCS Guidance Documents Evidence- and meeting-based guidance for primary care
EPCCS 2015 Report of 8th Annual EPCCS meeting held in Prague.
EPCCS 2014 Report of 7th Annual EPCCS meeting held in Brussels.
All meeting reports...