Use Of Oral Anticoagulant Drugs Research Articles

Prognosis Comparison of Use of Oral Anticoagulants and Vitamin K Antagonists in Patients with Intracerebral Hemorrhage

This study reviewed the literature on the incidence of Intracerebral Hemorrhage (ICH) associated with the use of oral anticoagulant drugs (OAC) and vitamin K antagonists (VKA), then compared the outcomes of using these drugs in terms of mortality, morbidity or prognosis in patients. We did a search on online databases including Pubmed, Google Scholar and Science Direct according to the specified keywords. The results obtained amounted to 935 articles. From these articles, the types of research that met the inclusion and exclusion criteria were then re-screened and the final search results were obtained as many as 10 articles. The results of this study found that of the 10 articles reviewed, 8 of them showed p value > 0.05 so that there was no significant difference between the outcomes of ICH related to OAC or VKA, where outcomes were viewed from the factors of bleeding widening, ICH volume, mortality, and functional impact. Meanwhile, from 2 articles that showed significant results, it was stated that the prognosis of the incidence of ICH related to the use of OAC was better than the use of VKA. Research on ICH, research on original article types, according to predetermined keywords, is a publication in the period 2012-2022, human studies and articles can be accessed.

Distribution of ischemic strokes in patients with atrial fibrillation: The FibStroke Study.

We aimed to determine the relative frequency of affected cerebrovascular territories in patients with atrial fibrillation (AF) suffering an ischemic stroke. Altogether, 1,976 patients who suffered their first-ever ischemic stroke during 2003-2012 and were diagnosed with AF either before or within 30 days after the event were included in this retrospective multicenter cohort study. Strokes were classified radiographically to be located either within the anterior or the posterior cerebrovascular territory, and the effect of the CHA2DS2-VASc score, oral anticoagulant (OAC) use, and timing of AF diagnosis on lesion localization was determined. The median age of the patients was 78.4 (interquartile range: 71.7-84.2) years, 1,137 (57.5%) of them were women, their mean CHA2DS2-VASc score was 3.5 (95% confidence interval: 3.4-3.5), 656 (33.2%) were receiving OAC drugs, and altogether, 1,450 (73%) had a previous AF diagnosis. The localization of ischemic lesions between the anterior and the posterior cerebrovascular territories was not affected by the timing of AF diagnosis (p = 0.46), use of OACs (p = 0.70), or the CHA2DS2-VASc score (p = 0.10). Within the anterior territory, altogether 774 strokes (53.2%) were located in the left hemisphere and 3 (0.2%) were bilateral. The timing of AF diagnosis (p = 0.84), use of OACs (p = 0.90), or the CHA2DS2-VASc score (p = 0.21) did not affect the location of the ischemic lesion between the hemispheres. The timing of AF diagnosis, use of OAC drugs, or the CHA2DS2-VASc score did not affect the distribution of ischemic strokes. Anterior territory strokes were slightly more often located within the left hemisphere.

Use of oral anticoagulant drugs is associated with carotid intraplaque hemorrhage in atherosclerosis patients: a meta-analysis.

Patients with carotid atherosclerosis, especially the elderly population, take antithrombotic medicine regularly. However, no previous meta-analysis has focused on one of the possible side effects of such drugs, namely intraplaque hemorrhage (IPH). To determine whether antiplatelet drugs or anticoagulants are associated with an increased risk of carotid IPH. We searched Pubmed, Embase, Ovid MEDLINE, Cochrane Library for relevant studies that were published in English, from January 1st, 1989 to January 1st, 2019. We pooled the odds ratio (OR) with 95% confidence interval (CI) from individual studies and conducted quality assessment, heterogeneity, publication bias analysis and sensitivity analysis. A total of four cross-sectional studies, involving 2714 participants with carotid atherosclerotic plaques was included into this meta-analysis. We found a significant association between the use of anticoagulants and higher risk of carotid IPH (OR 1.95; 95% CI 1.16-3.30, P = 0.92; I2 = 0). No significant association was found between the use of antiplatelet drugs and increased risk of carotid IPH (OR 1.34; 95% CI 0.68-2.61, P = 0.03; I2 = 65%). Our meta-analysis reveals that it is the use of oral anticoagulants rather than antiplatelet drugs that may be associated with an increased risk of carotid IPH in atherosclerosis patients.

P3475Relationship between age and use of oral anticoagulant drugs in european atrial fibrillation patients: the EORP-AF general long-term registry

P3475Relationship between age and use of oral anticoagulant drugs in european atrial fibrillation patients: the EORP-AF general long-term registry

Cerebrovascular disease, associated risk factors and antithrombotic therapy in a population screening cohort: Insights from the Belgian Heart Rhythm Week programme.

Background Cerebrovascular disease confers a major healthcare burden worldwide and is a major cause of death and disability. Several well-established risk factors, such as atrial fibrillation (AF), are associated with cerebrovascular disease and antithrombotic therapy reduces risk. Design This study was a subgroup analysis from the Belgian Heart Rhythm Week, a nationwide AF awareness programme. Methods We studied subjects screened between 2012 and 2014 with available data on clinical risk factors and antithrombotic treatment. Results Of the 38,034 subjects eligible for this analysis, 1513 (4.0%) reported a positive clinical history for cerebrovascular disease. Logistic regression analysis found that age, hypertension, diabetes mellitus, history of vascular disease, history of heart failure and history of AF (all p < 0.001) were independently associated with cerebrovascular disease. Among subjects with history of cerebrovascular disease and AF, 1.7% were taking oral anticoagulant drugs only, while both oral anticoagulant drugs and aspirin were used in 61.5% of subjects, aspirin in 4.3% of patients and no antithrombotic therapy in 32.5% of subjects. Among those subjects without AF, the corresponding figures were 0.8, 9.5, 2.0 and 87.6%, respectively. Conclusions The prevalence of cerebrovascular disease in this contemporary population screening project was higher than that reported in the general population and was associated with the major known stroke risk factors. Sub-optimal antithrombotic therapy management was evident, with a low use of oral anticoagulant drugs among patients with AF and a low use of aspirin among subjects without AF.

Treatment with oral anticoagulant drugs restrained from patients with atrial fibrillation: An assessment in a geographically well-defined catchment area.

Atrial fibrillation (AF) affects about 3.2% of the adult population in the western world and incurs an annual stroke risk of 4.5%. The use of oral anticoagulant (OAC) drugs significantly reduces this risk. OAC drugs seem to be under-utilized, but little is known about why their use is restrained in routine clinical management. The aim of this study was to assess this issue and, from these data, to estimate the proportion of patients with AF in a general population who were eligible for treatment with OAC drugs. Retrospective study of medical records. The study included all identified patients with AF in a well-defined catchment area of 65,532 people, among whom 1616 (3.2%) had documented AF. Of the patients with AF, 588 (36%) were originally reported not to be receiving OAC drugs. The patient-responsible physicians (n = 24) were requested to complete a standardized questionnaire to assess the reason for restraining the use of OAC drugs for each individual patient. Of the 588 patients originally reported not to be receiving OAC drugs, eight were shown to be using OAC drugs and seven were lost to follow up. Thus the reason for restraining OAC drugs was finally assessed in 573 patients. The primary reasons were: lack of indication, 26%; declined general condition, 14%; a history of bleeding, 12%; assumed poor compliance, 11%; repeated falls, 6%; and reason unknown, 9%. This is, to our knowledge, the first study to assess the reasons for restraining the use of OAC drugs in a geographically well-defined population including all hospital-based and non-hospital-based healthcare. Applying CHA2DS2-VASc and new strategies for OAC drugs to our study data indicated that between 72 and 88% of all patients with AF are eligible for treatment with OAC drugs.

Anticoagulation management in nonvalvular atrial fibrillation: current and future directions

Oral anticoagulant therapy, either with vitamin K antagonists (VKAs) or with novel oral anticoagulants such as dabigatran, rivaroxaban, and apixaban, is the mainstay for thromboprophylaxis in patients with atrial fibrillation (AF). Thromboembolic risk factors associated with AF and risk factors for bleeding associated with oral anticoagulant therapy are largely the same, and bleeding risk very rarely outweighs individual benefit of thrombosis prevention, thus resulting in positive net clinical benefit of oral anticoagulant therapy in almost all AF patients. Prevention of AF‑related thromboembolic events most commonly requires long‑term oral anticoagulant therapy. Over time, various clinical situations may occur in a given patient (e.g., a need for an urgent surgery or invasive intervention, acute stroke, etc.), which may require a temporary or permanent modification of anticoagulant therapy regardless of which anticoagulant drug has been used. This may be particularly challenging for physicians because many issues regarding optimal use of oral anticoagulant drugs in specific clinical situations still remain to be solved. In this review article, we discuss the periprocedural management of oral anticoagulant therapy, bridging, transition to another oral anticoagulant, the occurrence of acute stroke in a patient already taking an oral anticoagulant, and decision when it is safe to resume oral anticoagulation therapy after stroke. We summarize the available evidence and current (and future) approaches to oral anticoagulation management in such clinical situations.

Trombo pedunculado ao nível da transição entre a aorta ascendente e o arco aórtico

A 52-year-old male alcoholic patient with hypertension and a prior history of brain ischemia was admitted to the neurosurgery department with signs and symptoms of ischemic stroke. A transesophageal echocardiogram and computed tomography suggested a possible pedunculated thrombus at the transition of the ascending aorta to the aortic arch. The therapeutic option was surgical treatment using cardiopulmonary bypass, deep hyperthermia and total cardiac arrest. The procedure involved resection of the aortic wall together with the thrombus to avoid recurrence. There were no adverse consequences and the patient was released from hospital with the use of oral anticoagulant drugs.

Anticoagulación oral para la prevención secundaria del ictus isquémico

This review considers secondary prevention of ictus based on the use of oral anticoagulant drugs. For this, we analyze separately the secondary preventive aspects of the two most frequent ischemic aetiologies: cardioembolic and atherothrombotic infarcts.