OUTCOMES OF PERIPROCEDURAL ANTICOAGULATION THERAPY WITH WARFARIN VERSUS NEW ORAL ANTICOAGULANTS IN PATIENTS UNDERGOING CARDIAC IMPLANTABLE ELECTRONIC DEVICE PLACEMENT

Anticoagulation therapy is mandatory in patients with pulmonary embolism to prevent significant morbidity and mortality. The mainstay of therapy has been vitamin-K antagonist therapy bridged with parenteral anticoagulants. The recent approval of new oral anticoagulants (NOACs: apixaban, dabigatran, and rivaroxaban) has generated significant interest in their role in managing venous thromboembolism, especially pulmonary embolism due to their improved pharmacokinetic and pharmacodynamic profiles, predictable anticoagulant response, and lack of required efficacy monitoring. This paper addresses the available literature, on-going clinical trials, highlights critical points, and discusses potential advantages and disadvantages of the new oral anticoagulants in patients with pulmonary embolism.

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Perioperative management for the prevention of bacterial infection in cardiac implantable electronic device placement

Journal of Arrhythmia ◽

10.1016/j.joa.2015.06.007 ◽

2016 ◽

Vol 32 (4) ◽

pp. 283-286 ◽

Cited By ~ 6

Author(s):

Katsuhiko Imai

Keyword(s):

Bacterial Infection ◽

Perioperative Management ◽

Electronic Device ◽

Cardiac Implantable Electronic Device ◽

Device Placement

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Old and new oral anticoagulants for secondary stroke prevention in atrial fibrillation

Italian Journal of Medicine ◽

10.4081/itjm.2015.468 ◽

2015 ◽

Vol 9 (4) ◽

pp. 314

Author(s):

Tommaso Sacquegna ◽

Anna Zaniboni ◽

Andrea Rubboli ◽

Gaetano Procaccianti ◽

Michela Crisci ◽

...

Keyword(s):

Atrial Fibrillation ◽

Secondary Prevention ◽

Stroke Prevention ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Anticoagulation Therapy ◽

New Oral Anticoagulants ◽

Thrombin Inhibitors ◽

Direct Thrombin Inhibitors ◽

Significant Difference

Vitamin K antagonists, such as warfarin, used in oral anticoagulation therapy currently represent the standard drugs for the primary and secondary prevention of stroke in non-valvular atrial fibrillation (AF), with a relative risk reduction close to 70%. Newer oral anticoagulants, such as direct thrombin inhibitors (<em>i.e</em>., dabigatran) and direct factor Xa inhibitors (<em>i.e</em>., apixaban and rivaroxaban) have been recently compared with warfarin in large randomized trials for stroke prevention in AF. The new oral anticoagulants showed, compared with warfarin, no statistically significant difference in the rate of stroke or systemic embolism in secondary prevention (patients with previous transient ischemic attack or stroke) subgroups. With regard to safety, the risk of intracranial bleeding was reduced with new anticoagulants compared with warfarin. Indirect treatment comparisons of clinical trials on secondary prevention cohorts showed no significant difference in efficacy among apixaban, rivaroxaban, and dabigatran; but dabigatran 110 mg was associated with less intracranial bleedings than rivaroxaban.

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