scholarly journals Choice of New Oral Anticoagulant Agents Versus Vitamin K Antagonists in Atrial Fibrillation

2015 ◽  
Vol 21 (2) ◽  
pp. 150-156 ◽  
Author(s):  
José Moreno-Arribas ◽  
Vicente Bertomeu-González ◽  
Manuel Anguita-Sanchez ◽  
Ángel Cequier ◽  
Javier Muñiz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Vitamin K Antagonists ◽  
Anticoagulant Agents ◽  
New Oral Anticoagulant

Which Patients Would Be Willing to Change Anticoagulation From Vitamin-K Antagonists to a New Oral Anticoagulant?

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4318-4318
Author(s):  
Job Harenberg ◽  
Svetlana Marx ◽  
Nadja Abou-Ayash ◽  
Christophe Kremer ◽  
Vera Hoeing ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Vitamin K ◽  
Logistic Regression Analysis ◽  
Oral Anticoagulant ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulant ◽  
Willingness To Change

Abstract Abstract 4318 New oral anticoagulants have generated promising data on the prophylaxis of systemic and non-systemic embolism in patients with atrial fibrillation and treatment of acute venous thromboembolism and prolonged prophylaxis of recurrent events. For patients on chronic treatment with vitamin-K antagonists (VKA) we analysed the motivation and willingness to change the anticoagulation from VKA to new oral anticoagulants. Patients (n=110) on stable treatment with VKA for at least 3 months (indication for anticoagulation: atrial fibrillation or VTE) completed a validated personality inventory (Freiburger Persönlichkeitsinventar FPI-R), and a self-developed questionnaire on general attitudes regarding anticoagulant therapy (Q1). Patients were divided in two groups according to the reply to the question weather they were willing to switch to a new oral anticoagulant. Out of these sets of questions 7 questions were identified by means of a logistic regression analysis for the willingness to change anticoagulation with VKA to a new oral anticoagulant. The same patients completed this shortened questionnaire (Q2) (n=85) thereafter. Logistic regression analysis defined the 7 items of the FPI and Q1 questionaires as relevant for willingness of patients to change the medication. The probability to change medication was 98% using the 7 questions (Q2) compared to the 2 comlete questionnaires. The items were: extraversion – introversion scale on the FPI-R consisting of 14 questions, and from Q1: hope for a better quality of life with a new anticoagulant, no scepticism for new drugs, wish of a lack of routine monitoring for dose adjustment, relevance of the practitioners opinion, thoughts in the past of alternatives for anticoagulation, and difficulty to adjust the prothrombin time. Using Q2 85% of patients confirmed to be willing to change the anticoagulant drug compared to Q1 (chi square test p<0.0001). Seven questions were identified and confirmed to identify patients for their willingness to change anticoagulation from VKA to a new oral anticoagulant. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Régi és új orális antikoagulánsok hazai alkalmazása pitvarfibrillációban

2017 ◽  
Vol 158 (39) ◽  
pp. 1545-1549
Author(s):  
János Tomcsányi ◽  
Balázs Salfer ◽  
Bence Nagy
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Real Life ◽  
Vitamin K Antagonist ◽  
Anticoagulant Treatment ◽  
Oral Anticoagulant Treatment ◽  
New Oral Anticoagulant ◽  
Method Analysis

Abstract: Introduction: Despite a progress in the management of patients with atrial fibrillation this arrhythmia is one of the major causes of stroke, heart failure, sudden death and cardiovascular morbidity. Oral anticoagulation with vitamin K antagonist or non-vitamin K antagonist markedly reduces stroke and mortality in atrial fibrillation patients. Aim: To estimate the real-life vitamin K antagonist and non-vitamin K antagonist oral anticoagulant treatment in past years in Hungary. Method: Analysis of the National Health Insurance Administation database for atrial fibrillation (BNO: I48) between 2010–2015. We assumed that AF patient would turn to health care provides at least once either as inpatients or outpatients in a 5-year period. The patient was accepted as adherent after 6 months therapy and at least 80% oral anticoagulant prescription. Results: The prevalence of AF in Hungary is 3%. The mortality rate of AF 7%–10% per year. The adherence of the old oral anticoagulant treatment was 55%, but it was 69% among patient treated by “new” oral anticoagulant treatment. However, one third of the patients are not treated by effective old or new oral anticoagulant treatment. Conclusions: We need more effort to improve the effective and high adherence oral anticoagulant therapy in our country. Orv Hetil. 2017; 158(39): 1545–1549.

Chronic kidney disease and anticoagulation: from vitamin K antagonists and heparins to direct oral anticoagulant agents

2017 ◽  
Vol 12 (8) ◽  
pp. 1101-1108 ◽  
Author(s):  
Savino Sciascia ◽  
Massimo Radin ◽  
Karen Schreiber ◽  
Roberta Fenoglio ◽  
Simone Baldovino ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Vitamin K Antagonists ◽  
Direct Oral Anticoagulant ◽  
Anticoagulant Agents

scholarly journals Az edoxabán véralvadásgátló hatásossága és biztonságossága nonvalvuláris pitvarfibrillációban

2018 ◽  
Vol 159 (12) ◽  
pp. 466-469
Author(s):  
Andrea Szegedi ◽  
Zoltán Csanádi
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Randomized Trials ◽  
Vitamin K Antagonists ◽  
Thromboembolic Events ◽  
Direct Oral Anticoagulant ◽  
Anticoagulant Drugs

Abstract: The significantly increased incidence of stroke and systemic embolisation caused by atrial fibrillation can be prevented by adequately adjusted anticoagulant therapy. Vitamin K antagonists effectively decrease the risk of thromboembolic events but this effect is influenced by many factors. The development of the new direct oral anticoagulant drugs (DOAC) in the last few years provided new opportunities for us to choose the suitable anticoagulant therapy. According to the results of the ENGAGE AF–TIMI 48 and ENSURE-AF multicenter, randomized trials, edoxaban, the recently introduced DOAC is equally effective as the traditional coumarin therapy, nevertheless, it ensures more tolerable anticoagulation for patients suffering from non-valvular atrial fibrillation. Orv Hetil. 2018; 159(12): 466–469.

Stroke Prevention by Anticoagulants in Daily Practice Depending on Atrial Fibrillation Pattern and Clinical Risk Factors

Stroke ◽  
2021 ◽  
Author(s):  
Lamiae Grimaldi-Bensouda ◽  
Jean-Yves Le Heuzey ◽  
Jean Ferrières ◽  
Didier Leys ◽  
Jean-Marc Davy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Vitamin K ◽  
Oral Anticoagulant ◽  
Hemorrhagic Stroke ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Clinical Risk Factors ◽  
Direct Oral Anticoagulant

Background and Purpose: The objective of the study was to assess the effectiveness of individual direct oral anticoagulants versus vitamin K antagonists for primary prevention of stroke (ischemic and hemorrhagic) in routine clinical practice in patients with various clinical risk factors depending on their atrial fibrillation (AF) patterns. Methods: A nested case-referent study was conducted using data from 2 national registries of patients with stroke and AF. Stroke cases with previous history of AF were matched to up to 2 randomly selected referent patients with AF and no stroke. The association of individual anticoagulant use with ischemic or hemorrhagic stroke was studied in patients with or without permanent AF using multivariable conditional logistic models, controlled for clinically significant risk factors and multiple other cardiovascular risk factors. Results: In total, 2586 stroke cases with previous AF and 4810 nonstroke referent patients with AF were retained for the study. Direct oral anticoagulant users had lower odds of stroke of any type than vitamin K antagonist users: the adjusted-matched OR for ischemic stroke were 0.70 (95% CI, 0.50–0.98) for dabigatran, 0.68 (95% CI, 0.53–0.86) for rivaroxaban, and 0.73 (95% CI, 0.52–1.02) for apixaban while for hemorrhagic stroke they were 0.31 (95% CI, 0.14–0.68), 0.64 (95% CI, 0.39–1.06), and 0.70 (95% CI, 0.33–1.49), respectively. The effects of individual direct oral anticoagulants relative to vitamin K antagonists were similar in permanent AF and nonpermanent AF patients. Conclusions: Similar results were observed for each direct oral anticoagulant in real life as those observed in the pivotal clinical trials. The pattern of AF did not affect the outcome.

New Anticoagulants as an Alternative to Aspirin in Atrial Fibrillation – Implications of the Apixaban versus Acetylsalicylic Acid to Prevent Strokes (AVERROES) Trial

2011 ◽  
Vol 7 (3) ◽  
pp. 196
Author(s):  
Raffaele De Caterina ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Acetylsalicylic Acid ◽  
Vitamin K ◽  
Vitamin K Antagonists ◽  
Coagulation Factor ◽  
Clinical Information ◽  
Short Review ◽  
Factor X ◽  
New Anticoagulants ◽  
New Oral Anticoagulant

Atrial fibrillation (AF) is an extremely common arrhythmia, substantially increasing the risk of stroke and thromboembolism. Prevention of stroke and thromboembolism is, therefore, an important part of AF management. Guidelines until now have recommended that patients with AF receive some form of antithrombotic therapy, either as a vitamin K antagonist or aspirin, with a preference for anticoagulants in most cases. However, such current treatments are suboptimal, and despite recommendations, many patients do not receive adequate thromboprophylaxis because they are considered, for various reasons, ‘unsuitable’ to receive a vitamin K antagonists. In this patient population, apixaban, a new oral anticoagulant inhibiting activated coagulation factor X (FXa), administered in fixed doses and without anticoagulation monitoring, has undergone testing against aspirin in the recently published Apixaban versus acetylsalicylic acid to prevent strokes (AVERROES) trial. This short review will briefly address the strengths and limitations of this trial and the practical relevance of this new clinical information.

Sign in / Sign up

Export Citation Format

Share Document