POSSIBILITIES OF USING EDOXABAN IN STROKE PREVENTION IN PATIENTS WITH ATRIAL FIBRILLATION

Vestnik ◽  
2021 ◽  
pp. 62-67
Author(s):  
Н.Е. Айдаргалиева ◽  
А.О. Доскулова ◽  
Ж.C. Шерияздан ◽  
М.Е. Рамазанов
Keyword(s):  
Atrial Fibrillation ◽  
Evidence Based Medicine ◽  
Stroke Prevention ◽  
Factor Xa ◽  
Evidence Based ◽  
Factor Xa Inhibitor ◽  
Percutaneous Coronary Interventions ◽  
Efficacy And Safety ◽  
Percutaneous Coronary ◽  
Based Medicine

Применение антикоагулянтов у пациентов с фибрилляцией предсердий (ФП) - краеугольный камень профилактики инсульта. Обзор включает современные данные доказательной медицины по эффективности и безопасности применения Эдоксабана - ингибитора Xa фактора - для предупреждения инсульта при ФП, включая больных с чрескожными коронарными вмешательствами. The use of anticoagulants in patients with atrial fibrillation (AF) is the cornerstone of stroke prevention. The review includes modern evidence-based medicine data on the efficacy and safety of the use of Edoxaban, a factor Xa inhibitor, for the prevention of stroke in AF, including in patients with percutaneous coronary interventions.

scholarly journals Electronic Record Linkage cohort study of evidence-based management and outcomes in patients with ischaemic heart disease and atrial fibrillation

2021 ◽  
Author(s):  
◽  
Edward Daniel Harris
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Evidence Based Medicine ◽  
Lipid Lowering ◽  
Evidence Based ◽  
Lipid Lowering Therapy ◽  
Lipid Levels ◽  
Increased Risk ◽  
Based Medicine

BACKGROUND Implementation of evidence-based medicine is often suboptimal. The objectives of this thesis are to explore the delivery of evidence-based medicine and outcomes in patients with ischaemic heart disease (IHD) and atrial fibrillation (AF). METHODS Retrospective observational cohort studies were conducted using linked anonymised data from the secure anonymised information linkage (SAIL) databank. Patients included (i) those undergoing percutaneous coronary intervention, (ii) patients prescribed vitamin K antagonist (VKA) for AF, and (iii) patients with AF who had undergone successful PCI. RESULTS Amongst patients directed to take clopidogrel for one-year post-PCI, discontinuation was far lower (~6%) than in previous studies where the treatment duration was not known. Despite this, early discontinuation and/or bleeding was associated with an increased risk of adverse events. In a national cohort of PCI patients, we observed a low rate of achievement of international guideline target lipid levels (<25%) and low prescribing of intensive lipid lowering therapy amongst those not at target. Females and patients who had undergone elective PCI were least likely to have their lipid levels documented and be at target. In patients prescribed VKA for AF guideline defined poor anticoagulation control was common and associated with significantly higher bleeding event rates, independent of common comorbidities that are recognised as risk factors for stroke and bleeding. In patients with AF who had undergone PCI outcomes were poor: approximately 1 in 5 had either a stroke, acute coronary syndrome (ACS) or died in the year follow-up. Bleeding events were also common and associated with a five, three and four-fold increased risk of stroke, ACS, and death. CONCLUSION This thesis has characterised the nature of multiple therapeutic gaps and associated adverse outcomes with common clinical conditions. Thus, identifying opportunities to improve outcomes in individual patients and at population level.

scholarly journals THE RESULTS OF A SURVEY OF SURGEONS ON THE SAFETY OF PHARMACOTHERAPY

2018 ◽  
Vol 25 (6) ◽  
pp. 127-134
Author(s):  
I. N. Ochakovskaya ◽  
V. M. Durleshter ◽  
O. G. Ni ◽  
N. E. Shabanova
Keyword(s):  
Decision Making ◽  
Medical Errors ◽  
Evidence Based Medicine ◽  
Deep Understanding ◽  
Perioperative Period ◽  
Evidence Based ◽  
Efficacy And Safety ◽  
Quality Of Medical Care ◽  
Based Medicine

Aim. The study was conducted to assess the level of awareness of surgeons about the principles of safe perioperative pharmacotherapy.Materials and methods. The survey of surgeons was conducted in 2018 on the basis of a questionnaire made by the authors, consisting of 60 questions and tasks, divided into 6 thematic blocks. The respondents had to demonstrate their knowledge both in the field of general principles of safe pharmacotherapy and private issues of using analgesics, anticoagulants, antibiotics in the perioperative period. The results of the survey were assessed as a percentage (proportion of correct answers) individually for each respondent and in total.Results. The results of the survey showed a lack of a deep understanding of the principles of safe pharmacotherapy in most clinical cases. Despite the fact that a number of answers completely correlated with the positions of evidence-based medicine, in general, there was a lack of systemic knowledge. The survey made it possible to identify those important points that should be first highlighted in the preparation of the training program. Conclusion. Every doctor should strive to minimize the preventable medical errors associated with pharmacotherapy. This is feasible only in the process of continuous daily learning. Practitioners' interest in the efficacy and safety of pharmacotherapy and mastering the basic decision-making algorithms for prescribing, controlling safety and cancelling drugs will improve the quality of medical care.

scholarly journals Scientific Research in Homeopathic Medicine: Validation, Methodology and Perspectives

2007 ◽  
Vol 4 (2) ◽  
pp. 271-273 ◽  
Author(s):  
Giuseppina Pitari
Keyword(s):  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Scientific Research ◽  
Medical Community ◽  
Evidence Based ◽  
Efficacy And Safety ◽  
Homeopathic Medicine ◽  
Full Immersion ◽  
Based Medicine

Verona's School of Homeopathic Medicine (www.omeopatia.org) organized a day of full immersion in the field of homeopathy, focusing on the validity of this much-debated discipline. There is widespread consensus in the medical community that evidence-based medicine is the best standard for assessing efficacy and safety of healthcare practices, and systematic reviews with strict protocols are essential to establish proof for various therapies. Students, homeopathic practitioners, academic and business representatives, who are interested in or curious about homeopathic practices attended the conference.

scholarly journals Developing Traditional Chinese Medicine in the Era of Evidence-Based Medicine: Current Evidences and Challenges

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Foon Yin Fung ◽  
Yeh Ching Linn
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Medical Practice ◽  
Evidence Based Medicine ◽  
Best Interests ◽  
Current Status ◽  
Evidence Based ◽  
Efficacy And Safety ◽  
Therapeutic Benefits ◽  
Based Medicine

Evidence-based medicine (EBM), by integrating individual clinical expertise with the best available clinical evidence from systematic research, has in recent years been established as the standard of modern medical practice for greater treatment efficacy and safety. Traditional Chinese Medicine (TCM), on the other hand, evolved as a system of medical practice from ancient China more than 2000 years ago based on empirical knowledge as well as theories and concepts which are yet to be mapped by scientific equivalents. Despite the expanding TCM usage and the recognition of its therapeutic benefits worldwide, the lack of robust evidence from the EBM perspective is hindering acceptance of TCM by the Western medicine community and its integration into mainstream healthcare. For TCM to become an integral component of the healthcare system so that its benefits can be rationally harnessed in the best interests of patients, it is essential for TCM to demonstrate its efficacy and safety by high-level evidence in accordance with EBM, though much debate remains on the validity and feasibility of applying the EBM model on this traditional practice. This review aims to discuss the current status of research in TCM, explore the evidences available on its efficacy and safety, and highlight the issues and challenges faced in applying EBM to TCM.

scholarly journals Edoxaban in patients with atrial fibrillation

2016 ◽  
Vol 11 (3) ◽  
pp. 81-90 ◽  
Author(s):  
Alon Eisen ◽  
Christian T. Ruff
Keyword(s):  
Atrial Fibrillation ◽  
Factor Xa ◽  
Phase Iii ◽  
Factor Xa Inhibitor ◽  
Efficacy And Safety ◽  
Direct Factor ◽  
Nonvalvular Atrial Fibrillation ◽  
Preclinical Development ◽  
Phase Iii Trial ◽  
Prevention And Treatment

Edoxaban, a direct factor Xa inhibitor, was extensively studied in the prevention and treatment of venous thromboembolism and in patients with nonvalvular atrial fibrillation (AF). The aim of this review is to focus specifically on the efficacy and safety profile of edoxaban in patients with AF from preclinical development through the phase III trial that led to regulatory approval.

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