Review
Pharmacology & Pharmacy
Wenbing Hua, Zhengmei Huang, Zhuoli Huang
Summary: This systematic review found that patients receiving uninterrupted DOAC therapy may have a lower risk of bleeding after dental extraction. However, due to the limited quality of the evidence, the results should be interpreted with caution. Further studies with larger sample sizes are needed to support these conclusions.
FRONTIERS IN PHARMACOLOGY
(2021)
Review
Pharmacology & Pharmacy
Costas Thomopoulos, John Ntalakouras, Dimitris Polyzos, Dimitris Konstantinidis, Lina Palaiodimou, Georgios Tsivgoulis, Costas Tsioufis
Summary: This study conducted a meta-analysis of randomized trials to compare the efficacy and safety of low-dose DOACs and warfarin in preventing ischemic stroke and systemic embolism in patients with non-valvular Atrial Fibrillation. The results showed that low-dose DOACs had a more favorable net clinical benefit profile compared to warfarin.
PHARMACOLOGICAL RESEARCH
(2022)
Review
Anesthesiology
Kylynn K. Koh, Ryan R. Ling, Shaun Y. S. Tan, Ying Chen, Bingwen E. Fan, Kiran Shekar, Jai A. Sule, Senthil K. Subbian, Kollengode Ramanathan
Summary: This meta-analysis found that DOACs reduced bleeding and major neurological events in patients with post-cardiac surgical atrial fibrillation, appearing to be safer than warfarin in this context. However, further research is needed to determine which specific DOAC provides the most effective anticoagulation in this patient population.
BRITISH JOURNAL OF ANAESTHESIA
(2022)
Review
Cardiac & Cardiovascular Systems
Kaisaier Wulamiding, Zixuan Xu, Yili Chen, Jiangui He, Zexuan Wu
Summary: This meta-analysis demonstrates that non-vitamin K antagonist oral anticoagulants (NOACs) are at least as effective and safe as warfarin in patients with both atrial fibrillation (AF) and heart failure (HF). However, the superiority of NOACs over warfarin in stroke prevention varies among different HF subtypes.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Xinxing Gao, Donghua Huang, Yuting Hu, Yuanyuan Chen, Haidong Zhang, Fuwei Liu, Jun Luo
Summary: This meta-analysis compared the effectiveness and safety of DOACs and warfarin in patients with atrial fibrillation at risk of falling, and found that DOACs were significantly associated with reduced risks of hemorrhagic stroke, major or clinically relevant non-major bleeding, and intracranial bleeding compared to warfarin.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Review
Clinical Neurology
Shadi Yaghi, Ian J. Saldanha, Chelsea Misquith, Bashar Zaidat, Asghar Shah, Kareem Joudi, Bianca Persaud, Feras Abdul Khalek, Liqi Shu, Adam de Havenon, Eva A. Mistry, Ekaterina Bakradze, Eric D. Goldstein, John Reagan, Aikaterini Theodorou, Lina Palaiodimou, Karen Furie, Thalia S. Field, Georgios Tsivgoulis, Brian Mac Grory
Summary: This systematic review and meta-analysis suggest that DOACs and warfarin may have comparable efficacy and safety in patients with cerebral venous thrombosis. However, due to the limitations of the included studies, caution should be exercised in interpreting these findings until confirmation is obtained from ongoing randomized controlled trials and large, prospective, observational studies.
Article
Cardiac & Cardiovascular Systems
Anthony P. Carnicelli, Hwanhee Hong, Stuart J. Connolly, John Eikelboom, Robert P. Giugliano, David A. Morrow, Manesh R. Patel, Lars Wallentin, John H. Alexander, M. Cecilia Bahit, Alexander P. Benz, Erin A. Bohula, Tze-Fan Chao, Leanne Dyal, Michael Ezekowitz, Keith A.a. Fox, Baris Gencer, Jonathan L. Halperin, Ziad Hijazi, Stefan H. Hohnloser, Kaiyuan Hua, Elaine Hylek, Eri Toda Kato, Julia Kuder, Renato D. Lopes, Kenneth W. Mahaffey, Jonas Oldgren, Jonathan P. Piccini, Christian T. Ruff, Jan Steffel, Daniel Wojdyla, Christopher B. Granger
Summary: DOACs have more favorable efficacy and safety profiles compared to warfarin in patients with atrial fibrillation, showing significant advantages in terms of stroke, systemic embolism, and bleeding.
Review
Dentistry, Oral Surgery & Medicine
Johana Alejandra Moreno-Drada, Lucas Guimaraes Abreu, Patricia Azevedo Lino, Maria Auxiliadora Parreiras Martins, Isabela Almeida Pordeus, Mauro Henrique Nogueira Guimaraes de Abreu
Summary: The study found that tranexamic acid (TXA) is effective in preventing bleeding in dental procedures for individuals on oral anticoagulation therapy, with moderate certainty evidence. N-butyl-2-cyanoacrylate and calcium sulfate (CaSO4) also showed beneficial effects, but with low certainty evidence. There were no significant differences observed between the hemostatic agents or in mean bleeding time.
JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY
(2021)
Review
Multidisciplinary Sciences
Bailin Zhang, Winglam Cheng, Wulamiding Kaisaier, Zhenbang Gu, Wengen Zhu, Qiuhua Jiang
Summary: This meta-analysis found that edoxaban had lower risks of stroke or systemic embolism, major bleeding, and intracranial hemorrhage compared to other oral anticoagulants in patients with AF.
Article
Multidisciplinary Sciences
Ju-Chieh Wung, Hsin-Chung Lin, Chia-Chen Hsu, Chia-Chieh Lin, Szu-Yu Wang, Shih-Lin Chang, Yuh-Lih Chang
Summary: This study investigated drug-related problems in a pharmacist-managed anticoagulation clinic and explored the factors associated with solving these problems. The results showed that the solved status of drug-related problems was associated with the frequency of receiving clinic services. The secondary outcomes indicated that direct oral anticoagulant users had fewer thromboembolism events, major bleeding, and bleeding-related hospitalizations after clinic services, while warfarin users had an improved time in therapeutic range after services.
Article
Medicine, General & Internal
Celia C. Kamath, Rachel Giblon, Marlene Kunneman, Alexander I. Lee, Megan E. Branda, Ian G. Hargraves, Angela L. Sivly, Fernanda Bellolio, Elizabeth A. Jackson, Bruce Burnett, Haeshik Gorr, Victor D. Torres Roldan, Gabriella Spencer-Bonilla, Nilay D. Shah, Peter A. Noseworthy, Victor M. Montori, Juan P. Brito
Summary: The study found that conversations about the costs of anticoagulants for atrial fibrillation were common between patients and clinicians, especially for middle-income patients and with female and consultant-level primary care clinicians. These conversations were associated with patients' consideration of treatment cost burden but did not influence the final treatment choice.
Review
Pharmacology & Pharmacy
Li-Man Wang, Yan Chen, Li-Li Xu, Meng-Fei Dai, Yi-Jun Ke, Bao-Yan Wang, Lin Zhou, Ji-Fan Zhang, Zhang-Qi Wu, Yu-Jie Zhou, Zhi-Chun Gu, Hang Xu
Summary: This study investigated the safety and efficacy of different antithrombotic strategies after LAAO and found that there was no significant difference in stroke, DRT, and major bleeding events among patients receiving DAPT, DOACs, and VKA. DAPT ranked the worst in terms of these outcomes, while VKAs were ranked as the preferred antithrombotic strategy. However, DOACs should also be considered due to their convenience advantage.
FRONTIERS IN PHARMACOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Kandavadivu Umashankar, Marco Mammi, Ebtissam Badawoud, Yuzhi Tang, Mengqi Zhou, Jorge C. Borges, Aaron Liew, Mattia Migliore, Rania A. Mekary
Summary: DOACs were found to be more effective and safer than warfarin in atrial fibrillation patients with prior stroke, particularly in reducing the risk of systemic embolism, all-cause mortality, and intracranial hemorrhage (ICH).
CARDIOVASCULAR DRUGS AND THERAPY
(2022)
Article
Medicine, General & Internal
Arnar B. Ingason, Edward Rumba, Johann P. Hreinsson, Arnar S. Agustsson, Sigrun H. Lund, Daniel A. Palsson, Indridi E. Reynisson, Brynja R. Gudmundsdottir, Pall T. Onundarson, Geir Tryggvason, Einar S. Bjornsson
Summary: This study aims to compare the rates of clinically relevant epistaxis between different oral anticoagulants. The results show that warfarin treatment is associated with higher rates of clinically relevant epistaxis compared to direct oral anticoagulants.
JOURNAL OF INTERNAL MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Anastasios Papanastasiou, Antonios Morsi-Yeroyannis, Efstratios Karagiannidis, Anastasios Kartas, Ioannis Doundoulakis, Haralambos Karvounis, George Giannakoulas
Summary: Bleeding events in atrial fibrillation patients receiving oral anticoagulants may be a warning sign of cancer, with a higher risk of cancer detection associated with bleeding occurrences. The risk is particularly elevated in patients receiving vitamin K antagonists compared to non-vitamin K oral anticoagulants.
HELLENIC JOURNAL OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Robert G. Hart, Aristeidis H. Katsanos, Kanjana S. Perera, John W. Eikelboom
Summary: This study evaluated randomized clinical trials testing oral factor Xa inhibitors for prevention of ischemic stroke in patients without AF. The results showed that compared to placebo and aspirin, oral factor Xa inhibitors can reduce ischemic stroke in patients without AF, but they also increase the risk of major bleeding.
CANADIAN JOURNAL OF CARDIOLOGY
(2023)
Review
Cardiac & Cardiovascular Systems
Raffaele De Caterina, Domenico Prisco, John W. Eikelboom
Summary: This paper reviews the potential of drugs targeting factor XI in anticoagulant therapy, along with ongoing clinical trials and future research directions.
EUROPEAN HEART JOURNAL
(2023)
Article
Pharmacology & Pharmacy
Tjeerd Pieter van Staa, Munir Pirmohamed, Anita Sharma, Iain Buchan, Darren M. Ashcroft
Summary: This study evaluated drug-drug interactions (DDIs) between antibiotics and nonantibiotic drugs listed with warnings of severe outcomes in the British National Formulary. The results showed no substantial risk of DDIs despite the warnings in the national formulary.
CLINICAL PHARMACOLOGY & THERAPEUTICS
(2023)
Review
Genetics & Heredity
Munir Pirmohamed
Summary: In this Review, the current state of the pharmacogenomics field is discussed, along with clinically relevant drug-gene associations and the steps required for implementing pharmacogenomics into clinical practice. The role of pharmacogenomics in drug discovery and development is also considered. The variability in drug response between individuals, which can be attributed to genomic factors, is a global concern. Despite the availability and decreasing cost of genotyping technologies, challenges in implementing pharmacogenomics lie in adapting current clinical pathways and addressing the knowledge gap in healthcare professionals. Furthermore, pharmacogenomics shows promise in enhancing drug discovery and development outcomes.
NATURE REVIEWS GENETICS
(2023)
Review
Hematology
Rachel Eikelboom, Richard P. Whitlock, Renato D. Lopes, Deborah Siegal, Iqbal H. Jaffer, Paul Drakos, Sam Schulman, Emilie P. Belley-Cote
Summary: The optimal antithrombotic therapy after bioprosthetic aortic valve replacement is uncertain, and guidelines provide contradictory recommendations. Current guidelines from different professional bodies provide contradictory recommendations despite citing the same evidence.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Surgery
Christian Stoppe, Bernard McDonald, Patrick Meybohm, Kenneth B. Christopher, Stephen Fremes, Richard Whitlock, Siamak Mohammadi, Dimitri Kalavrouziotis, Gunnar Elke, Rolf Rossaint, Philipp Helmer, Kai Zacharowski, Ulf Guenther, Matteo Parotto, Bernd Niemann, Andreas Boening, C. David Mazer, Philip M. Jones, Marion Ferner, Yoan Lamarche, Francois Lamontagne, Oliver J. Liakopoulos, Matthew Cameron, Matthias Mueller, Alexander Zarbock, Maria Wittmann, Andreas Goetzenich, Erich Kilger, Lutz Schomburg, Andrew G. Day, Daren K. Heyland
Summary: High-dose intravenous sodium selenite treatment did not reduce morbidity or mortality in high-risk cardiac surgery patients.
Article
Cardiac & Cardiovascular Systems
Kelley R. H. Branch, Jeffrey L. Probstfield, Jackie Bosch, Deepak L. Bhatt, Aldo P. Maggioni, Eva Muehlhofer, Alvaro Avezum, Petr Widimsky, Stuart J. Connolly, Quilong Yi, Olga Shestakovska, Salim Yusuf, John W. Eikelboom
Summary: Low dose rivaroxaban with aspirin significantly reduces cardiovascular events compared with aspirin alone in patients with cardiovascular disease.
AMERICAN HEART JOURNAL
(2023)
Article
Cardiac & Cardiovascular Systems
Jr Tuman J. Milling, Saskia Middeldorp, Lizhen Xu, Bruce Koch, Andrew Demchuk, John W. Eikelboom, Peter Verhamme, Alexander T. Cohen, Jan Beyer-Westendorf, C. Michael Gibson, Jose Lopez-Sendon, Mark Crowther, Ashkan Shoamanesh, Michiel Coppens, Jeannot Schmidt, Pierre Albaladejo, Stuart J. Connolly
Summary: This study evaluated the safety and efficacy of andexanet alfa in patients with major bleeding caused by factor Xa inhibitors. The results showed that the drug reduced anti-FXa activity and achieved good or excellent hemostatic efficacy in 80% of the patients.
Article
Cardiac & Cardiovascular Systems
Alexander P. Benz, Stefan H. Hohnloser, John W. Eikelboom, Anthony P. Carnicelli, Robert P. Giugliano, Christopher B. Granger, Josephine Harrington, Ziad Hijazi, David A. Morrow, Manesh R. Patel, David J. Seiffge, Ashkan Shoamanesh, Lars Wallentin, Qilong Yi, Stuart J. Connolly
Summary: This study aimed to investigate the prognosis of patients with atrial fibrillation (AF) and ischemic stroke while on oral anticoagulation. The results showed that among the 1163 patients who had a post-randomization ischemic stroke while on study medication, 7.0% had a recurrent ischemic stroke within 1 year, and the all-cause mortality rate within 3 months was 12.4%.
EUROPEAN HEART JOURNAL
(2023)
Article
Public, Environmental & Occupational Health
Elpida Kontsioti, Simon Maskell, Munir Pirmohamed
Summary: This study aimed to evaluate the impact of multiple design criteria for reference sets used to assess the performance of signal detection algorithms for drug-drug interactions. Custom-made reference sets of different sizes were generated based on various design criteria. The performance metrics of three algorithms were assessed using FDA Adverse Event Reporting System data, and the results showed that the composition of reference sets significantly impacted the evaluation metrics.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Article
Cardiac & Cardiovascular Systems
Ziad Hijazi, Johan Lindbaeck, Jonas Oldgren, Alexander P. Benz, John H. Alexander, Stuart J. Connolly, John W. Eikelboom, Christopher B. Granger, Renato D. Lopes, Agneta Siegbahn, Lars Wallentin
Summary: This study evaluated the net clinical outcome of oral anticoagulation (OAC) in patients with atrial fibrillation (AF) and identified clinically relevant thresholds for OAC treatment decisions. The findings showed that OAC treatment provides greater net clinical benefit than no-OAC treatment in patients with higher stroke risk, while a balanced decision is needed for patients with lower stroke risk.
AMERICAN HEART JOURNAL
(2023)
Editorial Material
Cardiac & Cardiovascular Systems
Behnood Bikdeli, John W. Eikelboom
Article
Cardiac & Cardiovascular Systems
Alexander P. Benz, Ziad Hijazi, Johan Lindbaeck, Stuart J. Connolly, John W. Eikelboom, Peter Kastner, Andre Ziegler, John H. Alexander, Christopher B. Granger, Renato D. Lopes, Jonas Oldgren, Agneta Siegbahn, Lars Wallentin
Summary: This study aimed to evaluate the role of angiopoietin-2 in patients with atrial fibrillation (AF). The results showed that plasma angiopoietin-2 was independently associated with AF and various risk factors, such as heart failure, age, and smoking. Furthermore, plasma angiopoietin-2 could predict the risk of hospitalization for heart failure in AF patients. Therefore, angiopoietin-2 may be a promising biomarker for AF.
Article
Public, Environmental & Occupational Health
Tjeerd Pieter van Staa, Munir Pirmohamed, Anita Sharma, Darren M. M. Ashcroft, Iain Buchan
Summary: This study aims to assess the relationship between medication classes and adverse drug reactions (ADR) and emergency hospital admission. Through big data analysis, it was found that certain medication classes have a higher risk of ADR-related hospitalization. Therefore, there is a need for regular systematic assessment of the harm-benefit ratio of medicines.
PHARMACOEPIDEMIOLOGY AND DRUG SAFETY
(2023)
Article
Multidisciplinary Sciences
Sylvia Hartmann, Summaira Yasmeen, Benjamin M. Jacobs, Spiros Denaxas, Munir Pirmohamed, Eric R. Gamazon, Mark J. Caulfield, Harry Hemingway, Maik Pietzner, Claudia Langenberg
Summary: The study identified three novel genomic regions related to Raynaud's phenomenon risk, prioritized candidate causal genes, and revealed a likely detrimental effect of low fasting glucose levels on RP risk. The research also highlighted opportunities for drug repurposing and provided robust evidence for a strong genetic contribution to RP.
NATURE COMMUNICATIONS
(2023)