• But of note, major bleeds were an independent predictor of death, with an adjusted hazard ratio of 2.89 (95% CI 1.73-4.83), a finding that the authors say should prompt physicians to pay "special attention to the determinants of bleeding. (medscape.com)
  • however, it is an independent predictor of death. (medscape.com)
  • Admission NT-proBNP is an independent predictor for short- and long-term adverse events in Takotsubo syndrome patients. (cusabio.com)
  • Data suggest that intact FGF23 level in plasma is independent predictor of cardiovascular death in patients with heart failure and provides added value to standard of care, natriuretic peptide (NT-proBNP) plasma level, for risk estimation. (cusabio.com)
  • Several CYP2C9 gene polymorphisms decrease the activity of the CYP2C9 enzyme and slow the body's metabolism of warfarin. (medlineplus.gov)
  • DNA sensors to assess the effect of VKORC1 and CYP2C9 gene polymorphisms on warfarin dose requirement in Chinese patients with atrial fibrillation. (cdc.gov)
  • The influence of CYP2C9 and VKORC1 gene polymorphisms on optimal warfarin doses after heart valve replacement. (cdc.gov)
  • RESULTS: Among the factors examined, the strongest predictors of over-anticoagulation were warfarin indication (in particular, valvular atrial fibrillation and valve replacement), renal failure (with the risk increasing steeply with decreasing estimated glomerular filtration rate), cancer, anaemia, respiratory infections treated with antibiotics, chronic obstructive pulmonary disease treated with β2-agonists, polypharmacy (≥10 medications), low socio-economic status and residency in rural areas. (sdu.dk)
  • 4 The authors of "Efficacy and Safety of Rivaroxaban in Patients with Heart Failure and Non-Valvular Atrial Fibrillation: Insights from ROCKET-AF" postulated that the predictability of rivaroxaban made it a useful alternative to warfarin in patients with AF and HF. (acc.org)
  • Claxton JS, MacLehose RF, Lutsey PL, Norby FL, Chen LY, O'Neal WT, Chamberlain AM, Bengtson LGS , Alonso A. A new model to predict ischemic stroke in patients with atrial fibrillation using warfarin or direct oral anticoagulants. (optum.com)
  • As for antithrombotic choices in AF, Drs Jennifer G. Bekker, Sara D. Brouse, and Tracy E. Macaulay discuss the role of apixaban versus warfarin in the context of the Apixaban versus Warfarin in Patients with Atrial Fibrillation (ARISTOTLE) trial. (hcplive.com)
  • Trends in the prevalence of diagnosed atrial fibrillation, its treatment with anticoagulation and predictors of such treatment in UK primary care Heart . (medscape.org)
  • Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study. (medscape.org)
  • Amin A. Oral anticoagulation to reduce risk of stroke in patients with atrial fibrillation: current and future therapies. (medscape.org)
  • Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. (medscape.org)
  • Predictors and characteristics of multiple (more than 2) catheter ablation procedures for atrial fibrillation. (medscape.org)
  • Warfarin dose requirements with different genotypes of CYP2C9 and VKORC1 for patients with atrial fibrillation and valve replacement. (cdc.gov)
  • Clinical application of a new warfarin-dosing regimen based on the CYP2C9 and VKORC1 genotypes in atrial fibrillation patients. (cdc.gov)
  • Impact of GGCX polymorphisms on warfarin dose requirements in atrial fibrillation patients. (cdc.gov)
  • Stop Aspirin in Stable CAD/AF Patients on Warfarin? (medscape.com)
  • eg, warfarin ) were the key predictors of bleeding, but strikingly, the risk associated with warfarin use was statistically significant only in patients also taking aspirin. (medscape.com)
  • Indeed, the hazard ratio for the cumulative risk of bleeding was 7.30 (95% CI 3.91-13.64) among patients taking both aspirin and a VKA, but 1.69 (95% CI 0.39-7.30) among patients taking warfarin alone. (medscape.com)
  • In patients who are under age 65 and have no other risk factors for stroke, either aspirin therapy or no therapy at all is recommended. (aafp.org)
  • Aspirin or warfarin is recommended for use in patients between 65 and 75 years of age with no other risk factors, and warfarin is recommended for use in patients without risk factors who are older than 75 years of age. (aafp.org)
  • Since the advent of aspirin and warfarin, numerous antiaggregant and anticoagulant molecules have been developed to achieve this goal, but their anti-ischaemic efficacy is often obtained at the price of augmented bleedings, which are known to be strong predictors of adverse outcome. (univr.it)
  • Examples are deep vein thrombosis and pulmonary embolism, the risk of which can be mitigated by certain interventions, such as the administration of anticoagulants (e.g., warfarin or low molecular weight heparins), antiplatelet drugs (e.g., aspirin), compression stockings, and cyclical pneumatic calf compression in high risk patients. (wikipedia.org)
  • Stop ASA in Stable CAD/AF Patients on Warfarin? (medscape.com)
  • The purpose of this analysis was to assess potential predictors of intra-cranial bleeding (ICB) and gastrointestinal bleeding (GIB) in patients with symptomatic peripheral artery disease (PAD) in UK primary care. (thieme-connect.com)
  • Identifying bleeding predictors could help optimize treatment strategies for patients with PAD. (thieme-connect.com)
  • BACKGROUND: Many patients on warfarin therapy often present with supratherapeutic international normalized ratio (INR) levels, resulting from the influence of several patient-specific factors, which have been associated with adverse outcomes. (sdu.dk)
  • OBJECTIVE: This article aims to identify risk factors for over-anticoagulation (INR levels ≥4) in a cohort of patients taking warfarin. (sdu.dk)
  • CONCLUSION: Predictors of supratherapeutic INR levels found in this study might help physicians identify patients where closer INR monitoring is warranted. (sdu.dk)
  • Genetic variants of the enzyme that metabolizes warfarin, cytochrome P-450 2C9 (CYP2C9), and of a key pharmacologic target of warfarin, vitamin K epoxide reductase (VKORC1), contribute to differences in patients' responses to various warfarin doses, but the role of these variants during initial anticoagulation is not clear. (nih.gov)
  • In 297 patients starting warfarin therapy, we assessed CYP2C9 genotypes (CYP2C9 *1, *2, and *3), VKORC1 haplotypes (designated A and non-A), clinical characteristics, response to therapy (as determined by the international normalized ratio [INR]), and bleeding events. (nih.gov)
  • The goal of this document is to provide guidance from the Anticoagulation Forum, a North American organization of anticoagulation providers, regarding use of anticoagulant therapies in patients with COVID-19. (springer.com)
  • We discuss in-hospital and post-discharge venous thromboembolism (VTE) prevention, treatment of suspected but unconfirmed VTE, laboratory monitoring of COVID-19, associated anticoagulant therapies, and essential elements for optimized transitions of care specific to patients with COVID-19. (springer.com)
  • This guidance document addresses key issues pertaining to prevention or treatment of thrombotic events in hospitalized patients with COVID-19 with the overarching purpose of striking a balance between risks and benefits of anticoagulation therapies. (springer.com)
  • 1 ROCKET-AF was an international, multicenter, randomized, double-blind, study designed to assess the noninferiority of rivaroxaban to warfarin for the prevention of stroke and systemic embolic events in patients with non-valvular AF. (acc.org)
  • ROCKET-AF was a non-inferiority trial that compared rivaroxaban 20 mg daily (or 15 mg daily in patients with creatinine clearance 30-49 mL/min) with adjusted-dose warfarin (target international normalized ratio [INR] 2.5, range 2.0-3.0) in patients with non-valvular AF. (acc.org)
  • and (3) rivaroxaban vs. warfarin within subgroups of HF patients defined by EF, NYHA class, and CHADS 2 score. (acc.org)
  • Safety endpoints also were similar with rivaroxaban vs. warfarin among patients with HF and among patients without HF. (acc.org)
  • Patients with AF should be considered for anticoagulation or antiplatelet therapy based on the patient's age, the presence of other risk factors for stroke and the risk of complications from anticoagulation. (aafp.org)
  • In general, patients with risk factors for stroke should receive warfarin anticoagulation, regardless of their age. (aafp.org)
  • A severe coagulation defect and an exaggerated response to warfarin has been documented in patients with liver failure. (aafp.org)
  • A retrospective study of predictors of major bleeding in hospitalized patients receiving warfarin revealed that bleeding episodes correlated with evidence of worsening liver function. (aafp.org)
  • One study revealed that the mean half-life of warfarin is significantly reduced in patients with renal dysfunction, but the few studies of the effects of renal disease show no clinically relevant change in the response to warfarin. (aafp.org)
  • Toth PP, Philip S, Hull M , Granowitz C. Elevated triglycerides (≥150 mg/dL) and high triglycerides (200-499 mg/dL) are significant predictors of new heart failure diagnosis: A real-world analysis of high-risk statin-treated patients. (optum.com)
  • Therefore, antithrombotic therapy to modulate either pathway plays an important role for the reduction of ischaemic adverse events in ACS patients. (univr.it)
  • Of operative risk factors, surgical site is the most important predictor of risk for PPCs (aortic, thoracic, and upper abdominal surgeries being the highest-risk procedures, even in healthy patients. (wikipedia.org)
  • Respiratory therapy has a place in preventing pneumonia related to atelectasis, which occurs especially in patients recovering from thoracic and abdominal surgery. (wikipedia.org)
  • Incidence and predictors of bleeding or thrombosis after polypectomy in patients receiving and not receiving anticoagulation therapy. (ebgh.it)
  • The state of the art for academic medical centers in 2013 is determining a small number of relatively high-profile genomic variants from some or all of their patients likely to imminently require specific drug treatments (based on predictors in their clinical records) and integrating Chrysin these findings into the electronic health records (EHRs) of those patients. (techuniq.com)
  • Outcomes of anticoagulation therapy in patients with mental health conditions. (va.gov)
  • BACKGROUND: Patients with mental health conditions (MHCs) experience poor anticoagulation control when using warfarin, but we have limited knowledge of the association between specific mental illness and warfarin treatment outcomes. (va.gov)
  • PARTICIPANTS: We studied 103,897 patients on warfarin for 6 or more months cared for by the Veterans Health Administration during fiscal years 2007-2008. (va.gov)
  • Overall, our results suggest that appropriately selected patients with MHCs can safely receive therapy with warfarin. (va.gov)
  • Dr Marco Roffi comments on predictors and impact of bleeding complications in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). (hcplive.com)
  • Can a subset of intracerebral hemorrhage patients benefit from hemostatic therapy with recombinant activated factor VII? (jamanetwork.com)
  • A Multicenter, Single-Blind, Randomized, Warfarin-Controlled Trial of Edoxaban in Patients With Chronic Thromboembolic Pulmonary Hypertension: KABUKI Trial. (amedeo.com)
  • Factors influencing quality of anticoagulation control and warfarin dosage in patients after aortic valve replacement within the 3 months of follow up. (cdc.gov)
  • HAS-BLED and HEMORR2HAGES Scales in Assessment of Bleeding Risk in Patients on Long-Term Warfarin Therapy]. (cdc.gov)
  • Predictors of warfarin dose requirements in South African patients attending an anticoagulation clinic. (cdc.gov)
  • Doctors need to properly inquire about and understand their patients' supplement use, especially if CAM therapies are used in conjunction with conventional medications. (jcimjournal.com)
  • Thrombolytic therapy is a (relatively) safe alternative to surgery and should be considered first line for treatment of prosthetic valve thrombosis in all patients, especially in pregnant women. (cardionerds.com)
  • Combinative index (arterial lactate, NT-proBNP and CRP) could serve as a valuable predictor for the 28-day mortality rate in patients with sepsis. (cusabio.com)
  • The effect of cyclophosphamide therapy on longterm survival in patients with SSc-ILD is still unclear. (jrheum.org)
  • In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors. (rxlist.com)
  • Edoxaban versus Dual Antiplatelet Therapy for Leaflet Thrombosis and Cerebral Thromboembolism after TAVR: The ADAPT-TAVR Randomized Clinical Trial. (amedeo.com)
  • Treatment options for mechanical aortic valve thrombosis include slow-infusion, low-dose thrombolytic therapy or emergency surgery. (cardionerds.com)
  • ORs for ICB were 0.78 (0.50-1.21), 0.40 (0.09-1.82) and 1.27 (0.47-3.47) with use of acetylsalicylic acid (ASA), clopidogrel and warfarin monotherapy, respectively, compared with non-use of such therapy. (thieme-connect.com)
  • ORs for GIB were 1.78 (1.39-2.30), 2.03 (1.05-3.93) and 1.25 (0.72-2.16) with ASA, clopidogrel and warfarin monotherapy, respectively, compared with non-use. (thieme-connect.com)
  • Then if a drug such as warfarin clopidogrel mercaptopurine or codeine is ordered and a clinically significant drug-gene interaction is known an alert to the physician or pharmacist is made and in some settings an alternative recommended drug order is automatically generated. (techuniq.com)
  • This article discusses the issues involved in the risk of a thromboembolic event in association with AF and the indications for anticoagulation therapy. (aafp.org)
  • OBJECTIVE: To examine the relationship between the severity of MHCs and outcomes of anticoagulation therapy. (va.gov)
  • Initial variability in the INR response to warfarin was more strongly associated with genetic variability in the pharmacologic target of warfarin, VKORC1, than with CYP2C9. (nih.gov)
  • Demirkan and colleagues reviewed the literature to study the effects of concurrent disease on response to warfarin. (aafp.org)
  • A MEDLINE search was performed to identify prospective trials, case reports and retrospective studies of the effects of various disease states on response to warfarin. (aafp.org)
  • The authors found that the effects of liver disease, hyperthyroidism and hypothyroidism on the response to warfarin are well documented in the literature. (aafp.org)
  • The authors conclude that hepatic and thyroid diseases are well documented as disorders that can alter the response to warfarin. (aafp.org)
  • Other people with warfarin sensitivity do not need as much drug to prevent clots because their clot-forming process is naturally slower than average and can be stopped by low warfarin doses. (medlineplus.gov)
  • Small studies and case reports indicate that heart failure, cancer and febrile illness may alter warfarin metabolism, with potentially important clinical results. (aafp.org)
  • Progress in therapy is usually hampered by the difficulties of inadequate positive predictive value of antibody detection and clinical scores in suspected HIT, very limited availability of practical platelet activation assays, and the paucity of new agents in human clinical trials. (immune-source.com)
  • The choice of a subsequent therapy after nevirapine should be based on clinical experience and resistance testing (see section 5.1). (who.int)
  • Certain common changes (polymorphisms) in the CYP2C9 and VKORC1 genes account for most of the variation in warfarin metabolism due to genetic factors. (medlineplus.gov)
  • Warfarin prevents (inhibits) the action of the VKORC1 enzyme and slows the activation of clotting proteins and clot formation. (medlineplus.gov)
  • Individuals develop warfarin sensitivity because a lower warfarin dose is needed to inhibit the VKORC1 enzyme, as there is less functional enzyme that needs to be suppressed. (medlineplus.gov)
  • While changes in specific genes, particularly CYP2C9 and VKORC1 , affect how the body reacts to warfarin, many other factors, including sex, age, weight, diet, and other medications, also play a role in the body's interaction with this drug. (medlineplus.gov)
  • Both the CYP2C9 genotype and VKORC1 haplotype had a significant influence on the required warfarin dose after the first 2 weeks of therapy. (nih.gov)
  • Several articles in this issue address optimizing secondary preventive therapies for cardiovascular diseases. (hcplive.com)
  • Along the same lines, Dr Leslie Cho discusses suboptimal management of cardiovascular risk factors, particularly in women, and recommends a disease-oriented team approach using other medical personnel such as nurses and pharmacists along with physicians to improve both adherence to guidelines and patient compliance with therapies. (hcplive.com)
  • For GIB (506 cases), the OR was 1.40 (1.05-1.86) for peptic ulcer disease, 3.20 (1.81-5.64) for dual anti-platelet therapy use, 1.96 (1.46-2.64) for non-steroidal anti-inflammatory drug (NSAID) use and 1.01 (0.80-1.28) for proton pump inhibitor use. (thieme-connect.com)
  • Use of anti-platelet therapy or NSAIDs increased GIB risk. (thieme-connect.com)
  • Incidence of drug interaction when using proton pump inhibitor and warfarin according to cytochrome P450 2C19 (CYP2C19) genotype in Japanese. (cdc.gov)
  • They state that apixaban is the first agent to demonstrate the combined benefit of increased efficacy and safety versus warfarin and a significant decrease in mortality. (hcplive.com)
  • Interactions occur through a variety of mechanisms, including interference with warfarin metabolism, displacement from protein binding sites and disturbances of vitamin K absorption or metabolism. (aafp.org)
  • The authors urge physicians to consider the effect of concomitant disease as well as food or drug interactions when monitoring anticoagulation with warfarin. (aafp.org)
  • The advent of coronary care units and early reperfusion therapy (lytic or percutaneous coronary intervention) has substantially decreased in-hospital mortality rates and has improved the outcome in survivors of the acute phase of MI. (medscape.com)
  • Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage: a powerful and easy-to-use predictor of 30-day mortality. (jamanetwork.com)
  • Many genes are involved in the metabolism of warfarin and in determining the drug's effects in the body. (medlineplus.gov)
  • Polymorphisms in other genes, some of which have not been identified, have a smaller effect on warfarin metabolism. (medlineplus.gov)
  • The study outcomes were the time to the first INR within the therapeutic range, the time to the first INR of more than 4, the time above the therapeutic INR range, the INR response over time, and the warfarin dose requirement. (nih.gov)
  • If people with warfarin sensitivity take the average dose (or more) of warfarin, they are at risk of an overdose, which can cause abnormal bleeding in the brain, gastrointestinal tract, or other tissues, and may lead to serious health problems or death. (medlineplus.gov)
  • While it is unclear how many of these events are due to warfarin sensitivity, the most common sign is excessive internal bleeding, which often occurs when individuals with warfarin sensitivity are given too much of the medication. (medlineplus.gov)
  • In contrast, the CYP2C9 genotype was not a significant predictor of the time to the first INR within the therapeutic range (P=0.57) but was a significant predictor of the time to the first INR of more than 4 (P=0.03). (nih.gov)
  • Impact of six genetic polymorphisms on Warfarin maintenance dose variation in Chinese Han population]. (cdc.gov)
  • Of the approximately 2 million people in the U.S. who are prescribed warfarin annually, 35,000 to 45,000 individuals go to hospital emergency rooms with warfarin-related adverse drug events. (medlineplus.gov)
  • METHODS: A cohort of warfarin users aged 18 to 85 years from January 2005 to April 2013 was identified in The Health Improvement Network U.K. primary care database (N = 12,506). (sdu.dk)
  • Thrombolysis was successfully performed using a low dose ultra-slow infusion of thrombolytic therapy, leading to normal valve function eight days later. (cardionerds.com)
  • Among laboratory tests, a serum albumin level less than 35 g/L is the most powerful predictor and predicts PPC risk to a similar degree as the most important patient-related risk factors. (wikipedia.org)
  • Warfarin sensitivity is a condition in which individuals have a low tolerance for the drug warfarin. (medlineplus.gov)
  • Many people with warfarin sensitivity take longer than normal to break down (metabolize) warfarin. (medlineplus.gov)
  • Warfarin sensitivity does not appear to cause any health problems other than those associated with warfarin drug treatment. (medlineplus.gov)
  • The prevalence of warfarin sensitivity is unknown. (medlineplus.gov)
  • The polymorphisms associated with warfarin sensitivity often differ by population and ethnic background. (medlineplus.gov)
  • As a result, the drug remains active in the body for a longer period of time, leading to warfarin sensitivity. (medlineplus.gov)
  • which means one copy of the altered gene in each cell is sufficient to result in warfarin sensitivity. (medlineplus.gov)
  • Additionally, people who have more than one polymorphism in a gene or polymorphisms in multiple genes associated with warfarin sensitivity have a lower tolerance for the drug's effect or take even longer to clear the drug from their body. (medlineplus.gov)
  • Corticosteroid treatment and intensive insulin therapy for septic shock in adults: a randomized controlled trial. (ebgh.it)
  • The 2020 ACC/AHA guidelines gave a class I recommendation for treatment options using slow-infusion, low-dose fibrinolytic therapy or undergoing emergency surgery. (cardionerds.com)
  • Medication therapy management programs: forming a new cornerstone for quality and safety in Medicare. (ahrq.gov)
  • The case of warfarin-related medication errors. (ahrq.gov)
  • Predictors of unit-level medication administration accuracy: microsystem impacts on medication safety. (ahrq.gov)
  • These individuals are classified as "slow metabolizers" of warfarin. (medlineplus.gov)
  • Of the 192 individuals completing the study, 39% ( n =76) were currently using or had used CAM therapies in the past 12 months. (jcimjournal.com)
  • The mechanism may be that thyroxine increases the affinity of warfarin for receptor sites in the liver, leading to decreased production of clotting factors. (aafp.org)
  • Current therapy and outcome of Eisenmenger syndrome: data of the German National Register for congenital heart defects. (msdmanuals.com)
  • Many drugs and foods are known to interfere with the anticoagulation effect of warfarin. (aafp.org)