Around 12,500 strokes are caused by atrial fibrillation (AF) in the UK each year, and 7,100 of these are preventable with appropriate anticoagulation. Four new oral anticoagulants (NOACs) are now available in the UK in addition to warfarin.
CPD and research articles
Heparin is widely used for thromboprophylaxis or as a treatment in many clinical situations, however, it can cause serious adverse effects. Heparin-induced thrombocytopenia (HIT), an immune-mediated adverse drug reaction, is associated with high morbidity and mortality if undiagnosed.
How to identify causes of a subtherapeutic INRSubscription
Pharmacists and healthcare professionals are often involved in the management of patients with subtherapeutic international normalised ratios (INRs), the cause of which is important to identify because this will affect decisions and the subsequent management of the patient.
Local guidance, supported by the 2014 National Institute for Health and Care Excellence (NICE) guideline CG180 for atrial fibrillation (AF), recommends that patients receiving inadequate anticoagulation with a vitamin K antagonist (VKA), including time in therapeutic range (TTR) of <65%, should be reassessed. These patients were identified by the anticoagulation monitoring service (AMS) and highlighted to GPs for review. However, up to 59.3% of patients received ...
How antiphospholipid syndrome, also known as Hughes syndrome, is diagnosed and the appropriate therapeutic options for its management.
How patients on anticoagulants can be effectively managed in the perioperative period, including the evidence for the need for ‘bridging’ anticoagulation therapy and introduction of direct oral anticoagulants.
News and events
People with atrial fibrillation who have dementia are less likely to receive oral anticoagulants (OACs) than those without cognitive impairment, research has shown.
Direct oral anticoagulants carry lower risk of major bleeding versus warfarin, data showSubscription
Research from primary care suggests apixaban may be the safest of the direct oral anticoagulants overall.
Results from an ongoing trial of 228 patients with acute major bleeding show that patients taking andexanet experienced a reduction in anti-FXa activity.
The risk of both stroke and haemorrhage increases as chronic kidney disease progresses, which can complicate the decision on whether to begin anticoagulation in those with concomitant atrial fibrillation.
Community pharmacy is “ideally placed” to provide a safe anticoagulation service for patients needing warfarin monitoring
A Norwegian cohort study finds that warfarin has broad anticancer potential, which could have implications for medication choice for patients needing anticoagulation
A study in The New England Journal of Medicine has shown no significant difference in results following pharmacomechanical therapy for deep-vein thrombosis
Patients receiving genotype-guided dosing of warfarin were less likely to have a major bleed or die than patients whose dosing was clinically guided.
Anticoagulants could cut the risk of dementia for patients with atrial fibrillation, researchers find
Oral anticoagulants are associated with a significant reduction in the risk of dementia in patients with atrial fibrillation (AF), according to a study published in the European Heart Journal.
A new community pharmacy oral anticoagulant safety audit, developed by the NHS’s Specialist Pharmacy Service (SPS), has been endorsed by the SalvaDore.
Researchers find that idarucizumab effectively counteracts the workings of anticoagulant dabigatran in emergency situations.
Clinical commissioning groups have been offloading responsibility for prescribing specialist drugs onto GPs, but many GPs say they have not been trained or paid to provide this service.
Results reinforce the importance of starting anticoagulation treatment as soon as possible after diagnosis, researchers conclude.
Study results show that choosing apixaban over warfarin could reduce the risk of anticoagulation-related intracranial haemorrhage.
Among patients with nonvalvular atrial fibrillation, study data show the use of dabigatran rather than warfarin was associated with a lower risk of osteoporotic fracture.
Genotype-guided dosing improves safety of warfarin Subscription
Older adults who received a genotype-guided dose of warfarin via a web application were less likely to experience adverse effects compared with clinical dosing, trial results show.
Atrial fibrillation patients not receiving guideline-recommended drugs to reduce stroke riskSubscription
Retrospective data analysis results show that the 16% of patients who were given anticoagulant prior to stroke showed reduction in stroke severity, lower odds of mortality and better functional outcomes.
Researchers find that blood clot rates in patients taking rivaroxaban were significantly lower than those taking aspirin, and there were no significant differences between bleeding side effects.
Patients prescribed antithrombotic drugs, such as low-dose aspirin, clopidogrel or warfarin, are at increased risk of having a subdural haematoma, research published in JAMA has confirmed.
Analysis of ‘real-life’ data comparing newer direct oral anticoagulants with warfarin has identified adverse drug reactions (ADRs) ‘not previously associated’ with the new treatments, including hip fracture.
Janssen may have withheld data from the US Food and Drug Administration about a faulty blood testing device used in a trial of the anticoagulation drug rivaroxaban, according to the results of an investigation by The BMJ.
Only a third of patients taking warfarin will retain stable blood levels in the long term, research published in JAMA has revealed (online, 9 August 2016).
The oral anticoagulant apixaban is consistently more effective than warfarin for patients with atrial fibrillation regardless of the number of other drugs they take, a study has found.
Many atrial fibrillation patients at risk of stroke treated with aspirin over anticoagulantsSubscription
Around 40% of atrial fibrillation patients who have an intermediate or high risk of stroke are treated only with aspirin, even though aspirin is less effective than oral anticoagulation, according to new research.
Large analysis of data shows taking aspirin within two weeks of transient ischaemic attack or stroke cuts risk of secondary stroke by over 90%.
Patients with atrial fibrillation (AF) being treated with warfarin have higher rates of dementia compared with those taking the drug for other conditions, research shows.
A study of 40,000 patients with atrial fibrillation suggests that warfarin is a valid treatment for stroke prevention.
The educational background of patients with atrial fibrillation directly influences how they manage their anticoagulation, according to research.
European regulator says anticoagulant is safe, despite question marks over its pivotal trialSubscription
The European Medicines Agency has reiterated the overall safety of rivaroxaban (Xarelto), an anticoagulant, despite a defect in a device used in a pivotal study behind the drug’s marketing approval in the European Union and the United States.
The validity of the data produced by a pivotal trial to gain approval for the direct oral anticoagulant, rivaroxaban (Xarelto), from the US and European regulators, has been called into question by an investigation.