Fibrillazione Atriale Non Valvolare: Come Orientare La Scelta Dei Nuovi Anticoagulanti Orali
|
|
- Sharyl Martin
- 5 years ago
- Views:
Transcription
1 Fibrillazione Atriale Non Valvolare: Come Orientare La Scelta Dei Nuovi Anticoagulanti Orali Gianluca Botto, MD, FAAC, FESC Divisione di Cardiologia Ospedale Sant Anna, Como
2
3 The Promise of NOAs
4 Antithrombotic Treatments in non valvular AF (4.845 pts) OAC Other ATT Courtesy of Di Pasquale G. None
5 Desirable Qualities of a New Anticoagulant 5 Oral Fixed dosing Rapid onset and offset of action Predictable anticoagulant response (no monitoring) Minimal food and drug interactions Reversible As or more effective than current agents As or safer than current agents More cost-effective than current Rxs
6 Efficacy
7 Trials on New Oral Anticoagulants in AFIB Trial Drug Company Dose Design RE-LY Dabigatran Boeringer 110 mg and 150 mg bid PROBE ROCKET-AF Rivaroxaban Bayer 20 mg daily ARISTOTLE Apixaban Bristol MS / Pfizer 5 mg bid double-dummy, double-blind double-dummy, double-blind ENGAGE-AF Edoxaban Daiichi Sankyo EXPLORE-Xa Betrixaban Merck OPAL-2 YM150 Astrellas 30 mg and 60 mg daily 40,60,80 mg daily six regimens double-dummy, double-blind double-blind, open label W double-blind, open label W
8 NOAs vs Warfarin in Pts with AF ALL-CAUSE STROKE or SE ISCHEMIC STROKE HEMORRHAGIC STROKE Miller CS. Am J Cardiol 2012; 110:
9 Recent NOA Trials: Ischemic Stroke RELY Dabigatran 110 mg Dabigatran 150 mg Warfarin ROCKET Rivaroxaban 20 mg Warfarin ARISTOTLE Apixaban 5 mg Warfarin 1.34% / yr % / yr % / yr HR P-value (ITT) 1.62% / yr % / yr 0.97% / yr % / yr Patel MR. N Engl J Med 2011; Connolly SJ. N Engl J Med 2009; Granger C. N Eng J Med 2011
10 Efficacy and TTR in 3 SPAF Studies
11 Safety
12 NOAs vs Warfarin in Pts with AF MAJOR BLEEDING INTRACRANIAL BLEEDING GE BLEEDING Miller CS. Am J Cardiol 2012; 110:
13 Indirect Comparison of NOAs in Pts with AF A Network Meta-analisys Harenberg J. Int Angiol 2012; 31: 330-9
14 Net Clinical Benefit for Warfarin and NOAs by CHA 2 DS 2 -VASc Score Banerjee A. Thrombosis Haemost 2012
15 Cost-Efficacy
16 Anticoagulation Rx in Pts With NV-AF Projected Costs, Cost-Efficacy and Cost-Benefit Harrington AR. Stroke 2013 in press
17 Who is NOT a Candidate For NOAs? Mechanical valve Creat-Cl < 30 ml/min Severe hepatic dysfunction Non-compliant with W
18
19 Fibrillazione Atriale Non Valvolare: Come Orientare La Scelta Dei Nuovi Anticoagulanti Orali Gianluca Botto, MD, FAAC, FESC Divisione di Cardiologia Ospedale Sant Anna, Como
20 Putting it All Togeteher What Should We Do Now in Clinical Practice? Daily dosage (OD vs BID) Effect of renal funcion Perioperative managem Drug Interaction Elderly and fragile pts ACS/MI GI bleeding
21 Patients Preferences For Type 2 Diabetes Treatment Dosing Schedules Hauber AB. Patient Preference and Adherence 2013:
22 Summary Of The RCTs Involving Novel Anticoagulants vs Warfarin For Stroke Prevention In Non-Valvular AF
23 Apr 2012
24 Anticoagulants: PK Parameters AVK a-iia a-xa Poulsen BK et al, Drugs 2011
25 Clin Pharmacokinet 2010; 49:
26 Time Course of Effect of Dabigatran on aptt Weitz JI. Circulation 2012; 126:
27 Renal disease Hepatic disease Kreutz R, Fundamental Clin Pharmacol 2011
28 Estimated Drug Half-lives And Effect On AUC NOA Plasma Different Stages Of CKD Compared To Healthy Controls Apr 2012
29 Noacs In Renal Dysfunction Approved European Labels And Dosing In CKD Apr 2012
30 NOAs Last Intake Of Drug Before Elective Surgical Intervention Apr 2012
31 Effect on NOAs plasma levels (area under the curve, AUC) from drug drug interactions and clinical factors. Recommendations towards NOAC dosing EHRA Practical Guidelines Europace 2013; 15:
32 Dabigatran Etexilate And Dronedarone Effect of dronedarone (P-gp inhibitor) on pharmacokinetics and pharmacodynamics of dabigatran was studied 1 Sponsored by sanofi-aventis Dronedarone 400 mg BID increased steady-state dabigatran exposures by 1.7- to 2.0-fold 1 Due to increased absorption through P-gp inhibition Similar level of interaction to that observed for dabigatran in the presence of other P-gp inhibitors, such as amiodarone and verapamil No effect of dronedarone on renal clearance of dabigatran 1 EU SmPC: co-administration of dabigatran and dronedarone not recommended because inadequate clinical data are available (Pradaxa : EU SmPC, 2012) 1. Brunet A. Eur Heart J 2011; 32: 618 9
33 Circulation. 2012; 125:
34 ATLAS ACS 2 TIMI 51 N=15,526* Physician's decision to add thienopyridine or not Stratum 1: ASA alone (7%) ASA dose = mg/day Stratum 2: ASA + thienopyridine (93%) Placebo n=355 Rivaroxaban 2.5 mg bid n=349 Rivaroxaban 5 mg bid n=349 Placebo n=4821 Rivaroxaban 2.5 mg bid n=4825 Rivaroxaban 5 mg bid n=4827 Event-driven study 1002 events *184 patients were excluded from the efficacy analyses prior to unblinding because of trial misconduct at three sites Mega JL et al. N Engl J Med November 2011
35 NEJMed 2013
36 RE-LY Cardioversion Subgroup Stroke or Systemic Embolism with/without TEE Stroke/systemic embolism (%) With TEE prior to cardioversion (24.8% of pts) 0.61 Dabigatran 110 mg BID P= Dabigatran 150 mg BID P= Warfarin Without TEE prior to cardioversion (13.3% of pts) 0.83 Dabigatran 110 mg BID P= Dabigatran 150 mg BID P= Warfarin Similar rates of stroke or systemic embolism with/without TEE before cardioversion Nagarakanti R. Circulation 2011;123:131 6
37 Kirchhof P. EHRA-Europace Meeting, Athens 2013 Apr 2012
38 NOAs Global Market Share June 2013 RIVAROXABAN DABIGATRAN APIXABAN IMS MIDAS Database Monthly Sales
39 Humanity greatest advance are not in its discoveries, but in how those discoveries are applied Bill Gates, June 7, 2007 Harvard Commencement Address
40 Novel Oral Anticoagulants NOAs all provide important advantage over W, including convenience, at least as effective prevention of stroke, and less intracranial hemorrhage Until head-to-head trials or large scale observational studies that reflects routine use of these agents are available, indirect comparison are just one tool for hypothesis generating The new agents provide an important opportunity to improve the care of pts with AFIB including for pts with indications but not currently treated with any OAC.
NOACs Scegliere in Contesti Particolari
Gianluca Botto, FESC, FEHRA U.O.s. Elettrofisiologia ASST-Lariana, Como NOACs Scegliere in Contesti Particolari Presenter Disclosure Information Research support: Boston Scientific, Medtronic; St. Jude
More informationESC Congress 2012, Munich
ESC Congress 2012, Munich Anticoagulation in Atrial Fibrillation 2012: Which Anticoagulant for Which Patient? Stefan H. Hohnloser J.W. Goethe University Frankfurt am Main S.H.H. has served as a consultant,
More informationNUOVI ANTICOAGULANTI NELL ANZIANO: indicazioni e controindicazioni. Mario Cavazza Medicina d Urgenza Pronto Soccorso AOU di Bologna
NUOVI ANTICOAGULANTI NELL ANZIANO: indicazioni e controindicazioni Mario Cavazza Medicina d Urgenza Pronto Soccorso AOU di Bologna Two major concerns Atrial Fibrillation: Epidemiology The No. 1 preventable
More informationOld and New Anticoagulants For Stroke Prevention Benefits and Risks
Old and New Anticoagulants For Stroke Prevention Benefits and Risks September 15, 2014 Jonathan L. Halperin, M.D. The Cardiovascular Institute Mount Sinai Medical Center Disclosure Relationships with Industry
More informationThrombosis and Thromboembolsim October Stroke Prevention in Atrial Fibrillation Risk Stratification and Choice of Antithrombotic Therapy
Thrombosis and Thromboembolsim October 2012 Stroke Prevention in Atrial Fibrillation Risk Stratification and Choice of Antithrombotic Therapy Christian T. Ruff, MD, MPH TIMI Study Group Brigham and Women
More informationAtrial fibrillation and anticoagulation JIR-PING BOEY, DEPARTMENT OF HAEMATOLOGY, FLINDERS MEDICAL CENTRE FEBRUARY 2016
1 Atrial fibrillation and anticoagulation JIR-PING BOEY, DEPARTMENT OF HAEMATOLOGY, FLINDERS MEDICAL CENTRE FEBRUARY 2016 Disclosures 2 No conflicts of interest Some questions 3 Should my patient with
More informationADC Slides for Presentation 02/10/2017
ADC 2017 Slides for Presentation ANTI THROMBOTIC THERAPY FOR NON VALVULAR ATRIAL FIBRILLATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: CURRENT VIEWS Martin A. Alpert, MD Brent M. Parker Professor of Medicine
More informationNOAs for stroke prevention in Atrial Fibrillation: potential advantages in the elderly patients. Giancarlo Agnelli
NOAs for stroke prevention in Atrial Fibrillation: potential advantages in the elderly patients Giancarlo Agnelli Internal & Cardiovascular Medicine - Stroke Unit University of Perugia, Italy My talk today
More informationClinical issues which drug for which patient
Anticoagulants - a matter of heart! Towards a bright future? Clinical issues which drug for which patient Sabine Eichinger Dept. of Medicine I Medical University of Vienna/Austria Conflicts of interest
More informationEngage AF-TIMI 48. Edoxaban in AF: What can we expect? Cardiology Update John Camm. St. George s University of London United Kingdom
Cardiology Update 2013 N S N O N H O H N S1 pocket Aryl binding N site O O N H N Cl Engage AF-TIMI 48 Edoxaban in AF: What can we expect? John Camm St. George s University of London United Kingdom Advisor
More informationAtrial Fibrillation. Alan Bell, MD, CCFP. Staff Physician, Humber River Regional Hospital. University of Toronto
Pearls in Thrombosis 1 Atrial Fibrillation Alan Bell, MD, CCFP Staff Physician, Humber River Regional Hospital Assistant tprofessor, Department tof Family and Community Mdii Medicine University of Toronto
More informationIndications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute
Indications of Anticoagulants; Which Agent to Use for Your Patient? Marc Carrier MD MSc FRCPC Thrombosis Program Ottawa Hospital Research Institute Disclosures Research Support/P.I. Employee Leo Pharma
More informationAnticoagulant therapy, coumadines or direct antithrombins
ATRIAL FIBRILLATION (AF) Anticoagulant therapy, coumadines or direct antithrombins Felicita Andreotti, MD PhD Aggregated Professor Dept of Cardiovascular Sciences, Catholic University, Rome, IT Consultant
More informationIs There a Role For Pharmacokinetic/ Pharmacodynamics Guided Dosing For Novel Anticoagulants? Christopher Granger
Is There a Role For Pharmacokinetic/ Pharmacodynamics Guided Dosing For Novel Anticoagulants? Christopher Granger 1 Disclosures Research contracts: Armetheon, AstraZeneca, Bayer, Boehringer Ingelheim,
More informationNOAC trials for AF: A review
NOAC trials for AF: A review Chern-En Chiang, MD, PhD, FACC, FESC General Clinical Research Center Division of Cardiology Taipei Veterans General Hospital National Yang-Ming University Taipei, Taiwan Presenter
More informationcontroversies in anticoagulation: optimizing outcome for atrial fibrillation
controversies in anticoagulation: optimizing outcome for atrial fibrillation SUNDAY, NOVEMBER 13, 2016 WESTIN HOTEL NEW ORLEANS CANAL PLACE COLLABORATE INVESTIGATE EDUCATE PROVIDING PERSPECTIVE: CURRENT
More informationDabigatran Evidence in Real Practice
ADVANCES IN CARDIAC ARRHYTHMIAS and GREAT INNOVATIONS IN CARDIOLOGY XXVII GIORNATE CARDIOLOGICHE TORINESI Torino, Centro Congressi Unione Industriale 23-24 Ottobre 2015 Dabigatran Evidence in Real Practice
More informationEdoxaban in Atrial Fibrillation
Edoxaban in Atrial Fibrillation Glenn Gormley, MD, PhD Senior Executive Officer and Global Head of R&D, Daiichi Sankyo Co., Ltd Nov. 4, 2014 Tuesday Background Based on the results of ENGAGE AF-TIMI 48,
More informationMODULE 1: Stroke Prevention in Atrial Fibrillation Benjamin Bell, MD, FRCPC
MODULE 1: Stroke Prevention in Atrial Fibrillation Benjamin Bell, MD, FRCPC Specialty: General Internal Medicine Lecturer, Department of Medicine University of Toronto Staff Physician, General Internal
More informationPros and Cons of Individual Agents Based on Large Trial Results: RELY, ROCKET, ARISTOTLE, AVERROES
Pros and Cons of Individual Agents Based on Large Trial Results: RELY, ROCKET, ARISTOTLE, AVERROES Ralph L. Sacco, MS MD FAAN FAHA Olemberg Family Chair in Neurological Disorders Miller Professor of Neurology,
More informationPractical Considerations for Using Oral Anticoagulants in Patients with Chronic Kidney Disease
Practical Considerations for Using Oral Anticoagulants in Patients with Chronic Kidney Disease Cyrille K. Cornelio, Pharm.D. PGY2 Cardiology Pharmacy Resident The University of Oklahoma College of Pharmacy
More informationA Patient Unsuitable for VKA Treatment
Will Apixaban change practice in atrial fibrillation? A Patient Unsuitable for VKA Treatment Professor Yoseph Rozenman The E. Wolfson Medical Center Jerusalem June 2013 Disclosures I have the following
More informationDirect Oral Anticoagulants (DOACs). Dr GM Benson Director NI Haemophilia Comprehensive Care Centre and Thrombosis Unit BHSCT
Direct Oral Anticoagulants (DOACs). Dr GM Benson Director NI Haemophilia Comprehensive Care Centre and Thrombosis Unit BHSCT OAC WARFARIN Gold standard DABIGATRAN RIVAROXABAN APIXABAN EDOXABAN BETRIXABAN
More informationArrhythmias and Clinical EP Contemporary Management of Anticoagulant Therapies
Arrhythmias and Clinical EP Contemporary Management of Anticoagulant Therapies Samuel Asirvatham, MD & Ivan Mendoza, MD Saturday, June 24, 2017 11:15 a.m. to 12 p.m. Disclosures Relevant financial relationship(s)
More informationAims. AF and Stroke risk Guidance re anticoagulation Novel oral anticoagulants (NOACs) in non-valvular AF (NVAF) Practical Issues Patient Case Studies
Aims AF and Stroke risk Guidance re anticoagulation Novel oral anticoagulants (NOACs) in non-valvular AF (NVAF) Practical Issues Patient Case Studies AF and Stroke AF prevalence approx doubles with each
More informationRole of NOACs in AF Management. From Evidence to Real World Data Focus on Cardioversion
Role of NOACs in AF Management. From Evidence to Real World Data Focus on Cardioversion John Rickard MD, MPH Staff Electrophysiologist Cleveland Clinic Agenda NOACs: Update on Real World Data NOAC reversal:
More informationPharmacologic Agents to Prevent Stroke in Non-Valvular Atrial Fibrillation and PFO
Pharmacologic Agents to Prevent Stroke in Non-Valvular Atrial Fibrillation and PFO Gregg W. Stone, MD Columbia University Medical Center The Cardiovascular Research Foundation Disclosures None Risk of
More informationKCS Congress: Impact through collaboration
Stroke Prevention in Atrial Fibrillation (SPAF) in Kenya Elijah N. Ogola FACC University of Nairobi Kenya Cardiac Society Annual Scientific Congress Mombasa 28 th June 1 st July 2017 KCS Congress: Impact
More informationNOACs in AF. Dr Colin Edwards Auckland Heart Group and Waitemata DHB. Dr Fiona Stewart Auckland Heart Group and Auckland DHB
NOACs in AF Dr Colin Edwards Auckland Heart Group and Waitemata DHB Dr Fiona Stewart Auckland Heart Group and Auckland DHB Conflict of Interest Dr Fiona Stewart received funding from Pfizer to attend the
More informationINR as a Biomarker: Anticoagulation in Atrial Fib, Heart Failure, and Cardiovascular Disease Daniel Blanchard, MD, FACC, FAHA
INR as a Biomarker: Anticoagulation in Atrial Fib, Heart Failure, and Cardiovascular Disease Daniel Blanchard, MD, FACC, FAHA Professor of Medicine Director, Cardiology Fellowship Program Sulpizio Cardiovascular
More informationAnticoagulation: Novel Agents
Anticoagulation: Novel Agents Scott C. Woller, MD Medical Director, Anticoagulation Management, Intermountain Healthcare Central Region, co-director Venous Thromboembolism Program, Intermountain Medical
More informationAF in Asian: which NOAC to choose for particular patient and at what dose? DEJIA HUANG West China Hospital of Sichuan University, Chengdu, China
AF in Asian: which NOAC to choose for particular patient and at what dose? DEJIA HUANG West China Hospital of Sichuan University, Chengdu, China Case report 64-year-old Chinese man with history of hypertension,
More informationLessons from recent antithrombotic studies and trials in atrial fibrillation
Lessons from recent antithrombotic studies and trials in atrial fibrillation Thromboembolism cause of stroke in AF Lars Wallentin Uppsala Clinical Research Centre (UCR) Uppsala Disclosures for Lars Wallentin
More informationUtilizing Anticoagulants for Atrial Fibrillation Related Stroke Prevention
Utilizing Anticoagulants for Atrial Fibrillation Related Stroke Prevention Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania
More informationOral Anticoagulants Update. Elizabeth Renner, PharmD, BCPS, BCACP, CACP Outpatient Cardiology and Anticoagulation
Oral Anticoagulants Update Elizabeth Renner, PharmD, BCPS, BCACP, CACP Outpatient Cardiology and Anticoagulation Objectives List the direct oral anticoagulant (DOAC) drugs currently available Describe
More informationStepheny Sumrall, FNP, AGACNP Cardiovascular Clinic of Hattiesburg
Novel Oral Anticoagulants Analyzing Clinical Trial Findings of the Efficacy and Safety Profiles of Novel Anticoagulants for the Treatment of Atrial Fibrillation and Prevention of Stroke Stepheny Sumrall,
More informationUpdate on the NOAC s: 2018 Daniel Blanchard, MD, FACC, FAHA
Update on the NOAC s: 2018 Daniel Blanchard, MD, FACC, FAHA Professor of Medicine Director, Cardiology Fellowship Program Sulpizio Cardiovascular Center UC San Diego The NOACS, chronologically Dabigatran:
More informationEdoxaban. Direct Xa inhibitor Direct thrombin inhibitor Direct Xa inhibitor Direct Xa inhibitor
This table provides a summary of the pharmacotherapeutic properties, side effects, drug interactions and other important information on the four anticoagulant medications currently in use or under review
More informationTSHP 2014 Annual Seminar 1
Debate: Versus the Rest of the World for Stroke Prevention in Non-valvular Atrial Fibrillation Matthew Wanat, PharmD, BCPS Clinical Assistant Professor University of Houston College of Pharmacy Clinical
More informationNew options in Stroke Prevention in AF Paul Dorian University of Toronto St Michael s Hospital
New options in Stroke Prevention in AF Paul Dorian University of Toronto St Michael s Hospital Disclosures: Honoraria, research support, and consulting f Sanofi, Boehringer-Ingleheim, Portola, BMS, Bayer,
More informationStable CAD, Elective Stenting and AFib
Stable CAD, Elective Stenting and AFib Kurt Huber, MD, FESC, FACC, FAHA 3 rd Medical Department Cardiology & Intensive Care Medicine Wilhelminenhospital & Sigmund Freud Private University, Medical School
More informationWhen and how to combine antiplatelet agents and anticoagulant?
When and how to combine antiplatelet agents and anticoagulant? Christophe Beauloye, MD, PhD Head, Division of Cardiology Cliniques Universitaires Saint-Luc Brussels, Belgium Introduction Anticoagulation
More information6 th ACC-SHA Joint Meeting Jeddah, Saudi Arabia
6 th ACC-SHA Joint Meeting Jeddah, Saudi Arabia October 31 st - November 1 st, 2015 NOACS vs. Coumadin in Atrial Fibrillation: Is It Worth to Switch? Raed Sweidan, MD, FACC Consultant and Head of Cardiac
More informationPRACTICAL MANAGEMENT OF NOAC s December 8,
PRACTICAL MANAGEMENT OF NOAC s December 8, 2017 1 Faculty Disclosure Faculty: John Eikelboom MBBS, MSc, FRCPC Jack Hirsh/PHRI Chair in Thrombosis and Atherosclerosis Career Award, Heart and Stroke Foundation
More informationNOACs Update PD Dr. Jan Steffel Leitender Arzt, Klinik für Kardiologie Co-Leiter Rhythmologie Universitätsspital Zürich
NOACs Update 2016 PD Dr. Jan Steffel Leitender Arzt, Klinik für Kardiologie Co-Leiter Rhythmologie Universitätsspital Zürich Conflict of Interest Statement o o o o Consulting: Amgen, Astra Zeneca, AtriCure,
More informationAF stroke prevention in the Canadian context
AF stroke prevention in the Canadian context 5 th Annual State of the Heart Toronto, May 31, 2014 Andrew C.T. Ha, MD, MSc, FRCPC Cardiac Electrophysiology Toronto General Hospital, University Health Network
More informationScoring Systems in AF 8/10/2016. Strategies in the Prevention of Atrial Fibrillation-Related Strokes. Overview
Strategies in the Prevention of Atrial Fibrillation-Related Strokes Rajat Deo, MD, MTR Assistant Professor of Medicine Division of Cardiology, Electrophysiology Section University of Pennsylvania September
More informationCanadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC
Canadian Society of Internal Medicine Annual Meeting 2016 Montreal, QC DEBATE: DOAC vs Good Old Warfarin André Roussin MD, FRCP, CSPQ CHUM and ICM/MHI Associate professor University of Montreal A. Roussin
More informationAntithrombotics in Stroke management
Antithrombotics in Stroke management Faculty: Robert Beveridge Relationships with commercial interests: Grants/Research Support: N/A Speakers Bureau/Honoraria: Astra Zeneca, Bayer, Boerhinger Ingelheim,
More informationDIRECT ORAL ANTICOAGULANTS
2017 Cardiovascular Symposium DIRECT ORAL ANTICOAGULANTS ERNESTO UMAÑA, MD, FACC ORAL ANTICOAGULANTS Vitamin K Antagonists (VKAs): Warfarin Non Vitamin K Antagonists Direct oral anticoagulants Novel Oral
More informationThe INR: No Need Anymore? Daniel Blanchard, MD Professor of Medicine Director, Cardiology Fellowship Program UCSD Sulpizio Cardiovascular Center
The INR: No Need Anymore? Daniel Blanchard, MD Professor of Medicine Director, Cardiology Fellowship Program UCSD Sulpizio Cardiovascular Center What is the INR? Tissue Factor (Factor III) is added to
More informationAtrial Fibrillation: Risk Stratification and Treatment New Cardiovascular Horizons St. Louis September 19, 2015
Atrial Fibrillation: Risk Stratification and Treatment New Cardiovascular Horizons St. Louis September 19, 2015 Christopher E. Bauer, MD, FACC, FHRS SSM Health Heart & Vascular Care Clinical Cardiac Electrophysiology
More informationAnticoagulation Therapy in LTC
Anticoagulation Therapy in LTC By: Cynthia Leung, RPh, BScPhm, PharmD. Clinical Consultant Pharmacist MediSystem Pharmacy Jun 11, 2013 Agenda Stroke and Bleeding Risk Assessment Review of Oral Anticoagulation
More informationAn Overview of Non Vitamin-K Antagonist Oral Anticoagulants. Helen Williams Consultant Pharmacist for CV Disease South London
An Overview of Non Vitamin-K Antagonist Oral Anticoagulants Helen Williams Consultant Pharmacist for CV Disease South London Contents Drugs and drug classes Licensed indications and NICE recommendations
More informationPCI in Patients with AF Optimizing Oral Anticoagulation Regimen
PCI in Patients with AF Optimizing Oral Anticoagulation Regimen Walid I. Saliba, MD Director, Atrial Fibrillation Center Heart and Vascular Institute Cleveland Clinic 1 Epidemiology and AF and PCI AF and
More informationNovità in Tema di NOACs Cardioversione Riccardo Cappato, MD
Novità in Tema di NOACs Cardioversione Riccardo Cappato, MD Electrophysiology & Arrhythmia Center IRCCS Humanitas Research Institute, Milan & Gavazzeni Clinics, Bergamo - Italy Disclosure Statement of
More informationModern Management in Primary Care (AF1)
Modern Management in Primary Care (AF1) Dr Ravi Assomull Consultant Cardiologist London North West Healthcare NHS Trust Dr Yassir Javaid Primary Care Cardiovascular Lead East Midlands Strategic Clinical
More informationSecondary Preven-on of Thromboembolic Stroke: Clinical Data and Recommenda-ons from the ESC Atrial Fibrilla-on Guideline Update 2012
Secondary Preven-on of Thromboembolic Stroke: Clinical Data and Recommenda-ons from the ESC Atrial Fibrilla-on Guideline Update 2012 Professor Dan Atar Head, Dept. of Cardiology Councillor of the ESC,
More informationStroke prevention, Clinical trials
Received: 13 May 2016 Revised: 8 August 2016 Accepted: 18 August 2016 DOI 10.1002/clc.22596 REVIEWS Special considerations for therapeutic choice of non vitamin K antagonist oral anticoagulants for Japanese
More informationAnticoagulation with Direct oral anticoagulants (DOACs) and advances in peri-procedural interruption of anticoagulation-- Bridging
Anticoagulation with Direct oral anticoagulants (DOACs) and advances in peri-procedural interruption of anticoagulation-- Bridging Scott C. Woller, MD Co-Director, Thrombosis Program Intermountain Medical
More informationThe Role of Oral Anticoagulants in Atrial Fibrillation: What You Need to Know Now. Bradley A. Hardin, MD Richard F.
The Role of Oral Anticoagulants in Atrial Fibrillation: What You Need to Know Now Bradley A. Hardin, MD Richard F. Otten, MD, FACC Outline Atrial Fibrillation Overview Overview of New Oral Anticoagulants
More informationNOAC s across indications
Sektion CAMPUS INNENSTADT Med. Klinik und Poliklinik IV NOAC s across indications Ulrich Hoffmann, M.D. Division of Vascular Medicine University Hospital Munich, Germany Disclosure Speaker name: Ulrich
More informationIndividual Therapeutic Selection Of Anti-coagulants And Periprocedural. Miguel Valderrábano, MD
Individual Therapeutic Selection Of Anti-coagulants And Periprocedural Management Miguel Valderrábano, MD Outline Does the patient need anticoagulation? Review of clinical evidence for each anticoagulant
More informationΑντιπηκτική αγωγή 2017 Νέες μελέτες, πραγματικά δεδομένα και κλινική πράξη
Αντιπηκτική αγωγή 2017 Νέες μελέτες, πραγματικά δεδομένα και κλινική πράξη Σταύρος Β. Κωνσταντινίδης, MD, PhD, FESC Καθηγητής Καρδιολογίας Δημοκρίτειο Πανεπιστήμιο Θράκης skonst@med.duth.gr Medical Director
More informationACCP Cardiology PRN Journal Club
ACCP Cardiology PRN Journal Club 1 Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Valvular Heart Disease Cody A. Carson, PharmD, BCPS PGY2 Cardiology Pharmacy Resident
More informationAntithrombotic Efficacy and Safety of Dabigatran Etexilate
130419 Luncheon Symposium_2013 춘계심장학회 Antithrombotic Efficacy and Safety of Dabigatran Etexilate Hui-Nam Pak, MD, PhD. Division of Cardiology Yonsei University Health System Atrial Fibrillation Risk of
More informationSTROKE PREVENTION 5/11/2015. Stroke Incidence by Age. Cardiogenic Embolism is the most common cause of stroke
(%) (%) 5/11/15 STROKE PREVENTION Stroke Incidence by Age T H E G E N E R A L P R A C T I C E E D U C A T I O N D A Y U N I V E R S I T Y O F Q U E E N S L A N D 3 1 O C T O B E R 2 1 5 A S S O C I A T
More informationModeling the Risk of Stroke and Bleeding in Atrial Fibrillation: What Are the Optimal Risk Scores? Roxana Mehran, MD
Modeling the Risk of Stroke and Bleeding in Atrial Fibrillation: What Are the Optimal Risk Scores? Roxana Mehran, MD Mount Sinai School of Medicine New York, NY Session II. Weighing the Risks and Benefits
More informationAnticoagulation Beyond Coumadin
Anticoagulation Beyond Coumadin Saturday, September 21, 2013 Crystal Mountain Resort and Spa Pratik Bhattacharya MD, MPH Stroke Neurologist, Michigan Stroke Network; Assistant Professor of Neurology; Wayne
More informationNew Aspects in the Diagnosis and Treatment of Atrial Fibrillation: Antithrombotic Therapy
New Aspects in the Diagnosis and Treatment of Atrial Fibrillation: Antithrombotic Therapy Hans-Christoph Diener Department of Neurology and Stroke Center University Hospital Essen Germany Conflict of Interest
More informationNew Anticoagulants Therapies
New Anticoagulants Therapies Rachel P. Rosovsky, MD, MPH October 22, 2015 Conflicts of Interest No disclosures 2 Agenda 3 Historical perspective Novel oral anticoagulants Stats Trials Approval Concerns/Limitations
More informationAnticoagulation Task Force
Anticoagulation Task Force Newest Recommendations Donald Zabriskie, BPharm, MBA, RPh Pharmacy Patient Care Services Cleveland Clinic- Fairview Hospital THE DRUGS THE PERFECT ANTICOAGULANT Oral administration
More informationNew Antithrombotic Agents DISCLOSURE
New Antithrombotic Agents DISCLOSURE Relevant Financial Relationship(s) Speaker Bureau None Research Alexion (PNH) delought@ohsu.edu Tom DeLoughery, MD FACP FAWM Oregon Health and Sciences University What
More informationPrepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution
Prepared by Pfizer-BMS alliance in response to an unsolicited request Not for further distribution AF review Petr Polasek Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document
More informationAF review. Petr Polasek
AF review Petr Polasek Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or by any means graphic, electronic,
More informationDOAC the story so far... Dr GM Benson Director NI Haemophilia and Thrombosis Centre BHSCT
DOAC the story so far... Dr GM Benson Director NI Haemophilia and Thrombosis Centre BHSCT A rose by any other name.. Recommendation on the nomenclature for oral anticoagulants: communication from the SSC
More informationNovel Anticoagulants PHYSICIANS UPDATE 2014
Novel Anticoagulants PHYSICIANS UPDATE 2014 Farouk Mookadam MD FRCPC FACC MSc Professor College of Medicine Mayo Consultant Cardiovascular Diseases Medical Director Anticoagulation Clinic Assoc Programme
More informationNOAC 2015: What Have We Learned?
NOAC 2015: What Have We Learned? Milan Gupta, MD Canadian Cardiovascular Research Network University of Toronto, McMaster University www.ccrnmd.com Disclosures Honoraria / Research Grants Abbott, Aegerion
More informationOral Anticoagulation Drug Class Prior Authorization Protocol
Oral Anticoagulation Drug Class Prior Authorization Protocol Line of Business: Medicaid P & T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed through review
More informationDebate: New Generation Anti-Coagulation Agents are a Better Choice than Warfarin in the Management of AF
Debate: New Generation Anti-Coagulation Agents are a Better Choice than Warfarin in the Management of AF Bradley P. Knight, MD Director of Cardiac Electrophysiology Bluhm Cardiovascular Institute Northwestern
More informationWhat s new with DOACs? Defining place in therapy for edoxaban &
What s new with DOACs? Defining place in therapy for edoxaban & Use of DOACs in cardioversion Caitlin M. Gibson, PharmD, BCPS Assistant Professor, Department of Pharmacotherapy University of North Texas
More informationUpdate with the New Oral Anticoagulants: Today s Issues for the Front Line Pharmacist
Update with the New Oral Anticoagulants: Today s Issues for the Front Line Pharmacist Peter Thomson, Pharm D. Clinical Resource Pharmacist, Medicine Program Winnipeg Regional Health Authority Clinical
More informationApixaban versus Heparin/Vitamin K Antagonist in Anticoagulation-naïve Patients with Atrial Fibrillation Scheduled for Cardioversion: The EMANATE Trial
Apixaban versus Heparin/Vitamin K Antagonist in Anticoagulation-naïve Patients with Atrial Fibrillation Scheduled for Cardioversion: The EMANATE Trial Michael D. Ezekowitz, Professor, Sidney Kimmel Medical
More informationShow Me the Outcomes!
Show Me the Outcomes! Real-World Safety Data on Oral Anticoagulants in Nonvalvular Atrial Fibrillation Gabby Anderson, PharmD PGY1 Pharmacy Resident anderson.gabrielle@mayo.edu Pharmacy Grand Rounds October
More informationThe INR: No Need Anymore? Daniel Blanchard, MD Professor of Medicine Director, Cardiology Fellowship Program UCSD Sulpizio Cardiovascular Center
The INR: No Need Anymore? Daniel Blanchard, MD Professor of Medicine Director, Cardiology Fellowship Program UCSD Sulpizio Cardiovascular Center What is the INR? Tissue Factor (Factor III) is added to
More informationNew Strategies in the World of Anticoagulant Therapy. October 13, 2012 Elaine M. Hylek, MD, MPH Boston University Medical Center
New Strategies in the World of Anticoagulant Therapy October 13, 2012 Elaine M. Hylek, MD, MPH Boston University Medical Center Presenter Disclosure Information Elaine M. Hylek, MD, MPH Research: NIH/NINDS,
More informationNovel Anticoagulants : Bleeding and Bridging
Novel Anticoagulants : Bleeding and Bridging Michael D. Ezekowitz, MBChB, DPhil, FACC, FAHA, FRCP, MA Professor, Thomas Jefferson Medical School Director Atrial Fibrillation Research and Education The
More informationAfib, Stroke, and DOAC. Albert Luo, MD. Cardiology Lindsey Frischmann, DO. Neurology Xiao Cai, MD. HBS
Afib, Stroke, and DOAC Albert Luo, MD. Cardiology Lindsey Frischmann, DO. Neurology Xiao Cai, MD. HBS Disclosure of Relevant Financial Relationships I have no relevant financial relationships with commercial
More informationStroke Prevention in AF: How will it change in the next 5 years? Jeff Healey MD, MSc, FHRS Population Health Research Institute McMaster University
Stroke Prevention in AF: How will it change in the next 5 years? Jeff Healey MD, MSc, FHRS Population Health Research Institute McMaster University Disclosures Research Grants and speaking fees St. Jude
More informationPeer Review Report #2. Novel oral anticoagulants. (1) Does the application adequately address the issue of the public health need for the medicine?
20 th Expert Committee on Selection and Use of Essential Medicines Peer Review Report #2 vel oral anticoagulants (1) Does the application adequately address the issue of the public health need for the
More informationNovel Anticoagulants: Emerging Evidence
18/10/2016 Topics: Novel Anticoagulants: Emerging Evidence Dr Matthew Swale Electrophysiologist Genesis Care NOAC Novel Oral Anti Coagulant Now Non-Vit K Oral Anti Coagulant DOAC Direct Oral Anti Coagulant
More informationNew Antithrombotic Agents
New Antithrombotic Agents Tom DeLoughery, MD FACP FAWM Oregon Health and Sciences University DISCLOSURE Relevant Financial Relationship(s) Speaker Bureau None What I am Talking About 1. New Antithrombotic
More informationLeft Atrial Appendage Closure: The Rationale
Left Atrial Appendage Closure: The Rationale JOHN D. HUMMEL, MD DIRECTOR OF CLINCAL ELECTROPHYSIOLOGY RESEARCH PROFESSOR OF CLINICAL INTERNAL MEDICINE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER 1 Disclosures
More informationNEW APPROACHES AND NEW ANTICOAGULANTS FOR ATRIAL FIBRILLATION
NEW APPROACHES AND NEW ANTICOAGULANTS FOR ATRIAL FIBRILLATION MAY 1, 2015 Melissa R. Robinson, MD FACC FHRS CCDS Assistant Professor of Medicine Director of the Complex Arrhythmia Service POINTS TO MAKE
More informationJoshua D. Lenchus, DO, RPh, FACP, SFHM Associate Professor of Medicine and Anesthesiology University of Miami Miller School of Medicine
Joshua D. Lenchus, DO, RPh, FACP, SFHM Associate Professor of Medicine and Anesthesiology University of Miami Miller School of Medicine Antithrombotics Antiplatelets Aspirin Ticlopidine Prasugrel Dipyridamole
More informationThe Age of the Novel Anticoagulants. Peter Netzler, MD April 21, 2017 Carolina Cardiology Electrophysiology
The Age of the Novel Anticoagulants Peter Netzler, MD April 21, 2017 Carolina Cardiology Electrophysiology Disclosures Speaker bureau for the Bristol-Myers Squibb and Pfizer alliance for Eliquis Direct
More informationAntithrombotics in the elderly. Robert Gabor Kiss FESC FACC Budapest
Antithrombotics in the elderly Robert Gabor Kiss FESC FACC Budapest The patient in the elderly You are sitting in Your office prescribing drugs and observing outcome The black box from prescription to
More informationDaniela Poli 12 Novembre 2016
Daniela Poli 12 Novembre 2016 Prevalence of AF in relation to age and sex
More informationRETROSPECTIVE CLAIMS DATABASE STUDIES OF DIRECT ORAL ANTICOAGULANTS (DOACS) FOR STROKE PREVENTION IN NONVALVULAR ATRIAL FIBRILLATION
RETROSPECTIVE CLAIMS DATABASE STUDIES OF DIRECT ORAL ANTICOAGULANTS (DOACS) FOR STROKE PREVENTION IN NONVALVULAR ATRIAL FIBRILLATION Craig I. Coleman, PharmD Professor, University of Connecticut School
More informationModern management of atrial fibrillation, from blood pressure control to anticoagulation
Modern management of atrial fibrillation, from blood pressure control to anticoagulation Adel Khalifa S. Hamad, BMS, MD, FRCP(Canada) Consultant Cardiologist & Interventional Cardiac Electrophysiologist
More information