Antithrombotic Therapy in Atrial Fibrillation  - Evaluation and Positioning of New Oral Anticoagulant Agents -

Ogawa, Satoshi; Koretsune, Yukihiro; Yasaka, Masahiro; Aizawa, Yoshifusa; Atarashi, Hirotsugu; Inoue, Hiroshi; Kamakura, Shiro; Kumagai, Koji; Mitamura, Hideo; Okumura, Ken; Sugi, Kaoru; Yamashita, Takeshi

doi:10.1253/circj.cj-11-0304

Cited by 52 publications

(8 citation statements)

References 56 publications

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“…This is a relatively low percentage compared with the other studies [1] [2]. This result also warranted safety of the concomitant use of warfarin and PPI.…”

Section: Discussionmentioning

confidence: 66%

Interaction between Warfarin and Proton Pump Inhibitors

Shirayama¹,

Shiraishi²,

Kuroyanagi³

et al. 2014

IJCM

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Background: Interaction between proton pump inhibitors (PPI) and warfarin is controversial. Previous clinical studies have only a short follow-up period. Methods and Results: All patients (n = 716) for whom warfarin was prescribed from November 1, 2010 to October 30, 2011 were extracted from electronic health records. In retrospective analysis for 1 year, PPI were prescribed to 404 patients. Among them, 108 patients were taking warfarin for more than 6 weeks before and after PPI. The profile of these patients was analyzed: 63 patients took lansoprazole; 15 patients took omeprazole; 30 patients took rabeprazole. No statistical difference was observed among 3 groups in age, body weight, concomitant use of other drugs, and comorbidity. Warfarin dose and INR did not change after PPI. Multivariate stepwise logistic regression analysis revealed that upper quartile of increment of INR was associated with the presence of atrial fibrillation (OR 3.77, 95% CI 1.16 -12.27). The patients who had warfarin for shorter periods before PPI, or those who had PPI first (n = 141) had similar dose of warfarin and INR. In all patients analyzed (n = 404), including patients whose follow-up periods were shorter than 6 weeks (n = 155), a patient had cerebral bleeding, and 2 patients had cerebral infarction. Conclusions: Unfavorable interaction between warfarin and PPI was negligible in clinical use. Relatively higher INR was achieved after PPI in the presence of atrial fibrillation.

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“…This is a relatively low percentage compared with the other studies [1] [2]. This result also warranted safety of the concomitant use of warfarin and PPI.…”

Section: Discussionmentioning

confidence: 66%

Interaction between Warfarin and Proton Pump Inhibitors

Shirayama¹,

Shiraishi²,

Kuroyanagi³

et al. 2014

IJCM

View full text Add to dashboard Cite

show abstract

“…After the hemorrhagic event, warfarin was replaced with dabigatran, a novel oral anti-coagulant approved for use in Japan in 2011. 18 Although hemorrhagic complications are less common in patients using dabigatran than in those using warfarin, 18,19 there is a lack of data on the frequency of dabigatran-associated hemorrhage in patients who have already sustained warfarin-associated hemorrhage, and careful follow-up is warranted.…”

Section: Discussionmentioning

confidence: 99%

Warfarin-associated Intraspinal Hematoma

et al. 2016

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Intracerebral hemorrhage is a well-known complication resulting from warfarin use; however, warfarin-associated intraspinal hematoma is very rare. Warfarin-associated intraspinal hematoma may exhibit delayed progression, and patients may present with atypical symptoms, occasionally resulting in delayed diagnosis. We report the case of a 65-year-old man who visited our emergency department (ED) with acute urinary retention. He had been previously diagnosed with non-valvular atrial fibrillation, arterial hypertension, and benign prostatic hyperplasia, and he used warfarin for the prevention of systemic embolism. The patient was initially diagnosed with worsening of the prostatic hyperplasia. After 2 days, he revisited the ED with painless paraparesis. Magnetic resonance imaging of the thoracic spine revealed an intraspinal hematoma at Th7-8, and blood coagulation tests indicated a prothrombin time-international normalized ratio of 3.33. Despite attempts to reverse the effects of warfarin with vitamin K administration, the paraparesis progressed to paraplegia, necessitating urgent surgical removal of the hematoma. Partial recovery of motor function was evident after surgery. From the present case, we learned that intraspinal hematoma should be included in the differential diagnosis of patients using warfarin who present with acute urinary retention. Although there are no evidence-based treatment guidelines for warfarin-associated intraspinal hematoma, surgical treatment may be warranted for those who exhibit neurological deterioration.

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“…Table 2 shows the pharmacokinetic characteristics of edoxaban, rivaroxaban, and apixaban 5, 6) . Rivaroxaban and edoxaban are administered once a day, and apixaban is administered twice a day.…”

Section: Pharmacological Characteristics Of Doacsmentioning

confidence: 99%

Direct Oral Anticoagulants for the Treatment of Venous Thromboembolism in Japan

Nakamura

Yamada

2017

J Atheroscler Thromb

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Direct oral anticoagulants (DOACs) were developed to compensate for the demerits of warfarin. In Japan, three factor Xa inhibitors are used for the treatment of venous thromboembolism (VTE): edoxaban, rivaroxaban, and apixaban. Despite problems, such as the inability to monitor their effect and the lack of an antidote, these inhibitors have the same efficacy as conventional treatment with warfarin, and they are associated with a significantly high degree of safety in relation to hemorrhagic complications. East Asians, including Japanese, suffer from hemorrhage more frequently; therefore, DOACs are considered to be highly effective. Although there is no evidence to date, DOACs may be effective in a wide variety of ways, including the possibility that they prevent recurrence over the long term, reduce the length of hospitalization, allow treatment to be started on an outpatient basis, and be effective in cancer patients.

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Antithrombotic Therapy in Atrial Fibrillation - Evaluation and Positioning of New Oral Anticoagulant Agents -

Cited by 52 publications

References 56 publications

Interaction between Warfarin and Proton Pump Inhibitors

Interaction between Warfarin and Proton Pump Inhibitors

Warfarin-associated Intraspinal Hematoma

Direct Oral Anticoagulants for the Treatment of Venous Thromboembolism in Japan

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