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Peak and Trough Concentrations of Apixaban and Rivaroxaban in Adult Patients: A Systematic Review and Meta-Analysis.
J Thromb Haemost
January 2025
Center for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. Electronic address:
Article Synopsis
- Apixaban and rivaroxaban, both factor Xa inhibitors, are used for treating conditions like venous thromboembolism and preventing strokes in atrial fibrillation patients, but their optimal concentration levels in real-world settings are not well understood.
- Researchers conducted a meta-analysis of 16 observational studies to establish average peak and trough concentrations for these medications, involving a total of 2,375 patients.
- The study found that average peak concentrations for apixaban and rivaroxaban were within expected ranges, and certain factors like age and creatinine clearance were found to influence these concentrations.
Real-Time Imaging of Platelet-Initiated Plasma Clot Formation and Lysis Unveils Distinct Impacts of Anticoagulants.
Thromb Haemost
January 2025
Department of Medical Physiology, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Background: Fibrinolysis is spatiotemporally well-regulated and greatly influenced by activated platelets and coagulation activity. Our previous real-time imaging analyses revealed that clotting commences on activated platelet surfaces, resulting in uneven-density fibrin structures, and that fibrinolysis initiates in dense fibrin regions and extends to the periphery. Despite the widespread clinical use of direct oral anticoagulants (DOACs), their impact on thrombin-dependent activation of thrombin-activatable fibrinolysis inhibitor (TAFI) and fibrinolysis remains unclear.
View Article and Find Full Text PDFComorbid diabetes mellitus (DM) in patients with ischemic heart disease (IHD) is a serious factor that significantly impairs the life prognosis and increases the risk of cardiovascular complications (CVC) as well as the likelihood of death. The residual risk of developing CVC in such patients is largely determined by the high thrombotic status, that is associated with hypercoagulation characteristic of DM. Hypercoagulation causes activation of both platelet and coagulation pathways, which leads to an increased susceptibility to thrombosis.
View Article and Find Full Text PDFPulmonary Embolism Masquerading as Acute Abdominal Pain: A Rare and Challenging Diagnosis.
Cureus
November 2024
Radiology, Second Health Cluster, Jeddah, SAU.
Pulmonary embolism (PE) is a potentially fatal condition with variable clinical presentations, ranging from classic respiratory symptoms to rare atypical manifestations. This report describes a 47-year-old woman who presented with acute, severe right upper quadrant abdominal pain, nausea, and vomiting without respiratory complaints. Initial investigations, including abdominal ultrasound and contrast-enhanced CT of the abdomen, revealed no intra-abdominal abnormalities.
View Article and Find Full Text PDFDeterminants of Inappropriate Dosing of Direct Oral Anticoagulants in Non-Valvular Atrial Fibrillation in a Low-Income Country.
Cureus
November 2024
Cardiology, Asociacion Instituto Dominicano de Cardiologia, Santo Domingo, DOM.
Introduction The appropriate use of direct oral anticoagulants (DOACs) is crucial in patients with non-valvular atrial fibrillation (NVAF) to prevent thromboembolic complications. The use of inappropriate doses is common, but information on its prevalence and determining factors in low-income countries is insufficient. Objective The objective of this study is to quantify the prevalence and identify demographic, clinical, and treatment-related factors associated with inappropriate dosing of DOACs in patients with NVAF in a low-income country.
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