Anticoagulants oraux directs : dans quelles indications ? Lequel prescrire ? Pour ou contre chez les personnes fragiles et dans les situations atypiques ? Quelle surveillance et gestion des accidents hémorragiques ?

Hoffmann, Clément; Leven, Cyril; Mao, Raphaël Le; Moreuil, Claire de; Lacut, Karine

doi:10.1016/j.revmed.2020.05.026

Cited by 4 publications

(5 citation statements)

References 57 publications

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“…DOAC and VKA have similar indications, including stroke prevention in AF [11], curative treatment of VTE, and prevention of VTE recurrence [12]. Yet, there are also some notable differences between the two treatments.…”

Section: Introductionmentioning

confidence: 99%

“…Yet, there are also some notable differences between the two treatments. DOAC are not recommended in valvular AF, while they are specifically indicated in the prevention of VTE after surgery for total hip or knee replacement [12]. VKA are recommended in the prevention of thromboembolic complications in mitral valvular AF and prosthetic heart valve or thrombosis treatment in antiphospholipid syndrome [13].…”

Section: Introductionmentioning

confidence: 99%

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Direct Oral Anticoagulants versus Vitamin K Antagonists in Individuals Aged 80 Years and Older: An Overview in 2021

Azzoug¹,

Nuemi

et al. 2023

IJERPH

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Two main types of oral anticoagulants are available in France: vitamin K antagonists (VKA) and, more recently, direct oral anticoagulants (DOAC). The benefit–risk profile appears to be favorable for DOAC, which is as effective as VKA but safer (fewer cases of severe and cerebral bleeding). In a study in 2017, we observed that older adults did not seem to receive the same modalities of oral anticoagulants as younger individuals for various reasons. To assess anticoagulation prescribing practices over time, we repeated this cross-sectional study by comparing very old individuals taking DOAC to those taking VKA. Ambulatory individuals aged 80 years and older were included. They were affiliated with the Mutualité Sociale Agricole of Burgundy and were refunded for a medical prescription of oral anticoagulation in March 2021. The demographic characteristics, registered chronic diseases (RCD), number and types of prescribed drugs, and mortality of the DOAC group and the VKA group were compared. A total of 4275 subjects were included in the study: 67.44% (2883) received DOAC and 32.56% (1392) received VKA. The two groups were similar in age. In the DOAC group, there were more women (54.98% vs. 46.98%) (p < 0.001), fewer RCD (91.47% vs. 93.68%) (p = 0.014), and lower rates of venous thromboembolism (2.53% vs. 6.75%) (p < 0.001), severe heart failure (56.50% vs. 68.03%) (p < 0.001), and severe kidney diseases (1.38% vs. 3.59%) (p < 0.001), but there were more subjects with Alzheimer’s disease (7.49% vs. 4.31%) (p = 0.001). Individuals in the DOAC group had fewer prescriptions of furosemide (48.53% vs. 55.75%) (p < 0.001) and fibrates (2.32% vs. 3.88%) (p = 0.044). They also had more prescriptions of proton pump inhibitors (43.95% vs. 39.44%) (p = 0.006) and antirheumatics (1.60% vs. 0.65%) (p = 0.009) than those in the VKA group. There was no difference in mortality. This study revealed that prescribing practices for DOAC have changed over time.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Direct Oral Anticoagulants versus Vitamin K Antagonists in Individuals Aged 80 Years and Older: An Overview in 2021

Azzoug¹,

Nuemi

et al. 2023

IJERPH

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“…Both DOACs and VKAs are indicated: (1) to prevent stroke in AF, (2) in curative treatment of VTE, including pulmonary embolism, and (3) in prevention of VTE recurrence. However, DOACs cannot be used in valvular AF [ 8 , 9 ]. Another specific indication for DOACs is the prevention of VTE after surgery for total hip or knee prosthesis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, DOACs cannot be used in valvular AF [ 8 , 9 ]. Another specific indication for DOACs is the prevention of VTE after surgery for total hip or knee prosthesis [ 8 ]. In addition, rivaroxaban is indicated in prevention of atherothrombotic events after acute coronary syndrome or in case of stable coronary or peripheral artery disease [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Another specific indication for DOACs is the prevention of VTE after surgery for total hip or knee prosthesis [ 8 ]. In addition, rivaroxaban is indicated in prevention of atherothrombotic events after acute coronary syndrome or in case of stable coronary or peripheral artery disease [ 8 ]. As concerns VKAs, their specific indication is the prevention of thromboembolic complications in other heart rhythm disorders (atrial flutter, atrial tachycardia), mitral valve disease, heart valve prosthesis, or myocardial infarction with embolic risk (for example mural thrombus or severe left ventricular dysfunction) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older

Manckoundia

Nuemi

Hacquin³

et al. 2021

IJERPH

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The effectiveness of direct oral anticoagulants (DOAC) is non-inferior to vitamin K antagonists (VKA) to treat atrial fibrillation and venous thromboembolism (VTE). In this cross-sectional study, we compared older persons taking DOACs to those taking VKAs. We included ambulatory individuals ≥80 years, affiliated to Mutualité Sociale Agricole of Burgundy, who were refunded for a medical prescription in September 2017. The demographic conditions, registered chronic diseases (RCD), and number and types of prescribed drugs were compared in the DOAC group and VKA group. Of the 3190 included individuals, 1279 (40%) were prescribed DOACs and 1911 (60%) VKAs. Individuals taking VKAs were older than those taking DOACs (87.11 vs. 86.35 years). In the DOAC group, there were more women (51.92% vs. 48.25%) (p = 0.043), less RCD (89.60% vs. 92.73%) (p = 0.002), less VTE (1.80% vs. 6.59%), less severe heart failure (58.09% vs. 67.87%), less severe hypertension (18.22% vs. 23.60%), less severe kidney diseases (1.49% vs. 3.82%), and fewer drugs per prescription (6.15 vs. 6.66) (p < 0.01 for all). The DOAC group were also less likely to be taking angiotensin receptor blockers (10.79% vs. 13.97%), furosemide (40.81% vs. 49.66%) or digoxin (10.32% vs. 13.66%) than the VKA group (p = 0.009, p < 0.001, and p = 0.005). DOACs were less prescribed than VKAs. Individuals taking VKAs were older and had more severe comorbidities and more drugs per prescription than those taking DOACs.

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Advancements and Applications of Adipose-Derived Stem Cells in Modern Medicine: A Comprehensive Review

Pakhomova,

Vinnik,

Kochetova

et al. 2024

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The literature review examines the significant role of adipose-derived stem cells (ASCs) as a segment of mesenchymal stem cells in modern medicine. ASCs possess unique characteristics, such as a high ability to differentiate and regenerate, making them a valuable resource in regenerative medicine and therapy. The review focuses on methods for isolating and cultivating ASCs and emphasizes the importance of adhering to standards for monitoring the cultivation and storage processes of stem cells. The molecular and cellular characteristics that enable the use of ASCs in various medical fields, including the treatment of cardiovascular and neurological disorders, reconstructive surgery, and tissue engineering, are described. The ability of ASCs to differentiate into diverse cell types, including osteocytes, adipocytes, neural cells, vascular endothelial cells, and cardiomyocytes, underscores their potential in treating a wide range of diseases.The review addresses critical ethical and safety considerations related to the use of ASCs, particularly their interaction with tumor cells. It emphasizes the need for further in-depth, multidisciplinary studies of ASC interactions with host cells to ensure their safe and effective use in clinical practice. Evidence is presented for the potential of ASCs in treating long-term non-healing diabetic ulcers and wounds by enhancing epithelialization and accelerating granulation tissue formation. Additionally, their ability to reduce the number of fibroblasts in hypertrophied scars is highlighted.In conclusion, the review underscores the significance of ASCs as one of the most promising areas in modern biomedicine and regenerative medicine. It notes that further research on these cells may lead to new approaches in the treatment and prevention of various diseases.

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Anticoagulants oraux directs : dans quelles indications ? Lequel prescrire ? Pour ou contre chez les personnes fragiles et dans les situations atypiques ? Quelle surveillance et gestion des accidents hémorragiques ?

Cited by 4 publications

References 57 publications

Direct Oral Anticoagulants versus Vitamin K Antagonists in Individuals Aged 80 Years and Older: An Overview in 2021

Direct Oral Anticoagulants versus Vitamin K Antagonists in Individuals Aged 80 Years and Older: An Overview in 2021

Direct Oral Anticoagulants versus Vitamin K Antagonists in Patients Aged 80 Years and Older

Advancements and Applications of Adipose-Derived Stem Cells in Modern Medicine: A Comprehensive Review

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