Direct oral anticoagulants: analysis of worldwide use and popularity using Google Trends

Lippi, Giuseppe; Mattiuzzi, Camilla; Cervellin, Gianfranco; Favaloro, Emmanuel J.

doi:10.21037/atm.2017.06.65

Cited by 84 publications

(61 citation statements)

References 27 publications

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“…In comparison to warfarin, rivaroxaban performed better in terms of 30-day all-cause readmissions. Overall the DOACs are better tolerated and is continually gaining popularity as compared to VKA 26. The study also reports the significant lower discontinuation rate of rivaroxaban as compared to VKA 23…”

Section: Discussionmentioning

confidence: 82%

Impact of oral anticoagulants on 30-day readmission: a study from a single academic centre

Bhattarai

Hudali

Robinson

et al. 2018

BMJ EBM

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Researchers are extensively searching for modifiable risk factors including high-risk medications such as anticoagulation to avoid rehospitalisation. The influence of oral anticoagulant therapy on hospital readmission is not known. We investigated the impact of warfarin and direct oral anticoagulants (DOACs) on all cause 30-day hospital readmission retrospectively in an academic centre. We study the eligible cohort of 1781 discharges over 2-year period. Data on age, gender, diagnoses, 30-day hospital readmission, discharge medications and variables in the HOSPITAL score (Haemoglobin level at discharge, Oncology at discharge, Sodium level at discharge, Procedure during hospitalisation, Index admission, number of hospital Admissions, Length of stay) and LACE index (Length of stay, Acute/emergent admission, Charlson comorbidity index score, Emergency department visits in previous 6 months), which have higher predictability for readmission were extracted and matched for analysis. Warfarin was the most common anticoagulant prescribed at discharge (273 patients) with a readmission rate of 20% (p<0.01). DOACs were used by 94 patients at discharge with a readmission rate of 4% (p=0.219). Multivariate logistic regression showed an increased risk of readmission with warfarin therapy (OR 1.36, p=0.045). Logistic regression did not show DOACs to be a risk factor for hospital readmission. Our data suggests that warfarin therapy is a risk factor for all-cause 30-day hospital readmission. DOAC therapy is not found to be associated with a higher risk of hospital readmission. Warfarin anticoagulation may be an important target for interventions to reduce hospital readmissions.

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Section: Discussionmentioning

confidence: 82%

Impact of oral anticoagulants on 30-day readmission: a study from a single academic centre

Bhattarai

Hudali

Robinson

et al. 2018

BMJ EBM

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“…Also known by a myriad of other terms, including "nonvitamin K antagonist," novel or new oral anticoagulants, the direct oral anticoagulants (DOACs), currently comprising either anti-FXa (e.g., apixaban, rivaroxaban, edoxaban) or antithrombin (or anti-FIIa; e.g., dabigatran), are increasingly employed by clinicians to treat patients at risk of a thromboembolism, or those who have recently suffered a VTE, often as a replacement to the more classical anticoagulants. 72,73 This increasing usage has several explanations, including good safety and efficacy, and a lack of need to monitor therapy, unlike the classical anticoagulants heparin and warfarin/coumarins. [74][75][76] Despite the lack of need to monitor DOACs, measurement of their level in certain patient groups or situations may be needed or useful.…”

Section: Direct Oral Anticoagulantsmentioning

confidence: 99%

Recent Advances in Mainstream Hemostasis Diagnostics and Coagulation Testing

Favaloro

Lippi

2019

Semin Thromb Hemost

Self Cite

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The authors provide a narrative review of mainstream hemostasis analyzers. The review is presented in two parts. In the first part, the authors give voice to several internationally representative manufacturers of mainstream hemostasis analyzers. They ask these manufacturers to (1) answer a series of survey questions that may otherwise reflect common questions asked by users or potential users of their equipment, (2) provide a bullet list of their main focus areas, and (3) provide other information in regard to their instrumentation. The authors then offer their own personal perspective of the benefits of various aspects of such equipment, as well as a sampling of some hemostasis tests as currently available, or potentially in progress. It is hoped that this snapshot of mainstream hemostasis diagnostics and coagulation testing drives positive future changes that will ultimately provide the best outcomes for laboratories performing hemostasis assays and the patients they help diagnose and manage.

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“…We were unable to examine the post-operative management of antithrombotic and vaso-occlusive events because of insufficient information. With the increasing prescription of DOACs and decline in warfarin use, 27 our findings may not apply to patients on DOACs. Guidance on the management of DOACs perioperatively is available.…”

Section: Discussionmentioning

confidence: 60%

Influence of Antiplatelet and Anticoagulant Drug Use on Outcomes after Chronic Subdural Hematoma Drainage

Poon

Rea

Kolias

et al. 2021

Journal of Neurotrauma

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We aim to describe the outcomes after chronic subdural hematoma drainage (CSDH) management in a large cohort of patients on antithrombotic drugs, either antiplatelets or anticoagulants, at presentation and to inform clinical decision making on the timing of surgery and recommencement of these drugs. We used data from a previous UK-based multi-center, prospective cohort study. Outcomes included recurrence within 60 days, functional outcome at discharge, and thromboembolic event during hospital stay. We performed Cox regression on recurrence and multiple logistic regression on functional outcome. There were 817 patients included in the analysis, of which 353 (43.2%) were on an antithrombotic drug at presentation. We observed a gradual reduction in risk of recurrence for patients during the 6 weeks post-CSDH surgery. Neither antiplatelet nor anticoagulant drug use influenced risk of CSDH recurrence (hazard ratio, 0.93; 95% confidence interval [CI], 0.58-1.48; p = 0.76) or persistent/worse functional impairment (odds ratio, 1.08; 95% CI, 0.76-1.55; p = 0.66). Delaying surgery after cessation of antiplatelet drug did not affect risk of bleed recurrence. There were 15 in-hospital thromboembolic events recorded. Events were more common in the group pre-treated with antithrombotic drugs (3.3%) compared to the non-antithrombotic group (0.9%). Patients on an antithrombotic drug pre-operatively were at higher risk of thromboembolic events with no excess risk of bleed recurrence or worse functional outcome after CSDH drainage. The data did not support delaying surgery in patients on antithrombotic therapy. In the absence of a randomized controlled trial, early surgery and early antithrombotic recommencement should be considered in those at high risk of thromboembolic events.

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Direct oral anticoagulants: analysis of worldwide use and popularity using Google Trends

Cited by 84 publications

References 27 publications

Impact of oral anticoagulants on 30-day readmission: a study from a single academic centre

Impact of oral anticoagulants on 30-day readmission: a study from a single academic centre

Recent Advances in Mainstream Hemostasis Diagnostics and Coagulation Testing

Influence of Antiplatelet and Anticoagulant Drug Use on Outcomes after Chronic Subdural Hematoma Drainage

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