Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes

Chiarito, Mauro; Cao, Davide; Cannata, F.; Godino, Cosmo; Lodigiani, Corrado; Ferrante, Giuseppe; Lópes, Renato D.; Alexander, John H.; Reimers, Bernhard; Condorelli, Gianluigi; Stefanini, Giulio G.

doi:10.1001/jamacardio.2017.5306

Cited by 51 publications

(31 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Concomitant prescription of antiplatelet agents, or NSAIDs, and drugs that interact with P-glycoprotein or CYP3A4, can increase the risk of gastrointestinal bleeding with DOACs [20]. Because the DOACs are metabolized by CYP3A4, the potential for drug interactions should be considered when using vonoprazan, which is mainly metabolized via CYP3A4 [21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

A Study on the Status of Proton Pump Inhibitor Prescriptions Using Diagnosis Procedure Combination Data in Japan

et al. 2019

View full text Add to dashboard Cite

Background/Aims: Proton pump inhibitors (PPIs) are widely used for the management of acid-related diseases. This study aimed to clarify the status of PPI use in hospitalized patients. Method: A retrospective observational study was performed. We analyzed PPI prescription data for the past 8 years (2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) using Diagnosis Procedure Combination survey data from approximately 10,000 patients per year at Saga University Hospital. We investigated the trend in the number of hospitalized patients who were prescribed PPI for the past 8 years and the changes in patient characteristics. Results: We identified 11,009 patients using PPIs throughout the study period. PPI prescription proportions significantly increased over the study period. The use of PPIs increased steadily with increasing age. The proportion of PPIs prescribed was 1.3-times higher among men than compared with women. In most clinical departments, the num-ber of patients prescribed PPIs was up to 3 times higher in the second half of the period (2013-2016) compared with the first half of the period (2009)(2010)(2011)(2012). The number of patients taking concomitant PPIs and anticoagulants or dual antithrombotic combination therapy increased. Conclusion: PPI use has increased substantially in hospitalized patients. The prevalence of PPI prescription by doctors other than gastroenterologists also increased.

show abstract

Section: Discussionmentioning

confidence: 99%

A Study on the Status of Proton Pump Inhibitor Prescriptions Using Diagnosis Procedure Combination Data in Japan

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Minor hemorrhagic complications have been reported with LMWH therapy in dogs, although interestingly not in with combination therapy (1 LOE 3, Fair; 3 LOE 5, Fair) . In people with acute coronary syndromes, the addition of the direct oral anticoagulants to antiplatelet agents increases the risk of bleeding …”

Section: Pico Question: Combination Therapy For Venous Thrombosis On mentioning

confidence: 99%

“…There is little evidence from the veterinary literature evaluating the combined use of anticoagulant and antiplatelet therapy over antiplatelet therapy alone in dogs and cats at risk of thrombosis. Evidence from 2 studies in people (LOE 6, Good) and 3 studies (LOE 5, Fair) in dogs, documented improved outcomes (recurrence of thrombosis/return of ambulatory function) when the use of anticoagulant and antiplatelet agents was compared with the use of an anticoagulant agent alone for managing patients at risk of recurring arterial thrombosis . In a meta‐analysis of 6 trials comprising 29,667 people with acute coronary syndromes, the use of direct oral anticoagulants in addition to antiplatelet therapy reduced ischemic events .…”

Section: Pico Question: Combination Therapy On Arterial Thrombosis Onmentioning

confidence: 99%

“…Evidence from 2 studies in people (LOE 6, Good) and 3 studies (LOE 5, Fair) in dogs, documented improved outcomes (recurrence of thrombosis/return of ambulatory function) when the use of anticoagulant and antiplatelet agents was compared with the use of an anticoagulant agent alone for managing patients at risk of recurring arterial thrombosis . In a meta‐analysis of 6 trials comprising 29,667 people with acute coronary syndromes, the use of direct oral anticoagulants in addition to antiplatelet therapy reduced ischemic events . Two studies (LOE 5, Fair) described the use of antiplatelet therapy, whereas 3 studies (LOE 5, Fair) documented the use of combination therapies in dogs after their first incident of aortic thrombosis [N.B.…”

Section: Pico Question: Combination Therapy On Arterial Thrombosis Onmentioning

confidence: 99%

“…Experimental data support this proposition, and antiplatelet drugs reduce the risk of venous thrombosis in people . Accumulating data also suggests that anticoagulants may be valuable adjuncts to antiplatelet agents in people with acute coronary syndromes . Since many hypercoagulable states in small animals can result in venous or arterial thrombosis in an unpredictable fashion, the judicious use of anticoagulants and antiplatelet drugs concurrently may also have merit.…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 2—Defining rational therapeutic usage

Goggs

Bacek

Bianco

et al. 2019

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objectives:To systematically review available evidence to determine when small animals at risk of thrombosis should be treated with antiplatelet agents and anticoagulants, which antiplatelet and anticoagulant agents are most effective, and when multimodal therapy is indicated.Design: Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence (LOE) and quality (Good, Fair, or Poor), and development of consensus on conclusions via a Delphi-style survey for application of the concepts to clinical practice.Draft recommendations were presented at 2 international veterinary conferences and made available for community assessment, review, and comment prior to final revisions and publication.Settings: Academic and referral veterinary medical centers. Results: Databases searched included Medline via PubMed and CAB abstracts. Twelve PopulationIntervention Comparison Outcome questions were devised and generated corresponding worksheets investigating indications for use of antithrombotic drugs in small animals. Seventy-eight studies were reviewed in detail. Most studies assessed were experimentally controlled laboratory studies in companion animals (56 LOE 3) with smaller numbers of LOE 2 (1), LOE 4 (5), LOE 5 (6), and LOE 6 (4) studies assessed. Only 5 randomized controlled clinical trials were identified (LOE 1, Good-Fair). The 12 worksheets generated 21 guidelines with 17 guideline statements that were refined during 3 rounds of Delphi surveys. A high degree of consensus was reached across all guideline recommendations during the Delphi process. Conclusions:Overall, systematic evidence evaluations generated 2 strong recommendations, 19 weak recommendations (formulated as suggestions), 9 situations where the evidence was insufficient to make strong recommendations, and 8 situations where no relevant evidence was retrieved to aid guideline generation. Numerous significant knowledge gaps were highlighted by the evidence reviews undertaken, indicating the need for substantial additional research in this field.

show abstract

Errors in Figure 3 and Affiliations

2018

JAMA Cardiol

View full text Add to dashboard Cite

Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes

Cited by 51 publications

References 51 publications

A Study on the Status of Proton Pump Inhibitor Prescriptions Using Diagnosis Procedure Combination Data in Japan

A Study on the Status of Proton Pump Inhibitor Prescriptions Using Diagnosis Procedure Combination Data in Japan

Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 2—Defining rational therapeutic usage

Errors in Figure 3 and Affiliations

Contact Info

Product

Resources

About