OJN  Vol.5 No.12 , December 2015
Non-Vitamin K Antagonist Oral Anticoagulants: Redefining the Role of the Nurse to Improve Patient Care
Author(s) Marlene Robinson
ABSTRACT
Thromboembolic disorders and their associated long-term complications place a burden on patients, healthcare systems and society. Non-vitamin K antagonist (VKA) oral anticoagulants (OACs), including rivaroxaban, dabigatran, apixaban and edoxaban, are effective for the prevention of stroke in patients with non-valvular atrial fibrillation and for the treatment and secondary prevention of venous thromboembolism. The increasing uptake of the non-VKA OACs in primary care lessens the burden of care and allows for an easier transition of treatment from hospital to home. This transformation in terms of patient management has resulted in the need to empower nurses working in this field to endorse management strategies with a focus on patient education and long-term management (i.e. assessment of compliance, scheduling follow-up visits). Management of both venous thromboembolism and stroke prevention in patients with non-valvular atrial fibrillation requires a multidisciplinary team approach and, looking to the future, nurses are likely to have a key role at the heart of the thrombosis team. This review aims to provide nurses with the confidence to manage patients with thromboembolic disorders, and highlights the importance of responsible non-VKA OAC use and the impact that this can have on improving patient care and outcomes.

Cite this paper
Robinson, M. (2015) Non-Vitamin K Antagonist Oral Anticoagulants: Redefining the Role of the Nurse to Improve Patient Care. Open Journal of Nursing, 5, 1142-1157. doi: 10.4236/ojn.2015.512121.
References
[1]   Bonner, L. and Johnson, J. (2014) Deep Vein Thrombosis: Diagnosis and Treatment. Nursing Standard, 28, 51-58.
http://dx.doi.org/10.7748/ns2014.01.28.21.51.e8222

[2]   Chapman, N.H., Brighton, T., Harris, M.F., Caplan, G.A., Braithwaite, J. and Chong, B.H. (2009) Venous Thromboembolism—Management in General Practice. Australian Family Physician, 38, 36-40.

[3]   Cohen, A.T., Agnelli, G., Anderson, F.A., Arcelus, J.I., Bergqvist, D., Brecht, J.G., Greer, I.A., Heit, J.A., Hutchinson, J.L., Kakkar, A.K., Mottier, D., Oger, E., Samama, M.M., Spannagl, M. and VTE Impact Assessment Group in Europe (VITAE) (2007) Venous Thromboembolism (VTE) in Europe. The Number of VTE Events and Associated Morbidity and Mortality. Thrombosis and Haemostasis, 98, 756-764.
http://dx.doi.org/10.1160/th07-03-0212

[4]   Roger, V.L., Go, A.S., Lloyd-Jones, D.M., Benjamin, E.J., Berry, J.D., Borden, W.B., Bravata, D.M., Dai, S., Ford, E.S., Fox, C.S., Fullerton, H.J., Gillespie, C., Hailpern, S.M., Heit, J.A., Howard, V.J., Kissela, B.M., Kittner, S.J., Lackland, D.T., Lichtman, J.H., Lisabeth, L.D., Makuc, D.M., Marcus, G.M., Marelli, A., Matchar, D.B., Moy, C.S., Mozaffarian, D., Mussolino, M.E., Nichol, G., Paynter, N.P., Soliman, E.Z., Sorlie, P.D., Sotoodehnia, N., Turan, T.N., Virani, S.S., Wong, N.D., Woo, D. and Turner, M.B. (2012) Heart Disease and Stroke Statistics—2012 Update: A Report from the American Heart Association. Circulation, 125, e2-e220.

[5]   International Agency for Research on Cancer (2012) Globocan 2012: Estimated Cancer Incidence, Mortality and Prevance Worldwide in 2012.
http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx

[6]   Blann, A.D. and Lip, G.Y.H. (2006) Venous Thromboembolism. British Medical Journal, 332, 215-219.
http://dx.doi.org/10.1136/bmj.332.7535.215

[7]   Konstantinides, S.V., Torbicki, A., Agnelli, G., Danchin, N., Fitzmaurice, D., Galiè, N., Gibbs, J.S., Huisman, M.V., Humbert, M., Kucher, N., Lang, I., Lankeit, M., Lekakis, J., Maack, C., Mayer, E., Meneveau, N., Perrier, A., Pruszczyk, P., Rasmussen, L.H., Schindler, T.H., Svitil, P., Vonk Noordegraaf, A., Zamorano, J.L. and Zompatori, M. (2014) 2014 ESC Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism. European Heart Journal, 35, 3033-3069.
http://dx.doi.org/10.1093/eurheartj/ehu283

[8]   Beyth, R.J., Cohen, A.M. and Landefeld, C.S. (1995) Long-Term Outcomes of Deep-Vein Thrombosis. Archives of Internal Medicine, 155, 1031-1037.
http://dx.doi.org/10.1001/archinte.1995.00430100053006

[9]   Noble, S., Lewis, R., Whithers, J., Lewis, S. and Bennett, P. (2014) Long-Term Psychological Consequences of Symptomatic Pulmonary Embolism: A Qualitative Study. BMJ Open, 4, e004561.
http://dx.doi.org/10.1136/bmjopen-2013-004561

[10]   Limone, B.L., Hernandez, A.V., Michalak, D., Bookhart, B.K. and Coleman, C.I. (2013) Timing of Recurrent Venous Thromboembolism Early after the Index Event: A Meta-Analysis of Randomized Controlled Trials. Thrombosis Research, 132, 420-426.
http://dx.doi.org/10.1016/j.thromres.2013.08.003

[11]   Prandoni, P., Noventa, F., Ghirarduzzi, A., Pengo, V., Bernardi, E., Pesavento, R., Iotti, M., Tormene, D., Simioni, P. and Pagnan, A. (2007) The Risk of Recurrent Venous Thromboembolism after Discontinuing Anticoagulation in Patients with Acute Proximal Deep Vein Thrombosis or Pulmonary Embolism. A Prospective Cohort Study in 1626 Patients. Haematologica, 92, 199-205.
http://dx.doi.org/10.3324/haematol.10516

[12]   Hansson, P.O., Sorbo, J. and Eriksson, H. (2000) Recurrent Venous Thromboembolism after Deep Vein Thrombosis: Incidence and Risk Factors. JAMA Internal Medicine, 160, 769-774.
http://dx.doi.org/10.1001/archinte.160.6.769

[13]   Prandoni, P., Lensing, A.W.A., Prins, M.H., Bernardi, E., Marchiori, A., Bagatella, P., Frulla, M., Mosena, L., Tormene, D., Piccioli, A., Simioni, P. and Girolami, A. (2002) Residual Venous Thrombosis as a Predictive Factor of Recurrent Venous Thromboembolism. Annals of Internal Medicine, 137, 955-960.
http://dx.doi.org/10.7326/0003-4819-137-12-200212170-00008

[14]   Eichinger, S., Heinze, G., Jandeck, L.M. and Kyrle, P.A. (2010) Risk Assessment of Recurrence in Patients with Unprovoked Deep Vein Thrombosis or Pulmonary Embolism: The Vienna Prediction Model. Circulation, 121, 1630-1636. http://dx.doi.org/10.1161/CIRCULATIONAHA.109.925214

[15]   Prandoni, P., Lensing, A.W.A., Cogo, A., Cuppini, S., Villalta, S., Carta, M., Cattelan, A.M., Polistena, P., Bernardi, E. and Prins, M.H. (1996) The Long-Term Clinical Course of Acute Deep Venous Thrombosis. Annals of Internal Medicine, 125, 1-7.
http://dx.doi.org/10.7326/0003-4819-125-1-199607010-00001

[16]   Kachroo, S., Boyd, D., Bookhart, B.K., LaMori, J., Schein, J.R., Rosenberg, D.J. and Reynolds, M.W. (2012) Quality of Life and Economic Costs Associated with Postthrombotic Syndrome. American Journal of Health-System Pharmacy, 69, 567-572.
http://dx.doi.org/10.2146/ajhp110241

[17]   Kahn, S.R. (2006) The Post-Thrombotic Syndrome: The Forgotten Morbidity of Deep Venous Thrombosis. Journal of Thrombosis and Thrombolysis, 21, 41-48.
http://dx.doi.org/10.1007/s11239-006-5574-9

[18]   Kahn, S.R. (2009) How I Treat Postthrombotic Syndrome. Blood, 114, 4624-4631.
http://dx.doi.org/10.1182/blood-2009-07-199174

[19]   Pengo, V., Lensing, A.W.A., Prins, M.H., Marchiori, A., Davidson, B.L., Tiozzo, F., Albanese, P., Biasiolo, A., Pegoraro, C., Iliceto, S. and Prandoni, P. (2004) Incidence of Chronic Thromboembolic Pulmonary Hypertension after Pulmonary Embolism. The New England Journal of Medicine, 350, 2257-2264.
http://dx.doi.org/10.1056/NEJMoa032274

[20]   Camm, A.J., Lip, G.Y.H., De Caterina, R., Savelieva, I., Atar, D., Hohnloser, S.H., Hindricks, G., Kirchhof, P., Bax, J.J., Baumgartner, H., Ceconi, C., Dean, V., Deaton, C., Fagard, R., Funck-Brentano, C., Hasdai, D., Hoes, A., Kirchhof, P., Knuuti, J., Kolh, P., McDonagh, T., Moulin, C., Popescu, B.A., Reiner, Z., Sechtem, U., Sirnes, P.A., Tendera, M., Torbicki, A., Vahanian, A., Windecker, S., Vardas, P., Al Attar, N., Alfieri, O., Angelini, A., Blomstrom-Lundqvist, C., Colonna, P., De Sutter, J., Ernst, S., Goette, A., Gorenek, B., Hatala, R., Heidbuchel, H., Heldal, M., Kristensen, S.D., Kolh, P., Le Heuzey, J.Y., Mavrakis, H., Mont, L., Filardi, P.P., Ponikowski, P., Prendergast, B., Rutten, F.H., Schotten, U., Van Gelder, I.C. and Verheugt, F.W.A. (2012) 2012 Focused Update of the ESC Guidelines for the Management of Atrial Fibrillation: An Update of the 2010 ESC Guidelines for the Management of Atrial Fibrillation. Developed with the Special Contribution of the European Heart Rhythm Association. European Heart Journal, 33, 2719-2747.

[21]   Camm, A.J., Kirchhof, P., Lip, G.Y.H., Schotten, U., Savelieva, I., Ernst, S., Van Gelder, I.C., Al Attar, N., Hindricks, G., Prendergast, B., Heidbuchel, H., Alfieri, O., Angelini, A., Atar, D., Colonna, P., De Caterina, R., De Sutter, J., Goette, A., Gorenek, B., Heldal, M., Hohloser, S.H., Kolh, P., Le Heuzey, J.Y., Ponikowski, P., Rutten, F.H., Vahanian, A., Auricchio, A., Bax, J., Ceconi, C., Dean, V., Filippatos, G., Funck-Brentano, C., Hobbs, R., Kearney, P., McDonagh, T., Popescu, B.A., Reiner, Z., Sechtem, U., Sirnes, P.A., Tendera, M., Vardas, P.E., Widimsky, P., Vardas, P.E., Agladze, V., Aliot, E., Balabanski, T., Blomstrom-Lundqvist, C., Capucci, A., Crijns, H., Dahlof, B., Folliguet, T., Glikson, M., Goethals, M., Gulba, D.C., Ho, S.Y., Klautz, R.J., Kose, S., McMurray, J., Perrone Filardi, P., Raatikainen, P., Salvador, M.J., Schalij, M.J., Shpektor, A., Sousa, J., Stepinska, J., Uuetoa, H., Zamorano, J.L. and Zupan, I. (2010) Guidelines for the Management of Atrial Fibrillation: The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal, 31, 2369-2429.
http://dx.doi.org/10.1093/eurheartj/ehq278

[22]   Heeringa, J. (2010) Atrial Fibrillation: Is the Prevalence Rising? EP Europace, 12, 451-452.
http://dx.doi.org/10.1093/europace/euq056

[23]   Wolf, P.A., Abbott, R.D. and Kannel, W.B. (1991) Atrial Fibrillation as an Independent Risk Factor for Stroke: The Framingham Study. Stroke, 22, 983-988.

[24]   Lin, H.J., Wolf, P.A., Kelly-Hayes, M., Beiser, A.S., Kase, C.S., Benjamin, E.J. and D’Agostino, R.B. (1996) Stroke Severity in Atrial Fibrillation. The Framingham Study. Stroke, 27, 1760-1764.
http://dx.doi.org/10.1161/01.STR.27.10.1760

[25]   Jørgensen, H.S., Nakayama, H., Reith, J., Raaschou, H.O. and Olsen, T.S. (1996) Acute Stroke with Atrial Fibrillation. The Copenhagen Stroke Study. Stroke, 27, 1765-1769.
http://dx.doi.org/10.1161/01.STR.27.10.1765

[26]   Kelly-Hayes, M., Beiser, A., Kase, C.S., Scaramucci, A., D'Agostino, R.B. and Wolf, P.A. (2003) The Influence of Gender and Age on Disability Following Ischemic Stroke: The Framingham Study. Journal of Stroke and Cerebrovascular Diseases, 12, 119-126.
http://dx.doi.org/10.1016/S1052-3057(03)00042-9

[27]   Caro, J.J., Huybrechts, K.F. and Duchesne, I. (2000) Management Patterns and Costs of Acute Ischemic Stroke: An International Study. Stroke, 31, 582-590.
http://dx.doi.org/10.1161/01.str.31.3.582

[28]   Kearon, C., Akl, E.A., Comerota, A.J., Prandoni, P., Bounameaux, H., Goldhaber, S.Z., Nelson, M.E., Wells, P.S., Gould, M.K., Dentali, F., Crowther, M. and Kahn, S.R. (2012) Antithrombotic Therapy for VTE Disease: Antithrombotic Therapy and Prevention of Thrombosis. 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141, e419S-e494S.

[29]   Ageno, W., Gallus, A.S., Wittkowsky, A., Crowther, M., Hylek, E.M. and Palareti, G. (2012) Oral Anticoagulant Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141, e44S-e88S.

[30]   Laliberté, F., Pilon, D., Raut, M.K., Nelson, W.W., Olson, W.H., Germain, G., Schein, J.R. and Lefebvre, P. (2014) Hospital Length of Stay: Is Rivaroxaban Associated with Shorter Inpatient Stay Compared to Warfarin among Patients with Non-Valvular Atrial Fibrillation? Current Medical Research and Opinion, 30, 645-653.
http://dx.doi.org/10.1185/03007995.2013.867843

[31]   van Bellen, B., Bamber, L., Correa de Carvalho, F., Prins, M., Wang, M. and Lensing, A.W.A. (2014) Reduction in the Length of Stay with Rivaroxaban as a Single-Drug Regimen for the Treatment of Deep Vein Thrombosis and Pulmonary Embolism. Current Medical Research and Opinion, 30, 829-837.
http://dx.doi.org/10.1185/03007995.2013.879439

[32]   Vorchheimer, D.A., Lee, J., Muller, S., Zafar, M.U., Copeland-Halperin, R., Caliendo, G., et al. (2013) Dabigatran versus Standard Antithrombotic Therapy for New Onset Nonvalvular Atrial Fibrillation: Impact on Hospital Length of Stay. Journal of the American College of Cardiology, 61.

[33]   Xie, L., Vo, L., Keshishian, A., Price, K., Singh, P., Mardekian, J., et al. (2015) Comparison of Hospital Length of Stay and Costs between Non-Valvular Atrial Fibrillation Patients Treated with Either Apixaban or Warfarin. Circulation: Cardiovascular Quality and Outcomes, 8, A234.

[34]   The EINSTEIN Investigators (2010) Oral Rivaroxaban for Symptomatic Venous Thromboembolism. The New England Journal of Medicine, 363, 2499-2510.
http://dx.doi.org/10.1056/NEJMoa1007903

[35]   The EINSTEIN-PE Investigators (2012) Oral Rivaroxaban for the Treatment of Symptomatic Pulmonary Embolism. The New England Journal of Medicine, 366, 1287-1297.
http://dx.doi.org/10.1056/NEJMoa1113572

[36]   Agnelli, G., Buller, H.R., Cohen, A., Curto, M., Gallus, A.S., Johnson, M., Masiukiewicz, U., Pak, R., Thompson, J., Raskob, G.E. and Weitz, J.I. (2013) Oral Apixaban for the Treatment of Acute Venous Thromboembolism. The New England Journal of Medicine, 369, 799-808.
http://dx.doi.org/10.1056/NEJMoa1302507

[37]   The Hokusai-VTE Investigators (2013) Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism. The New England Journal of Medicine, 369, 1406-1415.
http://dx.doi.org/10.1056/NEJMoa1306638

[38]   Schulman, S., Kearon, C., Kakkar, A.K., Mismetti, P., Schellong, S., Eriksson, H., Baanstra, D., Schnee, J. and Goldhaber, S.Z. (2009) Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism. The New England Journal of Medicine, 361, 2342-2352.
http://dx.doi.org/10.1056/NEJMoa0906598

[39]   Schulman, S., Kakkar, A.K., Goldhaber, S.Z., Schellong, S., Eriksson, H., Mismetti, P., Vedel Christiansen, A., Friedman, J., Le Maulf, F., Peter, N. and Kearon, C. (2014) Treatment of Acute Venous Thromboembolism with Dabigatran or Warfarin and Pooled Analysis. Circulation, 129, 764-772.
http://dx.doi.org/10.1161/CIRCULATIONAHA.113.004450

[40]   Agnelli, G., Buller, H.R., Cohen, A., Curto, M., Gallus, A.S., Johnson, M., Porcari, A., Raskob, G.E. and Weitz, J.I. (2013) Apixaban for Extended Treatment of Venous Thromboembolism. The New England Journal of Medicine, 368, 699-708.
http://dx.doi.org/10.1056/NEJMoa1207541

[41]   Schulman, S., Kearon, C., Kakkar, A.K., Schellong, S., Eriksson, H., Baanstra, D., Kvamme, A.M., Friedman, J., Mismetti, P. and Goldhaber, S.Z. (2013) Extended Use of Dabigatran, Warfarin, or Placebo in Venous Thromboembolism. The New England Journal of Medicine, 368, 709-718.
http://dx.doi.org/10.1056/NEJMoa1113697

[42]   Ruff, C.T., Giugliano, R.P., Braunwald, E., Hoffman, E.B., Deenadayalu, N., Ezekowitz, M.D., Camm, A.J., Weitz, J.I., Lewis, B.S., Parkhomenko, A., Yamashita, T. and Antman, E.M. (2014) Comparison of the Efficacy and Safety of New Oral Anticoagulants with Warfarin in Patients with Atrial Fibrillation: A Meta-Analysis of Randomised Trials. The Lancet, 383, 955-962.
http://dx.doi.org/10.1016/S0140-6736(13)62343-0

[43]   Chang, H.Y., Zhou, M., Tang, W., Alexander, G.C. and Singh, S. (2015) Risk of Gastrointestinal Bleeding Associated with Oral Anticoagulants: Population Based Retrospective Cohort Study. The British Medical Journal, 350, h1585.

[44]   Abraham, N.S., Singh, S., Alexander, G.C., Heien, H., Haas, L.R., Crown, W. and Shah, N.D. (2015) Comparative Risk of Gastrointestinal Bleeding with Dabigatran, Rivaroxaban, and Warfarin: Population Based Cohort Study. The British Medical Journal, 350, h1857.

[45]   Miller, C.S., Grandi, S.M., Shimony, A., Filion, K.B. and Eisenberg, M.J. (2012) Meta-Analysis of Efficacy and Safety of New Oral Anticoagulants (Dabigatran, Rivaroxaban, Apixaban) versus Warfarin in Patients with Atrial Fibrillation. American Journal of Cardiology, 110, 453-460.
http://dx.doi.org/10.1016/j.amjcard.2012.03.049

[46]   Lip, G.Y.H., Larsen, T.B., Skjøth, F. and Rasmussen, L.H. (2012) Indirect Comparisons of New Oral Anticoagulant Drugs for Efficacy and Safety When Used for Stroke Prevention in Atrial Fibrillation. Journal of the American College of Cardiology, 60, 738-746.
http://dx.doi.org/10.1016/j.jacc.2012.03.019

[47]   Chatterjee, S., Sardar, P., Biondi-Zoccai, G. and Kumbhani, D.J. (2013) New Oral Anticoagulants and the Risk of Intracranial Hemorrhage: Traditional and Bayesian Meta-Analysis and Mixed Treatment Comparison of Randomized Trials of New Oral Anticoagulants in Atrial Fibrillation. JAMA Neurology, 70, 1486-1490.

[48]   Mann, K.G., Brummel, K. and Butenas, S. (2003) What Is All That Thrombin for? Journal of Thrombosis and Haemostasis, 1, 1504-1514.
http://dx.doi.org/10.1046/j.1538-7836.2003.00298.x

[49]   Berti, D., Hendriks, J.M., Brandes, A., Deaton, C., Crijns, H.J., Camm, A.J., Hindricks, G., Moons, P. and Heidbuchel, H. (2013) A Proposal for Interdisciplinary, Nurse-Coordinated Atrial Fibrillation Expert Programmes as a Way to Structure Daily Practice. European Heart Journal, 34, 2725-2730.
http://dx.doi.org/10.1093/eurheartj/eht096

[50]   Hendriks, J.M., de Wit, R., Crijns, H.J., Vrijhoef, H.J., Prins, M.H., Pisters, R., Pison, L.A., Blaauw, Y. and Tieleman, R.G. (2012) Nurse-Led Care vs. Usual Care for Patients with Atrial Fibrillation: Results of a Randomized Trial of Integrated Chronic Care vs. Routine Clinical Care in Ambulatory Patients with Atrial Fibrillation. European Heart Journal, 33, 2692-2699.
http://dx.doi.org/10.1093/eurheartj/ehs071

[51]   Lega, J.C., Bertoletti, L., Gremillet, C., Chapelle, C., Mismetti, P., Cucherat, M., Vital-Durand, D. and Laporte, S. (2014) Consistency of Safety and Efficacy of New Oral Anticoagulants Across Subgroups of Patients with Atrial Fibrillation. PLoS ONE, 9, e91398.
http://dx.doi.org/10.1371/journal.pone.0091398

[52]   Bauersachs, R.M., Lensing, A.W.A., Prins, M.H., Kubitza, D., Pap, á.F., Decousus, H., Beyer-Westendorf, J. and Prandoni, P. (2014) Rivaroxaban versus Enoxaparin/Vitamin K Antagonist Therapy in Patients with Venous Thromboembolism and Renal Impairment. Thrombosis Journal, 12, 25.
http://dx.doi.org/10.1186/1477-9560-12-25

[53]   Prins, M.H., Lensing, A.W.A., Brighton, T.A., Lyons, R.M., Rehm, J., Trajanovic, M., Davidson, B.L., Beyer-Westendorf, J., Pap, á.F., Berkowitz, S.D., Cohen, A.T., Kovacs, M.J., Wells, P.S. and Prandoni, P. (2014) Oral Rivaroxaban versus Enoxaparin with Vitamin K Antagonist for the Treatment of Symptomatic Venous Thromboembolism in Patients with Cancer (EINSTEIN-DVT and EINSTEIN-PE): A Pooled Subgroup Analysis of Two Randomised Controlled Trials. The Lancet Haematology, 1, e37-e46.
http://dx.doi.org/10.1016/S2352-3026(14)70018-3

[54]   Schulman, S., Eriksson, H., Goldhaber, S.Z., Kakkar, A., Kearon, C., Schellong, S.M., et al. (2013) Abstract 582 Influence of Active Cancer on the Efficacy and Safety of Dabigatran versus Warfarin for the Treatment of Acute Venous Thromboembolism: A Pooled Analysis from RE-COVER and RE-COVER II. Blood (ASH Annual Meeting Abstracts), 122.

[55]   Raskob, G.E., Buller, H., Angchaisuksiri, P., Oh, D., Boda, Z., Lyons, R.M., et al. (2013) Abstract 211 Edoxaban for Long-Term Treatment of Venous Thromboembolism in Cancer Patients. Blood (ASH Annual Meeting Abstracts), 122.

[56]   Heidbuchel, H., Verhamme, P., Alings, M., Antz, M., Hacke, W., Oldgren, J., Sinnaeve, P., Camm, A.J. and Kirchhof, P. (2013) European Heart Rhythm Association Practical Guide on the Use of New Oral Anticoagulants in Patients with Non-Valvular Atrial Fibrillation. Europace, 15, 625-651.
http://dx.doi.org/10.1093/europace/eut083

[57]   Hartikainen, S., Lonnroos, E. and Louhivuori, K. (2007) Medication as a Risk Factor for Falls: Critical Systematic Review. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 62, 1172-1181.
http://dx.doi.org/10.1093/gerona/62.10.1172

[58]   National Health Service (2014) Guidelines for Prescribing in Primary Care: Atrial Fibrillation.
http://medicines.necsu.nhs.uk/wp-content/uploads/2014/10/Gateshead-Atrial-Fibrillation-in-Primary-Care-Guidelines.pdf.

[59]   Beyer-Westendorf, J., Förster, K., Pannach, S., Ebertz, F., Gelbricht, V., Thieme, C., Michalski, F., Kohler, C., Werth, S., Sahin, K., Tittl, L., Hänsel, U. and Weiss, N. (2014) Rates, Management, and Outcome of Rivaroxaban Bleeding in Daily Care: Results from the Dresden NOAC Registry. Blood, 124, 955-962.

[60]   Tamayo, S., Frank, P.W., Patel, M., Sicignano, N., Hopf, K.P., Fields, L.E., Sarich, T., Wu, S., Yannicelli, D. and Yuan, Z. (2015) Characterizing Major Bleeding in Patients with Nonvalvular Atrial Fibrillation: A Pharmacovigilance Study of 27,467 Patients Taking Rivaroxaban. Clinical Cardiology, 38, 63-68.
http://dx.doi.org/10.1002/clc.22373

[61]   Tamayo, S., Patel, M., Yuan, Z., Hopf, K.P. and Peacock, F. (2015) Post-Marketing Pharmacovigilance Study for the Active Detection and Evaluation of Major Bleeding in Rivaroxaban Users with Non-Valvular Atrial Fibrillation. Journal of the American College of Cardiology, 65.
http://dx.doi.org/10.1016/s0735-1097(15)60281-9

[62]   Olesen, J.B., Lip, G.Y.H., Lindhardsen, J., Lane, D.A., Ahlehoff, O., Hansen, M.L., Raunso, J., Tolstrup, J.S., Hansen, P.R., Gislason, G.H. and Torp-Pedersen, C. (2011) Risks of Thromboembolism and Bleeding with Thromboprophylaxis in Patients with Atrial Fibrillation: A Net Clinical Benefit Analysis Using a “Real World”, Nationwide Cohort Study. Thrombosis and Haemostasist, 106, 739-749.
http://dx.doi.org/10.1160/TH11-05-0364

[63]   Friberg, L., Rosenqvist, M. and Lip, G.Y.H. (2012) Evaluation of Risk Stratification Schemes for Ischaemic Stroke and Bleeding in 182,678 Patients with Atrial Fibrillation: The Swedish Atrial Fibrillation Cohort Study. European Heart Journal, 33, 1500-1510.
http://dx.doi.org/10.1093/eurheartj/ehr488

[64]   Graham, D.J., Reichman, M.E., Wernecke, M., Zhang, R., Southworth, M.R., Levenson, M., Sheu, T.C., Mott, K., Goulding, M.R., Houstoun, M., MaCurdy, T.E., Worrall, C. and Kelman, J.A. (2015) Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated with Dabigatran or Warfarin for Non-Valvular Atrial Fibrillation. Circulation, 131, 157-164.
http://dx.doi.org/10.1161/CIRCULATIONAHA.114.012061

[65]   Larsen, T.B., Rasmussen, L.H., Skj?th, F., Due, K.M., Callréus, T., Rosenzweig, M. and Lip, G.Y.H. (2013) Efficacy and Safety of Dabigatran Etexilate and Warfarin in “Real-World” Patients with Atrial Fibrillation: A Prospective Nationwide Cohort Study. Journal of the American College of Cardiology, 61, 2264-2273.
http://dx.doi.org/10.1016/j.jacc.2013.03.020

[66]   Larsen, T.B., Gorst-Rasmussen, A., Rasmussen, L.H., Skjoth, F., Rosenzweig, M. and Lip, G.Y.H. (2014) Bleeding Events among New Starters and Switchers to Dabigatran Compared with Warfarin in Atrial Fibrillation. American Journal of Medicine, 127, 650-656.
http://dx.doi.org/10.1016/j.amjmed.2014.01.031

[67]   Lip, G.Y.H., Andreotti, F., Fauchier, L., Huber, K., Hylek, E., Knight, E., Lane, D., Levi, M., Marín, F., Palareti, G. and Kirchhof, P. (2011) Bleeding Risk Assessment and Management in Atrial Fibrillation Patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], Endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis. Thrombosis and Haemostasis, 106, 997-1011.
http://dx.doi.org/10.1160/TH11-10-0690

[68]   Nieto, J.A., Solano, R., Ruiz-Ribó, M.D., Ruiz-Gimenez, N., Prandoni, P., Kearon, C., Monreal, M. and for the Riete Investigators (2010) Fatal Bleeding in Patients Receiving Anticoagulant Therapy for Venous Thromboembolism: Findings from the RIETE Registry. Journal of Thrombosis and Haemostasis, 8, 1216-1222.
http://dx.doi.org/10.1111/j.1538-7836.2010.03852.x

[69]   Bristol-Myers Squibb and Pfizer (2015) Summary of Product Characteristics. Eliquis?.
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002148/WC500107728.pdf

[70]   Boehringer Ingelheim International GmbH (2015) Summary of Product Characteristics. Prad-axa?.
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002629/WC500189045.pdf

[71]   Daiichi Sankyo Europe GmbH (2015) Summary of Product Characteristics. Lixiana?.
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/002629/WC500189045.pdf

[72]   Bayer Pharma AG (2015) Summary of Product Characteristics. Xarelto?.
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000944/WC500057108.pdf

[73]   Bristol-Myers Squibb (2015) Prescribing Information Coumadin.
http://packageinserts.bms.com/pi/pi_coumadin.pdf

 
 
Top