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Special Issue "Warfarin Versus the Non-vitamin K Oral Anticoagulants (NOACs) in Clinical Practice"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: 30 May 2019

Special Issue Editors

Guest Editor
Dr. Shailendra Anoopkumar-Dukie

Griffith University School of Pharmacy and Pharmacology, Gold Coast, Queensland, Australia
Website | E-Mail
Interests: quality use of medicines; patient outcomes; optimising medication use; treatment adherence; pharmacology
Guest Editor
Ms. Nijole Bernaitis

Griffith University School of Pharmacy and Pharmacology, Gold Coast, Queensland, Australia
Website | E-Mail
Interests: cardiovascular medicine; anticoagulants; patient outcomes; quality use of medicines

Special Issue Information

Dear Colleagues,

On behalf of the Journal of Clinical Medicine (JCM) editorial team, we are delighted to present a new Special Issue on the topic of “Warfarin versus the Non-Vitamin K Oral Anticoagulants (NOACs) in Clinical Practice”, Guest Edited by Associate Professor Shailendra Anoopkumar-Dukie and Ms Nijole Bernaitis from the Griffith University School of Pharmacy and Pharmacology, Gold Coast, Queensland, Australia.

Introduction of the NOACs has provided options for anticoagulant therapy for patients with thromboembolic disease. Numerous factors, including health systems, clinical patient characteristics, and both prescriber and patient preferences, now influence choice of anticoagulant and associated efficacy and safety of agents. Differences in health outcomes with individual anticoagulants may be seen according to geographic region, ethnicity, and health management systems. Knowledge and understanding of the factors influencing the quality use of anticoagulants can contribute to identifying which population groups may get most benefit from anticoagulants. This may ultimately help in optimising patient outcomes with individual anticoagulants.

This Special Issue of the Journal of Clinical Medicine aims to examine advances in optimising oral anticoagulant therapy in clinical practice with application to different settings using real-world data. Of particular interest is the evaluation of health outcomes associated with anticoagulant use in different populations. International comparative outcomes and factors influencing these outcomes from real-world or observational data may further assist selection of appropriate anticoagulation for specific populations or individuals.

Dr. Shailendra Anoopkumar-Dukie
Ms. Nijole Bernaitis
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Warfarin, Rivaroxaban, Apixaban, Dabigatran, Edoxaban
  • Comparative effectiveness
  • Health outcomes
  • Pharmacoeconomic comparison
  • Real world or observational data
  • Patient management
  • Population health
  • Calcification

Published Papers (2 papers)

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Research

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Open AccessArticle
The CHA2DS2-VASc Score Predicts Major Bleeding in Non-Valvular Atrial Fibrillation Patients Who Take Oral Anticoagulants
J. Clin. Med. 2018, 7(10), 338; https://doi.org/10.3390/jcm7100338
Received: 14 September 2018 / Revised: 3 October 2018 / Accepted: 8 October 2018 / Published: 9 October 2018
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Abstract
Background: Patients with atrial fibrillation (AF) are at a substantial risk of ischemic stroke. The CHA2DS2-VASc score predicts the risk of thromboembolism, but its role in predicting major bleeding in patients taking oral anticoagulants is unclear. Methods: We used [...] Read more.
Background: Patients with atrial fibrillation (AF) are at a substantial risk of ischemic stroke. The CHA2DS2-VASc score predicts the risk of thromboembolism, but its role in predicting major bleeding in patients taking oral anticoagulants is unclear. Methods: We used the National Health Insurance Research Database (NHIRD) of Taiwan to identify patients with AF from 2010 to 2016. They were divided into four groups according to the oral anticoagulants. The outcomes were ischemic stroke/systemic thromboembolism, and major bleeding. Results: A total of 279,776 patients were identified. Ischemic stroke or systemic embolism events were observed in 1.73%, 3.62%, 4.36%, and 5.02% of the patients in the apixaban, rivaroxaban, dabigatran, and warfarin groups, respectively. Major bleeding was recorded in 1.18%, 2.66%, 3.23%, and 4.70% of the patients in the apixaban, rivaroxaban, dabigatran, and warfarin groups, respectively. The highest rates for both ischemic stroke and bleeding events occurred in the patients with a CHA2DS2-VASc score of five or more. Conclusion: Non-valvular AF patients with high CHA2DS2-VASc scores are susceptible to both systemic thromboembolism and major bleeding. The trend was consistently observed in patients who took non-vitamin K oral anticoagulants (NOACs) or warfarin. NOACs might be potentially more effective in reducing overall events. Full article
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Review

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Open AccessReview
Effectiveness and Safety of Direct Oral Anticoagulants versus Vitamin K Antagonists for People Aged 75 Years and over with Atrial Fibrillation: A Systematic Review and Meta-Analyses of Observational Studies
J. Clin. Med. 2019, 8(4), 554; https://doi.org/10.3390/jcm8040554
Received: 7 March 2019 / Revised: 18 April 2019 / Accepted: 18 April 2019 / Published: 24 April 2019
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Abstract
Older people, are underrepresented in randomised controlled trials of direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation (AF). The aim of this study was to combine data from observational studies to provide evidence for the treatment of people aged ≥75 years. [...] Read more.
Older people, are underrepresented in randomised controlled trials of direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation (AF). The aim of this study was to combine data from observational studies to provide evidence for the treatment of people aged ≥75 years. Medline, Embase, Scopus and Web of Science were searched. The primary effectiveness outcome was ischaemic stroke. Safety outcomes were major bleeding, intracranial haemorrhage, gastrointestinal bleeding, myocardial infarction, and mortality. Twenty-two studies were eligible for inclusion. Two studies related specifically to people ≥75 years but were excluded from meta-analysis due to low quality; all data in the meta-analyses were from subgroups. The pooled risk estimate of ischaemic stroke was slightly lower for DOACs. There was no significant difference in major bleeding, mortality, or myocardial infarction. Risk of intracranial haemorrhage was 44% lower with DOACs, but risk of GI bleeding was 46% higher. Our results suggest that DOACs may be preferable for the majority of older patients with AF, provided they are not at significant risk of a GI bleed. However, these results are based entirely on data from subgroup analyses so should be interpreted cautiously. There is a need for adequately powered research in this patient group. Full article
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J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
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