Use of oral anticoagulation therapy in patients with liver disease is complex. The risks and benefits of therapy need to be considered as those with liver disease can be at heightended risk of bleeding. This blog post will review the literature surrounding the use of oral anticoagulation in patients with atrial fibrillation and liver disease and recommendations on selecting therapy, if any, will be discussed.
The optimal antithrombotic regimen in patients with AF and comorbid CAD remains unclear. Current American College of Cardiology/American Heart Association guidelines provide minimal guidance on whether to continue antiplatelet therapy in combination with anticoagulation in this population. Additionally, while the 2017 European Society of Cardiology guidelines recommend oral anticoagulation alone, there is little supporting evidence for this recommendation. This blog discusses the implications of the recently published AFIRE study, which attempts to answer the question: In patients with stable CAD and AF, is combination therapy necessary or is anticoagulation monotherapy sufficient?
When it comes to triple therapy, the totality of the evidence strongly suggests “less is more”. While many practitioners have been quick to adopt dual antithrombotic therapy, it is important to consider the external validity of these trials and how we apply them to our patients. In this blog, Dr. Noel offers 3 considerations that require careful reflection before throwing in the towel on triple therapy.
Anticoagulants are some of the most commonly implicated drugs in emergency department visits and hospitalizations due to adverse drug events. Medication errors can significantly influence these events, and pharmacists are at the forefront for preventing medication errors from reaching the patient. Part 1 of this 2 part series on anticoagulation safety will focus on common medication errors involving direct oral anticoagulants. Part 2 will focus on ways pharmacists can help prevent medication errors with anticoagulants, particularly as it relates to anticoagulation stewardship programs.
Rivaroxaban (Xarelto) is often touted as the go-to oral anticoagulant for non-adherent patients because of its once daily administration. In this entry, we explore whether this is true based on the drug’s pharmacokinetics.