Oral Anticoagulation.

Abstract:

BACKGROUND:Much new evidence on oral anticoagulation has come to light in recent years. Non-vitamin-K-dependent oral anti- coagulants (NOAC) have been developed and have been introduced into clinical practice. In this review, we present the current state of the evidence on anticoagulation for various indications with vitamin K antagonists (VKA) and with NOAC. METHODS:This review is based on pertinent articles retrieved by a selective search in PubMed (search terms: anticoagulation, atrial fibrillation, prosthetic valve, thrombosis, pulmonary embolism) and on specialty society recommendations and relevant guidelines from the years 2000-2018. RESULTS:The main indications for oral anticoagulation are atrial fibrillation, venous thromboembolism, and status post heart valve replacement. In patients with atrial fibrillation and without valvular heart disease, anticoagulation is recommended for men with a CHA2DS2-VASc score ≥ 1 and for women with a score ≥ 2. NOAC for this indication are associated with a marginally lower rate of stroke than VKA (3.5% vs. 3.8%, number needed to treat [NNT] = 333) as well as a lower rate of major hemorrhage (5.1% vs. 6.2%, NNT = 91). NOAC are contraindicated for patients with mechanical heart valves. Anticoagulation with VKA can be predictably antagonized. Among the various types of NOAC, the anticoagulant effect of dabigatran can be safely antagonized with an antidote; no specific antidote is yet available for apixaban, rivaroxaban, or edoxaban. CONCLUSION:The evidence base for anticoagulation over a time frame of several years is inadequate at present, and direct comparative data for the different types of NOAC are not yet available.

journal_name

Dtsch Arztebl Int

authors

Altiok E,Marx N

doi

10.3238/arztebl.2018.0776

subject

Has Abstract

pub_date

2018-11-16 00:00:00

pages

776-783

issue

46

issn

1866-0452

pii

arztebl.2018.0776

journal_volume

115

pub_type

杂志文章,评审
  • Fenestrated and Branched Aortic Grafts.

    abstract:BACKGROUND:Abdominal and thoracic aortic aneurysms are diagnosed in 40 and 10 to 15 out of 100 000 persons per year, respectively. Fenestrated (fEVAR) and branched (bEVAR) stent grafts have been developed for abdominal juxtarenal and thoracoabdominal aneurysms. We discuss the patency and complication rates of fEVAR and...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2015.0816

    authors: Rylski B,Czerny M,Südkamp M,Russe M,Siep M,Beyersdorf F

    更新日期:2015-11-27 00:00:00

  • Preventing the spread of multidrug-resistant gram-negative pathogens: recommendations of an expert panel of the German Society For Hygiene and Microbiology.

    abstract:BACKGROUND:Infections with multidrug-resistant gram-negative bacteria are hard to treat and cause high morbidity and mortality. The direct transmission of such pathogens is well documented, and measures to protect other patients would seem indicated. Nonetheless, evidence-based recommendations are not yet available bec...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2012.0039

    authors: Mattner F,Bange FC,Meyer E,Seifert H,Wichelhaus TA,Chaberny IF

    更新日期:2012-01-01 00:00:00

  • The efficacy and duration of vaccine protection against human papillomavirus: a systematic review and meta-analysis.

    abstract:BACKGROUND:The German Standing Committee on Vaccination (STIKO) recommends vaccination against human papillomaviruses (HPV) of the high-risk types 16 and 18. The duration of protection afforded by HPV vaccines has been reported in multiple studies to date but has not been systematically evaluated. METHOD:Systematic li...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2014.0584

    authors: Deleré Y,Wichmann O,Klug SJ,van der Sande M,Terhardt M,Zepp F,Harder T

    更新日期:2014-09-01 00:00:00

  • The Treatment of Illnesses Arising in Pregnancy.

    abstract:BACKGROUND:The treatment of pregnant women who have illnesses unrelated to pregnancy can cause uncertainty among physicians. METHODS:We searched the PubMed database and specialty guidelines from Germany and abroad (the guidelines of the German Society for Gynecology and Obstetrics, the American Congress of Obstetri ci...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0616

    authors: Bolz M,Körber S,Reimer T,Buchmann J,Schober HC,Briese V

    更新日期:2017-09-15 00:00:00

  • The etiology, diagnosis and prevention of liver cirrhosis: part 1 of a series on liver cirrhosis.

    abstract:BACKGROUND:Cirrhosis of the liver is the end stage of chronic liver disease. Among the many liver disorders that can lead to cirrhosis, some progress rapidly (years) and others more slowly (decades). In Germany, cirrhosis is often a consequence of fatty liver disease due to alcoholism or other causes, but can also be c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2013.0085

    authors: Wiegand J,Berg T

    更新日期:2013-02-01 00:00:00

  • Antipsychotic prescription in children and adolescents: an analysis of data from a German statutory health insurance company from 2005 to 2012.

    abstract:BACKGROUND:Despite sparse documentation of their long-term therapeutic effects and side effects, antipsychotic drugs have come to be prescribed more frequently for children and adolescents in recent years, both in the USA and in Europe. No current data are available about antipsychotic prescriptions for this age group ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0025

    authors: Bachmann CJ,Lempp T,Glaeske G,Hoffmann F

    更新日期:2014-01-17 00:00:00

  • The Effect of Day of the Week on Morbidity and Mortality From Colorectal and Pancreatic Surgery.

    abstract:BACKGROUND:A number of studies have revealed higher postoperative mortality after operations that were performed toward the end of the week. It is not yet known whether a day-of-the-week effect exists after visceral surgical procedures for cancer in Germany. METHODS:Data on resections of carcinomas of the colon, rectu...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0521

    authors: Anger F,Wellner U,Klinger C,Lichthardt S,Haubitz I,Löb S,Keck T,Germer CT,Buhr HJ,Wiegering A

    更新日期:2020-08-03 00:00:00

  • Pneumococcal vaccination rates in adults in Germany: an analysis of statutory health insurance data on more than 850,000 individuals.

    abstract:BACKGROUND:The German Standing Committee on Vaccination Recommendations (Ständige Impfkommission, STIKO) recommends standard vaccination against pneumococcal infections for all persons aged 60 or older, and for all persons of any age with an increased health risk. It is not known how many persons in the target group in...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2013.0743

    authors: Theidel U,Kuhlmann A,Braem A

    更新日期:2013-11-01 00:00:00

  • Otitis Externa.

    abstract:BACKGROUND:Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms. METHODS:This review is based on publications retrieved by a selective search of the pertinent literature. RESULTS:The treatment of acute otitis media consists of anal- gesia, cleansing of the external au...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2019.0224

    authors: Wiegand S,Berner R,Schneider A,Lundershausen E,Dietz A

    更新日期:2019-03-29 00:00:00

  • Retinal Injury Following Laser Pointer Exposure.

    abstract:BACKGROUND:Recent years have seen a marked increase in laser-pointerrelated injuries, which sometimes involve severe retinal damage and irreversible visual impairment. These injuries are often caused by untested or incorrectly classified devices that are freely available over the Internet. METHODS:We reviewed pertinen...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0831

    authors: Birtel J,Harmening WM,Krohne TU,Holz FG,Charbel Issa P,Herrmann P

    更新日期:2017-12-08 00:00:00

  • The role of the complement system in age-related macular degeneration.

    abstract:BACKGROUND:Age-related macular degeneration (AMD) is a common retinal disease in older people. In Europe, about 1.6% of persons over age 65 and more than 13% of persons over age 85 have late-stage AMD, which can severely impair vision. The development of AMD is influenced both by environmental factors and by a strong h...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2014.0133

    authors: Weber BH,Charbel Issa P,Pauly D,Herrmann P,Grassmann F,Holz FG

    更新日期:2014-02-21 00:00:00

  • Implementation of warnings from Dear Doctor Letters (Rote-Hand-Briefe): an analysis of medication data from a large cohort of elderly patients.

    abstract:BACKGROUND:Dear Doctor Letters (also known as Direct Healthcare Professional Communications) inform physicians about significant newly discovered drug risks and about measures to take to reduce these risks. How far these warnings actually influence prescribing behavior is unclear. METHOD:The Geriatrics in Bavaria-Data...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0255

    authors: Schächtele S,Tümena T,Gaßmann KG,Fromm MF,Maas R

    更新日期:2014-04-11 00:00:00

  • Polar body biopsy in the diagnosis of monogenic diseases: the birth of three healthy children.

    abstract:BACKGROUND:For prospective parents at risk of transmitting a monogenic disease, polar body analysis is an option for pre-conception genetic diagnosis. In Germany, polar body analysis is currently performed in only two centers (Lübeck and Regensburg). METHODS:The authors present a clinical series of 9 couples at risk f...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2009.0533

    authors: Griesinger G,Bündgen N,Salmen D,Schwinger E,Gillessen-Kaesbach G,Diedrich K

    更新日期:2009-08-01 00:00:00

  • The interdisciplinary treatment of unruptured intracranial aneurysms.

    abstract:INTRODUCTION:The purpose of this article is to present the results of microsurgical clipping or endovascular coil obliteration of unruptured intracranial aneurysms (UIA), in a single cerebrovascular center with regard to successful obliteration and periprocedural complications. METHODS:Data concerning patients with UI...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0449

    authors: Seifert V,Gerlach R,Raabe A,Güresir E,Beck J,Szelényi A,Setzer M,Vatter H,Du Mesnil de Rochemont R,Zanella F,Sitzer M,Berkefeld J

    更新日期:2008-06-01 00:00:00

  • Organ Donor Cards in Resuscitation Room Patients.

    abstract:BACKGROUND:The percentage of organ donors among the German population is very low, and the supply of organs does not meet the demand. Relatively few organ explantations are performed in Germany, compared to other countries. The central element leading up to organ explantation is the donor's consent. This can be express...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0183

    authors: Küpers M,Dudda M,Kauther MD,Schwarz B,Hausen SA,Jöckel KH

    更新日期:2020-03-13 00:00:00

  • The Diagnosis and Treatment of Peripheral Arterial Vascular Disease.

    abstract:BACKGROUND:In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS:This guideline was prepared...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,实务指引

    doi:10.3238/arztebl.2016.0729

    authors: Lawall H,Huppert P,Espinola-Klein C,Rümenapf G

    更新日期:2016-10-28 00:00:00

  • Long-term opioid use in non-cancer pain.

    abstract:BACKGROUND:The long-term use of opioid analgesic drugs to treat chronic non-cancer pain (CNCP) is a major component of pain pharmacotherapy. The interpretation of the evidence concerning its efficacy and risks is currently debated. METHODS:An interdisciplinary evidence- and consensus-based S3 guideline was updated on ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0732

    authors: Häuser W,Bock F,Engeser P,Tölle T,Willweber-Strumpfe A,Petzke F

    更新日期:2014-10-24 00:00:00

  • Judging a plethora of p-values: how to contend with the problem of multiple testing--part 10 of a series on evaluation of scientific publications.

    abstract:BACKGROUND:When reading reports of medical research findings, one is usually confronted with p-values. Publications typically contain not just one p-value, but an abundance of them, mostly accompanied by the word "significant." This article is intended to help readers understand the problem of multiple p-values and how...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2010.0050

    authors: Victor A,Elsässer A,Hommel G,Blettner M

    更新日期:2010-01-01 00:00:00

  • Cardioversion in Non-Valvular Atrial Fibrillation.

    abstract:BACKGROUND:Atrial fibrillation is the most common type of cardiac arrhythmia and is associated with elevated rates of stroke, heart failure, hospital admission, and death. Its prevalence in the overall population is 1.5% to 2%. To convert atrial fibrillation to sinus rhythm, cardioversion is needed. METHODS:This revie...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2015.0856

    authors: Klein HH,Trappe HJ

    更新日期:2015-12-11 00:00:00

  • Atraumatic Femoral Head Necrosis in Adults.

    abstract:BACKGROUND:Atraumatic necrosis of the femoral head is a common cause of hip arthrosis in middle age. In Germany, it affects 5000-7000 patients per year, corresponding to an incidence of 0.01%. Though rarer than primary hip arthrosis, it is still of major clinical and socio-economic significance. Patients with this prob...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2016.0031

    authors: Arbab D,König DP

    更新日期:2016-01-22 00:00:00

  • Sexual impairment and its effects on quality of life in patients with rectal cancer.

    abstract:BACKGROUND:The effects of rectal surgery on patients' postoperative quality of life (QOL) and sexual function has been little studied to date. The present study aims to address this issue. METHODS:519 patients who had undergone surgery for rectal cancer from January 1997 to January 2003 were included in the study. The...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2010.0123

    authors: Schmidt C,Daun A,Malchow B,Küchler T

    更新日期:2010-02-01 00:00:00

  • The pharmacotherapy of neuropsychiatric symptoms of dementia: a cross-sectional study in 18 homes for the elderly in Berlin.

    abstract:BACKGROUND:The neuropsychiatric symptoms of dementia, including aggressiveness, agitation, depression, and apathy are often treated with psychotropic drugs and are a frequent reason for hospitalization, placing an economic burden on the health care system. International guidelines recommend syndrome-specific pharmacoth...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,多中心研究

    doi:10.3238/arztebl.2010.0320

    authors: Majic T,Pluta JP,Mell T,Aichberger MC,Treusch Y,Gutzmann H,Heinz A,Rapp MA

    更新日期:2010-05-01 00:00:00

  • Epilepsy in the elderly.

    abstract:BACKGROUND:Epilepsy is the third most common disease affecting the brain in the elderly. Current demographic trends will lead to an increased prevalence of epilepsy in the general population. METHOD:A selective literature search revealed 102 relevant publications as of September 2008, 50 of which were original article...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2009.0135

    authors: Werhahn KJ

    更新日期:2009-02-01 00:00:00

  • Skin tumors in childhood.

    abstract:BACKGROUND:Dermatologists, paediatricians, and general practitioners are often consulted by worried parents for the evaluation of a cutaneous tumor. METHODS:Selective literature review. RESULTS:Only 1-2% of skin tumors excised in children turn out to be malignant when examined histologically. Warning signs of maligna...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0347

    authors: Hamm H,Höger PH

    更新日期:2011-05-01 00:00:00

  • The diagnosis of urinary tract infection: a systematic review.

    abstract:BACKGROUND:Urinary tract infections (UTI) are among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Because this problem is so common and so significant in routine clinical practice, a high level of diagnostic accuracy is essential....

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2010.0361

    authors: Schmiemann G,Kniehl E,Gebhardt K,Matejczyk MM,Hummers-Pradier E

    更新日期:2010-05-01 00:00:00

  • Not all acne is acne vulgaris.

    abstract:BACKGROUND:Acne is the most common skin disease in adolescence, with a prevalence of nearly 100%. About 60% of affected adolescents have mild acne for which they use non-prescription preparations without consulting a physician. The remaining 40% constitute the population of acne patients seen in medical practice. The c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2014.0301

    authors: Gollnick HP,Zouboulis CC

    更新日期:2014-04-25 00:00:00

  • The treatment of anterior dental trauma.

    abstract:BACKGROUND:Avulsed frontal teeth often cannot be saved because of improper or lack of initial treatment. The result is a need for multiple interventions over the patient's lifetime, which also carry a high financial cost. METHODS:We explored the subject of lost anterior teeth in young patients with a PubMed search bas...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0565

    authors: Brüllmann D,Schulze RK,d'Hoedt B

    更新日期:2010-08-01 00:00:00

  • Exercise as stroke prophylaxis.

    abstract:BACKGROUND:Stroke is the third most common cause of death in industrialized countries, accounting for more than 10% of deaths over age 65. Most strokes are due to arteriosclerosis. Regular physical activity lowers arterial blood pressure and body weight and improves glucose and lipid metabolism, thereby slowing the dev...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztbl.2009.0715

    authors: Reimers CD,Knapp G,Reimers AK

    更新日期:2009-10-01 00:00:00

  • Outpatient Antibiotic Prescription.

    abstract:BACKGROUND:In view of the rise in antibiotic resistance and Clostridium difficile superinfection, close monitoring of antibiotic prescribing practices is essential so that targeted quality assurance measures can be taken. METHODS:We analyzed nationwide data from multiple statutory health insurance carriers on prescrip...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2016.0454

    authors: Bätzing-Feigenbaum J,Schulz M,Schulz M,Hering R,Kern WV

    更新日期:2016-07-01 00:00:00

  • Idiopathic scoliosis.

    abstract:BACKGROUND:Scoliosis is a three-dimensional deviation of the spinal axis. The main diagnostic criterion is spinal curvature exceeding 10° on a plain anteroposterior X-ray image. Scoliosis is called idiopathic when no other underlying disease can be identified. METHODS:Selective literature review and recommendations of...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2010.0875

    authors: Trobisch P,Suess O,Schwab F

    更新日期:2010-12-01 00:00:00