atrial fibrillation and stroke prevention - Continuing Medical ...
atrial fibrillation and stroke prevention - Continuing Medical ... atrial fibrillation and stroke prevention - Continuing Medical ...
Essentials in Primary Care Conference Wednesday, July 31, 2013 Rivaroxaban: Dosage Conversion Agent Heparin Enoxaparin Fondaprinux Conversion Instructions Discontinue the heparin infusion when the first evening dose of rivaroxaban is administered Start rivaroxaban at the time the next evening dose of enoxaparin was to be administered Start dabigatran at the time the next dose of fondaparinux as to be administered Conversion From warfarin To warfarin Recommendation Discontinue warfarin and start rivaroxaban when INR < 3. No clinical trial data available May consider: Start warfarin and parenteral anticoagulant at the time the next dose of rivaroxaban would have been taken Rivaroxaban Package Insert Stroke prevention in Atrial Fibrillation Apixaban vs warfarin (ARISTOTLE) Apixaban 5 mg oral twice daily (2.5 mg twice daily if Age > 80, < 60 kg body wt, creat > 1.5 mg/dl + Warfarin placebo Randomize Double blind (n = 18,201) Apixaban placebo twice daily + Warfarin (target INR 2-3) Primary outcome: stroke and systemic embolism Other outcomes: Death, MI, bleeding Stratified by warfarin-naïve status • Age 75 years • Prior stroke, TIA or SE • CHF or LVEF 40% • Diabetes mellitus • Hypertension Warfarin/warfarin placebo adjusted by INR/sham INR based on encrypted point-of-care testing device Granger CB et al. N Engl J Med 2011; 365:981-992. Jan Basile, MD Atrial Fibrillation & Stroke Prevention
Essentials in Primary Care Conference Wednesday, July 31, 2013 ARISTOTLE: Primary Outcome Stroke (Ischemic or Hemorrhagic) or Systemic Embolism P (noninferiority)
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Essentials in Primary Care Conference<br />
Wednesday, July 31, 2013<br />
ARISTOTLE: Primary Outcome<br />
Stroke (Ischemic or Hemorrhagic) or Systemic Embolism<br />
P (noninferiority)
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