Oral Anticoagulation and the Novel Oral Anticoagulants (NOACs):Where Are We at Midterm?

Academic Content

Program Overview

Faculty Presentations

Introduction Deepak L. Bhatt Elaine Hylek

Video Roundtable

Current Activity

Elaine Hylek, MD, MPH, Boston University School of Medicine, Boston, Massachusetts

NOACs in Clinical Care NOACS Prevention Data NOACS: Major Bleeding Meta-Analysis ESC 2012 Guidelines Update Garfield Registry Prophylaxis vs Anticoagulation Clinical Trial: Major Bleeding Benefit and Risk Bleeding Risk Score Consensus Statements CHA2DS2-VASc Bleeding Risk Score Circulation Article Patient Age vs TTR NOACs vs Warfarin NOACS & Renal Dysfunction EHRA NOACs Practical Guide Procedural Management NOACs Bleeding Management Life-threatening Hemorrhage CAT Scans of Cerebral Hemorrhage Intracerebral Hemorrhage: Limited Data Kcentra: FDA approval Safety: Meta-analysis Anticoagulation Antidotes Dose Differences: AFib vs VTE NOACS in Clinical Practice Continuing role for warfarin?

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Circulation Article

Since many patients who need anticoagulation will be on warfarin and may continue to be on warfarin, it is important to ask: How well are we controlling warfarin?

Figure 14 references a recent study that used data from a very interesting database from Quest Diagnostics (West Norriton, PA). Quest Diagnostics does a large proportion of the blood testing throughout the United States, and we were given access to this database. We looked at the INR levels for 138,000 individuals, totaling 2.7 million INR values for the period of January 2007 through 2008, asking "How good is medical practice in the United States at maintaining therapeutic warfarin levels?”

Hylek EM. Am J Med 2014; 00.

References

[11]

Dlott JS, George RA, Huang X, et al. National assessment of warfarin anticoagulation therapy for stroke prevention in atrial fibrillation. Circulation. 2014;129:1407-1414.