Elaine Hylek

..Translating the efficacy of clinical trials into effective use of these novel agents in clinical practice will require an understanding of their pharmacokinetic profiles, dose selection, and management in select clinical situations...

..Targeted strategies to improve TTR are urgently needed...

..By January 2005, phase II studies had begun in the US and Europe, and by March 2006, phase II studies had begun in Japan. Phase II trials for the prevention of thromboembolism were ongoing in mid 2007...

..In addition to baseline characteristics, we sought to define the physician-cited reason for not prescribing warfarin for each patient...

..We sought to determine if differences in baseline characteristics, use of potentially risk-modifying medications, or anticoagulation control help to explain the lower risk of stroke among warfarin-treated patients in SPORTIF V...

..We sought to define the tolerability of warfarin among an elderly inception cohort with atrial fibrillation...

..As a result, there is a pressing need for convenient new, well-tolerated and effective oral anticoagulants that do not require frequent dose adjustment and routine coagulation monitoring...

..An understanding of the pathological changes that predispose to hemorrhage, hazards of polypharmacy, and factors that contribute to variability in dose response will facilitate a more informed use of these medications in clinical care...

..Patient self-monitoring or self-management, however, is a choice made by patients and physicians that depends on many factors. We suggest that such therapeutic management be implemented where suitable (Grade 2B)...

....

....

..Quality indicators provide a framework for quality improvement, two goals of which are to maximize the effectiveness of therapy and to minimize harm...

..Among warfarin-treated patients with international normalized ratio (INR) >5, we sought to determine the risk of major bleeding within 30 days...

..Low international normalized ratio (INR; <or=1.5) increases risk for thromboembolism. However, little is known about the epidemiology of low INR...

..Our objective was to profile site performance in the Veterans Health Administration (VA) using risk-adjusted percent time in therapeutic range (TTR)...

..Is this also the case when cancer patients are anticoagulated for other indications?..

..Strategies are needed to improve the overall quality of anticoagulant care, including the substitution of low-molecular-weight heparin for unfractionated heparin, where appropriate...

....

..This report describes the methodology and preliminary results. Analysis is ongoing, and full results will be reported in the future...

..To compare prescription drug cost savings under the most commonly selected Medicare Part D prescription plan in 2006 with savings under the Medicare standard benefit and with drug costs assuming no coverage in an elderly cohort of patients...

..0 or greater reduces not only the frequency of ischemic stroke but also its severity and the risk of death from stroke. Our findings provide further evidence against the use of lower INR target levels in patients with atrial fibrillation...

..Since atrial and venous pressures are similar, genetic variants that promote venous thromboembolism may increase the risk of atrial thrombi and subsequent stroke in atrial fibrillation...

..Warfarin has been shown to be highly efficacious for preventing thromboembolism in atrial fibrillation in randomized trials, but its effectiveness and safety in clinical practice is less clear...

..However, higher intensities increase hemorrhage risk. Optimal use of warfarin for atrial fibrillation requires precise information on the risk for intracranial hemorrhage as a function of patient age and anticoagulation intensity...

..We examined data from a large contemporary cohort of AF patients to address this question...

....

..Additional research to identify an optimum scheme for primary prevention and subsequent standardization of recommendations may lead to more uniform selection of patients for anticoagulant prophylaxsis...

..We aimed to assess the frequency of thromboembolism and bleeding within a large cohort of patients whose warfarin therapy was temporarily withheld for an outpatient invasive procedure...

..To assess whether older age is independently associated with hemorrhage risk in patients with atrial fibrillation, whether or not they are taking warfarin therapy...

..We examined the rates of death and disability resulting from warfarin-associated intracranial and extracranial hemorrhages in a large cohort of patients with atrial fibrillation...