Prof. Dr. med. Martin Grond provides a neurologist’s perspective on the reversibility of NOAC therapies and in specific about reversing dabigatran anticoagulant effects using idarucizumab in life threatening emergency situations like ischemic stroke and ICH, based on a retrospective study and real-world experience.
Cardiovascular
Ep#1 Reversibility from a Cardiologist’s Perspective, Prof Tomaszuk-Kazberuk Episode 1
Use of direct oral anticoagulants has bridged the need for effective anticoagulation in patients with atrial fibrillation. Professor Anna Tomaszuk-Kazberuk throws light on the efficacy and safety of direct oral anticoagulants and use of idarucizumab to reverse their anticoagulant effect, when needed.
Ep#1 Reversibility from a Neurologist’s Perspective, Prof Martin Grond Episode 1
A stroke can create long-term challenges for patients and caregivers. Novel oral anticoagulants help in the prevention of stroke in patients with atrial fibrillation. In cases when patients are for emergency procedure like IV thrombolysis for ischemic stroke and are on dabigatran, it is always reassuring to know that reversibility of NOAC effect is possible to proceed with contemplated procedure. Professor Dr. Martin Grond opines on managing such critical situations with a specific reversal agent like idarucizumab.
Ep#2 Reversibility from a Cardiologist’s Perspective, Prof Tomaszuk-Kazberuk Episode 2
Professor Anna Tomaszuk-Kazberuk discusses a case where cardiac surgeons initially refused to operate a patient on anticoagulant treatment and how idarucizumab has paved the way for proceeding with the contemplated procedure.
Ep#2 Reversibility from a Neurologist’s Perspective, Prof Martin Grond Episode 2
Professor Dr. Martin Grond shares his clinical experience about a patient with TIA and brain hemorrhage. He shares his practice experience on the possibility of controlling hematoma growth in patients taking anticoagulants with a specific antidote.
Ep#3 Reversibility from a Cardiologist’s Perspective, Prof Tomaszuk-Kazberuk Episode 3
Professor Anna Tomaszuk-Kazberuk elaborates on how the use of idarucizumab changed the opinion of cardiac surgeons from withholding an emergency procedure for an imminent life-threatening condition to performing the same, while the patient was on dabigatran.
Ep#3 Reversibility from a Neurologist’s Perspective, Prof Martin Grond Episode 3
Professor Dr. Martin Grond describes idarucizumab, its mode of action and method of administration and elaborates how this reversal agent can provide value to dabigatran treated patients undergoing emergency surgery or with life-threatening bleeding.
Ep#4 Reversibility from a Cardiologist’s Perspective, Prof Tomaszuk-Kazberuk Episode 4
An elderly lady who had previous stroke and maintained on dabigatran had massive bleeding from her genital tract, as seen by her gynecologist. Professor Anna Tomaszuk-Kazberuk tells us how idarucizumab served as her rescue drug.
Ep#4 Reversibility from a Neurologist’s Perspective, Prof Martin Grond Episode 4
In patient on effective anticoagulation therapy, suffering from an ischemic stroke, is thrombolysis possible? Know it better from Professor Dr. Martin Grond.
Ep#5 Reversibility from a Cardiologist’s Perspective, Prof Tomaszuk-Kazberuk Episode 5
There are circumstances that may need for emergency reversal of anticoagulation in order to save lives of patients. Professor Anna Tomaszuk-Kazberuk deliberates on the use of idarucizumab by citing different clinical scenarios which were successfully managed with administration of idarucizumab based on her clinical experience.
Ep#5 Reversibility from a Neurologist’s Perspective, Prof Martin Grond Episode 5
During urgent interventions, normalizing coagulation values is a crucial step. Professor Dr. Martin Grond emphasizes the administration of idarucizumab in patients undergoing emergency surgeries, as he shares his experience with the drug.
Ep#6 Reversibility from a Neurologist’s Perspective, Prof Martin Grond Episode 6
The availability of specific reversal agent can change lives of people on anticoagulation therapy. Idarucizumab is the specific reversal agent for dabigatran that can be utilized as a rescue strategy in clinical scenarios of life-threatening bleeding and urgent surgical or medical intervention. Given his in-clinic experiences, Professor Dr. Martin Grond couldn’t agree more.
Professor Gregory Lip highlights the benefits of dabigatran (NOACs) for AF patients requiring anticoagulation therapy while citing evidence from some key clinical trial studies and real-world data of dabigatran showing a significant relative risk reduction in ischemic stroke, systemic embolism, intracranial hemorrhage and all-cause mortality when compared to OACs or other NOACs. The availability of idarucizumab, a specific dabigatran reversal agent adds greater control and is an important factor in oral anticoagulation therapy.
Cardiovascular
Triple antithrombotic therapy with warfarin is the standard of care in AF patients undergoing PCI, but this is associated with a high risk of bleeding. RE-DUAL PCI study compared trial triple therapy with warfarin and dual therapy with dabigatran post-PCI in patients with AF. Some important differences observed in primary and secondary end points have been shown here.
Cardiovascular
Anticoagulation Considerations of an Elderly Patient with Renal Impairment
Use of anticoagulation for stroke prevention is associated with high risk of bleeding in elderly. Dr. John W. Eikelboom provides insights from the RE-LY sub analyses which assessed patients with moderate renal impairment for the risk of ICH and stroke or systemic embolism when treated with both doses of dabigatran versus warfarin. RE-LY analyses showed decline in renal function over time in patients receiving warfarin or dabigatran indicating that renal function does not decide the choice of anticoagulation.
Setting New Standards for Patients with AF - Anticoagulation Academy 2019 Barcelona Q&A
This Q&A deals with setting new standards for patients with AF - AC 2019 Barcelona with the panel Dr. Marc Brouwer, Dr. Elaine Hylek, Dr. Georg Nickenig and Dr. Todd Villnes along with hosts Dr. John Eikelboom and Dr. Harry Buller.
RE-DUAL PCI : Safety and Efficacy of Two Regimens of Dual Therapy with Dabigatran without ASA
Dr. Dominick Angiolillo opines that AF patients undergoing PCI need protection from stroke. He shares the results of RE-DUAL PCI trial comparing dabigatran dual therapy versus warfarin triple therapy, to help physicians make better informed choices and minimize the risk of bleeding and mortality.
RE-DUAL OAC switching subanalysis animated video
AF patients undergoing PCI already on oral anticoagulant (OAC) therapy may need to switch to a different OAC for a variety of reasons. Switching OAC therapies can result in increased risk of bleeding and thromboembolic complications particularly in post PCI setting. The results from RE-DUAL PCI sub-group analysis prove otherwise. The RE-DUAL PCI sub-group analysis reassures safe switch to both doses of dabigatran in post PCI setting irrespective of prior OAC or warfarin use.
RE-DUAL PCI : Subgroup Analysis on baseline PPI use in post PCI
Use of PPI to reduce the risk of bleeding can affect the absorption of other drugs post PCI in patients with atrial fibrillation. The RE-DUAL PCI sub-analysis provides insights of the impact of baseline PPI on safety endpoints when tested with both the doses of dabigatran versus triple therapy.