Many take anticoagulants and OTC supplements, which poses risk
FINDINGSNearly 98% percent of people prescribed direct-acting oral anticoagulants such as apixaban also used over-the-counter products. Of those, 33% took at least one such product that, in combination with the anticoagulants, could cause dangerous internal bleeding. People taking these medications largely lacked knowledge of some potentially serious interactions.BACKGROUNDDirect-acting oral anticoagulants are the drug of choice for stroke prevention in patients with atrial fibrillation, which occurs most frequently in older patients. Apixaban is one of the most frequently prescribed. However, most people prescribed apixaban or other direct-acting oral anticoagulants are not followed in specialized anticoagulation clinics or monthly by health care professionals. As a result, these people may not be aware of potential drug interactions.METHODFrom April to October 2018, the researchers surveyed 791 English- and Spanish-speaking patients who had been prescribed apixaban. Subjects were asked about their knowledge of potential interactions between the drug and over-the-counter supplements. They were asked about how often they took aspirin, ibuprofen/naproxen, and acetaminophen, and 13 common dietary supplements, including Chinese he rbs, various fish oils, ginger and herbal teas, while also taking apixaban.Limitations to the study included a low response rate (33%), self-reported data, which can be unreliable due to faulty memories, and the researchers ’ focus&nb...
Conclusions: A substantial portion of hospitalized AF patients did not receive any AC therapy, particularly those patients with an AF diagnosis in the second position on hospital records. The predictors of inpatient AC treatment that were identified may be helpful in the clinical decision-making process for patients who are hospitalized with AF. PMID: 33021129 [PubMed - as supplied by publisher]
CONCLUSION: During the open-label extension, annual rates of stroke or systemic embolism, hemorrhagic stroke, and major bleeding remained as low as those observed during apixaban treatment in AVERROES. These data support the long-term efficacy and safety of apixaban in patients with atrial fibrillation. PMID: 33011964 [PubMed - as supplied by publisher]
CONCLUSIONS: In highly selected patients at very HBR, discontinuation of any antithrombotic therapy after LAAC appears safe and feasible. PMID: 32999093 [PubMed - in process]
CONCLUSIONS: Long-term incidence of thromboembolism was extremely low in patients with AF treated with CA, while that of major bleeding was not especially low. Clinical Trials Registry: UMIN000032829 / UMIN000032830. PMID: 33011056 [PubMed - as supplied by publisher]
ConclusionsConcurrent LAA exclusion during MVR is a safe and effective way to reduce postoperative ischemic stroke, particularly in patients with AF.
Abstract BACKGROUND: The effects of anticoagulants at extremes of body weight (BW) are not well described. The aim of this study was to analyze the pharmacokinetics/pharmacodynamics and clinical outcomes in patients randomized to warfarin, higher dose edoxaban (HDER), and lower dose edoxaban (LDER) regimens at extremes of BW in ENGAGE AF-TIMI 48. METHODS AND RESULTS: We analyzed three BW groups: low BW (LBW: 95th percentile, ≥120 kg, N = 1,093). In the warfarin arm, LBW patients had higher rates of stroke/systemic embolism (SSE: 6.5 vs. 4.7 in MBW vs. 1.6% in HBW, P trend
The incidence of stroke during TAVI up to 5 % (minimum ). Stroke risk reduction during TAVI is a critical requirement that can be a deterrent against this wonderful Intervention. Many devices are being considered EmbolX (Edwards life science) Emrella Sentinel (Claret medical) TriGaurd (Keystone) TriGaurd 3just got the approval from CE and appear promising. (REFLECT trial) It is inserted through the transfemoral route , deflects embolic material to descending aorta since it covers all the three branches of Arch.What happens to these deflected particles? Any bodys guess. So , in my understanding it conve...
AbstractPurpose of ReviewIn patients with atrial fibrillation who are unable to take novel oral anticoagulants for stroke prophylaxis due to bleeding risk or other contraindications, left atrial appendage (LAA) occlusion and exclusion devices have shown benefit. In this review, we highlight the risks and benefits associated with LAA removal.Recent FindingsLAA, once considered a vestigial organ, has been shown to have physiological, anatomical, and arrhythmogenic properties. Device-related complications such as pericardial effusion, device embolization, device-related thrombus, while uncommon, are still present. With increa...
AbstractObjectivesThe OVID study will demonstrate whether prophylactic-dose enoxaparin improves survival and reduces hospitalizations in symptomatic ambulatory patients aged 50 or older diagnosed with COVID-19, a novel viral disease characterized by severe systemic, pulmonary, and vessel inflammation and coagulation activation.Trial designThe OVID study is conducted as a multicentre open-label superiority randomised controlled trial.ParticipantsInclusion Criteria1. Signed patient informed consent after being fully informed about the study ’s background.2. Patients aged 50 years or older with a positive test for SARS-...
ConclusionAcross geriatric subgroups, apixaban was consistently associated with the most favourable benefit-risk profile and should therefore be preferred in geriatric patients with AF. However, research gaps on the impact of increased falling risk, frailty and baseline dementia were identified, requiring careful consideration while awaiting more results.
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