Algorithmic anticoagulation: streamlining the decision to hold and restart blood thinners in the periendoscopy period

The number and complexity of procedures performed by gastroenterologists are increasing in the United States.1,2 In addition, the number and complexity of antithrombotic agents are growing.3 These concurrent trends may lead to confusion among providers on the  appropriate management of these drugs during endoscopy. The skilled clinician must balance the risks of thrombosis, including myocardial infarction and stroke, against the risks of procedure-related hemorrhage, which can be potentially fatal.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research

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AbstractThe best strategy in atrial fibrillation (AF) after  >  12 months after an acute coronary syndrome or in patients with chronic coronary syndrome without an indication for interventional revascularization remains unclear. European guidelines generally recommend therapy with oral anticoagulation (OAC) alone, whereas North American guidelines advise com bination therapy consisting of OAC plus antiplatelet therapy in some patients. We performed a meta-analysis of available trials comparing these treatment strategies. The primary endpoint was major adverse cardiac events (MACE), secondary endp...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
ConclusionsThe meta-analysis shows that the DOACs had greater effectiveness and safety compared to warfarin in real-world practice for stroke prevention, among Asian patients with NVAF.
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
Abstract Vascular occlusion is one of the major causes of mortality and morbidity. Blood vessel blockage can lead to thrombotic complications such as myocardial infarction, stroke, deep venous thrombosis, peripheral occlusive disease, and pulmonary embolism. Thrombolytic therapy currently aims to rectify this through the administration of recombinant tissue plasminogen activator. Research is underway to design an ideal thrombolytic drug with the lowest risk. Despite the potent clot lysis achievable using approved thrombolytic drugs such as alteplase, reteplase, streptokinase, tenecteplase, and some other fibrinoly...
Source: Molecular Biology Reports - Category: Molecular Biology Authors: Tags: Mol Biol Rep Source Type: research
Authors: Lazăr AC, Ilea A, Moldovan B, Ionel A, Pop AS, Păcurar M, Câmpian RS Abstract Patients with anticoagulant therapy have a high thromboembolic risk. Due to the rich oro-maxillofacial vasculature and the fact that some dental procedures may cause a bleeding, the physician should be able to correlate this risk with the hemorrhagic risk. Dental procedures are a trigger for psychic stress. One of the most important changes in acute stress is in cardiovascular system. In healthy patients, these changes are reversible and have no significant consequences, but in patients with cardiovascular diseases, the r...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
This article is protected by copyright. All rights reserved. PMID: 31581363 [PubMed - as supplied by publisher]
Source: Biomed Res - Category: Research Authors: Tags: J Biomed Mater Res A Source Type: research
ConclusionsDouble bolus reteplase given with heparin is effective in the treatment of high, intermediate risk pulmonary embolism with minimal risk of bleeding.
Source: Indian Heart Journal - Category: Cardiology Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1693450There is a paucity of literature comparing the relative merits of open arthrotomy versus arthroscopy for the surgical treatment of septic knee arthritis. The primary goal of this study is to compare the risk of perioperative complications between these two surgical techniques. To this end, 560 patients treated for septic arthritis of the native knee with arthroscopy were statistically matched 1:1 with 560 patients treated with open arthrotomy. The outcome measures included major complications, minor complications, mortality, inpatient hospital charges, and length of stay (LOS). Major ...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
ConclusionsReversal of anticoagulation appears safe after LVAD-associated intracranial hemorrhage, though inadequate reversal was common. Resumption of warfarin ± antiplatelet was associated with fewer fatal and nonfatal thrombotic events compared with antiplatelets alone, though more nonfatal hemorrhage events occurred.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusions: Anemia on admission was associated with higher mortality and an increased risk of poor outcome in patients with ICH. However, the results were limited by the high heterogeneity of included studies. Prospective, multi-center or population-based, large sample cohort studies are needed in the future. Introduction Intracerebral hemorrhage (ICH) is the second most common cause of stroke and a highly lethal disease (1), which still lacks effective therapeutic interventions (2, 3). Although age, baseline ICH volume and neurological status on admission are well-known predictors of outcome of ICH (4), none of t...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Publication date: Available online 16 April 2019Source: Canadian Journal of CardiologyAuthor(s): Luca Baldetti, Francesco Giannini, Nicolas Van Mieghem, Nahid El Faquir, Didier Tchétché, Chiara De Biase, Anna Sonia Petronio, Cristina Giannini, Giuseppe Tarantini, Chiara Fraccaro, Ariel Finkelstein, Amit Segev, Israel Barbash, Giuseppe Bruschi, Corrado Tamburino, Marco Barbanti, Scott Lim, Ivandito Kuntjoro, Mohamed Abdel-Wahab, Antonio ColomboAbstractBackgroundTranscatheter aortic valve replacement (TAVR) is the gold-standard for severe valvular aortic stenosis in patients at high/prohibitive surgical risk. T...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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