SMC accepts rivaroxaban (Xarelto®) for treatment of PE and prevention of recurrent DVT or PE

Source: Scottish Medicines Consortium (SMC) Area: Evidence> Drug Specific Reviews The Scottish Medicines Consortium has accepted rivaroxaban (Xarelto®) for the treatment of pulmonary embolism (PE), and prevention of recurrent deep vein thrombosis (DVT) and PE in adults in NHS Scotland.   According to the SMC advice, rivaroxaban was non-inferior to a regimen including a low molecular weight heparin and a vitamin K antagonist for the treatment of PE and the prevention of recurrence of DVT or PE.  The duration of treatment was 3, 6 or 12 months at the discretion of the treating physician. Experience with rivaroxaban in this indication for more than 12 months is limited therefore the cost-effectiveness of indefinite treatment has not been demonstrated.
Source: NeLM - Cardiovascular Medicine - Category: Cardiology Source Type: news

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We report on clinical and biochemical features of these patients. They were all males, with a mean age of 70.3  years (range 58–84); traditional risk factors for venous thromboembolism were identified in the majority of patients with pulmonary embolism, however not differently from those without pulmonary embolism.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Short communication Source Type: research
AbstractPulmonary embolism (PE) is the third most frequent acute cardiovascular syndrome. Annual PE incidence and PE-related mortality rates rise exponentially with age, and consequently, the disease burden imposed by PE on the society continues to rise as the population ages worldwide. Recently published landmark trials provided the basis for new or changed recommendations included in the 2019 update of the European Society of Cardiology Guidelines (developed in cooperation with the European Respiratory Society). Refinements in diagnostic algorithms were proposed and validated, increasing the specificity of pre-test clini...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research
The objective was to determine incidence and risk factors of venous thromboembolism (VTE) in COVID-19 inpatients receiving thromboprophylaxis. In this retrospective French cohort study, patients hospitalized in medical wards non-ICU with confirmed COVID-19 and adequate thromboprophylaxis were included. A systematic low limb venous duplex ultrasonography was performed at hospital discharge or earlier if deep venous thrombosis (DVT) was clinically suspected. Chest angio-CT scan was performed when pulmonary embolism (PE) was suspected. Of 71 patients, 16 developed VTE (22.5%) and 7 PE (10%) despite adequate thromboprophylaxis...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
The Coronavirus Disease 2019 (COVID 19) has been reported in almost every country in the world. Although a large proportion of infected individuals develop only mild symptoms or are asymptomatic, the spectrum of the disease among others has been widely variable in severity. Besides, many infected individuals were found to have coagulation markers abnormalities, especially true among those progressing to severe pneumonia and multi-organ failure. While the incidence of venous thromboembolic (VTE) disease has been recently noted to be elevated among critically ill patients, the incidence among ambulatory and non-critically il...
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
Abstract Although the findings of some studies have been indicative of the direct relationship between the severity of clinical findings and imaging, reports have been published regarding inconsistency of clinical findings with imaging and laboratory evidence. Physicians treating these patients frequently report cases in which patients, sometimes in the recovery phase and despite improvements in imaging indices, suddenly deteriorate and in some instances suddenly expire. This letter aimed to draw attention to the role of pulmonary thromboembolism as a potential and possible cause of clinical deterioration in covid...
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
Conclusions: Clinically diagnosed symptomatic venous thromboembolism occurred in 1.4% of this large population of ICU patients with high adherence to chemoprophylaxis. Central venous catheterization and immobilization are potentially modifiable risk factors for venous thromboembolism. The ICU-Venous Thromboembolism score can identify patients at increased risk for venous thromboembolism.
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research
Emmental Hospital, situated in the rural town of Burgdorf in Switzerland, has treated a low volume of inpatients with COVID-19. Of the 13 admissions prior to 30th April 2020, 4 required treatment in the intensive care unit (ICU). Here we report on 3 consecutive inpatients with severe COVID-19, following the unexpected death of our first patient with severe COVID-19 from pulmonary embolism.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
ConclusionDaily supplementation of omega-3 fatty acids decreases the risk of pulmonary embolism as well as symptomatic deep vein thrombosis, after surgery among elderly patients with proximal femoral fractures, without causing elevated risk of bleeding episodes.
Source: International Orthopaedics - Category: Orthopaedics Source Type: research
New England Journal of Medicine, Ahead of Print.
Source: New England Journal of Medicine - Category: Internal Medicine Authors: Source Type: research
Patients with COVID-19 present a broad spectrum of clinical presentation. Whereas hypoxaemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with "normal" (>40 mL·cmH2O–1) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Perspective Source Type: research
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