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Efficacy and Safety Considerations With Dose-Reduced Direct Oral Anticoagulants: A Review
CONCLUSIONS AND RELEVANCE: Dose adjustment and low-intensity treatment are 2 different forms of dose-reduced DOACs. Dose adjustment is mostly relevant for AF and should be done based on the approved criteria. Dose adjustment of DOACs should not be used for acute VTE treatment in most cases. In contrast, low-intensity DOACs may be used for primary or secondary VTE prevention for studied and approved indications. Attention should be given to routine practice patterns to align the daily clinical practice with existing evidence of safety and efficacy.PMID:35648414 | DOI:10.1001/jamacardio.2022.1292
Source: Atherosclerosis - June 1, 2022 Category: Cardiology Authors: Behnood Bikdeli Farbod Zahedi Tajrishi Parham Sadeghipour Azita H Talasaz John Fanikos Giuseppe Lippi Deborah M Siegal John W Eikelboom Manuel Monreal David Jimenez Jean M Connors Walter Ageno Geoffrey D Barnes Gregory Piazza Dominick J Angiolillo Sahil A Source Type: research

Comparing pharmacotherapy in MINOCA versus medically managed obstructive acute coronary syndrome
This study uniquely compares the management and outcomes of MINOCA patients with a medically managed obstructive ACS (M-ACS) population. We retrospectively analysed registry data for consecutive patients admitted to the Gold Coast University Hospital with ACS requiring coronary angiography and identified patients with MINOCA and M-ACS. Baseline characteristics, pharmacological therapy and in-hospital outcomes were compared. In hospital outcomes were composite NACE, heart failure, stroke and major bleeding. Multivariate regression analysis was also performed to identify independent predictors of MINOCA. Multivariate regress...
Source: Heart and Vessels - March 23, 2022 Category: Cardiology Source Type: research

Impact of Clopidogrel Therapy on Mortality and Cancer in Patients With Cardiovascular and Cerebrovascular Disease: A Patient-Level Meta-Analysis Pharmacology
Conclusions— Across trials of cardiovascular and cerebrovascular disease, extended-duration clopidogrel on a background of aspirin has no overall effect on mortality or cancer but does reduce rates of myocardial infarction and stroke and increase rates of bleeding. These findings emphasize the need for selective use of extended clopidogrel therapy in patients in whom the risks of ischemia are not fully counterbalanced by the risks of bleeding.
Source: Circulation: Cardiovascular Interventions - January 8, 2018 Category: Cardiology Authors: Elmariah, S., Doros, G., Benavente, O. R., Bhatt, D. L., Connolly, S. J., Yusuf, S., Steinhubl, S. R., Liu, Y., Hsieh, W.-H., Yeh, R. W., Mauri, L. Tags: Pharmacology, Meta Analysis, Mortality/Survival Source Type: research

Use and Misuse of Aspirin in Primary Cardiovascular Prevention
The use of low-dose aspirin in primary prevention of cardiovascular (CV) events in healthy or apparently healthy people is a widely debated topic. Many arguments indicate that “primary prevention” is only a conventional definition and that the transition from primary to secondary prevention represents a continuum of increasing levels of CV risk. Although there are no direct proofs of a different efficacy of aspirin at different CV risk levels, in low-risk populations aspirin will appear to be less efficient. In fact, the lower number of events occurring in patients at low risk yields lower absolute numbers of events pr...
Source: Clinical Medicine Insights: Cardiology - April 21, 2017 Category: Cardiology Authors: Sergio. Coccheri Source Type: research

Ascertainment, classification, and impact of neoplasm detection during prolonged treatment with dual antiplatelet therapy with prasugrel vs. clopidogrel following acute coronary syndrome
Conclusions Neoplasm events were infrequent during long-term DAPT after ACS, were associated with differential cancer-screening practices across regions, and the frequency of neoplasm detection was similar with prasugrel vs. clopidogrel. Trial registration ClinicalTrials.gov identifier: NCT00699998.
Source: European Heart Journal - January 21, 2016 Category: Cardiology Authors: Roe, M. T., Cyr, D. D., Eckart, D., Schulte, P. J., Morse, M. A., Blackwell, K. L., Ready, N. E., Zafar, S. Y., Beaven, A. W., Strickler, J. H., Onken, J. E., Winters, K. J., Houterloot, L., Zamoryakhin, D., Wiviott, S. D., White, H. D., Prabhakaran, D., Tags: Acute coronary syndromes Source Type: research

Carotid Intima‐Media Thickness Measurement Promises to Improve Cardiovascular Risk Evaluation in Head and Neck Cancer Patients
ConclusionsCarotid IMT identified a much greater percentage of radiation‐treated HNC patients at high CV risk compared with standard CV‐risk calculators. By more accurately identifying the patients at high risk, this may lead to more effective prevention, and therefore a reduction in CV events.
Source: Clinical Cardiology - May 11, 2015 Category: Cardiology Authors: Douglas Jacoby, Jihane Hajj, Ali Javaheri, Emil deGoma, Alexander Lin, Peter Ahn, Harry Quon Tags: Clinical Investigations Source Type: research

Aspirin Therapy in Primary Cardiovascular Disease Prevention A Position Paper of the European Society of Cardiology Working Group on Thrombosis
Although the use of oral anticoagulants (vitamin K antagonists) has been abandoned in primary cardiovascular prevention due to lack of a favorable benefit-to-risk ratio, the indications for aspirin use in this setting continue to be a source of major debate, with major international guidelines providing conflicting recommendations. Here, we review the evidence in favor and against aspirin therapy in primary prevention based on the evidence accumulated so far, including recent data linking aspirin with cancer protection. While awaiting the results of several ongoing studies, we argue for a pragmatic approach to using low-do...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - July 14, 2014 Category: Cardiology Source Type: research

PodMed: A Medical News Roundup from Johns Hopkins (with audio)
(MedPage Today) -- This week's topics include infertility in women who've survived childhood cancer, targeting lung cancer screening, aspirin and colorectal cancer in women, and antihypertensive drugs, compliance and stroke risk.
Source: MedPage Today Cardiovascular - July 19, 2013 Category: Cardiology Source Type: news