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Inappropriate Combined Antiplatelet and Anticoagulant Therapy in Older Patients with Atrial Fibrillation: Trend over Time (2009 –18)
ConclusionsWhile inappropriate combined antiplatelet and anticoagulant therapy has declined over the last decade, there is still room for improvement. Antiplatelet deprescribing should be considered in all patients with inappropriate combined antiplatelet and anticoagulant therapy, including those with vascular disease and no recent cardiovascular event.
Source: Drugs and Aging - February 23, 2023 Category: Geriatrics Source Type: research

Anticoagulant choice in antiphospholipid syndrome – associated thrombosis
Background: DOACs have largely replaced VKAs as first-line therapy for venous thromboembolism in patients with adequate renal function. However, there is concern in APS that DOACs may have higher rates of recurrent thrombosis than VKAs when treating thromboembolism. Dr. David Portnoy Study design: Randomized noninferiority trial. Setting: Six teaching hospitals in Spain. Synopsis: Of adults with thrombotic APS, 190 were randomized to receive rivaroxaban or warfarin. Primary outcomes were thrombotic events and major bleeding. Follow-up after 3 years demonstrated new thromboses in 11 patients (11.6%) in the DOAC...
Source: The Hospitalist - December 10, 2021 Category: Hospital Management Authors: Daniel Hickman Tags: Hematology Thrombosis Source Type: research

Temporal Trends and Outcomes of Elective Thoracic Aortic Repair and Acute Aortic Syndromes in Bicuspid Aortic Valves: Insights from a National Database
ConclusionData from a national database showed no change in the number of hospitalizations for BAV-related aortopathy, with relatively lower incidence of AAS. Compared with TAV, elective aortic repair for BAV is associated with lower mortality, while BAV-related AAS is associated with higher in-hospital complications.
Source: Cardiology and Therapy - August 24, 2021 Category: Cardiology Source Type: research

Safety and efficacy of a new thromboprophylaxis regiment for total knee and total hip replacement: a retrospective cohort study in 265 patients.
Conclusion: The regimen consisting of sequential enoxaparin and rivaroxaban is associated with a significant bleeding risk, although the risk of patients requiring a return to theatre is low. Further prospective trials are required to compare the safety and efficacy profiles of this regimen with established thromboprophylaxis regimens. PMID: 30123323 [PubMed]
Source: Patient Safety in Surgery - August 22, 2018 Category: Surgery Authors: Fallaha MA, Radha S, Patel S Tags: Patient Saf Surg Source Type: research

88 One-year outcomes of triple therapy and adherence with ESC guidelines in patients with AF undergoing PCI in a teaching hospital
Background/Introduction: Oral anticoagulation is the corner-stone for stroke prevention in Atrial Fibrillation (AF).Following Percutaneous Coronary Intervention (PCI) the risk of bleeding increase due to concomitant prescription of antiplatelet agents. The 2016 European Society of Cardiology( ESC) guidelines for non valvular AF provide clear recommendations for triple therapy  , Combination of two anti-platelet and oral anticoagulant in patients with underlying AF undergoing PCI, either electively or for acute coronary syndrome (ACS). The risk of such therapy is based on treatment duration and patient characteristics.
Source: Europace - October 5, 2017 Category: Cardiology Source Type: research

Predictors of Direct Oral Anticoagulants Utilization for Thromboembolism Prevention in Atrial Fibrillation.
CONCLUSION: To the best of our knowledge, this is the first observational study finding that concomitant use of clopidogrel reduced the likelihood of DOAC utilization while prescription by a neurologist increased the probability of receiving a DOAC over warfarin in patients with AF.This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page. PMID: 28459661 [PubMed - in process]
Source: Journal of Pharmacy and Pharmaceutical Sciences - May 2, 2017 Category: Drugs & Pharmacology Tags: J Pharm Pharm Sci Source Type: research

Pilot of a Computerised Antithrombotic Risk Assessment Tool Version 2 (CARATV2.0) for stroke prevention in atrial fibrillation.
CONCLUSIONS: This decision support tool can help optimise the use of antithrombotic therapy in patients with AF by considering risk versus benefit profiles and rationalising treatment selection. PMID: 28070883 [PubMed - as supplied by publisher]
Source: Cardiology Journal - January 9, 2017 Category: Cardiology Authors: Wang Y, Bajorek B Tags: Cardiol J Source Type: research

Use of Warfarin at Discharge Among Acute Ischemic Stroke Patients With Nonvalvular Atrial Fibrillation in China Clinical Sciences
Conclusions— The rate of warfarin use remains low among patients with ischemic stroke and known nonvalvular atrial fibrillation in China. Hospital size and academic status together with patient age, heart failure, heavy alcohol drinking, international normalized ratio in hospital, and stroke severity on admission were each independently associated with the use of warfarin at discharge. There is much room for improvement for secondary stroke prevention in nonvalvular atrial fibrillation patients in China.
Source: Stroke - January 25, 2016 Category: Neurology Authors: Yang, X., Li, Z., Zhao, X., Wang, C., Liu, L., Wang, C., Pan, Y., Li, H., Wang, D., Hart, R. G., Wang, Y., Wang, Y., on behalf of the China National Stroke Registry II Investigators Tags: Anticoagulants, Treatment, Quality and Outcomes, Ischemic Stroke Clinical Sciences Source Type: research

Atrial fibrillation in older inpatients: are there any differences in clinical characteristics and pharmacological treatment between the frail and the non‐frail?
ConclusionsFrailty status had little impact on antithrombotic prescription and no impact on anti‐arrhythmic prescription.
Source: Internal Medicine Journal - September 19, 2015 Category: Internal Medicine Authors: T. N. Nguyen, R. G. Cumming, S. N. Hilmer Tags: Original Article Source Type: research

Association of the 2011 ACGME Resident Duty Hour Reforms With Mortality and Readmissions Among Hospitalized Medicare Patients
Conclusions and RelevanceAmong Medicare beneficiaries, there were no significant differences in the change in 30-day mortality rates or 30-day all-cause readmission rates for those hospitalized in more intensive relative to less intensive teaching hospitals in the year after implementation of the 2011 ACGME duty hour reforms compared with those hospitalized in the 2 years before implementation.
Source: JAMA - December 10, 2014 Category: Journals (General) Source Type: research

Appropriateness of Prescribing Dabigatran Etexilate and Rivaroxaban in Patients With Nonvalvular Atrial Fibrillation: A Prospective Study.
CONCLUSIONS:: Inappropriate use of DE and rivaroxaban in patients with NVAF is frequent and possibly leads to AEs. Reinforcing education of health care professionals and patients is needed. Collaboration with clinical pharmacists can contribute to better use. PMID: 24982310 [PubMed - as supplied by publisher]
Source: The Annals of Pharmacotherapy - June 30, 2014 Category: Drugs & Pharmacology Authors: Larock AS, Mullier F, Sennesael AL, Douxfils J, Devalet B, Chatelain C, Dogné JM, Spinewine A Tags: Ann Pharmacother Source Type: research

Abstract 340: Thirty-day Repeat Hospitalizations for Patients Treated with Prasugrel Compared to Ticagrelor following Acute Coronary Syndrome: Findings from a Large Hospital Charge Master Database Session Title: Poster Session III
Conclusion: Rehosp for MI, revasc or bleeding was non-inferior for pras compared to ticag at 30 days post discharge. Pts treated with pras had lower 30 day rehosp rates, particularly related to readmission for MI, compared with ticag. Although limited by selection bias, these results support the clinical utility of pras, regardless of cohort, to limit 30 day rehosp for pts undergoing PCI for ACS.
Source: Circulation: Cardiovascular Quality and Outcomes - June 2, 2014 Category: Cardiology Authors: Vetrovec, G. W., Larmore, C., Molife, C., DeKoven, M., Karkare, S., Zhu, Y. E., Frech-Tamas, F., Lu, J., Lee, W. C., Mc Collam, P., Marrett, E., Effron, M. B. Tags: Session Title: Poster Session III Source Type: research

Cost‐Effectiveness of Dabigatran Compared With Warfarin for Stroke Prevention in Patients With Atrial Fibrillation—A Real Patient Data Analysis in a Hong Kong Teaching Hospital
ConclusionsThe study favored dabigatran for stroke prophylaxis in patients with nonvalvular AF in Hong Kong under the current hospital's perspective and provided a reference for further comparisons under patient and subsidization perspectives.
Source: Clinical Cardiology - March 14, 2013 Category: Cardiology Authors: Andy M. Chang, Jason C. S. Ho, Bryan P. Yan, Cheuk Man Yu, Yat Yin Lam, Vivian W. Y. Lee Tags: Clinical Investigation Source Type: research

Doctors 'Reverse' Brain Bleed Procedure To Treat Critically Ill Stroke Patients
Doctors at Southampton's teaching hospitals have reversed a procedure developed to stem bleeding in the brain to help them save the lives of seriously ill stroke patients. � The innovation, which involves placing a thin wire into the groin and passing it up to the skull using high definition TV images, is based on a technique originally used as an alternative to surgery for patients with ruptured brain aneurysms - fluid-filled bulges which force blood vessels to tear...
Source: Health News from Medical News Today - February 11, 2013 Category: Consumer Health News Tags: Stroke Source Type: news