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Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study
This study is registered with ClinicalTrials.gov, number NCT02513316. Findings Between Aug 4, 2011, and July 31, 2015, we recruited 1490 participants of whom follow-up data were available for 1447 (97%), over a mean period of 850 days (SD 373; 3366 patient-years). The symptomatic intracranial haemorrhage rate in patients with cerebral microbleeds was 9·8 per 1000 patient-years (95% CI 4·0–20·3) compared with 2·6 per 1000 patient-years (95% CI 1·1–5·4) in those without cerebral microbleeds (adjusted hazard ratio 3·67, 95% CI 1·27–10·60). Compared with the HAS-BLED score alone (C-index 0·41, 95% CI 0·29–0Â...
Source: The Lancet Neurology - May 16, 2018 Category: Neurology Source Type: research

Management of oral anticoagulation in very old patients with non valvular atrial fibrillation related acute ischemic stroke
AbstractThe optimal management of oral anticoagulation (OAC) in the acute phase of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS) remains controversial, especially in very old patients. Therefore, the aim of our study was to evaluate the practical management of OAC in this context. We conducted an observational retrospective study on patients 85-years old and older admitted to two Italian hospitals for NVAF-related AIS. For each patient, clinical and brain computed tomography data were recorded. Type of OAC (vitamin K antagonists, VKAs or Direct Oral Anticoagulants, DOACs), dosage and starting ...
Source: Journal of Thrombosis and Thrombolysis - October 16, 2019 Category: Hematology Source Type: research

New XARELTO ® (rivaroxaban) Peripheral Artery Disease (PAD) Data from EXPLORER Clinical Research Program to be Unveiled at American Heart Association (AHA) Scientific Sessions 2020
RARITAN, N.J., November 9, 2020 – The Janssen Pharmaceutical Companies of Johnson & Johnson today announced that 10 data presentations will be shared at the virtual American Heart Association (AHA) Scientific Sessions 2020 from November 13-17. Most notably, four new sub-analyses of XARELTO® (rivaroxaban) from the landmark VOYAGER PAD trial, part of the EXPLORER global cardiovascular research program, will be presented, including two live, featured science oral presentations. “We're pleased VOYAGER PAD was selected to be front and center once again at a major medical congress, as there's an urgent need for data in ...
Source: Johnson and Johnson - November 9, 2020 Category: Pharmaceuticals Tags: Innovation Source Type: news

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

Effects of a Pharmacist-Led Educational Interventional Program on Electronic Monitoring-Assessed Adherence to Direct Oral Anticoagulants: A Randomized, Controlled Trial in Patients with Nonvalvular Atrial Fibrillation
In this study, the selection of DOACs was not randomized, and the lack of assessment of the association between adherence to DOACs and clinical outcomes was a limitation. Japan Registry of Clinical Trials (jRCT) indentifier: jRCTs031180142. (Clin Ther. 2022;44:XXX-XXX) © 2022 Elsevier Inc.PMID:36244853 | DOI:10.1016/j.clinthera.2022.09.011
Source: Clinical Therapeutics - October 16, 2022 Category: Drugs & Pharmacology Authors: Tsuyoshi Shiga Toshimi Kimura Noritoshi Fukushima Yuji Yoshiyama Kazunori Iwade Fumiaki Mori Yoichi Ajiro Shoji Haruta Yuichiro Yamada Emi Sawada Nobuhisa Hagiwara SMAAP-AF Investigators Source Type: research

Use of idarucizumab for dabigatran reversal in patients with non-valvular atrial fibrillation undergoing emergency surgical repair of strangulated femoral hernia
We report a case of a 61-year-old woman with history of NVAF on dabigatran, presented to the emergency department with a strangulated right femoral hernia causing small bowel obstruction, where idarucizumab was administered before surgery. The patient had received her last dose of dabigatran 4 hours before presenting to the emergency department and her activated partial thromboplastin time was over the upper limit of reference. Surgery followed about one hour after the administration of idarucizumab and surgeon reported normal perioperative haemostasis. The patient had a normal recovery, received parenteral anticoagulation...
Source: Hellenic Journal of Surgery - April 1, 2017 Category: Surgery Source Type: research

Annual costs attributed to atrial fibrillation management: cross-sectional study of primary healthcare electronic records
This study aims to describe overall annual costs per patient for management of non-valvular AF in a primary healthcare (PHC) setting and compare these costs between the groups of patients treated with vitamin K antagonists, antiplatelets or non-treated through a population-based study conducted with electronic health records. We analysed annual costs per person of 19,787 patients in 2012; PHC visits, hospital admissions, AF-related events requiring hospital admission, referrals to secondary specialists, sick leave, diagnostic tests and laboratory tests at PHC level, including INR determinations performed in PHC, and drug t...
Source: The European Journal of Health Economics - February 20, 2018 Category: Health Management Source Type: research

Perioperative management of a patient with Glanzmann thrombasthenia undergoing a coronary artery bypass graft surgery: a case report
We report herein the successful perioperative management of a 57-year-old man with a type I Glanzmann thrombasthenia undergoing coronary artery bypass graft surgery and right carotid endarterectomy. The patient suffered from several lesions in the three major coronary arteries and in the right carotid necessitating surgery. Prophylactic human leukocyte antigen (HLA)-matched platelets transfusions were continuous administrated before, and through the immediate perioperative period. Posttransfusion platelet recovery was monitored using flow cytometry to determine the percentage of circulating platelet expressing CD61 (β3). ...
Source: Blood Coagulation and Fibrinolysis - April 1, 2018 Category: Hematology Tags: Case Report Source Type: research

The effect of management models on thromboembolic and bleeding rates in anticoagulated patients: an ecological study
AbstractThe primary  study objective is to compare the outcomes of patients taking oral anticoagulant medications in two distinct populations treated according to different management models (comprehensive vs. usual care). (Design: regional prospective cohort study; setting: hospital admission data from two regions). Eligible partecipants were patients taking oral anticoagulant drugs (vitamin K antagonist or direct oral anticoagulants), residents in the Vicenza and Cremona districts from February 1st, 2016 to June 30th, 2017. Patients were identified by accessing the administrative databases of patient drug prescripti...
Source: Internal and Emergency Medicine - July 14, 2019 Category: Emergency Medicine Source Type: research

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