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Beyond warfarin: A patient‐centered approach to selecting novel oral anticoagulants for stroke prevention in atrial fibrillation
CONCLUSIONSWarfarin continues to play an important role in the prevention of stroke or systemic embolism in NVAF. Among selected patients, the use of NOACs provides equal or superior benefit, without the need for chronic anticoagulation monitoring or ongoing dose titration. Journal of Hospital Medicine 2014. © 2014 Society of Hospital Medicine
Source: Journal of Hospital Medicine - April 9, 2014 Category: Hospital Management Authors: Keval K. Patel, Ali A. Mehdirad, Michael J. Lim, Scott W. Ferreira, Peter C. Mikolajczak, Joshua M. Stolker Tags: Reviews Source Type: research

Edoxaban Effective in Preventing Stroke, Reducing Bleeding and Cardiovascular Death in Patients With Atrial Fibrillation
New study demonstrates that high- and low-dose edoxaban were at least as effective in preventing stroke or systemic embolism (blood clot), while significantly reducing bleeding and cardiovascular death, compared to warfarin.
Source: BWH News - November 19, 2013 Category: Hospital Management Source Type: news

Can I use DOAC in a patient with renal disease?
Case A 76-year-old man is diagnosed with non-valvular atrial fibrillation. His comorbid conditions are hypertension, diabetes complicated by neuropathy, and chronic kidney disease stage 3. His current medications include metformin, lisinopril, gabapentin, and aspirin. His most recent laboratories showed a creatinine 1.8, creatinine clearance (CrCl) 35 mL/min, hemoglobin 11g/dL, and international normalized ratio 1.0. His congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex (CHADSVASc) score is 4. Which medication should we use to prevent stroke in this patient?  Brief overview of the is...
Source: The Hospitalist - February 3, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Renal & Genitourinary 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

Updates in perioperative medicine
CONCLUSIONSThe body of literature reviewed provides important information for clinicians caring for surgical patients across multiple fronts, including preoperative risk assessment, medication management, and postoperative medical care. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine
Source: Journal of Hospital Medicine - September 18, 2015 Category: Hospital Management Authors: Suparna Dutta, Steven L. Cohn, Kurt J. Pfeifer, Barbara A. Slawski, Gerald W. Smetana, Amir K. Jaffer Tags: Reviews Source Type: research

Tranexamic acid minimized perioperative bleeding in patients undergoing noncardiac surgery
Dr. Menon Clinical question: Does tranexamic acid reduce the incidence of life-threatening perioperative bleeding in patients undergoing noncardiac surgery without increasing the risk of major cardiovascular adverse events? Background: Large surgical trials have shown that tranexamic acid reduces the incidence and severity of perioperative bleeding in patients undergoing a cesarean section or cardiac surgery. Other, smaller trials have suggested similar findings with tranexamic acid in patients undergoing orthopedic surgery as well. But, there are limited data on the use of tranexamic acid in patients undergoing non-ortho...
Source: The Hospitalist - August 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Critical Care In the Literature Perioperative Medicine Source Type: research

Rivaroxaban Monotherapy is Preferable to Combination Therapy with Antiplatelets with Regards to Total Cardiovascular and Bleeding Events in Patients with AF and Stable CAD
In this study conducted across 294 centers, 2,215 patients were randomly assigned to rivaroxaban monotherapy, or therapy with rivaroxaban in combination with aspirin or a P2Y12 inhibitor. All patients were diagnosed with AF with a CHADS2 score greater than one, as well as confirmed CAD without percutaneous coronary intervention (PCI) or coronary artery bypass grafting within 12 months. Primary endpoints were the total number of first and subsequent bleeding and thrombotic events over a 24-month follow-up period. Thrombotic events included ischemic stroke, systemic embolism, myocardial infarction, and unstable angina requir...
Source: The Hospitalist - January 3, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: CAD & Atherosclerosis Cardiology In the Literature Source Type: research