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Spontaneous Spinal Epidural Hematoma in an Adult Patient with Complex Congenital Heart Disease
We report the case of a 27-year-old man who developed sudden upper back pain with no specific precipitant. Five days later, he visited our emergency department complaining of weakness in both lower limbs and dysuria. He had a history of intracardiac repair and a Blalock-Park procedure for an interrupted aortic arch and ventricular septal defect in infancy. Additionally, he had undergone an aortic root dilatation and aortic valve replacement at the age of 10 because of progression of aortic and supra-aortic stenosis and had received chronic anticoagulation and antiplatelet therapy with warfarin and aspirin, respectively. An...
Source: International Heart Journal - July 8, 2021 Category: Cardiology Authors: Toshinobu Ifuku Toshihiro Nishiguchi Source Type: research

Janssen Submits New Drug Application to U.S. FDA for XARELTO ® (rivaroxaban) to Help Prevent and Treat Blood Clots in Pediatric Patients
RARITAN, NJ, June 23, 2021 – The Janssen Pharmaceutical Companies of Johnson & Johnson announced today it has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for the use of XARELTO® (rivaroxaban) in pediatric patients. The NDA seeks two pediatric indications: treatment of venous thromboembolism (VTE, or blood clots) and reduction in the risk of recurrent VTE in patients aged birth to less than 18 years of age after at least five days of initial parenteral anticoagulant treatment; and thromboprophylaxis (prevention of blood clots) in patients aged 2 years and older with congenita...
Source: Johnson and Johnson - June 23, 2021 Category: Pharmaceuticals Tags: Innovation Source Type: news

Efficacy and safety of direct oral anticoagulants for treatment of left ventricular thrombus; a systematic review
CONCLUSION: Based on our review, DOACs are likely to be at least as effective and safer as VKA for stroke prevention and thrombus resolution in patients with LVT.PMID:33970796 | DOI:10.1080/00015385.2021.1901024
Source: Acta Cardiologica - May 10, 2021 Category: Cardiology Authors: Dilpat Kumar F N U Warsha Nicholas Helmstetter Vishal Gupta Source Type: research

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asian Patients with Atrial Fibrillation and Valvular Heart Disease.
CONCLUSIONS: NOACs had a comparable risk of ischemic stroke and bleeding in patients with AF and VHD, and reduced the risk of venous thromboembolism, intracranial hemorrhage, and mortality, compared to warfarin. Therefore, NOAC is an effective and safe alternative to warfarin in these patients. PMID: 33538623 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - February 6, 2021 Category: Research Tags: Curr Med Res Opin Source Type: research

Stroke Prevention in Atrial Fibrillation: Looking Forward.
Abstract Ischemic strokes related to atrial fibrillation are highly prevalent, presenting with severe neurologic syndromes and associated with high risk of recurrence. Although advances have been made in both primary and secondary stroke prevention for patients with atrial fibrillation, the long-term risks for stroke recurrence and bleeding complications from antithrombotic treatment remain substantial. We summarize the major advances in stroke prevention for patients with atrial fibrillation during the past 30 years and focus on novel diagnostic and treatment approaches currently under investigation in ongoing cl...
Source: Circulation - December 15, 2020 Category: Cardiology Authors: Katsanos AH, Kamel H, Healey JS, Hart RG Tags: Circulation Source Type: research

Meta-Analysis of Direct Oral Anticoagulants in Patients with Atrial Fibrillation and Bioprosthetic Valves
Valvular heart disease is frequently complicated by atrial fibrillation, which is associated with an increased risk of mortality. In the presence of a surgical or transcatheter bioprosthetic valve, patients with atrial fibrillation are at increased risks of systemic thromboembolism.1 Although direct oral anticoagulants (DOACs) have been shown to be non-inferior or superior to warfarin in preventing stroke or thromboembolism associated with nonvalvular atrial fibrillation, the utilization of DOACs in patients with prior bioprosthetic valves has been limited in randomized clinical trials (RCTs).
Source: The American Journal of Cardiology - December 3, 2020 Category: Cardiology Authors: Babikir Kheiri, Ryle Przybylowicz, Timothy F Simpson, Hani Alhamoud, Mohammed Osman, Khidir Dalouk, Babak Nazer, Charles A. Henrikson, Eric Stecker Source Type: research

Use of Direct Oral Anticoagulants in the Treatment of Left Ventricular Thrombus: Systematic Review of Current Literature
Conclusions: The use of DOACs is a reasonable alternative to vitamin-K antagonists in the management of LVT.
Source: American Journal of Therapeutics - November 1, 2020 Category: Drugs & Pharmacology Tags: Systematic Review and Clinical Guidelines Source Type: research

Prognostic Value of Serum N-Terminal Pro-Brain Natriuretic Peptide Level over Heart Failure for Stroke Events and Deaths in Patients with Atrial Fibrillation.
Authors: Kuronuma K, Okumura Y, Morikawa T, Yokoyama K, Matsumoto N, Tachibana E, Oiwa K, Matsumoto M, Kojima T, Haruta H, Nomoto K, Sonoda K, Arima K, Kogawa R, Takahashi F, Kotani T, Ohkubo K, Fukushima S, Itou S, Kondo K, Chiku M, Ohno Y, Onikura M, Hirayama A, SAKURA AF Registry Investigators Abstract Atrial fibrillation (AF) and heart failure (HF) often coexist. The aims of this study were to explore the factors associated with the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), and the association between prognosis and a history of HF or the serum NT-proBNP level in Japanese patients wit...
Source: International Heart Journal - May 20, 2020 Category: Cardiology Tags: Int Heart J Source Type: research

Evaluation of stroke incidence with duty ‐cycled multielectrode‐phased radiofrequency ablation of persistent atrial fibrillation results of the VICTORY AF Study
ConclusionsVICTORY AF demonstrated a 1.6% incidence of stroke in PersAF undergoing ablation with a phased RF system which did not meet statistical confidence due to poor enrollment. The secondary outcomes suggest comparable efficacy to phased RF in the tailored treatment of permanent AF trial. Rigorous clinical evaluation of the stroke risk of new AF ablation technologies as well as restriction to Vitamin K antagonist anticoagulation appears to be unachievable goals in a clinical multicenter IDE trial of AF ablation in the current era.
Source: Journal of Cardiovascular Electrophysiology - April 23, 2020 Category: Cardiology Authors: John Hummel, Atul Verma, Hugh Calkins, Lee H. Schwamm, Daryl Gress, Darryl Wells, Joseph Souza, Robert B. Hokanson, Lauren Hemingway, Kurt Stromberg, Robert Hoyt, Andrew Wickliffe, David DeLurgio, Lucas Boersma Tags: ORIGINAL ARTICLE Source Type: research

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