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Source: Journal of Thrombosis and Thrombolysis
Condition: Stroke
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Total 309 results found since Jan 2013.
Assessing patient preferences for switching from warfarin to direct oral anticoagulants
This study assessed patient preference for warfarin or DOAC based on a willingness to pay more for potential DOAC benefits. Current warfarin patients with atrial fibrillation or venous thromboembolism enrolled in the University of Utah Health Thrombosis Service were given a one-time electronic survey that assessed preferences between warfarin and DOACs using scenarios comparing effectiveness, safety, and convenience. When DOACs were preferred, patients were asked how much more they would be willing to pay monthly for the perceived advantages associated with DOACs. With 123 completed surveys, 68% of patients preferred to st...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2019 Category: Hematology Source Type: research
Intravenous thrombolysis in acute ischemic stroke due to intracranial artery dissection: a single-center case series and a review of literature
AbstractEfficacy and safety of intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) due to intracranial artery dissection (IAD) are currently not established. We aimed to present a single-center experience on IAD-related AIS treated by IVT. We selected all consecutive patients with IAD-related AIS treated by IVT from a prospectively constructed single-center acute stroke registry from 2003 to 2017. We reviewed demographical, clinical and neuroimaging data and recorded hemorrhagic complications, mortality within 7 days and modified Rankin Scale at 3-months. Out of 181 AISs related to cervicocephalic dissections, ...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2019 Category: Hematology Source Type: research
Interhospital transfer on intravenous thrombolysis in patients with acute ischemic stroke in three chinese municipal stroke centers
AbstractWe included acute ischemic stroke (AIS) patients who received recombinant tissue plasminogen activator (rt-PA) at three stroke centers via either interhospital transfer or direct presentation and compared the clinical outcomes and time metrics to analyze the impact of interhospital transfer on intravenous thrombolysis (IVT). We retrospectively enrolled patients with AIS admitted to three stroke centers from October 1, 2016, to June 1, 2018. Patients treated with rt-PA were classified into the transfer and direct groups. We collected the patients ’ general information and time points. Statistical analyses were con...
Source: Journal of Thrombosis and Thrombolysis - October 19, 2019 Category: Hematology 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
Low persistence to rivaroxaban or warfarin among patients with new venous thromboembolism at a safety net academic medical center
This study evaluated 90 day persistence among patients prescribed rivaroxaban or warfarin for the treatment of acute VTE at an academic safety net hospital. We conducted a single center, retrospective cohort study of 314 consecutive patients newly prescribed rivaroxaban or warfarin for acute VTE between January 2016 and July 2017. Primary outcome was 90 day persistence, and secondary outcomes included 90 day readmission and/or ED visit, time to 90 m day readmission and/or ED visits, and attendance of direct oral anticoagulant education class. Of 314 patients, 78 were prescribed warfarin and 236 rivaroxaban. Patients had a ...
Source: Journal of Thrombosis and Thrombolysis - October 8, 2019 Category: Hematology Source Type: research
Prevalence and relevance of abnormal glucose metabolism in acute coronary syndromes: insights from the PLATelet inhibition and patient Outcomes (PLATO) trial
AbstractDiabetes mellitus (DM) and abnormal glucose metabolism are associated with cardiovascular (CV) disease. We investigated the prevalence and prognostic importance of dysglycaemia in patients with acute coronary syndromes (ACS) in the PLATelet inhibition and patient Outcomes (PLATO) trial. Diabetes was defined as known diabetes or HbA1c ≥ 6.5% or non-fasting glucose ≥ 11.1 mmol/L on admission, prediabetes as HbA1c ≥ 5.7% but< 6.5%, and no diabetes as HbA1c < 5.7%. The primary endpoint was the composite of CV death, spontaneous myocardial infarction type 1 (sMI) or stroke at 12 months. ...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2019 Category: Hematology Source Type: research
Survey of confidence in use of stroke and bleeding risk calculators, knowledge of anticoagulants, and comfort with prescription of anticoagulation in challenging scenarios: SUPPORT-AF II study
AbstractHalf of patients with atrial fibrillation (AF) and elevated stroke risk do not receive anticoagulation (AC). Explanations for undertreatment may relate to provider lack of confidence with or knowledge of the CHA2DS2-VASc stroke calculator, unfamiliarity with direct oral anticoagulants (DOACs), or uncertainty about use of AC after bleeding events or other challenging patient scenarios. We surveyed cardiology and primary care providers (PCPs) within a large healthcare system to investigate prescriber knowledge, confidence, and comfort prescribing AC for AF in challenging scenarios. Of 112 providers invited, 70 (63%) ...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2019 Category: Hematology Source Type: research
Age-related burden and characteristics of embolic stroke of undetermined source in the real world clinical practice
AbstractFew data are available on age-related burden and characteristics of embolic stroke of undetermined source (ESUS) in the real world clinical practice. The aim of our study was to provide information about it. We retrospectively analyzed data of patients consecutively admitted to our Stroke Unit along 1 year (2017, November 1st–2018, October 31st). The etiology of ischemic stroke was defined at hospital discharge; ESUS was considered as a subset of cryptogenic stroke, and defined according to the 2014 international criteria. In the analyzed period, 306 patients, 52.3% females, mean age ± S D 77.9 ± 11.9...
Source: Journal of Thrombosis and Thrombolysis - September 6, 2019 Category: Hematology Source Type: research
ADAMTS13 activity is associated with early neurological improvement in acute ischemic stroke patients treated with intravenous thrombolysis
AbstractAlthough intravenous thrombolysis (IVT) with recombinant tissue-plasminogen-activator represents a highly effective treatment in acute ischemic stroke patients, not every patient benefits. We hypothesized that pretreatment levels of mediators of hemostasis (VWF and ADAMTS13) and dimethylarginines (ADMA and SDMA) are associated with early neurological improvement and outcome after IVT in ischemic stroke. Moreover we aimed to investigate the link between ADAMTS13 and markers of inflammation (CRP, IL-6, MMP-9 and MCP-1). In 43 patients with acute ischemic stroke treated with IVT blood samples for determination of the ...
Source: Journal of Thrombosis and Thrombolysis - September 2, 2019 Category: Hematology Source Type: research
Determinants of anticoagulant therapy in atrial fibrillation at discharge from a geriatric ward: cross sectional study
AbstractOral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), but they are often underused in this particularly high-risk population. The aim of the study was to identify health and functional determinants of oral anticoagulant therapy (OA) in AF at discharge from a geriatric sub-acute ward. A cross-sectional study was conducted and patients who presented with atrial fibrillation were analyzed. They were interviewed, examined, assessed with comprehensive geriatric assessment protocol, and had their hospital records analyzed. Relative risks for OA were counted and multi...
Source: Journal of Thrombosis and Thrombolysis - August 29, 2019 Category: Hematology Source Type: research
Interactions between clopidogrel and traditional Chinese medicine
AbstractThe use of traditional Chinese medicine (TCM) has obtained more and more acceptance all over the world due to its multi-target and multi-level function characteristics. Clopidogrel is a major therapeutic option to reduce atherothrombotic events in patients with acute coronary syndrome, recent myocardial infarction, recent stroke or established peripheral arterial disease. These patients probably take TCM. Are there any interactions between clopidogrel and TCM? Whether TCM will affect the efficacy of clopidogrel or increase the adverse reactions of bleeding? Clarifying this information will help physicians make bett...
Source: Journal of Thrombosis and Thrombolysis - August 29, 2019 Category: Hematology Source Type: research
Outcomes associated with under-dosing of rivaroxaban for management of non-valvular atrial fibrillation in real-world Japanese clinical settings
AbstractThe approved dose of oral anticoagulant rivaroxaban for patients with non-valvular atrial fibrillation (NVAF) in Japan is 15 mg once daily (od) in patients whose creatinine clearance is ≥ 50 mL/min, but recent real-world studies have demonstrated that these patients often received less than the recommended dose due to bleeding concerns. The effect of under-dosing on safety and effectiveness outcomes remains uncle ar. We used 1-year follow-up data from the XAPASS, a real-world Japanese prospective, single-arm, observational study. Of the 11,308 patients, 6521 patients who completed a 1-year follow-up and ha...
Source: Journal of Thrombosis and Thrombolysis - August 19, 2019 Category: Hematology Source Type: research
Clinical profile of direct oral anticoagulants versus vitamin K anticoagulants in octogenarians with atrial fibrillation: a multicentre propensity score matched real-world cohort study
AbstractAtrial fibrillation (AF) is the most common arrhythmia in clinical practice and its prevalence increases with age. Few data are available about the clinical performance of direct oral anticoagulant (DOACs) in patients aged ≥ 80 years with AF. The aim of our propensity score matched cohort study was to compare the safety and efficacy of DOACs versus well-controlled VKA therapy among octogenarians with AF in real life setting. Data for this study were sourced from the multicenter prospectively maintained Atrial Fibrillation Research Database (NCT03760874), which includes all AF patients followed by the partic...
Source: Journal of Thrombosis and Thrombolysis - August 4, 2019 Category: Hematology Source Type: research
Does the administration of sonothrombolysis along with tissue plasminogen activator improve outcomes in acute ischemic stroke? A systematic review and meta-analysis
AbstractThis meta-analysis was conducted to assess the safety and efficacy of sonothrombolysis along with intravenous recombinant tissue plasminogen activator, alteplase (IV rtPA), in the management of acute ischemic stroke. Electronic databases were searched under different meSH terms without the restriction of time and language. 1415 studies were analyzed and seven studies that matched the inclusion criteria were selected. Multiple safety and efficacy outcomes were extracted. Our pooled analysis demonstrated that there is no significant difference between sonothrombolysis group and control group in preventing mortality (...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research
Comparative clinical outcomes between direct oral anticoagulants and warfarin among elderly patients with non-valvular atrial fibrillation in the CMS medicare population
AbstractAtrial fibrillation (AF) prevalence increases with age;> 80% of US adults with AF are aged ≥ 65 years. Compare the risk of stroke/systemic embolism (SE), major bleeding (MB), net clinical outcome (NCO), and major adverse cardiac events (MACE) among elderly non-valvular AF (NVAF) Medicare patients prescribed direct oral anticoagulants (DOACs)vs warfarin. NVAF patients aged ≥ 65 years who initiated DOACs (apixaban, dabigatran, and rivaroxaban) or warfarin were selected from 01JAN2013-31DEC2015 in CMS Medicare data. Propensity score matching was used to balance DOAC and warfarin cohorts. Cox proportion...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research
