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Total 173 results found since Jan 2013.

Testing and monitoring direct oral anticoagulants
Direct oral anticoagulants (DOACs) have significantly improved the care of patients requiring anticoagulation. With similar or better efficacy and safety outcomes and easier use in the outpatient setting compared with the standard-of-care vitamin K antagonists and low molecular weight heparin, DOACs are now endorsed as first-line treatment of indications including prevention of stroke and systemic embolism in nonvalvular atrial fibrillation and treatment of venous thromboembolism. DOACs are easy-to-use oral agents that offer simple dosing and short half-lives, with no need to test levels because of the wide therapeutic win...
Source: Blood - November 8, 2018 Category: Hematology Authors: Connors, J. M. Tags: Perspectives, Thrombosis and Hemostasis Source Type: research

Dabigatran - the First Approved DTI for SPAF.
Authors: Trailokya A, Hiremath JS Abstract Atrial fibrillation (AF) is commonly occurring arrhythmia in clinical practice. AF is easy to recognize but difficult to treat. Stroke is the most devastating complication of AF and is associated with a huge disease burden on the society. Effective stroke prevention is a priority for patients with AF. Two-thirds of strokes due to AF are preventable with suitable anticoagulant therapy. VKA like warfarin, acenocoumarol remains the gold standard for stroke prevention in AF (SPAF). However, it is associated with numerous limitations such as a high risk of drug-drug, drug-food ...
Source: Journal of the Association of Physicians of India - October 25, 2018 Category: General Medicine Tags: J Assoc Physicians India Source Type: research

Neovasc touts Tiara TMVR success rate in study
A small study of the Neovasc (NSDQ:NVCN) Tiara transcatheter mitral valve replacement (TMVR) in high-risk patients revealed a 100% procedural success rate and immediate elimination of mitral regurgitation. Published in Circulation: Cardiovascular Interventions, the study also showed no death, myocardial infarction, stroke, major bleeding, or access site complications at 30 days. The twelve patients in the study had had a previous aortic valve replacement. Such patients have been excluded from most TMVR trials because of the potential risks of left ventricular outflow tract obstruction or interaction between the TMVR anch...
Source: Mass Device - October 16, 2018 Category: Medical Devices Authors: Nancy Crotti Tags: Blog Cardiac Implants Cardiovascular Featured Replacement Heart Valves Research & Development Mayo Clinic neovasc Neovasc Inc. Source Type: news

The value of Stanford integrated psychosocial assessment for transplantation (SIPAT) in prediction of clinical outcomes following left ventricular assist device (LVAD) implantation
ConclusionIn this single-center retrospective study, SIPAT did not predict cumulative re-admissions. Further study is required to validate SIPAT before clinical implementation.
Source: Heart and Lung: The Journal of Acute and Critical Care - September 16, 2018 Category: Respiratory Medicine Source Type: research

Studies: Low-Dose Aspirin May Not Prevent Initial Heart Attack, Stroke
Taking a low-dose aspirin every day has long been known to cut the chances of another heart attack, stroke or other heart problem in people who already have had one, but the risks don’t outweigh the benefits for most other folks, major new research finds. Although it’s been used for more than a century, aspirin’s value in many situations is still unclear. The latest studies are some of the largest and longest to test this pennies-a-day blood thinner in people who don’t yet have heart disease or a blood vessel-related problem. One found that aspirin did not help prevent first strokes or heart attacks...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - August 27, 2018 Category: Consumer Health News Authors: Health – CBS Boston Tags: Boston News Health Healthwatch aspirin Source Type: news

EP News: Allied Professionals
Using data on patients in the United States Renal Data System (USRDS), Siontis et  al (Circulation 2018; https://doi.org/10.1161/CIRCULATIONAHA.118.035418 [Epub ahead of print], PMID 29954737) sought to assess patterns of apixaban use and outcomes related to use of anticoagulants in patients with end-stage renal disease (ESRD) and atrial fibrillation (AF). As background, patient s with ESRD have both higher risk of bleeding and higher risk of stroke with AF. The Food and Drug Administration has approved updated labeling for the use of apixaban in patients with ESRD on the basis of a small pharmacokinetic study.
Source: Heart Rhythm - July 26, 2018 Category: Cardiology Authors: Erica S. Zado Tags: EP News Source Type: research

Outcomes Associated with Apixaban Use in End-Stage Kidney Disease Patients with Atrial Fibrillation in the United States.
Conclusions -Among ESKD patients with AF on dialysis, apixaban use may be associated with lower risk of major bleeding compared with warfarin, with a standard 5 mg twice a day dose also associated with reductions in thromboembolic and mortality risk. PMID: 29954737 [PubMed - as supplied by publisher]
Source: Circulation - June 28, 2018 Category: Cardiology Authors: Siontis KC, Zhang X, Eckard A, Bhave N, Schaubel DE, He K, Tilea A, Stack AG, Balkrishnan R, Yao X, Noseworthy PA, Shah ND, Saran R, Nallamothu BK Tags: Circulation Source Type: research

Four factor prothrombin complex concentrate for warfarin reversal in patients with left ventricular assist devices
AbstractContinuous flow left ventricular assist devices (CF-LVAD) require therapeutic anticoagulation which is often interrupted for procedures or bleeding. Prior to the availability of four factor prothrombin complex concentrate (4F-PCC) in the United States, warfarin was held and its effects reversed by vitamin K or fresh frozen plasma. We evaluated the use of 4F-PCC for temporary warfarin reversal in patients with CF-LVADs and assessed outcomes. This analysis is a retrospective study of CF-LVAD patients who received 4F-PCC for warfarin reversal in the setting of bleeding or need for urgent or elective procedures. Primar...
Source: Journal of Thrombosis and Thrombolysis - May 21, 2018 Category: Hematology Source Type: research

Over-the-counter analgesic powder use in patients presenting with intracerebral hemorrhage: A case series
Conclusions: Over-the-counter analgesic powders containing high doses of aspirin including BC Powder and Goody's Powder may contribute to ICH in patients with no or minimal risk factors. Providers should inquire about the use of these powders in ICH patients particularly among African Americans.
Source: Medicine - April 1, 2018 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Predictors of Oral Anticoagulant Non-prescription in Patients with Atrial Fibrillation and Elevated Stroke Risk
Conclusions In this registry of AF patients, older patients at elevated stroke and low bleeding risk were commonly treated with OAC. However, a variety of factors were associated with OAC non-prescription. Specifically, antiplatelet use was prevalent and associated with the highest likelihood of OAC non-prescription. Future studies are warranted to understand provider and patient rationale that may underlie observed associations with OAC non-prescription.
Source: American Heart Journal - March 11, 2018 Category: Cardiology Source Type: research

Stroke prevention strategies in North American patients with atrial fibrillation: the GLORIA ‐AF registry program
ConclusionsIn GLORIA‐AF, 20% of the population comprising males with CHA2DS2‐VASc ≥1 and females with CHA2DS2‐VASc ≥2 did not receive oral anticoagulation therapy. Patient characteristics associated with a lower likelihood of OAC prescription were use of antiplatelet drugs, paroxysmal pattern of AF, a history of falls, and prior bleeding.
Source: Clinical Cardiology - February 1, 2018 Category: Cardiology Authors: William F. McIntyre, David Conen, Brian Olshansky, Jonathan L. Halperin, Emil Hayek, Menno V. Huisman, Gregory Y.H. Lip, Shihai Lu, Jeff S. Healey Tags: CLINICAL INVESTIGATIONS Source Type: research

Direct Oral Anticoagulants in End-Stage Renal Disease
Semin Thromb Hemost DOI: 10.1055/s-0037-1621715Patients with end-stage renal disease (ESRD) were excluded from pivotal clinical trials with oral anticoagulants. While such patients are at an increased risk of venous and arterial thromboembolism, their risk of bleeding is also elevated. It is thus of little surprise that stroke prevention with vitamin K antagonists (VKAs) in ESRD patients with atrial fibrillation is controversial, with observational evidence ranging from beneficial to harmful. This uncertainty extends to the less studied use of VKAs for venous thromboembolism in ESRD. The direct oral anticoagulants (DOACs) ...
Source: Seminars in Thrombosis and Hemostasis - January 10, 2018 Category: Hematology Authors: Klil-Drori, Adi J. Tagalakis, Vicky Tags: Review Article Source Type: research

Endovascular Versus Surgical Revascularization for Chronic Mesenteric Ischemia: Insights From the National Inpatient Sample Database
Conclusions In a large, retrospective analysis of patients with CMI, endovascular therapy remained the dominant revascularization modality, and was associated with lower rates of MACCE, composite in-hospital complications, lower costs, and shorter length of stay compared with surgery.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - December 4, 2017 Category: Cardiology Authors: Lima, F. V., Kolte, D., Kennedy, K. F., Louis, D. W., Abbott, J. D., Soukas, P. A., Hyder, O. N., Mamdani, S. T., Aronow, H. D. Tags: Peripheral Source Type: research

Warfarin Use And the Risk Of Stroke, Bleeding, And Mortality In Older Adults On Dialysis With Incident Atrial Fibrillation
ConclusionOlder ESRD patients with AF who were treated with warfarin had a no difference in stroke risk, lower mortality risk, but increased major bleeding risk. The bleeding risk associated with warfarin was greater among women than men. The risk/benefit ratio of warfarin may be less favorable among older women.
Source: Nephrology - December 1, 2017 Category: Urology & Nephrology Authors: Jingwen Tan, Sunjae Bae, Jodi B. Segal, Junya Zhu, G. Caleb Alexander, Dorry L. Segev, Mara McAdams ‐DeMarco Tags: Original Article Source Type: research

Stop Bleeding! Oral  Anticoagulation and Options for Reversal
Direct oral anticoagulants (DOACs) are widely used medications for stroke prevention in nonvalvular atrial fibrillation (AF), and for deep vein thrombosis treatment and prevention. The IMS Institute for Healthcare Informatics analyzed outpatient anticoagulant use in the United States between 2009 and 2014 and found that there has been a steady increase in DOAC use following their initial approval in 2010.1 DOACs include the direct thrombin inhibitor dabigatran, and the factor Xa inhibitors rivaroxaban, apixaban, and edoxaban, and recently approved betrixaban.
Source: The Journal for Nurse Practitioners - November 29, 2017 Category: Nursing Authors: Archna Jariwala, Kori Hamman Tags: Prescription Pad Source Type: research