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Total 134 results found since Jan 2013.

Patient perspectives on left main stem revascularization strategies, the OPINION-2 study.
CONCLUSIONS: Overall, patients who are informed about risk and benefits of each treatment modality clearly favor PCI over CABG and particularly value lower short-term morbidity while being aware of higher risk of repeat revascularization. Lower educational level was associated with a higher prevalence of psychosomatic phenotypes and a 14% preference for CABG. Educational and psychosocial background matter in the revascularization strategy decision-making process. PMID: 33041162 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - October 8, 2020 Category: Cardiology Authors: Nuis RJ, Jadoon A, van Dalen BM, Dulfer K, Snelder SM, Yazdi MT, Masdjedi K, den Dekker WK, Diletti R, Wilschut J, Daemen J, Lenzen MJ, Zijlstra F, Smits PC, Van Mieghem NM Tags: J Cardiol Source Type: research

Practical challenges in the conduct of pragmatic trials embedded in health plans: Lessons of IMPACT-AFib, an FDA-Catalyst trial.
Abstract IMPACT-AFib was an 80,000-patient randomized clinical trial implemented by five US insurance companies (health plans) aimed at increasing the use of oral anticoagulants by individuals with atrial fibrillation who were at high risk of stroke and not on treatment. The underlying thesis was that patients could be change agents to initiate prescribing discussions with their providers. We tested the effect of mailing information to both patients and their providers. We used administrative medical claims and pharmacy dispensing data to identify eligible patients, to randomize them to an early or delayed interve...
Source: Clinical Trials - June 25, 2020 Category: Research Authors: Garcia CJ, Haynes K, Pokorney SD, Lin ND, McMahill-Walraven C, Nair V, Parlett L, Martin D, Al-Khalidi HR, McCall D, Granger CB, Platt R, Cocoros NM Tags: Clin Trials Source Type: research

IJERPH, Vol. 17, Pages 4008: Evaluating Physician Adherence to Antithrombotic Recommendations in Patients with Atrial Fibrillation: A Pathway to Better Medical Education
Conclusions: The decision to use anticoagulants for stroke prevention was based on the type of atrial fibrillation, rather than on the risk of stroke as quantified by CHA2DS2-VASc as per the recommended guidelines.
Source: International Journal of Environmental Research and Public Health - June 3, 2020 Category: Environmental Health Authors: Vesa Vlaicu Sabin V ăcăraș Cri șan Istratoaie Samantar Popa Macarie Buzoianu Tags: Article Source Type: research

Safety of OnabotulinumtoxinA with Concomitant Antithrombotic Therapy in Patients with Muscle Spasticity: A Retrospective Pooled Analysis of Randomized Double-Blind Studies
ConclusionsNo apparent increased risk of bleeding complications was observed following administration of onabotulinumtoxinA to patients receiving antithrombotic therapy. Nonetheless, patient education and careful observation of the injection site in patients receiving antithrombotic therapy remains warranted.
Source: CNS Drugs - March 12, 2020 Category: Neurology Source Type: research

Association of patient satisfaction with direct oral anticoagulants and the clinical outcomes: Findings from the SAKURA AF registry.
CONCLUSIONS: We found a strong association between a low benefit satisfaction and increased stroke risk. We should follow patients carefully to educate them on treatment importance for patients unsatisfied with the benefits of DOACs for stroke prevention. PMID: 32089481 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - February 19, 2020 Category: Cardiology Authors: Hori K, Okumura Y, Koichi N, Yokoyama K, Matsumoto N, Tachibana E, Kuronuma K, Oiwa K, Matsumoto M, Kojima T, Arima K, Kotani T, Nomoto K, Ohkubo K, Fukushima S, Onikura M, Suzuki Y, Fujita M, Ando H, Ishikawa N, Hirayama A, SAKURA AF Registry Investigato Tags: J Cardiol Source Type: research

The Hospital Zambrano Hellion venous thromboembolism rapid response team (PREVENTION-team): Improving pulmonary embolism and deep venous thrombosis patient care.
Abstract Background: Fast-track worldwide reperfusion programs improve outcomes in ST-elevation myocardial infarction and stroke. Similar programs called Program Evaluation and Review Technique (PERT) focus on submassive and massive pulmonary embolism (PE) excluding deep venous thrombosis (DVT). Methods: PREVENTION-team (Hospital Zambrano Hellion Venous Thromboembolism [VTE] Rapid Response). Primary objective: Fast-track stratification, diagnostics, and treatment (60-90 min) to improve proximal DVT and submassive and massive PE patients care. Secondary objectives: Increase diagnosis rate of low-risk...
Source: Archivos de Cardiologia de Mexico - February 1, 2020 Category: Cardiology Authors: Toro-Mijares RD, Jerjes-Sánchez C, Rodríguez D, Panneflek J, Vázquez-Guajardo M, Fabiani MA, Quintanilla J, Manautou L, Peña-Almaguer E, Cadena A, Cassagne G, Torre-Amione G Tags: Arch Cardiol Mex Source Type: research

Is there a role for low-dose DOACs as prophylaxis?
Authors: Cohen AT, Hunt BJ Abstract The direct oral anticoagulants (DOACs) have transformed the management of thrombotic disorders. Large clinical trials have demonstrated that DOACs can replace vitamin K antagonists (VKAs) in the 2 existing major indications for anticoagulation: the prevention of stroke in atrial fibrillation and the acute treatment and secondary prevention of venous thromboembolism (VTE); this literature is widely known. In this article, we will concentrate on the less well-discussed benefits of the use of DOACs-using low doses as primary and secondary prophylaxis in both venous and arterial thro...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Bleeding in critical care associated with left ventricular assist devices: pathophysiology, symptoms, and management.
Authors: Leebeek FWG, Muslem R Abstract Chronic heart failure (HF) is a growing health problem, and it is associated with high morbidity and mortality. Left ventricular assist devices (LVADs) are nowadays an important treatment option for patients with end-stage HF not only as a bridging tool to heart transplantation but also, as a permanent therapy for end-stage HF (destination therapy). The use of LVAD is associated with a high risk for bleeding complications and thromboembolic events, including pump thrombosis and ischemic stroke. Bleeding is the most frequent complication, occurring in 30% to 60% of patients, b...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Evidence-Based Minireview: Mortality and thrombosis in patients receiving prothrombin complex concentrates or andexanet alfa for the management of direct oral factor Xa inhibitor-associated major bleeding.
Authors: Kimpton M, Siegal DM Abstract A 77-year-old man with atrial fibrillation and a CHA2DS2Vasc score of 6 for hypertension, age, diabetes, and previous stroke is brought to the emergency department with decreased level of consciousness. He is anticoagulated with rivaroxaban (a direct oral factor Xa inhibitor [FXaI]) and received his last dose about 4 hours before presentation. Urgent computed tomography of the head shows intracerebral hemorrhage. Because of his previous stroke, the patient's family is concerned about treating the bleed with pharmacological agents that may increase the risk of stroke. What are ...
Source: Hematology ASH Education Program - December 7, 2019 Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research

Prevalence and predictors of inappropriate apixaban dosing in patients with non-valvular atrial fibrillation at a large tertiary academic medical institution
ConclusionIn patients with NVAF receiving apixaban for stroke prevention in this real-world analysis,>  80% were prescribed an appropriate dosage of apixaban. Proactive procedures, such as integrating an electronic dosing algorithm, educating healthcare providers, and involving clinical pharmacists in medication review, may help ensure the use of appropriate apixaban dosages.
Source: Drugs and Therapy Perspectives - December 4, 2019 Category: Drugs & Pharmacology Source Type: research

Many take anticoagulants and OTC supplements, which poses risk
FINDINGSNearly 98% percent of people prescribed direct-acting oral anticoagulants such as apixaban also used  over-the-counter products. Of those, 33% took at least one such product that, in combination with the anticoagulants, could cause dangerous internal bleeding. People taking these medications largely lacked knowledge of some potentially serious interactions.BACKGROUNDDirect-acting oral anticoagulants are the drug of choice for stroke prevention in patients with atrial fibrillation, which occurs most frequently in older patients. Apixaban is one of the most frequently prescribed. However, most people prescribed apix...
Source: UCLA Newsroom: Health Sciences - October 31, 2019 Category: Universities & Medical Training Source Type: news

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

Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial
Publication date: 24–30 August 2019Source: The Lancet, Volume 394, Issue 10199Author(s): Gholamreza Roshandel, Masoud Khoshnia, Hossein Poustchi, Karla Hemming, Farin Kamangar, Abdolsamad Gharavi, Mohammad Reza Ostovaneh, Alireza Nateghi, Masoud Majed, Behrooz Navabakhsh, Shahin Merat, Akram Pourshams, Mahdi Nalini, Fatemeh Malekzadeh, Masoumeh Sadeghi, Noushin Mohammadifard, Nizal Sarrafzadegan, Mohammad Naemi-Tabiei, Abdolreza Fazel, Paul BrennanSummaryBackgroundA fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income ...
Source: The Lancet - August 23, 2019 Category: General Medicine Source Type: research

Mechanical Circulatory Support Driveline Infection Reduction through Nursing Quality Improvement
Infection in patients with left ventricular assist device is a leading cause of morbidity and mortality resulting in increased risk for additional complications such as bleeding, thrombosis and stroke. The purpose of this quality improvement project was to reduce driveline infections through implementation of an evidence-based bundled dressing kit and education to nursing staff.
Source: Journal of Cardiac Failure - July 31, 2019 Category: Cardiology Authors: Tania V. Randell, Tim Madeira, Noelle V. Pavlovic, Martha Abshire Tags: 335 Source Type: research

Stroke Prophylaxis for Atrial Fibrillation? To Prescribe or Not to Prescribe—A Qualitative Study on the Decisionmaking Process of Emergency Department Providers
ConclusionThe decision to prescribe oral anticoagulation in the ED is complex. Improving guideline adherence will require a multifaceted approach inclusive of system-level improvements, physician education, and the development of ED-specific tools and guidelines.
Source: Annals of Emergency Medicine - May 11, 2019 Category: Emergency Medicine Source Type: research