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Source: BMJ Open
Condition: Bleeding

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Total 38 results found since Jan 2013.

Outcome disparities in patients with atrial fibrillation based on insurance plan and educational attainment: a nationwide, multicenter and prospective cohort trial
Conclusion Educational attainment was independently associated with all-cause mortality and ischaemic stroke in patients with AF, but adverse clinical outcomes were not related to the types of health insurance in Thailand. Trial registration number Thai Clinical Trial Registration; Study ID: TCTR20160113002.
Source: BMJ Open - August 10, 2022 Category: General Medicine Authors: Apiyasawat, S., Thongsri, T., Jongpiputvanich, K., Krittayaphong, R., for the COOL-AF Investigators Tags: Open access, Cardiovascular medicine Source Type: research

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review
Conclusions OAC switching is common in patients with AF and patients often switch back to an OAC they have previously been on. There are aspects of OAC switching that have received little study, especially in switches from DOACs.
Source: BMJ Open - April 25, 2023 Category: General Medicine Authors: Adelakun, A. R., Turgeon, R. D., De Vera, M. A., McGrail, K., Loewen, P. S. Tags: Open access, Cardiovascular medicine Source Type: research

Rationale design and efficacy of a smartphone application for improving self-awareness of adherence to edoxaban treatment: study protocol for a randomised controlled trial (adhere app)
This study was approved by the Seoul National University Bundang Hospital Institutional Review Board and will be conducted according to the principles of the Declaration of Helsinki. The study results will be published in a reputable journal. Trial registration number KCT0004754.
Source: BMJ Open - April 27, 2022 Category: General Medicine Authors: Kim, I.-C., Lee, J. H., Choi, D.-J., Park, S.-J., Lee, J.-H., Park, S. M., Kim, M., Kim, H.-L., Lee, S., Kim, I. J., Choi, S., Bang, J., Ali, B., Hussain, M., Ali, T., Lee, S. Tags: Open access, Cardiovascular medicine Source Type: research

Comparative effectiveness and safety of oral anticoagulants for atrial fibrillation in real-world practice: a population-based cohort study protocol
Introduction Anticoagulants are arguably the most important drug family of all, based on the frequency and duration of their use, and the clinical importance and frequency of benefits and harms. Several direct acting oral anticoagulants (DOACs) have recently joined warfarin for the treatment of atrial fibrillation, with a resultant significant expansion in use of oral anticoagulants (OACs). Our objectives are to compare safety and effectiveness of DOACs versus warfarin in a full population where anticoagulation management is good and to identify which types of patients do better with DOACs versus warfarin and vice versa. ...
Source: BMJ Open - November 23, 2016 Category: Journals (General) Authors: Holbrook, A., Dormuth, C., Morrow, R., Lee, A., Troyan, S., Li, G., Pullenyegum, E. Tags: Open access, Cardiovascular medicine, Pharmacology and therapeutics Protocol Source Type: research

Treatment patterns for oral anticoagulants in older patients with atrial fibrillation: a retrospective, cross-sectional, nationwide study from Denmark
Conclusion In this large nationwide study, we found that in older patients with AF, the overall rates of OAC prescription were generally high (~80%) and increasing during the last decade. Factors associated with not receiving guideline recommended OAC treatment were generally related to bleeding risk factors or frailty.
Source: BMJ Open - September 1, 2022 Category: General Medicine Authors: Rasmussen, P. V., Sakthivel, T., Dalgaard, F., Gislason, G. H., Pallisgaard, J. L., Hansen, M. L. Tags: Open access, Cardiovascular medicine Source Type: research

Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (SALAMANDER): protocol for a prospective observational nationwide study
Introduction Atrial fibrillation (AF) is a prevalent disease considerably contributing to the worldwide cardiovascular burden. For patients at high thromboembolic risk (CHA2DS2-VASc ≥3) and not suitable for chronic oral anticoagulation, owing to history of major bleeding or other contraindications, left atrial appendage occlusion (LAAO) is indicated for stroke prevention, as it lowers patient’s ischaemic burden without augmentation in their anticoagulation profile. Methods and analysis Stand-Alone Left Atrial appendage occlusion for throMboembolism prevention in nonvalvular Atrial fibrillatioN DiseasE Registry (S...
Source: BMJ Open - September 21, 2022 Category: General Medicine Authors: Kowalewski, M., Wanha, W., Litwinowicz, R., Kołodziejczak, M., Pasierski, M., Januszek, R., Kuzma, Łukasz, Grygier, M., Lesiak, M., Kapłon-Cieslicka, A., Reczuch, K., Gil, R., Pawłowski, T., Bartus, K., Dobrzycki, S., Lorusso, Tags: Open access, Cardiovascular medicine Source Type: research

Study to Improve Cardiovascular Outcomes in high-risk older patieNts (ICON1) with acute coronary syndrome: study design and protocol of a prospective observational study
Introduction The ICON1 study (a study to Improve Cardiovascular Outcomes in high-risk older patieNts with acute coronary syndrome) is a prospective observational study of older patients (≥75 years old) with non-ST-elevation acute coronary syndrome managed by contemporary treatment (pharmacological and invasive). The aim of the study was to determine the predictors of poor cardiovascular outcomes in this age group and to generate a risk prediction tool. Methods and analysis Participants are recruited from 2 tertiary hospitals in the UK. Baseline evaluation includes frailty, comorbidity, cognition and quality-of-lif...
Source: BMJ Open - August 22, 2016 Category: Journals (General) Authors: Kunadian, V., Neely, R. D. G., Sinclair, H., Batty, J. A., Veerasamy, M., Ford, G. A., Qiu, W. Tags: Open access, Cardiovascular medicine Protocol Source Type: research

Antithrombotic stewardship: a multidisciplinary team approach towards improving antithrombotic therapy outcomes during and after hospitalisation: a study protocol
In this study, the effect of the implementation of a multidisciplinary antithrombotic team is compared with usual care using a pre-post study design. The study is performed at the Erasmus University Medical Center Rotterdam and the Reinier de Graaf Hospital Delft. Patients who are or will be treated with antithrombotics are included in the study. We aim to include 1900 patients, 950 in each hospital. Primary outcome is the proportion of patients with a composite end point consisting of ≥1 bleeding or ≥1 thrombotic event from the beginning of antithrombotic therapy (or hospitalisation) until 3 months after hospit...
Source: BMJ Open - December 19, 2016 Category: Journals (General) Authors: Dreijer, A. R., Kruip, M. J. H. A., Diepstraten, J., Polinder, S., Brouwer, R., Leebeek, F. W. G., Vulto, A. G., van den Bemt, P. M. L. A. Tags: Open access, Epidemiology, Haematology (incl blood transfusion), Health economics Protocol Source Type: research

Optimal duration of dual antiplatelet therapy following percutaneous coronary intervention: protocol for an umbrella review
Introduction Although dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting, the optimal duration is unknown. Recent evidence indicates there may be benefits in extending the duration beyond 12 months but such decisions may increase the risk of bleeding. Our objective is to provide a comprehensive overview of the literature for clinicians and policymakers via an umbrella review assessing the optimal duration of DAPT. Methods and analysis We will perform a comprehensive search of the published and grey literature for systematic reviews involving ra...
Source: BMJ Open - April 4, 2017 Category: Journals (General) Authors: Elliott, J., Kelly, S. E., Bai, Z., Liu, W., Skidmore, B., Boucher, M., So, D. Y. F., Wells, G. A. Tags: Open access, Cardiovascular medicine, Evidence based practice Protocol Source Type: research

Randomised controlled trial to investigate optimal antithrombotic therapy in patients with non-valvular atrial fibrillation undergoing percutaneous coronary intervention: a study protocol of the OPTIMA-AF trial
This study received approval from the Certified Review Board of Osaka University (a certified research ethics committee by the Japanese Clinical Research Act). The findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration number Japan Registry of Clinical Trials: jRCTs051190053; Pre-results.
Source: BMJ Open - December 14, 2021 Category: General Medicine Authors: Sotomi, Y., Kozuma, K., Kashiwabara, K., Higuchi, Y., Ando, K., Morino, Y., Ako, J., Tanabe, K., Muramatsu, T., Nakazawa, G., Hikoso, S., Sakata, Y., on behalf of the OPTIMA-AF Investigators Tags: Open access, Cardiovascular medicine Source Type: research

Disparities by sex in P2Y12 inhibitor therapy duration, or differences in the balance of ischaemic-benefit and bleeding-risk clinical outcomes in older women versus comparable men following acute myocardial infarction? A P2Y12 inhibitor new user retrospective cohort analysis of US Medicare claims data
Conclusions Risks for death/hospice and ischaemic events were lower among women still taking a P2Y12 inhibitor than comparable men, with no difference in bleeding risks. Shorter P2Y12 inhibitor durations in older women than comparable men observed between 12 and 24 months post-AMI may reflect a disparity that is not justified by differences in clinical need.
Source: BMJ Open - December 1, 2021 Category: General Medicine Authors: Hickson, R. P., Kucharska-Newton, A. M., Rodgers, J. E., Sleath, B. L., Fang, G. Tags: Open access, Cardiovascular medicine Source Type: research

Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database
Conclusions Surgical SAVR±CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results should inform consideration of treatment options in people with aortic valve disease.
Source: BMJ Open - October 28, 2021 Category: General Medicine Authors: Jahangiri, M., Bilkhu, R., Embleton-Thirsk, A., Dehbi, H.-M., Mani, K., Anderson, J., Avlonitis, V., Baghai, M., Birdi, I., Booth, K., Bose, A., Briffa, N., Buchan, K., Bhudia, S., Cale, A., Deglurkar, I., Farid, S., Hadjinikolaou, L., Jarvis, M., Javadpo Tags: Open access, Cardiovascular medicine Source Type: research

Prospective randomised trial examining the impact of an educational intervention versus usual care on anticoagulation therapy control based on an SAMe-TT2R2 score-guided strategy in anticoagulant-naïve Thai patients with atrial fibrillation (TREATS-AF): a study protocol
Introduction The burden of atrial fibrillation (AF) in Thailand is high and associated with increased morbidity, mortality and healthcare costs. Vitamin K antagonists (eg, warfarin), commonly used for stroke prevention in patients with AF in Thailand, are effective but are often suboptimally controlled. We aim to evaluate the impact of an SAMe-TT2R2 score-guided strategy and educational intervention compared to usual care on anticoagulation control expressed by the time in therapeutic range (TTR) at 12 months, in anticoagulant-naïve Thai patients with AF. Methods and analysis Multicentre, open-label, parallel-grou...
Source: BMJ Open - October 11, 2021 Category: General Medicine Authors: Phrommintikul, A., Nathisuwan, S., Gunaparn, S., Krittayaphong, R., Wongcharoen, W., Sehmi, S., Mehta, S., Winkles, N., Brocklehurst, P., Mathers, J., Jowett, S., Jolly, K., Lane, D., Thomas, G. N., Lip, G. Y. H., TREATS-AF Study Group, Prasertwitayakij, Tags: Open access, Medical management Source Type: research

Continuation versus discontinuation of aspirin-based antiplatelet therapy for perioperative bleeding and ischaemic events in adults undergoing neurosurgery: protocol for a systematic review and meta-analysis
Introduction Antiplatelet therapy is commonly used in primary or secondary prevention of atherosclerotic and thrombotic diseases, such as coronary artery disease, transient ischaemic attack or stroke. Recent studies noted that antiplatelet therapy should be continued perioperatively in patients at high risk of thrombosis and low bleeding risk in orthopaedic, spinal or urological surgery. However, evidence in neurosurgery is lacking. Thus, we aim to conduct a systematic review and meta-analysis to assess whether the continuous use of antiplatelet drugs in neurosurgery increases the risk of perioperative bleeding. Methods a...
Source: BMJ Open - September 30, 2021 Category: General Medicine Authors: Wang, X., Wang, X., Yu, Y., Han, R. Tags: Open access, Anaesthesia Source Type: research

In-hospital gastrointestinal bleeding in patients with acute myocardial infarction: incidence, outcomes and risk factors analysis from China Acute Myocardial Infarction Registry
Conclusions GIB is associated with both in-hospital and follow-up MACCEs. Gastrointestinal prophylactic treatment should be administered to patients with AMI who receive primary PCI, thrombolytic therapy or GPIIb/IIIa receptor inhibitor. Trial registration number NCT01874691.
Source: BMJ Open - September 7, 2021 Category: General Medicine Authors: Shi, W., Fan, X., Yang, J., Ni, L., Su, S., Yu, M., Yang, H., Yu, M., Yang, Y., On behalf of China Acute Myocardial Infarction(CAMI) Registry Study Group Tags: Open access, Cardiovascular medicine Source Type: research