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Screening for clinically relevant drug-drug interactions between direct oral anticoagulants and antineoplastic agents: a pharmacovigilance approach
ConclusionNo signal of DDIs between DOACs and antineoplastic agents was detected, except for DOAC-neratinib. Most DDIs between DOACs and antineoplastic agents may not be clinically relevant. The DDIs between DOACs and neratinib should be further examined in future research.
Source: Journal of Thrombosis and Thrombolysis - August 10, 2023 Category: Hematology Source Type: research

Gastrointestinal Dysfunction in Stroke
Semin Neurol DOI: 10.1055/s-0043-1771470Gastrointestinal (GI) complications are seen in over 50% of ischemic stroke survivors; the most common complications are dysphagia, constipation, and GI bleeding. The bidirectional relationship of the gut–brain axis and stroke has recently gained traction, wherein stroke contributes to gut dysbiosis (alterations in the normal host intestinal microbiome) and gut dysbiosis perpetuates poor functional neurologic outcomes in stroke. It is postulated that the propagation of proinflammatory cells and gut metabolites (including trimethylamine N-oxide and short-chain fatty acids) from the ...
Source: Seminars in Neurology - August 10, 2023 Category: Neurology Authors: Yong, Heather Y.F. Ganesh, Aravind Camara-Lemarroy, Carlos Tags: Review Article Source Type: research

Lower-adherence direct oral anticoagulant use is associated with increased risk of thromboembolic events than warfarin
ConclusionsIn this large real-world study, low adherence DOAC was associated with higher risk of TE events as compared to high and low adherence warfarin.
Source: Journal of Interventional Cardiac Electrophysiology - August 9, 2023 Category: Cardiology Source Type: research

Dual Antiplatelet Therapies and Causes in Minor Stroke or Transient Ischemic Attack: A Prespecified Analysis in the CHANCE-2 Trial
CONCLUSIONS: In this prespecified analysis of the CHANCE-2 trial, the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing new stroke were consistent in patients with different causes. The influence of stroke cause on benefit of gene-guided antiplatelet therapy should be explored by further trials.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT04078737.PMID:37548009 | DOI:10.1161/STROKEAHA.122.042233
Source: Atherosclerosis - August 7, 2023 Category: Cardiology Authors: Xuewei Xie Jing Jing Xia Meng S Claiborne Johnston Philip M Bath Zixiao Li Xingquan Zhao Liping Liu Yilong Wang Qin Xu Anxin Wang Yong Jiang Hao Li Yongjun Wang CHANCE-2 Investigators Source Type: research

Optimal anti-platelet therapy for older patients with acute coronary syndrome: a network meta-analysis of randomized trials comprising 59,284 older patients
AbstractThe aim of this study was to identify the optimal anti-platelet therapy in older acute coronary syndrome (ACS) patients with a mean age  ≥ 60 years by comparing the efficacy and safety of different anti-platelet therapies. The selection of antiplatelet therapy in older patients with ACS is a clinical challenge. Numerous evidences indicate that the de-escalation of dual anti-platelet therapy (DAPT) or P2Y12 inhibitor monotherap y may reduce bleeding risk without increasing thrombotic events. However, there is a lack of systematic reviews and optimal strategy analysis regarding older ACS patients. Randomized co...
Source: Journal of Thrombosis and Thrombolysis - August 7, 2023 Category: Hematology Source Type: research

A new strategy for anticoagulation: The factor XI inhibitors
Eur J Intern Med. 2023 Aug 4:S0953-6205(23)00284-4. doi: 10.1016/j.ejim.2023.08.001. Online ahead of print.ABSTRACTDirect oral anticoagulants (DOACs) are currently the first-choice therapy for the prevention of cardioembolic events in patients with atrial fibrillation and for the treatment of venous thromboembolism (VTE) due to their more favorable efficacy to safety profile in comparison to vitamin K antagonists (VKA). DOACs did not show a clinical benefit when used for in stroke prevention in patients with mechanic or rheumatic valves or in those who underwent transcatheter aortic valve implantation (TAVI), in the treatm...
Source: European Journal of Internal Medicine - August 6, 2023 Category: Internal Medicine Authors: Maria Cristina Vedovati Cecilia Becattini Giancarlo Agnelli Source Type: research

Antithrombotic Medication and Major Complications After Mechanical Aortic Valve Replacement
Patients with mechanical aortic valve replacement (AVR) require lifelong vitamin K antagonist (VKA) therapy for stroke and systemic embolism prevention. However, VKA treatment predisposes patients to various types of bleeding. In the present study, we sought to assess the success of antithrombotic therapy and the occurrence and timing of strokes and bleeding events after mechanical AVR. A total of 308 patients who underwent isolated mechanical AVR were included in the study, and follow-up data were completed for 306 patients (99.4%).
Source: The American Journal of Cardiology - August 5, 2023 Category: Cardiology Authors: Rikhard Bj örn, Joonas Lehto, Markus Malmberg, Vesa Anttila, K.E. Juhani Airaksinen, Jarmo Gunn, Tuomas Kiviniemi Source Type: research

5-year Stroke Rates in Nonvalvular Atrial Fibrillation after Watchman compared to Direct Oral Anticoagulants
CONCLUSION: Even in a high-risk population, the WATCHMAN is comparable to DOAC therapy in the primary prevention of hemorrhagic strokes and may provide benefit in the rates of bleeding events, TIAs, and ischemic strokes.PMID:37541428 | DOI:10.1016/j.jjcc.2023.07.015
Source: Journal of Cardiology - August 4, 2023 Category: Cardiology Authors: Syed I Khalid Shyama Sathianathan Kyle B Thomson Laura Stone McGuire Mona C Soni Ankit I Mehta Source Type: research

Safety outcomes of ticagrelor among patients with STE-ACS post streptokinase therapy-a retrospective observational study
Conclusion: In real practice, ticagrelor swi tching among patients with STE-ACS post streptokinase therapy did not differ regarding safety outcomes and composite of efficacy outcomes compared with clopidogrel.
Source: PLoS One - August 4, 2023 Category: Biomedical Science Authors: Phornpaka Ueapornpanith Source Type: research

LAAO Tied to Fewer Post-Fall Bleeds Than DOACs in AF LAAO Tied to Fewer Post-Fall Bleeds Than DOACs in AF
Left atrial appendage occlusion was associated with fewer injuries and less bleeding from falls in patients with atrial fibrillation and previous stroke, compared with oral anticoagulation.Medscape Medical News
Source: Medscape Cardiology Headlines - August 3, 2023 Category: Cardiology Tags: Cardiology News Source Type: news

LB-012 Incidence of intracranial hemorrhage after thrombectomy for large core infarcts: a sub analysis of the select2 trial
ConclusionIn a subset analysis of SELECT2 trial, patients receiving EVT had a higher rate of any intracranial hemorrhage when compared with those receiving medical management. Although EVT patients with ICH had a higher incidence of early neurological worsening, there was no difference in 90-day mRS, mortality and discharge dispositions between those with or without ICH.DisclosuresM. Chen: None. K. Joshi: None. B. Kolb: None. M. Hill: None. M. Abraham: None. A. Hassan: None. S. Ortega-Gutiérrez: None. M. Hussain: None. D. Pujara: None. C. Sitton: None. V. Pereira: None. M. Ribo: None. G. Albers: None. B. Campbell: N...
Source: Journal of NeuroInterventional Surgery - August 3, 2023 Category: Neurosurgery Authors: Chen, M., Joshi, K., Kolb, B., Hill, M., Abraham, M., Hassan, A., Ortega-Gutierrez, S., Hussain, M., Pujara, D., Sitton, C., Pereira, V., Ribo, M., Albers, G., Campbell, B., Sarraj, A. Tags: SNIS 20th annual meeting late-breaking oral abstracts Source Type: research

Atrial fibrillation and anticoagulation in patients hospitalised for stroke in the REGIONS Care Study
CONCLUSIONS: Although anticoagulation prescribing in AF has improved, one third of stroke patients with known AF were not taking an anticoagulant prior to admission and the majority did not appear to have an absolute contraindication offering a multidisciplinary opportunity for improvement. There were no significant differences for Māori and non-urban populations in anticoagulant prescribing.PMID:37536308
Source: New Zealand Medical Journal - August 3, 2023 Category: General Medicine Authors: Syrah Ranta Ralph Stewart Stephanie Thompson Alan Davis Peter Alan Barber Matire Harwood Anna Ranta Source Type: research