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DOACs use in extreme body-weighted patients: results from the prospective START-register
ConclusionsDOACs seem to be effective and safe also for the treatment of patients with extreme body weights, both underweight and overweight. Further prospective studies are needed to support these findings.
Source: Internal and Emergency Medicine - June 10, 2023 Category: Emergency Medicine Source Type: research

Mobile health-technology integrated care in secondary prevention atrial fibrillation patients: a post-hoc analysis from the mAFA-II randomized clinical trial
AbstractAF patients with history of thromboembolic events are at higher risk of thromboembolic recurrences, despite appropriate antithrombotic treatment. We aimed to evaluate the effect of mobile health (mHealth) technology-implemented ‘Atrial fibrillation Better Care’ (ABC) pathway approach (mAFA intervention) in secondary prevention AF patients. The Mobile Health Technology for Improved Screening and Optimized Integrated Care in AF (mAFA-II) cluster randomized trial enrolled adult AF patients across 40 centers in China. The main outcome was the composite outcome of stroke or thromboembolism, all-cause death, and reho...
Source: Internal and Emergency Medicine - March 16, 2023 Category: Emergency Medicine Source Type: research

Direct oral anticoagulants in patients with a left-sided bioprosthetic heart valve: a systematic review and meta-analysis
AbstractTo compare the efficacy/effectiveness and safety of DOACs versus VKAs in patients with a previously and newly surgically implanted BHV with or without AF. A systematic search on MEDLINE and EMBASE was performed till November 2022. Treatment effects were estimated with relative risk (RR) and 95% confidence intervals (CIs). Statistical heterogeneity was assessed with theI2 statistic. Four randomized controlled trials (RCTs), 2 subgroup analysis from ARISTOTLE and ENGAGE-AF-TIMI 48 and 4 observational studies were included for a total of 5808 patients, 1893 on DOACs and 3915 on VKAs. AF prevalence was 98.28%. In the o...
Source: Internal and Emergency Medicine - February 7, 2023 Category: Emergency Medicine Source Type: research

Thoracic aortic aneurysm and atrial fibrillation: clinical associations with the risk of stroke from a global federated health network analysis
ConclusionThis retrospective analysis reports a clinical concomitance of the two medical conditions, and shows in a PSM analysis an increased risk of ischemic events in patients affected by TAA and AF compared to AF alone.
Source: Internal and Emergency Medicine - January 14, 2023 Category: Emergency Medicine Source Type: research

Efficacy of mobile health-technology  integrated care based on the ‘Atrial fibrillation Better Care’ (ABC) pathway in relation to sex: a report from the mAFA-II randomized clinical trial
Abstract The Mobile Health Technology for Improved Screening and Optimized Integrated Care in AF (mAFA-II) cluster-randomized trial showed that a mobile health (mHealth)-implemented ‘Atrial fibrillation Better Care’ (ABC) pathway approach reduced the risk of adverse events in atrial fibrillation (AF) patients. Whether this benefit can be applied to both males and females is unclear, especially given the suboptimal management and poorer cardiovascular outcomes in females wit h AF. In this post-hoc analysis, we performed a sex-stratified analysis of the mAFA-II trial. Between June 2018 and August 2019, adult AF patient...
Source: Internal and Emergency Medicine - January 11, 2023 Category: Emergency Medicine Source Type: research

Bleeding and thrombotic events in atrial fibrillation patients with cancer: a systematic review and meta-analysis
AbstractAtrial fibrillation (AF) and cancer are frequently coexisting in elderly patients. Pooled metanalytic data on the impact of cancer on clinical outcomes in AF patients are lacking.  We performed a systematic review and meta-regression analysis of clinical studies retrieved from Medline (PubMed) and Cochrane (CENTRAL) databases according to PRISMA guidelines. Bleeding endpoints included any, major, gastrointestinal (GI) bleeding and intracranial haemorrhage (ICH). Cardiovascul ar (CV) endpoints included myocardial infarction (MI), ischemic stroke/systemic embolism (IS/SE), CV and all-cause death. PROSPERO registrati...
Source: Internal and Emergency Medicine - December 8, 2022 Category: Emergency Medicine Source Type: research

Impella versus extracorporeal membrane oxygenation in cardiogenic shock: a systematic review and meta-analysis
Conclusions: In patients with CS, the use of Impella is associated with lower rates of in-hospital mortality, bleeding, and stroke than ECMO. Future randomized studies with adequate sample sizes are needed to confirm these findings.
Source: Shock - November 1, 2022 Category: Emergency Medicine Tags: Review Article Source Type: research

Rhythm- or rate-control strategies according to 4S-AF characterization scheme and long-term outcomes in atrial fibrillation patients: the FAMo (Fibrillazione Atriale in Modena) cohort
AbstractThe 4S-AF scheme [Stroke risk, Symptom severity, Severity of atrial fibrillation (AF) burden, Substrate severity] was recently proposed to characterize AF patients. In this post hoc analysis we evaluated the agreement between the therapeutic strategy (rate or rhythm control, respectively), as suggested by the 4S-AF scheme, and the actual strategy followed in a patients cohort. Outcomes of interest were as follows: all-cause death, a composite of all-cause death/any thromboembolism/acute coronary syndrome, and a composite of all-cause death, any thrombotic/ischemic event, and major bleeding (net clinical outcome). W...
Source: Internal and Emergency Medicine - December 2, 2021 Category: Emergency Medicine Source Type: research

Appropriate Treatment of Ischemic Stroke That Is Essential for the Reduction of Mortality and Morbidity: Should We Use Hyperbaric Oxygen Therapy Together With Recombinant Tissue Plasminogen Activator for Improving Brain Oxygenation and Before Recombinant Tissue Plasminogen Activator to Minimize the Risk of Massive Bleeding?
No abstract available
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Association between acute heart failure and major cardiovascular events in atrial fibrillation patients presenting at the emergency department: an EMERG-AF ancillary study
Conclusions The coexistence of AHF in patients presenting with atrial fibrillation in ED is associated to a worse 1-year outcome mainly due to MACE, but does not impact in overall mortality.
Source: European Journal of Emergency Medicine - May 13, 2021 Category: Emergency Medicine Tags: Original Articles Source Type: research

Safety of antithrombotic therapy in East Asian patients
In conclusion, further investigations are necessary to clarify the specific conditions where the risk of serious bleeding events in East Asian patients differ substantially compared to the global. In addition, further understanding of the mechanisms causing the different bleeding response in specific conditions in East Asian is awaited.
Source: Internal and Emergency Medicine - March 8, 2021 Category: Emergency Medicine Source Type: research

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