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Specialty: General Medicine
Condition: Bleeding

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Total 566 results found since Jan 2013.

Anticoagulants for people hospitalised with COVID-19
CONCLUSIONS: When compared to a lower-dose regimen, higher-dose anticoagulants result in little to no difference in all-cause mortality and increase minor bleeding in people hospitalised with COVID-19 up to 30 days. Higher-dose anticoagulants possibly reduce pulmonary embolism, slightly increase major bleeding, may result in little to no difference in hospitalisation time, and may result in little to no difference in deep vein thrombosis, stroke, major adverse limb events, myocardial infarction, atrial fibrillation, or thrombocytopenia. Compared with no treatment, anticoagulants may reduce all-cause mortality but the evide...
Source: Cochrane Database of Systematic Reviews - March 4, 2022 Category: General Medicine Authors: Ronald Lg Flumignan Vinicius T Civile J éssica Dantas de Sá Tinôco Patricia If Pascoal Libnah L Areias Charbel F Matar Britta Tendal Virginia Fm Trevisani Álvaro N Atallah Luis Cu Nakano Source Type: research

Antiplatelet agents for chronic kidney disease
CONCLUSIONS: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovascular death among people with CKD and those treated with dialysis. The treatment effects of antiplatelet agents compared with each other are uncertain.PMID:35224730 | DOI:10.1002/14651858.CD008834.pub4
Source: Cochrane Database of Systematic Reviews - February 28, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Valeria M Saglimbene Marinella Ruospo Mona Razavian Jonathan C Craig Meg J Jardine Angela C Webster Giovanni Fm Strippoli Source Type: research

Rural-urban disparities in baseline health factors and procedure outcomes
CONCLUSIONS: Our study identified rural-urban differences in baseline factors and procedural outcomes in patients presenting to a tertiary care center for cardiac procedures. Providers should anticipate that health disparities may be associated with more intervention and worse outcomes in their rural patients. Being aware of such differences may also help policy makers in directing health care funding to lower gaps in health care and access ultimately leading to better health outcomes.PMID:35109969 | DOI:10.1016/j.jnma.2022.01.001
Source: Journal of the National Medical Association - February 3, 2022 Category: General Medicine Authors: Vinila S Baljepally William Metheny Source Type: research

Do baseline characteristics and treatments account for geographical disparities in the outcomes of patients with newly diagnosed atrial fibrillation? The prospective GARFIELD-AF registry
Conclusion The variability in outcomes across countries for patients with newly diagnosed AF is not accounted for by baseline characteristics and antithrombotic treatments. Residual mortality rates were correlated with Healthcare Access and Quality indices. The findings suggest the management of patients with AF needs to not only address guideline indicated and sustained anticoagulation, but also the treatment of comorbidities and lifestyle factors. Trial registration number NCT01090362.
Source: BMJ Open - January 7, 2022 Category: General Medicine Authors: Fox, K. A. A., Virdone, S., Bassand, J.-P., Camm, A. J., Goto, S., Goldhaber, S. Z., Haas, S., Kayani, G., Koretsune, Y., Misselwitz, F., Oh, S., Piccini, J. P., Parkhomenko, A., Sawhney, J. P. S., Stepinska, J., Turpie, A. G. G., Verheugt, F. W. A., Kakk Tags: Open access, Cardiovascular medicine Source Type: research

Transfusion thresholds for guiding red blood cell transfusion
CONCLUSIONS: Transfusion at a restrictive haemoglobin concentration decreased the proportion of people exposed to RBC transfusion by 41% across a broad range of clinical contexts. Across all trials, no evidence suggests that a restrictive transfusion strategy impacted 30-day mortality, mortality at other time points, or morbidity (i.e. cardiac events, myocardial infarction, stroke, pneumonia, thromboembolism, infection) compared with a liberal transfusion strategy. Despite including 17 more randomised trials (and 8846 participants), data remain insufficient to inform the safety of transfusion policies in important and sele...
Source: Cochrane Database of Systematic Reviews - December 21, 2021 Category: General Medicine Authors: Jeffrey L Carson Simon J Stanworth Jane A Dennis Marialena Trivella Nareg Roubinian Dean A Fergusson Darrell Triulzi Carolyn Dor ée Paul C H ébert Source Type: research

Informing the Choice of Direct Oral Anticoagulant Therapy in Patients With Atrial Fibrillation
Anticoagulation is the fundamental priority for the prevention of stroke in patients with atrial fibrillation, yet enthusiasm for use among patients at highest thromboembolic risk is often tempered by concern for increased bleeding. In one of the earliest studies evaluating vitamin K antagonists (VKA) in atrial fibrillation, Askey and Cherry noted in 1950 that anticoagulant use for thromboembolic prophylaxis requires “a reasonable assurance that the benefit will justify the bother and expense of control and the dangers of the drug,” and predicted that “safer anticoagulant drugs will be available eventually.” It wou...
Source: JAMA - December 21, 2021 Category: General Medicine 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

Gender differences in antithrombotic treatment in patients with atrial fibrillation from Spain versus the rest of Western Europe. GLORIA-AF Program
CONCLUSIONS: OAC rates were higher in Spain as compared to rWE. More women received OACs in Spain, while in rWE no difference by gender was observed. DOACs in rWE are the most prescribed OAC while in Spain, due to prescription barriers, its use remains low for both genders and VKAs are preferred. Spanish women received more DOACs compared to men. (NCT01468701).PMID:34895750 | DOI:10.1016/j.medcli.2021.09.016
Source: Medicina Clinica - December 13, 2021 Category: General Medicine Authors: Jos é L López-Sendón David Alonso-Rodr íguez Gonzalo Bar ón-Esquivias Juan Cosin-Sales Francisco Mar ín Jordi Galera-Llorca Natalia Jim énez Sabrina Marler Menno V Huisman Gregory Y H Lip Spanish GLORIA-AF investigators Source Type: research

Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis: a systematic review and meta-analysis
Conclusions No overall change in the risk of death from any cause or cardiovascular mortality was identified but 95% CIs were often wide, indicating uncertainty. TAVI may reduce the risk of certain side effects while SAVR may reduce the risk of others. Most long-term (5-year) results are limited to older patients at high surgical risk (ie, early trials), therefore more data are required for low risk populations. Ultimately, neither surgical technique was considered dominant, and these results suggest that every patient with SAS should be individually engaged in SDM to make evidence-based, personalised decisions around thei...
Source: BMJ Open - December 6, 2021 Category: General Medicine Authors: Swift, S. L., Puehler, T., Misso, K., Lang, S. H., Forbes, C., Kleijnen, J., Danner, M., Kuhn, C., Haneya, A., Seoudy, H., Cremer, J., Frey, N., Lutter, G., Wolff, R., Scheibler, F., Wehkamp, K., Frank, D. 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