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Efficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis
CONCLUSIONS: Among AF patients with ESRD on chronic hemodialysis, the risk of ischemic stroke, ischemic stroke or systemic embolism, minor bleeding, major bleeding, and all-cause mortality is similar in patients treated with DOACs compared to VKAs. Given that the meta-analysis of RCTs on gastrointestinal bleeding did not confirm the results of the meta-analysis of the observational studies, it cannot be concluded that gastrointestinal bleeding is lower among DOAC-treated patients.PROTOCOL REGISTRATION: PROSPERO CRD42023391966.PMID:37648582 | DOI:10.1016/j.ejim.2023.08.020
Source: European Journal of Internal Medicine - August 30, 2023 Category: Internal Medicine Authors: Ioannis Kyriakoulis Anastasia Adamou Iliana Stamatiou David Dimitris Chlorogiannis Ioannis Kardoutsos Despoina Koukousaki George Ntaios 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

Effect of extended duration of thromboprophylaxis for medically ill patients
CONCLUSIONS: Extended thromboprophylaxis, especially with LMWH, showed better efficacy in venous thromboembolism reduction with increased risk of major bleeding. The beneficial effect of LMWH with extended timing has also been shown in stroke patients. Overall, extended thromboprophylaxis is associated with a positive net clinical benefit.PMID:37029050 | DOI:10.1016/j.ejim.2023.03.032
Source: European Journal of Internal Medicine - April 7, 2023 Category: Internal Medicine Authors: Xing Wang Yuqi Chen Dingke Wen Chao You Lu Ma Source Type: research

Delaying clinical events among patients with non-valvular atrial fibrillation treated with oral anticoagulants: Insights from the ARISTOPHANES study
CONCLUSIONS: Over 12 months after initiation, apixaban and dabigatran conferred progressive increases in event free time for stroke/SE and MB vs warfarin, whereas rivaroxaban conferred an increase in stroke/SE-free time but a loss in MB-free time vs warfarin.PMID:36456387 | DOI:10.1016/j.ejim.2022.10.021
Source: European Journal of Internal Medicine - December 1, 2022 Category: Internal Medicine Authors: Steven Deitelzweig Allison Keshishian Amiee Kang Aaron Jenkins Nipun Atreja Patricia Schuler Jenny Jiang Huseyin Yuce Xiaoxi Sun Gregory Y H Lip Source Type: research

Mobile health-technology integrated care in atrial fibrillation patients with heart failure: A report from the mAFA-II randomized clinical trial
CONCLUSION: A mHealth-technology implemented ABC pathway provides consistent effects on the risks of primary outcome, rehospitalisation and bleeding, in AF patients both with and without HF. However, AF-HF patients may need tailored approaches to improve their overall prognosis, specifically to reduce the risk of recurrent AF, HF and acute coronary syndrome.PMID:36347740 | DOI:10.1016/j.ejim.2022.11.002
Source: European Journal of Internal Medicine - November 8, 2022 Category: Internal Medicine Authors: Yutao Guo Giulio Francesco Romiti Bernadette Corica Marco Proietti Niccol ò Bonini Hui Zhang Gregory Yh Lip mAF-App II trial investigators Source Type: research

Multivessel vs. culprit-only percutaneous coronary intervention strategy in older adults with acute myocardial infarction
CONCLUSIONS: In the setting of older adults with MVCAD who were managed invasively for AMI, a MV-PCI strategy to pursue complete revascularization was associated with better survival and lower risk of NACE compared to a CV-PCI. Adequately sized RCTs are required to confirm these findings.PMID:36109262 | DOI:10.1016/j.ejim.2022.09.006
Source: European Journal of Internal Medicine - September 15, 2022 Category: Internal Medicine Authors: Claudio Montalto Nuccia Morici Aung Myat Gabriele Crimi Giuseppe De Luca Irene Bossi Adam de Belder Stefano Savonitto Stefano De Servi Source Type: research

Evolving concepts in the management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation
Eur J Intern Med. 2022 May 24:S0953-6205(22)00171-6. doi: 10.1016/j.ejim.2022.05.002. Online ahead of print.ABSTRACTThromboembolic and bleeding complications negatively impact recovery and survival after transcatheter aortic valve implantation (TAVI). Particularly, there is a considerable risk of ischaemic stroke and vascular access related bleeding, as well as spontaneous gastro-intestinal bleeding. Therefore, benefit and harm of antithrombotic therapy should be carefully balanced. This review summarizes current evidence on peri- and post-procedural antithrombotic treatment. Indeed, in recent years, the management of anti...
Source: European Journal of Internal Medicine - May 27, 2022 Category: Internal Medicine Authors: Dirk Jan van Ginkel Willem L Bor Leo Veenstra Arnoud W J van 't Hof Enrico Fabris Source Type: research

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