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Specialty: Internal Medicine
Condition: Bleeding

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Total 325 results found since Jan 2013.

Bivalirudin in patients undergoing percutaneous coronary intervention and independent predictors of postoperative adverse events in these patients: A real world retrospective study
The efficacy and safety of bivalirudin in percutaneous coronary intervention (PCI) has always been a hot topic in perioperative antithrombotic therapy, but there are still some controversies. So studies are needed to provide more evidence, especially the real world study which includes patients excluded from previous RCT studys. Our study aimed to investigate these information and analyze the independent predictors of postoperative adverse events. A retrospective study enrolled 1416 patients underwent PCI in Tianjin Chest Hospital from May 2016 to October 2017. The incidence of stent-thrombosis and net clinical adverse ...
Source: Medicine - March 12, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Rare severe hypofibrinogenemia induced by tissue plasminogen activator in stroke patients: Case report
Rationale: Severe hypofibrinogenemia after intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) is rare and easily overlooked, but hypofibrinogenemia increases the risk of major bleeding. However, it is unclear when hypofibrinogenemia reaches the peak and when hypofibrinogenemia is resolved. Patient concerns: Case 1 was of a 66-year-old man who was hospitalized due to sudden onset of vague speech and right hemiplegia for 4 hours. Case 2 was of an 84-year-old woman who was hospitalized for sudden onset of left hemiplegia and vague speech for 4 hours. In case 1, fibrinogen level...
Source: Medicine - March 5, 2021 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Anticoagulant management by low-dose of low molecular weight heparin in patients with nonvalvular atrial fibrillation following hemorrhagic transformation and complicated with venous thrombosis: Five case reports and literature review
For patients with nonvalvular atrial fibrillation (NVAF) following hemorrhagic infarction (HI)/hemorrhage transformation (HT) and complicated with venous thrombosis, the management of anticoagulation is controversial. Our study intends to explore the safety and effectiveness of using low-dose of low molecular weight heparin (LMWH) to treat NVAF patients with HI (or HT) and complicated with venous thrombosis. Between January 2018 and January 2019, NVAF related acute ischemic stroke patients with HT/HI, hospitalized in the department of neurology or rehabilitation in our hospital, are enrolled retrospectively. Among them,...
Source: Medicine - February 19, 2021 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Anticoagulant Therapy for Frail Patients with Atrial Fibrillation.
Authors: Hori H, Fukuchi T, Sugawara H Abstract The prevalence of atrial fibrillation (AF) increases with age, as does the proportion of patients with frailty. AF patients with frailty have a higher risk of stroke than those without frailty, and progressive frailty caused by stroke is also associated with a worse prognosis. Despite this, anticoagulant therapy tends to not be used in frail patients because of the risk of falls and bleeding complications. However, some studies have shown that anticoagulant therapy improves the prognosis in patients with frailty. An accurate assessment of the "net-clinical-benefits" i...
Source: Internal Medicine - February 17, 2021 Category: Internal Medicine Tags: Intern Med Source Type: research

In older patients with AF, low-dose edoxaban reduced stroke or systemic embolism without increasing major bleeding.
Abstract SOURCE CITATION: Okumura K, Akao M, Yoshida T, et al. Low-dose edoxaban in very elderly patients with atrial fibrillation. N Engl J Med. 2020;383:1735-45. 32865374. PMID: 33395333 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - January 5, 2021 Category: Internal Medicine Authors: Steinberg DI Tags: Ann Intern Med Source Type: research

Stroke Prevention in Very Elderly Patients With Nonvalvular Atrial Fibrillation Revisited
Stroke prevention is the cornerstone in the management of patients with atrial fibrillation (AF). Oral anticoagulation (OAC) has been the main strategy to reduce the risk of thromboembolism in most AF patients.1 However, its effective use is hampered by several challenges, including the attended bleeding risk, noncompliance, and cost.2 Elderly patients are further disadvantaged with additional factors that may limit the use of OAC, such as frailty, polypharmacy, and functional dependence.3 In addition, there are limited data to guide stroke prevention decisions in these patients; octogenarians are typically excluded from c...
Source: Mayo Clinic Proceedings - January 1, 2021 Category: Internal Medicine Authors: Mohamad Alkhouli Tags: Editorial Source Type: research

In acute ischemic stroke or TIA, adding ticagrelor to aspirin reduced stroke or death and increased severe bleeding.
Abstract SOURCE CITATION: Johnston SC, Amarenco P, Denison H, et al. Ticagrelor and aspirin or aspirin alone in acute ischemic stroke or TIA. N Engl J Med. 2020;383:207-17. 32668111. PMID: 33316187 [PubMed - in process]
Source: Annals of Internal Medicine - December 15, 2020 Category: Internal Medicine Authors: Hill MD Tags: Ann Intern Med Source Type: research

Trends and outcomes of device-related 30-day readmissions after left ventricular assist device implantation.
CONCLUSION: Over one-fourth of LVAD recipients have 30-day readmissions, with most of them occurring within 15 days. Most frequent cause of readmission was gastrointestinal bleeding, which was associated with the lowest in-hospital mortality among other complications. PMID: 33039191 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - October 7, 2020 Category: Internal Medicine Authors: Briasoulis A, Ueyama H, Kuno T, Asleh R, Alvarez P, Malik AH Tags: Eur J Intern Med Source Type: research

Cerebral bleeding during a cryotherapy session: A case report.
CONCLUSION: We hypothesize that the whole-body cryotherapy was responsible for this stroke. PMID: 32994067 [PubMed - as supplied by publisher]
Source: Revue de Medecine Interne - October 2, 2020 Category: Internal Medicine Tags: Rev Med Interne Source Type: research

Impact of atrial fibrillation on outcomes of patients treated by transcatheter mitral valve repair: A systematic review and meta-analysis
Conclusion: AF may be related with worse outcomes in patients undergoing MC implantation, including long-term mortality, major bleeding, and rehospitalization. AF should be taken into account when referring a patient for MC treatment.
Source: Medicine - October 2, 2020 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Risk of Stroke and Bleeding in Atrial Fibrillation Treated with Apixaban Compared with Warfarin
ConclusionIn NVAF patients of all ages initiating either apixaban or warfarin for stroke prevention in the Sentinel System, apixaban was associated with a decreased risk of GI bleeding, ICH, and ischemic stroke compared with warfarin. Among patients less than 65  years of age, apixaban use was associated with a decreased risk of GI bleeding and ischemic stroke.
Source: Journal of General Internal Medicine - September 27, 2020 Category: Internal Medicine Source Type: research

Utility of HAS-BLED and CHA2DS2-VASc Scores Among Patients With Atrial Fibrillation and Imaging Evidence of Cerebral Amyloid Angiopathy
To determine the utility of the HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile international normalized ratio, Elderly, Drugs/alcohol concomitantly) and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age, Diabetes, previous Stroke/transient ischemic attack –VAScular disease) scores among patients on anticoagulation (AC) therapy for atrial fibrillation (AF) who have evidence of cerebral amyloid angiopathy (CAA).
Source: Mayo Clinic Proceedings - August 19, 2020 Category: Internal Medicine Authors: Robert Ward, Shiva Ponamgi, Christopher V. DeSimone, Stephen English, David O. Hodge, Joshua P. Slusser, Jonathan Graff-Radford, Alejandro A. Rabinstein, Samuel J. Asirvatham, David Holmes Tags: Original article Source Type: research

Microcatheter infusion of bolus-dose tirofiban for acute ischemic stroke due to distal intracranial artery occlusion
The utility of endovascular thrombectomy for acute occlusion of the distal intracranial artery (A2/A3/M2/M3/P2/P3) is unclear, and aspiration and stent thrombectomy are associated with risk of bleeding. We analyzed patients with acute occlusion of the distal intracranial artery to assess the safety and efficacy of microcatheter-based tirofiban infusion. We retrospectively reviewed data of the endovascular thrombectomy registry of our center between January 2018 and June 2019. Patients with distal intracranial artery occlusion who underwent endovascular thrombectomy with microcatheter-based infusion of tirofiban were recru...
Source: Medicine - July 24, 2020 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Safety and efficacy of anticoagulant monotherapy in atrial fibrillation and stable coronary artery disease: A systematic review and meta-analysis.
CONCLUSION: OAC monotherapy might have a lower incidence of major bleeding events with no higher overall risk of MACE, ischemic stroke and all-cause mortality compared to the combined therapy group. PMID: 32709546 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - July 21, 2020 Category: Internal Medicine Authors: Ullah W, Sattar Y, Shaukat M, Fischman DL Tags: Eur J Intern Med Source Type: research

Age- and Weight-Adapted Dose of Prasugrel Versus Standard Dose of Ticagrelor in Patients With Acute Coronary Syndromes: Results From a Randomized Trial.
CONCLUSION: In elderly or low-weight patients with ACS, a reduced dose of prasugrel compared with the standard dose of ticagrelor is associated with maintained anti-ischemic efficacy while protecting these patients against the excess risk for bleeding. PRIMARY FUNDING SOURCE: German Center for Cardiovascular Research and Deutsches Herzzentrum München. PMID: 32687741 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - July 20, 2020 Category: Internal Medicine Authors: Menichelli M, Neumann FJ, Ndrepepa G, Mayer K, Wöhrle J, Bernlochner I, Richardt G, Witzenbichler B, Sibbing D, Gewalt S, Angiolillo DJ, Lahu S, Hamm CW, Hapfelmeier A, Trenk D, Laugwitz KL, Schunkert H, Schüpke S, Kastrati A Tags: Ann Intern Med Source Type: research