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Specialty: Internal Medicine
Condition: Bleeding

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Total 325 results found since Jan 2013.

Tailored treatment strategies: a new approach for modern management of atrial fibrillation
Abstract Atrial fibrillation (AF) is not benign. Cardiovascular diseases and risk factors differ importantly amongst patients. Careful phenotyping with the aim to start tailored therapy may improve outcome and quality of life. Furthermore, structural remodelling plays an important role in initiation and progression of AF. Therapies that interfere in the remodelling processes are promising because they may modify the atrial substrate. However, success is still limited probably due to variations in the underlying substrate in individual patients. The most favourable effects of lifestyle changes on success of rhythm control h...
Source: Journal of Internal Medicine - March 16, 2016 Category: Internal Medicine Authors: I. C. Gelder, A. H. Hobbelt, E. G. Marcos, U. Schotten, R. Cappato, T. Lewalter, J. Schwieler, M. Rienstra, G. Boriani Tags: Review Source Type: research

Comparison of aspirin and Naoxintong Capsule (脑心通胶囊) with adjusted-dose warfarin in elderly patients with high-risk of non-valvular atrial fibrillation and genetic variants of vitamin K epoxide reductase
Conclusions Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596)
Source: Chinese Journal of Integrative Medicine - February 26, 2016 Category: Internal Medicine Source Type: research

Sex-Specific Differences at Presentation and Outcomes Among Patients Undergoing Transcatheter Aortic Valve Replacement: A Cohort Study.
Conclusion: Despite a higher incidence of vascular and bleeding complications, women having TAVR had lower mortality than men at 1 year. Thus, sex-specific risk in TAVR is the opposite of that in SAVR, for which female sex has been shown to be independently associated with an adverse prognosis. Primary Funding Source: Edwards Lifesciences. PMID: 26903039 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - February 23, 2016 Category: Internal Medicine Authors: Kodali S, Williams MR, Doshi D, Hahn RT, Humphries KH, Nkomo VT, Cohen DJ, Douglas PS, Mack M, Xu K, Svensson L, Thourani VH, Tuzcu EM, Weissman NJ, Leon M, Kirtane AJ Tags: Ann Intern Med Source Type: research

Effective practical management of patients with atrial fibrillation when using new oral anticoagulants.
Authors: Cox JL Abstract Practical management of stroke prevention in patients with non-valvular atrial fibrillation (AF) requires physicians to find the optimal balance between maximizing prevention of ischaemic stroke and minimizing the risk of bleeding. Vitamin K antagonists have traditionally been used for stroke prevention in patients with AF; however, they have been associated with increased risk of bleeding, particularly intracranial haemorrhage. New oral anticoagulants (OACs) have shown similar efficacy to the vitamin K antagonist warfarin but with a reduced risk of bleeding, particularly life-threatening b...
Source: Annals of Medicine - February 18, 2016 Category: Internal Medicine Tags: Ann Med Source Type: research

Warfarin Use and Risk of Stroke in Patients With Atrial Fibrillation Undergoing Hemodialysis: A Meta-Analysis
Abstract: In spite of the substantial burden of atrial fibrillation and associated elevated ischemic stroke risk in patients undergoing hemodialysis, the role of warfarin in these high-risk patients remains uncertain. Our objective was to clarify the association between warfarin use and risk of stroke for patients with atrial fibrillation undergoing dialysis. PubMed and Embase from January 1966 to January 2015 were searched to identify relevant studies. Inclusion criteria were cohort studies, patients with atrial fibrillation undergoing hemodialysis, and reported quantitative estimates of the multivariate adjusted relativ...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observ Studies in Epidemiology Source Type: research

Longer dual antiplatelet therapy (DAPT) after percutaneous coronary intervention has higher anti-ischaemic efficacy than shorter DAPT but is associated with more frequent bleeding
Commentary on: Spencer FA, Prasad M, Vandvik PO, et al.. Longer- versus shorter-duration dual-antiplatelet therapy after drug-eluting stent placement: a systematic review and meta-analysis. Ann Intern Med 2015;163:118–26. Context Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 receptor antagonist is recommended after drug eluting stent implantation (DES) for at least 12 months by the American College of Cardiology/American Heart Association1 and for 6–12 months by European guidelines. Recent randomised controlled trials (RCT) suggested comparable efficacy of short-term DAPT versus therapy o...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Navarese, E. P. Tags: Journalology, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests, Ethics Therapeutics/Prevention Source Type: research

Long-Term Use of Ticagrelor in Patients with Prior Heart Attack: Ticagrelor Plus Aspirin Versus Aspirin Monotherapy.
Authors: Amico F, Schlesinger A, Mazzoni J Abstract Review of: Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J. 167(4), 437-444.e5 (2014). This Practice Pearl reviews the recent study Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared With Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54). It cha...
Source: Postgraduate Medicine - December 26, 2015 Category: Internal Medicine Tags: Postgrad Med Source Type: research

In-hospital major cardiovascular events between STEMI receiving thrombolysis therapy and primary PCI.
CONCLUSION: the in-hospital major cardiovascular events between STEMI receiving thrombolysis therapy and primary PCI is not significantly different. Heart failure is significantly higher in thrombolysis therapy and the primary PCI reduces the risk. PMID: 25053685 [PubMed - indexed for MEDLINE]
Source: Acta medica Indonesiana - December 11, 2015 Category: Internal Medicine Tags: Acta Med Indones Source Type: research

Effectiveness and Safety of Warfarin in Dialysis Patients With Atrial Fibrillation: A Meta-Analysis of Observational Studies
The objective of this study was to assess the effectiveness and safety of warfarin use in patients with AF undergoing dialysis. Three databases PubMed, EMBASE, and OVID were searched from their inception to August 2015. Observational studies which assessed the ischemic stroke or bleeding risk of warfarin use in dialysis patients with AF were included. Two reviewers independently extracted data and assessed methodological quality based on the Newcastle–Ottawa Scale score. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model and heterogeneity was assessed based...
Source: Medicine - December 1, 2015 Category: Internal Medicine Tags: Research Article: Meta-Analysis of Observational Studies in Epidemiology Source Type: research

Interruption of all anticoagulation is non-inferior to the use of short-term parenteral bridging in patients with atrial fibrillation undergoing invasive procedures
Commentary on: Douketis JD, Spyropoulos AC, Kaatz S, et al., BRIDGE Investigators. Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med 2015;373:823–33 . Context Oral anticoagulation (OAC) has been demonstrated to reduce stroke in patients with atrial fibrillation (AF), however, its use conveys an increased risk of bleeding.1 Therefore, patients receiving OAC who undergo invasive procedures often ‘interrupt’ OAC. Use of short-term ‘bridging’ anticoagulants during such interruptions has been the source of significant debate.2 Although guidelines support a ri...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Steinberg, B. A. Tags: Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Valvar diseases, Arrhythmias Therapeutics/Prevention Source Type: research

Neuron-Specific Enolase, S100 Calcium-Binding Protein B, and Heat Shock Protein 70 Levels in Patients With Intracranial Hemorrhage
Abstract: The authors evaluated neuron-specific enolase (NSE), S100 calcium-binding protein B (S100B), and heat shock protein 70 (HSP 70) levels and their relationships with in-hospital mortality, Glasgow Coma Scale (GCS) scores, and National Institute of Health Stroke Scale (NIHSS) scores. In total, 35 patients older than 18 years were presented to our emergency department and were diagnosed with non-traumatic intracranial hemorrhage (ICH) and 32 healthy controls were included. Blood samples were drawn on days 0 and 5. S100 calcium-binding protein B and HSP levels were significantly higher in patients than in controls on ...
Source: Medicine - November 1, 2015 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

NSAIDs increase bleeding risk in patients with atrial fibrillation on antithrombotic therapy
This study determined the risk...
Source: Evidence-Based Medicine - September 24, 2015 Category: Internal Medicine Authors: McGrath, E. R. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease, Drugs: musculoskeletal and joint diseases, Arrhythmias Aetiology/Harm Source Type: research

Atrial fibrillation in older inpatients: are there any differences in clinical characteristics and pharmacological treatment between the frail and the non‐frail?
ConclusionsFrailty status had little impact on antithrombotic prescription and no impact on anti‐arrhythmic prescription.
Source: Internal Medicine Journal - September 19, 2015 Category: Internal Medicine Authors: T. N. Nguyen, R. G. Cumming, S. N. Hilmer Tags: Original Article Source Type: research

Patients with atrial fibrillation and low risk of stroke - do they really need anticoagulation?
Authors: Trusz-Gluza M, Filipecki A, Urbańczyk-Świć D Abstract Atrial fibrillation (AF) significantly increases risk of thromboembolic events, in particular the risk of stroke. Anticoagulation therapy reduces this risk and the treatment should be lifelong. However, the risk in patients with non-valvular AF is not equally distributed. There are patients at low risk. Assessment of the thromboembolic risk according to guidelines is mandatory, most frequently CHA2DS2-VASc scheme is used. In the large group with the CHA2DS2-VASc-0 (females 1) the annual risk of stroke was 0.49%, ischemic stroke 0.43%, on the other si...
Source: Polskie Archiwum Medycyny Wewnetrznej - August 28, 2015 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research

Perioperative anticoagulant management in patients with atrial fibrillation: practical implications of recent clinical trials.
Authors: Tafur A, Douketis JD Abstract Defining the safest perioperative anticoagulation management approach for patients who are receiving chronic anticoagulant therapy stroke prevention has been a challenging and longstanding dilemma, especially for patients with atrial fibrillation who constitute the most common patient group receiving long term anticoagulation. Using a case-based format we summarize the findings of recent clinical trials which have helped to informed best practices for perioperative anticoagulant management in patients with atrial fibrillation and provide an algorithmic management approach to t...
Source: Polskie Archiwum Medycyny Wewnetrznej - August 28, 2015 Category: Internal Medicine Tags: Pol Arch Med Wewn Source Type: research