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Source: The American Journal of Medicine
Condition: Thrombosis
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Total 32 results found since Jan 2013.
Above the threshold time of coagulation: delayed diagnosis of acquired hemophilia A
A man in his 80 ’s presented to our hospital's emergency department with left hip pain after falling while transferring from a wheelchair on a visit day. He had been taking clopidogrel for> 10 years after atherothrombotic stroke and apixaban 2.5 mg b.i.d. for 2 years since he was diagnosed with deep vein thrombosis. The patient had no coagulation abnormalities when he started apixaban therapy and had never experienced bleeding events. His medical history included cervical spondylosis surgery, right femoral neck fracture, hypertension, and benign prostatic hypertrophy.
Source: The American Journal of Medicine - February 23, 2023 Category: General Medicine Authors: Mayu Kikuchi, Yukinori Harada, Ayano Hamai, Sachi Takaoka Tags: Diagnostic dilemma Source Type: research
Microvascular dysfunction as a systemic disease: A review of the evidence
Microvascular dysfunction describes a varied set of conditions which includes vessel destruction, abnormal vasoreactivity, in situ thrombosis, and fibrosis which ultimately results in tissue damage and progressive organ failure. Microvascular dysfunction has a wide array of clinical presentations, ranging from ischemic heart disease to renal failure, stroke, blindness, pulmonary arterial hypertension, and dementia. An intriguing unifying hypothesis suggests that microvascular dysfunction of specific organs is an expression of a systemic illness that worsens with age and is accelerated by vascular risk factors.
Source: The American Journal of Medicine - April 22, 2022 Category: General Medicine Authors: Daniel S. Feuer, Eileen M. Handberg, Borna Mehrad, Janet Wei, C. Noel Bairey Merz, Carl J. Pepine, Ellen C. Keeley Tags: Review article Source Type: research
Oral Anticoagulant Use for Patients with Atrial Fibrillation with Concomitant Anemia and/or Thrombocytopenia
Atrial fibrillation is the most common sustained cardiac arrhythmia in clinical practice, which is associated with an increased risk of thromboembolism, heart failure and mortality.1 Previous studies in atrial fibrillation patients have reported that abnormal hemoglobin and platelet counts may be associated with adverse events. However, these studies that specifically examined the associations between hemoglobin and platelet levels and adverse outcomes reported conflicting data.2-5 Although warfarin effectively reduces the risk of ischemic stroke by 64% compared to placebo/control,6 and non-vitamin K antagonist oral antico...
Source: The American Journal of Medicine - April 2, 2022 Category: General Medicine Authors: Yung-Hsin Yeh, Yi-Hsin Chan, Shao-Wei Chen, Shang-Hung Chang, Chun-Li Wang, Chi-Tai Kuo, Gregory Y.H. Li, Shih-Ann Chen, Tze-Fan Chao Tags: Clinical Research Study Source Type: research
An updated review of the efficacy and safety of direct oral anticoagulants in treatment of left ventricular thrombus
Left ventricular (LV) thrombus is a potentially serious complication affecting males and females with ischemic and non-ischemic cardiomyopathy - specifically after acute myocardial infarctions of the anterior left ventricular wall, and long-standing tachyarrhythmias, respectively1. LV thrombi pose significant risks for systemic embolization and devastating stroke events, while also demanding a treatment carrying inherit risks of its own. It is therefore imperative to have accurate detection of these ventricular thrombi and an appropriate understanding of the risks and benefits regarding management.
Source: The American Journal of Medicine - August 29, 2021 Category: General Medicine Authors: Kevin A. Honan, Arjun Jogimahanti, Tarif Khair Tags: Review, meta-analysis Source Type: research
The Reply
Dr. Jolobe, in his comments on our case study,1 is quite right in highlighting 2 pertinent examples of the potentially severe iatrogenic patient harm that may result from erroneous treatment of pauci-symptomatic acute type A aortic dissection masquerading and possibly misdiagnosed as an acute vascular event, be it ischemic stroke, acute myocardial infarction, or pulmonary thromboembolism.
Source: The American Journal of Medicine - August 1, 2021 Category: General Medicine Authors: Ami Schattner Tags: Letter Source Type: research
Assessment of Cardiovascular Risk in Transgender Patients Presenting for Gender-Affirming Care
The transgender population is rapidly growing in the United States and abroad. Transgender men and women are marginalized as a result of their transgender status with resultant health repercussions. This and other factors such as increased substance use, mental health disorders, violence, and chronic stress may place transgender individuals at higher risk for cardiovascular disease. Additionally, many transgender patients pursue gender affirming hormone therapy which has been linked to increased rates of some cardiovascular events such as metabolic syndrome, venous thromboembolism, and stroke.
Source: The American Journal of Medicine - April 22, 2021 Category: General Medicine Authors: Kara J. Denby, Leslie Cho, Karlo Toljan, Meghana Patil, Cecile A. Ferrando Source Type: research
Oral Anticoagulation Use in High-Risk Patients Is Improved by Elimination of False-Positive and Inactive Atrial Fibrillation Cases
Multiple registries have reported that>40% of high-risk atrial fibrillation patients are not taking oral anticoagulants. The purpose of our study was to determine the presence or absence of active atrial fibrillation and CHA2DS2-VASc (Congestive heart failure, Hypertension, Age ≥75 y, Diabetes mellitus, prior Stroke [or transient ischemic attack or thromboembolism], Vascular disease, Age 65-74 y, Sex category) risk factors to accurately identify high-risk atrial fibrillation (CHA2DS2-VASc ≥2) patients requiring oral anticoagulants and the magnitude of the anticoagulant treatment gap.
Source: The American Journal of Medicine - December 23, 2020 Category: General Medicine Authors: Gerald V. Naccarelli, Mohammed Ruzieh, Deborah L. Wolbrette, Mauricio Sendra-Ferrer, John van Harskamp, Barbara Bentz, Gregory Caputo, Nathan McConkey, Kevin Mills, Stephen Wasemiller, Jovan Plamenac, Douglas Leslie, Frendy D. Glasser, Thomas W. Abendroth Tags: Clinical Research Study Source Type: research
High Fluctuation Between Anticoagulants, Frequent Off-Label Dosing, and No Difference Concerning Outcomes: Results of a Real-Life Cohort Study
Recently published studies indicated a high proportion of patients taking direct oral anticoagulants (DOACs) are off-label under- or overdosed. The present study aimed at investigating whether off-label dosages are corrected over time and whether off-label doses are associated with differences in bleeding rates, ischemic stroke, or venous thromboembolism.
Source: The American Journal of Medicine - October 24, 2020 Category: General Medicine Authors: Corinne M. Eschler, Ana Antelo, Georg-Christian Funk, Aristomenis K. Exadaktylos, Gregor Lindner Tags: Clinical Research Study Source Type: research
Peripheral arterial disease in patients with atrial fibrillation: The Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study.
Atrial fibrillation and peripheral arterial disease are two conditions associated with high risk of cardiovascular and cerebrovascular complications and mortality.1 –5 There is evidence that coexistence of both these clinical conditions can result to an additive risk of adverse events.6 Indeed, atherosclerotic vascular disease has been linked with stroke, thromboembolism and death in subjects with atrial fibrillation and has been therefore included as one of the components of risk scores, such as the CHA2DS2-VASc score (Congestive Heart failure, Hypertension Age> 75 years, DM, Stroke, Vascular disease) in order to strati...
Source: The American Journal of Medicine - September 17, 2020 Category: General Medicine Authors: Antonios Vitalis, Alena Shantsila, Marco Proietti, Rajiv K. Vohra, Mark Kay, Brian Olshansky, Gregory Y.H. Lip Source Type: research
Infection as a trigger for cardiovascular disease
A variety of clinical infections including the current pandemic and a variety of physical events such as bee stings and trauma have been documented as triggers of acute cardiovascular illness such as venous thromboembolism, myocardial infarction, and stroke.1 –12 A number of factors have been proposed to explain this association between infection and acute cardiovascular disease including activation of various inflammatory molecules and platelets, endothelial dysfunction, and/or augmented sympathetic nervous activity with release of high levels of cate cholamines into the circulation.
Source: The American Journal of Medicine - July 6, 2020 Category: General Medicine Authors: Joseph S. Alpert Tags: Commentary Source Type: research
Contemporary Meta-Analysis of Extended Direct Acting Oral Anticoagulant Thromboprophylaxis to Prevent Venous Thromboembolism Among Hospitalized Patients
There are over 36 million medical hospitalizations each year in the United States, with the majority being for acute medical illness.1 Cancer, chronic obstructive pulmonary disease, congestive heart failure, stroke and myocardial infarction are some of the most common indications for hospitalization and are additionally risk factors for venous thromboembolism.2 With over 900,000 patients suffering from venous thromboembolism each year, excess thrombosis causes a large medical and financial burden to patients and the health care system.
Source: The American Journal of Medicine - March 5, 2020 Category: General Medicine Authors: Vikas Bhalla, Olivia F Lamping, Ahmed Abdel-Latif, Meenakshi Bhalla, Khaled Ziada, Susan S. Smyth Tags: Clinical Research Study Source Type: research
Predictors of not initiating anticoagulation after incident venous thromboembolism: a Danish nationwide cohort study
Venous thromboembolism, com prising deep vein thrombosis and pulmonary embolism, is the third most common cause of cardiovascular death after stroke and myocardial infarction.1 Anticoagulation is the keystone in venous thromboembolism treatment and prevention of venous thromboembolism morbidity, mortality, and recurrence. International guidelines mandate anticoagulant therapy for a minimum of 3 months after proximal deep vein thrombosis and/or pulmonary embolism.2,3
Source: The American Journal of Medicine - October 9, 2019 Category: General Medicine Authors: Ida Ehlers Albertsen, Samuel Zachary Goldhaber, Gregory Piazza, Thure Filskov Overvad, Peter Br ønnum Nielsen, Torben Bjerregaard Larsen, Mette Søgaard Tags: Clinical Research Study Source Type: research
Arterial Ischemic Events Are a Major Complication in Cancer Patients with Venous Thromboembolism
A number of studies revealed that patients with venous thromboembolism are at increased risk of developing subsequent arterial ischemic events, such as myocardial infarction or stroke.1 –8 Prevention of such arterial ischemic events in addition to treating venous thromboembolismmay warrant combination therapy with antiplatelets and anticoagulants. Recent studies suggested an increased risk of arterial ischemic events in cancer patients.9,10 Accurate identification of patients at increased risk for arterial ischemic events during the course of anticoagulation for venous thromboembolismmay help to select those who would po...
Source: The American Journal of Medicine - May 26, 2018 Category: General Medicine Authors: Benjamin Brenner, Behnood Bikdeli, Inna Tzoran, Olga Madridano, Raquel L ópez-Reyes, José María Suriñach, Ángeles Blanco-Molina, Antonella Tufano, Juan José López Núñez, Javier Trujillo-Santos, Manuel Monreal, for the RIETE Investigators Tags: Clinical Research Study Source Type: research
Severity of Gastrointestinal Bleeding in Patients Treated with Direct-Acting Oral Anticoagulants
Direct-acting oral anticoagulants (DOACs), which have gained approval for stroke prevention in non-valvular atrial fibrillation and treatment of venous thromboembolism, have become increasingly preferred over warfarin given their predictable pharmacodynamics, lack of required monitoring, and superior outcomes. DOACs have been shown to be associated with an increased frequency of gastrointestinal bleeding compared to warfarin, but the severity and characteristics of gastrointestinal bleeding in these patients is poorly understood.
Source: The American Journal of Medicine - November 22, 2017 Category: General Medicine Authors: Mark M. Brodie, Jill C. Newman, Tyler Smith, Don C. Rockey Tags: Clinical Research Study Source Type: research
