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0484: The LEADERS FREE Trial: a double blind randomized comparison of a BMS and a polymer-free Drug Coated Stent (DCS) in 2,466 patients at high bleeding risk and treated with one month DAPT only
Conclusion The trial focuses on a never previously studied high bleeding risk population characterized by advanced age and more comorbid conditions. It is the 1st evaluation of a DCS with clinical endpoints and comprises the shortest ever DAPT course with an active stent to be evaluated for both safety and efficacy.
Source: Archives of Cardiovascular Diseases Supplements - March 7, 2016 Category: Cardiology Source Type: research

Obese women on the pill more likely to have rare stroke
Cerebral venous thrombosis more common in obese women if they use oral contraceptionRelated items from OnMedicaNew pill study reveals VTE riskOral contraceptive use not linked to major birth defects The pill could give long-term protection against womb cancer
Source: OnMedica Latest News - March 15, 2016 Category: UK Health Source Type: news

Evolving Treatments for Arterial and Venous Thrombosis: Role of the Direct Oral Anticoagulants.
Abstract The direct oral anticoagulants (DOACs) represent a major advance in oral anticoagulant therapy and have replaced the vitamin K antagonists as the preferred treatment for many indications. By simplifying long-term anticoagulant therapy and improving its safety, the DOACs have the potential to reduce the global burden of thrombosis. Postmarketing studies suggest that the favorable results achieved with DOACs in the randomized controlled trials can be readily translated into practice, but highlight the need for appropriate patient, drug and dose selection, and careful follow-up. Leveraging on their success t...
Source: Circulation Research - April 28, 2016 Category: Cardiology Authors: Chan NC, Eikelboom JW, Weitz JI Tags: Circ Res Source Type: research

Exploring unmet needs in venous and arterial thromboembolism with rivaroxaban.
This article will introduce and provide context for these RCTs in the contemporary management of arterial and venous thromboembolism in the following underserved areas: Patients with both NVAF and acute coronary syndrome (ACS) requiring percutaneous coronary intervention (PCI); patients with embolic stroke of undetermined source (ESUS); patients who require transcatheter aortic valve replacement (TAVR); patients with acute or chronic coronary artery disease (CAD; including those with heart failure [HF]); those at risk of or suffering from cancer-associated thrombosis (CAT) and those requiring long-term anticoagulation. It ...
Source: Thrombosis and Haemostasis - September 13, 2016 Category: Hematology Authors: Cappato R, Welsh R Tags: Thromb Haemost Source Type: research

Cerebral venous thrombosis.
Abstract Cerebral venous thrombosis (CVT) has an incidence of 1.32/100,000/years in high-income countries, and higher in middle- and low-income countries. CVT is more frequent in infants and children young adults and females, especially during pregnancy/puerperium. CVT are now being diagnosed with increasing frequency because of the increased awareness and higher use of magnetic resonance imaging (MR) for investigating patients with acute and subacute headaches and new onset seizures. CVT rarely present as a stroke syndrome. Their most frequent presentations are isolated headache, intracranial hypertension syndrom...
Source: Presse Medicale - November 1, 2016 Category: Journals (General) Authors: Ferro JM, Canhão P, Aguiar de Sousa D Tags: Presse Med Source Type: research

Hormonal Contraception and Risk of Thromboembolism in Women With Diabetes
CONCLUSIONS The absolute risk of thromboembolism among women with type 1 or 2 diabetes using hormonal contraception is low. Highly effective, intrauterine and subdermal contraceptives are excellent options for women with diabetes who hope to avoid the teratogenic effects of hyperglycemia by carefully planning their pregnancies.
Source: Diabetes Care - January 19, 2017 Category: Endocrinology Authors: OBrien, S. H.; Koch, T.; Vesely, S. K.; Schwarz, E. B. Tags: Epidemiology/Health Services Research Source Type: research

The evolving role of oral hormonal therapies and review of conjugated estrogens/bazedoxifene for the management of menopausal symptoms.
Authors: Parish SJ, Gillespie JA Abstract This review describes the evolving role of oral hormone therapy (HT) for treating menopausal symptoms and preventing osteoporosis, focusing on conjugated estrogens/bazedoxifene (CE/BZA). Estrogens alleviate hot flushes and prevent bone loss associated with menopause. In nonhysterectomized women, a progestin should be added to estrogens to reduce the risk of endometrial cancer. Use of HT declined since the Women's Health Initiative (WHI) studies showed that HT does not prevent coronary heart disease (CHD) and that conjugated estrogens/medroxyprogesterone acetate increased th...
Source: Postgraduate Medicine - February 1, 2017 Category: Internal Medicine Tags: Postgrad Med Source Type: research

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis – endorsed by the European Academy of Neurology
ConclusionsMulticentre observational and experimental studies are needed to increase the level of evidence supporting recommendations on the diagnosis and management of CVT.
Source: European Journal of Neurology - August 20, 2017 Category: Neurology Authors: J. M. Ferro, M. ‐G. Bousser, P. Canhão, J. M. Coutinho, I. Crassard, F. Dentali, M. Minno, A. Maino, I. Martinelli, F. Masuhr, D. Aguiar de Sousa, J. Stam, Tags: Guidelines Source Type: research

Causes of Death in Patients with Venous Thromboembolism Anticoagulated with Direct Oral Anticoagulants: A Systematic Review and Meta-Analysis
Semin Thromb Hemost DOI: 10.1055/s-0038-1642644Death is more frequent than nonfatal recurrent venous thromboembolism (VTE) and major bleeding after acute VTE. The analysis of the causes of death is fundamental to explore new strategies to reduce mortality rates in these patients. The authors performed a meta-analysis to analyze mortality and independently adjudicated causes of death in anticoagulated patients due to VTE, and to evaluate potential differences between different anticoagulant schemes. They searched MEDLINE and CENTRAL, from January 1, 2000, to January 31, 2017, and performed additional searches in Web sites o...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2018 Category: Hematology Authors: G ómez-Outes, Antonio Terleira-Fern ández, Ana Isabel Lecumberri, Ram ón Su árez-Gea, Mª Luisa Calvo-Rojas, Gonzalo Vargas-Castrill ón, Emilio Tags: Review Article Source Type: research

Atrial Fibrillation and Malignancy: The Clinical Performance of Non –Vitamin K Oral Anticoagulants—A Systematic Review
Semin Thromb Hemost DOI: 10.1055/s-0038-1661386Atrial fibrillation (AF) is commonly diagnosed in the setting of active cancer. Because of an increased risk of either thromboembolic events or bleeding, the decision to initiate therapeutic anticoagulation in patients with active cancer can be challenging. Moreover, little is still known about the optimal anticoagulation therapy in the setting of AF and cancer, and no guidelines are as yet available. Considering that nonvitamin K antagonist oral anticoagulants (NOACs) are recommended as alternatives to vitamin K antagonists for stroke prevention in AF patients with CHA2DS2-VA...
Source: Seminars in Thrombosis and Hemostasis - August 17, 2018 Category: Hematology Authors: Russo, Vincenzo Bottino, Roberta Rago, Anna Micco, Pierpaolo Di D' Onofrio, Antonio Liccardo, Biagio Golino, Paolo Nigro, Gerardo Tags: Review Article Source Type: research

Rivaroxaban Thromboprophylaxis in High-Risk Ambulatory Cancer Patients Receiving Systemic Therapy: Results of a Randomized Clinical Trial (CASSINI)
Conclusions: Rivaroxaban significantly reduced VTE and VTE-related death during the on-treatment period but not during the full study period; over one-third of events occurred post discontinuation of study drug. The incidence of major bleeding was low. The Khorana risk score cut-off of ≥2 identified cancer patients at high risk of thrombotic events both at baseline (4.53%) and during study (8.79% with additional 1.66% arterial events in placebo group). These results should inform future recommendations regarding thromboprophylaxis in at-risk ambulatory cancer patients.(Funded by Janssen; ClinicalTrials.gov number, NCT02...
Source: Blood - November 21, 2018 Category: Hematology Authors: Khorana, A. A., Soff, G. A., Kakkar, A. K., Vadhan-Raj, S., Riess, H., Wun, T., Streiff, M. B., Garcia, D. A., Liebman, H. A., Belani, C., O'Reilly, E. M., Patel, J. N., Yimer, H. A., Wildgoose, P., Burton, P., Vijapurkar, U., Kaul, S., Eikelboom, J., McB Tags: Late-Breaking Abstracts Session Source Type: research

Management of Cerebral Vein Thrombosis in a Canadian Tertiary Hospital
Introduction: Cerebral vein thrombosis (CVT) is an uncommon cause of stroke and is more likely to affect young adults and children. Women have a three-fold increased risk compared to men, owing to gender specific factors such as oral contraceptive use (OCP), pregnancy, and hormone replacement therapies. The presenting symptoms of CVT are non-specific and include headache, seizure, focal neurological deficits, or coma as the most severe presentation. The rarity and variable symptoms of the disease leads to delayed diagnosis and implementation of treatment. With improved imaging techniques and increased awareness in recent y...
Source: Blood - November 21, 2018 Category: Hematology Authors: Castellucci, L. A., Chiang, P. Tags: 332. Antithrombotic Therapy: Poster II Source Type: research

Treatment Failure in Patients Receiving Direct Oral Anticoagulants: Clinical Management and Outcomes from a Single-Center Review of 59 Consecutive Patients
In this study, we sought to characterise DOAC treatment failures in our institution, and to rationalise the subsequent anticoagulation strategies in this setting. All VTE patients starting a DOAC at our centre are followed in a consultant-led clinic. Cases of suspected treatment failure are also referred from other specialities and primary care. Between September 2014 and May 2018, we identified 59 consecutive patients (male/female: 34/25) in whom a DOAC treatment failure was diagnosed, including non-resolution of the presenting complaint, and recurrence of or a new thrombotic event. Patient mean age at DOAC initiation was...
Source: Blood - November 21, 2018 Category: Hematology Authors: McIlroy, G., Smith, N., Lokare, A., Beale, K., Kartsios, C. Tags: 332. Antithrombotic Therapy Source Type: research

Anticoagulation of Cardiovascular Conditions in the Cancer Patient: Review of Old and New Therapies
AbstractPurpose of ReviewThe anticoagulation strategies for various cardiac-specific pathologies including atrial fibrillation are changing. Applying these strategies in patients with concomitant active cancer requires additional considerations. Here, we review the most recent changes in the anticoagulation management of common cardiac diseases and their application in cancer patients.Recent FindingsThere are a range of indications for therapeutic anticoagulation in cancer patients including venous thromboembolism (VTE), atrial fibrillation/flutter (AF/AFL), prosthetic heart valves, and intracardiac thrombi. Certain cancer...
Source: Current Oncology Reports - April 3, 2019 Category: Cancer & Oncology Source Type: research

Is Reclassification of the Oral Contraceptive Pill from Prescription to Pharmacist-Only Cost Effective? Application of an Economic Evaluation Approach to Regulatory Decisions
ConclusionReclassifying OCPs is likely to be considered cost effective by Australian decision makers.
Source: PharmacoEconomics - May 8, 2019 Category: Health Management Source Type: research

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