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Management dilemmas in acute pulmonary embolism
Conclusion The suggested approaches are based on a review of the available evidence and guidelines and on our clinical experience. Management in an individual patient requires clinical assessment of risks and benefits and also depends on local availability of therapeutic interventions.
Source: Thorax - January 15, 2014 Category: Respiratory Medicine Authors: Condliffe, R., Elliot, C. A., Hughes, R. J., Hurdman, J., Maclean, R. M., Sabroe, I., van Veen, J. J., Kiely, D. G. Tags: Open access, Venous thromboembolism, Pulmonary embolism Review Source Type: research

A prospective study of estimated glomerular filtration rate and outcomes in patients with atrial fibrillation: The Loire Valley Atrial Fibrillation Project.
CONCLUSION Incidence rates of IS/TE, mortality and bleeding increased with reducing eGFR, across the whole range of renal function. OAC use was associated with a lower incidence of IS/TE and mortality at 1 year, compared with non-anticoagulated individuals in all categories of renal function as measured by eGFR. The NCB balancing IS against serious bleeding was positive, in favour of OAC use amongst patients with renal impairment. PMID: 24356875 [PubMed - as supplied by publisher]
Source: Chest - December 19, 2013 Category: Respiratory Medicine Authors: Banerjee A, Fauchier L, Vourc'h P, Andres CR, Taillandier S, Halimi JM, Lip GY Tags: Chest Source Type: research

The impact of smoking on thromboembolism and mortality in patients with incident atrial fibrillation: insights from the Danish Diet, Cancer and Health study.
CONCLUSIONS Smoking is associated with a higher risk of thromboembolism or death in patients with AF even after adjusting for well-recognised risk factors used in stroke risk stratification schemes. The associations may be modified by sex, as the associations were strongest among women. PMID: 24091709 [PubMed - as supplied by publisher]
Source: Chest - October 3, 2013 Category: Respiratory Medicine Authors: Albertsen IE, Rasmussen LH, Lane DA, Overvad TF, Skjøth F, Overvad K, Lip GY, Larsen TB Tags: Chest Source Type: research

Impending paradoxical embolism: Have we lost the clot?
First demonstrated on echocardiography in 1985, impending paradoxical embolism refers to a thrombus traversing an atrial septal defect, usually a patent foramen ovale (PFO) [1]. Estimates of the prevalence of PFO range from 15% to 35% but impending paradoxical embolism is rare, with fewer than 200 cases reported in the literature [2‐4]. Most cases are associated with pulmonary emboli. Elevated pulmonary and right atrial pressures may push a thrombus through a PFO into the systemic circulation, producing paradoxical systemic embolization. The high risk of cardio‐embolic stroke makes the diagnosis an emergency. Treatment...
Source: The Clinical Respiratory Journal - October 1, 2013 Category: Respiratory Medicine Authors: Finn Ghent, Levi Bassin, Michael Keller, Gregory Cranney, David McKenzie, Peter Grant Tags: Other Source Type: research

Development of a novel composite stroke and bleeding risk score in patients with atrial fibrillation: The AMADEUS study.
CONCLUSION We have developed and validated 2 novel composite scores for stroke/thromboembolism/ bleeding that offer good discriminatory and predictive performance. However, these composite risk scores did not perform better than the easier and more practical 'traditional' stroke and bleeding risk scores that are currently in use, which allow greater practically and more personalised balancing of risks. PMID: 24009027 [PubMed - as supplied by publisher]
Source: Chest - September 5, 2013 Category: Respiratory Medicine Authors: Lip GY, Lane DA, Buller H, Apostolakis S Tags: Chest Source Type: research

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