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The changing use of anticoagulants in New Zealand
CONCLUSIONS: The introduction of the DOACs was expected to reduce the use of warfarin. However, the rapid rise in DOAC use was not predicted. The increase is most likely in patients with atrial fibrillation with the positive benefit of reducing the incidence of embolic stroke. However, having a high proportion of the elderly population (15% of people over 75-years) on anticoagulants has implications for the health sector, making hospital admissions and surgery more complex.PMID:35728215
Source: New Zealand Medical Journal - June 21, 2022 Category: General Medicine Authors: Paul Harper Alison Chang Matt Stephens Source Type: research

Anticoagulant-related intracranial haemorrhage: time to anticoagulant reversal improving but still slower than thrombolysis for ischaemic stroke.
CONCLUSION: Door-to-any-reversal-agent and scan-to-PCC times have improved over time, but they remain significantly longer than IS thrombolysis times. Monitoring of reversal is inadequate, particularly for WRICH receiving PCC. PMID: 33582709 [PubMed - in process]
Source: New Zealand Medical Journal - February 17, 2021 Category: General Medicine Tags: N Z Med J Source Type: research

Commentary: The case for a comprehensive clinical, basic, and translational research strategy to understand, prevent, detect, and treat cerebrovascular injury in Fontan patients
In this issue of the Journal, the Australian and New-Zealand Fontan Registry Research group compares long-term rates of cerebrovascular injury, thrombosis, bleeding, bone mineral density, and quality of life in Fontan patients receiving warfarin and those receiving aspirin.1 Their take-home messages are (1) asymptomatic cerebrovascular injury is a frequent occurrence in Fontan patients, including stroke (39%), microhemorrhage (96%), and white matter injury (86%); (2) warfarin does not seem to protect against the risk of cerebrovascular injury when compared with aspirin; and (3) warfarin is associated with a greater risk of...
Source: The Journal of Thoracic and Cardiovascular Surgery - January 19, 2021 Category: Cardiovascular & Thoracic Surgery Authors: David Kalfa Tags: Commentary Source Type: research

Left ventricular thrombus after ST segment elevation myocardial infarction: a single-centre observational study.
CONCLUSIONS: The incidence of LV thrombus following STEMI was low and it was associated with a low rate of stroke and systemic embolism but high mortality. Randomised studies are needed to evaluate the efficacy of NOAC's in this context. PMID: 33332339 [PubMed - in process]
Source: New Zealand Medical Journal - December 19, 2020 Category: General Medicine Tags: N Z Med J Source Type: research

National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018.
Authors: Brieger D, Amerena J, Attia JR, Bajorek B, Chan KH, Connell C, Freedman B, Ferguson C, Hall T, Haqqani HM, Hendriks J, Hespe CM, Hung J, Kalman JM, Sanders P, Worthington J, Yan T, Zwar NA Abstract INTRODUCTION: Atrial fibrillation (AF) is increasing in prevalence and is associated with significant morbidity and mortality. The optimal diagnostic and treatment strategies for AF are continually evolving and care for patients requires confidence in integrating these new developments into practice. These clinical practice guidelines will assist Australian practitioners in the diagnosis and management of adult ...
Source: Medical Journal of Australia - August 3, 2018 Category: General Medicine Tags: Med J Aust Source Type: research