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Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Evaluation of Prescribing Practices and Outcomes Using Direct-Acting Oral Anticoagulants After Cardiac Surgery
Clin Ther. 2021 May 30:S0149-2918(21)00203-4. doi: 10.1016/j.clinthera.2021.04.009. Online ahead of print.ABSTRACTPURPOSE: Cardiac surgery patients frequently require anticoagulation. Warfarin remains the preferred agent, and a few trials have reported negative outcomes with the use of direct-acting oral anticoagulants (DOACs) in these patients. Therefore, limited literature exists that supports the dosing, safety, and efficacy of DOACs within the cardiac surgery population.METHODS: This single-center, retrospective analysis was conducted at a tertiary academic medical center. All data were extrapolated from electronic med...
Source: Clinical Therapeutics - June 3, 2021 Category: Drugs & Pharmacology Authors: Dareen M Kanaan Bryan M Cook Julie Kelly Rhynn Malloy Source Type: research

Risks and benefits of concurrent treatment with antiplatelet and anticoagulation therapy in post ‐op bioprosthetic aortic valve replacement patients
ConclusionPatients who underwent bAVR and were discharged on concurrent therapy compared to aspirin only had a significantly increased risk of bleeding without a significant difference in thromboembolic events.
Source: Journal of Cardiac Surgery - February 13, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Carma Yaghi, Rajeev Masson, Kyoko Yamada, Shiyun Zhu, Christine Fong, Aida Shirazi, Paul LaPunzina, Kenny Mok Tags: ORIGINAL ARTICLE Source Type: research

10-year results of On-X bileaflet mechanical heart valve in the aortic position: low target INR regimen in Japanese
ConclusionsAVR using On-X valve with low target INR regimen and low-dose aspirin resulted in a significantly low risk of bleeding.
Source: General Thoracic and Cardiovascular Surgery - April 19, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Management of New ‐Onset Postoperative Atrial Fibrillation Utilizing Insertable Cardiac Monitor Technology to Observe Recurrence of AF
Conclusion: POAF may represent a propensity for recurrent PAF, and not simply a transient consequence of post‐operative stress and inflammation. Better detection of recurrent AF might identify patients at risk for stroke who would benefit from continuing anticoagulation.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - July 31, 2016 Category: Cardiology Authors: MIKHAEL F. EL ‐CHAMI, FAISAL M MERCHANT, PAIGE SMITH, MATHEW LEVY, ANGELA GILL NELMS, JOHN MERLINO, JOHN PUSKAS, ANGEL R. LEON Tags: ELECTROPHYSIOLOGY Source Type: research

Aspirin Instead of Oral Anticoagulant Prescription in Atrial Fibrillation Patients at Risk for Stroke
ConclusionsIn a large, real-world cardiac outpatient population of AF patients with a moderate to high risk of stroke, more than 1 in 3 were treated with aspirin alone without OAC. Specific patient characteristics predicted prescription of aspirin therapy over OAC.
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

Anticoagulation for stroke prevention in new atrial fibrillation after coronary artery bypass graft surgery
The benefit of early anticoagulation for stroke prophylaxis in atrial fibrillation after coronary artery bypass graft (CABG) surgery is uncertain. We therefore studied what proportion of ischemic strokes in patients with atrial fibrillation early after CABG surgery were potentially preventable by anticoagulation with warfarin.
Source: Thrombosis Research - February 24, 2015 Category: Hematology Authors: S. Schulman, I. Cybulsky, J. Delaney Tags: Regular Article Source Type: research

Simultaneous Carotid Artery Stenting and Heart Surgery: Expanded Experience of Hybrid Surgical Procedures
Conclusions Same-day hybrid approach appeared safe in terms of early and long-term results not only for CAS and isolated CABG but also for CAS and noncoronary isolated procedures. In complex cases, the rate of stroke and myocardial infarction seemed low; in-hospital mortality, as expected, was higher. Long-term survival appeared similarly satisfactory, thus confirming the hybrid approach as a valid therapeutic option for all patients with significant internal carotid artery stenosis associated with coronary and other cardiac lesions, at least for noncomplex cases.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Cardiac Surgery in Indigenous Australians: Early Onset Cardiac Disease with follow-up Challenges
Conclusions: The mean age of 52 years at which Indigenous patients have cardiac surgery is significantly low compared to non-Indigenous patients. Indigenous patients have multiple risk factors for cardiac disease and with a large number requiring emergency surgery. Although surgical outcome in the short term is favourable, a large number of patients are lost to follow-up. The use of mechanical valve and warfarin should be individualised. Strategic post-operative follow-up mechanisms are needed to address these issues.
Source: Heart, Lung and Circulation - February 24, 2014 Category: Cardiology Authors: M.P. Matebele, S. Rohde, A. Clarke, J.F. Fraser Tags: Original Articles Source Type: research

232 * early anticoagulation therapy after bioprosthetic aortic valve implantation: comparing warfarin versus aspirin
Conclusions: This is to date the largest randomized trial comparing warfarin to aspirin as early anticoagulation therapy after implantation of bioprosthetic aortic valves. The results are not conclusive, but aspirin therapy seems as safe as warfarin therapy, and with significantly fewer gastrointestinal bleeding events, three months after surgery.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Rafiq, S., Steinbruchel, D. A., Moeller, C. H., Lund, J., Thiis, J. J., Koeber, L., Lilleoer, N. B., Olsen, P. S. Tags: Decision-making in aortic valve repair Source Type: research