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https://www.readbyqxmd.com/read/29667588/cholesterol-embolisms-as-possible-adverse-drug-reaction-of-direct-oral-anticoagulants
#1
A H G Muller-Hansma, C R G M Daemen-Gubbels, N H Schut
The Netherlands Pharmacovigilance Centre Lareb has received two reports of cholesterol crystal embolisms associated with the use of a direct oral anticoagulant (DOAC). The European pharmacovigilance database contains several other cases concerning this association, and one report was published in the scientific literature. Cholesterol crystal embolisms were described in association with the use of several other antithrombotic drugs, although the role as an independent risk factor is not conclusive. The case series described in this article, indicates the possibility of an adverse drug reaction when a patient develops cholesterol crystal embolisms while using a DOAC...
April 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29664991/haemostatic-therapies-for-acute-spontaneous-intracerebral-haemorrhage
#2
REVIEW
Rustam Al-Shahi Salman, Zhe Kang Law, Philip M Bath, Thorsten Steiner, Nikola Sprigg
BACKGROUND: Outcome after spontaneous (non-traumatic) intracerebral haemorrhage (ICH) is influenced by haematoma volume; up to one-third of ICHs enlarge within 24 hours of onset. Early haemostatic therapy might improve outcome by limiting haematoma growth. This is an update of a Cochrane Review first published in 2006, and last updated in 2009. OBJECTIVES: To examine 1) the effectiveness and safety of individual classes of haemostatic therapies, compared against placebo or open control, in adults with acute spontaneous intracerebral haemorrhage, and 2) the effects of each class of haemostatic therapy according to the type of antithrombotic drug taken immediately before ICH onset (i...
April 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29664423/long-term-follow-up-of-antithrombotic-management-patterns-in-acute-coronary-syndrome-patients
#3
Fatih Sinan Ertaş, Lale Tokgozoglu
OBJECTIVE: The aim of this study was to evaluate the longterm, post-discharge follow-up of antithrombotic management patterns (AMPs), clinical outcomes, and real-life health status of patients hospitalized acute coronary syndrome (ACS). METHODS: A total of 1034 patients hospitalized for ACS within 24 hours of symptom onset who survived to discharge were included. Of those, 514 had ST-segment elevation myocardial infarction (STEMI) and 520 had unstable angina (UA)/non-STEMI (NSTEMI)...
April 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29663443/time-trends-in-antithrombotic-management-of-patients-with-atrial-fibrillation-treated-with-coronary-stents-results-from-talent-af-the-international-stent-atrial-fibrillation-study-multicenter-registry
#4
Brian J Potter, Giuseppe Andò, Giovanni Cimmino, Ricardo Ladeiras-Lopes, Zied Frikah, Xin Yue Chen, Vittorio Virga, Joao Goncalves-Almeida, A John Camm, Keith A A Fox
BACKGROUND: Antithrombotic management of patients with atrial fibrillation (AF) requiring percutaneous coronary intervention (PCI) is highly variable; limited evidence-based guidelines exist to influence practice. HYPOTHESIS: Patient characteristics and availability of novel drugs may have contributed to practice variability. METHODS: We undertook an international multicenter retrospective registry of AF patients treated with PCI. The primary measures of interest were antiplatelet and OAC prescriptions at discharge...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29662292/post-polypectomy-bleeding-and-thromboembolism-risks-associated-with-warfarin-vs-direct-oral-anticoagulants
#5
Naohiro Yanagisawa, Naoyoshi Nagata, Kazuhiro Watanabe, Tatsuhiro Iida, Mariko Hamada, Sakurako Kobayashi, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
AIM: To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants (DOAC). METHODS: We collected data from 218 patients receiving oral anticoagulants (73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics (age- and sex-matched controls) who underwent polypectomy. (1) We evaluated post-polypectomy bleeding (PPB) risk in patients receiving warfarin or DOAC compared with controls; (2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge (HPB) (endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB...
April 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29661787/thromboembolism-in-acute-lymphoblastic-leukemia-results-of-nopho-all2008-protocol-treatment-in-patients-1-45-years
#6
Cecilie Utke Rank, Nina Toft, Ruta Tuckuviene, Kathrine Grell, Ove Juul Nielsen, Thomas Leth Frandsen, Hanne Vibeke Hansen Marquart, Birgitte Klug Albertsen, Ulf Tedgård, Helene Hallböök, Ellen Ruud, Kirsten Brunsvig Jarvis, Petter Quist-Paulsen, Pasi Huttunen, Ulla Wartiovaara-Kautto, Ólafur Gísli Jónsson, Sonata Saulyte Trakymiene, Laimonas Griškevičius, Kadri Saks, Mari Punab, Kjeld Schmiegelow
Thromboembolism frequently occurs during acute lymphoblastic leukemia (ALL) therapy. We prospectively registered thromboembolic events during treatment of 1772 consecutive Nordic/Baltic ALL patients 1-45years treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL2008 protocol (7/2008-4/2017). The 2.5-year cumulative incidence of thromboembolism (N=137) was 7.9% (95% confidence interval (CI) 6.6-9.1); higher in patients ≥10years ( P <.0001). Adjusted hazard ratios (HRa) were associated with greater age (10...
April 16, 2018: Blood
https://www.readbyqxmd.com/read/29657077/reprint-of-marine-omega-3-fatty-acids-in-the-prevention-of-cardiovascular-disease
#7
Trevor A Mori
Omega-6 (ω6) and omega-3 (ω3) fatty acids are two classes of dietary polyunsaturated fatty acids derived from linoleic acid (18:2ω6) and α-linolenic acid (18:3ω3), respectively. Enzymatic metabolism of linoleic and α-linolenic acids generates arachidonic acid (20:4ω6) and eicosapentaenoic acid (20:5ω3; EPA), respectively, both of which are substrates for enzymes that yield eicosanoids with multiple and varying physiological functions. Further elongation and desaturation of EPA yields the 22-carbon fatty acid docosahexaenoic acid (22:6ω3; DHA)...
April 12, 2018: Fitoterapia
https://www.readbyqxmd.com/read/29652672/early-discontinuation-of-prasugrel-or-clopidogrel-in-acute-coronary-syndromes-insights-from-the-trilogy-acs-trial
#8
Andrew T Yan, Matthew T Roe, Megan Neely, Derek D Cyr, Harvey White, Keith A A Fox, Dorairaj Prabhakaran, Paul W Armstrong, Erik M Ohman, Shaun G Goodman
BACKGROUND: In the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial of patients with non-ST-segment elevation acute coronary syndrome managed medically without revascularization, treated with prasugrel versus clopidogrel for less than or equal to 30 months after index acute coronary syndrome, post-hoc analyses showed a divergence of treatment effect in favor of prasugrel after 12 months. Potential influential factors, including a potential late treatment effect after early study drug discontinuation in the intention-to-treat analysis, have not been explored...
April 12, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29650125/restenosis-stent-thrombosis-and-bleeding-complications-navigating-between-scylla-and-charybdis
#9
REVIEW
Juan Torrado, Leo Buckley, Ariel Durán, Pedro Trujillo, Stefano Toldo, Juan Valle Raleigh, Antonio Abbate, Giuseppe Biondi-Zoccai, Luis A Guzmán
The field of interventional cardiology has significantly evolved over 40 years by overcoming several challenges. The introduction of first-generation drug-eluting stents significantly reduced the rates of restenosis, but at the expense of an increase of late stent thrombosis. Prolonged antithrombotic therapy reduced rates of stent thrombosis, but at the cost of increased bleeding. Although the advent of second-generation drug-eluting stents subsequently reduced the incidence of late stent thrombosis, its permanent nature prevents full recovery of vascular structure and function with accordant risk of very late stent failure...
April 17, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29644411/noac-monotherapy-in-patients-with-concomitant-indications-for-oral-anticoagulation-undergoing-transcatheter-aortic-valve-implantation
#10
Nicolas A Geis, Christina Kiriakou, Emmanuel Chorianopoulos, Lorenz Uhlmann, Hugo A Katus, Raffi Bekeredjian
AIMS: Antithrombotic therapy after transcatheter aortic valve implantation (TAVI) is highly controversial and guideline recommendations are not evidence based. We assessed efficacy and safety of non-vitamin K antagonist oral anticoagulant (NOAC) monotherapy in patients with concomitant indications for OAC undergoing TAVI. METHODS: Among more than 1300 TAVI patients since 2008, 154 patients were identified who received postinterventional NOAC monotherapy. Outcomes were compared to 172 patients treated with vitamin K antagonist (VKA) monotherapy...
April 11, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29642709/thromboembolism-and-mortality-in-the-tasmanian-atrial-fibrillation-study
#11
Endalkachew Admassie, Leanne Chalmers, Luke R Bereznicki
BACKGROUND: Although utilization of anticoagulation in patients with atrial fibrillation (AF) has increased in recent years, contemporary data regarding thromboembolism and mortality incidence rates are limited outside of clinical trials. This study aimed to investigate the impact of the direct oral anticoagulants (DOACs) on the clinical outcomes of patients with AF included in the Tasmanian Atrial Fibrillation Study. METHODS: The medical records of all patients with a primary or secondary diagnosis of AF who presented to public hospitals in Tasmania, Australia, between 2011 and 2015, were retrospectively reviewed...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29629551/totally-thoracoscopic-left-atrial-occlusion-concomitant-to-endoscopic-atraumatic-coronary-artery-bypass-grafting-eacab
#12
Piotr Suwalski, Anna Witkowska
Atrial fibrillation, as the most prevalent arrhythmia, has more impact on morbidity and mortality than any other rhythm disorder. It is often concomitant with structural heart diseases like coronary artery disease. The worst complication of atrial fibrillation is stroke, but the double or triple antithrombotic therapy especially in fragile and elderly patients is associated with significant risk of bleeding. The left atrial appendage occlusion may reduse both the risk of stroke and drug intake. Here we present, to our knowledge, the first description of a simultaneous totally thoracoscopic 3D augmented coronary artery bypass grafting and left atrial appendage occlusion...
March 15, 2018: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/29627809/antithrombotic-therapy-in-patients-receiving-saphenous-vein-coronary-artery-bypass-grafts-a-protocol-for-a-systematic-review-and-network-meta-analysis
#13
Karla Solo, Janet Martin, Shahar Lavi, Conrad Kabali, Ava John-Baptiste, Immaculate F Nevis, Tawfiq Choudhury, Mamas A Mamas, Rodrigo Bagur
INTRODUCTION: The current evidence for the prevention of saphenous vein graft failure (SVGF) after coronary artery bypass graft (CABG) surgery consists of direct head-to-head comparison of treatments (including placebo) in randomised-controlled trials (RCTs) and observational studies. However, summarising the evidence using traditional pairwise meta-analyses does not allow the inclusion of data from treatments that have not been compared head to head. Exclusion of such comparisons could impact the precision of pooled estimates in a meta-analysis...
April 7, 2018: BMJ Open
https://www.readbyqxmd.com/read/29622563/noncanonical-matrix-metalloprotease-1-protease-activated-receptor-1-signaling-drives-progression-of-atherosclerosis
#14
Rajashree Rana, Tianfang Huang, Georgios Koukos, Elizabeth K Fletcher, Susan E Turner, Andrew Shearer, Paul A Gurbel, Jeffrey J Rade, Carey D Kimmelstiel, Kevin P Bliden, Lidija Covic, Athan Kuliopulos
OBJECTIVE: Protease-activated receptor-1 (PAR1) is classically activated by thrombin and is critical in controlling the balance of hemostasis and thrombosis. More recently, it has been shown that noncanonical activation of PAR1 by matrix metalloprotease-1 (MMP1) contributes to arterial thrombosis. However, the role of PAR1 in long-term development of atherosclerosis is unknown, regardless of the protease agonist. APPROACH AND RESULTS: We found that plasma MMP1 was significantly correlated ( R =0...
April 5, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29621998/a-factor-xia-activatable-hirudin-albumin-fusion-protein-reduces-thrombosis-in-mice-without-promoting-blood-loss
#15
William P Sheffield, Louise J Eltringham-Smith, Varsha Bhakta
BACKGROUND: Hirudin is a potent thrombin inhibitor but its antithrombotic properties are offset by bleeding side-effects. Because hirudin's N-terminus must engage thrombin's active site for effective inhibition, fusing a cleavable peptide at this site may improve hirudin's risk/benefit ratio as a therapeutic agent. Previously we engineered a plasmin cleavage site (C) between human serum albumin (HSA) and hirudin variant 3 (HV3) in fusion protein HSACHV3. Because coagulation factor XI (FXI) is more involved in thrombosis than hemostasis, we hypothesized that making HV3 activity FXIa-dependent would also improve HV3's potential therapeutic profile...
April 5, 2018: BMC Biotechnology
https://www.readbyqxmd.com/read/29618696/subclinical-leaflet-thrombosis-in-transcatheter-aortic-valve-replacement-detected-by-multidetector-computed-tomography-a-review-of-current-evidence
#16
Hashrul N Rashid, Adam J Brown, Liam M McCormick, Ameera S Amiruddin, Kim K Be, James D Cameron, Arthur Nasis, Robert P Gooley
Subclinical leaflet thrombosis (SLT) following transcatheter aortic valve replacement (TAVR) has been increasingly recognized. SLT has the hallmark features of hypo-attenuated leaflet thickening (HALT) on multidetector computed tomography (MDCT), which may result in hypoattenuation affecting motion (HAM). The actual prevalence of this condition is uncertain, with limited observational registries. SLT has caught the attention of the cardiovascular community because of concerns regarding its clinical sequelae, specifically the potential increased incidence of cerebrovascular events...
April 4, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29614521/targeting-coagulase-activity-in-staphylococcus-aureus-bacteraemia-a-randomized-controlled-single-centre-trial-of-staphylothrombin-inhibition
#17
Marijke Peetermans, Laurens Liesenborghs, Kathelijne Peerlinck, Eric Van Wijngaerden, Olivier Gheysens, Karolien E Goffin, Marc F Hoylaerts, Marc Jacquemin, Jan Verhaegen, Willy E Peetermans, Peter Verhamme, Thomas Vanassche
BACKGROUND:   Staphylococcus aureus ( S. aureus ) bacteraemia is frequent and carries a high morbidity and mortality. Coagulases secreted by S. aureus initiate blood coagulation by directly activating prothrombin. This pathogen-activated coagulation is insensitive to most antithrombotic drugs, with the exception of small molecule direct thrombin inhibitors (DTIs). DTIs inhibit the coagulase-prothrombin complex, or staphylothrombin, and improve outcome in preclinical models of S. aureus infection...
April 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29611483/management-of-antithrombotic-therapy-in-patients-with-coronary-artery-disease-or-atrial-fibrillation-who-underwent-abdominal-surgical-operations
#18
Dimitrios Schizas, Maria Kariori, Konstantinos Dean Boudoulas, Gerasimos Siasos, Nikolaos Patelis, Charalampos Kalantzis, Moldovan Carmen-Maria, Manolis Vavuranakis
BACKGROUND: Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. METHODS: The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations...
April 2, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29611444/combination-oral-antithrombotic-therapy-for-the-treatment-of-myocardial-infarction-recent-developments
#19
Udaya S Tantry, Eliano P Navarese, Aung Myat, Rahul Chaudhary, Paul A Gurbel
There have been significant new developments in the treatment of patients with myocardial infarction with respect to oral antithrombotic agents over the past decade. Recent studies have explored the potential utility of targeting the dual pathway inhibition of platelet function with single or dual antiplatelet agents and the thrombin pathway with direct thrombin inhibitors or factor Xa inhibitors. Areas covered: In this review, the authors focus on the recent developments of oral antithrombotic agents including antiplatelet and antithrombin agents...
April 3, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29611427/impact-of-known-or-new-onset-atrial-fibrillation-on-2-year-cardiovascular-event-rate-in-patients-with-acute-coronary-syndromes-results-from-the-prospective-epicor-registry
#20
Uwe Zeymer, Lieven Annemans, Nicolas Danchin, Stuart Pocock, Simon Newsome, Frans Van de Werf, Jesús Medina, Héctor Bueno
BACKGROUND: Atrial fibrillation (AF) is associated with increased morbidity in acute coronary syndrome patients, but impact on outcomes beyond 1 year is unclear. METHODS: This was a post-hoc analysis from the long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients (EPICOR) registry (NCT01171404), a prospective, observational study conducted in Europe and Latin America, which enrolled acute coronary syndrome survivors at discharge...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
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