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https://www.readbyqxmd.com/read/29037012/medical-treatment-of-intracranial-atherosclerosis-an-update
#1
REVIEW
Jong S Kim, Oh Young Bang
For patients with symptomatic intracranial atherosclerosis (ICAS), antithrombotic agents are the mainstay of therapy. Anticoagulation (warfarin) is not widely used since it is not more effective than aspirin and carries a high risk of bleeding. New oral anticoagulants are showing promise, but their use has not been investigated in appropriate clinical trials. Since the recurrent stroke risk is high with aspirin monotherapy, dual antiplatelets are considered in the early stage of symptomatic ICAS. Based on the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) results, aspirin plus clopidogrel has been recommended...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29034832/new-advances-in-atrial-fibrillation-management-the-role-of-apixaban
#2
Giuseppe Mc Rosano, Ilaria Spoletini, Walter Gianni, Cristiana Vitale
Prevention of stroke is a pivotal intervention in the management of patients with atrial fibrillation (AF) at increased risk of systemic embolism. Because of the difficulties of safely implementing Vitamin K Antagonists in all patients, there has been a growing interest in improving the pharmacological management of AF, with newer antithrombotic agents. The new oral anticoagulants (NOACs) have been developed to overcome the limitations and improve the efficacy of the conventional oral anticoagulant drugs. Among the NOACs, apixaban - a very specific antagonist of activated factor Xa - has pharmacokinetic and pharmacodynamic properties that allow significant efficacy in AF management...
October 12, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/29031497/patent-foramen-ovale-and-the-risk-of-cerebral-infarcts-in-acute-pulmonary-embolism-a-prospective-observational-study
#3
David Vindiš, Martin Hutyra, Daniel Šaňák, Michal Král, Eva Čecháková, Simona Littnerová, Tomáš Adam, Jan Přeček, Štěpán Hudec, Markéta Ječmenová, Miloš Táborský
BACKGROUND: Pulmonary embolism (PE) is associated with a risk of consecutive paradoxical embolism with brain infarction through a patent foramen ovale (PFO). The aims of this study were to assess the rate of new ischemic brain lesions (IBLs) using magnetic resonance imaging (MRI) during a 12-month follow-up period with anticoagulation and to evaluate the potential relationship with the presence of PFO on transesophageal echocardiography (TEE). SUBJECTS AND METHODS: Seventy-eight patients with acute PE underwent baseline contrast TEE with brain MRI...
October 11, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29029905/perioperative-complications-with-new-oral-anticoagulants-dabigatran-apixaban-and-rivaroxaban-in-mohs-micrographic-surgery-a-retrospective-study
#4
Camila Antia, Natalie Hone, Hugh Gloster
No abstract text is available yet for this article.
November 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29028452/atrial-fibrillation-in-women-risks-and-management
#5
Sindhu Prabakaran, Maria Carolina Gongora Nieto, Gina Lundberg
Atrial fibrillation (AF) is one of the most commonly occurring arrhythmias and a major modifiable risk factor for stroke, especially in women. While its prevalence is similar in both men and women, women unfortunately face a greater intrinsic AF-related risk of stroke than men do. This is likely one of the reasons that more women than men die from strokes, in addition to experiencing more new and recurrent strokes. Therefore, in women especially, it is imperative to diagnose and treat AF as early as possible...
October 13, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29028119/comparison-of-treatment-persistence-with-dabigatran-or-rivaroxaban-versus-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-a-competing-risk-analysis-in-the-french-nationwide-healthcare-databases
#6
Géric Maura, Cécile Billionnet, François Alla, Joshua J Gagne, Antoine Pariente
BACKGROUND: Direct oral anticoagulants (DOACs) have been proposed as a more convenient alternative to vitamin K antagonists (VKAs), which are commonly associated with poor treatment persistence in nonvalvular atrial fibrillation (nv-AF). METHODS: Using data from the French National Healthcare databases (Régime Général, 50 million beneficiaries), a cohort study was conducted to compare the 1-year non-persistence rates in nv-AF patients initiating dabigatran (N=11,141) or rivaroxaban (N=11,126) versus VKA (N=11,998)...
October 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29027516/-chronic-thromboembolic-pulmonary-hypertension-recognition-diagnosis-and-treatment
#7
D Ruigrok, P Symersky, P W G Elbers, S Kamminga, L J Meijboom, H J Bogaard
- Chronic thromboembolic pulmonary hypertension (CTEPH), characterised by pulmonary hypertension and persistent perfusion defects despite adequate anticoagulation, causes significant morbidity and mortality.- Persistent dyspnoea after acute pulmonary embolism is frequent and an indication for additional diagnostics. Only a minority of these patients develop CTEPH.- Echocardiography and perfusion scintigraphy are the cornerstone of diagnostics when suspecting CTEPH. Right-heart catheterisation and pulmonary angiography should confirm the diagnosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29026346/treatment-with-direct-oral-anticoagulants-in-patients-with-upper-extremity-deep-vein-thrombosis
#8
Francisco Sánchez Montiel, Raein Ghazvinian, Anders Gottsäter, Johan Elf
BACKGROUND: Upper extremity deep vein thrombosis (UEDVT) constitutes around 10% of all DVT, and can cause both pulmonary embolism (PE) and postthrombotic syndrome (PTS) in the arm. The incidence of secondary UEDVT is increasing due to widespread use of central venous catheters in patients with cancer and other chronic diseases. The safety and efficacy of using new direct acting oral anti coagulants (DOAC) in the treatment of UEDVT has not been systematically evaluated. Our aims were to evaulate efficacy, safety, and risk of recurrence of venous thromboembolism (VTE) during DOAC treatment in UEDVT patients...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/29025746/clinical-prediction-model-for-time-in-therapeutic-range-while-on-warfarin-in-newly-diagnosed-atrial-fibrillation
#9
Brent A Williams, Michael A Evans, Ashley M Honushefsky, Peter B Berger
BACKGROUND: Though warfarin has historically been the primary oral anticoagulant for stroke prevention in newly diagnosed atrial fibrillation (AF), several new direct oral anticoagulants may be preferred when anticoagulation control with warfarin is expected to be poor. This study developed a prediction model for time in therapeutic range (TTR) among newly diagnosed AF patients on newly initiated warfarin as a tool to assist decision making between warfarin and direct oral anticoagulants...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29022529/deep-vein-thrombosis-in-the-era-of-high-hiv-and-tuberculosis-prevalence-a-prospective-review-of-its-diagnosis-and-treatment-in-a-quaternary-centre
#10
K E Hodkinson, J N Mahlangu
BACKGROUND: Venous thromboembolic disease (VTE) is a leading cause of morbidity and mortality worldwide. HIV and tuberculosis (TB) infections have an aetiological association with VTE. Implementation of national HIV and TB programmes in South Africa (SA) has changed the burden of these two conditions, with resultant effects on VTE prevalence. Furthermore, with the increased use of direct oral anticoagulants (DOACs), baseline thrombosis data are needed to evaluate the effect of these new agents...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29016369/newly-developed-left-ventricular-apical-thrombus-under-dabigatran-treatment
#11
Adem Adar, Orhan Onalan, Fahri Cakan
: Left ventricular (LV) thrombi are mostly formed in the aneurysmal or akinetic segment of the LV apex. Thromboembolism to the brain is usually fatal. There is not enough information available regarding the use of these new oral anticoagulant agents in LV thrombi. In this case, we present a 56-year-old male patient who was given dabigatran (150 mg, twice a day) for paroxysmal atrial fibrillation after experiencing anterior myocardial infarction. During the use of dabigatran, thrombus formation, which was not present earlier, was observed in the LV apical aneurysm...
October 7, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28994871/evaluation-of-anticoagulation-therapy-in-non-valvular-atrial-fibrillation-in-the-emergency-department
#12
Hanen Ghazali, Jihen Essid, Anware Yahmadi, Moez Mougaida, Mahbouba Chkir, Sami Souissi
INTRODUCTION: The vitamin K antagonists (VKAs) are currently the most effective therapeutic class for the prevention of cerebrovascular eventsin atrial fibrillation (AF) patients. However, several studies showed an under-prescription of this therapy.The aim of the study was to assess the prescription of VKAs in non-valvular AF (NVAF) patients and factors influencing the non-prescription ofsuch treatment. METHODS: We conducted a prospective, observational study in an emergency department (ED)...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28994120/complications-after-endoscopic-laryngopharyngeal-surgery
#13
Yo Kishimoto, Tohru Sogami, Ryuji Uozumi, Makiko Funakoshi, Shin-Ichi Miyamoto, Morimasa Kitamura, Chiaki Suzuki, Manabu Muto, Ichiro Tateya, Koichi Omori
OBJECTIVES/HYPOTHESIS: Endoscopic laryngopharyngeal surgery (ELPS), a hybrid of head and neck surgery and gastrointestinal endoscopic treatment, has been attracting attention as a new therapeutic modality for superficial laryngopharyngeal cancers. Although this technique is less invasive than traditional open procedures, some complications including postoperative bleeding, subcutaneous emphysema, or aspiration pneumonia can occur after treatment. The purpose of this study was to investigate the complications associated with ELPS to better understand the indications for this procedure...
October 10, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28990803/new-onset-postoperative-atrial-fibrillation-and-early-anticoagulation-after-cardiac-surgery
#14
Martin Maaroos, Hanna Pohjantähti-Maaroos, Jari Halonen, Juha Vähämetsä, Johanna Turtiainen, Juha Rantonen, Tapio Hakala, Ari A Mennander, Juha Hartikainen
OBJECTIVES: New onset postoperative atrial fibrillation (POAF) after cardiac surgery is associated with increased risk for thromboembolic complications. Compliance with anticoagulation treatment is prerequisite for successful outcome after POAF. We hypothesized that a disciplined anticoagulation protocol initiated instantly after POAF secures a long-term outcome. DESIGN: A total of 519 consecutive patients undergoing cardiac surgery were retrospectively analyzed...
October 9, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28988455/safety-profiles-of-percutaneous-left-atrial-appendage-closure-devices-an-analysis-of-the-food-and-drug-administration-manufacturer-and-user-facility-device-experience-maude-database-from-2009-2016
#15
Mohammad-Ali Jazayeri, Venkat Vuddanda, Mohit K Turagam, Valay Parikh, Madhav Lavu, Donita Atkins, Matthew Earnest, Luigi Di Biase, Andrea Natale, David Wilber, Yeruva Madhu Reddy, Dhanunjaya Lakkireddy
BACKGROUND: Percutaneous left atrial appendage closure (LAAC) is a viable option for AF patients who are unable to tolerate long term oral anticoagulation (OAC). OBJECTIVE: We sought to assess the safety of two commonly used percutaneous devices for LAA closure in the United States by analysis of surveillance data from the FDA Manufacturer and User Facility Device Experience (MAUDE) database. METHODS: The MAUDE database was queried between May 1, 2006 and May 1, 2016 for LARIAT® (SentreHEART Inc...
October 8, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28986431/a-novel-antithrombin-domain-dictates-the-journey-s-end-of-a-proteinase
#16
Ingrid M Verhamme
Antithrombin (AT) is an anticoagulant serpin that irreversibly inactivates the clotting proteinases factor Xa and thrombin by forming covalent complexes with them. Mutations in its critical domains, such as those that impair the conformational rearrangement required for proteinase inactivation, increase the risk of venous thrombosis. Águila et al. characterize for the first time the destabilizing effects of mutations in the region of AT that makes contact with the proteinase in the final acyl-enzyme complex...
October 6, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28986350/post-myocardial-infarction-left-ventricular-pseudoaneurysm-diagnosed-incidentally-by-echocardiography
#17
Rienzi Díaz-Navarro, Petros Nihoyannopoulos
A 54-year-old male developed a left ventricular pseudoaneurysm (Ps) along the lateral wall of the left ventricle (LV), which was diagnosed incidentally by two-dimensional transthoracic echocardiography (2DTTE) 6 months after an acute myocardial infarction. Color flow imaging (CFI) showed blood flow from the LV into the aneurysmal cavity and invasive coronary angiography revealed sub-occlusion of the circumflex artery. A complementary study using cardiovascular magnetic resonance (CMR) confirmed a dilated left ventricle with depressed ejection fraction, thin dyskinetic anterolateral and inferolateral walls, a Ps adjacent to the lateral wall of the LV contained by the pericardium and blood passing in and out through a small defect in the LV mid-anterolateral wall...
December 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28983573/risk-of-intraocular-bleeding-and-the-new-anticoagulants-not-such-a-big-effect
#18
Richard Wormald, Jennifer Evans
No abstract text is available yet for this article.
October 5, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28983572/risk-of-intraocular-bleeding-and-the-new-anticoagulants-not-such-a-big-effect-reply
#19
Michelle T Sun, Christopher X Wong
No abstract text is available yet for this article.
October 5, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#20
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
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