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https://www.readbyqxmd.com/read/28107569/use-of-higher-maximum-doses-and-infusion-rates-compared-with-those-used-in-standard-unfractionated-heparin-therapy-is-associated-with-adequate-anticoagulation-without-increased-bleeding-in-both-obese-and-nonobese-patients-with-cardiovascular-indications
#1
Catherine K Floroff, Nicole M Palm, Daniel H Steinberg, Eric R Powers, Barbara S Wiggins
STUDY OBJECTIVE: To evaluate the time to achieve therapeutic activated partial thromboplastin time (aPTT) values and occurrence of bleeding based on standard unfractionated heparin (UFH) weight-based dosing recommendations compared with an aggressive weight-based UFH dosing strategy using higher maximum doses and infusion rates in both obese and nonobese patients who presented with non-ST-Segment Elevation Myocardial Infarction or unstable angina (NSTEMI/UA) or atrial fibrillation. DESIGN: Retrospective cohort study...
January 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28107211/type-2-myocardial-infarction-incidence-presentation-treatment-and-outcome-in-routine-clinical-practice
#2
Dragana Radovanovic, Thomas Pilgrim, Burkhardt Seifert, Philip Urban, Giovanni Pedrazzini, Paul Erne
AIMS: The clinical definition and optimal treatment for myocardial infarction (MI) type 2 (T2MI) are not well established. We assessed differences in presentation, treatment and outcomes of patients with MI type 1 (T1MI) and T2MI. METHODS: The data of MI patients enrolled in the AMIS Plus cohort with T2MI were compared with T1MI using propensity score matching. RESULTS: A total of 13 829 patients had T1MI and 1091 (7.3%) T2MI. Patients with T2MI were older, often female, with more risk factors and comorbidities, and less ST segment elevation...
January 19, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28106922/recurrence-risk-of-venous-thromboembolism-and-hormone-use-in-women-from-england-a-cohort-study-using-clinical-practice-research-datalink
#3
Sylvia Kiconco, Alyshah Abdul Sultan, Matthew J Grainge
It is vital to identify people with low recurrence risk of venous thromboembolism (VTE) so as to protect them from dangers of prolonged anticoagulation therapy. Among women who develop VTE following hormone use, the evidence as to whether their risk of recurrence is low if they cease this therapy is conflicting. We investigated whether women whose initial VTE event was hormone-related have a lower risk of VTE recurrence than women whose initial event had no obvious cause (unprovoked). A cohort study utilising the Clinical Practice Research Datalink linked to Hospital Episode Statistics data from England was conducted...
January 20, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28106485/management-strategies-for-atrial-fibrillation
#4
Peysh A Patel, Noman Ali, Andrew Hogarth, Muzahir H Tayebjee
Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80 years. Despite multiple treatment options, it remains an independent prognostic marker of mortality due to its association with clinical sequelae, particularly cerebrovascular events. Management can be broadly divided into treatment of the arrhythmia, via rhythm or rate control, and stroke thromboprophylaxis via anticoagulation. Traditional options for pharmacotherapy include negatively chronotropic drugs such as β-blockers, and/or arrhythmia-modifying drugs such as amiodarone...
January 2017: Journal of the Royal Society of Medicine
https://www.readbyqxmd.com/read/28106147/prediction-of-very-late-arrhythmia-recurrence-after-radiofrequency-catheter-ablation-of-atrial-fibrillation-the-mb-later-clinical-score
#5
Nebojša Mujović, Milan Marinković, Nebojša Marković, Alena Shantsila, Gregory Y H Lip, Tatjana S Potpara
Reliable prediction of very late recurrence of atrial fibrillation (VLRAF) occuring >12 months after catheter ablation (CA) in apparently "cured" patients could optimize long-term follow-up and modify decision-making regarding the discontinuation of oral anticoagulant therapy. In a single-centre cohort of consecutive patients post radiofrequency AFCA, we retrospectively derived a novel score for VLRAF prediction. Of 133 consecutive post AFCA patients (mean age 56.9 ± 11.8 years, 63.9% male, 69.2% with paroxysmal AF) who were arrhythmia-free at 12 months (excluding 3-month "blanking period"), 20 patients expirienced a VLRAF during a 29...
January 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28106053/risk-of-gastrointestinal-bleeding-among-dabigatran-users-a-self-controlled-case-series-analysis
#6
Wenze Tang, Hsien-Yen Chang, Meijia Zhou, Sonal Singh
This article aims to evaluate the real world risk of gastrointestinal bleeding among users naïve to dabigatran. We adopted a self-controlled case series design. We sampled 1215 eligible adult participants who were continuous insured users between July 1, 2010 and March 31, 2012 with use of dabigatran and at least one gastrointestinal bleeding episode. We used a conditional Poisson regression to estimate incidence rate ratios. The population consisted of 64.69% of male and 60.25% patients equal to or greater than age 65 at start of observation...
January 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28106016/gender-related-differences-in-presentation-and-treatment-of-patients-with-non-valvular-atrial-fibrillation-results-from-ramses-study
#7
Volkan Doğan, Özcan Başaran, Osman Beton, Mehmet Tekinalp, Ahmet Çağrı Aykan, Ezgi Kalaycıoğlu, İsmail Bolat, Onur Taşar, Özgen Şafak, Macit Kalçık, Cevat Kırma, Murat Biteker
OBJECTIVE: Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey. METHODS: As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multicenter, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28106001/impact-of-femoral-artery-puncture-using-digital-subtraction-angiography-and-road-mapping-on-vascular-and-bleeding-complications-after-transfemoral-transcatheter-aortic-valve-implantation
#8
Mohamed El-Mawardy, Bettina Schwarz, Martin Landt, Dmitriy Sulimov, Julia Kebernik, Abdelhakim Allali, Bjoern Becker, Ralph Toelg, Gert Richardt, Mohamed Abdel-Wahab
AIMS: The use of large-diameter sheaths carries the risk of significant vascular and bleeding complications after transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to assess the impact of a modified femoral artery puncture technique using digital subtraction angiography (DSA) and road mapping during transfemoral TAVI on periprocedural vascular and bleeding events. METHODS AND RESULTS: This is a retrospective analysis of transfemoral TAVI patients included in a prospective institutional database...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105561/the-rise-and-fall-of-anticoagulation-with-bivalirudin-during-percutaneous-coronary-interventions-a-review-article
#9
REVIEW
Constantinos Andreou, Christos Maniotis, Michael Koutouzis
Bivalirudin is a direct thrombin inhibitor used during percutaneous coronary intervention (PCI). Treatment with bivalirudin compared to heparin plus glycoprotein IIb/IIIa inhibitors (GPI) reduced bleeding complications, but resulted in higher rates of ischemic events, including acute stent thrombosis in ST segment elevation myocardial infarction (STEMI) patients. Thus, it may be considered a reasonable alternative antithrombotic agent in patients at high risk of bleeding undergoing PCI. However its superiority over heparin alone is questioned particularly in the era of novel antiplatelet agents and transradial PCI...
January 19, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28105087/long-term-prognostic-analysis-of-early-interventional-therapy-for-lower-extremity-deep-venous-thrombosis
#10
Qiang Li, Zongxue Yu, Jinjun Wang, Xiao Chen, Lin Li
The aim of the present study was to observe the long-term prognostic value of early interventional therapy for lower extremity deep venous thrombosis (LDVT). In total, 85 patients diagnosed with LDVT for the first time were consecutively selected (identified course of disease was <3 months), and were divided into the control group with 43 cases and the observation group with 42 cases according to different therapeutic methods. The control group received anticoagulation therapy and thrombolysis, or integrated surgical thrombectomy, a conventional open operation, while the observation group received comprehensive treatment, combining endovascular catheter-directed thrombolysis and thrombectomy...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28104608/prothrombin-loading-of-vascular-smooth-muscle-cell-derived-exosomes-regulates-coagulation-and-calcification
#11
Alexander N Kapustin, Michael Schoppet, Leon J Schurgers, Joanne L Reynolds, Rosamund McNair, Alexander Heiss, Willi Jahnen-Dechent, Tilman M Hackeng, Georg Schlieper, Paul Harrison, Catherine M Shanahan
OBJECTIVE: The drug warfarin blocks carboxylation of vitamin K-dependent proteins and acts as an anticoagulant and an accelerant of vascular calcification. The calcification inhibitor MGP (matrix Gla [carboxyglutamic acid] protein), produced by vascular smooth muscle cells (VSMCs), is a key target of warfarin action in promoting calcification; however, it remains unclear whether proteins in the coagulation cascade also play a role in calcification. APPROACH AND RESULTS: Vascular calcification is initiated by exosomes, and proteomic analysis revealed that VSMC exosomes are loaded with Gla-containing coagulation factors: IX and X, PT (prothrombin), and proteins C and S...
January 19, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28104479/benefits-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-go-beyond-stroke-prevention
#12
EDITORIAL
Jay A Montgomery, Gregory F Michaud
No abstract text is available yet for this article.
January 16, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28103946/epcr-promotes-breast-cancer-progression-by-altering-spock1-testican-1-mediated-3d-growth
#13
Naiara Perurena, Carolina Zandueta, Susana Martínez-Canarias, Haritz Moreno, Silvestre Vicent, Ana S Almeida, Elisabet Guruceaga, Roger R Gomis, Marta Santisteban, Mikala Egeblad, José Hermida, Fernando Lecanda
BACKGROUND: Activated protein C/endothelial protein C receptor (APC/EPCR) axis is physiologically involved in anticoagulant and cytoprotective activities in endothelial cells. Emerging evidence indicates that EPCR also plays a role in breast stemness and human tumorigenesis. Yet, its contribution to breast cancer progression and metastasis has not been elucidated. METHODS: Transcriptomic status of EPCR was examined in a cohort of 286 breast cancer patients. Cell growth kinetics was evaluated in control and EPCR and SPARC/osteonectin, Cwcv, and kazal-like domains proteoglycan (SPOCK1/testican 1) silenced breast cancer cells in 2D, 3D, and in co-culture conditions...
January 19, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28103532/timing-of-anticoagulant-re-initiation-following-intracerebral-hemorrhage-in-mechanical-heart-valves-survey-of-neurosurgeons-and-thrombosis-experts
#14
Fahad AlKherayf, Yan Xu, Harrison Westwick, Ioana Doina Moldovan, Philip S Wells
BACKGROUND: While oral anticoagulation (OAC) is universally indicated for patients with mechanical heart valves (MHVs), OAC resumption following anticoagulant-associated intracerebral hemorrhage (ICH) is an area of uncertainty. We sought to determine the practice preferences of North American neurosurgeons and thrombosis experts on optimal timing of OAC re-initiation. METHODS: A cross-sectional survey was disseminated to North American members of the American Association of Neurological Surgeons and the International Society for Thrombosis and Haemostasis...
January 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28102879/the-conservative-and-pharmacological-management-of-chronic-subdural-haematoma
#15
Jehuda Soleman, Fabio Noccera, Luigi Mariani
Chronic subdural haematoma (cSDH), one of the most common neurosurgical entities, occurs typically in elderly patients. The incidence is expected to double by the year 2030, owing to the continuous aging of the population. Surgery is usually the treatment of choice, but conservative treatment may be a good alternative in some situations. We provide a systematic review of studies analysing the conservative treatment options and the natural history of cSDH. Of 231 articles screened, 35 were included in this systematic review...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28102773/the-optimal-duration-of-anticoagulant-therapy-after-unprovoked-venous-thromboembolism-still-a-challenging-issue
#16
Giovanna Elmi, Giuseppe Di Pasquale, Raffaele Pesavento
As about 50 % of patients with unprovoked venous thromboembolism (VTE) will develop new episodes after discontinuing therapy, indefinite treatment is suggested in patients with low or moderate bleeding risk. Baseline and post-baseline factors can help clinicians to identify patients at high risk of recurrence, who require extended treatment. Residual vein obstruction and D-dimer assay have been shown to be suitable methods for assessing the risk of VTE recurrences after a first unprovoked VTE. In treatment for VTE the use of direct oral anticoagulants (DOAC) is growing instead of the standard adjusted dose of vitamin K antagonists...
January 19, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28102426/improved-anticoagulant-effect-of-fucosylated-chondroitin-sulfate-orally-administered-as-gastro-resistant-tablets
#17
Roberto J C Fonseca, Isabela D Sucupira, Stephan Nicollas M C G Oliveira, Gustavo R Santos, Paulo A S Mourão
Fucosylated chondroitin sulfate (FucCS) is a potent anticoagulant polysaccharide extracted from sea cucumber. Its anticoagulant activity is attributed to the presence of unique branches of sulfated fucose. Although this glycosaminoglycan exerts an antithrombotic effect following oral administration, high doses are necessary to achieve the maximum effect. The diminished activity of FucCS following oral administration is likely due to its degradation in the gastrointestinal tract and its limited ability to cross the intestinal cell membranes...
January 19, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28100898/new-oral-anticoagulants-turkey-noac-turk-multicenter-cross-sectional-study
#18
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
OBJECTIVE: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed. METHODS: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study...
January 17, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28100834/soft-robotic-sleeve-supports-heart-function
#19
Ellen T Roche, Markus A Horvath, Isaac Wamala, Ali Alazmani, Sang-Eun Song, William Whyte, Zurab Machaidze, Christopher J Payne, James C Weaver, Gregory Fishbein, Joseph Kuebler, Nikolay V Vasilyev, David J Mooney, Frank A Pigula, Conor J Walsh
There is much interest in form-fitting, low-modulus, implantable devices or soft robots that can mimic or assist in complex biological functions such as the contraction of heart muscle. We present a soft robotic sleeve that is implanted around the heart and actively compresses and twists to act as a cardiac ventricular assist device. The sleeve does not contact blood, obviating the need for anticoagulation therapy or blood thinners, and reduces complications with current ventricular assist devices, such as clotting and infection...
January 18, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28100362/-severe-obstructive-sleep-apnea-hypopnea-syndrome-with-dilated-cardiomyopathy-leading-to-pulmonary-hypertension-case-report-and-literature-review
#20
R K Chen, C Hong, Y M Zhou, A L Kuang, Y T Zhang, S M Qing, C L Liu, N F Zhang
Objective: To study the relationship between dilated cardiomyopathy and obstructive sleep apnea-hypopnea syndrome (OSAHS) and to evaluate the curative effects of continuous positive airway pressure (CPAP) in OSAHS complicated with dilated cardiomyopathy. Methods: We reported one case with the symptom of exertional dyspnea for 1 year and aggravating for 1 month. The patient finally was diagnosed with severe OSAHS complicated with dilated cardiomyopathy leading to pulmonary hypertension. A systematic literature review was performed for similar published cases in Pubmed, Wanfang and CNKI database, using the keywords (obstructive sleep apnea) OR(OSA) OR(OSAHS) AND(dilated cardiomyopathy OR DCM)from January 1990 to May 2016...
January 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
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