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Older women with AF face higher stroke risk than men
Older women with AF face higher stroke risk than men In a study that examined use of the anticoagulant medication warfarin and risk of stroke in older patients following a diagnosis of atrial fibrillation, women, especially those ages 75 and older, had a higher risk of stroke than men, regardless of their risk profile and use of warfarin.
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Venous thromboembolism: EINSTEIN transforms anticoagulant therapy in acute PE
A report by the EINSTEIN-PE investigators, which was presented at the ACC Scientific Sessions in March 2012 and published simultaneously in the New England Journal of Medicine, represents a potential tectonic shift in the care of patients with acute pulmonary embolism (PE). The study gives solid evidence for the efficacy and safety of rivaroxaban, which is an oral alternative to subcutaneous injection of heparins followed by oral administration of coumarins such as warfarin.
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Aspirin and Warfarin Equally Effective for Most Heart Failure Patients, Study Suggests
Neither aspirin nor warfarin is superior for preventing a combined risk of death, stroke, and cerebral hemorrhage in heart failure patients with normal heart rhythm, according to a landmark clinical trial published in the May 3, 2012, New England Journal of Medicine.
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Warfarin May Be OK for Heart Device Implantation
Continuing oral anticoagulation when undergoing implantation of a cardiac device appears to minimize the bleeding risk compared with a heparin bridging strategy, a meta-analysis showed.
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Outpatient Surgery Patients also at Risk
Hospitalised patients are often warned of the possibility of venous thromboembolism, which include blood clots that can form in the veins and travel to the lungs. However these warnings have not necessarily been extended to the outpatient surgery population, says Doctor Christopher J. Pannucci.
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CHA2DS2-VASc score gives best prediction of stroke risk in AF
Another study has suggested that the newer CHA2DS2-VASc score may be more suitable than the CHADS2 score for assessing risk of stroke and thromboembolic events in AF patients, particularly in those at lower risk.
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Single scan could safely rule out pregnancy-related deep vein thrombosis
A single ultrasound scan (known as compression ultrasonography) may safely rule out a diagnosis of deep vein thrombosis (DVT) in women during pregnancy or in the first few weeks after giving birth (post-partum period), finds a study published in the British Medical Journal today.
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Additional heparin unnecessary for anticoagulated patients undergoing PCI
Additional heparin does not provide any benefit over uninterrupted therapeutic oral anticoagulation (OAC) for patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), Finnish researchers report.
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Once-daily oral anticoagulant receives positive Common Drug Review recommendation for stroke prevention in atrial fibrillation
The Canadian Agency for Drugs and Technologies in Health (CADTH) through the Common Drug Review (CDR), has positively recommended to Canada's provincial and other publicly funded drug plans that they reimburse the once-daily oral anticoagulant rivaroxaban for the prevention of stroke and systemic embolism in patients with non-valvular AF, in whom warfarin is indicated, and who meet all of the following criteria: are unable to achieve adequate anticoagulation with warfarin and have a CHADS2 score of = 2.
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Women don't receive the same treatment as men for heart disease the world-over
Women with acute coronary syndrome∗ (ACS) receive inferior or less aggressive treatment compared to men, according to three large studies presented at the World Congress of Cardiology
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Under-Treated Heart Condition That Causes a 500 Percent Increase in the Risk of Stroke Unites Medical and Patient Communities
In a global call to action, 68 patient organisations and medical societies from around the world are asking the general public, healthcare professionals and policy makers to work with them to drive action that will prevent serious and devastating AF-related strokes. People are being encouraged to show their support by visiting the campaign website, www.signagainststroke.com, and signing the Charter.
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Real-World Experience Reaffirms Bayer’s Rivaroxaban as Effective in Protecting Patients Against Venous Blood Clots
The international, non-interventional open-label cohort XAMOS [...] study examined the safety and efficacy of rivaroxaban in preventing potentially dangerous venous blood clots (venous thromboembolism or VTE) in adult patients following elective total hip or knee replacement surgery by comparison to injectable enoxaparin. The results support the clinical findings of RECORD – the world’s largest trial programme assessing oral anticoagulation in the orthopaedic surgery clinical setting, which showed rivaroxaban to have consistently superior efficacy as well as a comparable safety profile to enoxaparin.
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AF patients admitted to the hospital on weekends have worse outcomes
Atrial-fibrillation patients admitted on the weekend tend to stay in the hospital longer, are less likely to undergo cardioversion, and are more likely to die in the hospital than similar patients admitted during the week, a new study shows.
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Bayer's [...] Rivaroxaban Submitted for EU Marketing Authorisation for the Treatment of Pulmonary Embolism (PE) and Prevention of Recurrent Deep Vein Thrombosis (DVT) and PE
"In the EINSTEIN-PE study we demonstrated that rivaroxaban is the first oral single-drug solution for the initial treatment of PE and long-term prevention of recurrent venous thromboembolism," said Dr Kemal Malik, Member of the Bayer HealthCare Executive Committee and Head of Global Development.
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Cost-Effectiveness of Rivaroxaban in the Prevention of Venous Thromboembolism: A Canadian Analysis using the Ontario Ministry of Health Perspective
When comparing equal durations of therapy, rivaroxaban dominated enoxaparin in the prevention of VTE events in patients undergoing THR and TKR, providing more benefit at a lower cost. Rivaroxaban was cost-effective when comparing 35 days’ prophylaxis with 14 days’ prophylaxis with enoxaparin following THR.
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Infection May Be Trigger for Venous Thromboembolism
Older adults recovering from an infection are at increased risk of being hospitalized for a venous thromboembolism, according to a study published online April 3 in Circulation.
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Elderly Stroke Patients Have High Atrial Fibrillation Prevalence
Nearly half of elderly patients who have an ischemic stroke also have atrial fibrillation, based on a review of 527 stroke patients aged 75 or older.
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New analysis extends dabigatran MI signal to other thrombin inhibitors
A new meta-analysis of trials of oral direct thrombin inhibitors—which included two studies of the new anticoagulant dabigatran and three studies of an older, discontinued drug, ximelagatran —shows an increased rate of MI in those receiving these agents as compared with warfarin.
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One-a-day heart pill to stave off stroke is given the green light
The first once-a-day anti-clotting drug for patients with an irregular heartbeat has been given the green light for use on the NHS. Rivaroxaban works as well as warfarin, a treatment based on rat poison which has been used since the 1950s, but with fewer side effects.
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EINSTEIN PE: Rivaroxaban equals standard therapy, halves major bleeding
The new oral anticoagulantrivaroxaban is at least as effective as the standard therapy of injected low-molecular-weight heparin (LMWH) followed bywarfarin for the treatment of pulmonary embolism (PE), according to the results of theEINSTEIN PE study reported today at the American College of Cardiology 2012 Scientific Sessions and simultaneously published online in the New England Journal of Medicine.
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Dual, triple antiplatelet regimens equal for prevention of blood clots after angioplasty
Adding cilostazol to a dual antiplatelet regimen of aspirin and clopidogrel appears to be as safe and effective as double-dose dual antiplatelet therapy alone for the prevention of blood clots after angioplasty.
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Latest Canadian AF guidelines encourage new oral anticoagulants
The Canadian Cardiovascular Society has updated its guidelines on atrial fibrillation to reflect some major new findings that have been reported during the past year.
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Renal patients with ACS don't benefit from antiplatelets
Chronic kidney disease (CKD) patients with acute coronary syndrome (ACS) do not appear to benefit from the use of antiplatelet agents for secondary prevention and may, in fact, be harmed by these drugs, according to a new meta-analysis of almost 10 000 patients.
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Radiology: Additional MR sequences improve pulmonary embolism detection
Adding two MRI sequences to a common MR pulmonary angiogram (MRPA) significantly improves detection of pulmonary embolism and could provide an alternative to CT angiography (CTA) for diagnosis, according to a study published in the April issue of Radiology.
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Prolonged Versus Standard Duration Venous Thromboprophylaxis in Major Orthopedic Surgery
Prolonged prophylaxis decreases the risk for venous thromboembolism, PE, and DVT while increasing the risk for minor bleeding in patients undergoing total hip replacement.
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Oral Direct Factor Xa Inhibitors Versus Low-Molecular-Weight Heparin to Prevent Venous Thromboembolism in Patients Undergoing Total Hip or Knee Replacement
Compared with LMWH, lower doses of oral factor Xa inhibitors can achieve a small absolute risk reduction in symptomatic deep venous thrombosis without increasing bleeding.
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A randomised assessment of the pharmacokinetic, pharmacodynamic and safety interaction between apixaban and enoxaparin in healthy subjects.
Enoxaparin had no effect on the pharmacokinetics of apixaban. The increase in anti-Xa activity after co-administration was modest and appeared to be additive.
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Atrial Fibrillation, Stroke Risks Rise in Rheumatoid Arthritis
Rheumatoid arthritis patients had a 40% increased risk of atrial fibrillation and a 30% increased risk of stroke compared to the general population, based on data from a national cohort study in Denmark.
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Rivaroxaban compared with warfarin in patients with atrial fibrillation and previous stroke or transient ischaemic attack: a subgroup analysis of ROCKET AF
There was no evidence that the relative efficacy and safety of rivaroxaban compared with warfarin was different between patients who had a previous stroke or TIA and those who had no previous stroke or TIA. These results support the use of rivaroxaban as an alternative to warfarin for prevention of recurrent as well as initial stroke in patients with AF.
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In Suspected PE, A-fib Doesn't Raise Odds of the Diagnosis
In general, the presence of atrial fibrillation does not increase the likelihood of pulmonary embolism, according to a study published in the March issue of the Journal of Thrombosis and Haemostasis.
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Evaluation of the Prothrombin Time for Measuring Rivaroxaban Plasma Concentrations Using Calibrators and Controls
This study evaluated the prothrombin time (PT) assay for the measurement of plasma concentrations of rivaroxaban using calibrators and controls. The intra- and interlaboratory precision of the measurement was investigated in a field trial involving 21 laboratories.
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Stroke: Dabigatran cost-effective in AF patients with prior stroke, TIA
Dabigatran appears to be a cost-effective treatment for preventing stroke in atrial fibrillation (AF) patients who had a prior stroke or transient ischemic attack (TIA) when compared with warfarin, according to an analysis in the March issue of Stroke. But dabigatran loses that economic edge in institutions with superior warfarin management.
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CT/CTA predicted recurrent stroke in patients with TIA, minor stroke
In patients with transient ischemic attack and minor stroke, use of CT/CTA in an early assessment of the intracranial and extracranial vasculature predicted recurrent stroke, according to recent study results.
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Antibiotics ‘double bleeding risk’ in warfarin patients
A nested-case control study of 38,762 warfarin users aged 65 years or older found the risk of being admitted to hospital for bleeding increased two-fold (odds ratio 2.01) if the patient had been exposed to an antibiotic within the previous 15 days.
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Guidance Ignored on Warfarin in Non-STEMI
Guidelines for managing patients who are already taking warfarin when they present with a non-ST-segment elevation myocardial infarction (non-STEMI) -- which lack backing from evidence -- are not followed closely in practice, researchers found.
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More hope for factor Xa reversal
Another study has suggested that the anticoagulant effects of the new factor Xa inhibitors could be reversed by several hemostatic agents currently used to control excessive bleeding in other situations, such as with warfarin overdose.
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Warfarin, Aspirin Similar in Preventing Deaths, Strokes
Warfarin and Aspirin were similar in preventing the deaths and strokes in heart failure patients with normal heart rhythm, according to a new study.
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Rivaroxaban Tied to Lower Brain Bleed Risk in A-Fib
A once daily oral dose of rivaroxaban significantly lowers the risk of intracranial hemorrhage in patients with atrial fibrillation at moderate to high risk of stroke, according to a study presented at the American Heart Association's International Stroke Conference, held from Feb. 1 to 3 in New Orleans.
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Apixaban more effective than aspirin in reducing stroke recurrence
The oral factor Xa inhibitor apixaban was more effective than aspirin in reducing the risks for stroke and systemic embolism in patients with atrial fibrillation who have already experienced a stroke or transient ischemic attack and are unsuitable for warfarin therapy.
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Decision Support Tools Help Optimize Acute PE Detection
Implementing evidence-based clinical decision support significantly improves the efficiency of computed tomographic angiography use to detect acute pulmonary embolism for patients presenting to an emergency department, according to a study published in the February issue of Radiology.
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ACE Inhibitors Not Linked to Improved Outcomes After ACS
For patients with acute coronary syndrome, prior chronic use of an angiotensin-converting enzyme inhibitor is not independently associated with improved in-hospital outcomes, according to a study published in the Feb. 1 issue of The American Journal of Cardiology.
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Rates of VTE after surgery vary by procedure type
Using current venous thromboembolism preventive medications, approximately 1 in every 100 patients undergoing knee replacement and 1 in every 200 patients undergoing hip replacement will develop a VTE before hospital discharge, according to a review and analysis of previous studies.
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Warfarin Patients With Head Trauma Need Second CT Scan
For patients on warfarin with minor head trauma who have an initial negative computed tomography (CT) scan, 24-hour observation followed by an additional CT scan identifies the majority of cases of delayed bleeding, according to a study published online Jan. 16 in the Annals of Emergency Medicine.
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New AF ablation consensus doc previewed at Boston AF symposium
The forthcoming international consensus statement on atrial fibrillation (AF) includes a new set of standardized definitions, indications classed by evidence-level, and more information about anticoagulant therapy, among other improvements to the first AF ablation consensus released in 2007.
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Dabigatran Tied to Increase in Heart Attack Risk
The direct thrombin inhibitor dabigatran appears to raise the risk of myocardial infarction or acute coronary syndromes, according to a meta-analysis of seven randomized clinical trials published online Jan. 9 in the Archives of Internal Medicine.
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Fondaparinux Reduces Events From Superficial Vein Thromboses
In patients with spontaneous, isolated superficial vein thrombosis, a 45-day course of fondaparinux significantly reduced the rate of systemic thromboembolic complications compared with placebo, including events linked to thrombi with extensions more than 3 cm from the saphenofemoral junction, according to results of a post hoc analysis from the CALISTO trial.
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Risk for very late stent thrombosis, late TLR rose steadily up to 5 years after stenting
After implantation of sirolimus-eluting stents, the risk for very late stent thrombosis and late target lesion revascularization remained steady up to 5 years, according to study data from the j-Cypher Registry.
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Rivaroxaban approved in Europe for AF and DVT treatment
The factor Xa oral anticoagulant rivaroxaban (Xarelto, Bayer/Johnson & Johnson) has been approved in the European Union for the prevention of nonvalvular AF-related stroke and systemic embolism and for the treatment of deep venous thrombosis (DVT).
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Malaysia the first Asian country to use stroke medication
KUALA LUMPUR: Malaysia has approved the use of rivaroxaban, a once-daily oral anticoagulant for reduction of stroke-risk in patients with sustained irregular heart rhythm.
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ASH: Rivaroxaban Better in Practice than Expected
The anticoagulant drug rivaroxaban (Xarelto) has turned out better in everyday clinical practice for preventing venous thromboembolism (VTE) in surgery patients than expected from the drug's registration studies, a German researcher said here.
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ASH: Catheter-Directed Thrombolysis Cuts DVT Risks
For patients with deep vein thrombosis, additional catheter-directed thrombolysis reduces the frequency of post-thrombotic syndrome and improves iliofemoral patency, according to a study published online Dec. 13 in The Lancet.
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Warfasa: Aspirin associated with 40% reduced risk for unprovoked VTE recurrence
Aspirin, when administered 6 to 12 months after anticoagulant therapy, was associated with a significant reduced risk for recurrence of unprovoked venous thromboembolism, according to results from the Warfasa study.
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Blood clot risk halved for patients checking own warfarin dose
Patients who monitor their own treatment with warfarin or other blood-thinning drugs reduce their risk of developing blood clots by half, an Oxford University study has found.
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NEJM: Warfarin culprit for most hospitalizations in elderly; management may help
Warfarin, the most commonly prescribed and trickiest to manage anticoagulant, is the key culprit of hospitalizations for the elderly patient population, according to a study published Nov. 24 in the New England Journal of Medicine.
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Patients With Autoimmune Disorders Have Higher Risk Of Pulmonary Embolism
According to a report published Online First by The Lancet, individuals admitted to hospital for an autoimmune disorder have a significantly higher risk of experiencing a pulmonary embolism during the next 12 months.
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ELEVATE-TIMI 52: High-dose clopidogrel reduced platelet reactivity in CYP2C19*2 carriers
Higher doses of clopidogrel, up to 300 mg daily, were more effective than standard doses in patients with the CYP2C19 gene variant, according to late-breaking research from the ELEVATE-TIMI 56 trial.
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AHA: A-Fib in Sepsis Ups In-Hospital Stroke, Death Risk
Patients who develop new-onset atrial fibrillation during hospitalization for severe sepsis are at an increased risk of in-hospital stroke and mortality, according to a study published online Nov. 13 in the Journal of the American Medical Association.
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Thrombosis publications recommended by the Board of Advisers has been updated for September 2011
New Thrombosis publications available for October 2011.
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ATLAS ACS: Adding rivaroxaban to antiplatelet therapy reduced death rates in ACS
Rivaroxaban added to standard treatment reduced the risk for CV death, MI and stroke among patients with acute coronary syndrome.
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TRACER: Vorapaxar failed to reduce death, MI, stroke risks
When added to standard care in patients with non-ST-segment elevation acute coronary syndrome, the first-in-class PAR-1 agonist, vorapaxar, did not reduce CV death, MI or stroke. Conversely, the drug was associated with a significantly increased risk for bleeding, compared with placebo.
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ADOPT: Apixaban not superior to enoxaparin for thromboprophylaxis
Treatment with 30 days of low-dose apixaban was no more effective than a shorter course of enoxaparin for the prevention of venous thromboembolism, according to results of the ADOPT trial.
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NEW Survey of Atrial Fibrillation Patients Demonstrates Gaps in Awareness of Stroke Risk and Perceived Barriers Associated with Anticoagulation Therapy
While most patients affected by atrial fibrillation (AF) know what a blood clot is, more than one-quarter (27%) surveyed said they were not told by their doctor or other healthcare professional that they were at risk for blood clots that can lead to a stroke due to their irregular heartbeat, according to new survey results being unveiled by the National Blood Clot Alliance (NBCA) at the 2011 Scientific Sessions of the American Heart Association, in Orlando, FL, November 12 through 16.
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FDA approves rivaroxaban for stroke prevention in AF patients
Another oral anticoagulant will soon be available to US physicians treating patients with atrial fibrillation. Today, the US Food and Drug Administration approved rivaroxaban for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation, the agency has announced.
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Thrombosis publications recommended by the Board of Advisers has been updated for September 2011
New Thrombosis publications available for September 2011.
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Venous Thromboembolism Prophylaxis in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians
The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on prophylaxis of venous thromboembolism for hospitalized nonsurgical patients (medical patients and patients with acute stroke).
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Clinical and genetic risk factors associated with early stent thrombosis
Patients with certain genes or specific factors related to use of the anti-clotting drug clopidogrel are more likely to experience a blood clot within a coronary stent shortly after placement, according to a study in the October 26 issue of JAMA.
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Costly clots common in cancer
As many as 1 in 5 people risk developing a venous thromboembolism (VTE) within a year after undergoing treatment for some types of cancers, researchers reported at the 2011 European Multidisciplinary Cancer Congress, held in Stockholm, Sweden, September 23-27, 2011.
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