Alex is a candidate for non-vitamin K antagonist oral anticoagulant (NOAC) treatment, his renal function was tested to check whether he would require dose reduction and, while his estimated glomerular filtration rate indicates mild renal impairment, it might not be considered severe enough to substantially worsen his prognosis or require special management.
Like many meetings planned for 2020, this year’s European Society of Cardiology (ESC) congress moved online. Although it was not possible for delegates to meet in person in Amsterdam, the sessions were still able to provide participants with the new data, expert discussion and clinical guidelines that they have come to expect. What’s more, this edition of the ESC congress was the largest ever, with over 100,000 people taking part from around the world.
Cameron, aged 42 years, is a former smoker who maintains an active lifestyle. He recently presented with another deep vein thrombosis (DVT) and was admitted to hospital. He had a DVT 3 years ago and was treated with a vitamin K antagonist for 6 months, after which he discontinued therapy, and he was advised to stop smoking. Cameron’s preference is to be treated with a once-daily regimen that avoids injections. His doctor was confident in prescribing rivaroxaban given the evidence available for effective clot resolution within 21 days. He received rivaroxaban for 6 months and is now at clinical equipoise for continued anticoagulation.
Anne is a 68-year-old retired nurse with two grown-up sons. She enjoys walking her dog in the local park and playing with her three young grandchildren. Five years ago, Anne was diagnosed with type II diabetes and has been taking metformin to control her blood sugar level. After complaining of shortness of breath and palpitations, Anne was referred for an electrocardiogram and was subsequently diagnosed with atrial fibrillation (AF).
The coronavirus outbreak is changing the way we all live our lives. As healthcare practioners, you can help your patients on anticoagulation therapy to cope and adapt. Together with “PatientConsult” we are providing an e-Checklist to support the clinical dialogue between you and your patients for initiating and maintaining anticoagulation therapy during the COVID-19 pandemic.
Acute PE is a feared clinical presentation of VTE and is a frequent cause of cardiovascular mortality worldwide. However, PE is characterized by a wide spectrum of severity and there are many benefits to adopting the appropriate management strategy for patients depending on risk.
Having better kidney function is associated with improved outcomes in patients with atrial fibrillation (AF). Indeed, kidney impairment is associated with an increased risk of stroke and embolic events, bleeding and death in patients with non-valvular AF (NVAF), emphasizing the importance of preserving kidney function to avoid adverse outcomes.
Previously, there was often clinical uncertainty on the use of oral anticoagulants to treat cancer-associated thrombosis (CAT). However, in 2019, several guidelines were brought up to date with clinical evidence and now provide clear advice on protecting patients with cancer from venous thromboembolism (VTE).
Every patient is different. But patients also change.
For patients who need anticoagulation, the choice of anticoagulant regimen should only be taken once the entire clinical situation has been considered.
Patients with these co-morbidities often have an increased risk of stroke compared with patients who only have AF, so it is important that their risk of cardiovascular (CV) events is well managed. However, as every patient with AF is different, expertise to see the bigger picture is required to ensure that patients get the right dose at the right time for the right reason.
Nearly 300 delegates from around the world gathered in Barcelona, Spain, to attend European Society of Cardiology (ESC) Heart & Stroke, the international conference of the ESC Council on Stroke. An engaging programme provided an opportunity for the attending experts of various disciplines – including cardiologists, neurologists, vascular surgeons and interventional neuroradiologists – to discuss a multidisciplinary approach to stroke prevention and treatment.
This year marked a significant milestone in the rapidly evolving therapeutic landscape for venous thromboembolism (VTE). In late August, the much-anticipated updated guidelines for the diagnosis and management of acute pulmonary embolism (PE) were presented at the European Society of Cardiology (ESC) congress. These updates show a strengthening of the recommendations around duration of therapy, the choice of dose, early discharge and home management, and the treatment of patients with cancer and acknowledge the robustness of a wealth of new data from clinical trials.
The focus on careful management of patients with atrial fibrillation (AF) and co-morbidities, such as renal impairment and diabetes, has recently intensified. 2019 has seen an accumulation of real-world data on the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with AF who also have renal impairment and/or diabetes, as well as data on the effect of NOACs on preserving renal function in these patients. These data have been published and/or presented at various congresses throughout the year.