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Stroke Anticoagulation and Prophylaxis

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What's new in VTE risk and prevention in orthopedic surgery.

Susan R Kahn, Sudeep Shivakumar,

A State of the Art lecture titled "What's New in VTE Risk and Prevention in Orthopedic Surgery" was presented at the ISTH congress in 2019. Patients undergoing orthopedic surgery have long been recognized to be at increased risk of venous thromboembolism (VTE) and were among the first patient groups to ... Read more >>

Res Pract Thromb Haemost (Research and practice in thrombosis and haemostasis)
[2020, 4(3):366-376]

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Evaluation of unmet clinical needs in prophylaxis and treatment of venous thromboembolism in at-risk patient groups: pregnancy, elderly and obese patients.

Benjamin Brenner, Roopen Arya, Jan Beyer-Westendorf, James Douketis, Russell Hull, Ismail Elalamy, Davide Imberti, Zhenguo Zhai,

Background:Venous thromboembolism (VTE) accounts for an estimated 900,000 cases per year in the US alone and constitutes a considerable burden on healthcare systems across the globe. Objective:To understand why the burden is so high, qualitative and quantitative research was carried out to gain insights from experts, guidelines and published studies ... Read more >>

Thromb J (Thrombosis journal)
[2019, 17:24]

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Impact of adherence to key performance indicators on mortality among patients managed for ischemic stroke.

Mustapha Mohammed, Hadzliana Zainal, Balamurugan Tangiisuran, Sabariah N. Harun, Siti M. Ghadzi, Irene Looi, Norsima N. Sidek, Keng L. Yee, Zariah A. Aziz,

Background:Stroke is a leading cause of death worldwide. The cases of acute ischemic stroke are on the increase in the Asia Pacific, particularly in Malaysia. Various health organizations have recommended guidelines for managing ischemic stroke, but adherence to key performance indicators (KPI) from the guidelines and impact on patient outcomes, ... Read more >>

Pharm Pract (Granada) (Pharmacy Practice)
[2020, 18(1):]

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Reasons for discontinuation of novel oral anticoagulant therapy in patients with atrial fibrillation.

Darko Mitrovic, Richard Folkeringa, Nic Veeger, Eric van Roon,

Aims: We sought to investigate the reasons for, and rates of, novel oral anticoagulant (DOAC) therapy discontinuation.Methods: This was an observational cohort study of patients with atrial fibrillation (AF) referred to a regional DOAC outpatient clinic between February 2013 and October 2017. The study population consisted of 875 consecutive patients ... Read more >>

Curr Med Res Opin (Current medical research and opinion)
[2020, :1-7]

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Risk profiling in patients undergoing penile prosthesis implantation.

Linda M Huynh, Mohamad M Osman, Faysal A Yafi,

Penile prosthesis implantation is the gold standard of surgical therapy for patients with medication-refractory erectile dysfunction. However, this umbrella definition includes significant heterogeneity and associated risk profiles that should be candidly discussed and addressed perioperatively. Factors associated with operative success and patient satisfaction are often surgery specific; however, risk profiling ... Read more >>

Asian J. Androl. (Asian journal of andrology)
[2020, 22(1):8-14]

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Peripheral Embolization of Left Ventricular Thrombus Leading to Acute Bilateral Critical Limb Ischemia: A Rare Phenomenon.

Khushboo K. Agarwal, Steven Douedi, Abbas Alshami, Brook DeJene, Robert G. Kayser,

Left ventricular thrombus (LVT) is a well-known complication of myocardial infarction (MI) leading to significant morbidity and mortality. LVT can also lead to systemic thromboembolic events causing threatening limb ischemia. We report a rare case of critical bilateral limb ischemia that resulted from peripheral embolization of LVT post MI, which ... Read more >>

Cardiol Res (Cardiology Research)
[2020, 11(2):134-137]

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Periodontitis and cardiovascular diseases: Consensus report.

Mariano Sanz, Alvaro Marco Del Castillo, Søren Jepsen, Jose R Gonzalez-Juanatey, Francesco D'Aiuto, Philippe Bouchard, Iain Chapple, Thomas Dietrich, Israel Gotsman, Filippo Graziani, David Herrera, Bruno Loos, Phoebus Madianos, Jean-Baptiste Michel, Pablo Perel, Burkert Pieske, Lior Shapira, Michael Shechter, Maurizio Tonetti, Charalambos Vlachopoulos, Gernot Wimmer,

BACKGROUND:In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of ... Read more >>

J. Clin. Periodontol. (Journal of clinical periodontology)
[2020, 47(3):268-288]

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Direct Oral Anticoagulants in the Prevention of Venous Thromboembolism Following Surgery for Hip Fracture in Older Adults: A Population-Based Cohort Study.

En Lin Goh, Pratha Kumari Gurung, Shaocheng Ma, Timothy Pilpel, James Henderson Dale, Angela Kannan, Sambandam Anand,

Introduction:Direct oral anticoagulants (DOACs) decrease the risk of venous thromboembolism (VTE) without increasing the risk of hemorrhage in elective lower limb orthopedic surgery. However, the role of DOACs in preventing VTE following hip fracture surgery in the older adults remains unclear. This study aims to evaluate the efficacy and safety ... Read more >>

Geriatr Orthop Surg Rehabil (Geriatric orthopaedic surgery & rehabilitation)
[2020, 11:2151459319897520]

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Secondary stroke prophylaxis in atrial fibrillation patients with chronic kidney disease: a nationwide cohort study.

Mathias Aagaard Christensen, Emil Loldrup Fosbøl, Anders Nissen Bonde, Jonas Bjerring Olesen, Gunnar H Gislason, Christian Torp-Pedersen, Anna Gundlund,

AIMS:Oral anticoagulation (OAC) therapy as secondary stroke prophylaxis in atrial fibrillation (AF) patients with chronic kidney disease (CKD) remains unexplored and poses a clinical treatment dilemma. We assessed the long-term risk of thromboembolic events according to post-stroke OAC therapy in AF patients with CKD after their first ischaemic stroke. METHODS ... Read more >>

Europace (Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology)
[2019, :]

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Characteristics of Symptomatic Pulmonary Thromboembolism among Postoperative and Hospitalized Patients.

Naoto Yamamoto, Naoki Unno, Kazunori Inuzuka, Masaki Sano, Takaaki Saito, Ryota Sugisawa, Kazuto Katahashi, Tatsuro Yata, Takafumi Kayama, Yuta Yamanaka,

Backgrounds: Pulmonary thromboembolism (PTE) is severe complication which may arise during all medical service. The purpose of this study is to evaluate inpatient symptomatic PTE. Materials and Methods: From 2005 to 2016, we experienced 75 symptomatic PTE patients among 600 venous thromboembolism patients. According to the place of occurrence, patients ... Read more >>

Ann Vasc Dis (Annals of vascular diseases)
[2019, 12(4):480-486]

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Is there a role for low-dose DOACs as prophylaxis?

Alexander T Cohen, Beverley J Hunt,

The direct oral anticoagulants (DOACs) have transformed the management of thrombotic disorders. Large clinical trials have demonstrated that DOACs can replace vitamin K antagonists (VKAs) in the 2 existing major indications for anticoagulation: the prevention of stroke in atrial fibrillation and the acute treatment and secondary prevention of venous thromboembolism ... Read more >>

Hematology Am Soc Hematol Educ Program (Hematology. American Society of Hematology. Education Program)
[2019, 2019(1):187-193]

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Stroke Prophylaxis in Patients with Atrial Fibrillation and End-Stage Renal Disease.

Martin van Zyl, Hafez M Abdullah, Peter A Noseworthy, Konstantinos C Siontis,

Atrial fibrillation (AF) is an important comorbidity in patients with end-stage renal disease (ESRD) undergoing dialysis that portends increased health care utilization, morbidity, and mortality in this already high-risk population. Patients with ESRD have a particularly high stroke risk, which is further compounded by AF. However, the role of anticoagulation ... Read more >>

J Clin Med (Journal of clinical medicine)
[2020, 9(1):]

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Age-Related Differences in the Clinical Characteristics and Treatment of Elderly Patients With Atrial Fibrillation in Japan - Insight From the ANAFIE (All Nippon AF In Elderly) Registry.

Ken-Ichi Hiasa, Hidetaka Kaku, Hiroshi Inoue, Takeshi Yamashita, Masaharu Akao, Hirotsugu Atarashi, Yukihiro Koretsune, Ken Okumura, Wataru Shimizu, Takanori Ikeda, Kazunori Toyoda, Atsushi Hirayama, Masahiro Yasaka, Takenori Yamaguchi, Satoshi Teramukai, Tetsuya Kimura, Jumpei Kaburagi, Atsushi Takita, Hiroyuki Tsutsui,

BACKGROUND:Atrial fibrillation (AF) is increasing as the global population ages. Elderly AF patients (≥75 years) have a worse prognosis than younger patients, and effective management is often difficult due to multiple comorbidities. This analysis examined the age-related differences in clinical characteristics and treatment in real-world elderly Japanese AF patients.Methods and Results:The ANAFIE ... Read more >>

Circ. J. (Circulation journal : official journal of the Japanese Circulation Society)
[2020, 84(3):388-396]

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Potential Role of Atrial Myopathy in the Pathogenesis of Stroke in Rheumatoid Arthritis and Psoriasis: A Conceptual Framework and Implications for Prophylaxis.

Milton Packer,

J Am Heart Assoc (Journal of the American Heart Association)
[2020, 9(3):e014764]

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The Timing of Symptomatic Pulmonary Embolism in Patients With Nonwarfarin Anticoagulants Following Elective Primary Total Joint Arthroplasty.

Chuan Hu, Chuan Liu, Yuanhe Wang, Tao Ding, Kang Sun, Shaoqi Tian,

BACKGROUND:The purpose of this study is to investigate the incidence and timing of postoperative, symptomatic pulmonary embolism (PE) in patients receiving nonwarfarin treatment following primary total joint arthroplasty (TJA), to clarify the appropriate duration of postoperative VTE prophylaxis. METHODS:We retrospectively reviewed the medical records of 11,148 patients who underwent primary ... Read more >>

J Arthroplasty (The Journal of arthroplasty)
[2020, :]

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Cervical Spine Decompression and Fusion Outcomes in Trauma Patients Actively Receiving Anticoagulation Treatment for Cerebrovascular Injury: A Retrospective Comparative Study.

Francis X Camillo, Sean M Mitchell,

Background:Cervical spine blunt trauma patients with the presence of a cerebrovascular injury may be given initiation of heparin anticoagulation treatment prior to necessary surgical stabilization. Literature regarding the safety and efficacy of these procedures while a patient is on active anticoagulation is limited, requiring further investigation. The primary research question ... Read more >>

Int J Spine Surg (International Journal of Spine Surgery)
[2020, 14(1):66-71]

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The role of prophylactic use of low molecular weight heparin or aspirin in thromboembolic events in primary membranous nephropathy.

Peimei Zou, Hang Li, Jianfang Cai, Chao Li, Zhenjie Chen, Xuewang Li,

Objective: The aim of this study is to investigate the role of prophylactic anticoagulation regimens based on low molecular weight heparin (LMWH) or aspirin in thromboembolic events in patients with primary membranous nephropathy (PMN). Methods: A total of 717 patients with PMN were consecutively enrolled in this retrospective study. The ... Read more >>

Ren Fail (Renal Failure)
[2019, 41(1):623-628]

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Stroke prophylaxis in critically-ill patients with new-onset atrial fibrillation.

Robert S Schoaps, Ashley Quintili, Anthony Bonavia, Zyad J Carr, Erik B Lehman, Thomas Abendroth, Kunal Karamchandani,

Despite a high incidence of new onset atrial fibrillation (NOAF) in critically ill patients and its association with short and long-term incidence of stroke, there is limited data assessing anticoagulation on hospital discharge in these patients. We retrospectively reviewed electronic medical records of all adult patients admitted to non-cardiac ICUs ... Read more >>

J. Thromb. Thrombolysis (Journal of thrombosis and thrombolysis)
[2019, 48(3):394-399]

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Safety of direct oral anticoagulants versus traditional anticoagulants in venous thromboembolism.

Michela Giustozzi, Laura Franco, Maria Cristina Vedovati, Cecilia Becattini, Giancarlo Agnelli,

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality worldwide. For decades, low molecular weight heparins (LMWH) and vitamin K-antagonists have been the gold standard of anticoagulation for VTE. Recently, direct oral anticoagulants (DOACs) that can be administered in fixed doses, without laboratory monitoring and dose adjustment have ... Read more >>

J. Thromb. Thrombolysis (Journal of thrombosis and thrombolysis)
[2019, 48(3):439-453]

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Use of Idarucizumab to Revert the Anticoagulant Effect of Dabigatran in Heart Transplant Surgery: An Institutional Experience.

Álvaro Herrera-Escandón, Orlando Castaño-Cifuentes, Carlos A Plata-Mosquera,

Heart transplant is a surgical procedure with a high risk of perioperative bleeding in patients with a previous history of sternotomy, congestive liver disease, and/or use of oral anticoagulants. Anticoagulation is usually done with coumarin agents (warfarin, acenocoumarol), while on the waiting list, vitamin K is available allowing for partial ... Read more >>

Case Rep Cardiol (Case reports in cardiology)
[2020, 2020:6927423]

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An anticoagulant that does not cause bleeding - an abrupt stop on the road to the Holy Grail.

Joost C M Meijers, Saskia Middeldorp,

J. Thromb. Haemost. (Journal of thrombosis and haemostasis : JTH)
[2019, 17(12):2019-2021]

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Direct-Acting Oral Anticoagulants and Their Reversal Agents-An Update.

Stephanie A Kustos, Pius S Fasinu,

Background: Over the last ten years, a new class of drugs, known as the direct-acting oral anticoagulants (DOACs), have emerged at the forefront of anticoagulation therapy. Like the older generation anticoagulants, DOACs require specific reversal agents in cases of life-threatening bleeding or the need for high-risk surgery. Methods: Published literature ... Read more >>

Medicines (Basel) (Medicines (Basel, Switzerland))
[2019, 6(4):]

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Thrombolysis in Postoperative Pulmonary Embolism Following Liver Transplantation: A Case Report.

Thamer H Al-Ghamdi, Anwar Jarrad, Abdalla Younes Bashir, Thomas Lorf, Aiman Obed,

BACKGROUND Postoperative pulmonary embolism following liver transplantations is still one of the most fatal complications, especially during the early postoperative phase. The use of a thrombolytic agent such as the recombinant tissue-type plasminogen activator (rtPA) is considered a contraindication early after major abdominal surgery such as liver transplantation. However, thrombolysis ... Read more >>

Am J Case Rep (The American journal of case reports)
[2020, 21:e918857]

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A practical approach to evaluating postoperative thrombocytopenia.

Leslie Skeith, Lisa Baumann Kreuziger, Mark A Crowther, Theodore E Warkentin,

Identifying the cause(s) of postoperative thrombocytopenia is challenging. The postoperative period includes numerous interventions, including fluid administration and transfusion of blood products, medication use (including heparin), and increased risk of organ dysfunction and infection. Understanding normal thrombopoietin physiology and the associated expected postoperative platelet count changes is the crucial first ... Read more >>

Blood Adv (Blood advances)
[2020, 4(4):776-783]

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Patient values and preferences regarding VTE disease: a systematic review to inform American Society of Hematology guidelines.

Itziar Etxeandia-Ikobaltzeta, Yuan Zhang, Francesca Brundisini, Ivan D Florez, Wojtek Wiercioch, Robby Nieuwlaat, Housne Begum, Carlos A Cuello, Yetiani Roldan, Ru Chen, Chengyi Ding, Rebecca L Morgan, John J Riva, Yuqing Zhang, Rana Charide, Arnav Agarwal, Sara Balduzzi, Gian Paolo Morgano, Juan José Yepes-Nuñez, Yasir Rehman, Ignacio Neumann, Nicole Schwab, Tejan Baldeh, Cody Braun, María Francisca Rodríguez, Holger J Schünemann,

Values and preferences relate to the importance that patients place on health outcomes (eg, bleeding, having a deep venous thrombosis) and are essential when weighing benefits and harms in guideline recommendations. To inform the American Society of Hematology guidelines for management of venous thromboembolism (VTE) disease, we conducted a systematic ... Read more >>

Blood Adv (Blood advances)
[2020, 4(5):953-968]

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