Articles Tagged With: anticoagulation
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Stroke Risk in Patients with New AF During Hospitalization for Other Reasons
In a Canadian administrative database study of patients who developed atrial fibrillation during a hospitalization for other reasons, researchers followed the patients for one year to ascertain the risk of subsequent stroke. The incidence of stroke in those not anticoagulated generally was below the 2% per year threshold recommended for treatment with anticoagulants. However, in those with a CHA2DS2-VA score ≥ 5 (sex not included based on new data) and in those admitted for cardiac medical problems, the 95% confidence intervals of stroke risk did cross 2%. Thus, selected patients may be candidates for anticoagulation.
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POPular PAUSE TAVI Trial Supports Interrupting Oral Anticoagulation Before TAVR in Patients with Afib
In this investigator-initiated, open-label trial, continuing oral anticoagulation leading up to a transcatheter aortic valve replacement procedure led to more bleeding and no reduction in thromboembolic events compared with interrupting anticoagulation.
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DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke
In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), resulted in no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.
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DOACs Can Safely Be Started Early After Atrial Fibrillation-Associated Stroke
In ischemic stroke associated with atrial fibrillation, early restart of anticoagulation with apixaban one to three days after ischemic stroke, compared to late restart (seven to 14 days), there were no significant differences between the groups in the primary outcome — a composite endpoint including recurrent ischemic stroke, symptomatic intracranial hemorrhage, and systemic embolism.
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Is Anticoagulation Necessary for Post-CABG Surgery Atrial Fibrillation?
A meta-analysis of non-randomized trials of oral anticoagulant use for new atrial fibrillation (AF) after coronary artery bypass surgery involving almost 1.7 million patients has shown that AF is frequent, but the incidence of thromboembolism, bleeding, and death are low. Oral anticoagulants, when given, do not significantly affect thromboembolism or mortality rates, but they do increase bleeding.
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Rapid Reversal of Anticoagulation Reduces Mortality from Intracerebral Hemorrhage
Intracerebral hemorrhage (ICH) is the deadliest type of stroke. ICH associated with anticoagulation carries an even higher mortality. Serial imaging studies have demonstrated that there is significant hematoma enlargement during the first few hours after arrival at the hospital, and this also portends a poor outcome.
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Rapid Reversal of Anticoagulation Reduces Mortality from Intracerebral Hemorrhage
Because the numbers of patients with primary intracerebral hemorrhage are far lower than those with ischemic stroke, it has been difficult to accumulate a large enough number of patients to clearly analyze the relationship between the time of the hemorrhage and the time to treatment. We need to answer the important question: Does rapid treatment result in a better outcome?
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Anticoagulated Trauma Patient
Emergency medicine providers commonly encounter anticoagulated trauma patients, and it is essential to understand the critical aspects of caring for this unique subpopulation, including specific traumatic injury patterns, emergent reversal, and surgical considerations, as well as relevant emerging concepts.
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Timing of Anticoagulation Administration Following Atrial Fibrillation-Associated Stroke
A prospective, blinded, randomized study of early vs. later administration of oral anticoagulation after ischemic stroke in patients with atrial fibrillation calibrated by cerebral imaging showed no significant difference in 30-day outcomes.
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Timing of Anticoagulation Administration Following Atrial Fibrillation-Associated Stroke
A prospective, blinded, randomized study of early vs. later administration of oral anticoagulation after ischemic stroke in patients with atrial fibrillation calibrated by cerebral imaging showed no significant difference in 30-day outcomes.