Tag Archives: anticoagulation

What’s new in transplantation Are kidney donors worse off? The meeting was opened by Dr Anna Price (Queen Elizabeth University Hospital, Birmingham) who addressed the long-term cardiovascular effects of unilateral nephrectomy in living kidney donors.1 Previous studies have shown a significant prevalence of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD),2,3 but the effects of reduced renal function in living kidney donors has been unexplored until now. A recent study by Price et al. demonstrated that living kidney donors had a reduction in estimated glomerular filtration rate (eGFR) from 95 to 67 ml/min

Introduction Anticoagulation is utilised in the management of venous thromboembolism and to prevent thrombotic complications in patients with cardiac comorbidities, e.g. atrial fibrillation (AF), valvular heart disease, congenital heart disease, and other indications. Direct oral anticoagulants (DOACs), also known as NOACs (non-vitamin K antagonist oral anticoagulants), have shown superior efficacy, safety, adherence and tolerability over traditional anticoagulants, such as vitamin K antagonists and low-molecular weight heparins, and this has resulted in a paradigm shift with DOACs as the preferred options for most patients with thrombotic d

Video of our BJC webinar: ‘Haemorrhage with anticoagulants: risk reduction and reversibility’ Healthcare professionals are invited to watch our video where our expert panel discuss risk reduction and reversibility in haemorrhage with anticoagulation. This is a recording of a webinar which took place on 20th July 2021. Please note CPD points were awarded for watching the live event. We are unable to offer CPD points post-event so there is no longer a CPD feedback form underneath the viewing window. Learning objectives An assessment of the most common types of life-threatening bleeds requiring immediate emergency treatment Life-th

Introduction Peripheral artery disease (PAD) refers to all arterial disease outside of the coronary arteries and the aorta.1 It is estimated that over 200 million individuals are living with PAD globally.2,3 In the Western world, one in five adults over the age of 75 has PAD, including over 40 million Europeans.3-6 Though the prevalence of PAD is already at endemic levels worldwide, ageing populations and the increasing burden of chronic disease (i.e. hypertension, dyslipidaemia, diabetes mellitus, smoking) will contribute to further increases in the incidence and prevalence of PAD in the coming decades.2,3 As a consequence, PAD is the third

Background, epidemiology and rationale for the COMPASS study One quarter of all deaths in the UK in 2017 occurred as a result of diseases of the heart and circulation.1 One in seven men and one in twelve women died from coronary heart disease (CHD).1 The presence of CHD doubles the risk of stroke,2 and more than 100,000 strokes occur in the UK each year.1 Although the mortality rate from circulatory diseases is declining due to advances in treatment,1,3 more than 100,000 deaths resulted from CHD or stroke combined in the UK each year.1 CHD and stroke are the two leading causes of death worldwide.4 Circulatory disease is also associated with a

Until recently, warfarin was the drug of choice for patients with atrial fibrillation. Data from the ROCKET-AF (Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation),1 ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation),2 RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy)3 and ENGAGE AF-TIMI 48 (Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48)4 trials demonstrated non-inferior or superior reduction in str

Background, epidemiology and rationale for study The PIONEER AF-PCI (Open-Label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies of Rivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Subjects with Atrial Fibrillation who Undergo Percutaneous Coronary Intervention) trial addressed an important medical question, which is potentially relevant for the 20–45% of atrial fibrillation (AF) patients who also have coronary artery disease and are likely to undergo percutaneous coronary intervention (PCI). Prior to the PIONEER AF-PCI trial, there was an unmet need for evidence-based recommendati

In the study, patients newly diagnosed with hip fracture from 2005 –2013 were followed until late 2016. Among 34,991 patients, 4602 (13%) received osteoporosis treatment during follow-up. Alendronate was associated with 67% and 45% lower risks of one-year CV death and heart attack, respectively. It was associated with an 18% reduced risk of stroke within five years and a 17% reduced risk of stroke within 10 years. Protective effects were not evident for other classes of osteoporosis treatments. “There is a world-wide crisis in the treatment of osteoporosis, due to patients’ awareness of the extremely rare side effects,” said senior au

Current treatment recommendation for the prevention of recurrent VTE is anticoagulation therapy for three months or longer, depending on the balance between the risk of recurrent VTE and the risk of bleeding. However, the risk of patients with unprovoked VTE or with ongoing risk factors experiencing a second event is up to 10% in the first year if treatment is stopped. More than 25,000 people in the UK die from VTE every year. More news in this issue: NICE publishes updated familial hypercholesterolaemia guidance REDUCE shows non-inferiority of short versus long DAPT in acute coronary syndrome Primary Care Cardiovascular Society announces it

Over a mean follow-up of 23 months, there was a marked decrease in the primary composite end point of cardiovascular death, stroke, or myocardial infarction in the combination therapy group by 24% (hazard ration [HR] 0.76; 95% CI 0.66-0.86; p<0.001) over aspirin monotherapy, and improved survival by 18%. The trial terminated prematurely by the data monitoring committee due to due to overwhelming efficacy. Rivaroxaban monotherapy showed no efficacy benefit. The anticipated trade-off was apparent with increased major bleeding in the combination therapy arm (HR 1.70, 95% CI 1.40–2.05; p<0.001), although fatal and intracranial bleeds wer