Tag Archives: VTE

Effective anticoagulation improves outcomes in patients with AF or VTE.4-7 Non-vitamin K antagonist oral anticoagulants (NOACs) have provided an alternative to warfarin for prevention of stroke or recurrent VTE in these patients in recent years. Compared with warfarin, NOACs have more predictable pharmacokinetics and pharmacodynamics, do not require monitoring of the international normalised ratio (INR), and have a wider therapeutic window that enables prescription at fixed daily doses over an extended period.8 Edoxaban, an inhibitor of Factor Xa is a member of the NOAC class. The accompanying articles summarise latest findings on the effect

European Society of Cardiology congress 2018, held in Munich The principal safety outcome of major bleeding also showed no significant difference between the rivaroxaban and placebo groups. Rivaroxaban, however, did reduce the rate of symptomatic VTE only, and symptomatic VTE and all-cause mortality, compared to placebo. On leaving hospital, the rate of symptomatic VTE more than doubles over the first 21 days and is associated with a five-fold increased risk of fatal pulmonary embolism (PE) within 30 days post-discharge. The MARINER trial investigated whether continuing thromboprophylaxis with an oral anticoagulant after discharge could reduc

New practical NOACs guide A new version of EHRA Practical Guide on the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) was launched at the congress. ESC guidelines state that NOACs should be preferred over vitamin K antagonists, such as warfarin, for stroke prevention in AF patients, except those with a mechanical heart valve or rheumatic mitral valve stenosis, and their use in clinical practice is increasing. The guide gives concrete, practical advice on how to use NOACs in specific clinical situations. The guide is published in European Heart Journal (doi: 10.1093/eurheartj/ehy136). Anti

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

When the NOACs (novel oral anticoagulants) were introduced over three years ago, they promised to revitalise the management of conditions such as atrial fibrillation (AF), venous thromboembolism (VTE) and thromboprophylaxis after major joint replacement surgery. Rivaroxaban is currently available in multiple indications, including (but not limited to): prevention of stroke and systemic embolism in adult patients with non-valvular AF, treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and the prevention of recurrent DVT and PE in adults. For decades anticoagulant therapy in these conditions had relied on the vitamin K antagon

NICE calculates that an estimated 25,000 people who are admitted to hospital die from preventable VTE each year.  The NICE guideline, jointly developed with the National Clinical Guideline Centre for Acute and Chronic Conditions, recommends that all patients should be assessed for risk of developing blood clots on admission to hospital, and then given preventative treatment that suits their individual needs. Options include anticoagulant drugs such as heparin, anti-embolism stockings and foot impulse or pneumatic devices.  This advice covers all patients admitted to hospital – including those having day-case procedures – and not just th