Medicare part D prescribing for direct oral anticoagulants in the United States: Cost, use and the "rubber effect".

Introduction: Direct oral anticoagulants (DOAC) have gained an increased share over warfarin for prevention and treatment of thromboembolic disease. We studied DOAC adoption across providers and medical specialties.

Methods: Retrospective, cross-sectional analysis of Medicare Part D public use files (PUF), 2013 to 2015.

Bosentan for patients with echocardiographic evidence of pulmonary hypertension due to long-standing rheumatic mitral stenosis.

Introduction: Vasoconstrictive endothelin signaling is not limited to idiopathic pulmonary arterial hypertension, but has also been implicated in pulmonary hypertension due to valvular heart disease. The efficacy and safety of endothelin receptor antagonists in these patients is unknown. We investigated the effects of bosentan in patients with transthoracic echocardiographic (TTE) evidence of pulmonary hypertension due to mitral stenosis associated with rheumatic fever.