Publications by authors named "K S Pieper"
The natural, built, and social environments shape drinking water quality supplied by private wells. However, the combined effects of these factors are not well understood. Using North Carolina as a case study, we (i) estimate the demographic characteristics of the private well population; (ii) evaluate representation in well testing records; and (iii) demonstrate how spatial scale influences knowledge of well-using household demographics and representation in testing.
View Article and Find Full Text PDFBackground: Decisions about stroke prevention strategies in atrial fibrillation (AF) typically balance thromboembolism reduction against increased bleeding from oral anticoagulation therapy (OAC). When determining eligibility for OAC, guidelines recommend calculation of thromboembolic event rates using a validated score such as CHA2DS2-VASc. In contrast, routine calculation of bleeding scores is not recommended, in part because many patient factors associated with an increased risk of bleeding are associated with an even larger increased risk of ischemic stroke.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to compare stroke prevention strategies, management of comorbidities, and clinical outcomes in patients with atrial fibrillation (AF) across different healthcare specialties: cardiology, primary care, and others.
- Among 52,011 patients, those in cardiology were more likely to receive non-vitamin K oral anticoagulants (NOACs) compared to those in primary care or other specialties, while comorbidity management was similar across all groups.
- Patients receiving care outside of cardiology faced higher risks for non-cardiovascular mortality, major bleeding, and worsening heart failure, indicating a need for improved AF management in these settings.
Article Synopsis
- Direct oral anticoagulants are commonly used for preventing strokes in patients with atrial fibrillation and flutter, but concerns about bleeding limit their use; milvexian is a new drug that might work as well with less bleeding risk.
- The LIBREXIA AF trial is a large global study comparing milvexian to apixaban, enrolling 15,500 participants to assess if milvexian can prevent strokes without increasing bleeding events significantly.
- The results from this study aim to clarify the efficacy and safety of milvexian compared to apixaban over a projected 4-year follow-up period.