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Prevalence and predictors of sub-optimal laboratory monitoring of selected higher risk medicines in Irish general practice: a 5-year retrospective cohort study of community-dwelling older adults.
BMJ Open
January 2025
Department of General Practice, University College Cork, Cork, Ireland
Objectives: To describe the prevalence of sub-optimal monitoring for selected higher-risk medicines in older community-dwelling adults and to evaluate patient characteristics and outcomes associated with sub-optimal monitoring.
Study Design: Retrospective observational study (2011-2015) using historical general practice-based cohort data and linked dispensing data from a national pharmacy claims database.
Setting: Irish primary care.
Diagnosis and treatment of pulmonary embolism. Recommendations of the Thromboembolic Disease Group of the Spanish Society of Internal Medicine 2024.
Rev Clin Esp (Barc)
January 2025
Medicina Interna, Hospital Clínico Universitario de Valladolid, Universidad de Valladolid, Valladolid, Spain.
Pulmonary embolism (PE) is a disease with a rising incidence rate. This article presents the recommendations for the diagnosis and treatment of PE of the Thromboembolic Disease Group of the Spanish Society of Internal Medicine (SEMI). The main objective is to facilitate decision making to improve the diagnostic and therapeutic approach based on published evidence.
View Article and Find Full Text PDFApixaban versus aspirin for stroke prevention in people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack: subgroup analysis of the ARTESiA randomised controlled trial.
Lancet Neurol
February 2025
Department of Medicine, McMaster University, Population Health Research Institute, Hamilton, ON, Canada.
Background: People with subclinical atrial fibrillation are at increased risk of stroke, albeit to a lesser extent than those with clinical atrial fibrillation, leading to an ongoing debate regarding the benefit of anticoagulation in these individuals. In the ARTESiA trial, the direct-acting oral anticoagulant apixaban reduced stroke or systemic embolism compared with aspirin in people with subclinical atrial fibrillation, but the risk of major bleeding was increased with apixaban. In a prespecified subgroup analysis of ARTESiA, we tested the hypothesis that people with subclinical atrial fibrillation and a history of stroke or transient ischaemic attack, who are known to have an increased risk of recurrent stroke, would show a greater benefit from oral anticoagulation for secondary stroke prevention compared with those without a history of stroke or transient ischaemic attack.
View Article and Find Full Text PDFDesign and early progress of the Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial.
Int J Stroke
January 2025
Medical University of South Carolina, Charleston, SC, USA.
Background: The usual antithrombotic treatment for symptomatic intracranial atherosclerotic stenosis (ICAS) consists of dual treatment with clopidogrel and aspirin for 90 days followed by aspirin alone but the risk of recurrent stroke remains high up to 12 months. The Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial was designed to determine whether other combinations of dual antithrombotic therapy are superior to clopidogrel and aspirin.
Methods: CAPTIVA is an ongoing, prospective, double-blinded, three-arm clinical trial at over 100 sites in the United States and Canada that will randomize 1683 high-risk subjects with a symptomatic infarct attributed to 70-99% stenosis of a major intracranial artery to 12 months of treatment with (1) ticagrelor (180 mg loading dose, then 90 mg twice daily), (2) low-dose rivaroxaban (2.
Comparison of Different Thromboprophylaxis Regimens in Elderly Patients Following Hip Arthroplasty.
Br J Hosp Med (Lond)
January 2025
Department of Osteoarthritis, Yantai City Yantai Shan Hospital, Yantai, Shandong, China.
Deep venous thrombosis (DVT) represents a significant postoperative complication after artificial femoral head replacement, with the incidence increasing proportionally with patient age. This study aimed to evaluate the effect of early postoperative use of intermittent pneumatic compression devices (IPC), followed by the combined use of low molecular weight heparin (LMWH) after 48 hours, for the prevention of postoperative lower limb DVT in elderly patients undergoing hip arthroplasty. The retrospective study included 100 elderly patients who underwent unilateral femoral head replacement.
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