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Usual On-therapy Ranges of Drug Concentrations in Patients with Atrial Fibrillation Treated with Direct Oral Anticoagulants: A Systematic Review and Meta-analysis.
Thromb Haemost
November 2024
Division of Hematology and Thromboembolism, Department of Medicine, Population Health Research Institute, Hamilton, Ontario, Canada.
Background: Although most patients with atrial fibrillation (AF) receiving a direct oral anticoagulant (DOAC) do not require drug concentration measurements, there are situations where such information could be useful. Existing guidance documents provide usual on-therapy ranges for drug concentrations, but these have important limitations.
Methods: This is a systematic review and meta-analysis of studies reporting trough and peak levels of DOAC regimens approved for stroke prevention in AF.
Direct Oral Anticoagulants Versus Traditional Anticoagulation in Cirrhotic Patients with Portal Vein Thrombosis: Updated Systematic Review.
Clin Appl Thromb Hemost
November 2024
Department of Hepatopancreatobiliary Surgery, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
Background: This systematic review aimed to evaluate the comparative effectiveness and safety of direct oral anticoagulants (DOACs) compared to traditional anticoagulation (vitamin K antagonists or low-molecular-weight heparins) in cirrhotic patients with portal vein thrombosis (PVT).
Methods: We conducted a literature search in PubMed and Embase databases up to May 2024. Studies were selected according to the PICOS criteria, focusing on cirrhotic patients with PVT treated with DOACs (dabigatran, rivaroxaban, apixaban, or edoxaban) compared to traditional anticoagulation.
Comparative safety and effectiveness of oral anticoagulants in patients with non-valvular atrial fibrillation and high risk of gastrointestinal bleeding: A nationwide French cohort study.
PLoS One
November 2024
Pfizer LTD., Surrey, United Kingdom.
Background: This observational study compared effectiveness and safety of direct oral anticoagulants (DOACs; apixaban, rivaroxaban, dabigatran) or vitamin K antagonists (VKAs) in patients with non-valvular atrial fibrillation (NVAF) at high risk for gastrointestinal bleeding (GIB).
Methods: Anticoagulant-naïve adults with NVAF with ≥1 GIB risk factor, initiating anticoagulant treatment January 2016-December 2019, and covered by the French national health data system were eligible. Outcomes included major bleeding (MB) and stroke/systemic embolism (SE).
Effects of Catheter-Based Renal Denervation in Hypertension: A Systematic Review and Meta-Analysis.
Circulation
November 2024
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Universität des Saarlandes, Homburg, Germany (D.V., L.L., M.B., F.M.).
Article Synopsis
- A meta-analysis of randomized, sham-controlled trials was conducted to evaluate the effectiveness and safety of catheter-based renal denervation (RDN) in treating hypertension, involving 10 trials with a total of 2,478 patients.
- The study found that RDN significantly lowered both 24-hour and office systolic and diastolic blood pressure compared to sham procedures, without a notable difference in complications or changes in renal function.
- Overall, RDN appears to be a safe and effective method for reducing blood pressure in patients with hypertension, although significant variability was noted among the studies analyzed.
Prediction of Severe Baseline Asymptomatic Carotid Stenosis and Subsequent Risk of Stroke and Cardiovascular Disease.
Stroke
November 2024
Department of Vascular Surgery (G.J.B.), University Medical Center Utrecht, Utrecht University, the Netherlands.
Article Synopsis
- The study evaluated the PACAS risk model's ability to identify patients at high risk for severe asymptomatic carotid artery stenosis (ACAS) and predict future strokes and cardiovascular disease (CVD) risk.
- It involved 26,384 patients aged 45-80, finding that 6.3% had severe ACAS at baseline and that higher PACAS scores correlated with increased incidences of stroke and CVD over roughly 70,000 patient-years of follow-up.
- The PACAS model was confirmed to effectively discriminate and calibrate risk levels, indicating that patients with higher scores had a significantly higher prevalence of severe ACAS and related events during the follow-up period.
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