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Epistaxis Versus Nonepistaxis Bleeding in Anticoagulated Patients With Atrial Fibrillation: Results From the ENGAGE AF-TIMI 48 Trial.
J Am Heart Assoc
January 2025
Thrombolysis in Myocardial Infarction (TIMI) Study Group, Cardiovascular Division Brigham and Women's Hospital and Harvard Medical School Boston MA USA.
Background: Epistaxis is common with antithrombotic therapy and is often troublesome to patients, yet its frequency, severity, and outcomes are poorly characterized.
Methods And Results: Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48 (ENGAGE AF-TIMI 48) randomized 21 105 patients with atrial fibrillation and CHADS2 risk score ≥2 to higher-dose edoxaban regimen (60 mg daily, dose-reduced to 30 mg), lower-dose edoxaban regimen (30 mg, dose reduced to 15 mg, daily), or warfarin. Bleeds were adjudicated using International Society on Thrombosis and Haemostasis criteria.
Initiation of Anticoagulants During the COVID-19 Pandemic in Sweden: An Interrupted Time Series Analysis.
Basic Clin Pharmacol Toxicol
February 2025
Pharmacoepidemiology, Department of Pharmacy, Uppsala University, Uppsala, Sweden.
The COVID-19 pandemic may have increased anticoagulant initiation due to the thrombogenic nature of the disease or decreased due to the societal impact of the pandemic. We aimed to study the effect of the COVID-19 pandemic on initiation of anticoagulants in Sweden. We conducted a single interrupted time series analysis on the monthly cumulative incidence of nonvitamin K antagonist oral anticoagulants (NOAC), warfarin, or heparins, before and after March 2020, using SCIFI-PEARL dataset.
View Article and Find Full Text PDFChronic Subdural Hematoma in the Posterior Fossa Associated with Hearing Impairment during Warfarin Therapy, Improved by Middle Meningeal Artery Embolization: A Case Report.
NMC Case Rep J
October 2024
Department of Neurological Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Kagawa, Japan.
Article Synopsis
- Chronic subdural hematoma (CSDH) in the posterior fossa is uncommon, and both its cause and treatment options are not well established.
- This case study discusses a 59-year-old man on warfarin who underwent successful middle meningeal artery (MMA) embolization after being diagnosed with CSDH, initially presenting with hearing loss and headaches.
- Following the procedure, the patient showed immediate improvement in symptoms, was discharged after 10 days, and had no recurrence 100 days later, highlighting the efficacy of MMA embolization while maintaining anticoagulation therapy.
The Effects of Removing the Requirement for Prior Reimbursement Approval on Anticoagulant Use in Ireland: A Cross-Sectional Study.
Pharmacoepidemiol Drug Saf
October 2024
School of Public Health, University College Cork, Cork, Ireland.
Article Synopsis
- The study investigates the effectiveness of a prior approval policy for reimbursement of direct oral anticoagulants (DOACs) in Ireland, aiming to manage costs while ensuring oversight of medicines.
- Utilizing data from the Irish Health Service Executive, the research compares the prescribing frequencies and costs of DOACs and warfarin from 2018 to 2021, analyzing changes after the removal of approval requirements.
- Results reveal an overall increase in OAC prescriptions by nearly 20%, but the removal of prior approval had only a minimal impact on the prescribing trends for DOACs, highlighting the need for careful policy considerations in future healthcare decisions.
Peri-operative Anticoagulation Strategies, Bleeding and Thrombotic Complications in Pediatric Patients Undergoing Intervention for Congenital Portosystemic Shunts.
J Pediatr Surg
October 2024
Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Background: Congenital portosystemic shunts (CPSS) are rare congenital abnormalities causing abnormal blood flow between the portal vein and systemic circulation. This study reports on the peri-operative anticoagulation management of CPSS patients post closure, focusing on the incidence of thrombotic and bleeding complications.
Methods: This is a single-center retrospective analysis of CPSS patients who underwent surgery or endovascular intervention between 2005 and 2021.
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