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Anticoagulation in Atrial Fibrillation Patients With Frailty.
JACC Case Rep
November 2024
Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Aims: The Peri-Implant and PeriProsthetic Survival AnalysiS (PIPPAS) study aimed to investigate the risk factors for one-year mortality of femoral peri-implant fractures (FPIFs).
Methods: This prospective, multicentre, observational study involved 440 FPIF patients with a minimum one-year follow-up. Data on demographics, clinical features, fracture characteristics, management, and mortality rates were collected and analyzed using both univariate and multivariate analyses.
Inappropriate antithrombotic use in geriatric patients with complicated traumatic brain injury.
J Trauma Acute Care Surg
January 2025
From the Spencer Fox Eccles School of Medicine (D.G., J.A.), Department of Neurosurgery (D.B., M.T.B., S.T.M., R.G.), Department of Surgery (S.L., J.C., M.M., T.E.), Division of Geriatrics and Department of Internal Medicine (M.P.), University of Utah, Salt Lake City, Utah; and Bowers Neurosurgical Frailty and Outcomes Data Science Lab (C.A.B.), Flint, Michigan.
Background: Preinjury antithrombotic (AT) use is associated with worse outcomes for geriatric (65 years or older) patients with traumatic brain injury (TBI). Previous studies have found that use of AT outside established guidelines is widespread in TBI patients.
Methods: In this single-center retrospective cross-sectional study, we examined inappropriate AT use among geriatric patients presenting with traumatic intracranial hemorrhage.
Article Synopsis
- Managing cancer-associated thrombosis (CAT) poses challenges due to factors like bleeding risk, patient frailty, and drug interactions, necessitating careful treatment decisions.
- With the introduction of direct oral anticoagulants (DOACs), not all CAT patients benefit equally due to varied clinical and laboratory characteristics.
- This review discusses four specific scenarios in CAT management—brain metastasis, gastrointestinal malignancies, drug interactions, and thrombocytopenia—suggesting tailored treatment approaches based on current literature.
Article 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.
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