Objectives: The present study describes the use of octreotide (OCT) in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC) who have gastrointestinal (GI) bleeding related to arteriovenous malformations (AVMs), as well as its effect on OAC tolerance and subsequent rebleeding.
Background: AVMs cause significant GI bleeding, especially in patients with AF who are receiving OAC for stroke prevention. OCT has been shown to minimize recurrent GI bleeds related to AVMs.
Methods: In a multicenter, observational study, 38 AF patients with contraindications to OAC because of AVM-related GI bleeding were started on 100 μg of subcutaneous OCT twice daily. OAC was resumed in all patients within 48 h. Incidence of recurrent GI bleeds was calculated, and hemoglobin levels were recorded at enrollment and at 3 and 6 months' follow-up.
Results: After a median follow-up of 8 months, 36 patients (mean age 69 ± 8.0 years; mean CHADS-VASc score 3 ± 1 and mean HAS-BLED score 3 ± 1) were available for analysis. All were able to successfully resume OAC, and 28 of 36 (78%) remained on OAC at the conclusion of the study, whereas 8 underwent left atrial appendage closure with subsequent OAC discontinuation. No systemic thromboembolic events occurred in follow-up. Of the 28 patients who continued receiving OAC, 19 (68%) were free of recurrent GI bleed, 4 had minor GI bleeds, 4 required transfusion, and 1 required colectomy for GI bleeding. Mean hemoglobin levels in all patients receiving OAC were significantly higher at 3- and 6-month follow-up than at baseline (p < 0.001).
Conclusions: Subcutaneous OCT therapy is an attractive option in AF patients receiving OAC who have AVM-related GI bleeds. It allows successful reinitiation of OAC as a bridge to left atrial appendage exclusion or short-term relief from bleeding.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jacep.2017.04.022 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Role of Atrial Fibrillation and Oral Anticoagulation Status in Health-Related Quality of Life 12 Months After Ischemic Stroke or TIA.
Brain Behav
January 2025
Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Aims: Atrial fibrillation (AF) accounts for about 20% of all ischemic strokes worldwide. It is known that AF impairs health-related quality of life (HRQOL) in the general population, but data on HRQOL in stroke patients with newly diagnosed AF are sparse.
Methods: Post hoc analysis of the prospective, investigator-initiated, multicenter MonDAFIS study (NCT02204267) to analyze whether AF-related oral anticoagulation (OAC), and/or AF-symptom severity are associated with HRQOL after ischemic stroke or transient ischemic attack (TIA).
A Rare Case of Early Left Ventricular Thrombus Development After Off-Pump Coronary Artery Bypass Grafting for Unstable Angina Pectoris With Reduced Left Ventricular Ejection Fraction.
Cureus
December 2024
Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, JPN.
Left ventricular (LV) thrombus is a serious complication of myocardial infarction (MI) that can lead to a fetal systemic embolism. Although coronary artery bypass graft surgery (CABG) after MI is widely performed, to our knowledge, there are no reports of LV thrombus in the early postoperative period. Here, we report a rare case of a 70-year-old man who underwent off-pump coronary artery bypass grafting (OPCAB) for unstable angina pectoris with reduced left ventricular ejection fraction (LVEF).
View Article and Find Full Text PDFOropharyngeal Colostrum Administration in Premature Infants: Impact on Immune Status and Incidence of Common Morbidities.
Int J Prev Med
November 2024
Department of Pediatrics, School of Medicine and Child Health Promotion Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Article Synopsis
- This study investigates whether giving colostrum orally to preterm infants immediately after birth has benefits beyond standard feeding practices, particularly its effects on immune function and clinical outcomes.
- In a randomized trial with 60 preterm infants, those receiving oropharyngeal colostrum showed a significant increase in urinary IgA levels over 15 days, while those given distilled water did not.
- Despite the positive impact on IgA levels, there were no significant differences in serious health issues like late onset sepsis or necrotizing enterocolitis between the two groups, highlighting the need for further research on the clinical implications of increased IgA.
Assessment of Knowledge and Medication Adherence Among Patients Prescribed with Oral Anticoagulants in Atrial Fibrillation at a Tertiary Care Centre: A Cross Sectional Study.
J Blood Med
December 2024
Department of Pharmacy, Kathmandu University, Dhulikhel, Nepal.
Purpose: Atrial fibrillation (AF) being a prevalent cardiovascular condition globally, has an increased risk of stroke and other complications. The effective management of AF often involves the use of oral anticoagulants (OACs) to prevent thromboembolic events. This study aimed to evaluate anticoagulation knowledge and medication adherence in AF patients on OACs at a tertiary care center in Nepal.
View Article and Find Full Text PDFIntroduction Parenteral heparin is widely used as bridging therapy while optimising oral anticoagulation(OAC). Newer Direct-Acting OACs(DOACs) attain therapeutic effect very quickly. We report the use of dabigatran as bridging therapy during warfarin optimization for cardioembolic stroke in two patients who opted to receive warfarin for long-term anticoagulation for secondary stroke prevention.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!