Introduction: Oral anticoagulation (OAC) significantly mitigates thromboembolism risks in atrial fibrillation (AF) and venous thromboembolism (VTE) patients yet concern about major bleeding events persist. In fact, clinically relevant hemorrhages can be life-threatening. Bleeding risk is dynamic and influenced by factors such as age, new comorbidities, and drug therapies, and should not be assessed solely based on static baseline factors.
Areas Covered: We comprehensively review the bleeding risk associated with OAC therapy. Emphasizing the importance of assessing both thromboembolic and bleeding risks, we present clinical tools for estimating stroke and systemic embolism (SSE) and bleeding risk in AF and VTE patients. We also address overlapping risk factors and the dynamic nature of bleeding risk.
Expert Opinion: The OAC management is undergoing constant transformation, motivated by the primary objective of mitigating thromboembolism and bleeding hazards, thereby amplifying patient safety throughout the course of treatment. The future of OAC embraces personalized approaches and innovative therapies, driven by advanced pathophysiological insights and technological progress. This holds promise for improving patient outcomes and revolutionizing anticoagulation practices.
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http://dx.doi.org/10.1080/14779072.2023.2275662 | DOI Listing |
Sci Rep
December 2024
Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
The aim of this study was to evaluate how COVID-19 affected acute stroke care and outcome in patients with acute ischemic or hemorrhagic stroke. We performed a retrospective analysis on patients who were admitted with acute ischemic (AIS) or hemorrhagic (ICH) stroke from September 2020 to May 2021 with and without COVID-19. We recorded demographic and clinical data, imaging parameters, functional outcome and mortality at one year.
View Article and Find Full Text PDFTrials
December 2024
Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Background: Intermediate-high risk pulmonary embolism (PE) carries a significant risk of hemodynamic deterioration or death. Treatment should balance efficacy in reducing clot burden with the risk of complications, particularly bleeding. Previous studies on high-dose, short-term thrombolysis with alteplase (rtPA) showed a reduced risk of hemodynamic deterioration but no change in mortality and increased bleeding complications.
View Article and Find Full Text PDFCardiovasc Revasc Med
December 2024
Division of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, United States of America. Electronic address:
Background: Percutaneous left atrial appendage occlusion (pLAAO) presents an alternative to anticoagulation (AC) for stroke prophylaxis in atrial fibrillation (Afib) patients with high bleeding risk. pLAAO was associated with lower rates of disabling stroke which was mainly attributed to the reduction of hemorrhagic stroke (HS). Little is known about the impact of pLAAO on the severity of ischemic strokes which we sought to study.
View Article and Find Full Text PDFWorld Neurosurg
December 2024
Department of Neurosurgery, Oxford University Hospitals NHS Foundation Trust, Oxford, Oxfordshire, UK.
Objective: Hyponatremia after aneurysmal subarachnoid hemorrhage (aSAH) is common, however the incidence, and association with vasospasm, morbidity, and mortality, has yet to be defined. We aimed to identify incidence of hyponatremia after aSAH, and quantify its association with measurable outcomes.
Methods: A PRISMA-compliant systematic review and meta-analysis was conducted (PROSPERO ID CRD42022363472).
Ann Vasc Surg
December 2024
Department of Orthopedics, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China, 213003. Electronic address:
Objective: To identify risk factors for loss to follow-up after inferior vena cava (IVC) filter placement in inpatients of other departments (IODs) and to determine whether a quality improvement project launched at our institution in April 2022 improved follow-up and filter retrieval rates in these patients.
Methods: Consecutive patients who underwent retrievable filter placement at our institution between March 2021 and March 2023 were included in this study. Patients were divided into preimprovement (before April 2022; n = 81) and postimprovement (after April 2022; n = 77) groups.
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