warfarin

WOEST: Randomized trial that compared dual therapy versus triple therapy on anticoagulated patients.

A multicenter randomized study, (n = 573), that evaluated the role of aspirin in anticoagulated patients undergoing angioplasty. The primary endpoint was the rate of total bleeding, (TIMI), at 12 months follow-up. The administration of a dual therapy, (warfarin + clopidogrel), showed a significant reduction compared with the triple therapy, (19.5% vs. 44.9%, P &lt;0.001).<a href="https://solaci.org/en/2015/06/24/woest-randomized-trial-that-compared-dual-therapy-versus-triple-therapy-on-anticoagulated-patients/" title="Read more" >...</a>

PRAGUE 14: Anti-thrombotic therapy before non-cardiac surgery may be associated with a higher incidence of bleeding.

The majority of coronary patients are under anti-thrombotic therapy and its interruption may increase cardiovascular risk, while on the other hand, continuation during a surgical procedure may increase the risk of bleeding. This study, which included 1211 patients who underwent non-cardiac surgery, compared the interruption of anti-thrombotic therapy at least 7 days prior vs continuing<a href="https://solaci.org/en/2015/06/24/prague-14-anti-thrombotic-therapy-before-non-cardiac-surgery-may-be-associated-with-a-higher-incidence-of-bleeding/" title="Read more" >...</a>

RE-ALIGN: Dabigatran in mechanical valves. Suspended early due to more bleeding and thrombotic events.

The use of vitamin K antagonists provides excellent protection against thromboembolic complications in patients with mechanical valves, however long-term INR monitoring is needed. Dabigatran is an oral direct thrombin inhibitor which was shown to be effective in patients with atrial fibrillation. Based on these promising results this study was designed to evaluate its use in<a href="https://solaci.org/en/2015/06/24/re-align-dabigatran-in-mechanical-valves-suspended-early-due-to-more-bleeding-and-thrombotic-events/" title="Read more" >...</a>

Patent Foramen Ovale: when to indicate closure

References:&nbsp;Matthew Nayor et al. Contemporary Approach to Paradoxical Embolism. Circulation. 2014;129:1892-1897. Marco Hernandez-Enrıquez et al. &nbsp;Current Indications for Percutaneous Closure of Patent Foramen Ovale. &nbsp;Rev Esp Cardiol. 2014;67(8):603&ndash;607. The debate on patent foramen ovale behavior in different clinical contexts remains open, no pun intended. Based on numerous observational studies and expert recommendations, when facing the<a href="https://solaci.org/en/2014/10/27/patent-foramen-ovale-when-to-indicate-closure/" title="Read more" >...</a>

Percutaneous Left Atrial Appendage Suture: more options in atrial fibrillation patients with antiguagulation contraindication

Original title:&nbsp;Percutaneous Left Atrial Appendage Suture Ligation Using the Lariat Device In Patines UIT Atrial Fibrillation&nbsp;Reference:&nbsp;Krystof Bartus, et al. J Am Coll Cardiol 2013;62:108&ndash;18. Atrial fibrillation (AF) is the most frequent arrhythmia and is associated with a 5 fold increase in stroke risk and the resulting morbimortality. Warfarin anticoagulation therapy can be effective but only<a href="https://solaci.org/en/2013/07/18/percutaneous-left-atrial-appendage-suture-more-options-in-atrial-fibrillation-patients-with-antiguagulation-contraindication/" title="Read more" >...</a>

Foramen ovale closure for cryptogenic stroke

Original title:&nbsp;Closure of Patent Foramen Ovale versus Medical Therapy after Cryptogenic Stroke. Randomized Evaluation of Recurrent Stroke Comparing PFO Closure to Established Current Standard of Care Treatment (RESPECT).&nbsp;Reference:&nbsp;John D. Carroll et al. N Engl J Med 2013;368:1092-100. It is still unclear if the closure of patent foramen ovale (PFO) is effective in preventing recurrent stroke<a href="https://solaci.org/en/2013/04/03/foramen-ovale-closure-for-cryptogenic-stroke/" title="Read more" >...</a>

Appendage trans-catheter closure is equivalent to anticoagulation in fibrillated patients.

Original title:&nbsp;Percutaneous Left Atrial Appendage Closure for Stroke Prophylaxis in Patients With Atrial Fibrillation: 2.3-Year Follow-up of the PROTECT AF (Watchman Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) Trial.&nbsp;Reference:&nbsp;Vivek Y. Reddy et al. Circulation. 2013;127:720-729. Atrial fibrillation is the most common sustained arrhythmia in the world and its importance lies<a href="https://solaci.org/en/2013/03/01/appendage-trans-catheter-closure-is-equivalent-to-anticoagulation-in-fibrillated-patients/" title="Read more" >...</a>

Critical limb ischemia with infrapatellar disease. High odds of limb salvage despite restenosis. 

Original title:&nbsp;Long-term outcomes following infrapopliteal angioplasty for critical limb ischemia.&nbsp;Reference:&nbsp;Ruby C. Lo et al. J Vasc Surg 2013;-:1-10. Angioplasty has established itself as an alternative for the treatment of infrainguinal peripheral disease with comparable results in terms of limb salvage for surgery.&nbsp; However, this data refers to the iliac or femoral territory but it is<a href="https://solaci.org/en/2013/02/28/critical-limb-ischemia-with-infrapatellar-disease-high-odds-of-limb-salvage-despite-restenosis/" title="Read more" >...</a>

Balloon Pulmonary Angioplasty (BPA) in patients with Chronic Thromboembolic Pulmonary Hypertension

Original title:&nbsp;Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension.&nbsp;Reference:&nbsp;Hiroki Mizoguchi et al. Circ Cardiovasc Interv. 2012;5:748-755. Patients with Chronic Thromboembolic Pulmonary Hypertension (CTE-PH) have bad prognosis. Pulmonary thromboendarterectomy can significantly reduce pulmonary pressure but, due to comorbidity or technical matters (very peripheral thrombi), not all patients are good candidates for this<a href="https://solaci.org/en/2013/01/11/balloon-pulmonary-angioplasty-bpa-in-patients-with-chronic-thromboembolic-pulmonary-hypertension/" title="Read more" >...</a>

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