CardioExchange Archive

September 1st, 2013

Is It Time to RE-ALIGN Our Thinking About Direct Thrombin Inhibitors?

Judith Andersen, AB, MD

Reflecting on the RE-ALIGN trial of dabigatran, Judith Andersen muses on the mechanisms of direct thrombin inhibitors.

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June 24th, 2013

Roller Coaster Path to Approval for Eliquis Uncovered by FDA Documents

Larry Husten, PHD

After the presentation and publication of the pivotal ARISTOTLE trial,  the novel anticoagulant apixaban (Eliquis, Pfizer and Bristol-Myers Squibb) was widely expected to be  a blockbuster. But then it got bogged down at the FDA where initial hopes for a speedy approval were dashed after highly critical reviews. Approval of the drug was delayed for 9 months […]

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June 3rd, 2013

Selections from Richard Lehman’s Literature Review: June 3rd

Richard Lehman, BM, BCh, MRCGP

This week’s topics include pacemaker or ICD surgery without interrupting anticoagulation, the diagnostic accuracy of conventional or age-adjusted D-dimer cut-off values in older patients with suspected VTE, and ICD shocks.

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May 9th, 2013

Bruise Control: Continued Warfarin Beats Heparin Bridging During Device Implantation

Larry Husten, PHD

Many patients receiving an ICD or a pacemaker are already receiving oral anticoagulants. Current guidelines recommend replacement of the oral anticoagulant with the temporary use of heparin as a bridging strategy. Now a new study, BRUISE CONTROL (Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial), offers convincing evidence that this strategy is not […]

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April 4th, 2013

Registry Study Offers Reassurance About Safety and Efficacy of Dabigatran

Larry Husten, PHD

As the first new oral anticoagulant since warfarin, dabigatran (Pradaxa, Boehringer-Ingelheim) has been subject to intense concerns over its safety and efficacy in a real-world population. Last November an FDA investigation found no indication that bleeding rates for dabigatran were any higher than bleeding rates for warfarin. A new study from Scandinavia, published in the Journal of the American […]

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March 18th, 2013

Vena Cava Filters: Little Evidence and Wide Variation in Use

Larry Husten, PHD

Despite the absence of any evidence demonstrating benefit or showing how best to use them, vena cava filters (VCF) are used in most hospitals. Now a new study published in JAMA Internal Medicine suggests that this same lack of evidence results in an extremely broad rate of use in different hospitals. An accompanying viewpoint raises the […]

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February 14th, 2013

No Aspirin After DES? Is This The Wild, Wild WOEST?

Richard A. Lange, MD, MBA and L. David Hillis, MD

According to the recently published results of the WOEST trial, patients receiving anticoagulation thereapy who undergo stenting have better outcomes with clopidogrel only than with clopidogrel plus aspirin. Rick Lange and David Hillis ask: Are you ready to stop prescribing aspirin to these patients?

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January 22nd, 2013

How Will You PROTECT Your Patients with Nonvalvular Afib?

Eiman Jahangir, MD

For which patients is the Watchman left-atrial appendage closure device a better alternative to warfarin and other anticoagulant medications?

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January 17th, 2013

Revisiting Novel Anticoagulants in Atrial Fibrillation

John Ryan, MD and Christian Thomas Ruff, MD, MPH

Two experts discuss the evolving landscape of novel anticoagulants for patients with AF. Do you agree with their perspectives? What questions do you have? What has your experience taught you?

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December 19th, 2012

Pradaxa To Be Contraindicated in Patients with Mechanical Heart Valves

Larry Husten, PHD

Boehringer Ingelheim is starting to inform physicians about a new contraindication for its oral anticoagulant drug Pradaxa (dabigatran). The company has told investigators in trials utilizing dabigatran that it will shortly be sending a “Dear Doctor Letter,” also known as a Direct Healthcare Professional Communication (DHPC), to healthcare professionals. The letter will inform physicians that, […]

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