CardioExchange Archive

October 23rd, 2012

High Rate of Warfarin Discontinuation Observed in Study

Larry Husten, PHD

One of the many potential problems with warfarin-based anticoagulant therapy is the poor rate of adherence and persistence among patients who are prescribed the drug. Now an observational study published in the Archives of Internal Medicine raises the possibility that the problem may be even worse than many have suspected, as discontinuation rates in clinical trials appear […]

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October 15th, 2012

Stable Anticoagulation, Unstable Gait

Jeff Dickey, MD and James Fang, MD

A 91-year-old man with mild drug-controlled hypertension and atrial fibrillation has long-term, well-managed stability on warfarin anticoagulation. After developing problems with his balance and some gait instability, a physical exam reveals a carotid bruit. Carotid ultrasound and magnetic resonance angiography (MRA) confirm >95% stenosis of the right internal carotid artery. Brain CT is negative. Questions: 1.      […]

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October 8th, 2012

Triple Antithrombotic Therapy: What — and When — Is the Bleeding Risk?

Morten Lamberts, MD and John Ryan, MD

Morten Lamberts, MD, lead investigator of a recent registry study of various combinations of antithrombotic agents in patients with AF and CAD, answers John Ryan’s questions about the study and its implications.

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July 2nd, 2012

Selections from Richard Lehman’s Literature Review: July 2nd

Richard Lehman, BM, BCh, MRCGP

This week’s topics include pay for performance, Don Berwick’s Harvard commencement address, tPA for ischemic stroke in warfarin-treated patients, surgery for infective endocarditis, the American health care system, and the record number of RECORD studies.

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June 7th, 2012

Growing Popularity of Dabigatran Leads to Increased Complications

Larry Husten, PHD

Since its approval in the United States in October 2010, dabigatran (Pradaxa) has been prescribed 3.2 million times to more than 600,000 patients with nonvalvular atrial fibrillation (AF), according to its manufacturer, Boehringer Ingelheim. The company also announced that, based on the pivotal RE-LY trial, the “Clinical Studies” section of the drug’s prescribing information now includes the statement […]

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May 24th, 2012

Aspirin Found to Prevent Recurrent Venous Thromboembolism

Larry Husten, PHD

Aspirin can help prevent the recurrence of venous thromboembolism (VTE) after discontinuation of anticoagulation therapy, according to results of the WARFASA (the Warfarin and Aspirin) study published in the New England Journal of Medicine. Following 6 to 18 months of oral anticoagulation, 403 patients with first-time unprovoked VTE were randomized to aspirin (100 mg daily) or placebo for 2 […]

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May 21st, 2012

Selections from Richard Lehman’s Literature Review: Week of May 21st

Richard Lehman, BM, BCh, MRCGP

This week’s topics include warfarin vs. aspirin for stroke prevention in HF, CVD risks and azithromycin, coffee’s benefits, the old news that statins work, the question of HDL-C, abdominal aortic aneurysm, omega-3 fatty acid supplements, and Abbott’s methods for staying ahead with fenofibrate prescriptions.

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May 8th, 2012

In AF, Women Have a Higher Stroke Risk Than Men

Larry Husten, PHD

In an elderly population, when compared to men with atrial fibrillation, women with AF have a significantly elevated risk for stroke. This increased risk occurs regardless of warfarin use.

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May 3rd, 2012

WARCEF: No Advantage for Warfarin over Aspirin in Heart Failure

Larry Husten, PHD

A new study offers “no compelling reason” to use warfarin instead of aspirin in heart failure patients who don’t have atrial fibrillation. In a paper published in the New England Journal of Medicine, Shunichi Homma and members of the Warfarin versus Aspirin in Reduced Cardiac Ejection Fraction (WARCEF) study group report the results of a trial in which […]

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April 30th, 2012

Selections from Richard Lehman’s Literature Review: Week of April 30th

Richard Lehman, BM, BCh, MRCGP

This week, Richard looks at endocarditis and ICDs, more stent wars, stroke prevention in A-Fib, and more.

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