Discover and read the best of Twitter Threads about #doac

Most recents (12)

Perioperative #DOAC management. Important differences between PAUSE and ASRA. How can we come to consensus? Dr Douketis is proposing PAUSE-2 trial aiming for a single approach. #ISTH2022 ImageImageImage
He performed a small, pilot study to assess feasibility of randomizing to ASRA vs PAUSE approach. High level of consent in this cohort. Will other sites be willing to randomize? I hope so! #ISTH2022 ImageImageImageImage
Interestingly, both approaches had similarly low #DOAC drug levels. How well protocols were followed and impact of renal function will be important to explore. #ISTH2022 Image
Read 3 tweets
#WeekendLecture
#ISC22
Highlights

300 invited talks
Nearly 200 oral abstracts
>1000 posters
Here we review some of trials and presentation from Main Events at #ISC22
#ISC22 Highlights
#RESCUE_Japan LIMIT
EVT for acute LVO with #large ischemic #Core

NIHSS>6, #ASPECT 3-5 , CT or MRI (~85%)
<6hr, or DWI/FLAIR mismatch <24hr
🚶mRS 0-3 at 90d: 31 vs 12.8%, RR 2.43🩸sICH,<48hr: 9 vs 4.9% NS
⚫️Death: 18 vs 23.5%, NS

nejm.org/doi/full/10.10…
#ISC22 Highlights
#Rescue-BT EVT with or w/o #tirofiban in LVO stroke
GPIIb/IIIa-R inhibitor could ⏬reocclusion after MT
55🏥in🇨🇳AIS<24hr, no IVT, ASPECT≥6
950pts
🚶mRS at 90d: 3 vs 3
🩸sICH: 9.7 vs 6.4%, NS
⚫️Death: 18.1 vs 16.9%
Treatment effect modification in LAA subgroup
Read 12 tweets
1) Welcome to a new #accredited #tweetorial on managing #VTE at the extremes of weight & renal function. Free CE/#CME credit for following along with expert author @AryaRoopen from King’s Thrombosis Centre at King's College Hospital in London! Only the best for our learners! Image
2) When we think about "special populations" in #VTE, we think weight, age, and #cancer status. @aakonc already addressed the last of those (earn credit still at cardiometabolic-ce.com/antithrombotic…). Learn the rest here! Hello to @ProfMakris @bhwords @MiddeldorpS @fniainle @AliTaherMD
3) This educational program is intended for health care providers & is supported by a grant from Bristol Myers Squibb & its Alliance partner Pfizer, Inc. Faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #physicianassociates #nurses #NPs #pharmacists
Read 51 tweets
1) Welcome to a new #accredited #tweetorial on a🗝️ topic in #cancer care & #vascular medicine: #VTE (#DVT and #PE). Cancer patients are at⬆️risk from their disease, their comorbidities, & often from their treatment. It's a sticky wicket & @cardiomet_CE is proud to welcome ...
2) ... one of the world's leading authorities on cancer-associated VTE as new faculty both here and on @onc_ce: Dr. Alok Khorana @aakonc of @ClevelandClinic, to talk about advances and best treatment in this space!
3) This educational program is intended for health care providers & is supported by a grant from Bristol Myers Squibb & its Alliance partner Pfizer, Inc. Faculty disclosures are listed at cardiometabolic-ce.com/disclosures/. Earn CE/#CME credit from prior programs at cardiometabolic-ce.com.
Read 39 tweets
In our @JAMA_current editorial, we tackle a timely question in #CardioTwitter: should we recommend #apixaban or #rivaroxaban as first-line anticoagulant for #Afib?The two #DOACs are not interchangeable for bleeding or stroke. Let's review all RCTs & RWE🧵
jamanetwork.com/journals/jama/… Image
Why should you care? Why now? 1) >70% of #Medicare pts on anticoagulation are taking #DOACs, practically replacing warfarin 2) Generic DOACs will enter the market in 2022, massively ⬆️ patient access & use 3) Insurance companies may not cover all DOACs in their formularies 💵💊 Image
RCTs first: in ROCKET-AF (n=14K pts), riva was NON-INFERIOR to warfarin for stroke (per-protocol)🧠, w/ similar rates of major/non-major bleed🩸. In ARISTOTLE (n=18K pts), apixa was SUPERIOR to warfarin for stroke (ITT)🧠 AND w significantly⬇️ major bleed🩸, AND even⬇️mortality. Image
Read 17 tweets
Don’t miss a new accredited #tweetorial launching TOMORROW here on @cardiomet_CE. #Emergencymedicine #thrombosis researcher @md_pollack will be discussing safe, effective management of selected patients with venous thromboembolism (#VTE) from the #emergencydepartment.
It used to be SOOO much more complicated, but since we entered the era of the #DOACs, #lifeisgood! #Physicians #nurses #pharamcists all work together to make it happen, and all can earn CE/#CME here! @AlexSpyropoul @ScottKaatz @RenatoDLopes1 @GenoMerli @aakonc @vic_tapson
1) Welcome to a #tweetorial on the safe and effective management of acute venous #thromboembolism (#VTE) directly from the #emergencydepartment. This program is accredited for 0.50 credits for #physicians #nurses #pharmacists by @academiccme! I am @md_pollack. Image
Read 23 tweets
World class ⁦@ClevelandClinic⁩ Hospital Medicine Grand Rounds - Update in #HospitalMedicine by Dr. Jessica Donato! A rising star! ⁦@BIDMC_IM⁩ ⁦@HarvardHospMed⁩ ⁦@CWRUSOM⁩ ⁦@SocietyHospMed
Is postop #afib associated w increased risk for CVA/TIA?
Is one #DOAC better than other for #afib?
Read 21 tweets
1/
Ever wonder if all #DOACs were created equal? #GITwitter #livertwitter #MedTwitter

Let's start with a poll followed by a #tweetorial on direct oral anticoagulants. First things first, which is your go-to choice of #DOAC ? (COI: none):
2/
These agents work "directly" to anti-coagulate and since they are hardly "new' anymore the term #NOAC has become obsolete. Dabigatran is a direct thrombin inhibitor (factor IIa), whereas the others are factor Xa inhibitors (note the Xa in their names)

3/
In general they share many characteristics such as a quick onset of action, shorter half-lives, potential for drug-drug interactions (CYP3A4 & P-gp) and renal elimination (except apixaban) when compared with warfarin

ncbi.nlm.nih.gov/pmc/articles/P…
Read 18 tweets
Kicking off multidisciplinary Research Consensus Panel (RCP) to finally investigate the ❓: what is the optimal medical therapy (OMT) following venous recan? Follow #VenousRCP throughout the day to learn more and contribute! #SIRFoundation @SIRRFS @SIR_ECS @JVIRmedia
🔴 Pathophysiology of venous thromboembolism #VTE
🟠Venous recanalization & stenting
🟡The mystery of medical therapy following recanalization
🟢Patency & outcome measures
🔵Economics & cost-effectiveness of treatment
🟣Future directions
#VenousRCP
🔴 ✅#VTE affects ~100 of every 100,000 people yearly in the US
✅Incidence of VTE ⬆️⬆️ exponentially with age, especially after 40
#Endovascular recan is a common tx; post-tx algorithms vary widely
✅More #epidemiology info @CircAHA bit.ly/37IptZh
@Pertconsortium
Read 24 tweets
‘Overall, #antiplatelet monotherapy is ineffective for #stroke prevention [for #AtrialFibrillation] & potentially harmful (especially #elderly), whereas #DAPT associated with bleeding risk similar to OAC. Hence, antiplatelets should not be used for #stroke prevention in #AF
2020 ESC Guidelines for the diagnosis and management of #AtrialFibrillation #ESCCongress : academic.oup.com/eurheartj/adva…
‘Between 2009 & 2018, in #England, the use of #OAC for #stroke prophylaxis in #AtrialFibrillation increased, with #DOAC accounting for over half of OAC uptake in 2018.’
Read 7 tweets
This population-based, multicentre, 10-year study of the use of oral #anticoagulants for #stroke prophylaxis for ~0.5M patients with #AFib found that their prescription for patients with #AF at high risk of stroke increased by nearly 60%.
Between 2009 & 2018, 3352 individual General Practices provided a total of 5968 uploads into the GRASP-AF database. From the first upload per General Practice, there were an estimated 450 518 patients with #AFib from a total of 24 644 210 people.
Over the study period the prevalence of AF was 1.8% [95% CI 1.7–1.9%], which increased from 1.6% (1.5–1.7%) in 2009 to 2.4% (2.3–2.5%) in 2018 (P-trend < 0.001). Image
Read 17 tweets
Study warns against combined use of oral #anticoagulants , #antiplatelet therapy for #AFib 1️⃣

#GARFIELD-AF registry

escardio.org/The-ESC/Press-…
2️⃣ Currently, do you stop #aspirin w #NOAC #DOAC for #AFIB in pts w previous history of stent (>1yr prior) for non-ACS CAD ? (Yes- I know it should be a less and less common scenario)
3️⃣ Currently, do you stop #aspirin w #NOAC #DOAC for #AFIB in pts w previous history of CAD ( #STEMI / #NSTE-ACS >1year prior) ?
Read 3 tweets

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