Discover and read the best of Twitter Threads about #Apixaban
Most recents (11)
1/
Second day of @Smart_Meeting_M
Professor @giovannilandoni talking about management of #anticoagulant in #perioperative patients 💉
✅You surely all know how to deal with #antithrombotic and #regionalanesthesia, here the guidelines:
pubmed.ncbi.nlm.nih.gov/34980845/
#FOAMed #FOAMcc
Second day of @Smart_Meeting_M
Professor @giovannilandoni talking about management of #anticoagulant in #perioperative patients 💉
✅You surely all know how to deal with #antithrombotic and #regionalanesthesia, here the guidelines:
pubmed.ncbi.nlm.nih.gov/34980845/
#FOAMed #FOAMcc
2/
💡Let's focus on perioperative #DOAC /#NOAC / #TSOAC
➡️Consider both #surgical blood loss risk and #patient characteristics.
⚠️Remember NOT to bridge with #LMWH or #UFH.
pubmed.ncbi.nlm.nih.gov/33895845/
💡Let's focus on perioperative #DOAC /#NOAC / #TSOAC
➡️Consider both #surgical blood loss risk and #patient characteristics.
⚠️Remember NOT to bridge with #LMWH or #UFH.
pubmed.ncbi.nlm.nih.gov/33895845/
3/
What if it's not an elective patient??
Use #reversal agents when needed❗
🔹#Idarucizumab for #dabigatran
🔹#Andexanet for #apixaban and #rivaroxaban
💡#Prothrombin complex concentrates in addiction
pubmed.ncbi.nlm.nih.gov/36988142/
What if it's not an elective patient??
Use #reversal agents when needed❗
🔹#Idarucizumab for #dabigatran
🔹#Andexanet for #apixaban and #rivaroxaban
💡#Prothrombin complex concentrates in addiction
pubmed.ncbi.nlm.nih.gov/36988142/
1a) Welcome to a new #accredited #tweetorial on the management of aFXa-DOAC-associated #hemorrhage and specifically the role of coag laboratory testing in these challenging cases.
1b) Our expert author is #pharmacist Craig Beavers, PharmD @beaverspharmd CV Clinical Pharmacy Specialist @UK_COP, and Immediate Past Chair of the @ACCinTouch #ACCCVT Section
2) This 🆓program is accredited for 0.5h CE/#CME for #physicians #physicianassociates #nurses #nurespractitioners #pharmacists and is supported by a grant from AstraZeneca. See statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
1a) Welcome to a new #accredited #tweetorial on a very challenging topic: managing #ICH in a patient taking anti-FXa #DOACs! Your expert authors are both #neurointensivists: Richard Choi, DO @rkchoi @christianacare and Casey Albin, MD @caseyalbin @EmoryNeuroCrit
1b) #Physicians #Nurses #Pharmacists #physicianassociate #NPs earn 0.5h CE/#CME from @academiccme for following this 🧵
2) This program is supported by an educational grant from AstraZeneca and is intended for #HCPs. Accreditation statement and faculty disclosures at cardiometabolic-ce.com/disclosures/. Prior (& future) programs in this space, available for 🆓CE/#CME credit, at cardiometabolic-ce.com/category/antit….
1) Welcome to an #accredited #tweetorial on a unique emerging (in Ph3 now) option for specifically reversing the #antiplatelet effects of #ticagrelor: it's #bentracimab. Expert faculty is antithrombotic agent reversal guru @md_pollack of @UMMCnews, working to create #AHealthierMS
2) This program is intended for #healthcare professionals and is supported by an educational grant from PhaseBio Pharmaceuticals. Faculty disclosures are listed at cardiometabolic-ce.com/disclosures/, and prior programs are available for 🆓CE/#CME credit at cardiometabolic-ce.com.
3) It is an unfortunate fact of life that one cannot prescribe #anticoagulant or #antiplatelet (together, #antithrombotic) therapy without increasing a patient's #bleedingrisk. That is why it should be an individualized risk:benefit decision, ideally . . .
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!
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
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.
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/…
jamanetwork.com/journals/jama/…
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 💵💊
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.
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.
#ACC21 late-breakers🧵
1/Antiplatelets: Let's start with #aspirin
❌ADAPTABLE :Aspirin 325 mg vs 81 mg in ASCVD pts
No difference in death/ MI/ stroke/major bleeding
💎pragmatic trial: EHR-identified pts
💎significant dose switching in 325 mg group
nejm.org/doi/full/10.10…
1/Antiplatelets: Let's start with #aspirin
❌ADAPTABLE :Aspirin 325 mg vs 81 mg in ASCVD pts
No difference in death/ MI/ stroke/major bleeding
💎pragmatic trial: EHR-identified pts
💎significant dose switching in 325 mg group
nejm.org/doi/full/10.10…
✅Host Exam: Aspirin vs Clopidogrel in chronic Maintenance monotherapy after #PCI w/ DES
#Clopidogrel monotherapy reduced composite of death, non-fatal MI, stroke, ACS re-admission, BARC >=3 bleeding, compared to #aspirin monotherapy.
❓East Asian paradox
thelancet.com/journals/lance…
#Clopidogrel monotherapy reduced composite of death, non-fatal MI, stroke, ACS re-admission, BARC >=3 bleeding, compared to #aspirin monotherapy.
❓East Asian paradox
thelancet.com/journals/lance…
✅TALOS- AMI: De-escalation ✅
In pts w/ no major events in 1st month after index PCI, de-escalation of DAPT from #ticagrelor to #clopidogrel is superior to tica-only DAPT in terms of net clinical benefit, with
⬇️decreased bleeding 🩸risk
- no increase in ischaemic risk
#ACC21
In pts w/ no major events in 1st month after index PCI, de-escalation of DAPT from #ticagrelor to #clopidogrel is superior to tica-only DAPT in terms of net clinical benefit, with
⬇️decreased bleeding 🩸risk
- no increase in ischaemic risk
#ACC21
#FibrilaciónAuricular
#Anticoagulación
🧐Revisiones muy útiles siempre para afianzar conceptos.
👏Si además son compañeros🇪🇸 me quito el 🎩
👩🎓En tres minutos se repasa la FA y su tratamiento
💊ACOD hay que saberse todo! #MIR #MIR2021 #EIR
🧓Pensar en los mayores siempre!
#Anticoagulación
🧐Revisiones muy útiles siempre para afianzar conceptos.
👏Si además son compañeros🇪🇸 me quito el 🎩
👩🎓En tres minutos se repasa la FA y su tratamiento
💊ACOD hay que saberse todo! #MIR #MIR2021 #EIR
🧓Pensar en los mayores siempre!
1⃣ACOD
2⃣Riesgo embólico vs Hemorrágico
3⃣Edad
4⃣Problemas de dosis (Cuidado!🆘)
The problem of underdosing with direct-acting oral anticoagulants in elderly patients with nonvalvular atrial fibrillation | Journal of Comparative Effectiveness Research futuremedicine.com/doi/full/10.22…
2⃣Riesgo embólico vs Hemorrágico
3⃣Edad
4⃣Problemas de dosis (Cuidado!🆘)
The problem of underdosing with direct-acting oral anticoagulants in elderly patients with nonvalvular atrial fibrillation | Journal of Comparative Effectiveness Research futuremedicine.com/doi/full/10.22…
1⃣La #FA es un problema muy común🌏
2⃣Crecimiento en los próximos años
3⃣Aumento de prevalencia con la edad🧓
4⃣Aumento de complicaciones con la edad🧓
2⃣Crecimiento en los próximos años
3⃣Aumento de prevalencia con la edad🧓
4⃣Aumento de complicaciones con la edad🧓
#WeeklyCardioReview AUGUSTUS trial #NeverTooLate #Apixaban in patients requiring DAPT. Two key aspects to discuss here: 1) Should Apixaban 5mg/BID be the only NOAC used with triple therapy? 2) Time to move to NOAC+Clopidogrel dual therapy? enjoy thread and comment! 😉
Summary: AUGUSTUS RCT 4,614 ppl requiring DAPT (ACS and-or PCI) factorial design: Apixa vs Warfarin (NOAC research question), and ASA vs placebo (triple vs dual tx question) for 6 months. Study powered for bleeding outcomes and had guts to assume no interaction, stay tuned
Major or clinically relevant nonmajor bleeding lower in Apixa vs Warfarin HR 0.69 (0.58-0.81; superiority P<0.001), ASA vs placebo 1.89 (1.59-2.24; placebo superiority P<0.001). Apixa Vs Warfa, and ASA vs placebo similar incidence of ischemic events
