Discover and read the best of Twitter Threads about #rivaroxaban
Most recents (9)
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/
Have you been prescribed #rivaroxaban for #BloodClots?
A major trial of the anti-clotting drug rivaroxaban (XARELTO®) is now under scrutiny, after my BMJ investigation into the FDA's oversight of clinical trials.
maryannedemasi.substack.com/p/lancet-opens… @bmj_latest @rfsquared @drjohnm
A major trial of the anti-clotting drug rivaroxaban (XARELTO®) is now under scrutiny, after my BMJ investigation into the FDA's oversight of clinical trials.
maryannedemasi.substack.com/p/lancet-opens… @bmj_latest @rfsquared @drjohnm
Dubbed the "warfarin alternative," rivaroxaban has been prescribed more than 80 million times in the US alone. In 2020, it was rated 10th in the global sales rankings and generated almost US$7 billion that year.
The FDA identified numerous & serious data integrity deficiencies at 8 of the study’s 16 clinical trial sites. But when the trial was published in the Lancet in 2009 the investigators made no mention of the data integrity issues.
It took my legs a few minutes to warm up this morning, but glad to report that long morning walks remain easy, in contrast to later in the day. #Totnes is waking up beautifully ☀️
5 miles walked this morning, with no adverse effects. Then strimmed & mowed a lawn. Great to not be worried about my heart and lungs as I got a real workout from the gardening. However, I'm mindful of the warnings of some with #LongCovid that I should continue to pace myself.
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 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.
#WeekendLecture
Intracranial Atherosclerotic Disease #ICAD
#ICAD leads to changes ranging from minor wall thickening to #hemodynamically significant luminal stenosis and is one of the most #common causes of #stroke worldwide
ahajournals.org/doi/10.1161/CI…
🧵
Intracranial Atherosclerotic Disease #ICAD
#ICAD leads to changes ranging from minor wall thickening to #hemodynamically significant luminal stenosis and is one of the most #common causes of #stroke worldwide
ahajournals.org/doi/10.1161/CI…
🧵
#WeekendLecture
#ICAD
✅10% of stroke, based on autopsy studies
bit.ly/3v6Lhrd
✅More prevalent in #African Americans, #Hispanics, and #Asians as compared with whites
bit.ly/3AuSiDt
Other risk factors in table
#ICAD
✅10% of stroke, based on autopsy studies
bit.ly/3v6Lhrd
✅More prevalent in #African Americans, #Hispanics, and #Asians as compared with whites
bit.ly/3AuSiDt
Other risk factors in table
#WeekendLecture
#ICAD
In postmortem studies
👉degree of luminal #stenosis
👉% of the plaques containing >40% #lipid area
👉prevalence of intraplaque #hemorrhage, #neovasculature and #thrombus,
were higher in those #plaques associated with #infarct
🔹karger.com/Article/Abstra…
#ICAD
In postmortem studies
👉degree of luminal #stenosis
👉% of the plaques containing >40% #lipid area
👉prevalence of intraplaque #hemorrhage, #neovasculature and #thrombus,
were higher in those #plaques associated with #infarct
🔹karger.com/Article/Abstra…
#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
