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Periprocedural dabigatran use is associated with higher major bleeding rate than warfarin, study finds
Patients using periprocedural dabigatran had a significantly higher major bleeding rate than those using warfarin, according to a study published online first February 1, 2012, in the Journal of the American College of Cardiology.
Patients using periprocedural dabigatran had a significantly higher major bleeding rate than those using warfarin, according to a study published online first February 1, 2012, in the Journal of the American College of Cardiology.
Lead author Dhanunjaya Lakkireddy, MD, with the Cardiovascular Research Institute, Mid-America Cardiology at the University of Kansas Hospital and Medical Center in Kansas City, and fellow researchers set out to study the feasibility and safety of dabigatran during atrial fibrillation (AF) ablation, since the safety and efficacy of dabigatran as an anticoagulant for AF ablation are unknown.
The researchers performed a multicenter, observational study from a prospective registry, including all consecutive patients undergoing AF ablation in 8 high-volume centers in the United States. A total of 290 patients, including 145 taking periprocedural dabigatran and an equal number of matched patients taking uninterrupted periprocedural warfarin, were included in the study.
The dabigatran group had a significantly higher major bleeding rate of 6% versus 1% in the warfarin group, a total bleeding rate of 14% versus 6% in the warfarin group, and 16% composite of bleeding and thromboembolic complications versus 6% in the warfarin group.
“In patients undergoing AF ablation, continuation of dabigatran during the periprocedural period is associated with an increased risk of bleeding and composite of bleeding or embolic complications compared with uninterrupted warfarin therapy,” Dr Lakkireddy wrote in the study. More studies are needed to identify the optimal periprocedural anticoagulation strategies in patients on dabigatran undergoing AF ablation, he added.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
