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Burden of venous thromboembolism in patients with pancreatic cancer

World Journal of Gastroenterology 2021年第19期27卷 2325-2340页

作者： Corinne Frere Department of Haematology Pitie-Salpetriere HospitalAssistance Publique Hopitaux de ParisParis F-75013France INSERM UMRS_1166 Institute of Cardiometabolism And NutritionGRC 27 GRECOSorbonne UniversitéParis F-75013France Groupe Francophone Thrombose et Cancer Saint-Louis HospitalParis F-75010France

Pancreatic cancer(PC)is a devastating malignancy with fewer than 10%of patients being alive at 5 years after *** thromboembolism(VTE)occurs in approximatively 20%of patients with PC,resulting in increased morbidity,mortality and significant health care *** management of VTE is particularly challenging in these frail *** selection of the most appropriate anticoagulant for each individual patient according to the current international guidelines is warranted for overcoming treatment *** International Initiative on Thrombosis and Cancer multi-language web-based mobile application(downloadable for free at ***)has been developed to help clinicians in decision making in the most complex *** this narrative review,we will discuss the contemporary epidemiology and burden of VTE in PC patients,the performances and limitations of current risk assessment models to predict the risk of VTE,as well as evidence from recent clinical trials for the primary prophylaxis and treatment of cancer-associated VTE that support updated clinical practice guidelines.

关键词： Pancreatic cancer Venous thromboembolism Low-molecular weight heparin direct oral anticoagulant Multi-language mobile application Risk-assessment models Thromboprophylaxis

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Dabigatran,rivaroxaban,and apixaban are superior to warfarin in Asian patients with non-valvular atrial fibrillation:An updated metaanalysis

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World Journal of Cardiology 2021年第4期13卷 82-94页

作者： Wei-Jia Li Paraschos Archontakis-Barakakis Leonidas Palaiodimos Dimitrios Kalaitzoglou Lazaros Tzelves Apostolos Manolopoulos Yu-Chiang Wang Stefanos Giannopoulos Robert Faillace Damianos G Kokkinidis Department of Medicine Jacobi Medical CenterBronxNY 10461United States Department of Surgery 424 General Army Hospital of ThessalonikiThessaloniki 56429Greece Department of Urology Sismanogleio HospitalAthens 15126Greece Clinical Research and Evidence-Based Medicine Unit Aristotle University of ThessalonikiThessaloniki 54124Greece Division of Cardiology Rocky Mountain Regional VA Medical CenterDenverCO 80045United States

BACKGROUND Most of the randomized clinical trials that led to the wide use of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with atrial fibrillation(AF)originated from western *** To systematically review and quantitatively synthesize the real-world data regarding the efficacy and safety of dabigatran,rivaroxaban,and apixaban compared to warfarin for stroke prevention in Asian patients with non-valvular *** Medline,Cochrane,and *** databases were reviewed.A randomeffect model meta-analysis was used and I-square was utilized to assess the *** primary outcome was ischemic *** secondary outcomes were all-cause mortality,major bleeding,intracranial hemorrhage,and gastrointestinal *** Twelve studies from East Asia or Southeast Asia and 441450 patients were ***,rivaroxaban,and apixaban were associated with a significant reduction in the incidence of ischemic stroke[hazard ratio(HR)=0.78,95%confidence interval(CI):0.65-0.94;HR=0.79,95%CI:0.74-0.85,HR=0.70,95%CI:0.62-0.78;respectively],all-cause mortality(HR=0.68,95%CI:0.56-0.83;HR=0.66,95%CI:0.52-0.84;HR=0.66,95%CI:0.49-0.90;respectively),and major bleeding(HR=0.61,95%CI:0.54-0.69;HR=0.70,95%CI:0.54-0.90;HR=0.58,95%CI:0.43-0.78;respectively)compared to *** Dabigatran,rivaroxaban,and apixaban appear to be superior to warfarin in both efficacy and safety in Asians with non-valvular AF.

关键词： Novel oral anticoagulant direct oral anticoagulant Atrial fibrillation Asian population Dabigatran Rivaroxaban Apixaban Warfarin

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Systemic right ventricle complications in levo-transposition of the great arteries: A case report and review of literature

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World Journal of Cardiology 2023年第10期15卷 542-552页

作者： Mohamed Ramzi Almajed Abdulla Almajed Naoshin Khan Mark S Obri Karthikeyan Ananthasubramaniam Department of Internal Medicine Henry Ford HospitalDetroitMI 48202United States College of Medicine and Medical Sciences Arabian Gulf UniversityManama 00000Bahrain Heart and Vascular Institute Henry Ford West Bloomfield HospitalWest BloomfieldMI 48322United States

BACKGROUND Congenitally corrected levo-transposition of the great arteries(L-TGA)is a congenital heart disease in which the ventricles and great arteries are transposed from their typical *** L-TGA,the double discordance,atrioventricular and ventriculoarterial,create an acyanotic milieu which allows patients to survive their early decades,however,progressive systemic right ventricle(sRV)dys-function creates complications later in *** dysfunction and remodeling predisposes patients to intracardiac thrombus(ICT)*** SUMMARY A 40-year-old male with L-TGA presented with symptoms of acute decom-pensated heart *** childhood,he had surgical repair of a ventricular septal *** adulthood,he developed sRV dysfunction,systemic tricuspid valve(sTV)regurgitation,and left-bundle branch block for which he underwent cardiac resynchronization *** echocardiogram showed a sRV ejection fraction of 40%,severe sTV regurgitation,and a newly identified sRV *** was confirmed by ultrasound-enhancing agents and transesophageal *** patient was optimized with guideline-directed medical therapy and *** was achieved with a vitamin K antagonist(VKA)and he was later referred for evaluation by advanced heart failure and heart transplant *** Anticoagulation with VKA is the mainstay of treatment in the absence of conclusive data supporting direct oral anticoagulant use in ICT in patients with congenital heart *** case illustrates the natural history of L-TGA and highlights the importance of surveillance and monitoring with dedicated cardiac imaging to identify complications.

关键词： Levo-transposition of the great arteries Systemic right ventricle Congenital heart disease Intracardiac thrombus Anticoagulation direct oral anticoagulant Case report

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Effectiveness and safety of apixaban and rivaroxaban vs warfarin in patients with atrial fibrillation and chronic kidney disease

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World Journal of Nephrology 2023年第5期12卷 132-146页

作者： Sylvie Perreault Laurie-Anne Boivin Proulx Aurélie Lenglet Ziad A Massy Marc Dorais Faculty of Pharmacy University of MontrealQuebecMontreal H3C3J7Canada Department of Cardiology Faculty of MedicineUniversity of Ottawa Heart InstituteOntarioOttawa K1Y4W7Canada Department of Pharmacy Amiens-Picardie Hospital University CenterAmiens 80000France Faculty of Pharmacy MP3CV LaboratoryUR7545University of Picardie Jules VerneAmiens 80000France Division of Nephrology University of Paris Ouest-Versailles-Saint-Quentin-en-Yvelines(UVSQ)VillejuifFrance.AP-HP Ambroise-ParéHospitalBoulogne Billancourt/Paris 92104France StatSciences Inc. Notre-Dame-de-l’Île-PerrotQuebecMontreal J7W 3K8Canada

BACKGROUND Randomized controlled trials(RCTs)of direct oral anticoagulants(DOACs)included a low proportion of atrial fibrillation(AF)patients with chronic kidney disease(CKD),and suggested that DOACs are safe and effective in patients with mild-to-moderate *** a metanalysis of RCTs and observational studies,DOACs were associated with better efficacy(vs warfarin)in early CKD and had similar efficacy and safety profiles in patients with stages IV-V *** few studies have provided data on the safety and effectiveness of each DOAC vs warfarin in patients with stage III *** effectiveness and safety of DOACs in those patients are still subject to *** To assess and compare the effectiveness and safety of apixaban and rivaroxaban vs warfarin in this patient *** A cohort of patients with an inpatient or outpatient code for AF and stage III CKD who were newly prescribed apixaban and rivaroxaban was created using the administrative databases from the Quebec province of Canada between 2013 and *** primary effectiveness outcome was a composite of ischemic stroke,systemic embolism,and death,whereas the primary safety outcome was a composite of major bleeding within a year of DOAC vs warfarin *** groups were compared in an under-treatment analysis using inverse probability of treatment weighting and Cox proportional *** A total of 8899 included patients filled out a new oral anticoagulation therapy claim;3335 for warfarin and 5564 for *** with warfarin,15 mg and 20 mg rivaroxaban presented a similar effectiveness and safety composite *** 5.0 mg was associated with a lower effectiveness composite risk[Hazard ratio(HR)0.76;95%confidence interval(CI):0.65-0.88]and a similar safety risk(HR 0.94;95%CI:0.66-1.35).Apixaban 2.5 mg was associated with a similar effectiveness composite(HR 1.00;95%CI:0.79-1.26)and a lower safety risk(HR 0.65;95%CI:***,apixaban 5.0 mg was associated with a bet

关键词： Atrial fibrillation Chronic kidney disease direct oral anticoagulant Effectiveness Safety Warfarin

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