Friday, 18 March 2016 20:22

Anticoagulation news items. Weeks commencing 14th March 2016

Safer Prescribing — A Trial of Education, Informatics, and Financial Incentives

New England Journal of Medicine

Trial in 34 Scottish practices found a complex intervention combining professional education, informatics, and financial incentives reduced rate of high-risk prescribing of antiplatelets and NSAIDs (OR 0.63; 95% CI, 0.57 to 0.68; p<0.001) and may have improved clinical outcomes.

 

Reimagining anticoagulation clinics in the era of direct oral anticoagulants

Circulation: Cardiovascular Quality and Outcomes

Review outline 3 key purposes that a reimagined clinic would serve: assist patients/clinicians with selecting most appropriate drug/dose, help patients minimise risk of serious bleeding with careful long-term monitoring/peri-procedural management, and encourage ongoing adherence.

 

Non-vitamin K antagonist oral anticoagulants (NOACs) for the management of venous thromboembolism

Heart

This review aims to provide the reader with an understanding of the importance of venous thrombosis in cardiovascular medicine, the mode of action of different oral anticoagulants, and the uses, risks and benefits of each non-vitamin K antagonist oral anticoagulant.

 

Cardiovascular safety of non-aspirin non-steroidal anti-inflammatory drugs: review and position paper by the working group for Cardiovascular Pharmacotherapy of the European Society of Cardiology

European Heart Journal

This review summarises the current evidence from randomised and observational studies on the cardiovascular safety of non-aspirin NSAIDs and presents a position for their use.

 

Risk of Cerebral Venous Thrombosis (CVT) in Obese Women

JAMA Neurology

This case-control study (185 cases, 6134 controls) found an increased risk of CVT among obese women (OR, 2.63, 95% CI, 1.53-4.54).The risk is 30-fold higher in obese women using oral contraceptives (OCs) compared with normal-weight women not using OCs.

 

The Use of Oral Anticoagulants for Stroke Prevention in Atrial Fibrillation Patients with History of Intra-Cranial Hemorrhage

Circulation

This review of people with atrial fibrillation and prior Intra-Cranial Haemorrhage (ICH), found that the NNT (warfarin vs anti-platelet) for preventing 1 ischaemic stroke was lower than NNH for 1 ICH if CHA2DS2-VASc≥6 (37vs56). NNT was higher than NNH if CHA2DS2-VASc<6 (63vs53).

 

 

The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:
http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services