Nikolay Dimitrov’s Post

Optimal timing of anticoagulation after acute ischaemic stroke with atrial fibrillation (OPTIMAS): a multicentre, blinded-endpoint, phase 4, randomised controlled trial Werring, David JJelley, Benjamin et al. The Lancet, Volume 404, Issue 10464, 1731 - 1741 Early DOAC initiation within 4 days after ischemic stroke associated with atrial fibrillation was noninferior to delayed initiation for the composite outcome of ischemic stroke, intracranial hemorrhage, unclassifiable stroke, or systemic embolism at 90 days.

In patients undergoing PCI, ticagrelor but not clopidogrel monotherapy was non-inferior to DAPT for the prevention of ischemic events and superior for NACE. Major bleeding was similarly reduced with ticagrelor and clopidogrel monotherapy vs DAPT. https://ja.ma/3Tp0HUg

Great Article on Recent Study by Susan Hughes in Medscape Challenges the Practice of Rapidly Lowering Blood Pressure (BP) in Acute Ischemic Stroke to Allow for Speedy Thrombolysis. https://lnkd.in/gHWzWGbx

Mitigating adverse ischemic events while minimizing the risk of bleeding during antithrombotic therapy in ACS patients remains a challenge 🙇♀️. Our review provides an overview of the current data and possible personalized approaches to implement in your clinical practice.

WOW ... From the 2023 ACC Expert Consensus Decision Pathway on Comprehensive Multidisciplinary Care for the Patient With Cardiac Amyloidosis. "There are over 130 known TTR variants associated with ATTR amyloidosis of which the most common in the United States is the substitution of isoleucine for valine at position 122 of the protein sequence (reported as pV142I or Val122Ile or V122I). The prevalence of the Val122Ile variant has been reproducibly shown to be 3.5% in the self-identified U.S. Black population, corresponding to approximately 1.5 million carriers." https://lnkd.in/enYUW2XN

Anemia is one of the most common laboratory abnormalities observed in pediatric practice. It can arise from three primary mechanisms: decreased production of red blood cells (RBCs), increased loss of RBCs, or premature destruction of RBCs, known as hemolysis. In some conditions, these mechanisms can occur concurrently. Hemolytic anemias are characterized by a reduced lifespan of erythrocytes due to premature destruction.... https://lnkd.in/dyHs25Bf

OAC alone is superior on bleeding with similar ischemic event rates in patients with AFib and CAD: new meta-analysis of 3 trials. This appears to be the new optimal strategy.

#FactorXI inhibitors hold promise for safer #anticoagulants, potentially offering #stroke protection without severe bleeding risks. This innovation could bring peace of mind to patients and benefit those at high bleeding risk. How might this be achieved? Factor XI inhibitors specifically target the pathological #thrombosis pathway, leaving the physiological #hemostasis pathway unaffected. Learn more about the potential of the emerging class of Factor XI from a recent article published in The Wall Street Journal: https://bit.ly/3Twwh2C. #atrialfibrillation #afib #afibawareness #stroke #strokeawareness #venousthromboembolism #cancerassociatedthrombosis #thrombosis #hemostasis #FactorXI  

#Oligonucleotides #Nusinersen* : used in treating spinal muscular atrophy (SMA), a rare neuromuscular disorder. #CPG 1018/2007/2216 #Givosiran*: to treat patients with acute hepatic porphyria. #Inclisiran*: used for the treatment of high low-density lipoprotein (LDL) cholesterol and for the treatment of people with atherosclerotic cardiovascular disease (ASCVD) #Patisiran*: a liposomal siRNA molecule, is used to treat patients with polyneuropathy (sensorimotor and autonomic neuropathy) and cardiomyopathy associated with hereditary transthyretin-mediated amyloidosis and wild-type transthyretin-mediated amyloidosis (ATTRwt). #Vutrisiran*: treatment of the polyneuropathy of hereditary transthyretin-mediated amyloidosis in adults. *Disclaimer: Due to the limitation of patent protection, commercial production and sales will not be carried out for the time being, and will only be used for scientific research and administrative approval.

Effects of levothyroxine in subclinical hypothyroidism and heart failure with reduced ejection fraction: An open-label randomized trial #CellReportsMedicine https://hubs.li/Q02vrtfV0