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MeSH: Aspirin-škodlivé účinky

295 záznamů v Články Filtry

Článek

Apixaban for Stroke Prevention in Subclinical Atrial Fibrillation

Healey, Jeff S
Autor Healey, Jeff S ORCID From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Lopes, Renato D
Autor Lopes, Renato D From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Granger, Christopher B
Autor Granger, Christopher B From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Alings, Marco
Autor Alings, Marco From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Rivard, Lena
Autor Rivard, Lena From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
McIntyre, William F
Autor McIntyre, William F From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Atar, Dan
Autor Atar, Dan From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Birnie, David H
Autor Birnie, David H From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Boriani, Giuseppe
Autor Boriani, Giuseppe From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)
Camm, A John
Autor Camm, A John From the Population Health Research Institute, McMaster University, Hamilton, ON (J.S.H., W.F.M., D.C., J.A.W., L.X., K.S., S.N., R.M., S.J.C.), the Montreal Heart Institute, University of Montreal, Montreal (L.R.), the University of Ottawa Heart Institute, Ottawa (D.H.B.), Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, QC (F.P.), the Department of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB (S.B.C.), and the Université de Sherbrooke, Sherbrooke, QC (F.A.-P.) - all in Canada the Duke Clinical Research Institute, Duke University, Durham, NC (R.D.L., C.B.G.) Amphia Ziekenhuis, Breda, the Netherlands (M.A.) Oslo University Hospital and the University of Oslo, Oslo (D.A.) the University of Modena and Reggio Emilia, Modena (G.B.), and the Department of Clinical Sciences and Community Health, University of Milan, and the Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan (M. Proietti) - all in Italy St. George's, University of London, London (A.J.C.), and Liverpool Heart and Chest Hospital, Liverpool (D.J.W.) - both in the United Kingdom J.W. Goethe University, University Hospital Department of Cardiology, Frankfurt, Germany (J.W.E., S.H.H.) the Medical University of South Carolina, Charleston (M.R.G.) Michigan State University, Lansing (J.I.) the Institute for Clinical and Experimental Medicine, Prague, Czech Republic (J.K.) the University of Rochester, Rochester, NY (V.K.) Semmelweis University, Budapest, Hungary (V.K.) Karolinska Institutet and the Heart, Vascular, and Neurology Theme, Karolinska University Hospital, Stockholm (C.L.) the University of Rennes, Rennes, France (P.M.) Cliniques du Sud-Luxembourg, Arlon, Belgium (G.M.) Hospital Universitario La Luz, Madrid (J.B.M.), and Hospital Costa del Sol, Marbella (M. Pombo) - both in Spain Aarhus University Hospital and Aarhus University, Aarhus, Denmark (J.C.N.) University Hospital Basel, University of Basel, Basel, Switzerland (C.S.) the Veterans Affairs Portland Health Care System, Portland, OR (I.G.Z.) and Abrazo Arrowhead Hospital, Glendale, AZ (A.K.)

The New England journal of medicine. 2024 ; 390 (2) : 107-117. [pub] 20231112

N Engl J Med
ISSN 1533-4406
Medvik
Zdroj

BACKGROUND: Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit. METHODS: We conducted a trial involving patients with subclinical atrial fibrillation lasting 6 minutes to 24 hours. Patients were randomly assigned in a double-blind, double-dummy design to receive apixaban at a dose of 5 mg twice daily (2.5 mg twice daily when indicated) or aspirin at a dose of 81 mg daily. The trial medication was discontinued and anticoagulation started if subclinical atrial fibrillation lasting more than 24 hours or clinical atrial fibrillation developed. The primary efficacy outcome, stroke or systemic embolism, was assessed in the intention-to-treat population (all the patients who had undergone randomization); the primary safety outcome, major bleeding, was assessed in the on-treatment population (all the patients who had undergone randomization and received at least one dose of the assigned trial drug, with follow-up censored 5 days after permanent discontinuation of trial medication for any reason). RESULTS: We included 4012 patients with a mean (±SD) age of 76.8±7.6 years and a mean CHA2DS2-VASc score of 3.9±1.1 (scores range from 0 to 9, with higher scores indicating a higher risk of stroke); 36.1% of the patients were women. After a mean follow-up of 3.5±1.8 years, stroke or systemic embolism occurred in 55 patients in the apixaban group (0.78% per patient-year) and in 86 patients in the aspirin group (1.24% per patient-year) (hazard ratio, 0.63; 95% confidence interval [CI], 0.45 to 0.88; P = 0.007). In the on-treatment population, the rate of major bleeding was 1.71% per patient-year in the apixaban group and 0.94% per patient-year in the aspirin group (hazard ratio, 1.80; 95% CI, 1.26 to 2.57; P = 0.001). Fatal bleeding occurred in 5 patients in the apixaban group and 8 patients in the aspirin group. CONCLUSIONS: Among patients with subclinical atrial fibrillation, apixaban resulted in a lower risk of stroke or systemic embolism than aspirin but a higher risk of major bleeding. (Funded by the Canadian Institutes of Health Research and others; ARTESIA ClinicalTrials.gov number, NCT01938248.).

MeSH
antikoagulancia * škodlivé účinky terapeutické užití MeSH
Aspirin * škodlivé účinky terapeutické užití MeSH
cévní mozková příhoda * etiologie prevence a kontrola MeSH
dvojitá slepá metoda MeSH
embolie * etiologie prevence a kontrola MeSH
fibrilace síní * komplikace diagnóza MeSH
inhibitory faktoru Xa škodlivé účinky terapeutické užití MeSH
krvácení chemicky indukované MeSH
lidé MeSH
pyridony škodlivé účinky MeSH
senioři nad 80 let MeSH
senioři MeSH
výsledek terapie MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
senioři nad 80 let MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
randomizované kontrolované studie MeSH
srovnávací studie MeSH
Geografické názvy
Kanada MeSH

Článek

Aspirin-induced anaphylactoid reactions in a patient with acute coronary syndrome complicating acute lung edema: a case report

Cor et Vasa. 2023 ; 65 (6) : 874-876. [pub] 20231222

ISSN 0010-8650
Medvik
Zdroj

Kontext: Antiagregační terapie sice představuje základní způsob léčby pacientů s akutním koronárním syndromem, avšak vzhledem k tomu, že již byl popsán případ hypersenzitivity na kyselinu acetylsalicylovou, může být léčba pacienta s akutním koronárním syndromem problematická. Popis případu: Na oddělení urgentního příjmu byla přepravena 65letá Jávanka s dyspnoe přetrvávající po dobu tří dní a s ortopnoe. Na základě fyzikálního vyšetření a výsledků pomocných testů byla pacientce stanovena diagnóza akutní dekompenzace srdečního selhání. Třetí den léčby byla na EKG záznamu pozorována nová inverze vlny T ve svodech V 1 až V 6 , I a aVL, prokazující akutní koronární syndrom bez elevace úseku ST. Byla podána nasycovací dávka antiagregancií (clopidogrelu a kyseliny acetylsalicylové). Tři dny po podání léčiv si pacientka stěžovala na náhlé zhoršení dušnosti; současně byly slyšet hvízdavé zvuky. Vzniklo tak podezření na alergickou reakci, a vzhledem k četným alergickým reakcím na nesteroidní antiflogistika v anamnéze pacientky se předpokládalo, že tentokrát reakci vyvolala kyselina acetylsalicylová. Diskuse: Kyselina acetylsalicylová se jako inhibitor COX-1 často podílí na vyvolání hypersenzitivních reakcí. V takových případech je léčebnou strategií podání silnějšího antagonisty receptoru P2Y12 a rychlá perorální desenzibilizace ihned po stabilizaci pacientova stavu.

Background: Antiplatelet therapy is an essential treatment for patients with acute coronary syndrome. But a history of aspirin hypersensitivity has been reported and it might be challenging to treat a patient with this case. Case: A 65-year-old Javanese woman came to the emergency department and presented with dyspnea for three days and with orthopnea. Based on physical and supporting examination, the patient was diagnosed with ADHF. However, on the 3rd day of treatment, ECG showed new T wave inversion at lead V1 to V6, I, and aVL lead to NSTEACS. Loading doses of antiplatelets (clopidogrel and aspirin) were administered. Three hours after the drug administration, the patient complained of sudden worsening shortness of breath with pronounced wheezing. Allergic reaction was suspected and due to the patient's history of multiple NSAIDs allergies, aspirin was suspected as the culprit. Discussion: Aspirin as a COX-1 inhibitor, is often implicated with hypersensitivity reactions. Using a more potent P2Y12 receptor antagonist and performing rapid oral desensitization once the patient has stabilized is a strategy in this kind of case.

MeSH
akutní koronární syndrom diagnóza farmakoterapie komplikace MeSH
alergie MeSH
anafylaxe etiologie MeSH
Aspirin * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
inhibitory agregace trombocytů aplikace a dávkování škodlivé účinky terapeutické užití MeSH
lidé MeSH
senioři MeSH
srdeční selhání diagnóza terapie MeSH
Check Tag
lidé MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
kazuistiky MeSH

Článek

Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy

Journal of vascular and interventional radiology. 2023 ; 34 (9) : 1502-1510.e12. [pub] 20230514

J Vasc Interv Radiol
ISSN 1535-7732
Medvik
Zdroj

PURPOSE: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. RESULTS: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. CONCLUSIONS: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.

Článek

Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial

JAMA (Chicago, Ill.). 2023 ; 330 (22) : 2171-2181. [pub] 2023Dec12

JAMA
ISSN 1538-3598
Medvik
Zdroj

IMPORTANCE: Left ventricular assist devices (LVADs) enhance quality and duration of life in advanced heart failure. The burden of nonsurgical bleeding events is a leading morbidity. Aspirin as an antiplatelet agent is mandated along with vitamin K antagonists (VKAs) with continuous-flow LVADs without conclusive evidence of efficacy and safety. OBJECTIVE: To determine whether excluding aspirin as part of the antithrombotic regimen with a fully magnetically levitated LVAD is safe and decreases bleeding. DESIGN, SETTING, AND PARTICIPANTS: This international, randomized, double-blind, placebo-controlled study of aspirin (100 mg/d) vs placebo with VKA therapy in patients with advanced heart failure with an LVAD was conducted across 51 centers with expertise in treating patients with advanced heart failure across 9 countries. The randomized population included 628 patients with advanced heart failure implanted with a fully magnetically levitated LVAD (314 in the placebo group and 314 in the aspirin group), of whom 296 patients in the placebo group and 293 in the aspirin group were in the primary analysis population, which informed the primary end point analysis. The study enrolled patients from July 2020 to September 2022; median follow-up was 14 months. INTERVENTION: Patients were randomized in a 1:1 ratio to receive aspirin (100 mg/d) or placebo in addition to an antithrombotic regimen. MAIN OUTCOMES AND MEASURES: The composite primary end point, assessed for noninferiority (-10% margin) of placebo, was survival free of a major nonsurgical (>14 days after implant) hemocompatibility-related adverse events (including stroke, pump thrombosis, major bleeding, or arterial peripheral thromboembolism) at 12 months. The principal secondary end point was nonsurgical bleeding events. RESULTS: Of the 589 analyzed patients, 77% were men; one-third were Black and 61% were White. More patients were alive and free of hemocompatibility events at 12 months in the placebo group (74%) vs those taking aspirin (68%). Noninferiority of placebo was demonstrated (absolute between-group difference, 6.0% improvement in event-free survival with placebo [lower 1-sided 97.5% CI, -1.6%]; P < .001). Aspirin avoidance was associated with reduced nonsurgical bleeding events (relative risk, 0.66 [95% confidence limit, 0.51-0.85]; P = .002) with no increase in stroke or other thromboembolic events, a finding consistent among diverse subgroups of patient characteristics. CONCLUSIONS AND RELEVANCE: In patients with advanced heart failure treated with a fully magnetically levitated LVAD, avoidance of aspirin as part of an antithrombotic regimen, which includes VKA, is not inferior to a regimen containing aspirin, does not increase thromboembolism risk, and is associated with a reduction in bleeding events. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04069156.

MeSH
Aspirin škodlivé účinky MeSH
cévní mozková příhoda * etiologie prevence a kontrola farmakoterapie MeSH
dvojitá slepá metoda MeSH
fibrinolytika škodlivé účinky MeSH
inhibitory agregace trombocytů škodlivé účinky MeSH
krvácení etiologie MeSH
lidé MeSH
podpůrné srdeční systémy * škodlivé účinky MeSH
srdeční selhání * patofyziologie MeSH
tromboembolie * etiologie prevence a kontrola MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
komentáře MeSH
práce podpořená grantem MeSH

Článek

Využití kyseliny acetylsalicylové (ASA) v prevenci aterosklerotických kardiovaskulárních onemocnění (ASKVO)

Practicus. 2022 ; 21 (4) : 19-21.

ISSN 1213-8711
Medvik
Zdroj

Klíčová slova
enterosolventní léková forma,
MeSH
Aspirin * farmakologie škodlivé účinky terapeutické užití MeSH
kardiovaskulární nemoci * prevence a kontrola MeSH
lidé MeSH
primární prevence MeSH
sekundární prevence MeSH
žaludeční sliznice účinky léků MeSH
Check Tag
lidé MeSH

Článek

Aspirin jako prevence infarktu a mrtvice u zdravých lidí nad 60 let není na místě. Rizika se vyrovnají benefi tům

Practicus. 2022 ; 21 (5) : 30.

ISSN 1213-8711
Medvik
Zdroj

MeSH
Aspirin * škodlivé účinky MeSH
kardiovaskulární nemoci prevence a kontrola MeSH
krvácení etiologie MeSH
lidé MeSH
nežádoucí účinky léčiv MeSH
směrnice pro lékařskou praxi jako téma MeSH
Check Tag
lidé MeSH

Článek

Low-dose rivaroxaban plus aspirin in patients with polypharmacy and multimorbidity: an analysis from the COMPASS trial

European heart journal. Cardiovascular pharmacotherapy. 2022 ; 8 (5) : 462-473. [pub] 2022Aug11

Eur Heart J Cardiovasc Pharmacother
ISSN 2055-6845
Medvik
Zdroj

AIMS: To analyse whether the benefits and risks of rivaroxaban plus aspirin vary in patients with comorbidities and receiving multiple drugs. In patients with coronary or peripheral artery disease, adding low-dose rivaroxaban to aspirin reduces cardiovascular events and mortality. Polypharmacy and multimorbidity are frequent in such patients. METHODS AND RESULTS: We describe ischaemic events (cardiovascular death, stroke, or myocardial infarction) and major bleeding in participants from the randomized, double-blind COMPASS study by number of cardiovascular medications and concomitant medical conditions. We compared event rates and hazard ratios (HRs) for rivaroxaban plus aspirin vs. aspirin alone by the number of medications and concomitant conditions, and tested for interaction between polypharmacy or multimorbidity and the antithrombotic regimen. The risk of ischaemic events was higher in patients with more concomitant drugs (HR 1.7, 95% confidence interval 1.5-2.1 for >4 vs. 0-2) and with more comorbidities (HR 2.3, 1.8-2.1 for >3 vs. 0-1). Multimorbidity, but not polypharmacy, was associated with a higher risk of major bleeding. The relative efficacy, safety, and net clinical benefit of rivaroxaban were not affected by the number of drugs or comorbidities. Patients taking more concomitant medications derived the largest absolute reduction in the net clinical outcome with added rivaroxaban (1.1% vs. 0.4% reduction with >4 vs. 0-2 cardiovascular drugs, number needed to treat 91 vs. 250). CONCLUSION: Adding low-dose rivaroxaban to aspirin resulted in benefits irrespective of the number of concomitant drugs or comorbidities. Multiple comorbidities and/or polypharmacy should not dissuade the addition of rivaroxaban to aspirin in otherwise eligible patients.

MeSH
Aspirin škodlivé účinky MeSH
kombinovaná farmakoterapie MeSH
krvácení chemicky indukované epidemiologie MeSH
lidé MeSH
multimorbidita * MeSH
rivaroxaban * škodlivé účinky MeSH
Check Tag
lidé MeSH
Publikační typ
časopisecké články MeSH
randomizované kontrolované studie MeSH

Článek

Polypill Strategy in Secondary Cardiovascular Prevention

The New England journal of medicine. 2022 ; 387 (11) : 967-977. [pub] 20220826

N Engl J Med
ISSN 1533-4406
Medvik
Zdroj

BACKGROUND: A polypill that includes key medications associated with improved outcomes (aspirin, angiotensin-converting-enzyme [ACE] inhibitor, and statin) has been proposed as a simple approach to the secondary prevention of cardiovascular death and complications after myocardial infarction. METHODS: In this phase 3, randomized, controlled clinical trial, we assigned patients with myocardial infarction within the previous 6 months to a polypill-based strategy or usual care. The polypill treatment consisted of aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and atorvastatin (20 or 40 mg). The primary composite outcome was cardiovascular death, nonfatal type 1 myocardial infarction, nonfatal ischemic stroke, or urgent revascularization. The key secondary end point was a composite of cardiovascular death, nonfatal type 1 myocardial infarction, or nonfatal ischemic stroke. RESULTS: A total of 2499 patients underwent randomization and were followed for a median of 36 months. A primary-outcome event occurred in 118 of 1237 patients (9.5%) in the polypill group and in 156 of 1229 (12.7%) in the usual-care group (hazard ratio, 0.76; 95% confidence interval [CI], 0.60 to 0.96; P = 0.02). A key secondary-outcome event occurred in 101 patients (8.2%) in the polypill group and in 144 (11.7%) in the usual-care group (hazard ratio, 0.70; 95% CI, 0.54 to 0.90; P = 0.005). The results were consistent across prespecified subgroups. Medication adherence as reported by the patients was higher in the polypill group than in the usual-care group. Adverse events were similar between groups. CONCLUSIONS: Treatment with a polypill containing aspirin, ramipril, and atorvastatin within 6 months after myocardial infarction resulted in a significantly lower risk of major adverse cardiovascular events than usual care. (Funded by the European Union Horizon 2020; SECURE ClinicalTrials.gov number, NCT02596126; EudraCT number, 2015-002868-17.).

Článek

Pro léčbu ASA má rozhodující význam výše kardiovaskulárního skóre - rozhovor

Remedia. 2022 ; 32 (4) : 376-378.

ISSN 0862-8947
Medvik
Zdroj

MeSH
Aspirin * aplikace a dávkování škodlivé účinky terapeutické užití MeSH
kardiovaskulární nemoci prevence a kontrola MeSH
lidé MeSH
primární prevence MeSH
rizikové faktory kardiovaskulárních chorob MeSH
sekundární prevence MeSH
tromboembolie prevence a kontrola MeSH
Check Tag
lidé MeSH
Publikační typ
rozhovory MeSH

Článek

Rivaroxaban and Risk of Venous Thromboembolism in Patients With Symptomatic Peripheral Artery Disease After Lower Extremity Revascularization

JAMA network open. 2022 ; 5 (6) : e2215580. [pub] 20220601

JAMA Netw Open
ISSN 2574-3805
Medvik
Zdroj

Importance: Prior studies have observed an association between the burden of atherosclerotic vascular disease and the risk of venous thromboembolism (VTE). The association is not well described in peripheral artery disease (PAD) after lower extremity revascularization (LER). Objective: To describe the risk of, factors associated with, and outcomes after VTE, as well as the association of low-dose rivaroxaban plus antiplatelet therapy with VTE after LER. Design, Setting, and Participants: This global, multicenter cohort study used data from the Vascular Outcomes Study of ASA (acetylsalicylic acid) Along With Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD (VOYAGER PAD) randomized clinical trial, which enrolled patients from 2015 to 2018 with median follow-up of 28 months. Participants included patients with PAD undergoing LER. Patients with an indication for therapeutic anticoagulation were excluded. Data were analyzed from September 2020 to September 2021. Exposure: Randomization to rivaroxaban 2.5 mg twice daily or placebo on a background of aspirin 100 mg daily; short-term clopidogrel was used at the discretion of the treating physician. Main Outcomes and Measures: Symptomatic VTE was a prespecified secondary outcome and prospectively collected. Results: Among 6564 patients (median [IQR] age, 67 [61-73] years; 4860 [74.0%] men), 66 patients had at least 1 VTE. The 3-year rate of VTE in patients receiving placebo was 1.7%, and the pattern of risk was linear (year 1: 0.5%; year 2: 1.1%). After multivariable modeling, weight (hazard ratio [HR], 3.04; 95% CI, 1.09-8.43), hypertension (HR, 2.11; 95% CI, 0.91-4.89), prior amputation (HR, 2.07; 95% CI, 0.95-4.53), and older age (HR, 1.81; 95% CI, 1.06-3.11) were associated with increased risk of VTE. VTE was associated with risk of subsequent mortality (HR, 7.22; 95% CI, 4.66-11.19). Compared with aspirin alone, rivaroxaban plus aspirin was associated with lower VTE risk (HR, 0.61; 95% CI, 0.37-0.998; P = .047), with benefit apparent early and sustained over time. This association was not modified by use of clopidogrel at randomization (without clopidogrel: HR, 0.55; 95% CI, 0.29-1.07; with clopidogrel: HR, 0.69; 95% CI, 0.32-1.48; P for interaction = .67). Conclusions and Relevance: In this cohort study, there was continuous risk for VTE after LER in patients with PAD, with greater risk in patients who were older and had obesity and those with more severe PAD, as reflected by prior amputation. Low-dose rivaroxaban plus aspirin was associated with lower VTE risk compared with aspirin alone, with benefits apparent early and continued over time. The spectrum of venous and arterial thrombotic events and overall benefits of more potent antithrombotic strategies for prevention should be considered after LER for PAD.

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