Published on
What’s Hot in Clots – October 2024
Key Updates in Thrombosis
Table of Contents
Okay, I promised a few studies from ESC. And there’s more!
Continue or interrupt aspirin in patients with prior stents undergoing non-cardiac surgery?
This is one of the most common questions that both cardiologists and surgeons run into. What should we do? I don’t think this randomized trial had clear answers, but it’s still the largest on the topic – and informative. Read more.
Storm in the OCEAN(IC-AF)?
There has been a lot of hope about inhibitors of factor XI or XIa, with the theoretical dissociation of thrombosis from hemostasis. But I am yet unaware of definitive evidence of effectiveness. Even in the VTE prophylaxis space, much of the events were asymptomatic or of limited clinical significance. So, I find it a bit disappointing that in one of the first large-scale phase III trials, asundexian had inferior effectiveness in reducing stroke or systemic embolism compared with apixaban. Some are questioning the patient population, the agent, or the dose. And there may be some truth to those questions. But until I see new evidence with promising protective effects, I remain curious about effectiveness of these agents, particularly for arterial thrombosis. Read more.
Anticoagulation with or without antiplatelet therapy for AF and stable CAD
Results from another randomized trial, this time with edoxaban, suggest that anticoagulant monotherapy causes fewer bleeds without a significant increase in ischemic events. However, this trial (much like others) was not powered for ischemic events. So, we may need more data, and there may still be subgroups who need dual therapy. Regardless, such an important study! Read more.
Food and oral anticoagulants: Beyond warfarin
“Have a consistent intake of dietary vitamin K when using warfarin…” This is important, but boring! In this review, we go a few steps beyond and cover pharmacokinetic/pharmacodynamic interactions with all kinds of food and herbal supplements and warfarin – but also few considerations that are important for patients taking DOACs! Read more.
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Behnood Bikdeli, MD, MS
Cardiologist, Section of Vascular Medicine, Division of Cardiovascular Medicine, Brigham and Women’s Hospital
Investigator, Thrombosis Research Group, Division of Cardiovascular Medicine, Brigham and Women’s Hospital
Assistant Professor of Medicine, Harvard Medical School
Investigator, Yale/ YNHH Center for Outcomes Research and Evaluation, Yale School of Medicine
Investigator, Cardiovascular Research Foundation