dicumarol and Chronic-Disease

Topics: Anticoagulants; Chronic Disease; Dicumarol; Evaluation Studies as Topic; Humans; Myocardial Infarction; Thromboembolism; Thrombosis

Atrial fibrillation (AF) is the most common arrhythmia occurring in clinical practice. It is the most frequent cause of hospitalization in cardiac rhythm disturbance. Despite comprehensive progress in the research into electrophysiological mechanisms leading to this loss of normal rhythm and new procedures dealing with it, the main problem being the conversion to and maintaining the normal sinus rhythm (SR) has not been solved. The polish study "Hot Cafe" is trying to evaluate the advantages and risks of the two procedures widely used in clinical practice in patients (pts) with chronic AF, i.e. conversion and maintaining SR vs leaving pts with the arrhythmia. Pts with non-valvular chronic AF fulfilling the criteria for including them into the sample are randomly assigned to two procedures: conversion to SR by means of direct current cardioversion and maintaining it or leaving pts with AF. Pts left with AF are treated by rate control and antithrombotic treatment. The project is of prospective kind and it will be carried out by many medical institutions. It is planned to include 200 pts. The observation period will last at least 12 months. Preliminary results after inclusion of the first 121 pts are shown.

Topics: Aged; Amiodarone; Anti-Arrhythmia Agents; Anticoagulants; Atrial Fibrillation; Chronic Disease; Dicumarol; Electric Countershock; Female; Humans; Male; Middle Aged; Premedication; Prospective Studies

The safety of direct oral anticoagulants (DOACs) in oldest old patients with nonvalvular atrial fibrillation (NVAF) in daily clinical practice has not been systematically assessed. This study examined the safety of DOACs and dicumarol (a vitamin K antagonist) in NVAF geriatric patients.. Prospective study from January 2010 through June 2015, with follow-up through January 2016.. Geriatric medicine department at a tertiary hospital.. A total of 554 outpatients, 75 years or older, diagnosed of NVAF and starting oral anticoagulation.. The main outcome was bleeding, which was classified into major (including those life-threatening) and nonmajor episodes. Statistical analyses were performed with Cox regression.. A total of 351 patients received DOACs and 193 dicumarol. Patients on DOACs were older, with more frequent comorbidities, mobility limitation and disability in activities of daily living, as well as higher mortality, than those treated with dicumarol. The incidence of any bleeding was 19.2/100 person-years among patients on DOACs and 13.7/100 person-years on dicumarol; corresponding figures for major bleeding were 5.2 for those on DOACs, and 3.3 for those on dicumarol. In crude analyses, hazard ratios (95% confidence intervals) for any bleeding, and for mayor bleeding in patients on DOACs vs dicumarol were 1.60 (1.04-2.44) and 2.22 (0.88-5.59), respectively. Excess risk of bleeding associated with DOACs vs dicumarol disappeared after adjustment for clinical characteristics, so that corresponding figures were 1.19 (0.68-2.08) and 1.01 (0.35-2.93). Results did not vary across subgroups of high-risk patients.. In very old patients with NVAF, the higher risk of bleeding associated with DOACs vs dicumarol could be mostly explained by the worse clinical profile of patients receiving DOACs. Risk of bleeding was rather high, and warrants close clinical monitoring.

Topics: Administration, Oral; Age Factors; Aged; Aged, 80 and over; Anticoagulants; Atrial Fibrillation; Chronic Disease; Comorbidity; Dabigatran; Dementia; Dicumarol; Disabled Persons; Follow-Up Studies; Hemorrhage; Humans; Mobility Limitation; Prospective Studies; Pyrazoles; Pyridones; Rivaroxaban; Vitamin K

The morbidity and mortality of pulmonary embolism (PE) have been found to be related to early diagnosis and appropriate treatment. The examinations used to diagnose PE are expensive and not always easily accessible. These options include noninvasive examinations, such as clinical pretests, ELISA D-dimer (DD) tests, and volumetric capnography (VCap). We report the case of a patient whose diagnosis of PE was made via pulmonary arteriography. The clinical pretest revealed a moderate probability of the patient having PE, and the DD result was negative; however, the VCap associated with arterial blood gases result was positive. The patient underwent all noninvasive exams following admission to hospital and again eight months after discharge. Results gained from invasive tests were similar to those produced by image exams, highlighting the importance of VCap as an important noninvasive tool.

Topics: Adult; Anticoagulants; Biomarkers; Capnography; Chronic Disease; Dicumarol; Enzyme-Linked Immunosorbent Assay; Fibrin Fibrinogen Degradation Products; Humans; Lung; Male; Perfusion Imaging; Predictive Value of Tests; Prognosis; Pulmonary Embolism; Respiratory Dead Space; Thromboembolism; Ventilation-Perfusion Ratio

Topics: Aged; Anticoagulants; Atrial Fibrillation; Chronic Disease; Dicumarol; Female; Humans; Male; Platelet Aggregation Inhibitors; Risk Factors; Thromboembolism; Thrombolytic Therapy

Topics: Acute Disease; Adult; Anticoagulants; Arrhythmias, Cardiac; Chronic Disease; Coronary Disease; Dicumarol; Female; Heart Failure; Humans; Male; Middle Aged; Myocardial Infarction; Prognosis; Prothrombin Time; Thrombelastography; Thrombosis; Warfarin

Topics: Arteriosclerosis; Arteriosclerosis Obliterans; Chronic Disease; Dicumarol; Heparin; Humans; Postoperative Complications; Thrombosis

Topics: Aged; Chronic Disease; Coumarins; Dicumarol; Humans; Recurrence