rivaroxaban and Peripheral-Vascular-Diseases

The recent publication of the PEGASUS and COMPASS studies could have a great influence on the clinical management of patients with stable ischemic heart disease. In the presence of possible eligibility for both approaches, a practical tool based on inclusion/exclusion criteria of the two studies could be useful for clinical decision of ideal treatment for suitable patients. We therefore report a simple nomogram helpful in identifying the treatment indicated on the base of patient's characteristics.

Topics: Aspirin; Cerebrovascular Disorders; Clinical Decision-Making; Clinical Protocols; Drug Administration Schedule; Drug Therapy, Combination; Factor Xa Inhibitors; Humans; Myocardial Infarction; Myocardial Ischemia; Peripheral Vascular Diseases; Platelet Aggregation Inhibitors; Randomized Controlled Trials as Topic; Registries; Risk; Rivaroxaban; Ticagrelor

Whilst athletes are the epitome of health, venous thromboembolisms (VTE) including deep vein thrombosis and pulmonary embolism have been demonstrated to occur in well-trained athletes. VTE is frequently misdiagnosed and poorly treated within this population, often resulting in career or life-threatening ramifications. Furthermore, VTE risk rises with increasing age (> 40 years), potentially affecting masters athletes. A 44-year-old well-trained male cyclist volunteered to participate in a research project investigating the influence of exercise on haemostasis in well-trained athletes. The cyclist presented with elevated D-Dimer levels both pre- (2251 ng/mL) and post-exercise (2653 ng/mL). The cyclist reported constant mild-pain in the left mid-calf region, with a cold tingling sensation in their left foot. Diagnosis of DVT was confirmed via a DVT squeeze test and Doppler ultrasound, with the clot located in the left popliteal vein. During the research project, the cyclist was exposed to numerous thrombogenic risk factors including travel, dehydration, prolonged sitting and exercise. The DVT in the popliteal vein may have resulted from repetitive movements associated with cycling. Additionally, hypertrophy of the gastrocnemius muscle may have impinged the vein. When diagnosing DVT within a cycling population, PVES should not be overlooked as a contributing factor.

Topics: Adult; Bicycling; Factor Xa Inhibitors; Humans; Male; Muscle Contraction; Peripheral Vascular Diseases; Physical Endurance; Popliteal Vein; Risk Factors; Rivaroxaban; Syndrome; Treatment Outcome; Ultrasonography, Doppler; Venous Thrombosis

Topics: Aged; Blood Coagulation; Factor Xa Inhibitors; Female; Heparin; Heparin Antagonists; Humans; Kidney Failure, Chronic; Male; Middle Aged; Morpholines; Peripheral Vascular Diseases; Platelet Count; Renal Dialysis; Rivaroxaban; Thiophenes; Thrombocytopenia; Venous Thrombosis

Topics: Aged; Amputation, Surgical; Anticoagulants; Arterial Occlusive Diseases; Benzimidazoles; Dabigatran; Fibrinolytic Agents; Germany; Humans; Morpholines; Peripheral Vascular Diseases; Pyridines; Rivaroxaban; Thiophenes; Thrombosis