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православные мультфильмы торрент в хорошем качестве, Aspirin on Top of Anticoagulation in Patients With Concomitant Stable , Combining Aspirin With Oral Anticoagulant Therapy: - AHA/ASA Journals, Combining antiplatelet and anticoagulant therapy in cardiovascular , Combined Aspirin and Anticoagulant Therapy in Patients with Atrial , 7. Anticoagulant Therapy for Atrial Fibrillation, Combination Antiplatelet and Oral Anticoagulant - AHA/ASA Journals, Efficacy and Safety of Oral Anticoagulants Versus Aspirin for Patients .
Atrial fibrillation (AF) is the most common significant cardiac rhythm disorder and is also a powerful common risk factor for stroke: about 15% of all strokes in the U.S. are attributable to AF. The use of combined antiplatelet and anticoagulant therapy in patients with AF has recently come under scrutiny. It is common for patients with AF to have co-morbidities that may necessitate the use of antiplatelet therapy. However, multiple studies examining outcomes of combined antiplatelet and anticoagulant therapy in patients with indications for both have demonstrated an increased risk of major hemorrhage compared with either treatment alone; and among patients with stable coronary artery disease (CAD), in particular, combined antiplatelet and anticoagulant therapy has not been shown to reduce either AF-related stroke or cardiovascular events.– The 2012 AF guidelines from the American College of Chest Physicians (ACCP) recommends against the use of combined antiplatelet and anticoagulant therapy for AF patients with stable CAD, indicating that warfarin alone within a therapeutic INR range of 2–3 is sufficient. As part of a system-wide performance improvement initiative focused on improving antithrombotic therapy decisions for patients with AF in our UC Health Primary Care Network, we discovered a large number of patients who were receiving treatment with both aspirin and oral anticoagulant (OAC) therapy. Our goal was to determine the indications for combined antiplatelet and anticoagulant therapy in these patients and to identify those who might reasonably be treated with OAC therapy alone. Furthermore, we evaluated the time course in which these therapies were initiated to elucidate what led to the use of dual therapy. We hypothesized that the majority of these patients likely had a prior indication for antiplatelet therapy, such as stable CAD or diabetes (DM) with a 10-year predicted risk of cardiovascular disease exceeding 10%, subsequently developed AF and had warfarin added to their regimen without discontinuing aspirin.Methods, However, based on observational data, 3,4,7,8 current guidelines and expert consensus recommend using oral anticoagulation alone as the default strategy to limit the risk of bleeding in such patients. 9–11 Indeed, most observational studies suggest that the combination of single antiplatelet therapy and oral anticoagulation is associated with , Risks and benefits of combining aspirin with anticoagulant therapy in patients with atrial fibrillation: an exploratory analysis of stroke prevention using an oral thrombin inhibitor in atrial fibrillation (SPORTIF) trials..
In the past 5 years, a number of randomized clinical trials have explored different combinations of anticoagulation plus antiplatelet agents aimed at minimizing bleeding risk while preserving low thrombotic event rates., The combined use of aspirin and oral anticoagulant therapy in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) has been questioned due to an increased risk of major bleeding with little to no benefit in preventing ischemic events., For most patients requiring anticoagulants for atrial fibrillation, a direct oral anticoagulant (DOAC) such as apixaban, dabigatran, edoxaban, or rivaroxaban should be prescribed in preference over warfarin [Evidence Level A]., ASA has been reported to modulate clot porosity through non–COX-1–mediated effects. Activated platelets generate thrombin on their surface, an event that is attenuated by antiplatelet therapy. ASA indicates acetylsalicylic acid; EC, endothelial cell; FXa, factor Xa; PAR, protease activated receptor; and WBC, white blood cell., Anticoagulants appear to be more effective than aspirin in preventing embolisms in patients with AF, as the risk of bleeding is not increased., The combined use of aspirin and oral anticoagulant therapy in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) has been questioned due to an increased risk of major bleeding with little to no benefit in preventing ischemic events..