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In December 2020, the American College of Cardiology issued new guidelines to help clinicians overcome the challenges involved in selecting antithrombotic therapy for patients with atherosclerotic cardiovascular disease and atrial fibrillation or venous thromboembolism, including deep venous thrombosis and pulmonary embolism. The 2020 Expert Consensus Decision Pathway recommends against the commonly used “triple antithrombotic therapy,” supported by older clinical trials, noting that it significantly increases the risk of bleeding.
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— Kate Jackson, editor |
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New Guidelines Reshape Approach to Antithrombotic Therapy
Around 1 in 4 individuals will develop atrial fibrillation (AF) during their lifetime, a development that increases their risk of stroke four- to five-fold. For most patients with AF, treatment with oral anticoagulant (OAC) therapy is associated with significantly lower stroke rates compared with aspirin or placebo.
Like AF, venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, has a high overall incidence estimated to be 1 to 2 per 1,000 person-years and is usually treated with OAC as well. Choosing the optimal antithrombotic regimen for patients with atherosclerotic cardiovascular disease and concomitant AF or VTE who require an anticoagulant and antiplatelet therapy can be a challenge for clinicians.
This 2020 Expert Consensus Decision Pathway (ECDP) aims to fill the gap for much-needed guidance on antithrombotic therapy for this patient population.
This ECDP highlights that patients with either AF or VTE undergoing percutaneous coronary intervention have usually been treated with an anticoagulant and dual antiplatelet therapy, so-called “triple therapy.” Support for this practice came from older clinical trials that suggested an OAC alone was not an optimal treatment for those undergoing percutaneous coronary intervention and, similarly, that dual antiplatelet therapy was not an optimal treatment for AF or VTE. However, triple antithrombotic therapy significantly increases the risk of bleeding and the writing committee for this document recommends against the routine use of triple antithrombotic therapy for most patients.
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Hypertension in Black Americans
Why is the prevalence so high and what can physicians do? Read more »
Easy Does It
An occupational therapy–based fall prevention program reduces risks. Read more »
The Emotional Toll of the Pandemic
In addition to mourning for the loss of life, there’s grief related to the loss of life as it was. Read more » |
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New TeleCare Platform
CareTrack has launched its Telecare platform designed to ensure better Medicare patient outcomes by facilitating continuous out-of-office coordination of care between physicians, extended care teams, and the patient. Among its benefits are that it integrates seamlessly with most electronic health record systems and decentralizes care planning to support better collaboration. Learn more »
Supporting Foot Health
Select Flex is an arch control insole that promotes foot health and quality of life among older adults. Created by Alliance Design and Development group, a biomechanics company, the insole relies on a patented adjustable suspension and joint support technology, the variable resistance beam, pioneered by Alliance Design and Development Group. The insole not only alleviates pain caused by a range of foot conditions common among geriatric patients but it also increases ankle alignment and stability and helps to improve balance. Learn more » |
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Have a product or service you want to market to geriatricians, other physicians and the geriatric care team of professionals who treat aging patients? Are you a recruiter looking to fill the many geriatric professional openings within a facility, physician practice, or academic institution? Then utilize the reach of Today's Geriatric Medicine to accomplish your marketing goals and fill any open positions.
A resource for professionals looking for new opportunities, as well as those physicians just curious to see what's out there, our Physician Recruitment Center gives physician recruiters a powerful tool to fill partnership opportunities, academic appointments, and hospital staff positions. To support your product marketing or recruiting needs, e-mail our experienced account executives today at sales@gvpub.com for more information or call 800-278-4400! |
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A Patient’s Bequest to Medical Science
A Columbia woman began developing symptoms of dementias at age 72, before she died of cancer. That wouldn't be unusual, except she was a member of a family whose members carry a rare genetic mutation associated with early-onset Alzheimer’s. Researchers have been following the family for more than 30 years, during which there have been no cases as remarkable as hers. Her brain, which she donated to researchers, may hold clues to what puts individuals at risk for Alzheimer’s disease, according to reporting by The New York Times.
Pulse Oximetry Devices Less Reliable for Black Patients
Not only are Black individuals at greater risk for developing COVID-19 but the tools used to monitor their blood oxygen levels also may not work as well for them as for others. The Washington Post reports that researchers at the University of Michigan Hospital in Ann Arbor found that pulse oximeters did not detect low oxygen levels in 11.7% of Black patients, but only 3.6% in white patients.
What’s Sleep Got to Do With COVID-19?
When using artificial intelligence to investigate how the coronavirus enters human cells, a researcher at the Cleveland Clinic made an unexpected discovery—that melatonin might block the virus from invading. His research indicated that those who took melatonin were at less risk for developing COVID-19 and from succumbing to it. Melatonin is now the subject of eight clinical trials throughout the world. But it may not be melatonin that influences risk, but rather sleep, which is influenced by melatonin. The Atlantic reports on the research and the hypotheses.
How the Brain Encodes Time
UT Southwestern researchers in two recently published studies have explored the role of a group of cells that play a role in the brain’s encoding of time and place in memory. These workings of these cells, known as time cells, may lead to new treatments for memory loss resulting from Alzheimer’s disease, traumatic brain injury, and other conditions. |
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