(Press-News.org) In an analysis of the results of nearly 50 randomized trials that examined treatments of venous thromboembolisms (blood clot in a vein), there were no significant differences in clinical and safety outcomes associated with most treatment strategies when compared with the low-molecular-weight heparin-vitamin K antagonist combination, according to a study in the September 17 issue of JAMA.
Venous thromboembolism, manifested as deep vein thrombosis or pulmonary embolism (blood clot in a lung), is a common medical condition and is the third leading cause of cardiovascular death. Clinicians have many potential treatment options regarding management of this condition, although little guidance exists about which treatment is most effective yet safe, according to background information in the study.
Lana A. Castellucci, M.D., of the Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada, and colleagues conducted a network meta-analysis to summarize and compare the efficacy and safety outcomes for the treatment of venous thromboembolism associated with 8 anticoagulation options (unfractionated heparin [UFH], low-molecular-weight heparin [LMWH], or fondaparinux in combination with vitamin K antagonists); LMWH with dabigatran or edoxaban; rivaroxaban; apixaban; and LMWH alone). The researchers conducted a search of the medical literature and identified 45 randomized trials (44,989 patients) for inclusion in the analyses.
The UFH-vitamin K antagonist combination was associated with a higher percentage of patients experiencing recurrent venous thromboembolism during 3 months of treatment (1.84 percent) than patients taking the LMWH-vitamin K antagonist combination (1.30 percent). Rivaroxaban and apixaban were associated with the lowest bleeding risk compared with the LMWH-vitamin K antagonist combination, with a lower proportion of patients experiencing a major bleeding event during 3 months of anticoagulation: 0.49 percent for rivaroxaban, 0.28 percent for apixaban, and 0.89 percent for the LMWH-vitamin K antagonist combination.
All other treatment regimens were associated with bleeding risks that did not differ significantly from the LMWH-vitamin K antagonist combination.
"To our knowledge, this network meta-analysis is the largest review, including nearly 45,000 patients, assessing the clinical outcomes and safety associated with different anticoagulation strategies for the treatment of acute venous thromboembolism. We provide estimates on symptomatic recurrent venous thromboembolism and major bleeding outcomes (both patient-important outcomes), which are clinically relevant and are what clinical practice guideline recommendations are based on," the authors write.
"All management options, with the exception of the UFH-vitamin K antagonist combination, were associated with similar clinical outcomes compared with a management strategy using the LMWH vitamin K antagonist combination. Treatment using the UFH-vitamin K antagonist combination was associated with a higher risk of recurrent venous thromboembolism during the follow-up period."
INFORMATION:
(doi:10.1001/jama.2014.10538; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Study compares effectiveness of treatments for blood clots
2014-09-16
ELSE PRESS RELEASES FROM THIS DATE:
New radiosurgery technology provides highly accurate treatment, greater patient comfort
2014-09-16
DETROIT – A new stereotactic radiosurgery system provides the same or a higher level of accuracy in targeting cancer tumors – but offers greater comfort to patients and the ability to treat multiple tumors at once – when compared to other radiation therapy stereotactic systems, according to researchers at Henry Ford Hospital in Detroit.
The study shows the Edge™ Radiosurgery Suite is able to target cancer tumors within 1 mm, providing sub-millimeter accuracy with extreme precision.
"Radiosurgery is just one shot of precision radiation with a very high dose to treat ...
Patient's question triggers important study about blood thinners
2014-09-16
Ottawa – September 16, 2014 – Physicians around the world now have guidance that can help them determine the best oral blood thinners to use for their patients suffering from blood clots in their veins, thanks to a patient of The Ottawa Hospital who asked his physician a question he couldn't answer. This new guidance is found in a study published today by JAMA, the Journal of the American Medical Association.
"Right there in the clinic, he identified an important knowledge gap for clinicians. We decided to act on it and find the answer," says hematologist Dr. Marc Carrier, ...
Novel capability enables first test of real turbine engine conditions
2014-09-16
Manufactures of turbine engines for airplanes, automobiles and electric generation plants could expedite the development of more durable, energy-efficient turbine blades thanks to a partnership between the U.S. Department of Energy's Argonne National Laboratory, the German Aerospace Center and the universities of Central Florida and Cleveland State.
The ability to operate turbine blades at higher temperatures improves efficiency and reduces energy costs. For example, energy companies estimate that raising the operating temperature by 1 percent at a single electric generation ...
Boosting global corn yields depends on improving nutrient balance
2014-09-16
WEST LAFAYETTE, Ind. - Ensuring that corn absorbs the right balance of nitrogen, phosphorus and potassium is crucial to increasing global yields, a Purdue and Kansas State University study finds.
A review of data from more than 150 studies from the U.S. and other regions showed that high yields were linked to production systems in which corn plants took up key nutrients at specific ratios - nitrogen and phosphorus at a ratio of 5-to-1 and nitrogen and potassium at a ratio of 1-to-1. These nutrient uptake ratios were associated with high yields regardless of the region ...
Dry conditions and lightning strikes make for a long California fire season
2014-09-16
The fire season in California has been anything but cooperative this year. Hot conditions combined with a state-wide drought and dry lightning makes for unpleasant conditions and leads to an abundance of forest fires.
On August 12, lightning struck and started the fire that grew into the Happy Camp Complex. Currently over 113,000 acres have been affected and the fire is only 55% contained as of today. Strong winds tested fire lines yesterday (8/15), and are expected to do so again today. Despite the high winds, existing fire lines held with no spotting or expansion ...
Do wearable lifestyle activity monitors really work?
2014-09-16
Wearable electronic activity monitors hold great promise in helping people to reach their fitness and health goals. These increasingly sophisticated devices help the wearers improve their wellness by constantly monitoring their activities and bodily responses. This information is organized into companion computer programs and mobile apps.
Given the large and quickly growing market for these devices, researchers at the University of Texas Medical Branch at Galveston analyzed 13 of these activity monitors, such as those made by Fitbit, Jawbone or Nike, to compare how the ...
NASA HS3 instrument views 2 dimensions of clouds
2014-09-16
VIDEO:
Global Hawk observes the Saharan Air Layer through the Cloud Physics Lidar(CPL) during Hurricane Nadine (id 4102). More information on this topic available at:
http://www.nasa.gov/content/goddard/nasa-hs3-instrument-views-2-dimensions-of-clouds/....
Click here for more information.
NASA's Cloud Physics Lidar (CPL) instrument, flying aboard an unmanned Global Hawk aircraft in this summer's Hurricane and Severe Storm Sentinel, or HS3, mission, is studying the changing profile ...
NASA's HS3 mission covers transition of Hurricane Cristobal
2014-09-16
NASA's Global Hawk 872 aircraft flew over Hurricane Cristobal on August 28 and 29 and gathered data on the storm as it was becoming extra-tropical.
NASA's airborne Hurricane and Severe Storm Sentinel, or HS3, mission kicked off on August 26 when one of the remotely piloted Global Hawk aircraft flew a "lawnmower" or back and forth pattern over Hurricane Cristobal while gathering data using dropsondes and two other instruments. The Global Hawk dropped 81 dropsondes over Cristobal. A dropsonde is a device that measures winds, temperature, pressure and humidity as it falls ...
Results of OCT STEMI trial reported at TCT 2014
2014-09-16
WASHINGTON, DC – September 16, 2014 – The first randomized trial to examine serial optical coherence tomography (OCT) in primary percutaneous coronary intervention (PCI) was reported at the 26th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world's premier educational meeting specializing in interventional cardiovascular medicine.
OCT uses light emitted from an intravascular catheter to capture high-resolution cross sectional imaging from within coronary arteries. OCT ...
Results of IVUS-CTO trial reported at TCT 2014
2014-09-16
WASHINGTON, DC – September 14, 2014 – A new study found that intravascular ultrasound (IVUS) -guided intervention in patients with chronic total occlusion (CTO) could improve outcomes compared to a conventional angiography-guided approach during percutaneous coronary intervention (PCI). The IVUS-CTO study is the first randomized trial to examine the clinical impact of IVUS guidance for CTO intervention.
Findings were reported today at the 26th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation ...