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Update on anticoagulation for atrial fibrillation: Encouraging news for rivaroxaban (Xarelto)

It’s time to do an update on the treatment of atrial fibrillation. It’s been a while, and there are worthy things to report from the real world. Stroke prevention in AF: Always start with basics: The most important aspect of treating atrial fibrillation is preventing stroke. Although there are some innovative devices and procedures in… Continue reading Update on anticoagulation for atrial fibrillation: Encouraging news for rivaroxaban (Xarelto)

Thinning the blood with dabigatran (Pradaxa) and rivaroxaban (Xarelto) –Thoughts on fear and lack of reversal agents…

The good news: Patients with heart disease have enjoyed great advances in stroke and heart attack prevention in the last few years. The bad news: most of these advances have involved novel new blood-thinning drugs. The idea of blood thinners is quite simple: Heart attacks and strokes most often stem from clotted blood. The same… Continue reading Thinning the blood with dabigatran (Pradaxa) and rivaroxaban (Xarelto) –Thoughts on fear and lack of reversal agents…

New post up on Trials and Fibrillation blog: Dabigatran, Rivaroxaban and Apixaban

For 57 years, doctors and patients have eagerly awaited an adequate substitute for the maligned blood thinner, warfarin. Now they are here. Boy are they ever. There has been oodles written about the new blood thinners, dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (soon to be Eliquis). As you might expect, thinning the blood with a… Continue reading New post up on Trials and Fibrillation blog: Dabigatran, Rivaroxaban and Apixaban

Rivaroxaban: The next non-warfarin oral blood thinner

The unrelenting epidemic of inactivity and excessive eating wreaks havoc on more than just the heart and blood vessels. Lugging around extra weight also breaks down the joints and back. For evidence, look no further than the waiting room of any orthopedist; the people waiting for joint replacements look the same as those waiting to… Continue reading Rivaroxaban: The next non-warfarin oral blood thinner

How dangerous are NSAIDs in patients with AF?

One of the most commonly asked questions in the office is the treatment of arthritis pain. This comes up because of the concern over taking NSAIDs (non steroidal anti-inflammatory drugs) in patients who are on anticoagulants (such as warfarin, or dabigatran, rivaroxaban, apixaban). My views on this matter have changed. But first, I want to… Continue reading How dangerous are NSAIDs in patients with AF?

Take-home messages from Western AF 2018

The Western AF symposium may have had corporate sponsors, but it was no boondoggle. The sessions start at 0715 and go through 1830. Your head spins at the end of the conference. I learned a lot. Here are some fast-writing thoughts: New Energy Source for Ablation Electroporation looks to be a promising new energy source… Continue reading Take-home messages from Western AF 2018

Inflammation, Ablation, Fats, LDL, etc .. My review of ESC 2017

The European Cardiology Congress, ESC as it is called, has grown into the largest medical meeting in the world. This year, more than 31,000 attendees from 153 countries came to Barcelona. I was busy. Here is an update of the big stories: Inflammation:  Experts agree that inflammation associates with heart disease. One of the keys… Continue reading Inflammation, Ablation, Fats, LDL, etc .. My review of ESC 2017

Statins, Like All Medicines, Are Neither Good Nor Bad

We have to talk about drugs. No, not illicit drugs, but medications used by doctors and patients. Plaintiff attorneys run ads on TV that fool people into thinking certain meds are bad. The current one I deal with is the clot-blocking drug rivaroxaban (Xarelto.) Before that, it was dabigatran (Pradaxa). If, or when, the makers… Continue reading Statins, Like All Medicines, Are Neither Good Nor Bad

Small Clots on Replacement Aortic Valves Deserve Attention

A large study presented at last month’s American College of Cardiology meeting reported that slightly more than 1 in 10 patients with aortic valve replacements (tissue valve) had small clots on the leaflet of the new valve. The study included 890 patients. The clots, which doctors call “subclinical thrombosis,” cannot be seen on regular echo… Continue reading Small Clots on Replacement Aortic Valves Deserve Attention

My latest on the NOAC drugs for AFib

Three weeks ago I wrote about the growing dominance of the new oral anticoagulant (NOAC) drugs for stroke prevention in patients with atrial fibrillation. (Another common name for these drugs is direct acting oral anticoagulants or DOACs.) The post generated many comments–some privately and some on the blog. Your responses induced me to think a… Continue reading My latest on the NOAC drugs for AFib

2017 update on the changing use of “blood thinners” for AF

Times have changed in the treatment of patients with atrial fibrillation (AF). First some background: The first of the four pillars of AF care is stroke prevention. The only proven means to protect patients with AF from stroke is use of drugs that block clotting factors–or anticoagulants. Some people call these drugs blood thinners. I… Continue reading 2017 update on the changing use of “blood thinners” for AF