Tagged: Physicians

Elevated International Normalized Ratio and Mortality in Hospitalized Patients Treated with Direct Oral Anticoagulants

: Direct oral anticoagulants (DOACs) are associated with a prolongation of the prothrombin time and an increased international normalized ratio (INR). The clinical significance of these changes is unclear. This study aimed to examine the association between an elevated INR on admission and in-hospital death and long-term survival in patients treated with DOACs.

BMI and Clinical and Health Status Outcomes in Chronic Coronary Disease and Advanced Kidney Disease in ISCHEMIA-CKD

Although overweight and obesity are associated with greater mortality and cardiovascular morbidity in patients without known cardiovascular disease, a paradoxical relationship between body mass index (BMI) and clinical outcomes has been observed in patients with cardiovascular disease.1–4 For example, the International VErapamil SR-trandolopril Study demonstrated that participants with chronic coronary disease and hypertension with Class I obesity (BMI 30 to 35 kg/m2) had a lower risk for all-cause mortality, non-fatal myocardial infarction or non-fatal stroke than those with normal BMI (20 to 25 kg/m2).

The safe use of analgesics in patients with cirrhosis: a narrative review

Pain is prevalent in patients with cirrhosis. Due to potential alterations in drug metabolism, risk for adverse effects, and complications from cirrhosis, physicians are often faced with difficult choices when choosing appropriate analgesics in these patients. Overall, acetaminophen remains the preferred analgesic. Despite its potential for intrinsic liver toxicity, acetaminophen is safe when used at 2g/day. In contrast, non-selective nonsteroidals should be avoided due to their multiple side effects including worsening renal function, blunting diuretic response, and increasing risk of portal hypertensive and peptic ulcer bleeding.