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Full-Text Articles in Medicine and Health Sciences

Retrospective Comparison Of Patients ≥ 80 Years With Atrial Fibrillation Prescribed Either An Fda-Approved Reduced Or Full Dose Direct-Acting Oral Anticoagulant, Roy Taoutel, Michael D. Ezekowitz, Usman A. Chaudhry, Carly Weber, Dana Hassan, Ed J. Gracely, Mohammed H. Kamareddine, Benjamin I. Horn, Glenn R. Harper Oct 2022

Retrospective Comparison Of Patients ≥ 80 Years With Atrial Fibrillation Prescribed Either An Fda-Approved Reduced Or Full Dose Direct-Acting Oral Anticoagulant, Roy Taoutel, Michael D. Ezekowitz, Usman A. Chaudhry, Carly Weber, Dana Hassan, Ed J. Gracely, Mohammed H. Kamareddine, Benjamin I. Horn, Glenn R. Harper

Department of Medicine Faculty Papers

Direct-acting oral anticoagulants (DOACs) represent the standard for preventing stroke and systemic embolization (SSE) in patients with atrial fibrillation (AF). There is limited information for patients ≥ 80 years. We report a retrospective analysis of AF patients ≥ 80 years prescribed either a US Food and Drug Administration (FDA)-approved reduced (n = 514) or full dose (n = 199) DOAC (Dabigatran, Rivaroxaban, or Apixaban) between January 1st, 2011 (first DOAC commercially available) and May 31st, 2017. The following multivariable differences in baseline characteristics were identified: patients prescribed a reduced dose DOAC were older (p < 0.001), had worse renal function (p = 0.001), were more often prescribed aspirin (p = 0.004) or aspirin and clopidogrel (p < 0.001), and more often had new-onset AF (p = 0.001). SSE and central nervous system (CNS) bleed rates were low and not different (1.02 vs 0 %/yr and 1.45 vs 0.44 %/yr) for the reduced and full dose groups, respectively. For non-CNS bleeds, rates were 10.89 vs 4.15 %/yr (p < 0.001, univariable) for the reduced and full doses, respectively. The mortality rate was 6.24 vs 1.75 %/yr (p = 0.001, univariable) for the reduced and full doses. Unlike the non-CNS bleed rate, mortality rate differences remained significant when adjusted for baseline characteristics. Thus, DOACs in patients ≥ 80 with AF effectively reduce SSE with a low risk of CNS bleeding, independent of DOAC dose. The higher non-CNS bleed rate and not the mortality rate is explained by the higher risk baseline characteristics in the reduced DOAC dose group. Further investigation of the etiology of non-CNS bleeds and mortality is warranted.


Cognitive Impairment And Risk Of All-Cause And Cardiovascular Disease Mortality Over 20-Year Follow-Up: Results From The Blsa, Ji An, Haibin Li, Zhe Tang, Deqiang Zheng, Jin Guo, Yue Liu, Wei Feng, Xia Li, Anxin Wang, Xiangtong Liu, Lixin Tao, Chengbei Hou, Feng Zhang, Xinghua Yang, Qi Gao, Wei Wang, Xiuhua Guo, Yanxia Luo Jan 2018

Cognitive Impairment And Risk Of All-Cause And Cardiovascular Disease Mortality Over 20-Year Follow-Up: Results From The Blsa, Ji An, Haibin Li, Zhe Tang, Deqiang Zheng, Jin Guo, Yue Liu, Wei Feng, Xia Li, Anxin Wang, Xiangtong Liu, Lixin Tao, Chengbei Hou, Feng Zhang, Xinghua Yang, Qi Gao, Wei Wang, Xiuhua Guo, Yanxia Luo

Research outputs 2014 to 2021

Background-Cognitive impairment may increase the risk of all-cause and cardiovascular disease (CVD) mortality. This study examined the association between cognitive function and risk of all-cause and CVD mortality among the elderly in Beijing, China. Methods and Results-A total of 1996 participants aged ≥55 years at baseline were enrolled from the BLSA (Beijing Longitudinal Study of Aging). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), and participants were categorized as:


A Review Of Echocardiograms In Hypertensive Patients Greater Than 60 Years In A Community Based Family Medicine Program, Shideh Doroudi, Michael Delisi, Vincent Debari Mar 2017

A Review Of Echocardiograms In Hypertensive Patients Greater Than 60 Years In A Community Based Family Medicine Program, Shideh Doroudi, Michael Delisi, Vincent Debari

NYMC Faculty Publications

Background: Heart disease as a result of Hypertension is known to occur. Anatomical and functional changes of the heart can easily be detected by echocardiography, which is a safe and readily available study. Objectives: The aims of this study were to evaluate the prevalence of common echocardiographic changes in chronic hypertensive patients and to compare these changes in male and female populations. Design/methods: The study was a community-based cross-sectional study, on 227 hypertensive patients, 60 years and older, seen in St. Joseph's Family Medicine at Clifton, with integrated clinical and echocardiographic data. Results: Study population consisted of 227 hypertensive patients, …