Edoxaban therapy in non-valvular atrial fibrillation patients: Paradoxical effect on mean platelet volume

Introduction: New generation oral anticoagulants (NOACs), which selectively and reversibly block the activity of clotting factor Xa, are now preferred as first-line therapy for preventing ischemic stroke in the treatment of atrial fibrillation (AF). Edoxaban, one of these NOACs, has been shown to be as effective as warfarin in preventing stroke or systemic embolism, while carrying a lower risk of bleeding and cardiovascular death. Mean platelet volume (MPV), as an indicator of platelet activity, is associated with an increased risk of ischemic stroke in patients with AF. Therefore, medical therapies that reduce MPV may play an important role in preventing unwanted ischemic events. Objective: The aim of this study is to determine whether edoxaban has an effect on platelet volume and other platelet indices, in addition to its protective anticoagulant effect against ischemic stroke. Materials and Methods: The study was designed as a retrospective cross-sectional study. Two hundred non-valvular AF patients without a history of oral anticoagulant use were included in the study. Complete blood count (CBC) and basic biochemical parameters (urea, creatinine, electrolytes, etc.) were recorded from the hospital registration system before edoxaban treatment was started, along with basic demographic data. The CBCs of the patients were reevaluated an average of 6 months (184 ± 9 days) after edoxaban treatment initiation, and platelet indices after edoxaban treatment were compared. Results were presented as mean ± standard deviation and percentage. Data were compared using Student's t-test and Wilcoxon test, and

Prevalence of post-procedural pain and associated factors experienced after transradial coronary angiography

Introduction: Coronary angiography is a principle diagnostic and therapeutic procedure in modern cardiology practice. The transradial access for cardiac catheterization has overtaken the transfemoral approach because of many advantages. However, some patients suffer radial pain after the procedure. Unfortunately, this complication has been poorly evaluated in previous studies. The present study aimed to determine the prevalence of radial pain after transradial coronary angiography and investigate factors that influence post-procedural pain. Methods: This is a cross-sectional study in which a total of 100 consecutive patients who underwent elective transradial coronary angiography ± percutaneous coronary intervention between January 2015–2016 were evaluated. The patients were asked about presence of disturbing pain in the forearm especially wrist region after the procedure. Verbal rating scale was used to evaluate pain assessment. The patients were divided as early pain group (two hours after the procedure) and prolonged pain group (one month after the procedure) and analysis was performed. Results: A total of 55 patients suffered from pain in the early phase (after two hours), and 26 of patients had prolonged pain at one month after the radial intervention. Independent pain predictors in the early pain group were male operator (p = 0.004, OR = 3.386, 95% CI: 1.484–7.725) and experience of operator (OR = 4.147, 95% CI: 1.637–10.506, p = 0.003). On the other hand, the younger age of patients (OR = 0.955, 95% CI: 0.915–0.966, p = 0.032) and experience of operator (OR = 3.947, 95% CI: 1.547–10.047, p = 0.004) were the independent predictors of prolonged radial pain. Conclusion: Pain after radial coronary angiography is not uncommon. Experience, operator gender, and age of the patients were independent predictors of pain after transradial coronary angiography