8 research outputs found
Sudden Unexpected Natural Death in the Youth; an Iranian Single Center Investigation
Background: Sudden unexpected natural death (SUND) has not been studied in Iran. Herein we investigated its main causes in our country.Methods: Records of 80 cases registered to a single referral center were investigated to determine the distribution of sex, age, and etiology of death.Results: Fifty eight (72.5%), 6 (7.5%), 6 (7.5%) and 4 (5%) of our cases have died due to various types of heart diseases, cerebral events, pulmonary emboli and gastrointestinal bleeding (GIB), respectively. Moreover, men are victims of SUND more that women (83.7% vs.16.3%, respectively).Conclusion: Policies should be planned by the governments to prevent youth mortality in societies. These attempts should especially target ischemic heart disease
Factors associated with physical growth of children during the first two years of life in rural and urban areas of Vietnam
Edoxaban versus Vitamin K Antagonist for Atrial Fibrillation after TAVR
Background The role of direct oral anticoagulants as compared with
vitamin K antagonists for atrial fibrillation after successful
transcatheter aortic-valve replacement (TAVR) has not been well studied.
Methods We conducted a multicenter, prospective, randomized, open-label,
adjudicator-masked trial comparing edoxaban with vitamin K antagonists
in patients with prevalent or incident atrial fibrillation as the
indication for oral anticoagulation after successful TAVR. The primary
efficacy outcome was a composite of adverse events consisting of death
from any cause, myocardial infarction, ischemic stroke, systemic
thromboembolism, valve thrombosis, or major bleeding. The primary safety
outcome was major bleeding. On the basis of a hierarchical testing plan,
the primary efficacy and safety outcomes were tested sequentially for
noninferiority, with noninferiority of edoxaban established if the upper
boundary of the 95% confidence interval for the hazard ratio did not
exceed 1.38. Superiority testing of edoxaban for efficacy would follow
if noninferiority and superiority were established for major bleeding.
Results A total of 1426 patients were enrolled (713 in each group). The
mean age of the patients was 82.1 years, and 47.5% of the patients were
women. Almost all the patients had atrial fibrillation before TAVR. The
rate of the composite primary efficacy outcome was 17.3 per 100
person-years in the edoxaban group and 16.5 per 100 person-years in the
vitamin K antagonist group (hazard ratio, 1.05; 95% confidence interval
[CI], 0.85 to 1.31; P=0.01 for noninferiority). Rates of major
bleeding were 9.7 per 100 person-years and 7.0 per 100 person-years,
respectively (hazard ratio, 1.40; 95% CI, 1.03 to 1.91; P=0.93 for
noninferiority); the difference between groups was mainly due to more
gastrointestinal bleeding with edoxaban. Rates of death from any cause
or stroke were 10.0 per 100 person-years in the edoxaban group and 11.7
per 100 person-years in the vitamin K antagonist group (hazard ratio,
0.85; 95% CI, 0.66 to 1.11). Conclusions In patients with mainly
prevalent atrial fibrillation who underwent successful TAVR, edoxaban
was noninferior to vitamin K antagonists as determined by a hazard ratio
margin of 38% for a composite primary outcome of adverse clinical
events. The incidence of major bleeding was higher with edoxaban than
with vitamin K antagonists. (Funded by Daiichi Sankyo; ENVISAGE-TAVI AF
ClinicalTrials.gov number, .)
Edoxaban for Atrial Fibrillation with TAVR In a randomized trial
involving patients who had atrial fibrillation after TAVR, edoxaban was
noninferior to vitamin K antagonists with respect to a composite outcome
of death, MI, stroke, thromboembolism, valve thrombosis, or major
bleeding but was associated with a higher incidence of major bleeding