Potential Causes and Implications of Low Target Therapeutic Ratio in Warfarin-Treated Patients for Thrombosis Prophylaxis: A Single-Center Experience

[Anticoagulant therapy for chronic heart disease atrial failure and fibrillation: a review]

Atrial fibrillation (AF) and heart failure (HF) often accompany each other, as they share similar risk factors and pathophysiological mechanisms. AF in patients with HF is known to increase hospitalizations and worsen prognosis. A combination of AF and HF translates into high risks of thromboembolic complications, which renders anticoagulants an important aspect of therapy for these patients. Vitamin K antagonists make achieving the target level of anticoagulation challenging due to drug interactions and comorbidities. Direct oral anticoagulants (DOACs) are preferred medications owing to a more favorable risk-benefit ratio in this group of patients. At the same time, patients with HF often require a personalized approach when choosing an anticoagulant due to increased risks of thromboembolic complications and bleeding, as well as multiple comorbidities. The article presents the results of sub-analyses of key studies on the efficacy and safety of DOACs vs vitamin K antagonists in patients with HF and AF. It also explores DOACs use in patients with chronic kidney disease.

A Vascular Thrombus Therapy Method Based on Magnetic-Induced Vibration

A vascular thrombus therapy method based on magnetic-induced vibration is presented. It is a mechanicalway of removing vascular thrombus that adopts the combined use of two concepts, namely (i) magnetic-induced vibration of magnetostrictive materials and (ii) changes in physical form of thrombus under high-frequency impact and vibration. This method has many advantages that (i) eliminate the side effects of drug treatment, (ii) reduce the complexity of traditional mechanical method, and (iii) improve the reliability of treatment. Practical results obtained from the simulations and experiments are included. They verify the proposed system and indicate that this method can effectively treat vascular thrombus and reduce patient's suffering and costs. Bioelectromagnetics. 2019;40:391-401. © 2019 Bioelectromagnetics Society.