The therapeutic management of venous thromboembolism (VTE) is rapidly evolving. Following the positive results of pivotal large-scale randomised trials, the non-vitamin K antagonist oral anticoagulants (NOACs) represent an important alternative to standard anticoagulation. In phase III studies, dabigatran was as effective as, and significantly safer than warfarin. Additional information on real-world data of dabigatran is now warranted. RE-COVERY DVT/PE is a multi-centre, international, observational (i. e. non-interventional) study enrolling patients with acute DVT and/or PE within 30 days after objective diagnosis. The study is designed with two phases. Phase 1 has a cross-sectional design, enrolling approximately 6000 patients independently of treatment choice, with the aim of providing a contemporary picture of the management of VTE worldwide. Phase 2 has a prospective cohort design, with follow-up of one year, enrolling 8000 patients treated with dabigatran or vitamin K antagonists (VKAs) with the aim of comparing their safety, defined by the occurrence of major bleeding, and effectiveness, defined by the occurrence of symptomatic recurrent VTE. RE-COVERY DVT/PE will complement both the results of other observational studies in this field and the results of phase III studies with dabigatran, in particular by assessing its clinical benefit in various patient subgroups treated in routine clinical practice.
Atrial fibrillation (AF) imposes substantial burdens of morbidity and impaired health‐related quality of life, and significantly increases sufferers' risk of having a cardiovascular event, in particular a stroke. Prevalence of AF in Asia and the associated healthcare costs are likely to have been underestimated and are expected to increase due to greater awareness, population ageing and increasing prevalence of associated risk factors and comorbidities.
The AF management paradigm is shifting from a conventional focus on achieving heart rate or rhythm control, towards endeavouring to use the safest agents available to reduce patients' symptoms and improve their quality of life and cardiovascular outcomes. No new anti‐AF drugs have been introduced for decades and existing pharmacotherapeutic modalities have potentially serious side effects as well as sub‐optimal efficacy in converting to and maintaining normal sinus rhythm and preventing recurrence.
There is an unmet need for better anti‐arrhythmic drugs that are well tolerated, efficacious, cost‐effective and have a more favourable safety profile than current options. Although the perfect agent remains to be discovered, some promising new anti‐arrhythmic drugs have the potential to overcome certain limitations of established approaches to AF management.
FIGURE 1. A, Chest x-ray with foreign body. B, Computed tomography scan of chest with embolized catheter segment between the pulmonary artery trunk and the left pulmonary artery. The distal end of the catheter is surrounded by a 3.7mm-diameter calcified tissue mass.
Razali Omar MD FHRS FACC Ã1 , Wee Siong Teo MBBS (NUS) FRCP (Edin) FHRS Ã2 , David Foo MBBS MRCP (UK) FACC Ã3 , Chee Kok Han MBBS MMed FNHAM Ã4 , Ahmad Nizar Jamaluddin MD MRCP (UK) FACC (USA) Ã5 , Lip Ping Low MBBS FRACP FACC Ã6;Ã7 , Tiong Kiam Ong FRCP FACC FESC Ã8Atrial fibrillation (AF) imposes substantial burdens of morbidity and impaired healthrelated quality of life, and significantly increases sufferers' risk of having a cardiovascular event, in particular a stroke. Prevalence of AF in Asia and the associated healthcare costs are likely to have been underestimated and are expected to increase due to greater awareness, population ageing and increasing prevalence of associated risk factors and comorbidities.The AF management paradigm is shifting from a conventional focus on achieving heart rate or rhythm control, towards endeavouring to use the safest agents available to reduce patients' symptoms and improve their quality of life and cardiovascular outcomes. No new anti-AF drugs have been introduced for decades and existing pharmacotherapeutic modalities have potentially serious side effects as well as sub-optimal efficacy in converting to and maintaining normal sinus rhythm and preventing recurrence.There is an unmet need for better anti-arrhythmic drugs that are well tolerated, efficacious, cost-effective and have a more favourable safety profile than current options. Although the perfect agent remains to be discovered, some promising new anti-arrhythmic drugs have the potential to overcome certain limitations of established approaches to AF management. (J Arrhythmia 2011; 27: 171-185)
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