Journal of Internal Medicine最新文献

{"title":"Treatment strategies to reduce cardiovascular risk in persons with chronic kidney disease and Type 2 diabetes.","authors":"Faiez Zannad, Darren K McGuire, Alberto Ortiz","doi":"10.1111/joim.20050","DOIUrl":"https://doi.org/10.1111/joim.20050","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a prevalent and progressive condition associated with significant mortality and morbidity. Diabetes is a common cause of CKD, and both diabetes and CKD increase the risk of cardiovascular disease (CVD), the leading cause of death in individuals with CKD. This review will discuss the importance of early detection of CKD and prompt pharmacological intervention to slow CKD progression and delay the development of CVD for improving outcomes. Early CKD is often asymptomatic, and diagnosis usually requires laboratory testing. The combination of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) measurements is used to diagnose and determine CKD severity. Guidelines recommend at least annual screening for CKD in at-risk individuals. While eGFR testing rates are consistently high, rates of UACR testing remain low. This results in underdiagnosis and undertreatment of CKD, leaving many individuals at risk of CKD progression and CVD. UACR testing is an actionable component of the CKD definition. A four-pillar treatment approach for slowing the progression of diabetic kidney disease is suggested, comprising a renin-angiotensin-system (RAS) inhibitor, a sodium-glucose cotransporter 2 inhibitor, a glucagon-like peptide 1 receptor agonist, and the nonsteroidal mineralocorticoid receptor antagonist finerenone. The combination of these agents provides a greater cardiorenal risk reduction compared with RAS inhibitors alone. Early detection of CKD and prompt intervention with guideline-directed medical therapy are crucial for reducing CVD risk in individuals with CKD and diabetes. Evidence from ongoing studies will advance our understanding of optimal therapy in this population.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid overload trajectories and mortality in hemodialysis patients","authors":"Carmine Zoccali,&nbsp;Giovanni Tripepi,&nbsp;Paola Carioni,&nbsp;Francesca Mallamaci,&nbsp;Matteo Savoia,&nbsp;Len S Usvyat,&nbsp;Franklin W. Maddux,&nbsp;Stefano Stuard","doi":"10.1111/joim.20049","DOIUrl":"10.1111/joim.20049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fluid overload remains critical in managing patients with end-stage kidney disease. However, there is limited empirical understanding of fluid overload's impact on mortality. This study analyzes fluid overload trajectories and their association with mortality in hemodialysis patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and patients</h3>\u0000 \u0000 <p>This longitudinal study included 9332 incident hemodialysis patients from the EuCliD database, treated in Fresenius Medical Care NephroCare dialysis centers across seven countries between January 2016 and December 2019, with follow-up until May 2023. Fluid overload was assessed using bioimpedance spectroscopy, and patients were grouped based on fluid overload trajectories using group-based trajectory modeling. Cox regression models, adjusted for potential confounders, were used to investigate the relationship between trajectory groups and mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four distinct fluid overload trajectories were identified. Patients in the highest trajectory group (8.5% of the cohort) had more frequent background cardiovascular complications, lower BMI and serum albumin, and their adjusted mortality risk was 2.20 times higher than the lowest trajectory. There was a dose–response relationship between trajectories and mortality. The incidence rate of death increased with the degree of fluid overload, from 8.6 deaths per 100 person-years in the lowest trajectory to 18.6 in the highest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This longitudinal study highlights the significant risk of chronic fluid overload in hemodialysis patients. Latent trajectory analysis provides novel information into the dynamic nature of fluid overload and its impact on mortality in the hemodialysis population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 2","pages":"201-212"},"PeriodicalIF":9.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of an intensive lifestyle intervention on cystatin C–based kidney function in adults with overweight and obesity: From the PREDIMED-Plus trial","authors":"José Ignacio Martínez-Montoro,&nbsp;Isabel Cornejo-Pareja,&nbsp;Andrés Díaz-López,&nbsp;Antoni Sureda,&nbsp;Estefania Toledo,&nbsp;Itziar Abete,&nbsp;Nancy Babio,&nbsp;Josep A. Tur,&nbsp;Miguel A. Martinez-Gonzalez,&nbsp;J. Alfredo Martínez,&nbsp;Montse Fitó,&nbsp;Jordi Salas-Salvadó,&nbsp;Francisco J. Tinahones,&nbsp;PREDIMED-Plus Investigators","doi":"10.1111/joim.20038","DOIUrl":"10.1111/joim.20038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Large-scale trials evaluating a multicomponent lifestyle intervention aimed at weight loss on kidney function are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a post hoc analysis of the “PREvención con DIeta MEDiterránea-Plus” (PREDIMED-Plus) randomized controlled trial, including patients with overweight/obesity and metabolic syndrome, measured cystatin C and creatinine. Participants were randomly assigned (1:1) to an intensive weight loss lifestyle intervention (intervention group [IG]) consisting of an energy-restricted Mediterranean diet (MedDiet), physical activity promotion and behavioral support, or a control group (CG) receiving ad libitum MedDiet recommendations. The primary outcome was between-group differences in cystatin C–based kidney function (cystatin C–based estimated glomerular filtration rate—eGFRcys—and combined cystatin C–creatinine-based eGFR—eGFRcr-cys) change from baseline to 12 and 36 months. Secondary outcomes included between-group differences in creatinine-based eGFR (eGFRcr) and urinary albumin-to-creatinine ratio (UACR) change and the predictive capacity of these formulas at baseline for new-onset chronic kidney disease (CKD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1909 participants (65 ± 5 years, 54% men) were included. Twelve-month decline in eGFRcys, eGFRcr-cys, and eGFRcr was greater in the CG compared to the IG, with between-group differences of −1.77 mL/min/1.73 m² [95% confidence interval −2.92 to −0.63], −1.37 [−2.22 to −0.53], and −0.91 [−1.74 to −0.71], respectively. At 36 months, the decline in eGFRcr-cys and eGFRcr was greater in the CG. No between-group differences in UACR were found. Significant adjusted areas under the curve for baseline eGFRcys and eGFRcr-cys were observed for incident CKD at 36 months, which were similar to those for eGFRcr and UACR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In older adults with overweight/obesity and metabolic syndrome, the PREDIMED-Plus intervention may be an optimal approach to preserve kidney function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 2","pages":"141-155"},"PeriodicalIF":9.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: Delirium and frailty in older adults: Clinical overlap and biological underpinnings","authors":"Giuseppe Bellelli,&nbsp;Maria Cristina Ferrara,&nbsp;Federico Triolo,&nbsp;Davide Liborio Vetrano","doi":"10.1111/joim.20047","DOIUrl":"10.1111/joim.20047","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We thank Drs. da Silva and Caldas for showing interest in our review paper recently published in the &lt;i&gt;Journal of Internal Medicine&lt;/i&gt; and for their thoughtful contributions, which enrich the discussion on this topic [&lt;span&gt;1, 2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;A highlighted key point pertains to the pathophysiology of frailty and delirium. As acknowledged, the biological mechanisms underlying these two conditions remain largely unknown. This limited understanding explains why current prevention and treatment strategies predominantly focus on minimizing observable clinical manifestations (i.e., secondary rather than primary prevention). From a biological perspective, identifying whether certain individuals have an increased susceptibility to develop frailty and delirium remains a key challenge. This underscores the urgent need for a paradigm shift in our approach to these conditions.&lt;/p&gt;&lt;p&gt;In our review, we proposed a unifying framework aimed at offering a novel reading of the complex pathophysiological mechanisms underlying these conditions and, most importantly, providing research perspectives for future etiological studies. While recognizing frailty and delirium as distinct clinical entities, we postulated that they may reflect different manifestations of accelerated biological aging. This viewpoint opens new avenues from a geroscience perspective, particularly in identifying individuals at higher risk of developing delirium when frail or presenting with worsening frailty status after a delirium episode. Additionally, exploring upstream interventions targeting shared biological mechanisms holds significant promise for mitigating both conditions, as well as other burdensome geriatric syndromes. Advancing this line of research could lead to breakthroughs in risk stratification and the development of early, personalized interventions, ultimately improving care outcomes for older adults.&lt;/p&gt;&lt;p&gt;The letter by da Silva and Caldas also raises the critical issue of cognitive decline underdiagnosis, which we fully acknowledge. Cognitive impairment often goes unnoticed, either because healthcare access is strongly influenced by one's socioeconomic status or because healthcare providers often lack the necessary training to identify it. Expanding awareness among healthcare professionals about the interplay among frailty, delirium, and cognitive decline is essential to enhance prevention efforts and foster a more integrated, multidisciplinary approach to the care of, among others, at-risk hospitalized older adults. Equally important is educating communities to recognize cognitive decline as a serious issue that impacts the quality of care for older individuals.&lt;/p&gt;&lt;p&gt;Although our review is not systematic, we believe that its narrative approach offers valuable insights by synthesizing fragmented evidence and generating hypotheses for future studies. Addressing the identified gaps will enable healthcare systems and caregivers to implement interventions ","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 2","pages":"232-233"},"PeriodicalIF":9.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of moderate-intensity statin with ezetimibe in elderly patients with atherosclerotic cardiovascular disease.","authors":"Jung-Joon Cha, Ju Hyeon Kim, Soon Jun Hong, Subin Lim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Pil Hyung Lee, Seung Whan Lee, Cheol Whan Lee, Jae Youn Moon, Jong-Young Lee, Jung-Sun Kim, Jae Suk Park, Do-Sun Lim","doi":"10.1111/joim.20029","DOIUrl":"https://doi.org/10.1111/joim.20029","url":null,"abstract":"<p><strong>Background: </strong>High-intensity statin therapy significantly reduces mortality and cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD). However, moderate-intensity statins are often preferred for elderly patients due to their higher risk of intolerance to high-intensity statins.</p><p><strong>Objective: </strong>To compare the incidence of statin-associated muscle symptoms (SAMS) and the effect on low-density lipoprotein cholesterol (LDL-C) levels between elderly ASCVD patients receiving high-intensity statin monotherapy and those receiving moderate-intensity statin with ezetimibe in a combination therapy.</p><p><strong>Method: </strong>In a prospective, multicenter, open-label trial conducted in South Korea, 561 patients aged 70 years or above with ASCVD were randomly assigned to receive either moderate-intensity statin with ezetimibe combination therapy (rosuvastatin 5 mg with ezetimibe 10 mg) or high-intensity statin monotherapy (rosuvastatin 20 mg) over 6 months. The primary endpoint was the incidence of SAMS, and the key secondary endpoint was the achievement of target LDL-C levels (<70 mg/dL) within 6 months.</p><p><strong>Results: </strong>The primary endpoint showed a lower incidence of SAMS in the combination therapy group (0.7%) compared to the high-intensity statin monotherapy group (5.7%, p = 0.005). Both groups achieved similar LDL-C levels, with 75.4% in the combination therapy group and 68.7% in the monotherapy group reaching target levels.</p><p><strong>Conclusion: </strong>Moderate-intensity statin with ezetimibe combination therapy offers a lower risk of SAMS and similar LDL-C reduction in elderly patients with ASCVD, compared to high-intensity statin monotherapy.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of delirium and frailty in hospitalized older adults: Implications for healthcare utilization","authors":"Zhiying Lim,&nbsp;Natalie Ling,&nbsp;Reshma Aziz Merchant","doi":"10.1111/joim.20046","DOIUrl":"10.1111/joim.20046","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 2","pages":"227-229"},"PeriodicalIF":9.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol-induced pancreatitis and alcohol-related liver disease: Two different phenotypes of alcohol-related harm or related conditions?","authors":"Einar Stefan Björnsson","doi":"10.1111/joim.20043","DOIUrl":"10.1111/joim.20043","url":null,"abstract":"&lt;p&gt;It is well known that overconsumption of alcohol can cause tissue injury in the liver and the pancreas, apart from many other organs such as the heart, brain, and peripheral nervous system. It has also been recognized that less than 5% of individuals who drink excessively will develop episodes of acute pancreatitis [&lt;span&gt;1&lt;/span&gt;]. The definition of heavy drinking is beyond the scope of this editorial, and obtaining a reliable history of alcohol use can be a challenge. The pattern of use and the lifetime drinking history did not reveal any major differences among patients with alcohol use disorder (AUD) who were hospitalized for alcohol rehabilitation (without a history of alcoholic pancreatitis) and patients previously diagnosed with alcohol-induced pancreatitis (AIP) [&lt;span&gt;2&lt;/span&gt;]. In that study, males with AIP had a significantly lower total amount of spirits and a lower proportion of binge drinking than those with AUD, suggesting the &lt;i&gt;idiosyncratic&lt;/i&gt; etiology of AIP [&lt;span&gt;2&lt;/span&gt;]. In a study from Portugal, lifestyle and eating habits seemed to impact the development of alcoholic pancreatitis [&lt;span&gt;3&lt;/span&gt;]. Patients with alcoholic liver disease (ALD) had significantly higher alcohol consumption than AIP patients, and the latter group reported a more abundant diet in the past [&lt;span&gt;3&lt;/span&gt;]. A Swedish prospective and population-based study revealed that vegetable but not fruit consumption might prevent the development of non-gallstone-related acute pancreatitis [&lt;span&gt;4&lt;/span&gt;]. Thus, lifestyle and diet may influence the development of AIP apart from alcohol consumption [&lt;span&gt;2-4&lt;/span&gt;]. Although more knowledge is available on the risk of ALD based on threshold values of alcohol consumption, only a minority of heavy drinkers develop ALD [&lt;span&gt;5&lt;/span&gt;]. However, the incidence of both ALD and AIP has been shown to increase with increased per capita alcohol consumption in the general population [&lt;span&gt;6&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In the present issue of the Journal of Internal Medicine, Dugic et al. reported a sixfold increase in AIP in patients with ALD compared to matched controls [&lt;span&gt;7&lt;/span&gt;]. A total of 7% of the patients had experienced pancreatitis prior to the diagnosis of ALD, suggesting a ninefold higher risk compared with the matched controls. However, the cumulative incidence of hospitalization for AIP in patients with ALP was only 2.7% [&lt;span&gt;7&lt;/span&gt;]. Although the risk was higher than in matched controls, the risk seems very low that ALD patients will suffer from AIP. In the study by Dugic et al., independent risk factors for developing AIP were younger age, male sex, and diagnoses of alcohol and obstructive pulmonary disease [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The study included an impressive number of patients diagnosed with ALD, and the study has a long follow-up. This was a registry study from good quality health care in Sweden and a socialized medicine system, which means that all patients hospitalized for ALD in Sweden durin","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 2","pages":"122-123"},"PeriodicalIF":9.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Six-fold increased risk of acute pancreatitis in alcohol-related liver disease compared to matched comparators: A population-based cohort study","authors":"Ana Dugic,&nbsp;Linnea Widman,&nbsp;J.-Matthias Löhr,&nbsp;Hannes Hagström","doi":"10.1111/joim.20026","DOIUrl":"10.1111/joim.20026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Patients with alcohol-related liver disease (ALD) might be at increased risk of acute pancreatitis (AP), but large-scale data are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Population-based cohort study using data from the Swedish National Patient Register on 37,062 patients with ALD from 1969 to 2020. Patients were matched to ≤10 general population comparators (<i>n</i> = 352,931). We used logistic regression to estimate the risk of acute or chronic pancreatitis prior to ALD diagnosis and Cox regression to estimate rates for hospitalization for AP after ALD diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median age at ALD diagnosis was 59 years; 72% were men, and 67% had cirrhosis at baseline. Overall, 7% had experienced pancreatitis before ALD diagnosis, resulting in 9-fold higher odds of pancreatitis compared to comparators. The 10-year cumulative incidence of hospitalization for AP was 2.7% (95%CI = 2.5–2.8) in ALD and 0.6% (95%CI = 0.58–0.63) in comparators, yielding an adjusted HR of 6.3 (95%CI = 5.8–6.9). Younger age, male sex, and diagnoses of alcohol use disorders and chronic obstructive pulmonary disease were independent risk factors for developing AP in ALD. Continued drinking after baseline was associated with a higher risk of AP (adjusted hazard ratio [aHR] 2.6, 95%CI = 2.29–2.85).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ALD is associated with 9-fold higher odds of prevalent pancreatitis compared to the general population. The hospitalization rate for AP following ALD diagnosis is 6-fold higher. About 10% of patients with ALD have or develop AP, suggesting that assessing history of pancreatitis and its sequelae might be relevant for patients with ALD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 2","pages":"213-226"},"PeriodicalIF":9.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors’ reply: Apixaban, edoxaban and rivaroxaban, but not dabigatran, are associated with higher mortality compared to vitamin K antagonists","authors":"Christiane Engelbertz,&nbsp;Holger Reinecke,&nbsp;Jeanette Köppe","doi":"10.1111/joim.20045","DOIUrl":"10.1111/joim.20045","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 1","pages":"119-120"},"PeriodicalIF":9.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding: Apixaban, edoxaban and rivaroxaban, but not dabigatran, are associated with higher mortality compared to vitamin K antagonists","authors":"Enrico Brunetti,&nbsp;Roberto Presta,&nbsp;Mario Bo","doi":"10.1111/joim.20044","DOIUrl":"10.1111/joim.20044","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"297 1","pages":"117-118"},"PeriodicalIF":9.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}