Vascular Health and Risk Management最新文献

{"title":"Thromboprophylaxis in Patients Admitted to the Surgical Ward: Clinical Audit.","authors":"Yassin Abdelrahim Abdalla,&nbsp;Arwa Mustafa Kamil,&nbsp;Samya Abbas Abdelrazig Mohamed,&nbsp;Ahmed Hashim Ahmed Mohamed,&nbsp;Eman Khalifa,&nbsp;Mohamed Hamid Abdelsalam Mohamed,&nbsp;Eilaf Eltayeb Abdalla Abdelgadir,&nbsp;Muawiya Dabora,&nbsp;Mohammed Salah Eldin Mohammed Elshikh Awoda","doi":"10.2147/VHRM.S418808","DOIUrl":"https://doi.org/10.2147/VHRM.S418808","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired thrombosis (HAT) is associated with significant morbidity, mortality, and financial burden globally. Following trusted guidelines for VTE prevention has shown effective, safe, and satisfactory results. This prompts national collaborative efforts to maintain a consensus approach for the safe risk assessment of inpatients and the prescription of thromboprophylaxis.</p><p><strong>Objective: </strong>This study aimed to detect and estimate deviations from international thromboprophylaxis protocols. The study also aimed to raise the quality of practice and adherence to evidence-based protocols in Alshuhada Teaching Hospital.</p><p><strong>Methods: </strong>A cross-sectional audit of general surgical inpatients was performed from October 2021 to May 2022. The first cycle was from 1/10/2021 to 21/10/2021, and the second cycle was from 13/5/2022 to 31/5/2022. The target population was adults aged >18 years. Data were collected via an online checklist on two separate occasions. The criteria were based on the NICE guideline for venous thromboembolism in individuals aged over 16 years: \"Reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism NG89\".</p><p><strong>Results: </strong>Forty-five surgical inpatients were included in this study: 20 in the first cycle and 25 in the second cycle. The first-cycle report showed that only 25% of VTE candidates received this regimen. In the second cycle, practice significantly improved, with 92% of admitted patients having their risk assessment tool completed within 24 h of admission. 79% of VTE prophylaxis candidates were prescribed adequate pharmacological prophylaxis within 14 h of admission.</p><p><strong>Conclusion: </strong>The rate of adequate thromboprophylaxis for inpatients undergoing surgery was very low before clinicians received education on VTE prevention, whereas was evidently high after they had received them. The cause of non-adherence in the pre-intervention phase was a lack of adequate knowledge regarding the magnitude and burden of HAT and the importance of thromboprophylaxis, which has a potential role in preventing the majority of HAT.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"651-656"},"PeriodicalIF":2.9,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/a6/vhrm-19-651.PMC10521924.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suboptimal Knowledge and Care of Patients with Acute Coronary Syndrome Among Nurses Working in Selected Hospitals in Addis Ababa, Ethiopia 2021.","authors":"Bizuayehu Ashine Lakew,&nbsp;Daniel M Bekele,&nbsp;Wudma Alemu Kassa,&nbsp;Boka Dugassa Tolera","doi":"10.2147/VHRM.S422339","DOIUrl":"https://doi.org/10.2147/VHRM.S422339","url":null,"abstract":"<p><strong>Background: </strong>Acute Coronary Syndrome is the leading cause of morbidity and mortality in developing nations including Ethiopia. As frontline healthcare providers, nurses need to be prudent in handling cases of acute coronary syndrome. However, nurses' knowledge and practice of acute coronary syndrome are not well-known across Ethiopia. Thus, this study aimed to assess knowledge, practice, and associated factors regarding the care of acute coronary syndrome among acute care nurses working at selected hospitals in Addis Ababa, Ethiopia.</p><p><strong>Methods: </strong>Institution-based descriptive cross-sectional study design was conducted from February to March among 252 purposively selected nurses working in tertiary hospitals of Addis Ababa, Ethiopia. A pretested and structured questionnaire was used for data collection. Data were entered into Epi-Data 4.6 and exported to SPSS version 25. Both descriptive and inferential statistics were used to describe and test the association between selected variables. P-values < 0.05 were declared as significant factors for the outcome variable.</p><p><strong>Results: </strong>Out of 252 nurses, (52%) had good knowledge, and (44.4%) had good practice towards care of Acute Coronary Syndrome. Being a master's degree [AOR=3.801, (95% CI:1.314-10.996), P =0.014] and having guidelines [AOR= 10.998, (95% CI:2.478-48.805), P =0.002] were significantly associated with nurse's good knowledge of ACS. While having a master's degree [AOR=4.258, (95% CI:1.676-10.820), P=0.002] and getting in-service training [AOR= 1.902, (95% CI:1.022-3.539), P = 0.042] were significantly associated with nurse's good level of practice.</p><p><strong>Conclusion: </strong>In this study, nurses had inadequate knowledge and practice regarding the care of Acute Coronary Syndrome. Nurses' educational level, presence of clinical practice guidelines, and getting training were determinant factors associated with good knowledge and practice. Therefore, organizational and nursing educational support are needed to improve this gap by providing short- and long-term training, and updated evidence-based clinical practice guidelines should be available for all acute care nurses.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"637-649"},"PeriodicalIF":2.9,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/fa/vhrm-19-637.PMC10519216.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint Modeling of Blood Pressure Measurements and Survival Time to Cardiovascular Disease Complication among Hypertension Patients Follow-up at DebreTabor Hospital, Ethiopia.","authors":"Abebe Nega Zelelew,&nbsp;Demeke Lakew Workie","doi":"10.2147/VHRM.S418568","DOIUrl":"10.2147/VHRM.S418568","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is also referred to as a silent killer and a leading factor for cardiovascular disease complication in the world today. This study aimed to identify the factors that affect longitudinal outcomes and survival time for cardiovascular disease complications among patients with hypertension.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among a randomly selected sample of 178 outpatients with hypertension at the Debre Tabor Specialized Hospital between September 2017 and December 2019. Three different models were used to analyze the data: the bivariate mixed-effects model, Cox proportional hazard model, and bivariate joint model for longitudinal and survival sub-models linked by shared random effects.</p><p><strong>Results: </strong>Bivariate mixed-effects and Cox proportional hazards survival sub-models were jointly preferred based on the minimum Akaike Information Criterion value. The estimated values of the association parameters were 0.0655 (p = 0.0270) and 0.963 (p = 0.0387), indicating that the association between systolic and diastolic blood pressure with time to event was guaranteed. The joint bivariate mixed-effects model analysis showed that patients with hypertension with a family history of hypertension and clinical stage II hypertension have a high chance of developing cardiovascular disease complications and have high average systolic and diastolic blood pressure compared to their counterparts. Patients with hypertension and diabetes have higher systolic and diastolic blood pressure than their counterparts.</p><p><strong>Conclusion: </strong>Generally, systolic and diastolic blood pressure stabilized over the follow-up period of treatment, while sex and residence were statistically insignificant to the survival time of cardiovascular disease complication. Health professionals and concerned bodies should therefore focus on patients with comorbidities, older age, and poor adherence to hypertension control and cardiovascular disease complications using technology, such as text messaging, and mobile application to promote cardiovascular health at early stage. It is important to provide early interventions for these groups of people, especially for those with family history.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"621-635"},"PeriodicalIF":2.9,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/35/vhrm-19-621.PMC10518359.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical Aortic Valve Thrombosis with Heart Failure Successfully Treated with Oral Anticoagulation: A Case Report.","authors":"Muhannad Ababneh, Abdullah Al-Kasasbeh, Emad Algorani","doi":"10.2147/VHRM.S425525","DOIUrl":"10.2147/VHRM.S425525","url":null,"abstract":"<p><strong>Background: </strong>The use of anticoagulation is mandatory for prevention of prosthetic valve thrombosis (PVT) worldwide, regardless of the valve type or position in the heart. In case a thrombosis causes symptomatic dysfunction, treatment usually includes the use of thrombolytic therapy or surgery. We report a case of PVT involving a patient with a mechanical aortic valve which was treated entirely with the use of anticoagulation therapy (warfarin).</p><p><strong>Case presentation: </strong>A 58-year-old man had an aortic valve replacement using a Carbomedics^® mechanical valve due to severe aortic stenosis as a result of a calcific bicuspid native aortic valve. He was commenced on warfarin after surgery which was continued thereafter. He presented to our hospital after three years with shortness of breath at rest. On clinical examination, his condition was poor with a New York Heart Association functional classification of IV. He was in sinus rhythm and had an enlarged heart shadow on chest X-ray. Transesophageal echocardiography (TEE) revealed aortic valve regurgitation with vegetations on the anterior valve leaflet causing reduced hemi leaflet motility and a mean pressure gradient of 50 mmHg. Cinefluoroscopy revealed a dysfunctional mechanical valve leaflet. Surgery was at high risk of mortality due to the patient's clinical status and he was continued on warfarin therapy with close monitoring. Cinefluoroscopy and echocardiography done six months later revealed complete dissolution of thrombus and a normally functioning mechanical aortic valve.</p><p><strong>Conclusion: </strong>Only a few cases of symptomatic, thrombotic mechanical aortic valve were entirely treated with anticoagulation only. Our patient is one such case who had resolution of symptoms and improvement on NYHA functional classification (IV to I).</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"617-620"},"PeriodicalIF":2.6,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/79/ce/vhrm-19-617.PMC10506610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41145040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of the Polypill on Medication Adherence in the Primary and Secondary Prevention of Cardiovascular Disease: A Systematic Review.","authors":"Jose P Lopez-Lopez, Ana Maria Gonzalez, Paola Lanza, Patricio Lopez-Jaramillo","doi":"10.2147/VHRM.S421024","DOIUrl":"10.2147/VHRM.S421024","url":null,"abstract":"<p><strong>Background: </strong>Higher medication adherence reduces the risk of new cardiovascular events. However, there are individual and health system barriers that lead to lower adherence. The polypill has demonstrated benefits in cardiovascular morbidity and mortality mainly driven by an increase in adherence. We aim to evaluate the impact of the polypill on adherence to cardiovascular medication, its efficacy and safety in cardiovascular disease (CVD) prevention.</p><p><strong>Methods: </strong>A systematic review following PRISMA guidelines was conducted. Databases were searched from January 2003 to December 2022. We included randomized, pragmatic, or real-world clinical trials and observational studies. The primary outcome was medication adherence, secondary outcomes were efficacy in cardiovascular disease in primary and secondary prevention and safety.</p><p><strong>Results: </strong>From the 490 publications screened, 13 met the inclusion criteria and were incorporated into a comparative table Of those included, 70% were randomized controlled trials (RCTs) and 53.8% focused on secondary prevention. Most of the studies received a high and moderate quality rating. Self-report, pill counting and, the Morisky scale were the most frequent methods to evaluate adherence (84.6%). Compared with standard medication, the polypill improved overall medication adherence by 13%, with percentages ranging from 7.6% to 34.9%. Moreover, a potential benefit was also observed in reducing Major Adverse Cardiovascular Events (MACE), particularly in secondary prevention studies, with hazard ratios ranged between 0.43 to 0.76. Compared to standard care, the profile of side effects was similar.</p><p><strong>Conclusion: </strong>The polypill is an effective, safe, and practical strategy to improve adherence in people at risk of CVD. Although there is a demonstrated benefit in reducing MACE, predominantly in secondary prevention, there are still gaps in its efficacy in primary prevention and reducing total mortality. Therefore, the importance of obtaining long-term results of the polypill effect and how this strategy can be implemented in real practice.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"605-615"},"PeriodicalIF":2.6,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/23/vhrm-19-605.PMC10504901.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10307990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Participation in Cardiac Rehabilitation Among Patients with Coronary Heart Disease After Reperfusion Therapy: A Scoping Review.","authors":"Firman Sugiharto, Aan Nuraeni, Yanny Trisyani, Azalia Melati Putri, Nuraulia Aghnia Armansyah","doi":"10.2147/VHRM.S425505","DOIUrl":"10.2147/VHRM.S425505","url":null,"abstract":"<p><p>Patients with coronary heart disease (CHD) experience many barriers to participate in cardiac rehabilitation (CR) programs. Several studies identify barriers that can affect participation in CR among patients with CHD after reperfusion therapy. However, there has yet to be a review specifically in this population. This review aims to identify the literature systematically that analyzes the barriers that affect the participation of CHD patients after reperfusion therapy in implementing the CR program. This study used the Preferred Reporting Item for PRISMA Extension for Scoping Reviews (PRISMA-ScR) with databases PubMed, ScienceDirect, EBSCO-hosted Academic Search Complete, Scopus, Taylor & Francis, and Sage Journals. The keywords used in English were \"coronary artery disease OR myocardial infarction OR cardiovascular disease OR heart disease\" AND \"Barrier OR obstacle\", AND \"percutaneous coronary intervention OR PCI OR angioplasty OR coronary artery bypass graft surgery OR CABG\" AND \"cardiac rehabilitation OR rehabilitation OR recovery\". The inclusion criteria in this review were full-text articles in English, articles with a descriptive, cross-sectional, and cohort design with a minimum of 100 participants that discussed barriers to participation in patients with CHD after undergoing reperfusion therapy, and the CR phases such as I, II, III, and IV have also been identified. Based on the initial search, there are 23 relevant studies out of 7400. The results of this study reported that most of the participants from the studies analyzed had a low level of participation in CR (≤50%). We classify the factors that affect the level of CR participation into five categories: individual factors, health history, environmental, logistical, and health system. The most reported barriers in each category were age, comorbidities, lack of support from friends, family and health workers, distance or travel time, and cost and economic status. Professional health workers, especially nurses, can identify various barriers that patients feel so that they can increase their participation in attending CR.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"557-570"},"PeriodicalIF":2.6,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/32/vhrm-19-557.PMC10476659.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10522988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival status and predictors of mortality among adult Stroke patients admitted to Jimma University Medical Center, South west Ethiopia: A retrospective Cohort study.","authors":"Wakgari Mosisa,&nbsp;Yenealem Gezehagn,&nbsp;Guta Kune,&nbsp;Melese Chego,&nbsp;Hamba Fida Yigezu,&nbsp;Masrie Getnet","doi":"10.2147/VHRM.S399815","DOIUrl":"10.2147/VHRM.S399815","url":null,"abstract":"<p><strong>Background: </strong>Stroke is the leading cause of cardiovascular disease death in sub-Saharan Africa and the second leading cause of mortality worldwide. In 2016, 6.23% of all fatalities in Ethiopia were stroke-related.</p><p><strong>Objective: </strong>To assess survival status and predictors of mortality among adult stroke patients admitted to Jimma University Medical Center from April 1/2017 to March 31/2022.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 480 adult stroke patients selected by simple random sampling from patients admitted to the Jimma University Medical Center Stroke Unit from April 1, 2017 to March 31, 2022. Data were extracted from May to June 2022 and entered Epi-data v.3.1 and analyzed by R v.4.2. The Kaplan-Meier curve with Log rank test was used to estimate survival time and to compare survival experience between categories of explanatory variables. The Cox regression model was computed to identify predictors of survival status in stroke patients. Then the 95% CI of the hazard ratio was set with corresponding p-value < 0.05 to declare statistical significance.</p><p><strong>Results: </strong>During 4350 person-days of follow-up; 88 (18.33%) patients died; resulting in an incidence mortality of 20.23 per 1000 person-days, with a median survival time of 38 days. Glasgow coma score <8 on admission (AHR = 7.71; 95% CI: 3.78, 15.69), dyslipidemia (AHR = 3.96; 95% CI: 2.04, 7.69), aspiration pneumonia (AHR 2.30; 95% CI: 1.23-4.26), and increased intracranial pressure (AHR = 4.27; 95% CI: 2.33, 7.81), were the independent predictors of the time until death.</p><p><strong>Conclusion: </strong>The incidence of stroke mortality was higher at the seven and fourteen days. Glasgow Coma Scale, increased intracranial pressure, dyslipidemia, and aspiration pneumonia were independent predictors of mortality.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"527-541"},"PeriodicalIF":2.9,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/6a/vhrm-19-527.PMC10464890.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment: Prevalence of Hypercholesterolemia and Awareness of Risk Factors, Prevention and Management Among Adults [Letter].","authors":"Heru Santoso Wahito Nugroho, I Putu Suiraoka, Sunarto","doi":"10.2147/VHRM.S419214","DOIUrl":"10.2147/VHRM.S419214","url":null,"abstract":"","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"505-506"},"PeriodicalIF":2.6,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/a2/vhrm-19-505.PMC10405911.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10319261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structured Rehabilitation for Patients with Atrial Fibrillation Based on an Integrated Care Approach: Protocol for a Prospective, Observational Cohort Study.","authors":"Hui Zhang, Zhigeng Jin, Hao Wang, Yutao Guo, Gregory Y H Lip","doi":"10.2147/VHRM.S407974","DOIUrl":"10.2147/VHRM.S407974","url":null,"abstract":"<p><strong>Background: </strong>Guideline-recommended integrated care based on the ABC (Atrial fibrillation Better Care) pathway for \"general\" patients with atrial fibrillation (AF) improves clinical outcomes, as demonstrated in our prior mobile Atrial Fibrillation Application (mAFA)-II cluster randomized trial. The present study aims to investigate whether mAFA III-supported structured follow-up rehabilitation packages adapted to patient risk profiles and different treatment patterns (eg, for patients receiving drug treatment only, AF ablation, or left atrial appendage occlusion [LAAO]) will improve guideline adherence and reduce the risk of adverse cardiovascular events.</p><p><strong>Methods and analysis: </strong>In this prospective, observational mAFA III pilot cohort study, patients with AF aged ≥ 18 years will be enrolled using the mAFA III App for self-management. Assuming an annual rate of composite outcome of \"ischaemic stroke or systemic embolism, all-cause death and cardiovascular hospitalization\" of 29.3% for non-ABC pathway compliance compared with 20.8% for ABC pathway compliance, at least 1475 patients would be needed to detect the outcome of the A, B and C components of the ABC pathway, assuming a withdrawal rate of 20% in the first year. The primary endpoint is adherence to guidelines regarding the A, B and C components of the ABC pathway. Ancillary analyses will be performed to determine the impact of the ABC pathway using smart technologies on the outcomes among the \"high-risk\" population (eg, ≥75 years old, with multimorbidities, with polypharmacy) and the application of artificial intelligence machine-learning AF risk prediction management in assessing AF recurrence. The individualised anticoagulants with AF burden will be monitored by smart devices.</p><p><strong>Trial registration number: </strong>ISRCTN13724416.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"485-494"},"PeriodicalIF":2.6,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fc/4d/vhrm-19-485.PMC10402885.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9950575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Thromboembolism in Pregnancy: Challenges and Solutions.","authors":"Dimitrios Varrias, Michail Spanos, Damianos G Kokkinidis, Panagiotis Zoumpourlis, Dimitrios Rafail Kalaitzopoulos","doi":"10.2147/VHRM.S404537","DOIUrl":"10.2147/VHRM.S404537","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is a serious medical condition that can lead to severe morbidity and mortality, making it a significant public health concern. VTE is a multifactorial condition that results from the interaction of genetic, acquired, and environmental factors. Physiological changes during pregnancy increase the risk of VTE as they express Virchow's triad (increased coagulation factors, decreased fibrinolysis, trauma, and venous stasis). Moreover, pregnancy-related risk factors, such as advanced maternal age, obesity, multiple gestations, and cesarean delivery, further increase the risk of VTE. Managing VTE in pregnancy is challenging due to the complexity of balancing the risks and benefits of anticoagulant therapy for both the mother and the fetus. A multidisciplinary approach involving obstetricians, hematologists, and neonatologists, is necessary to ensure optimal outcomes for both the mother and baby. This review aims to discuss the current challenges associated with VTE in pregnancy and identify potential solutions for improving outcomes for pregnant women at risk for VTE.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"469-484"},"PeriodicalIF":2.6,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/8d/vhrm-19-469.PMC10364824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9872710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}