Recurrent PE risk after long-term warfarin therapy remains high (PADIS-PE)

Not long ago, doctors were taught that 6 months of anticoagulation was plenty for patients with unprovoked pulmonary embolism. That standard was never based on long-term outcomes studies. And as longer-range data started to come in -- gulp -- it was clear that large numbers of people treated with 6-month warfarin courses after unprovoked PE [... read more]

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Bridging anticoagulation for procedures after DVT/PE: usually, more harm than help?

"Bridging" anticoagulation -- usually, interrupting chronic warfarin therapy, starting injectable or intravenous heparin, stopping just before an invasive procedure, restarting heparin and warfarin after, then stopping heparin -- is a cumbersome and common practice in medicine. A new paper in JAMA Internal Medicine suggests that for most patients taking anticoagulation after deep venous thrombosis (DVT) [... read more]

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Medicare will pay for death panels, I mean end-of-life counseling

Medicare announced last week it will finally pay doctors for their time spent talking to patients about their end-of-life preferences, among the most important medical decisions most people will make. The decision overcomes years of setbacks brought about by Sarah Palin's politicizing of the Affordable Care Act's provision for end-of-life counseling as endorsing "death panels" of [... read more]

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Direct thrombin inhibitors increase heart attack risk in multiple trials

Direct thrombin inhibitors (DTIs) are anticoagulants (blood thinners) most often used as alternatives to heparin and warfarin. DTIs are approved by the FDA for prevention and treatment of venous thromboembolism (deep venous thrombosis and pulmonary embolism) and to prevent blood clots in people with atrial fibrillation. But multiple randomized trials suggest these widely used anticoagulants can [... read more]

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