Lifestyle
Stroke, Clot Risk Halved in Heart Disease and Arrhythmia Patients Who Took Blood Thinners Apixaban Versus Rivaroxaban
A difference in the effectiveness against strokes and other blood clots was easily visible in the first year among patients who’d taken the anticoagulant apixaban rather than rival rivaroxaban, according to researchers at the Perelman School of Medicine at the University of Pennsylvania.
Last Updated on November 16, 2024 by Daily News Staff
Newswise — PHILADELPHIA—A difference in the effectiveness against strokes and other blood clots was easily visible in the first year among patients who’d taken the anticoagulant apixaban rather than rival rivaroxaban, according to researchers at the Perelman School of Medicine at the University of Pennsylvania.
In the “emulated” clinical trial—an analysis comparing matched patients in a large health insurance database—all of the patients whose data were analyzed were those who have atrial fibrillation (AF) and associated valvular heart disease (VHD). Each patient took one form of an anticoagulant, also known as blood thinners, to slow down the formation of new blood clots and help avoid existing clots from growing larger and potentially more harmful. The study showed that those who took apixaban had their dangerous clot risk decrease almost by half compared with rivaroxaban.
At least several million Americans have AF, a type of irregular heartbeat that lead to blood clots in the heart, and it is thought that more than 60 percent of these patients have associated VHD, which essentially means that they also have significant heart valve damage. Stroke or systemic embolism risk increase by several times in those with AF compared to those without it, and VHD is suspected of adding to the risk of stroke or death.
Since 2016, apixaban and rivaroxaban have been the most prescribed anticoagulants for reducing stroke and systemic embolism risk in AF/VHD patients. While some traditional blood thinners can be affected by a patient’s diet, apixaban and rivaroxaban do not, making them easier to manage. But, so far, there have been no clinical trials directly comparing the two drugs in this patient population.
“The lack of clinical trial evidence and wide use of both drugs in patients with AF and VHD calls for real-world evidence that can guide treatment selection in clinical practice,” said Ghadeer Dawwas, PhD, a postdoctoral fellow in Biostatistics, Epidemiology, and Informatics at Penn, and first author of the study, published today in the Annals of Internal Medicine.
Almost 10,000 patients who had recently started taking apixaban were compared with another 10,000 newly taking rivaroxaban. The study was not of the clinical trial type, in which patients are randomly assigned to different groups to minimize differences between them. Rather, the researchers emulated a clinical trial by matching each patient in the apixaban group to one in the rivaroxaban group with similar age and other characteristics that could affect outcomes. The patient records compared in the study came from a large commercial health insurance database with de-identified data from 2013 to 2020.
The number of strokes, as well as blood clots in the body other than the brain (called “systemic embolisms”) in the patients seen over the span of several years after they began taking the medications suggested that patients in the apixaban group had a 43 percent lower risk of a clotting event, and a 49 percent lower risk of a gastrointestinal or intracranial bleeding event.
“Until evidence from randomized controlled trials becomes available, we believe clinicians should consider our findings when selecting anticoagulants in patients with AF and VHD,” said study senior author Sean Hennessy, PharmD, PhD, a professor of Epidemiology and director of Penn’s Center for Real-world Effectiveness and Safety of Therapeutics.
The analysis showed that the numbers of patients who had strokes or systemic emboli in each group diverged almost immediately. Patients in the rivaroxaban group had markedly more of these events at six months and twelve months of follow-up. The researchers calculated that the rate of stroke or systemic embolism per patient per year of follow-up was about one percent (0.91 percent) for rivaroxaban users, and about half that (0.52 percent) for apixaban users. Similarly, the rate of bleeding events in the rivaroxaban group was about double that in the apixaban group.
Overall the results suggested that, in comparison to the rivaroxaban group, the apixaban group had 43 percent lower risk of stroke or systemic embolism, and 49 percent the risk of a bleeding events compared with rivaroxaban.
Support for the research was provided by the National Institutes of Health (K99HL159230).
Source: Perelman School of Medicine at the University of Pennsylvania
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Child Health
Changing the Landscape of Childhood Cancer Survivorship
Childhood Cancer: hile “cancer” is a term no family wants to hear, especially when it comes to their children, there is reason for hope. Today, 85% of children diagnosed with cancer survive at least five years. Survival is only part of the journey, however.
Changing the Landscape of Childhood Cancer Survivorship
(Feature Impact) While “cancer” is a term no family wants to hear, especially when it comes to their children, there is reason for hope. Today, 85% of children diagnosed with cancer survive at least five years, according to the National Cancer Institute, up from 75% three decades ago.
Watch this video to learn more
“This progress is driven in large part by dedicated research,” Hyundai Hope on Wheels Board Member Kevin Reilly said. “Over the last 28 years, Hyundai Hope on Wheels has committed over $300 million in pediatric cancer research and program grants, awarding more than 1,600 grants to 210 medical institutions nationwide, impacting thousands of young lives each year.”
Survival is only part of the journey, however. Nearly half (46%) of U.S. adults believe a child ringing the hospital bell after cancer treatment means the child is cancer-free and their medical journey is largely over, according to a survey conducted by Atomik Research on behalf of Hyundai Hope on Wheels. For the children and families living through a diagnosis, the reality is far more complex.
“The reality is that healing continues long after treatment, which is why sustained investment in survivorship care is a priority for us,” said John Guastaferro, executive director of Hyundai Hope on Wheels.
Isabella Franco-Capps, 11, understands that journey firsthand. Diagnosed with B-cell acute lymphoblastic leukemia at age 5, her journey took two years before she could say she’s “a cancer survivor.”
“I was diagnosed with b-cell acute lymphoblastic leukemia,” she said. “This began my two-year-long journey of scans, pokes, chemotherapy and hospital stays. And now I’m a cancer survivor.”
Fellow Hyundai Hope on Wheels National Youth Ambassador, Jackson Trihn, 12, is using his voice to call for continued research and to bring hope to others.
“The role … is being able to share my story,” he said. “Not just to spread awareness but to spread hope to kids that need it. And awareness is so important because people don’t understand how hard pediatric cancer can be.”
Continued progress can help ensure more children ring the bell and receive the care and support they need long after they’ve had the opportunity to do so. To learn more about these efforts and how you can help, visit HyundaiHopeOnWheels.org.
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(Feature Impact) Driven by rising rates of obesity, diabetes, high blood pressure and other risk factors,cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the United States.
Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation’s largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high-quality healthcare. A new scientific statement published in the American Heart Association’s flagship journal, “Circulation,” revealed how social, economic, cultural and environmental factors contribute to persistent disparities in cardiovascular health, calling for culturally tailored prevention strategies, equitable access to care and greater representation of Hispanic populations in cardiovascular research.
“Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health,” said Johanna Contreras, M.D., M.Sc., FAHA, director of the Division of Heart Failure and medical director of the Hispanic Heart Center within the Mount Sinai Health System. “Yet Hispanic people remain underrepresented overall in the research that guides prevention and treatment strategies… Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives.”
Hispanic Cardiovascular Health by the Numbers
Cardiovascular risk factors – obesity (nearly 46%), type 2 diabetes (15.5%) and high blood pressure (approximately 44%) – are prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.
According to the report, only about 1 in 5 Hispanic adults achieves ideal cardiovascular health as defined by the American Heart Association’s original Life’s Simple 7 metrics. Updated analyses using the Life’s Essential 8 framework demonstrated persistent disparities for heart and brain health, as well as suboptimal dietary quality, sleep patterns and levels of physical activity.
Social and Economic Barriers Matter
Biology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, impact heart health. In fact, approximately 17% of Hispanics live below the federal poverty threshold, compared with 8.2% of white adults.
“Many Hispanic adults face obstacles that extend far beyond the doctor’s office,” Contreras said. “Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment.”
Contreras emphasized the cultural values and practices of Hispanic people also influence how they perceive their health and healthcare options.
“Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience,” Contreras said. “At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon.”
An Action Plan for Improving Hispanic Health
There are practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.
“Reducing cardiovascular disease among Hispanic populations demands action at every level,” Contreras said, “from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health.”
By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives. Learn more at Heart.org.
Photo courtesy of Shutterstock
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(Feature Impact) Every year, approximately 200,000 service men and women transition from military life to corporate America. Finding the right civilian career is a transition, but it’s an opportunity to leverage military leadership and mission-driven talent.
Traditional hiring processes often focus on conventional resumes, but forward-thinking organizations recognize military experience as a competitive advantage in today’s workforce. The resilience, integrity and adaptability of America’s veterans and military families make them uniquely positioned to drive growth and innovation in their communities.
“Veterans bring unmatched discipline, adaptability and a results-driven mindset that directly translates to high-impact corporate careers,” said Drew Matheson, senior director at Capital One’s Commercial Bank and retired U.S. Army infantry officer. “While military experience doesn’t always fit perfectly on a traditional paper resume, employers like Capital One who know how to decode these unique leadership skills are able to unlock an incredible pipeline of proven performers.”
To help transitioning service members successfully navigate this career pivot, military community leaders at Capital One offer these five essential tips for service members entering the civilian workforce:
Start With What You’ve Already Earned
Opportunity starts with preparation. Beyond the well-known Post-9/11 GI Bill, which can cover tuition, housing and books, transitioning service members can look into vocational rehab or the SkillBridge program, which allows them to do civilian internships during the last 180 days of service. Many employers also offer internal tuition reimbursement programs. Taking the time to proactively map out these benefits ensures you aren’t leaving valuable opportunities or money on the table.
Find Employers with Veteran Support Structures
With almost half of veterans leaving their first post-military job within a year, according to research published by the Institute for Veterans and Military Families and VetAdvisor, finding the right culture and community is key to a successful transition. Look for employers with active veteran networks and dedicated mentorship.
For example, Capital One’s Salute Business Resource Group serves as a thriving internal community of more than 6,000 members, offering peer support, year-round professional development and mentorship for veterans, reservists and military spouses. Additionally, partner organizations like Hiring Our Heroes provide career workshops, fellowships and job fairs to ensure you’re employment-ready from day one.
Lean Into and Translate Your Soft Skills
Veterans bring a distinct competitive advantage to the applicant pool. You should confidently lean into the cross-functional “soft skills” learned in the line of duty such as risk management, crisis resolution and building trust under high-pressure scenarios.
The trick is translating these capabilities out of military jargon on your resume. Swap military terms like “NCOIC” for “Operations Manager” or “commanded” for “directed.” To make this easier, look for military-friendly employers that employ dedicated military recruiters who specialize in decoding military resumes to align skills with the right roles.
Prioritize Support for the Whole Family
Military service is a family commitment, and the transition out of uniform affects everyone. Military spouses often face unique career hurdles, including frequent relocations and employment gaps. When evaluating employers, look for companies that offer holistic benefits and flexible structures.
For example, Capital One, recognized by “U.S. Veterans Magazine” as a Top Veteran Employer and Top Military Spouse Employer, actively supports military spouses and families through dedicated spouse hiring initiatives and internal support mechanisms. Furthermore, look for organizations that support continued military training and active-duty leave, ensuring military associates never have to choose between their service and their careers.
Build Your Civilian Network Early
In the military, your network is built in. In the civilian world, you have to cultivate it. Long before your terminal leave begins, connect with veterans who work at companies you admire. Reach out for brief, 15-minute informational interviews to learn about their transition journeys rather than simply asking for a job. With more than 70% of civilian jobs filled through networking, according to estimates from Career Horizons, making organic connections early is a powerful tool for getting your foot in the door.
To find additional resources and learn more about how to support the hiring of veterans and military spouses, visit CapitalOneCareers.com/Military.
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