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
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
(Feature Impact) Menopause is a phase of life every woman knows will come eventually yet few are truly prepared for. Beyond stereotypical symptoms like hot flashes and mood swings, the other realities of menopause can be mysterious, taking women by surprise when their experiences differ from expectations.
Rather than being a single event, menopause involves a gradual transition that happens as estrogen production changes – meaning symptoms can appear and evolve unpredictably. According to a survey commissioned by the National Menopause Foundation, 63% of U.S. women ages 35-54 experienced symptoms they believed may be related to perimenopause or menopause, yet nearly half (49%) said they weren’t prepared for the changes beforehand.
When women and their loved ones understand what they’re facing, they can approach this time with patience and compassion, which can make a real difference to the 71% of women who wished the people in their lives understood more about perimenopause or menopause. Consider these five facts to help fill in the menopause knowledge gap.
Perimenopause Can Start Years Before Menopause
The physiological transition to menopause can happen up to 10 years before a woman’s final menstrual period, although the average length of perimenopause is about four years. Symptoms may quietly begin in a woman’s 30s, 40s or 50s, and what might look like an isolated problem at first – like brain fog, a night of insomnia or an irregular monthly cycle – could be connected to broader hormonal changes.
Menopause Is More Than Just “Hot Flashes”
Since more than half of women surveyed were already aware of menopause symptoms like hot flashes, mood changes, anxiety and fatigue, these may not take them by surprise. Little-known symptoms are a different story – the majority of respondents didn’t anticipate menopausal issues like rage, inner-ear itching or reduced joint mobility. According to the National Menopause Foundation, women may also experience sleep disturbances, sweating, changes in libido, vaginal dryness, incontinence, weight changes and more.
Every woman’s experience is unique, so these symptoms could present in different combinations and intensities during menopausal years or may not appear at all.
Talking About Menopause Can Be Difficult
Even as women go through these physical and emotional shifts, many struggle to open up about their experiences. In fact, women rank menopause symptoms (17%) more difficult to discuss than hot-button topics like political views (13%), weight (13%) and religious beliefs (10%).
However, suffering in silence can lead to feelings of isolation, relationship misunderstandings and hesitation to seek help, which is why 66% of women said the lack of open discussion about menopause makes the experience worse.
Menopause Isn’t All Bad News
Although this season of life comes with challenges, there are joys to embrace as well. Women navigating midlife can come out the other side with more resilience, emotional awareness and a stronger sense of self. In fact, 44% of women surveyed said their outlook on life became more positive since their transition.
What Loved Ones Can Actually Do
Menopause is a highly individual experience, but that doesn’t mean women have to navigate it alone. Support from partners, families and friends can lift women up during difficult moments, and it can be as simple as taking the time to ask questions, listen and learn about how menopause is affecting their lives. With 30% of women in the U.S. labor force – approximately 15-16 million – in the age range corresponding to menopausal transition (ages 45-60), workplaces can also take steps to become more menopause friendly.
For more resources to help understand symptoms and discuss the transition with loved ones, visit nationalmenopausefoundation.org.
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home gardening
Beyond the Leaf Pile: 4 Tips for Autumn Lawn Care
4 Tips for Autumn Lawn Care: Many people associate fall yardwork with raking up the crispy, colorful leaves that have drifted down from surrounding trees. Don’t let that be the only task on your outdoor agenda, however, because this season is also an opportunity to improve the overall health of your lawn so it’s ready to thrive once spring arrives.
Beyond the Leaf Pile: 4 Tips for Autumn Lawn Care
(Feature Impact) Many people associate fall yardwork with raking up the crispy, colorful leaves that have drifted down from surrounding trees. Don’t let that be the only task on your outdoor agenda, however, because this season is also an opportunity to improve the overall health of your lawn so it’s ready to thrive once spring arrives.
Start with these autumn lawn care tips:
- Continue Mowing
As long as the grass keeps growing, homeowners should keep mowing – with a couple of smart seasonal adjustments. First, lower the mower height for your final two cuts so the grass isn’t too tall going into winter. Second, instead of raking all the leaves up beforehand, think about leaving a layer on the lawn so the mower can shred them and effectively turn them into mulch, returning their nutrients to the soil.
- Fertilize the Lawn
Especially if you grow cool-weather grass varieties like rye or fescue, feeding your lawn can actually be most effective in the fall. Fertilizer helps nourish the roots of your grass, strengthening it through the winter and preparing it to grow lush and green in the spring and summer. Aim to feed it once in the beginning of the season then again 6-8 weeks later or according to the recommended schedule for your region.
- Battle Stubborn Weeds
If you’ve been dealing with perennial weeds throughout the summer, fall could mean your chance to get rid of them once and for all. Weeds absorb herbicides readily on days with moderate temperatures and moist soil, so this task might be well-timed after some autumn rain has fallen.
- Add Grass Seed to Thin Spots
Whether you have bare patches on your lawn or areas of thinning grass, fall is the best time to seed cool-season lawns. (Skip this tip if you live in the South and have a warm-season lawn.) At least six weeks before the first hard frost in your area, spread grass seed over the areas you want to replenish or thicken then keep the lawn consistently watered until it germinates. Aerating the soil first can help the seed take root.
Find more seasonal home and garden tips by visiting eLivingtoday.com.
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Lifestyle
7 Fire Prevention Tips to Protect Your Home and Community
7 Fire Prevention Tips: Fires can be devastating, but many of them are preventable with simple precautions and smart everyday choices. Consider these tips to reduce the risk of fires and keep your household, family and community safe.
7 Fire Prevention Tips to Protect Your Home and Community
(Feature Impact) In observance of National Fire Prevention Month, it’s a good time to review your fire safety habits at home and in your neighborhood. Fires can be devastating, but many of them are preventable with simple precautions and smart everyday choices.
Consider these tips to reduce the risk of fires and keep your household, family and community safe.
Test Your Smoke Alarms
Smoke detectors are one of the simplest yet most important tools for protecting your home, loudly alerting you to potential danger at any time of the day or night. Test them monthly, follow manufacturer’s instructions for replacement and change batteries as needed.
Heat Your Home Safely
Depending on how you heat your home, there can be different hazards to remain aware of. Never leave fireplaces unattended when in use and have them inspected and maintained as recommended by a trained professional. If you use portable heaters, keep them at least three feet away from curtains, bedding, furniture and other flammable materials.
Prevent Electrical Fires
Frayed cords, damaged outlets or overloaded appliances can pose real danger to your home when they overheat or spark. Particularly if you live in an older home or have outdated appliances, keep an eye out for warning signs like tripped circuit breakers, malfunctioning devices or the smell of burning. If you’re concerned, have your system inspected by a qualified electrician.
Store Flammable Objects Carefully
Keeping matches and lighters out of reach of children is always a smart first step for household fire safety. Also follow safe storage practices for items like lighter fluid, propane, aerosol cans and other household products that could potentially ignite when exposed to heat or a stray spark.
Practice Smart Kitchen and Grill Habits
From sparks flying off the grill to hot oil forgotten in the frying pan, cooking is the leading cause of household fires. Stay attentive in the kitchen, never leave cooking food unattended and avoid setting combustible materials like paper plates or fabric towels too close to a stove or grill. Also keep your appliances cleaned and well-maintained.
Plan Your Escape Route
Fires can spread quickly, which is why it’s important for everyone in your household to know the plan (and backup plan) for safely exiting different areas of the house during an emergency. Decide on a specific meeting place outside and practice quick fire drills together to build muscle memory.
Observe Local Fire Safety Rules
Where you live determines what kinds of fire risks affect your community, so make sure you stay informed about local regulations. For instance, areas prone to drought or wildfire may have rules about outdoor burning, and local fire prevention ordinances may outline specific requirements for smoke alarms in your home.
Find more home safety tips at eLivingtoday.com.
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eLivingtoday.com
