Cardio Round-Up: Assessing Dose-Response Between PAD and Physical Activity; and More

VTE Patients have a Risk of Major Bleeding Once Anticoagulants are Discontinued

Currently, the long-term risk of major bleeding after discontinuing anticoagulant therapy for a first unprovoked venous thromboembolism (VTE) is uncertain. A study published in Thrombosis and Haemostasis sought to discern the incidence of major bleeding up to 5 years after discontinuing anticoagulation for a first unprovoked VTE.

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To conduct this analysis, the investigators searched MEDLINE, EMBASE, and Cochrane CENTRAL from inception to January 2021 to identify relevant randomized controlled trials (RCTs) and prospective cohort studies reporting major bleeding after discontinuing anticoagulation in patients with a first unprovoked VTE who had completed at least three months of initial treatment. In total, the analysis consisted of 20 studies (17 RCTs), and 8,740 patients.

“Patients with a first unprovoked VTE have a non-trivial risk of major bleeding once anticoagulants are discontinued,” the researchers concluded. “Estimates from this study can help clinicians counsel patients about the incremental risk of major bleeding with extended anticoagulation to guide decision making about treatment duration for unprovoked VTE.”

Analyzing the Dose-Response Relationship Between Physical Activity and PAD

A study found that the prevalence of peripheral artery disease (PAD) is inversely associated with physical activity (PA). The results appeared in Frontiers in Cardiovascular Medicine.

This study assessed 1,370 adults aged 40 years and older who had participated in the National Health and Nutrition Examination Survey (NHANES) from 1999-2004. The ABI of the participants were measured, and PAD was defined as ABI ≦0.9. PA was procured via a standard questionnaire, and metabolic equivalents (MET) were used to quantify the PA level. Logistic regression was employed to discern the link association between PA and incidence of PAD, and the dose-response relationship was analyzed with RCS.

Assessing the Effects of Intracranial Atherosclerosis and AFib on the Prognosis of Ischemic Stroke with Active Cancer

A study found that intracranial atherosclerosis (ICAS), but not atrial fibrillation (AF), was closely associated with poor prognosis in ischemic stroke patients with active cancer. The results were published in PLoS One.

“In ischemic stroke patients with active cancer, cryptogenic stroke has worse prognosis than stroke by conventional mechanisms. However, the individual effects of ICAS or AF on the prognosis of these patients have not been studied,” the researchers wrote.