Journal Scan 8 – Diagnosis of Diabetis, anticoagulation in AF.

How to diagnose diabetes. The standard way is to do a glucose tolerance test, with a fasting and 2hour blood test. Now it seems that doing a single test of longer term sugar, HbA1c, above 6.5% (48 mmol/mol) would be enough. Either way, diagnosis and treatment in diabetes is essential!

Efficacy and Safety of the Novel Oral Anticoagulants in Atrial Fibrillation: A Systematic Review and Meta-Analysis of the Literature-CIRCULATION 2012;126;20:Page2381

Novel oral anticoagulants (Dabigatran, Rivaroxaban, Apixaban, Edoxaban), have been proposed as alternatives to vitamin K antagonists (warfarin and Coumadin) for the prevention of stroke and systemic embolism in patients with atrial fibrillation. This systematic of randomized, controlled trials looked at 12 studies (3 administering Dabigatran, 4 administering Rivaroxaban, 2 administering Apixaban, and 3 administering Edoxaban) enrolling >50 000 patients. Novel oral anticoagulants significantly reduced death, and stroke or systemic embolism. Furthermore, these drugs showed a trend toward reduced major bleeding, with a significant reduction of intracranial (brain) haemorrhage. They need to be proven to be cost effective, but they appear to be an advance on current therapy.




Posted on 26 November 2012
Author: LCC
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