2) Actually, the #DOACs ARE safer than #VKAs, but there is still room for improvement in risk of both major & #gastrointestinal #Bleeding #GIB 🩸 and also to improve some issues with #underprescribing, #underfilling, & #adherence.
— cardio-met (@cardiomet_CE) November 8, 2023
4) We'll learn today from returning @cardiomet_ceexpert author Geoff Barnes MD @GBarnesMD, Vascular #Cardiologist @umichCVC, Co-director @MAQI_2, & Board of Directors @AnticoagForum. pic.twitter.com/WwKz35u8s2
— cardio-met (@cardiomet_CE) November 8, 2023
6) The new chapter in this story will be written on November 12th as a #LBCT at @American_Heart Scientific Sessions 2023 in #Philadelphia. #ChristianRuffMD will be presenting interim results on the Phase 2B #AZALEA #TIMI_71 study NCT04755283.
— cardio-met (@cardiomet_CE) November 8, 2023
8a) Whoa, back up. Tell me again why we think we need a better #anticoagulant than a #DOAC for #stroke prevention in #AFib.
— cardio-met (@cardiomet_CE) November 8, 2023
Despite well-documented advances in #anticoagulation tx (#warfarin➡️#DOACs), unmet needs persist:
1⃣ 1 in 4 🪦 globally are due to #thrombosis
(cont)
8c)
— cardio-met (@cardiomet_CE) November 8, 2023
5⃣ Other limitations of #DOACs:
👉Relatively short half-life requires once/twice daily adherence/persistence
👉Drug-drug interactions
👉Dependent on renal clearance to some extent
👉DOAC dose adjustment may be inappropriate pic.twitter.com/eRxkXTqFYn
9b) You know how we have always been taught that better #anticoagulation necessitates accepting more bleeding?? pic.twitter.com/ijUVdJKQvS
— cardio-met (@cardiomet_CE) November 8, 2023
9d) Envisioning this requires rewiring our traditional thinking about the #coagulation cascade: pic.twitter.com/Qz49jPsCN1
— cardio-met (@cardiomet_CE) November 8, 2023
11a) And so #AZALEA_TIMI_71 is testing the SAFETY side of that #FXI inhibitor vs #FXa inhibitor cage match. What do we know about the upcoming #LBCTresults?
— cardio-met (@cardiomet_CE) November 8, 2023
👉 Study initiated March 2021 & completed enrollment December 2021
👉Median duration of treatment >20 months
(cont)
12a) The EFFICACY considerations of selective #FXI inhibition for #stroke prevention in #AFib is being addressed separately:
— cardio-met (@cardiomet_CE) November 8, 2023
1⃣ #abelacimab vs placebo (#LILAC_TIMI_76, NCT05712200) in #AFib pts deemed unsuitable for oral anticoagulation
(cont)
13a) So, a quick review: Specific interference with #FXI in the coagulation cascade results in
— cardio-met (@cardiomet_CE) November 8, 2023
a. interference with hemostasis
b. interference with thrombosis
c. less thrombin generation
d. less stable clots
14a) Which of the following data to date support the "#FXI Hypothesis"?
— cardio-met (@cardiomet_CE) November 8, 2023
a. #TKA data vs #LMWH
b. animal data
c. natural history of individuals with congenital FXI deficiency
d. all of the above
15) So what should you do now?
— cardio-met (@cardiomet_CE) November 8, 2023
1⃣ claim your 🆓 0.5hr CE/#CME now at https://t.co/JLnQl6ND2f
2⃣ FOLLOW US now so you don't miss a LIVE update from #AHA2023 on #AZALEA_TIMI_71
3⃣ thank expert faculty @GBarnesMD for this program