Heart failure is common in older people and its prevalence is increasing.The Heart ＇omics＇ in AGEing（HOMAGE） project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A la...Heart failure is common in older people and its prevalence is increasing.The Heart ＇omics＇ in AGEing（HOMAGE） project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A large clinical database,based on（1） prospective population studies or（2） cross-sectional,prospective studies or randomized controlled trials（RCTs） of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising ＇omics＇-based biomarkers to identify the risk of developing heart failure and/or comorbidities.Population studies,patient cohorts and RCTs are eligible for inclusion in the common database,if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk factors.Currently,the HOMAGE database includes 43,065 subjects,from 20 studies in eight European countries,including healthy subjects from three population studies in France,Belgium and Italy（n = 7,124）,patients with heart failure（n = 4,312） from four cohorts in the UK,Spain and Switzerland and patients at high risk for cardiovascular disease（n = 31,629） in 13 cohorts.It is anticipated that more partners will join the consortium and enlarge the pooled data.This large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure.展开更多
A patient treated with a vitamin K antagonist (VKA) since the implantation of two mechanical heart valves developed acute anemia after the extraction of a tooth. This case report and data in the literature indicate a ...A patient treated with a vitamin K antagonist (VKA) since the implantation of two mechanical heart valves developed acute anemia after the extraction of a tooth. This case report and data in the literature indicate a need for specific measures before, during, and after oral surgery in patients taking anticoagulant therapy: 1) the bleeding risk should be evaluated before the procedure. The INR should be measured routinely, 2) the procedure should be scheduled early in the week to allow an evaluation at the fibrinolysis peak, i.e., 48 to 72 hours after surgery, which is the time of greatest risk of delayed bleeding, 3) the surgical procedure should be appropriate for the elevated bleeding risk, 4) postoperative monitoring is of the most importance, as bleeding is usually delayed in patients on VKA therapy, 5) when poor treatment adherence is expected, day-hospital admission is useful to ensure that the postoperative protocol is implemented properly and to detect early bleeding. The treatment of post-extraction acute anemia includes local hemostasis protocol with the revision of the socket followed by red-blood-cell pack transfusion. A daily fluindione dosage control, and a normal hemoglobin level will allow the patient to leave the hospital.展开更多
文摘Heart failure is common in older people and its prevalence is increasing.The Heart ＇omics＇ in AGEing（HOMAGE） project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A large clinical database,based on（1） prospective population studies or（2） cross-sectional,prospective studies or randomized controlled trials（RCTs） of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising ＇omics＇-based biomarkers to identify the risk of developing heart failure and/or comorbidities.Population studies,patient cohorts and RCTs are eligible for inclusion in the common database,if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk factors.Currently,the HOMAGE database includes 43,065 subjects,from 20 studies in eight European countries,including healthy subjects from three population studies in France,Belgium and Italy（n = 7,124）,patients with heart failure（n = 4,312） from four cohorts in the UK,Spain and Switzerland and patients at high risk for cardiovascular disease（n = 31,629） in 13 cohorts.It is anticipated that more partners will join the consortium and enlarge the pooled data.This large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure.
文摘A patient treated with a vitamin K antagonist (VKA) since the implantation of two mechanical heart valves developed acute anemia after the extraction of a tooth. This case report and data in the literature indicate a need for specific measures before, during, and after oral surgery in patients taking anticoagulant therapy: 1) the bleeding risk should be evaluated before the procedure. The INR should be measured routinely, 2) the procedure should be scheduled early in the week to allow an evaluation at the fibrinolysis peak, i.e., 48 to 72 hours after surgery, which is the time of greatest risk of delayed bleeding, 3) the surgical procedure should be appropriate for the elevated bleeding risk, 4) postoperative monitoring is of the most importance, as bleeding is usually delayed in patients on VKA therapy, 5) when poor treatment adherence is expected, day-hospital admission is useful to ensure that the postoperative protocol is implemented properly and to detect early bleeding. The treatment of post-extraction acute anemia includes local hemostasis protocol with the revision of the socket followed by red-blood-cell pack transfusion. A daily fluindione dosage control, and a normal hemoglobin level will allow the patient to leave the hospital.
