Treatment with the thrombin inhibitor dabigatran was associated with a decreased incidence of Staphylococcus aureus bacteremia compared with treatment with the factor Xa inhibitors rivaroxaban and apixaban.
Among patients with permanent atrial fibrillation, cognitive impairment may be more common in those with suboptimal antithrombotic therapy, oral anticoagulation, or heart rate control.
African Americans may be at greater risk for ventricular arrhythmias and sudden cardiac death if infected with SARS-CoV-2, due to genetic susceptibility and environmental factors.
A combination of hydroxychloroquine and azithromycin to treat patients with COVID-19 was found to prolong QTc interval without clinically affecting patients.
For patients with atrial fibrillation, the risk for osteoporotic fracture appears to be lower with direct oral anticoagulant use, compared with warfarin use.
![Decisions regarding thromboprophylaxis requires weighing the risk of stroke against the risk of bleeding in each patient.[3,4] Numerous risk assessment tools are available, including CHADS2, CHA2DS2-VASc, and HAS-BLED. American and European guidelines recommend the use of CHA2DS2-VASc, which considers sex, age, and history of congestive HF, hypertension, stroke/transient ischemic attack/thromboembolism, vascular disease, and diabetes mellitus.[3,4] Compared with other stroke risk assessment measures, this tool performed best in identifying patients at low risk of stroke who did not require anticoagulation therapy.[12] Oral anticoagulation is recommended in any patient with a score ≥2 on the CHA2DS2-VASc. In these patients, warfarin or the novel anticoagulants dabigatran, rivaroxaban, apixaban, or edoxaban can be considered, except in the setting of moderate to severe chronic kidney disease, where reduced doses of direct thrombin or factor Xa inhibitors are preferable.[4]](https://3fvcugvijkt9bj7w3wf2t712-wpengine.netdna-ssl.com/wp-content/uploads/sites/17/2019/01/slideshowsizeatrialfibrillati_1061315.jpg)
