Background: Patients with end stage renal disease (ESRD) are at significantly increased risk for both thrombosis and bleeding relative to those with normal renal function, which makes anticoagulation particularly challenging. Evidence suggests that rivaroxaban and dabigatran are associated with a higher risk of bleeding in ESRD patients. To date, no large national cohort studies have [...]

Background: Arterial (3-fold) and venous (10-fold) thromboembolism are more common in myeloproliferative neoplasm (MPN) than general population with rates as high as 50% in polycythemia vera (PV) and essential thrombocythemia (ET).1,2 While primary prophylaxis with aspirin is not debated for prevention of arterial and venous thromboembolism, the choice of anticoagulant for secondary prophylaxis and treatment [...]

Background: Unstable Angina (UA) is a common subset of Acute Coronary Syndrome (ACS) and presents as atypical chest pain without the presence of cardiac biomarkers. It accounts for nearly 550,000 hospital admissions each year in the United States [1]. Management of UA can vary depending on the physician and/or intensity of symptoms. Prior studies have [...]

Background: Systemic Sclerosis (SSc) is an autoimmune condition characterized by widespread skin fibrosis and/or end-organ damage. Previous studies have reported variable outcomes of the disease process, with males and patients of certain ethnicities suffering from the severe form of the disease leading to end-organ damage and an increase in mortality (1,2). The aim of this [...]

Background: Direct acting oral anticoagulants (DOACs) have been approved for conditions such as non-valvular atrial fibrillation and venous thromboembolism. High quality randomized controlled trials have demonstrated the safety and efficacy of DOACs as compared to warfarin with exceptions in specific patient populations (such as those with mechanical heart valves). DOACs are more convenient and generally [...]

Case Presentation: A 78-year-old African American female with a history of coronary artery disease (CAD) with stent placement, hypertension, and hyperlipidemia developed chest pain after being admitted for pulmonary embolism secondary to recently diagnosed pancreatic cancer. She was treated appropriately, but developed severe chest pain on day six of her stay. The patient’s vital signs [...]

Case Presentation: A 67-year-old female with a medical history of coronary artery disease, hypertension, and hyperlipidemia presented to the hospital with several days of worsening epigastric pain and chest pain. The pain had a band-like distribution with radiation to her back and no clear aggravating or alleviating factors. She reported chills and one day of [...]