In college student-athletes, risk of sudden death due to cardiovascular disease is relatively low, with mortality rates similar to suicide and drug abuse, but less than expected in the general population, although highest in African-American athletes. A substantial minority of confirmed cardiovascular deaths would not likely have been reliably detected by pre-participation screening with 12-lead electrocardiograms.
Within this large forensic registry of competitive athletes, cardiovascular sudden deaths due to genetic and/or congenital heart diseases were uncommon in females and more common in African Americans/other minorities than in whites. Hypertrophic cardiomyopathy is an under-appreciated cause of sudden death in male minority athletes.
Venous thromboembolism (VTE) is a common health condition with a high mortality and morbidity as well as significant health cost. Traditional treatment with parenteral heparin followed by vitamin K antagonist (VKA) has helped to decrease both morbidity and mortality over years. However, difficulties with warfarin such as INR monitoring, drug-drug interactions, and dietary restrictions has led to research for new anticoagulants. Thus, novel anticoagulants such as direct thrombin and factor X inhibitors have been developed and studied for various indications including the management of VTE. There is now good evidence that some novel anticoagulants are at least as effective as traditional anticoagulation therapy with probably safer outcomes. We have reviewed the literature on the medical management of VTE with the focus on the role of dabigatran, rivaroxaban, apixaban and edoxaban for this indication.
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