Do Minor Cuts Lead To More Strokes & Heart Attacks‏

Do Minor Cuts Lead to More Strokes & Heart Attacks? For stroke & MI (myocardial infarction, aka heart attack) prevention, people are put on anticoagulation therapy (aka blood thinners) People are put on blood thinners for stroke or heart attack prevention Billions are spent every year on stroke & second MI (MI = heart attack) prevention. This can be derailed by something as simple as a minor cut. Can we improve stroke prevention and second MI prevention with a piece of gauze? 6 million people in US on anti-coagulation therapy These are people that are at elevated risk for stroke or MI. 800,000 strokes and 715,000 heart attacks in US 28% have bleeding, that is difficult to control, from a minor cut (Nuisance Bleeding) 28% of patients on anti-coagulation therapy experience a minor or Nuisance Bleeding episode (American Journal of Cardiology, 2008) annually Negative Consequences Z from this Bleeding: 1 IMPACT ON ER/ED VISITS 2 IMPACT ON OUTCOMES Discontinuation of anticoagulation therapy is the leading independent predictor for stent thrombosis Estimated that there are 68,000 annual ER/ED visits for hemorrhage-related AEs by patients receiving clopidogrel/aspirin or warfarin Most visits due to epistaxis, skin, or other minor hemorrhages (54% - 59%) Rate per 1000 outpatient Rxs = 1.2 for clopidogrel/ aspirin and 2.5 for warfarin Anticoagulants are among the top five drugs that cause AEs treated in the ER/ED Premature discontinuation results in a 30x greater risk of stent thrombosis Greater than 25% of patients with premature discontinuation had the event within 30 days • Mortality over the 11 discontinuation is 7.5% vs. 0.7% for those %3D months post- remaining on therapy Cost of one ER/ED visit for an open wound = $1,363 11% of people on a blood thinner stop taking their blood thinner due to this Nuisance Bleeding 11% of patients discontinue Plavix because of Nuisance Bleeding (American Journal of Cardiology, 2008) 81% of the patients that discontinued warfarin during the first year cited concerns about bleeding • Mayo Clinic cites nuisance bleeding as significant factor in non-adherence, given the asymptomatic condition • If people stop taking complications, such as a stroke, heart attack, hospitalization, etc. Premature discontinuation of anti-coagulation therapy has been shown to greatly increase the risk of stent thrombosis, MI, and death. (Circulation, 2007) THESE COMPLICATIONS COST MONEY Recently, a case report was published of a patient who developed angina symptoms within 30 days of discharge after stent implantation and who admitted to stopping antiplatelet therapy (prasugrel and aspirin) because of repeated bleeding from cuts incurred while shaving. a COULD HAVE BEEN PREVENTEDBY A PIECE OF GAUZE: ALLAQUIX™ TM A SOLUTION YABÐAU2 Inspiration Medical is proposing a solution to reduce the impact of Nuisance Bleeding on stroke and MI prevention. patients need to be equipped with the proper information and tools to understand and manage Nuisance Bleeding. AllaQuixTM is a sterile, topical, active hemostatic, wound dressing that works independent of the body's clotting mechanism. AllaQuix™ is FDA-cleared for OTC use. At-risk AllaQuixTM is made from chitosan, which has shown many medical benefits, including rapid control of bleeding (hemostasis), antimicrobial activity, and stimulation of wound healing. Provide education to members on Nuisance Bleeding, anticoagulation therapy, stroke prevention, heart health, etc. through NuisanceBleeding.com and other channels Provide members a sample of AllaQuix™ REFERENCES Cohen, MD, Marc. "Expanding the Recognition and Assessment of Bleeding Events Associated With Antiplatelet Therapy in Primary Care." Mayo Clinic Proceedings 84.2 (2009): 149-160. Web. . Rau, Jordan. "Medicare To Penalize 2,217 Hospitals For Excess Readmissions." Kaiser Health News. 12 2012. . Shehab, Nadine, Laurence S. Sperling, and Scott R. Kegler. "National Estimates of Emergency Department Visits for Hemorrhage-Related Adverse Events From Clopidogrel Plus Aspirin and From Warfarin." Arch Intern Med 170 (2010): 1926-933. Web. . American Diabetes Association. Total prevalence of diabetes & pre-diabetes. . Budnitz, MD, MPH, Daniel S., Nadine Shehab, and Scott R. Kegler, PhD. "Medication Use Leading to Emergency Department Visits for Adverse Drug Events in Older Adults." Annals of Internal Medicine 147.11 (2007): 755-65. Web. . Antithrombotic Trialists' Collaboration. Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ (Clinical Research Ed.). 2002;324:71-86. Haffner SM, Lehto S, RÖnnemaa T, et al. Mortality from coronary heart disease in subjects with type-2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339:229-234. ALLAQUIX" Grines, Cindy L., Robert O. Bonow, and Donald E. Casey, Jr. "Prevention of Premature Discontination of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents: A Science Advisory From the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, With Representation From the American College of Physicians." Journal of the American Heart Association 115 (2007): 813-18. Web. . HEMOSTATIC PAD For Management of Minor Topical Bleeding Wounds such as Minor Abrasiens and Minar Skin Lacerations. Angiolillo DJ, Siva Suryadevara . Aspirin and clopidogrel: efficacy and resistance in diabetes mellitus. Best Pract Res Clin Endocrinol Metab. In Do not use fal h denaged Contents of uncpT, undamaged paelage are Sterile.Donot Rester iz. STERILE R NSTRUCTION press. Dstrbuted by saalkn alT Maulastaud is he by Chirogen inc, Minnespe Centers for Medicare & Medicaid Services. "National Medicare Readmission Findings: Recent Data and Trends.". . J.D. Power and Associates. 2010 U.S. Member Health Insurance Plan Study. INSPIRATION MEDICAL TECHNOLOGY, IN C. ALLAQUIX TM