Erratum to "Twice- or once-daily dosing of direct oral anticoagulants and gastrointestinal bleeding in patient with atrial fibrillation" [Am. Heart J. Plus: Cardiol. Res. Pract. Volume 22, October 2022, 100203].

[This corrects the article DOI: 10.1016/j.ahjo.2022.100203.].

Cardiac involvement of diffuse large B-cell lymphoma presenting as various arrythmias.

Symptomatic cardiac involvement of malignant lymphoma is rare. Silent invasion of malignant lymphoma makes it difficult to diagnose it in the early phase of clinical course. We describe a case with cardiac involvement of diffuse large B-cell lymphoma presenting various types of arrythmias that were not diagnosed until autopsy.

Twice- or once-daily dosing of direct oral anticoagulants and gastrointestinal bleeding in patient with atrial fibrillation.

Aims: Direct oral anticoagulant (DOAC) is widely used for the prevention of embolic stroke in non-valvular atrial fibrillation (NVAF) patients. However, the gastrointestinal bleeding risk in several DOAC regimens was higher than warfarin, especially in once-daily regimens. Methods and results: We conducted a single-center prospective registry of patients with NVAF treated with DOACs: the DIRECT registry (N = 2216; follow-up duration 650 [IQR 103-1574] days, UMIN000033283). All patients were divided into 2 groups: the twice-daily (BID) regimen group (dabigatran and apixaban) versus the once-daily (QD) regimen group (rivaroxaban and edoxaban). Out of 2216 patients, we successfully matched 904 patients in the QD group and 904 patients in the BID group using propensity score. The primary endpoint was gastrointestinal bleeding defined as any bleeding in the gastrointestinal tract that was identified through medical records regardless of bleeding site or severity. The BID group showed a significantly lower gastrointestinal bleeding rate than the QD group (3.5/100 person-year vs. 6.2/100 person-year, log-rank P < 0.0001). The secondary endpoints were all death, stroke, major bleeding, and any bleeding. The rate of major bleeding was significantly lower in patients with BID regimen group (log-rank P = 0.040). In contrast, all death, stroke, and any bleeding did not differ between both groups (log-rank P = 0.280, 0.520 and 0.066, respectively). Conclusions: The BID regimen as compared with the QD regimen was associated with reduced risk of gastrointestinal bleeding.

Synergistic mechanism of coincidence of two subacute stent thromboses: Insights from multiple imaging observations.

In the drug-eluting stent era, stent thrombosis is uncommon but still a life-threatening complication after percutaneous coronary intervention. There are several types of risk factors associated with stent thrombosis, which could work synergistically to produce thrombus. We report the case of subacute stent thrombosis. A 66-year-old male was hospitalized due to ST-segment elevation myocardial infarction and received emergency percutaneous coronary intervention to the obtuse marginal branch and the posterolateral artery. Five days later, he complained of chest pain. Emergency coronary angiography was performed and revealed stent thromboses in both the obtuse marginal branch and the posterolateral artery. Remarkably, in this case, stent thromboses occurred in the obtuse marginal branch and the posterolateral artery simultaneously. Finally, we overcame this situation by stenting to the main branch of left circumflex artery. We speculated the precise mechanism of simultaneously occurring two subacute stent thromboses through multiple intracoronary imaging modalities. In this case, we hypothesized that the combination of the protrusion of obtuse marginal branch stent to the main branch of left circumflex artery, blood flow turbulence due to the ulcer, and relatively high thrombogenicity of acute coronary syndrome lesion synergistically generated the thrombus. .