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Women With Pregnancy-associated Stroke At Higher Risk Of MI, VTE: JAMA
France: Stroke survivors who are females would have a unique set of long-term cardiovascular (CV) risks if they had a pregnancy-associated stroke, says a recent study published in JAMA Network Open.
The cohort study revealed that women with pregnancy-associated stroke had lower risks of overall CV events, ischemic stroke, and death and similar risks of cerebral venous thrombosis and intracerebral haemorrhage compared to non–pregnancy-associated stroke. However, there was a greater risk of acute coronary syndrome with ST-segment elevation and venous thromboembolism.
Previous studies have shown that women with pregnancy-associated stroke might have different risks of stroke recurrence, including during subsequent pregnancies and other CV events due to pregnancy-specific stroke risk factors, such as preeclampsia, gestational hypertension, or gestational diabetes.
Yannick Béjot, University Hospital and Medical School of Dijon, University of Burgundy, Burgundy, France, and colleagues aimed to estimate the rate of cardiovascular hospitalization, stroke recurrence, and death in women with pregnancy-associated stroke versus women with non–pregnancy-associated stroke.
The study comprised all women ages 15 to 49 years in France who were affiliated with the general scheme of French health care insurance (94% of women) and had a first admission for stroke between 2010 to 2018. They were followed up until December 31, 2020, and noted for death, hospitalization for cardiovascular conditions, and stroke recurrence. Data were obtained from the French healthcare database.
The study led to the following findings:
In the study, the recurrence of ischemic stroke, death, and overall long-term cardiovascular outcomes remained lower after pregnancy than in women with non–pregnancy-associated stroke except for myocardial infarction (MI) and venous thromboembolism (VTE).
"These findings indicate that pregnancy-associated risk factors for stroke can disappear after pregnancy and postpartum, decreasing the risk of recurrence," the researchers wrote. "The higher risk of VTE and acute MI after pregnancy-associated stroke compared with non–pregnancy-associated stroke underscores the additional risk associated with pregnancy regarding these events."
Reference:
Béjot Y, Olié V, Lailler G, et al. Comparison of Stroke Recurrence, Cardiovascular Events, and Death Among Patients With Pregnancy-Associated vs Non–Pregnancy-Associated Stroke. JAMA Netw Open. 2023;6(6):e2315235. Doi:10.1001/jamanetworkopen.2023.15235
What Is Medical Malpractice? Definition & Examples
Any failure on the part of a medical provider to offer an acceptable level of care can be considered medical malpractice. But, some types of medical mistakes are more common than others. Here are some of these common examples.
MisdiagnosisIf a medical care provider diagnoses you with the wrong medical condition, this can be a form of medical malpractice–as long as a reasonably competent physician with a similar level of training would have provided an accurate diagnosis.
For example, if an ER doctor diagnoses you with heartburn when it would be clear to a competent doctor that you are actually having a heart attack, this misdiagnosis would likely be considered medical malpractice.
Delayed DiagnosisPrompt diagnosis is crucial to treating many medical conditions. If a doctor fails to diagnose a medical issue when a reasonably competent physician would have identified the problem, the care provider can be held accountable for losses that occur as a result of your delayed diagnosis.
Failure to Obtain Informed ConsentBefore providing you with treatment, caregivers must obtain your informed consent. This means you must agree to undergo a particular procedure after you have been told about the process, the risks and the alternatives.
If a healthcare worker doesn't go through the process of explaining things properly and getting your permission to proceed with treatment, this can give rise to a medical malpractice claim.
Incorrect TreatmentDoctors are expected to choose a treatment that is actually likely to help your medical condition. While they don't have to be perfect, they can be held accountable for instead offering a treatment no reasonably competent physician would have offered under the circumstances. For example, if your doctor recommends taking supplements instead of getting chemotherapy for an aggressive cancer, this could result in a medical malpractice claim.
Treatment MistakesDoctors who make mistakes while treating you can be held accountable if a reasonably competent physician with similar training would not have made the same error. For example, if a doctor prescribes a drug that is the wrong medication or botches a procedure they're performing, both of these failures could be treatment mistakes that lead to a malpractice claim.
While mistakes sometimes happen, a doctor who is incompetent and who hurts you as a result can be made to pay for resulting damages.
Surgical MalpracticeSurgeons have a high level of training, and can face a medical malpractice claim if they botch a procedure. This is especially true in certain circumstances where serious mistakes are made.
For example, if a surgeon operates on the wrong body part or leaves an instrument inside of you, this medical malpractice can result in serious injuries and you should be compensated for the damage caused.
Birth InjuriesMany things can go wrong when a baby is born, and the consequences can be lifelong for the mother and child. If a birth injury is caused by a care provider's negligence, this can give rise to a malpractice claim.
For example, a doctor who fails to properly monitor a baby's heartbeat during delivery could possibly be held accountable for any resulting damage the baby suffers if the child is in distress.
Wrongful DeathIf a physician makes a mistake that causes death, the patient's family can pursue a wrongful death claim and obtain damages.
Inari Medical (NARI) Launches New Catheters To Address VTE
Inari Medical, Inc. NARI recently announced the commercial launch of two new purpose-built products, the RevCore thrombectomy catheter and the Triever16 Curve catheter. RevCore is currently the first mechanical thrombectomy device designed to address venous in-stent thrombosis, whereas the Triever16 Curve catheter is the latest addition to Inari Medical's FlowTriever platform.
The latest launches are expected to significantly solidify Inari Medical's foothold in the Venous Stent Thrombosis and Venous Thromboembolism (VTE) treatment space globally.
Significance of the LaunchPer Inari Medical's estimates, approximately half a million venous stents have been placed in the United States in the past few years. However, the company also confirmed that venous in-stent thrombosis is an increasingly common occurrence, affecting more patients every year. Inari Medical believes that RevCore will likely be able to address this issue as this is a solution for an entirely new patient pool, which is not currently addressed by the ClotTriever or FlowTriever platforms.
Per Inari Medical, the Triever16 Curve catheter, which features a pre-shaped curve for targeted aspiration, is purpose-built to be versatile for both pulmonary embolism and peripheral thrombectomy. Triever16 Curve offers unique advantages over 16F continuous aspiration catheters, including compatibility with the FlowSaver blood return system and simple access to larger, more powerful 20F or 24F catheters within the company's price-per-procedure model.
An expert familiar with RevCore believes that it is an innovative tool as it physically removes in-stent thrombus and restores flow. It could also potentially reduce the need for additional reintervention. Another medical personnel commented that with the availability of the Triever16 Curve catheter, a wider VTE patient population will likely be served.
Industry ProspectsPer a report by Future Market Insights, the global VTE treatment market was estimated to be $1.53 billion and is anticipated to reach $1.91 billion in 2029 at a CAGR of 3.7%. Factors like the increasing pervasiveness of cardiovascular diseases and cancer due to the adoption of smoking and increasing obesity rate, the rising elderly population and technological advancements are likely to drive the market.
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Given the market potential, the commercial launches are likely to provide a significant boost to Inari Medical's business globally.
Notable DevelopmentsLast month, Inari Medical announced planned enrollment of the PEERLESS II trial, its third randomized controlled trial (RCT) in VTE. PEERLESS II is a prospective, global, multi-center RCT comparing the outcomes of intermediate-risk pulmonary embolism (PE) patients treated with the FlowTriever system versus anticoagulation alone.
The same month, Inari Medical announced its first-quarter 2023 results, wherein it registered a solid uptick in its year-over-year revenues. Management also confirmed the receipt of FDA clearances for several new products that are expected to drive market expansion while safeguarding the company from both existing and future competition.
In March, Inari Medical announced positive results from the FLAME study in high-risk/massive PE. FLAME is the largest prospective study of interventional treatment in high-risk PE, a patient population with a historical mortality rate of 25-50%.
Price PerformanceShares of the company have lost 6.7% in the past year against the industry's 4.3% rise and the S&P 500's 6.4% growth.
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Zacks Rank & Key PicksCurrently, Inari Medical carries a Zacks Rank #3 (Hold).
Some better-ranked stocks in the broader medical space are Hologic, Inc. HOLX, Merit Medical Systems, Inc. MMSI and Boston Scientific Corporation BSX.
Hologic, carrying a Zacks Rank #2 (Buy) at present, has an estimated growth rate of 5.1% for fiscal 2024. HOLX's earnings surpassed estimates in all the trailing four quarters, the average being 27.3%. You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here.
Hologic has gained 6.9% compared with the industry's 4.3% rise in the past year.
Merit Medical, carrying a Zacks Rank #2 at present, has an estimated long-term growth rate of 11%. MMSI's earnings surpassed estimates in all the trailing four quarters, the average surprise being 20.2%.
Merit Medical has gained 45.9% compared with the industry's 10.5% rise over the past year.
Boston Scientific, carrying a Zacks Rank #2 at present, has an estimated long-term growth rate of 11.5%. BSX's earnings surpassed estimates in two of the trailing four quarters and missed in the other two, the average surprise being 1.9%.
Boston Scientific has gained 33.5% against the industry's 29.8% decline over the past year.
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