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Collections Anticoagulation

Anticoagulation

Anticoagulation for atrial fibrillation, thromboembolism and IHD

https://read.qxmd.com/read/31102275/anticoagulation-in-chronic-kidney-disease-from-guidelines-to-clinical-practice
#1
REVIEW
Viviana Aursulesei, Irina Iuliana Costache
BACKGROUND: Chronic kidney disease (CKD) is a major global public health problem, being closely connected to cardiovascular disease. CKD involves an elevated thromboembolic risk and requires anticoagulation, but the high rates of hemorrhage render it quite challenging. HYPOTHESIS: There are no consensus recommendations regarding anticoagulation in CKD. Due to the currently limited data, clinicians need practical clues for monitoring and optimizing the treatment...
August 2019: Clinical Cardiology
https://read.qxmd.com/read/30415934/timing-of-anticoagulation-after-recent-ischaemic-stroke-in-patients-with-atrial-fibrillation
#2
REVIEW
David J Seiffge, David J Werring, Maurizio Paciaroni, Jesse Dawson, Steven Warach, Truman J Milling, Stefan T Engelter, Urs Fischer, Bo Norrving
BACKGROUND: About 13-26% of all acute ischaemic strokes are related to non-valvular atrial fibrillation, the most common cardiac arrhythmia globally. Deciding when to initiate oral anticoagulation in patients with non-valvular atrial fibrillation is a longstanding, common, and unresolved clinical challenge. Although the risk of early recurrent ischaemic stroke is high in this population, early oral anticoagulation is suspected to increase the risk of potentially harmful intracranial haemorrhage, including haemorrhagic transformation of the infarct...
January 2019: Lancet Neurology
https://read.qxmd.com/read/30511879/apixaban-to-prevent-venous-thromboembolism-in-patients-with-cancer
#3
RANDOMIZED CONTROLLED TRIAL
Marc Carrier, Karim Abou-Nassar, Ranjeeta Mallick, Vicky Tagalakis, Sudeep Shivakumar, Ariah Schattner, Philip Kuruvilla, Danny Hill, Silvana Spadafora, Katerine Marquis, Mateya Trinkaus, Anna Tomiak, Agnes Y Y Lee, Peter L Gross, Alejandro Lazo-Langner, Robert El-Maraghi, Glenwood Goss, Gregoire Le Gal, David Stewart, Timothy Ramsay, Marc Rodger, Debra Witham, Philip S Wells
BACKGROUND: Patients with active cancer have an increased risk of venous thromboembolism, which results in substantial morbidity, mortality, and health care expenditures. The Khorana score (range, 0 to 6, with higher scores indicating a higher risk of venous thromboembolism) has been validated to identify patients with cancer at elevated risk for this complication and may help select those who could benefit from thromboprophylaxis. METHODS: We conducted a randomized, placebo-controlled, double-blind clinical trial assessing the efficacy and safety of apixaban (2...
February 21, 2019: New England Journal of Medicine
https://read.qxmd.com/read/19696423/neurological-outcomes-in-patients-with-ischemic-stroke-receiving-enoxaparin-or-heparin-for-venous-thromboembolism-prophylaxis-subanalysis-of-the-prevention-of-vte-after-acute-ischemic-stroke-with-lmwh-prevail-study
#4
RANDOMIZED CONTROLLED TRIAL
Carlos S Kase, Gregory W Albers, Christopher Bladin, Cesare Fieschi, Alberto A Gabbai, William O'Riordan, Graham F Pineo
BACKGROUND AND PURPOSE: The Prevention of VTE after Acute Ischemic Stroke with LMWH (PREVAIL) study demonstrated that enoxaparin was superior to unfractionated heparin (UFH) in preventing venous thromboembolism in patients with ischemic stroke and was associated with a small but statistically significant increase in extracranial hemorrhage rates. In this PREVAIL subanalysis, we evaluate the long-term neurological outcomes associated with the use of enoxaparin compared with UFH. We also determine predictors of stroke progression...
November 2009: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/17925410/differences-between-low-molecular-weight-and-unfractionated-heparin-for-venous-thromboembolism-prevention-following-ischemic-stroke-a-metaanalysis
#5
COMPARATIVE STUDY
Andrew F Shorr, William L Jackson, John H Sherner, Lisa K Moores
BACKGROUND: Venous thromboembolism (VTE) remains a major cause of morbidity following stroke. The optimal form of pharmacologic prophylaxis following stroke is unknown. METHODS: We identified randomized trials comparing unfractionated heparin (UFH) to low-molecular-weight heparin (LMWH) for VTE prevention in ischemic stroke patients. We focused on the risk for VTE, pulmonary embolism (PE), bleeding, and mortality as a function of the type of agent used for prophylaxis...
January 2008: Chest
https://read.qxmd.com/read/24158253/atrial-fibrillation-patients-do-not-benefit-from-acetylsalicylic-acid
#6
JOURNAL ARTICLE
Sara Själander, Anders Själander, Peter J Svensson, Leif Friberg
AIMS: Oral anticoagulation is the recommended treatment for stroke prevention in patients with atrial fibrillation. Notwithstanding, many patients are treated with acetylsalicylic acid (ASA) as monotherapy. Our objective was to investigate if atrial fibrillation patients benefit from ASA as monotherapy for stroke prevention. METHODS AND RESULTS: Retrospective study of patients with a clinical diagnosis of atrial fibrillation between 1 July 2005 and 1 January 2009 in the National Swedish Patient register, matched with data from the National Prescribed Drugs register...
May 2014: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://read.qxmd.com/read/24810397/stroke-thromboembolism-and-intracranial-hemorrhage-in-a-real-world-atrial-fibrillation-population-the-complications-of-atrial-fibrillation-in-the-bologna-area-cafbo-study
#7
JOURNAL ARTICLE
Gualtiero Palareti, Luisa Salomone, Mario Cavazza, Marcello Guidi, Antonio Muscari, Giuseppe Boriani, Antonio Di Micoli, Giordano Guizzardi, Gaetano Procaccianti, Angelo Guidetti, Nicola Binetti, Simona Malservisi, Marco Masina, Antonella Viola, Vincenzo Bua, Maurizio Ongari, Giampaolo Diaspri, Gregory Y H Lip
BACKGROUND: Ischemic events (IEs) and intracranial hemorrhages (ICHs) are feared complications of atrial fibrillation (AF) and of antithrombotic treatment in patients with these conditions. METHODS: Patients with AF admitted to the EDs of the Bologna, Italy, area with acute IE or ICH were prospectively recorded over 6 months. RESULTS: A total of 178 patients (60 male patients; median age: 85 years) presented with acute IE. Antithrombotic therapy was as follows: (1) vitamin K antagonists (VKAs) in 31 patients (17...
October 2014: Chest
https://read.qxmd.com/read/23769405/expert-consensus-of-the-french-society-of-geriatrics-and-gerontology-and-the-french-society-of-cardiology-on-the-management-of-atrial-fibrillation-in-elderly-people
#8
JOURNAL ARTICLE
Olivier Hanon, Patrick Assayag, Joel Belmin, Jean Philippe Collet, Jean Paul Emeriau, Laurent Fauchier, Françoise Forette, Patrick Friocourt, Armelle Gentric, Christophe Leclercq, Michel Komajda, Jean Yves Le Heuzey
Atrial fibrillation (AF) is a common and serious condition in the elderly. AF affects between 600,000 and one million patients in France, two-thirds of whom are aged above 75 years. AF is a predictive factor for mortality in the elderly and a major risk factor for stroke. Co-morbidities are frequent and worsen the prognosis. The management of AF in the elderly should involve a comprehensive geriatric assessment (CGA), which analyses both medical and psychosocial elements, enabling evaluation of the patient's functional status and social situation and the identification of co-morbidities...
May 2013: Archives of Cardiovascular Diseases
https://read.qxmd.com/read/17646601/pharmacological-venous-thromboembolism-prophylaxis-in-hospitalized-medical-patients-a-meta-analysis-of-randomized-controlled-trials
#9
RANDOMIZED CONTROLLED TRIAL
Lironne Wein, Sara Wein, Steven Joseph Haas, James Shaw, Henry Krum
BACKGROUND: There is uncertainty regarding which pharmacological agents most effectively prevent venous thromboembolism in hospitalized medical patients. We therefore performed a meta-analysis to determine this. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from 1950, 1966, and 1800, respectively, through June 30, 2006, for randomized controlled trials that involved medical patients comparing unfractionated heparin (UFH) or low-molecular-weight heparin or heparinoid (LMWH) with a control, LMWH with UFH, or selective factor Xa inhibitors with a comparator...
July 23, 2007: Archives of Internal Medicine
https://read.qxmd.com/read/27347226/newer-oral-anticoagulants-stroke-prevention-and-pitfalls
#10
JOURNAL ARTICLE
Anand Patel, Richard P Goddeau, Nils Henninger
Warfarin is very effective in preventing stroke in patients with atrial fibrillation. However, its use is limited due to fear of hemorrhagic complications, unpredictable anticoagulant effects related to multiple drug interactions and dietary restrictions, a narrow therapeutic window, frequent difficulty maintaining the anticoagulant effect within a narrow therapeutic window, and the need for inconvenient monitoring. Several newer oral anticoagulants have been approved for primary and secondary prevention of stroke in patients with non-valvular atrial fibrillation...
2016: Open Cardiovascular Medicine Journal
https://read.qxmd.com/read/27566810/new-antiplatelet-drugs-and-new-oral-anticoagulants
#11
JOURNAL ARTICLE
V Koenig-Oberhuber, M Filipovic
In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this review, the authors discuss the most important antiplatelet and anticoagulant drugs, the perioperative management, the handling of bleeding complications, and the interpretation of some laboratory analyses related to these agents...
September 2016: British Journal of Anaesthesia
https://read.qxmd.com/read/27103740/end-of-the-road-for-heparin-thromboprophylaxis
#12
COMMENT
Lori-Ann Linkins
No abstract text is available yet for this article.
April 21, 2016: Blood
https://read.qxmd.com/read/24335403/new-oral-anticoagulants-and-regional-anaesthesia
#13
REVIEW
H T Benzon, M J Avram, D Green, R O Bonow
The new oral anticoagulants are approved for a variety of clinical syndromes, including the prevention of stroke in atrial fibrillation, acute coronary syndromes, treatment of venous thromboembolism (VTE), and prevention of venous thrombosis after total joint surgery or hip fracture. Published guidelines have differing recommendations on the safe interval between discontinuation of the anticoagulant and performance of neuraxial procedures and between the interventional procedure and redosing of the drug. While two to three half-life intervals might be acceptable in patients who are at high risk for VTE or stroke, an interval of four to six half-lives between discontinuation of the drug and neuraxial injections is probably safer in most patients at low risk of thrombosis...
December 2013: British Journal of Anaesthesia
https://read.qxmd.com/read/20052816/regional-anesthesia-in-the-patient-receiving-antithrombotic-or-thrombolytic-therapy-american-society-of-regional-anesthesia-and-pain-medicine-evidence-based-guidelines-third-edition
#14
JOURNAL ARTICLE
Terese T Horlocker, Denise J Wedel, John C Rowlingson, F Kayser Enneking, Sandra L Kopp, Honorio T Benzon, David L Brown, John A Heit, Michael F Mulroy, Richard W Rosenquist, Michael Tryba, Chun-Su Yuan
The actual incidence of neurologic dysfunction resulting from hemorrhagic complications associated with neuraxial blockade is unknown. Although the incidence cited in the literature is estimated to be less than 1 in 150,000 epidural and less than 1 in 220,000 spinal anesthetics, recent epidemiologic surveys suggest that the frequency is increasing and may be as high as 1 in 3000 in some patient populations.Overall, the risk of clinically significant bleeding increase with age,associated abnormalities of the spinal cord or vertebral column, the presence of an underlying coagulopathy, difficulty during needle placement,and an indwelling neuraxial catheter during sustained anticoagulation( particularly with standard heparin or low-molecular weight heparin)...
2010: Regional Anesthesia and Pain Medicine
https://read.qxmd.com/read/24946813/new-oral-anticoagulants-a-practical-guide-on-prescription-laboratory-testing-and-peri-procedural-bleeding-management-australasian-society-of-thrombosis-and-haemostasis
#15
JOURNAL ARTICLE
H Tran, J Joseph, L Young, S McRae, J Curnow, H Nandurkar, P Wood, C McLintock
New oral anticoagulants (NOAC) are becoming available as alternatives to warfarin to prevent systemic embolism in patients with non-valvular atrial fibrillation and for the treatment and prevention of venous thromboembolism. An in-depth understanding of their pharmacology is invaluable for appropriate prescription and optimal management of patients receiving these drugs should unexpected complications (such as bleeding) occur, or the patient requires urgent surgery. The Australasian Society of Thrombosis and Haemostasis has set out to inform physicians on the use of the different NOAC based on current available evidence focusing on: (i) selection of the most suitable patient groups to receive NOAC, (ii) laboratory measurements of NOAC in appropriate circumstances and (iii) management of patients taking NOAC in the perioperative period, and strategies to manage bleeding complications or 'reverse' the anticoagulant effects for urgent invasive procedures...
June 2014: Internal Medicine Journal
https://read.qxmd.com/read/26319422/peri-procedural-management-of-dabigatran-and-rivaroxaban-duration-of-anticoagulant-discontinuation-and-drug-concentrations
#16
MULTICENTER STUDY
Anne Godier, Anne-Céline Martin, Isabelle Leblanc, Elisabeth Mazoyer, Marie-Hélène Horellou, Firas Ibrahim, Claire Flaujac, Jean-Louis Golmard, Nadia Rosencher, Isabelle Gouin-Thibault
BACKGROUND: Peri-procedural management of direct oral anticoagulants (DOAC) is challenging. The optimal duration of pre-procedural discontinuation that guarantees a minimal DOAC concentration ([DOAC]) at surgery is unknown. The usual 48-hour discontinuation might not be sufficient for all patients. OBJECTIVES: To test the hypothesis that a 48-hour DOAC discontinuation is not sufficient to ensure a minimal per-procedural [DOAC], defined as [DOAC]<30ng/mL. To investigate the factors associated with per-procedural [DOAC]...
October 2015: Thrombosis Research
https://read.qxmd.com/read/26890676/endoscopy-in-patients-on-antiplatelet-or-anticoagulant-therapy-including-direct-oral-anticoagulants-british-society-of-gastroenterology-bsg-and-european-society-of-gastrointestinal-endoscopy-esge-guidelines
#17
JOURNAL ARTICLE
Andrew M Veitch, Geoffroy Vanbiervliet, Anthony H Gershlick, Christian Boustiere, Trevor P Baglin, Lesley-Ann Smith, Franco Radaelli, Evelyn Knight, Ian M Gralnek, Cesare Hassan, Jean-Marc Dumonceau
The risk of endoscopy in patients on antithrombotics depends on the risks of procedural haemorrhage vs. thrombosis due to discontinuation of therapy. P2Y12 receptor antagonists (clopidogrel, prasugrel, ticagrelor): For low-risk endoscopic procedures we recommend continuing P2Y12 receptor antagonists as single or dual antiplatelet therapy (low quality evidence, strong recommendation);For high-risk endoscopic procedures in patients at low thrombotic risk, we recommend discontinuing P2Y12 receptor antagonists five days before the procedure (moderate quality evidence, strong recommendation)...
April 2016: Endoscopy
https://read.qxmd.com/read/26780747/guidance-for-the-practical-management-of-the-direct-oral-anticoagulants-doacs-in-vte-treatment
#18
REVIEW
Allison E Burnett, Charles E Mahan, Sara R Vazquez, Lynn B Oertel, David A Garcia, Jack Ansell
Venous thromboembolism (VTE) is a serious medical condition associated with significant morbidity and mortality, and an incidence that is expected to double in the next forty years. The advent of direct oral anticoagulants (DOACs) has catalyzed significant changes in the therapeutic landscape of VTE treatment. As such, it is imperative that clinicians become familiar with and appropriately implement new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance for VTE treatment with the DOACs...
January 2016: Journal of Thrombosis and Thrombolysis
https://read.qxmd.com/read/26713281/monitoring-anticoagulant-therapy-with-new-oral-agents
#19
REVIEW
Allan Ramos-Esquivel
Thromboembolic disease is a major leading cause of mortality and morbidity in industrialized countries. Currently, the management of these patients is challenging due to the availability of new drugs with proven efficacy and security compared to traditional oral vitamin K antagonists. These compounds are characterized by a predictable pharmacokinetic profile for which blood monitoring is not routinely needed. Nevertheless, some data have suggested inter-patient variability in the anticoagulant effect of these drugs, raising concerns about their effectiveness and safety...
December 26, 2015: World Journal of Methodology
https://read.qxmd.com/read/23861512/use-and-associated-risks-of-concomitant-aspirin-therapy-with-oral-anticoagulation-in-patients-with-atrial-fibrillation-insights-from-the-outcomes-registry-for-better-informed-treatment-of-atrial-fibrillation-orbit-af-registry
#20
JOURNAL ARTICLE
Benjamin A Steinberg, Sunghee Kim, Jonathan P Piccini, Gregg C Fonarow, Renato D Lopes, Laine Thomas, Michael D Ezekowitz, Jack Ansell, Peter Kowey, Daniel E Singer, Bernard Gersh, Kenneth W Mahaffey, Elaine Hylek, Alan S Go, Paul Chang, Eric D Peterson
BACKGROUND: The role of concomitant aspirin (ASA) therapy in patients with atrial fibrillation (AF) receiving oral anticoagulation (OAC) is unclear. We assessed concomitant ASA use and its association with clinical outcomes among AF patients treated with OAC. METHODS AND RESULTS: The Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry enrolled 10 126 AF patients from 176 US practices from June 2010 through August 2011. The study population was limited to those on OAC (n=7347)...
August 13, 2013: Circulation
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