Reversal of Apixaban and Rivaroxaban Using Activated Prothrombin Complex Concentrates in Patients with Major Bleeding

ConclusionsOur study suggests that aPCC could be an option in patients with major bleeding associated with apixaban or rivaroxaban. It may be an alternative for patients who need anticoagulation reversal if the specific antidote, andexanet alfa, is unavailable.
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research

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Conclusion Compared with heparin plus GPI or bivalirudin plus GPI, bivalirudin monotherapy provides similar protection from ischemic events with less major bleeding at 30 days among patients with NSTE-ACS and positive biomarkers.
Source: Coronary Artery Disease - Category: Cardiology Tags: Adjunctive Pharmacology Source Type: research
Congenital fibrinogen disorders are rare inherited bleeding disorders characterized by bleeding or thrombosis. They can be divided into type I deficiencies or quantitative defects (afibrinogenemia and hypofibrinogenemia) which are defined when those with fibrinogen levels are below 1.5  g/L and type II deficiencies or qualitative defects (dysfibrinogenemia and hypodysfibrinogenemia) [1]. The estimated prevalence of afibrinogenemia is about 1:1,000,000. Although dysfibrinogenemia and hypofibrinogenemia are more frequent, their accurate prevalence remains unknown as most cases are asymptomatic [1,2].
Source: Thrombosis Research - Category: Hematology Authors: Tags: Letter to the Editors-in-Chief Source Type: research
CONCLUSION: Mepacrine fluorescence can be used as a screening tool to exclude δ-SPD in a large number of patients with a suspected platelet function disorder. PMID: 31815339 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: J Thromb Haemost Source Type: research
Studies have indicated differences between Asians and Whites in their propensity for stroke, coronary artery disease, heart failure, bleeding and thrombosis. We investigated whether Asian-Americans on durable left ventricular assist devices (LVADs) exhibit differential morbidity and mortality when compared to Whites.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Original Article Source Type: research
AbstractThe use of intramuscular injections is widely recommended to be avoided in patients who are prescribed anticoagulant agents, both oral and parenteral due to concerns of haematoma. Benzathine penicillin G (BPG), administered via intramuscular injection, is a vital treatment component for patients with rheumatic heart disease. BPG must be administered long term (for at least a decade) as part of treatment and alternative options to intramuscular injection are currently limited. Many of these patients with rheumatic heart disease will also require long term or lifelong anticoagulation. Our retrospective, single centre...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Authors: Stein BL, Martin K Abstract Thrombotic and hemorrhagic complications are prevalent in patients with essential thrombocythemia, polycythemia vera, and myelofibrosis. Given the impact on morbidity and mortality, reducing the risk of thrombosis and/or hemorrhage is a major therapeutic goal. Historically, patients have been risk stratified on the basis of traditional factors, such as advanced age and thrombosis history. However, multiple factors contribute to the thrombotic tendency, including gender, mutational profile, inflammatory stress, and abnormal cell adhesion. Management includes cardiovascular risk r...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Authors: Al-Samkari H, Connors JM Abstract The association between malignancy and thrombosis has been recognized for over a century and a half. Patients with cancer have an elevated risk of both initial and recurrent venous thromboembolism (VTE) compared with patients without cancer owing to cancer- and patient-specific factors. Recurrent VTE is common despite anticoagulation, presenting additional management challenges. Patients with cancer also have an increased risk of bleeding when on anticoagulants compared with patients without cancer. This bleeding risk is heightened by the thrombocytopenia common in patient...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Authors: Sarode R Abstract Direct oral anticoagulants (DOACs) are increasingly used in the treatment and prophylaxis of thromboembolism because of several advantages over vitamin K antagonists, including no need for laboratory monitoring. However, it has become increasingly important in certain clinical scenarios to know either actual DOAC concentration (quantitative) or presence of DOAC (qualitative). These clinical conditions include patients presenting with major bleeding or requiring urgent surgery who may need a reversal or hemostatic agent, extremes of body weight, failed therapy, etc. Prothrombin time and ac...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Authors: Cohen AT, Hunt BJ Abstract The direct oral anticoagulants (DOACs) have transformed the management of thrombotic disorders. Large clinical trials have demonstrated that DOACs can replace vitamin K antagonists (VKAs) in the 2 existing major indications for anticoagulation: the prevention of stroke in atrial fibrillation and the acute treatment and secondary prevention of venous thromboembolism (VTE); this literature is widely known. In this article, we will concentrate on the less well-discussed benefits of the use of DOACs-using low doses as primary and secondary prophylaxis in both venous and arterial thro...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Authors: Hisada Y, Mackman N Abstract Cancer patients have an increased risk of venous thromboembolism (VTE). The rate of VTE varies with cancer type, with pancreatic cancer having one of the highest rates, suggesting that there are cancer type-specific mechanisms of VTE. Risk assessment scores, such as the Khorana score, have been developed to identify ambulatory cancer patients at high risk of VTE. However, the Khorana score performed poorly in discriminating pancreatic cancer patients at risk of VTE. Currently, thromboprophylaxis is not recommended for cancer outpatients. Recent clinical trials showed that facto...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
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