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Reducing delays to administration of prothrombin complex concentrate in patients with vitamin K antagonist-related intracerebral haemorrhage.
Abstract BACKGROUND/AIMS: Four-factor prothrombin complex concentrate is the first-line treatment in vitamin K antagonist-related intracerebral haemorrhage. Early administration is associated with improved patient outcomes. A quality improvement project investigated delays in prothrombin complex concentrate administration in vitamin K antagonist-related intracerebral haemorrhage in order to reduce the time from computed tomography scan confirming intracerebral haemorrhage to prothrombin complex concentrate administration (scan-to-needle time). METHOD: Twenty patients were identified by retrospective audit ove...
Source: British Journal of Hospital Medicine - February 1, 2020 Category: Internal Medicine Authors: Marrinan E, Chen L, Werring D, Turner D Tags: Br J Hosp Med (Lond) Source Type: research

Benefits and Harms of Oral Anticoagulant Therapy in Chronic Kidney Disease: A Systematic Review and Meta-analysis.
Conclusion: In early-stage CKD, NOACs had a benefit-risk profile superior to that of VKAs. For advanced CKD or ESKD, there was insufficient evidence to establish benefits or harms of VKAs or NOACs. Primary Funding Source: None. (PROSPERO: CRD42017079709). PMID: 31307056 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - July 15, 2019 Category: Internal Medicine Authors: Ha JT, Neuen BL, Cheng LP, Jun M, Toyama T, Gallagher MP, Jardine MJ, Sood MM, Garg AX, Palmer SC, Mark PB, Wheeler DC, Jha V, Freedman B, Johnson DW, Perkovic V, Badve SV Tags: Ann Intern Med Source Type: research

Efficacy and Safety of Prothrombin Complex Concentrate (PCC) for Direct Oral Anticoagulant Reversal: A Single Institutional Experience
ConclusionIn this cohort, 80% of pts demonstrated clinical stability/improvement of hemorrhage. All pts were able to undergo surgical procedures; however 17% required additional FFP to achieve hemostasis. Thromboembolism occurred in 12% of patients. No deaths could definitely be attributed to 4PCC; however, 30% of deaths could be attributable to the underlying hemorrhagic episode.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Sridharan, M., Ou, N. N., Oyen, L. J., Ashrani, A. A., McBane, R. D., Pruthi, R. K. Tags: 332. Antithrombotic Therapy: Poster II Source Type: research

Timing of anticoagulation after recent ischaemic stroke in patients with atrial fibrillation
Publication date: Available online 8 November 2018Source: The Lancet NeurologyAuthor(s): David J Seiffge, David J Werring, Maurizio Paciaroni, Jesse Dawson, Steven Warach, Truman J Milling, Stefan T Engelter, Urs Fischer, Bo NorrvingSummaryBackgroundAbout 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,...
Source: The Lancet Neurology - November 9, 2018 Category: Neurology Source Type: research

Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial
Publication date: May 2016 Source:The Lancet Neurology, Volume 15, Issue 6 Author(s): Thorsten Steiner, Sven Poli, Martin Griebe, Johannes Hüsing, Jacek Hajda, Anja Freiberger, Martin Bendszus, Julian Bösel, Hanne Christensen, Christian Dohmen, Michael Hennerici, Jennifer Kollmer, Henning Stetefeld, Katja E Wartenberg, Christian Weimar, Werner Hacke, Roland Veltkamp Background Haematoma expansion is a major cause of mortality in intracranial haemorrhage related to vitamin K antagonists (VKA-ICH). Normalisation of the international normalised ratio (INR) is recommended, but optimum haemostatic managemen...
Source: The Lancet Neurology - April 19, 2016 Category: Neurology Source Type: research

Vitamin K Antagonist–associated Intracerebral Hemorrhage: Lessons from a Devastating Disease in the Dawn of the New Oral Anticoagulants
Conclusions: VKA-associated ICH presents in a particularly vulnerable population and has a poor prognosis that may be reliably predicted by several clinicoradiologic features.
Source: Journal of Stroke and Cerebrovascular Diseases - August 19, 2013 Category: Neurology Authors: Marta Suárez-Pinilla, Ángeles Fernández-Rodríguez, Lorena Benavente-Fernández, Sergio Calleja-Puerta Tags: Original Articles Source Type: research