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Practical Considerations for the Use of Direct Oral Anticoagulants in Patients With Atrial Fibrillation
Atrial fibrillation (AF) is a significant risk factor for stroke and peripheral thromboembolic events (TEs). Preventing blood clots in the heart to reduce stroke and TE risk is a key goal of AF therapy. Traditional stroke risk assessment tools for patients with nonvalvular AF include the CHADS2 and CHA(2)DS(2)-VASc scores, while long-term outcome data with the newer direct oral anticoagulants (DOACs) are emerging. The goals of this review were to assess traditional therapies and existing treatment guidelines and to discuss key pharmacologic properties of the DOACS, noting how these may benefit at-risk patients with AF. Thi...
Source: Clinical and Applied Thrombosis/Hemostasis - November 27, 2016 Category: Hematology Authors: Stacy, Z., Richter, S. Tags: Review Source Type: research

Anticoagulation in Patients With Left Ventricular Systolic Dysfunction and Sinus Rhythm: When?
Left ventricular (LV) systolic dysfunction and chronic systolic heart failure (HF) predispose to intraventricular thrombus formation and embolization resulting in stroke. Current guideline recommends the use of oral anticoagulants in patients with atrial fibrillation and history of previous thromboembolism. However, anticoagulant treatment in patients with LV systolic dysfunction with sinus rhythm and without history of previous thromboembolism is still on debate. Recent epidemiologic date has reported increased stroke rate in patients with systolic HF shortly after diagnosis. This review focuses on the possible causes of ...
Source: Clinical and Applied Thrombosis/Hemostasis - August 26, 2014 Category: Hematology Authors: Sivri, N., Yetkin, E., Tekin, G. O., Yalta, K., Waltenberger, J. Tags: Original Articles Source Type: research

Comparison of Medical Costs of Patients With Atrial Fibrillation Unsuitable for Warfarin Treatment With Apixaban or Aspirin Based on AVERROES Trial
Conclusions: Based on AVERROES trial results, among patients with AF unsuitable for warfarin therapy, apixaban use was estimated to be associated with a mean medical cost avoidance of US$735 in a patient-year relative to aspirin. The primary driver was the significant reduction in ischemic stroke rate. The medical cost reduction associated with apixaban use was consistent in sensitivity analyses.
Source: Clinical and Applied Thrombosis/Hemostasis - February 27, 2015 Category: Hematology Authors: Amin, A., Deitelzweig, S., Jing, Y., Makenbaeva, D., Wiederkehr, D., Lin, J., Graham, J. Tags: Original Articles Source Type: research

The Efficacy and Safety of Oral Anticoagulants in Warfarin-Suitable Patients With Nonvalvular Atrial Fibrillation: Systematic Review and Meta-Analysis
The novel oral anticoagulants (NOACs) apixaban, dabigatran, and rivaroxaban have been recently indicated for stroke prevention in patients with atrial fibrillation (AF) . Due to a lack of direct head-to-head trials comparing the NOACs, the current systematic review and network meta-analysis (NMA) were conducted to assess their relative efficacy and safety. Three phase III randomized controlled trials enrolling 50 578 patients were included. Results of the NMA show a clear trend favoring NOACs over warfarin with regard to the key outcomes of stroke/systemic embolism and all-cause mortality, with apixaban also showing a...
Source: Clinical and Applied Thrombosis/Hemostasis - November 14, 2013 Category: Hematology Authors: Mitchell, S. A., Simon, T. A., Raza, S., Jakouloff, D., Orme, M. E., Lockhart, I., Drost, P. Tags: Original Articles Source Type: research

Direct Oral Anticoagulants for the Management of Thromboembolic Disorders: The Importance of Adherence and Persistence in Achieving Beneficial Outcomes
Anticoagulation therapy is central to the management of thromboembolic disorders, and the use of direct oral anticoagulants offers several advantages over standard therapy with parenteral heparins and vitamin K antagonists. In phase III clinical trials, the direct oral anticoagulants (given once or twice daily) all demonstrated favorable benefit–risk profiles compared with conventional standard therapy for the treatment and secondary prevention of venous thromboembolism and for stroke prevention in patients with nonvalvular atrial fibrillation. In clinical practice, many factors may influence overall clinical outcome...
Source: Clinical and Applied Thrombosis/Hemostasis - August 29, 2016 Category: Hematology Authors: Amin, A., Marrs, J. C. Tags: Review Source Type: research

Increased Thrombopoietin and Mean Platelet Volume in Patients With Ischemic Stroke
Source: Clinical and Applied Thrombosis/Hemostasis - June 3, 2013 Category: Hematology Authors: Varol, E. Tags: Letter to the Editor Source Type: research

Cerebral Artery Velocity Determined by Transcranial Doppler Ultrasonography in Patients With {beta}-Thalassemia Intermedia Compared to {beta}-Thalassemia Major
We aimed to compare cerebral artery velocity and relevant clinical factors in patients with β-thalassemia intermedia (β-TI), β-thalassemia major (β-TM), and healthy individuals. For this study, 60 patients with β-TM and 64 with β-TI were randomly selected. Sixty healthy adults comprised the control group. Time average maximum mean velocity (TAMMV) was measured in large cerebral arteries with transcranial Doppler (TCD) ultrasonography. In all arteries, TAMMV was significantly higher in the β-TI group than that of β-TM or controls (P < .001). Patients with β-TM had significantl...
Source: Clinical and Applied Thrombosis/Hemostasis - July 3, 2013 Category: Hematology Authors: Karimi, M., Haghpanah, S., Ashjazadeh, N., Shariat, A., Nazeri, M., Emami, S., Forough, A. A., Petramfar, P., Yaghoubi, E. Tags: Original Articles Source Type: research

Impact of Altitude on Predicting Midterm Outcome in Patients With ST Elevation Myocardial Infarction
In conclusion, altitude status and altitude-related hematologic changes had no influence over the mid-term outcomes in STEMI patients treated with percutaneous intervention.
Source: Clinical and Applied Thrombosis/Hemostasis - July 3, 2013 Category: Hematology Authors: Isik, T., Tanboga, I. H., Ayhan, E., Uyarel, H., Kaya, A., Kurt, M., Erdogan, E., Ergelen, M., Cicek, G., Akgul, O., Ghannadian, B. Tags: Original Articles Source Type: research

Antithrombotic Medication Use and Bleeding Risk in Medically Ill Patients After Hospitalization
Conclusions: Careful consideration of these demonstrated bleed-associated comorbidities before initiating anticoagulation or combining antithrombotic medications in medically ill patients may improve strategies for prevention of postdischarge thromboembolism.
Source: Clinical and Applied Thrombosis/Hemostasis - September 15, 2013 Category: Hematology Authors: Mahan, C. E., Spyropoulos, A. C., Fisher, M. D., Fields, L. E., Mills, R. M., Stephenson, J. J., Fu, A.-C., Klaskala, W. Tags: Original Articles Source Type: research

Intracerebral Hemorrhage: A Review of Coagulation Function
Intracerebral hemorrhage (ICH) is associated with a higher mortality rate among stroke subtypes. The amount of hematoma at baseline and subsequent expansion are considered strong independent markers for determining poor clinical outcome. Even though reduction in blood pressure to prevent and control the amount of bleeding in ICH has received considerable amount of attention, the impact of coagulopathy and platelet dysfunction, on the bleeding diathesis has not been extensively investigated. With the increasing use of antiplatelets and/or anticoagulants, given the aging population, a deeper understanding of the interactions...
Source: Clinical and Applied Thrombosis/Hemostasis - November 14, 2013 Category: Hematology Authors: Emiru, T., Bershad, E. M., Zantek, N. D., Datta, Y. H., Rao, G. H. R., Hartley, E. W., Divani, A. A. Tags: Original Articles Source Type: research

The Association of Interleukin 6-634C/G Polymorphism With Left Atrial Thrombus and Severe Spontaneous Echocontrast in Patients With Atrial Fibrillation
Atrial fibrillation (AF) not only is an independent risk factor for death but also confers significant risk of morbidity from stroke associated with left atrial thrombus. The association of interleukin 6 (IL-6) polymorphism with thrombus in AF has not been investigated before. We carried out a case–control study in Han Chinese. The IL-6 –634C/G genotypes of 31 patients with thrombus and 45 patients without thrombus were detected by polymerase chain reaction and restriction fragment length polymorphism. The frequencies of the IL-6 genotypes (CC, CG, and GG) were 29.03%, 54.54%, and 16.13% for the patients with t...
Source: Clinical and Applied Thrombosis/Hemostasis - November 14, 2013 Category: Hematology Authors: Deng, X.-T., Jiang, M.-H., Zhu, J.-H., Ge, L.-J., Guo, J., Gao, S.-P., Zheng, J.-G., Luan, H., Shi, G.-L., Wang, R.-X., Shi, H.-F., Pan, M. Tags: Original Articles Source Type: research

Oral Anticoagulation Therapy for Elderly Patients With Atrial Fibrillation: Utility of Bleeding Risk Covariates to Better Understand and Moderate Risks
Elderly individuals are prone to nonvalvular atrial fibrillation (AF) with associated risks of arterial thromboembolic disease. Despite definitive guidelines, oral anticoagulant therapy (OAC) is notoriously underutilized in patients with AF. Physicians cite excessive bleeding risk as one reason they omit OAC for their older patients with AF. Improved understanding of the pathophysiology of age-related bleeding may improve risk–benefit assessments for warfarin and newer antithrombotic agents. We reviewed the literature to identify age-related pathophysiological elements that can exacerbate the likelihood of bleeding. ...
Source: Clinical and Applied Thrombosis/Hemostasis - December 12, 2013 Category: Hematology Authors: Forman, D. E., Goyette, R. E. Tags: Original Articles Source Type: research

The Effects of Eosinophil on the Left Atrial Thrombus in Patients With Atrial Fibrillation
Conclusion: As a result, our study revealed a relationship between eosinophil count and LA thrombus in patients with nonvalvular AF.
Source: Clinical and Applied Thrombosis/Hemostasis - February 27, 2014 Category: Hematology Authors: Keceoğlu, S., Demir, M., Uyan, U., Melek, M. Tags: Original Articles Source Type: research

Risk Assessment to Predict Arterial and Venous Events in Patients Undergoing Percutaneous Coronary Intervention
Atherosclerosis and venous thromboembolism (VTE) share common risk factors. We set to assess the strength of the association between atherosclerosis risk factors and disease manifestation, and VTE, in patients with coronary artery disease undergoing percutaneous coronary intervention. We pooled data from 6 global randomized controlled trials assessing coronary stenting (ENDEAVOR and SIRIUS programs), developed separate risk scores to predict major adverse cardiac and cerebrovascular events (MACCEs: cardiac death, myocardial infarction, and stroke) and VTE, and compared their performance. The 5-year rates of MACCE and VTE w...
Source: Clinical and Applied Thrombosis/Hemostasis - May 26, 2014 Category: Hematology Authors: Vardi, M., Piazza, G., Pencina, M. J., Burke, D. A., Lei, L., Goldhaber, S. Z., Cutlip, D. E. Tags: Original Articles Source Type: research

Major Bleeding With Dabigatran and Rivaroxaban in Patients With Atrial Fibrillation: A Real-World Setting
Conclusion: We observed a rate of major bleeding similar to that reported in randomized clinical trials among patients with AF prescribed dabigatran or rivaroxaban.
Source: Clinical and Applied Thrombosis/Hemostasis - August 26, 2014 Category: Hematology Authors: Fontaine, G. V., Mathews, K. D., Woller, S. C., Stevens, S. M., Lloyd, J. F., Evans, R. S. Tags: Original Articles Source Type: research

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