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Specialty: Hematology
Nutrition: Vitamin K
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Total 149 results found since Jan 2013.
Pulmonary embolism four days after interruption of therapy with rivaroxaban.
We report on a 58-year-old male with paroxysmal atrial fibrillation (AF) with a CHA2DS2VASC score of 4 who developed central pulmonary embolism four days after interruption of rivaroxaban because of parotid surgery. He had received 40 mg enoxaparin/d. The parotid gland was partially resected within 6 hours without blood loss. Pulmonary embolism and AF occurred on the first postoperative day. He recovered with low-molecular-weight heparin in therapeutic dosages and amiodarone and was discharged with phenprocoumon. The relevance of a rivaroxaban rebound phenomenon, manifesting as arterial embolism, stroke or venous thrombo...
Source: Hamostaseologie - August 24, 2017 Category: Hematology Authors: Stöllberger C, Göndör G Tags: Hamostaseologie Source Type: research
Efficacy and safety of dabigatran in patients with atrial fibrillation scheduled for transoesophageal echocardiogram-guided direct electrical current cardioversion: a prospective propensity score-matched cohort study
This study investigated the long-term efficacy and safety of newly initiated anticoagulation with dabigatran versus uninterrupted vitamin K antagonist (VKA) therapy in patients with AF scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC). Consecutive adult patients with persistent AF scheduled to undergo DCC were included in the study. Patients received dabigatran 110 mg or 150 mg twice daily (bid) or VKA at therapeutic doses for at least 3 weeks before and 4 weeks after DCC. All patients underwent anamnestic, clinical, electrocardiographic and echocardiographic eva...
Source: Journal of Thrombosis and Thrombolysis - December 19, 2017 Category: Hematology Source Type: research
Direct Oral Anticoagulants in End-Stage Renal Disease
Semin Thromb Hemost DOI: 10.1055/s-0037-1621715Patients with end-stage renal disease (ESRD) were excluded from pivotal clinical trials with oral anticoagulants. While such patients are at an increased risk of venous and arterial thromboembolism, their risk of bleeding is also elevated. It is thus of little surprise that stroke prevention with vitamin K antagonists (VKAs) in ESRD patients with atrial fibrillation is controversial, with observational evidence ranging from beneficial to harmful. This uncertainty extends to the less studied use of VKAs for venous thromboembolism in ESRD. The direct oral anticoagulants (DOACs) ...
Source: Seminars in Thrombosis and Hemostasis - January 10, 2018 Category: Hematology Authors: Klil-Drori, Adi J. Tagalakis, Vicky Tags: Review Article Source Type: research
Direct oral anti-coagulants compared to vitamin-K antagonists in cardioversion of atrial fibrillation: an updated meta-analysis
AbstractPharmacological or electrical cardioversion allows immediate symptoms improvement in the setting of paroxysmal or persistent atrial fibrillation (AF), although the periprocedural risk of systemic embolism should be considered. Recently, there was a great interest on the safety and efficacy of direct oral anticoagulants (DOACs) when used for the cardioversion of non-valvular AF. We performed a random-effects meta-analysis of patients undergoing both electrical and pharmacologic cardioversion for non-valvular AF in the RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE AF-TIMI 48, X-VeRT, ENSURE-AF, and EMANATE trials. We assessed ...
Source: Journal of Thrombosis and Thrombolysis - February 5, 2018 Category: Hematology Source Type: research
Direct Oral Anticoagulants and the Paradigm Shift in the Management of Venous Thromboembolism
Semin Thromb Hemost DOI: 10.1055/s-0038-1637750The advent of direct oral anticoagulants (DOACs) has revolutionized anticoagulation management in both stroke prevention and venous thromboembolism (VTE) treatment/prevention. Clinical trials and secondary real-world data have shown that DOACs have similar efficacy and, in some cases, improved bleeding safety profiles compared with vitamin K antagonists. Together with benefits of patient convenience, this has shifted the risk–benefit ratio toward long-term anticoagulation. However, current VTE risk assessment models are based on vitamin K antagonists and do not take into acc...
Source: Seminars in Thrombosis and Hemostasis - March 20, 2018 Category: Hematology Authors: Lim, Hui Yin Nandurkar, Harshal Ho, Prahlad Tags: Review Article Source Type: research
The Rivaroxaban Program and the Management of Unmet Needs in Thromboembolic Disease.
Abstract
Rivaroxaban is a non-vitamin K antagonist oral anticoagulant that acts as a direct factor Xa inhibitor, and is widely used for the prevention and treatment of thromboembolic disorders. As further knowledge gaps are identified in thrombosis management, the rivaroxaban research program has expanded in an attempt to elucidate the wider benefits of rivaroxaban. An increased understanding of the interactions taking place within the coagulation cascade may support a broader role for rivaroxaban (2.5 mg twice daily [bid] or 5 mg bid) in the setting of vascular protection, either alone or in combination with ...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Camm AJ Tags: Thromb Haemost Source Type: research
Perioperative management of a patient with Glanzmann thrombasthenia undergoing a coronary artery bypass graft surgery: a case report
We report herein the successful perioperative management of a 57-year-old man with a type I Glanzmann thrombasthenia undergoing coronary artery bypass graft surgery and right carotid endarterectomy. The patient suffered from several lesions in the three major coronary arteries and in the right carotid necessitating surgery. Prophylactic human leukocyte antigen (HLA)-matched platelets transfusions were continuous administrated before, and through the immediate perioperative period. Posttransfusion platelet recovery was monitored using flow cytometry to determine the percentage of circulating platelet expressing CD61 (β3). ...
Source: Blood Coagulation and Fibrinolysis - April 1, 2018 Category: Hematology Tags: Case Report Source Type: research
Four factor prothrombin complex concentrate for warfarin reversal in patients with left ventricular assist devices
AbstractContinuous flow left ventricular assist devices (CF-LVAD) require therapeutic anticoagulation which is often interrupted for procedures or bleeding. Prior to the availability of four factor prothrombin complex concentrate (4F-PCC) in the United States, warfarin was held and its effects reversed by vitamin K or fresh frozen plasma. We evaluated the use of 4F-PCC for temporary warfarin reversal in patients with CF-LVADs and assessed outcomes. This analysis is a retrospective study of CF-LVAD patients who received 4F-PCC for warfarin reversal in the setting of bleeding or need for urgent or elective procedures. Primar...
Source: Journal of Thrombosis and Thrombolysis - May 21, 2018 Category: Hematology Source Type: research
Impact of cost on use of non-vitamin K antagonists in atrial fibrillation patients in Ontario, Canada
AbstractCanadian guidelines recommend non vitamin K antagonists (NOACs) in preference to vitamin K antagonists (VKAs) for stroke prevention in patients with atrial fibrillation (AF), but NOACs are more expensive than VKAs. Canada has a universal healthcare system that covers the cost of NOACs for select patient groups. Ability to pay for NOACs may influence their use. We reviewed medical charts of Hamilton General Hospital outpatients under the age of 65 with a new diagnosis of AF who were referred for initiation of OAC therapy. We contacted these patients by phone and asked them to complete a questionnaire regarding their...
Source: Journal of Thrombosis and Thrombolysis - June 5, 2018 Category: Hematology Source Type: research
Appropriateness of non-vitamin K antagonist oral anticoagulant dose in patients with atrial fibrillation in Israel: A population-based study
The non-vitamin K oral antagonists (NOACs) are at least as effective as warfarin in the prevention of stroke in non valvular atrial fibrillation (NVAF) and are associated with less intracranial hemorrhage. Many patients with NVAF inappropriately do not receive anticoagulants often because of the inconvenience associated with warfarin administration. NOACs have the potential to increase anticoagulation use because they are safer and easier to administer than warfarin. Indeed, the use of anticoagulation in patients with newly diagnosed AF in many countries is increasing as a result of the use of NOACs in preference to warfarin [1].
Source: Thrombosis Research - July 24, 2018 Category: Hematology Authors: Martin H. Ellis, Sari Greenberg Dotan, Ariel Hammerman, Erez Battat, Estela Derazne, Orly Avnery Tags: Letter to the Editors-in-Chief Source Type: research
Atrial Fibrillation and Malignancy: The Clinical Performance of Non –Vitamin K Oral Anticoagulants—A Systematic Review
Semin Thromb Hemost DOI: 10.1055/s-0038-1661386Atrial fibrillation (AF) is commonly diagnosed in the setting of active cancer. Because of an increased risk of either thromboembolic events or bleeding, the decision to initiate therapeutic anticoagulation in patients with active cancer can be challenging. Moreover, little is still known about the optimal anticoagulation therapy in the setting of AF and cancer, and no guidelines are as yet available. Considering that nonvitamin K antagonist oral anticoagulants (NOACs) are recommended as alternatives to vitamin K antagonists for stroke prevention in AF patients with CHA2DS2-VA...
Source: Seminars in Thrombosis and Hemostasis - August 17, 2018 Category: Hematology Authors: Russo, Vincenzo Bottino, Roberta Rago, Anna Micco, Pierpaolo Di D' Onofrio, Antonio Liccardo, Biagio Golino, Paolo Nigro, Gerardo Tags: Review Article Source Type: research
Pharmacodynamic safety of clopidogrel monotherapy in patients under oral anticoagulation with a vitamin K antagonist undergoing coronary stent implantation.
This study enrolled 100 patients on aspirin plus clopidogrel (DAPT-cohort, without indication for VKA) and 100 patients on clopidogrel monotherapy plus phenprocoumon (OAC-cohort) undergoing elective PCI. Platelet reactivity was assessed by impedance aggregometry on day 1 following PCI. Ischemic (death, stroke, or myocardial infarction) and bleeding (BARC 2-5) events within 12 months were compared in a propensity score adjusted model. Platelet reactivity was not different in the OAC- and DAPT-cohort (187 [127-242] vs. 167 [126-218] AU×min; p = 0.23). Overall, 17 ischemic and 34 bleeding events were recorded during follo...
Source: Platelets - September 14, 2018 Category: Hematology Tags: Platelets Source Type: research
Early therapeutic persistence on dabigatran versus warfarin therapy in patients with atrial fibrillation: results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) registry
We examined rates of continued use of dabigatran versus warfarin over 1 year among AF patients in the ORBIT-AF registry between June 29, 2010 and August 09, 2011. Multivariable logistic regression analysis was used to identify characteristics associated with 1-year persistent use of dabigatran therapy or warfarin. At baseline, 6.4 and 93.6% of 7150 AF patients were on dabigatran and warfarin, respectively. At 12 months, dabigatran-treated patients were less likely to have continued their therapy than warfarin-treated patients [Adjusted persistence rates: 66% (95% CI 60–72) vs. 82% (95% CI 80–84),p < .0001]. ...
Source: Journal of Thrombosis and Thrombolysis - October 5, 2018 Category: Hematology Source Type: research
6. Abstract Title: Thrombotic and Bleeding Outcomes Following Perioperative Interruption of DOACs and VKAs in Patients with Non-Valvular Atrial Fibrillation - A Comparative Analysis
Background: Atrial fibrillation (AF) is a common disorder that will affect up to 5.6 million patients in the U.S. by 2050. Both direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs), typically warfarin, are used for stroke prevention in AF and such patients frequently undergo invasive procedures, requiring anticoagulant interruption. Temporary interruption of anticoagulants can be associated with significant morbidity and mortality in the form of thromboembolic and bleeding complications.
Source: Thrombosis Research - October 1, 2018 Category: Hematology Authors: Joseph Shaw, Tinghua Zhang, Gregoire Le Gal, James Douketis, Marc Carrier Source Type: research
