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Source: Journal of Thrombosis and Thrombolysis
Condition: Bleeding
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Total 121 results found since Jan 2013.
Effectiveness and safety of direct oral anticoagulants in patients with venous thromboembolism and creatinine clearance & lt; 30 mL/min
AbstractThe few studies that compared direct oral anticoagulants (DOAC) vs. warfarin in the setting of advanced renal insufficiency have focused on patients with atrial fibrillation. The purpose of this observational, matched, cohort study of patients was to assess the effectiveness and safety of DOAC vs. warfarin for the treatment of venous thromboembolism (VTE) among patients with a creatinine clearance (CrCl) < 30 mL/min. This observational, cohort study included patients with VTE and CrCl < 30 mL/min who were newly initiated on a DOAC or warfarin between January 1, 2016 and December 31, 2020. DOAC pati...
Source: Journal of Thrombosis and Thrombolysis - December 23, 2022 Category: Hematology Source Type: research
Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients
AbstractPatient education of high-risk medications such as direct oral anticoagulants (DOACs) is limited in ambulatory care settings. Clinical pharmacists are uniquely equipped to educate patients about DOACS but seldom interact with patients in those settings where patient education and satisfaction are often overlooked. Recently, the Anticoagulation Forum endorsed a checklist (DOAC Checklist) to guide and educate patients initiating or resuming DOACs. We assessed the impact on knowledge and satisfaction of an intervention framed around the checklist. Randomized clinical trial. Ambulatory patients starting a DOAC or res...
Source: Journal of Thrombosis and Thrombolysis - December 12, 2022 Category: Hematology Source Type: research
Clinical impact of oral anticoagulation among octogenarians with atrial fibrillation and anaemia
AbstractOur study aimed to describe the efficacy and safety of oral anticoagulation (OAC) use in elderly patients (> or = 80 years-old) with atrial fibrillation (AF) and concomitant anaemia. Data for this study were sourced from AF Research Database (NCT03760874). AF patients aged ≥ 80 who received OAC treatment, both direct oral anticoagulant (DOAC) and vitamin K antagonist (VKA) were selected. Partici pants were categorized as anaemic and non-anaemic. The primary outcome was the occurrence of overall bleeding. The primary effectiveness outcome was the occurrence of thromboembolic events (a composite of isch...
Source: Journal of Thrombosis and Thrombolysis - December 6, 2022 Category: Hematology Source Type: research
Favourable collaterals according to the Careggi Collateral Score grading system in patients treated with thrombectomy for stroke with middle cerebral artery occlusion
AbstractThe ability of the current grading systems to predict optimal outcomes in stroke patients with favourable collaterals remains unexplored. We evaluated differences in the performance of grading systems between Careggi Collateral Score and ASITN/SIR collateral score to predict clinical and radiological outcomes in stroke patients with favourable collaterals who underwent thrombectomy. We included stroke patients receiving thrombectomy within 360 min after symptom onset with MCA occlusion and favourable collaterals (i.e., without poor collaterals) defined by ASITN/SIR collateral score between 2 and 4. Using ordinal ...
Source: Journal of Thrombosis and Thrombolysis - August 18, 2022 Category: Hematology Source Type: research
Predictors of symptomatic intracranial hemorrhage after endovascular treatment for acute large vessel occlusion: data from ANGEL-ACT registry
AbstractSymptomatic intracranial hemorrhage (SICH) is a catastrophic complication of endovascular treatment (EVT) for large vessel occlusion (LVO). We aimed to investigate the incidence and predictors of SICH after EVT. Patients were selected from the ANGEL-ACT registry. We diagnosed SICH according to the Heidelberg Bleeding Classification. Logistic regression analyses were performed to determine the independent predictors of SICH. Of the 1283 patients, SICH was observed in 116 patients (9.0%). On multivariable analysis, admission National Institutes of Health Stroke Scale (NIHSS) > 12 (odds ratio [OR] = 1.86,...
Source: Journal of Thrombosis and Thrombolysis - August 1, 2022 Category: Hematology Source Type: research
Intravenous thrombolysis and endovascular thrombectomy for acute ischaemic stroke in patients with Moyamoya disease - a systematic review and meta-summary of case reports
ConclusionsIn this systematic review and meta-summary, the utility of IVT and ET in MMD-associated AIS appears feasible in selected cases. Further larger cohort studies are required to evaluate these treatment approaches.Highlights· AIS in MMD was typically managed with bypass surgery but not via thrombolysis or thrombectomy.· In this meta-summary, all patients treated with thrombolysis and/or thrombectomy survived and some experienced symptomatic and/or functional improvement.· Further larger cohort studies are necessary for investigating the role of thrombolysis and/or thrombectomy as treatment of AIS in MMD.
Source: Journal of Thrombosis and Thrombolysis - June 14, 2022 Category: Hematology Source Type: research
Effectiveness and safety of oral anticoagulants in non-valvular atrial fibrillation patients with prior bleeding events: a retrospective analysis of administrative claims databases
ConclusionsIn this real-world analysis of a large sample of NVAF patients with prior bleeding, NOACs were associated with similar or lower risk of stroke/SE and MB vs. warfarin and variable risk of stroke/SE and MB against each other.
Source: Journal of Thrombosis and Thrombolysis - May 17, 2022 Category: Hematology Source Type: research
Prescribing of anticoagulation for atrial fibrillation in primary care
The objective of this study was to describe anticoagulation prescribing by primary care physicians. We conducted an observational study in the Cleveland Clinic Health System among patients with AF and ≥ 1 primary care appointment between 2015 and 2018 and their physicians. We estimated differences in the odds of an eligible patient receiving anticoagulation versus not and a DOAC versus warfarin using two mixed effects logistic regression models, adjusted for patient sociodemographic factor s, history of falls or dementia, and CHA2DS2-VASc and HAS-BLED scores. We categorized physicians into prescribing tertiles, base...
Source: Journal of Thrombosis and Thrombolysis - April 21, 2022 Category: Hematology Source Type: research
Antiplatelet therapy indication in patients also prescribed direct oral anticoagulants
This study highlights the tremendous potential to improve patient safety and reduce bleeding harm.
Source: Journal of Thrombosis and Thrombolysis - April 20, 2022 Category: Hematology Source Type: research
Association of the careggi collateral score with radiological outcomes after thrombectomy for stroke with an occlusion of the middle cerebral artery
AbstractWe aimed to examine the association between Careggi Collateral Score (CCS) and radiological outcomes in a large multicenter cohort of patients receiving thrombectomy for stroke with occlusion of middle cerebral artery (MCA). We conducted a study on prospectively collected data from 1785 patients enrolled in the Italian Registry of Endovascular Treatment in Acute Stroke. According to the extension of the retrograde reperfusion in the cortical anterior cerebral artery-MCA territories, CCS ranges from 0 (absence of retrograde filling) to 4 (visualization of collaterals until the alar segment of the MCA). Radiological ...
Source: Journal of Thrombosis and Thrombolysis - April 8, 2022 Category: Hematology Source Type: research
Prevalence of recommended anticoagulation by guidelines preadmission and its impact on the incidence of acute myocardial infarction (AMI) and in-hospital outcomes after AMI in atrial fibrillation patients
This study was designed to explore the prevalence of recommended anticoagulation by guidelines before admission and its impact on the incidence of acute myocardial infarction (AMI) and the AMI associated in-hospital outcomes in patients with atrial fibrillation (AF). 10,725 patients with AF at their first hospitalizations in our hospitals were retrospectively reviewed, with a prevalence of recommended anticoagulation preadmission 24.41% (Number = 2618). They had lower risk of AMI incidence (Adjusted OR 0.66, 95%CI 0.54 –0.81, p < 0.001) compared to those without recommended anticoagulation after multivariate logist...
Source: Journal of Thrombosis and Thrombolysis - January 24, 2022 Category: Hematology Source Type: research
Comparison of biodegradable and newer generation durable polymer drug-eluting stents with short-term dual antiplatelet therapy: a systematic review and Bayesian network meta-analysis of randomized trials comprising of 43,875 patients
This study compares the safety and efficacy profiles of DP-DES and BP-DES based on short-term (1–3 months), intermediate-term (4–6 months) and standard DAPT (6–12 months) durations. A searc h was conducted on Embase and Medline for Randomized Controlled Trials (RCTs) comparing stent types, and DAPT durations. Primary endpoints include cardiac death, myocardial infarction (MI), definite stent thrombosis, stroke, target vessel revascularization (TVR) and major bleeding. Network analysis was conducted to summarize the evidence. A total of 15 RCTs involving 43,875 patients were included. DP-DES was associated with sig...
Source: Journal of Thrombosis and Thrombolysis - January 4, 2022 Category: Hematology Source Type: research
Incidence of thrombotic complications related to weight-based dosing of activated prothrombin complex concentrate (aPCC) for reversal of apixaban and rivaroxaban in obese patients
AbstractFactor eight inhibitor bypassing activity (aPCC) is recommended as a non-specific reversal agent for direct oral anticoagulants (DOACs) according to the 2017 American College of Cardiology (ACC) guidelines for reversal of anticoagulation. Factor eight inhibitor bypassing activity carries a black box warning for thrombotic events such as stroke, pulmonary embolism, deep vein thrombosis, and myocardial infarction, particularly at high doses. This was a retrospective, single-center, cohort investigation that included patients who received a weight-based dose of aPCC for reversal of apixaban and rivaroxaban between Jan...
Source: Journal of Thrombosis and Thrombolysis - November 17, 2021 Category: Hematology Source Type: research
Metal ion chelation enhances tissue plasminogen activator (tPA)-induced thrombolysis: an in vitro and in vivo study
AbstractStroke is the third leading cause of death in the United States and the leading cause of adult disability. Despite enormous research efforts including many clinical trials, tissue plasminogen activator (tPA) remains the only FDA-approved treatment for acute ischemic stroke. Unfortunately, only 1 –3% of stroke patients in the US receive this therapy because of the narrow time window and severe side effects for using tPA. The most deadly and damaging side effect is the risk of intracranial bleeding or hemorrhage. For that reason, the dose of tPA and its overall administration are under tigh t control, which may com...
Source: Journal of Thrombosis and Thrombolysis - November 10, 2021 Category: Hematology Source Type: research
