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Specialty: Hematology
Condition: Bleeding
Management: Hospitals

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Total 36 results found since Jan 2013.

Direct oral anticoagulants: patient reported adherence and minor bleedings
AbstractData regarding adherence and minor bleeding on direct oral anticoagulants in everyday life are still sparse. Inclusion criteria: treatment initiated with dabigatran, rivaroxaban or apixaban in non-valvular atrial fibrillation patients from a center in northern Sweden between 2011 and 2019 (n  = 668). Exclusion criteria: cognitive impairment, dose dispensing, need of interpreter or hospital admission (n = 67). By a telephone interview adherence was measured in 569 patients (response rate 94.8%) using the 8-item Morisky medication adherence scale and minor bleeding was asked for. CHA2DS2-VASc and HAS-BLED sco...
Source: Journal of Thrombosis and Thrombolysis - June 22, 2023 Category: Hematology Source Type: research

Poststroke venous thromboembolism and neutrophil activation: an illustrated review
Res Pract Thromb Haemost. 2023 Apr 29;7(4):100170. doi: 10.1016/j.rpth.2023.100170. eCollection 2023 May.ABSTRACTPatients with acute ischemic stroke are at a high risk of venous thromboembolism (VTE), such as deep vein thrombosis (DVT), estimated to affect approximately 80,000 patients with stroke each year in the United States. The prevalence of symptomatic DVT after acute stroke is approximately 10%. VTE is associated with increased rates of in-hospital death and disability, with higher prevalence of in-hospital complications and increased 1-year mortality in patients with stroke. Current guidelines recommend the use of ...
Source: Thrombosis and Haemostasis - June 5, 2023 Category: Hematology Authors: Nirav Dhanesha Junaid Ansari Nilesh Pandey Harpreet Kaur Chiranjiv Virk Karen Y Stokes Source Type: research

Real-world clinical outcomes among US Veterans with oral factor xa inhibitor –related major bleeding treated with andexanet alfa or 4-factor prothrombin complex concentrate
AbstractOral factor Xa (FXa) inhibitors significantly reduce incidence of stroke and thromboembolic events in patients with atrial fibrillation or venous thromboembolism. Due to various factors and the lack of a randomized controlled trial comparing andexanet alfa to usual care, non-specific replacement agents including 4  F-PCC are still used off-label for FXa inhibitor bleed management. Clinical and mortality data were extracted from the inpatient medical data and Veteran Affairs (VA) vital status files over the time of March 2014 through December 2020. Propensity score-weighted models were used for this retrospec tive ...
Source: Journal of Thrombosis and Thrombolysis - May 23, 2023 Category: Hematology Source Type: research

Anticoagulation practices and complications associated with Impella ® support at an advanced cardiac center in the Middle East gulf region
AbstractAnticoagulation during Impella ® support is a challenge due to its complications and inconsistent practice across the globe. This observational, retrospective chart review included all patients with Impella® support at our advanced cardiac center at a quaternary care hospital in the Middle East gulf region. The study was conduc ted over six years (2016–2022), a time period during which manufacturer recommendations for purge solution, anticoagulation protocols as well as Impella® place in therapy and utilization were all evolving. We aimed to evaluate the efficacy of different anticoagulation practices and asso...
Source: Journal of Thrombosis and Thrombolysis - April 25, 2023 Category: Hematology Source Type: research

Reduced dose direct oral anticoagulants compared with warfarin with high time in therapeutic range in nonvalvular atrial fibrillation
The objective of this study was to compare effectiveness and safety between reduced dose DOACs and high TTR warfarin treatment (TTR  ≥ 70%) in NVAF. A Swedish anticoagulation registry was used in identifying eligible patients from July 2011 to December 2017. The study cohort consisted of 40,564 patients with newly initiated DOAC (apixaban, dabigatran, or rivaroxaban) (11,083 patients) or warfarin treatment (29,481 patients ) after exclusion of 374,135 patients due to not being warfarin or DOAC naïve, not being prescribed reduced dose, having previous mechanical heart valve (MHV), or being under 18 years old. The me...
Source: Journal of Thrombosis and Thrombolysis - January 6, 2023 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

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

Examination of anticoagulation prescription among elderly patients with atrial fibrillation after in-hospital fall
AbstractMechanical fall is common among elders and has been associated with a lack of anticoagulant therapy among patients with atrial fibrillation (AF). However, anticoagulant therapy is recommended despite frequent fall due to an increased risk of a thromboembolic event. Using data from a large health system, we investigated the predictors of anticoagulation prescription on discharge in AF elderly patients after an in-hospital fall.  In this retrospective analysis, we examined patients aged 60 years and older discharged from 2013 to 2018 with a diagnosis of AF and a secondary diagnosis of in-hospital fall. The primary o...
Source: Journal of Thrombosis and Thrombolysis - September 4, 2021 Category: Hematology Source Type: research

Clinical Characteristics of Pediatric Patients with Congenital Erythrocytosis: A Single-Center Study
AbstractAlthough congenital erythrocytosis (CE), an inherited disorder, impairs pediatric quality of life, physicians often overlook high hemoglobin (Hgb) levels and its symptoms due to lack of knowledge of age-adjusted pediatric Hgb levels and CE ’s rarity. In a retrospective, single-center study, data from hospital records of pediatric patients diagnosed with CE were evaluated. Twenty-six patients from 25 families (80.8% male) had been diagnosed with CE in 20 years, at a mean age of 14.9 ± 2.8 years (8.3–17.8) and with a mean Hgb level of 17.36 ± 1.44 g/dL (14.63–22.1). No serum erythropoietin levels e...
Source: Indian Journal of Hematology and Blood Transfusion - August 25, 2021 Category: Hematology Source Type: research

Appropriateness of inpatient dosing of direct oral anticoagulants for atrial fibrillation
The objective was to determine the rates of inappropriate inpatient DOAC dosing in AF and identifying its associated underlying factors. We conducted a retrospective cross-sectional study from December 2013 to November 2019 across six South Australian public hospitals utilising a centralised electronic health record. Multivariate analysis was used to identify factors associated with underdosing of patients prescribed apixaban. Of 1882 inpatients, 544 (28.9  %) were inappropriately dosed. Underdosing was the most common form of inappropriate dosing with rates of 22.9 % (n = 295), 7.1 % (n = 7), and 25.1 % (n...
Source: Journal of Thrombosis and Thrombolysis - July 24, 2021 Category: Hematology Source Type: research

Interaction between thrombin potential and age on early clinical outcome in patients hospitalized for COVID-19
AbstractPatients with Coronavirus Disease-2019 (COVID ‐19) have haemostatic dysfunction and are at higher risk of thrombotic complications. Although age is a major risk factor for outcome impairment in COVID-19, its impact on coagulative patterns here is still unclear. We investigated the association of Endogenous Thrombin Potential (ETP) with thromb otic and haemorrhagic events according to different ages in patients admitted for COVID-19. A total of 27 patients with COVID‐19-related pneumonia, without need for intensive care unit admission or mechanical ventilation at hospital presentation, and 24 controls with non-C...
Source: Journal of Thrombosis and Thrombolysis - June 10, 2021 Category: Hematology Source Type: research

The outcomes of three-factor prothrombin complex concentrate (3F-PCC) in warfarin anticoagulation reversal: a prospective, single-arm, open-label, multicentre study
AbstractThere is a wide variation on the efficacy of three-factor Prothrombin Complex Concentrate (3F-PCC) in warfarin reversal. We aimed to determine the efficacy and safety of 3F-PCC in warfarin reversal. This multicentre prospective study analysed data from adult patients on warfarin who received 3F-PCC (Prothrombinex-VF ®) for anticoagulation reversal between June 2019 to October 2020. Purposive sampling was used in this study. Study endpoints included target INR achievement, adverse drug reactions (ADRs), and in-hospital all-cause mortality. Logistic regression analyses were used to assess independent predictors of s...
Source: Journal of Thrombosis and Thrombolysis - March 21, 2021 Category: Hematology Source Type: research