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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

Hyperdense middle cerebral artery sign predicts favorable outcome in patients undergoing mechanical thrombectomy
AbstractNon-contrast computer tomography detects the presence of hyperdense middle cerebral artery sign (HMCAS). Studies on the prognostic value of HMCAS among patients undergoing mechanical thrombectomy (MT) are conflicting. A retrospective analysis of consecutive patients with acute ischemic stroke due to middle cerebral artery occlusion, presenting with or without HMCAS, who underwent MT, was performed. We enrolled 191 patients (HMCAS +, n  = 140; HMCAS –, n = 51). Prevalence of successful recanalization was significantly higher in patients with HMCAS than in those without HMCAS (92.1% versus 74.5%, p = 0....
Source: Journal of Thrombosis and Thrombolysis - November 25, 2022 Category: Hematology Source Type: research

Association of coagulation factors profile with clinical outcome in patient with COVID-19 and acute stroke: A second wave cohort study
This study reported coagulation profile of COVID-19 patients with acute stroke and its association with patients' outcome.METHOD: This is a cohort-retrospective study conducted during the second wave of COVID-19, June-August 2021 in Cipto Mangunkusumo General Hospital. Inclusion criteria were adult patients with confirmed COVID-19 and diagnosed with acute stroke confirmed by radiological evidences. Exclusion criteria were COVID-19 patients with prior diagnosis of acute stroke. Coagulation factors were analyzed and presented with tables and graphs.RESULTS: A total of 33 patients included in this study with majority experien...
Source: Clinical Hemorheology and Microcirculation - July 24, 2022 Category: Hematology Authors: Al Rasyid Dinda Larastika Riyanto Salim Harris Mohammad Kurniawan Taufik Mesiano Rakhmat Hidayat Elvan Wiyarta Source Type: research

Pre-admission antithrombotic use is associated with 3-month mRS score after thrombectomy for acute ischemic stroke
AbstractIn patients who undergo thrombectomy for acute ischemic stroke, the relationship between pre-admission antithrombotic (anticoagulation or antiplatelet) use and both radiographic and functional outcome is not well understood. We sought to explore the relationship between pre-admission antithrombotic use in patients who underwent thrombectomy for acute ischemic stroke at two medical centers in New York City between December 2018 and November 2020. Analyses were performed using analysis of variance and Pearson ’s chi-squared tests. Of 234 patients in the analysis cohort, 65 (28%) were on anticoagulation, 64 (27%) we...
Source: Journal of Thrombosis and Thrombolysis - July 21, 2022 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

Long-term outcomes of left atrial appendage occlusion in high-risk atrial fibrillation patients: 4-year follow up data
AbstractLong-term follow-up data of left atrial appendage (LAA) occlusion in patients with atrial fibrillation (AF) are sparse. To address these data gaps, we analysed the 4-year outcomes of AF patients following LAA occlusion. The was a retrospective cohort study of high-risk patients with AF who underwent successful implantation of the Amulet device at our center between 2014 and 2017. Study endpoints were the rate of stroke, major bleeding and all-cause mortality. We included 71 patients (35.2% females) with a median age of 78 (IQR 73 –82) years. Over a median follow-up period of 46 (IQR 19–56) months, the annual ra...
Source: Journal of Thrombosis and Thrombolysis - November 9, 2020 Category: Hematology Source Type: research

Intravenous Fat Emulsion Does Not Significantly Alter Clotting Markers in Dabigatran-Treated Blood
AbstractDabigatran etexilate is an oral direct thrombin (Factor IIa) inhibitor approved for patients with atrial fibrillation and for management of risk of deep vein thrombosis and pulmonary embolism. Dabigatran offers advantages over treatment with warfarin, including limited laboratory monitoring. It is equivalent in prevention of stroke and deep vein thrombosis with essentially equivalent complication rates. In contrast to warfarin, reversal of the anticoagulation is less well established. Idarucizumab is available for reversal, however supporting research is mixed; the agent also happens to be quite expensive making av...
Source: Indian Journal of Hematology and Blood Transfusion - June 21, 2020 Category: Hematology Source Type: research

Impacts of in-hospital workflow on functional outcome in stroke patients treated with endovascular thrombectomy
This study aimed to evaluate the impacts of in-hospital workflow on functional outcomes after thrombectomy. Patients were enrolled from a multi-center registry program in China. Based on in-hospital managing procedure and personnel involved, two workflow models, neurologist-dominant and non-neurologist-dominant, were identified in the participating centers. Favorable outcome was defined as a mRS score of  ≤ 2 at 90 days of stroke onset. After patients being matched with propensity score matching (PSM) method, ratios of favorable outcomes and symptomatic intracerebral hemorrhage (sICH) were compared between patients ...
Source: Journal of Thrombosis and Thrombolysis - June 9, 2020 Category: Hematology Source Type: research

Revascularization outcomes following acute ischemic stroke in patients taking direct oral anticoagulants: a single hospital cohort study
AbstractSuccessful revascularization therapy is of paramount importance in patients suffering acute ischemic stroke (AIS). However, there is currently only limited evidence on revascularization outcomes for patients suffering AIS while treated with direct oral anticoagulants (DOACs). The aim of our study was to determine the efficacy and safety of intravenous thrombolysis (IVT) and mechanical reperfusion (MeR) in AIS patients taking DOACs, and compare them to randomized clinical trials (RCTs), which included patients without DOAC treatment. In an observational cohort study, we analyzed clinical and radiological outcomes fo...
Source: Journal of Thrombosis and Thrombolysis - June 5, 2020 Category: Hematology Source Type: research

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