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Specialty: Hematology
Condition: Hemorrhagic Stroke

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Total 295 results found since Jan 2013.

Efficacy and safety of edoxaban in comparison with dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation. An indirect comparison analysis.
Abstract Large Phase 3 clinical trials for stroke prevention in atrial fibrillation (AF) have compared non-vitamin K antagonist oral anticoagulants (NOACs) against warfarin, with the edoxaban trial only recently reported. In the absence of head to head trials directly comparing these NOACs against each other, we compared the efficacy and safety of edoxaban to other agents by an indirect comparison analysis. We performed an indirect comparison analysis of edoxaban (2 dose strategies) against apixaban (1 dose), dabigatran etexilate (2 doses) and rivaroxaban (1 dose), for their relative efficacy and safety against ea...
Source: Thrombosis and Haemostasis - February 28, 2014 Category: Hematology Authors: Skjøth F, Larsen TB, Rasmussen LH, Lip GY Tags: Thromb Haemost Source Type: research

Outcome of overt stroke in sickle cell anaemia, a single institution's experience
Summary Stroke is a traumatic complication in sickle cell anaemia (SCA) that is associated with significant morbidity and a risk of recurrent overt stroke of 2·2–6·4 events per 100 patient‐years. A retrospective study was performed on all paediatric SCA patients diagnosed with a history of overt stroke between 1997 and 2010. A total of 31 children with SCA had new onset overt stroke. The mean age of the active patients (n = 27) was 17·9 years (range 6·8–27·6 years) with a total period of observation of 305 patient‐years. Twenty‐two of 27 (81%) were receiving long term red blood cell transfusions and 16 (...
Source: British Journal of Haematology - February 27, 2014 Category: Hematology Authors: Suvankar Majumdar, Morgan Miller, Majid Khan, Catherine Gordon, Amy Forsythe, Mary G. Smith, Gail Megason, Rathi Iyer Tags: Research Paper Source Type: research

Comparing patient-level and site-level anticoagulation control as predictors of adverse events
Conclusion: iTTR significantly predicted risk of major hemorrhage, ischemic stroke, and all-cause mortality. cTTR was a weak predictor of all-cause mortality. Though cTTR may be a better target for site-level quality improvement efforts, iTTR may be a more suitable measure for use in comparative effectiveness research.
Source: Thrombosis Research - February 6, 2014 Category: Hematology Authors: Ramon S. Cancino, Elaine M. Hylek, Joel I. Reisman, Adam J. Rose Tags: Coagulation and Fibrinolysis Source Type: research

Composite risk scores and composite endpoints in the risk prediction of outcomes in anticoagulated patients with atrial fibrillation. The Loire Valley Atrial Fibrillation Project.
In conclusion, composite risk scores did not significantly improve risk prediction of endpoints in patients with NVAF, regardless of how endpoints were defined. This would support individualised prediction of IS/TE and bleeding separately using different separate risk prediction tools, and not the use of composite scores or endpoints for everyday 'real world' clinical practice, to guide decisions on thromboprophylaxis. PMID: 24452108 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 23, 2014 Category: Hematology Authors: Banerjee A, Fauchier L, Bernard-Brunet A, Clementy N, Lip GY Tags: Thromb Haemost 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

Patient outcomes using the European label for dabigatran. A post-hoc analysis from the RE-LY database.
In conclusion, this post-hoc simulation of dabigatran usage based on RE-LY trial dataset indicates that "EU label simulated dabigatran treatment" may be associated with superior efficacy and safety compared to warfarin, and are in support of the EU label and the 2012 European Society of Cardiology AF guideline recommendations. Thus, adherence to European label/guideline use results in a clinically relevant benefit for dabigatran over warfarin, for both efficacy and safety. PMID: 24326736 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - December 11, 2013 Category: Hematology Authors: Lip GY, Clemens A, Noack H, Ferreira J, Connolly SJ, Yusuf S Tags: Thromb Haemost Source Type: research

Cardiovascular comorbidities are increased in US patients with haemophilia A: a retrospective database analysis
This study evaluated the prevalence of cardiovascular comorbidities among USA males with haemophilia A, relative to an unaffected general male population with similar characteristics. Males with haemophilia A and continuous insurance coverage were identified by ICD‐9‐CM code 286.0 (1 January 2007–31 December 2009) using the MarketScan® Commercial and Medicare Research Databases. Individuals with haemophilia A were exact matched 1:3 with males without a diagnosis of haemophilia A. The prevalence of cardiovascular comorbidities identified by ICD‐9‐CM code was determined for matched cohorts. Of the study population...
Source: Haemophilia - November 29, 2013 Category: Hematology Authors: J. Pocoski, A. Ma, C. M. Kessler, S. Boklage, T. J. Humphries Tags: Original Article Source Type: research

Unanswered questions and research priorities to optimise stroke prevention in atrial fibrillation with the new oral anticoagulants.
Abstract This review article discusses the following, as yet unanswered, questions and research priorities to optimise patient management and stroke prevention in atrial fibrillation with the new direct oral anticoagulants (NOACs): 1. In patients prescribed a NOAC, can the anticoagulant effects or plasma concentrations of the NOACs be measured rapidly and reliably and, if so, can "cut-off points" between which anticoagulation is therapeutic (i.e. the "therapeutic range") be defined? 2. In patients who are taking a NOAC and bleeding (e.g. intracerebral haemorrhage), can the anticoagulant effects of the direct NOACs...
Source: Thrombosis and Haemostasis - November 28, 2013 Category: Hematology Authors: Hankey GJ Tags: Thromb Haemost Source Type: research

Should oral anticoagulants be restarted after warfarin-associated cerebral haemorrhage in patients with atrial fibrillation?
Abstract Intracranial haemorrhage (ICH), which affects up to 1% of patients on oral anticoagulation per year, is the most feared and devastating complication of this treatment. After such an event, it is unclear whether anticoagulant therapy should be resumed. Such a decision hinges upon the assessment of the competing risks of haematoma growth or recurrent ICH and thromboembolic events. ICH location and the risk for ischaemic cerebrovascular event seem to be the key factors that lead to risk/benefit balance of restarting anticoagulation after ICH. Patients with lobar haemorrhage or cerebral amyloid angiopathy rem...
Source: Thrombosis and Haemostasis - November 21, 2013 Category: Hematology Authors: Paciaroni M, Agnelli G Tags: Thromb Haemost 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

Sickle‐cell disease stroke throughout life: A retrospective study in an adult referral center
Abstract Strokes are one of the most severe complications of sickle‐cell disease. Most studies have been restricted to children with sickle‐cell disease. To better understand the characteristics and follow‐up of strokes occurring from childhood to adulthood, we undertook a retrospective cohort study of 69 stroke patients among the 2,875 patients consulting at the French Adult Sickle‐Cell Disease Referral Center. Between 1970 and 2008, they had experienced 104 strokes: 80 ischemic, 22 hemorrhagic and 2 intracranial sinus thromboses. Coma and/or fatal outcomes underscored the severity of strokes in sickle‐cell dise...
Source: American Journal of Hematology - November 8, 2013 Category: Hematology Authors: Antoine Gueguen, Matthieu Mahevas, Ruben Nzouakou, Hassan Hosseini, Anoosha Habibi, Dora Bachir, Pierre Brugière, François Lionnet, Jean‐Antoine Ribeil, Bertrand Godeau, Robert Girot, Vahid Ibrahima, David Calvet, Frédéric Galactéros, Pablo Bartolu Tags: Research Article Source Type: research

Questionable reversal of anticoagulation in the therapeutic management of cerebral haemorrhage associated with vitamin K antagonists.
Abstract Reversal of anticoagulation is recommended to correct the international normalised ratio (INR) for patients with intracranial haemorrhage (ICH) associated with vitamin K antagonists (VKA). However, the validity of such treatment is debated. We sought to identify, prospectively, the prognostic effect of VKA-ICH treatment in a cohort of patients (n=71; median age 78 years, range 20-89; 57% males). Data collated were: baseline characteristics, treatments, baseline and post-treatment INR, haematoma volume, and haematoma enlargement. Treatment effects and prognostic factor assessment were in relation to mortal...
Source: Thrombosis and Haemostasis - September 12, 2013 Category: Hematology Authors: Alonso de Leciñana M, Huertas N, Egido JA, Muriel A, García A, Ruiz-Ares G, Díez-Tejedor E, Fuentes B Tags: Thromb Haemost Source Type: research

Dabigatran versus warfarin under standard or pharmacogenetic-guided management for the prevention of stroke and systemic thromboembolism in patients with atrial fibrillation: a cost/utility analysis using an analytic decision model
Conclusion: SD-W has the lowest C/U ratio among the 3 options. However, dabigatran might be considered as an alternative. GT-W is not C/U and should not currently be recommended for the routine anticoagulotherapy management of AF patients.
Source: Thrombosis Journal - July 17, 2013 Category: Hematology Authors: Léon NshimyumukizaJulie DuplantieMathieu GagnonXavier DouvilleDiane FournierCarmen LindsayMarc ParentAlain MilotYves GiguèreChristian GagnéFrançois RousseauDaniel Reinharz Source Type: research

Impact of double‐blind vs. open study design on the observed treatment effects of new oral anticoagulants in atrial fibrillation: a meta‐analysis
ConclusionsOur meta‐analysis showed no significant interaction of study design for the main efficacy and safety outcomes. However, the non‐significantly exaggerated reduction in SSE suggests interdependence of treatment effect and PROBE design, especially for hemorrhagic stroke.
Source: Journal of Thrombosis and Haemostasis - July 15, 2013 Category: Hematology Authors: J.‐C. Lega, P. Mismetti, M. Cucherat, T. Fassier, L. Bertoletti, C. Chapelle, S. Laporte Tags: Original Article Source Type: research

Reperfusion of cerebral artery thrombosis by the GPIb-VWF blockade with the Nanobody ALX-0081 reduces brain infarct size in guinea pigs
Thrombolytic therapy is the cornerstone of treatment of acute atherothrombotic ischemic stroke but is associated with brain hemorrhage; antiplatelet therapy has limited efficacy and is still associated with intracranial bleeding. Therefore, new antithrombotic approaches with a better efficacy/safety ratio are required. We have assessed the effect of ALX-0081, a Nanobody against the A1 domain of von Willebrand factor (VWF) that blocks VWF binding to GPIb, of the thrombolytic agent recombinant tissue plasminogen activator (rtPA), and of the GPIIb/IIIa antagonist tirofiban, in a middle cerebral artery (MCA) thrombosis model i...
Source: Blood - June 20, 2013 Category: Hematology Authors: Momi, S., Tantucci, M., Van Roy, M., Ulrichts, H., Ricci, G., Gresele, P. Tags: Platelets and Thrombopoiesis, Thrombosis and Hemostasis Source Type: research