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Source: Journal of Thrombosis and Thrombolysis
Condition: Thrombosis
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Total 309 results found since Jan 2013.
Efficacy outcomes and safety measures of intravenous tirofiban or eptifibatide for patients with acute ischemic stroke: a systematic review and meta-analysis of prospective studies
AbstractTo review the literature for randomized control trials (RCTs) and prospective cohort studies investigating the safety and efficacy of tirofiban and eptifibatide in patients with acute ischemic stroke (AIS). PubMed, Embase, and the Cochrane library were searched for available papers published up to September 2021. The efficacy was evaluated based on the 3-month favorable outcome [modified Rankin scale (mRS) = 0–1], functional outcome (mRS = 0–2), and the last available National Institutes of Health Stroke Scale (NIHSS) score measured in each study. Twelve studies (two RCTs and 10 prospective cohorts) an...
Source: Journal of Thrombosis and Thrombolysis - November 15, 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
Antithrombotic strategy and its relationship with outcomes in patients with atrial fibrillation and chronic coronary syndrome
This study aimed to explore antithrombotic strategy and its relationship with outcomes in patients with atrial fibrillation (AF) at high risk for stroke and chronic coronary syndrome (CCS) in real-world clinical practice. Patients with AF at high risk for stroke complicated with CCS from China Atrial Fibrillation Registry (CAFR) were enrolled. The patients were divided into non-antithrombotic (Non-AT) group, oral anticoagulants (OAC) group, antiplatelet therapy (APT) group (aspirin or clopidogrel), and dual antiplatelet therapy (DAPT) group (aspirin + clopidogrel) according to their antithrombotic strategies at baseli...
Source: Journal of Thrombosis and Thrombolysis - October 22, 2021 Category: Hematology Source Type: research
Direct oral anticoagulants for secondary stroke prevention in patients over 80 years of age: the role of geriatric functional status
AbstractPrescribing anticoagulation therapy in very old ( ≥ 80-years) patients with atrial fibrillation (AF) is an emerging clinical issue, but current knowledge and recommendations are insufficient. We aimed to determine the efficacy and safety of direct oral anticoagulants (DOACs) in secondary stroke prevention in very old patients and to explore the related geriatric functional status of these patients. Three hundred fifty-three consecutive ≥ 80-year-old patients treated for transient ischemic attack (TIA) or ischemic stroke (IS) at the neurological clinic at UMC Ljubljana, who were prescribed DOACs for AF bet...
Source: Journal of Thrombosis and Thrombolysis - October 16, 2021 Category: Hematology Source Type: research
Oral anticoagulation patterns and prognosis in octogenarian patients with atrial fibrillation
In conclusion, in this cohort of post-discharge octogenarian patients with AF, the risk for all-cause death was similar in NOAC versus VKA users, after adjustment for baseline covariates. No differences in stroke and major bleeding events among these treatment groups were revealed.Graphic abstract
Source: Journal of Thrombosis and Thrombolysis - September 25, 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
Efficacy of prothrombin complex concentrate in the management of oral factor Xa inhibitors associated major bleed assessed by ISTH and ANNEXA-4 criteria
AbstractDirect oral anticoagulants (DOACs) are increasingly used for stroke prevention in atrial fibrillation and treatment and prevention of venous thromboembolism. They are also associated with bleeding risk. Existing literature suggests that prothrombin complex concentrate (PCC) administration may help control bleeding due to factor Xa inhibitors (FXaI). To determine the hemostatic efficacy of PCC in patients with major bleeding due to FXaI, we performed a retrospective chart review of 50 patients who presented with FXaI associated major bleeding that required urgent hemostatic management. Hemostatic assessment was pe...
Source: Journal of Thrombosis and Thrombolysis - August 9, 2021 Category: Hematology Source Type: research
Safety of apixaban for venous thromboembolic primary prophylaxis in patients with newly diagnosed malignant glioma
In this study, we treated ten patients with newly diagnosed MG with apixaban, 2.5 mg twice daily beginning 2–21 days after craniotomy and continuing for up to 6 months. Unacceptable toxicity was defined by ≥ grade 2 CNS or non-CNS hemorrhage, a thromboembolic event (i.e. stroke) or cardiovascular event requiring anticoagulation or anti-platelet therapy. There were no unacc eptable toxicities to report and no treatment-related adverse events. None of the patients on the study were diagnosed with a VTE while receiving apixaban. We conclude that apixaban can be given safely to patients with primary MG shortly after cra...
Source: Journal of Thrombosis and Thrombolysis - August 4, 2021 Category: Hematology Source Type: research
Oral anticoagulation for patients with atrial fibrillation in the ED: RE-LY AF registry analysis
AbstractOral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF). We sought to determine predictors of OAC initiation in AF patients presenting to the emergency department (ED). Secondary analysis of the RE-LY AF registry which enrolled individuals from 47 countries between 2007 and 2011 who presented to an ED with AF and followed them for 1 year. A total of 4149 patients with AF as their primary diagnosis who were not already taking OAC and had a CHA2DS2-VASc ≥ 1 for men or ≥ 2 for women were included in this analysis. Of these individuals, 26.8% were started on OAC (99.2% vi...
Source: Journal of Thrombosis and Thrombolysis - August 2, 2021 Category: Hematology Source Type: research
Evaluating the safety and efficacy of intravenous thrombolysis for acute ischemic stroke patients with a history of intracerebral hemorrhage: a systematic review and meta-analysis
This study aims to investigate the safety and efficacy of IV-tPA in AIS patients with previous ICH. We performed a systematic review and meta-analysis of studies reporting on IV-tPA use in AIS patients with and without previous ICH. We searched Embase, PubMed and Cochrane Library from inception to 20 April 2021. Outcomes measured included symptomatic ICH (sICH), 3-month modified Rankin Scale (mRS) score, and 3-month mortality. We included seven retrospective cohort studies comprising 5760 AIS patients who had received IV-tPA, of which 134 had previous ICH. There was no significant difference in the odds of sICH (OR 1.57, 9...
Source: Journal of Thrombosis and Thrombolysis - July 24, 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
Adverse consequences of immediate thrombolysis-related complications: a multi-centre registry-based cohort study of acute stroke
In conclusion, the risk of nosocomial infections, worsening of stroke severity, longer HASU stay, disability and death is increased following immediate TRC. The management of patients following immediate TRC is more complex than previously thought and such complexity needs to be considere d when planning an increased thrombolysis service.
Source: Journal of Thrombosis and Thrombolysis - July 13, 2021 Category: Hematology Source Type: research
The clot thickens —enhanced integration of stroke and thrombosis training
AbstractThere is significant overlap between knowledge and its clinical application in stroke and thrombosis& vascular medicine. Formal integration of training is, however, not standard. After the hyperacute phase of management, personalized medical decisions are often needed regarding antithrombotics and anticoagulants that leverage clinical practice parameters from both disciplines with a unique emphasis on minimizing neurologic treatment complications. We completed an ad hoc survey of adult thrombosis fellowships at several North American centers. We discovered that direct integration of training programs is not pre...
Source: Journal of Thrombosis and Thrombolysis - July 7, 2021 Category: Hematology Source Type: research
Management of tandem occlusions in patients who receive rtPA
ConclusionThe use of GP2b3aI in the setting of tandem occlusions that required emergent stent placement post-rtPA appears safe and effective. Given the small sample size, these findings should be interpreted cautiously, and need to be confirmed in a larger patient population.
Source: Journal of Thrombosis and Thrombolysis - June 23, 2021 Category: Hematology Source Type: research
