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Source: Journal of Thrombosis and Thrombolysis
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Total 309 results found since Jan 2013.
Associations between use of prasugrel vs clopidogrel and outcomes by type of acute coronary syndrome: an analysis from the PROMETHEUS registry
AbstractWe sought to investigate the utilization of prasugrel and its association with outcomes relative to clopidogrel in three typical subgroups of ACS in a real-world setting. Prasugrel is superior to clopidogrel for reducing risk of ischemic events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), but is associated with an increased risk of bleeding complications. PROMETHEUS was a retrospective multicenter observational study of 19,913 ACS patients undergoing PCI from 8 centers in the United States between 2010 and 2013. Major adverse cardiovascular events (MACE) were define...
Source: Journal of Thrombosis and Thrombolysis - June 8, 2019 Category: Hematology Source Type: research
Efficacy and safety of rivaroxaban on the resolution of left atrial/left atrial appendage thrombus in nonvalvular atrial fibrillation patients
AbstractData on LA/LAA thrombus resolution after rivaroxaban treatment has not been established. The aim of the present study was to compare the efficacy and safety on the resolution of LA/LAA thrombus between rivaroxaban and warfarin in nonvalvular atrial fibrillation (AF) patients. 80 AF patients with LA/LAA thrombus between January 2013 and June 2016 were randomized divided into warfarin group (n = 40) and rivaroxaban group (n = 40). Compared to warfarin group, thrombin time (TT; p < 0.0001), plasma prothrombin time (PT; p < 0.0001), and activated partial thromboplastin time (APTT; p = 0.001...
Source: Journal of Thrombosis and Thrombolysis - June 4, 2019 Category: Hematology Source Type: research
Assessing the accuracy of ICD-10 codes for identifying acute thromboembolic events among patients receiving anticoagulation therapy
AbstractInternational classification of disease (ICD) codes can improve the efficiency of epidemiological research provided the codes accurately identify outcomes of interest. The purpose of this retrospective cross-sectional study is to evaluate the accuracy of ICD-10 codes for identifying thromboembolic events occurring during anticoagulation therapy. Medical charts of patients hospitalized for any reason while receiving anticoagulant therapy between September 1, 2017 and December 31, 2017 were revie wed by two reviewers blinded to ICD-10 code status. Following identification of confirmed acute thromboembolic events, ...
Source: Journal of Thrombosis and Thrombolysis - May 22, 2019 Category: Hematology Source Type: research
Creatinine monitoring patterns in the setting of direct oral anticoagulant therapy for non-valvular atrial fibrillation
AbstractGuidelines and experts note that patients with atrial fibrillation require regular renal function monitoring to ensure safe use of direct oral anticoagulants (DOACs). Insufficient monitoring could lead to inappropriate dosing and adverse events. Our objective was to describe the frequency of insufficient creatinine monitoring among patients on DOACs, and to describe clinical factors associated with insufficient monitoring. We hypothesized that renal impairment would be associated with insufficient monitoring. A retrospective cohort study was performed with data from the Michigan Anticoagulant Quality Improvement ...
Source: Journal of Thrombosis and Thrombolysis - May 19, 2019 Category: Hematology Source Type: research
Patient selection and methods of surgical left atrial appendage exclusion
AbstractThe left atrial appendage (LAA) is a major source of thromboembolism, particularly in patients with atrial fibrillation (AF). LAA exclusion has arisen as a method of stroke prophylaxis in high-risk patients who have failed medical management, in whom medical management is contraindicated, and in those undergoing concomitant cardiac surgery. Percutaneous LAA exclusion with devices such as the Watchman has been described extensively in the cardiology literature, but surgical exclusion is less often discussed. Several techniques exist for surgical LAA exclusion, including appendage excision (removal), internal ligatio...
Source: Journal of Thrombosis and Thrombolysis - May 16, 2019 Category: Hematology Source Type: research
The pleiotropic effect of rs7903146 on type 2 diabetes and ischemic stroke: a family-based study in a Chinese population
In conclusion, our study provided evidence that a T2D-independent path was identified out of the pleiotropic effect of rs7903146 on IS. However, further studies were needed to validate the biological mechanisms behind the pleiotropic effect and the modification by l ifestyle intervention.
Source: Journal of Thrombosis and Thrombolysis - April 11, 2019 Category: Hematology Source Type: research
International normalized ratio control and subsequent clinical outcomes in patients with atrial fibrillation using warfarin
AbstractWe explored associations between INR measures and clinical outcomes in patients with AF using warfarin, and whether INR history predicted future INR measurements. We included patients in ARISTOTLE who were randomized to and received warfarin. Among patients who had events, we included those with ≥ 3 INR values in the 180 days prior to the event, with the most recent ≤ 60 days prior to the event, who were on warfarin at the time of event (n = 545). Non-event patients were included in the control group if they had ≥ 180 days of warfarin exposure with ≥ 3 INR measure ments (n = 7259). Th...
Source: Journal of Thrombosis and Thrombolysis - April 9, 2019 Category: Hematology Source Type: research
Stroke prophylaxis in critically-ill patients with new-onset atrial fibrillation
AbstractDespite a high incidence of new onset atrial fibrillation (NOAF) in critically ill patients and its association with short and long-term incidence of stroke, there is limited data assessing anticoagulation on hospital discharge in these patients. We retrospectively reviewed electronic medical records of all adult patients admitted to non-cardiac ICUs at our institution between January 2009 and March 2016. Patients with NOAF were identified and CHA2DS2-VASc score of ICU survivors was calculated. Prescription of oral anticoagulant therapy on hospital discharge was analyzed. A total of 640 (1.7% [38,708 patients]; 95%...
Source: Journal of Thrombosis and Thrombolysis - April 7, 2019 Category: Hematology Source Type: research
Leukoaraiosis is an independent predictor of intracranial hemorrhage in patients with atrial fibrillation
AbstractWe evaluated the predictive value of several clinical, radiological and laboratory parameters on the risk of predict intracranial hemorrhage (ICH) in patients with atrial fibrillation (AF). We conducted a case-control study on a consecutive hospital based series of patients with AF and ICH. A random sample of subjects with AF without ischemic or hemorrhagic stroke was selected from the same hospital in the same period to perform as the control group, with a ratio of two controls per case. All patients underwent the same evaluation protocol. Patients without neuroimaging exams were excluded. During the study period ...
Source: Journal of Thrombosis and Thrombolysis - March 13, 2019 Category: Hematology Source Type: research
Hospitalization affects the anticoagulation patterns of patients with atrial fibrillation
In conclusion, in patients with known AF at high risk for stroke, hospitalization was associated with an increase in OAC uptake, dri ven mainly by NOAC initiation. Three out of 10 patients initiated, switched or discontinued OAC treatment during hospitalization and this was associated with discrete epidemiologic parameters.
Source: Journal of Thrombosis and Thrombolysis - March 3, 2019 Category: Hematology Source Type: research
Characterisation of acute ischemic stroke in patients with left ventricular thrombi after myocardial infarction
AbstractAcute ischemic stroke (AIS) is a feared complication in post-acute myocardial infarction (AMI) patients who develop left ventricular (LV) thrombus. There is limited data available on the incidence of stroke in this population, and characterisation of stroke subtypes has not been previously reported. Our study aims to evaluate the incidence of AIS in post-AMI patients with LV thrombus and to characterise the pattern of stroke subtypes. We screened 5829 patients with echocardiogram reports containing the “thrombus” keyword from August 2006 to September 2017. AIS that occurred after LV thrombosis was captured and ...
Source: Journal of Thrombosis and Thrombolysis - February 25, 2019 Category: Hematology Source Type: research
Interacting medication use and the treatment effects of apixaban versus warfarin: results from the ARISTOTLE Trial
AbstractWarfarin is dependent on multiple hepatic enzymes for metabolism while apixaban is a substrate for P-glycoprotein (P-gp) transport and hepatic CYP3A4 metabolism. The aim of this analysis was to assess the impact of interacting medication use on the treatment effects of apixaban versus warfarin. Outcomes were compared between apixaban and warfarin using Cox proportional hazards modeling according to the use of interacting medications at randomization in ARISTOTLE (n = 18,201). Interacting medications for apixaban were identified as combined P-gp and 3A4 inhibitors or inducers while interacting medications for w...
Source: Journal of Thrombosis and Thrombolysis - February 21, 2019 Category: Hematology Source Type: research
Guided de-escalation of DAPT in acute coronary syndrome patients undergoing percutaneous coronary intervention with BVS implantation: a post-hoc analysis from the randomized TROPICAL-ACS trial
AbstractTo investigate the safety and efficacy of an early platelet function testing (PFT)-guided de-escalation of dual antiplatelet treatment (DAPT) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) with bioresorbable vascular scaffolds (BVS). Early DAPT de-escalation is a new non-inferior alternative to 12-months DAPT in patients with biomarker positive ACS treated with stent implantation. In this post-hoc analysis of the TROPICAL-ACS trial, which randomized 2610 ACS patients to a PFT-guided DAPT de-escalation (switch from prasugrel to clopidogrel) or to control group (uniform ...
Source: Journal of Thrombosis and Thrombolysis - February 9, 2019 Category: Hematology Source Type: research
Impact of time in therapeutic range after left ventricular assist device placement: a comparison between thrombus and thrombus-free periods
This study assessed TTR using the Rosendaal Method prior to suspected or confirmed pump thrombosis or ischemic stroke. Each patient served as their own control. Characteristics and TTR in 1, 2, and 3 months prior to thrombus (thrombus period) were compared to a thrombus-free period during 6 months to 3 months prior to thrombus (control period). There were 30 thrombus events observed in 25 patients for a rate of 0.06 events per LVAD day. Average TTR (target INR = 2–3) over 3 months for patients combined in both the thrombus and control time period was 53.4%. TTR (target INR = 2–3) was 11.4% lower 1 month prior ...
Source: Journal of Thrombosis and Thrombolysis - February 9, 2019 Category: Hematology Source Type: research
Thrombotic events in severe FXII deficiency in comparison with unaffected family members during a long observation period
AbstractTo investigate the occurrence of thrombotic events (myocardial infarction, deep vein thrombosis or ischemic stroke) in a group of 39 cases of severe FXII deficiency during a mean 22.5 years follow-up. All patients seen in Padua during the years 1968–2006 will the object of this investigation. FXII was less than or 1% of normal in all cases. Factor FXII activity in unaffected family members was 98% (range 90–140%). No patient or control had a thrombotic event in the past and none were on anticoagulant therapy. FV Leiden was present in one patient and in two controls whereas the G to A20210 prothrombin polymorp...
Source: Journal of Thrombosis and Thrombolysis - January 29, 2019 Category: Hematology Source Type: research
