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Journal of Thrombosis and Thrombolysis

Rachel Rosovsky, Yuchiao Chang, Kenneth Rosenfield, Richard Channick, Michael R Jaff, Ido Weinberg, Thoralf Sundt, Alison Witkin, Josanna Rodriguez-Lopez, Blair A Parry, Savannah Harshbarger, Praveen Hariharan, Christopher Kabrhel
Multidisciplinary pulmonary embolism response teams (PERTs) are being implemented to improve care of patients with life-threatening PE. We sought to determine how the creation of PERT affects treatment and outcomes of patients with serious PE. A pre- and post-intervention study was performed using an interrupted time series design, to compare patients with PE before (2006-2012) and after (2012-2016) implementation of PERT at a university hospital. T-tests, Chi square tests and logistic regression were used to compare outcomes, and multivariable regression were used to adjust for differences in PE severity...
September 21, 2018: Journal of Thrombosis and Thrombolysis
Kassandra Marsh, Tania Ahuja, Veronica Raco, David Green, Akhilesh K Sista, John Papadopoulos
Limited evidence is available to guide periprocedural management of oral anticoagulants in the setting of interventional radiology (IR) procedures. For direct oral anticoagulants, therapy interruption (TI) is based on medication half-life and procedural bleeding risk. Periprocedural management of warfarin includes INR monitoring, and possible bridging with parenteral anticoagulants. It is unknown if these recommendations apply to IR procedures. To evaluate bleeding complications and thromboembolic events following periprocedural management of the factor Xa (FXa) inhibitors or warfarin in patients undergoing IR procedures...
September 17, 2018: Journal of Thrombosis and Thrombolysis
Sonja Kroep, Ling-Hsiang Chuang, Alexander Cohen, Pearl Gumbs, Ben van Hout, Manuel Monreal, Stefan N Willich, Anselm Gitt, Rupert Bauersachs, Giancarlo Agnelli
Venous thromboembolism (VTE) is often accompanied by co-morbidities, which complicate and confound data interpretation concerning VTE-related mortality, costs and quality of life. We aimed to assess the contribution of co-morbidities to the burden of VTE. The PREFER in VTE registry, across seven European countries, documented and followed acute VTE patients over 12 months. Patients with co-morbidities were grouped in major co-morbidity groups: cancer, cardiovascular (CV) comorbidity (other than VTE), CV risks, venous, renal, liver, respiratory, bone and joint diseases, and lower extremity paralysis...
September 14, 2018: Journal of Thrombosis and Thrombolysis
Ehteramolsadat Hosseini, Pezhman Beshkar, Mehran Ghasemzadeh
Platelet receptor GPVI plays an important role in platelet firm adhesion to site of vascular injury. Receptor ligation with collagen, in company with other agonist/receptor interactions, augments inside out signaling pathways leading to platelet aggregation and thrombus formation. As GPVI expression is significantly modulated by ectodomain shedding, this study aimed to examine whether GPVI shedding functionally affects collagen-mediated platelet activation during storage. 6 PRP-platelet concentrates were subjected to adhesion analysis on collagen matrix under mild stirring condition as well as collagen-induced aggregation on day 1, 3 and 5 post-storage...
September 14, 2018: Journal of Thrombosis and Thrombolysis
Sake J van der Wall, Jules R Olsthoorn, Samuel Heuts, Robert J M Klautz, Anton Tomsic, Evert K Jansen, Alexander B A Vonk, Peyman Sardari Nia, Frederikus A Klok, Menno V Huisman
The original version of this article unfortunately contained a mistake in the author name. The co-author name should be Frederikus A. Klok instead of Frederik A. Klok. The original article has been corrected.
September 10, 2018: Journal of Thrombosis and Thrombolysis
Ido Weinberg, Jay Giri, Raghu Kolluri, Juan Ignacio Arcelus, Conxita Falgá, Silvia Soler, Andrei Braester, José Bascuñana, Javier Gutiérrez-Guisado, Manuel Monreal
Knee arthroscopy is the most common orthopedic procedure worldwide. While incidence of post-arthroscopy venous thromboembolic events (VTE) is low, treatment patterns and patient outcomes have not been described. Patients from the "Registro Informatizado Enfermedad TromboEmbolica" who had confirmed post-arthroscopy VTE were compared to patients with provoked, post bone-fracture, and to patients with unprovoked VTE. Baseline characteristics, presenting signs and symptoms, treatment and outcomes including recurrent VTE, bleeds or death were compared...
September 8, 2018: Journal of Thrombosis and Thrombolysis
Bruria Hirsh Raccah, Amihai Rottenstreich, Netanel Zacks, Mordechai Muszkat, Ilan Matok, Amichai Perlman, Yosef Kalish
Data are limited on the effects of drug interactions on direct-acting oral anticoagulant (DOAC) levels. We evaluated the effects of the use of interacting drugs on DOAC levels in patients with atrial fibrillation (AF). We reviewed data of AF patients tested for DOAC levels in 2013-2017. The primary outcomes were drug levels exceeding the expected steady-state range, and in the highest quartile. A multivariate analysis was performed to evaluate the correlation of treatment by the use of interacting drugs, CYP3A4 and P-glycoprotein (P-gp) inhibitors, with the primary outcomes...
September 8, 2018: Journal of Thrombosis and Thrombolysis
Jessica Hedvat, Christina Howlett, James McCloskey, Ruchi Patel
Direct oral anticoagulants (DOACs) have become an attractive option for the treatment of venous thromboembolism (VTE) in cancer patients. However, their use is currently not recommended as first-line treatment by national guidelines due to limited data in this patient population. The objective of this study was to evaluate the practice and safety patterns of DOACs when used for VTE treatment in the oncology population. This study was a retrospective chart review of adult cancer patients treated at Hackensack University Medical Center from January 2013 to October 2015 who received dabigatran, rivaroxaban, or apixaban for VTE treatment...
September 6, 2018: Journal of Thrombosis and Thrombolysis
Utku Iltar
No abstract text is available yet for this article.
September 6, 2018: Journal of Thrombosis and Thrombolysis
Angelo Di Vincenzo, Alessandro Rizzo, Lucia Russo, Roberto Mioni
Thromboembolism is a known complication of pacemaker implantation. However, published literature describes only a few cases, in which the events occurred in absence of antithrombotic prophylaxis, not routinely employed for its prevention in current clinical practice. We report a case of pacemaker lead-associated thrombosis in a patient taking continuative oral anticoagulant therapy with edoxaban tosylate (edoxaban). No data in present literature supports the use of anticoagulant prophylaxis for pacemaker lead thrombosis...
September 4, 2018: Journal of Thrombosis and Thrombolysis
Nina Rise, Jacobina Kristiansen, Anne-Mette Hvas, Erik L Grove, Morten Würtz, Søs Neergaard-Petersen, Steen Dalby Kristensen
Remote ischaemic conditioning (RIC) is a new beneficial treatment for patients with ST-elevation myocardial infarction. RIC may inhibit thrombus formation and, therefore, we investigated whether RIC affects platelet aggregation and turnover. 30 healthy male volunteers were subjected to intervention on day 1 (sham intervention, no aspirin), day 2 (RIC, no aspirin), and day 16 (RIC, treated 7 days with aspirin 75 mg/day). RIC was performed as four cycles of 5 min interchangeable inflation and deflation using an automated cuff...
August 30, 2018: Journal of Thrombosis and Thrombolysis
Hobart Owen Ng Tsai, Janice Jia Ni Goh, Jernice Wan Xin Aw, Yingying Lin, Alan Yean Yip Fong, Lee Len Tiong, Doreen Su-Yin Tan
The objectives of this study are to compare steady-state trough (Cmin,ss) and peak (Cmax,ss) concentrations of rivaroxaban between Asians and Caucasians and to evaluate the relationship between rivaroxaban concentrations and prothrombin time/international normalized ratio (PT/INR). Recruited patients were advised on the time to take rivaroxaban. Cmin,ss and PT/INR were taken when patients arrived. Cmax,ss and PT/INR were drawn between 2 and 4 h later after the patient took rivaroxaban with food. Thirty patients were included in the analyses: 57% (n = 17) males and 43% (n = 13) females, 77% (n = 23) on 20 mg and 23% (n = 7) on 15 mg...
August 28, 2018: Journal of Thrombosis and Thrombolysis
Linda Hoang, Shahidul Islam, Alexander Hindenburg
Despite advantages of low molecular weight heparin (LMWH), enoxaparin over heparin (UFH) for venous thromboembolism (VTE), a hospital's prescribing trends analysis showed use of each was about equal. In an attempt to increase LMWH over UFH use, electronic medical record (EMR) changes for medical service patients and education via multidisciplinary grand rounds was provided to all services. This was a unique opportunity to study LMWH and UFH use pre and post interventions at our institution. Citrix Pharmacy data was extracted for 3 months pre and post intervention (August 2016-February 2017)...
August 22, 2018: Journal of Thrombosis and Thrombolysis
Sake J van der Wall, Jules R Olsthoorn, Samuel Heuts, Robert J M Klautz, Anton Tomsic, Evert K Jansen, Alexander B A Vonk, Peyman Sardari Nia, Frederikus A Klok, Menno V Huisman
The optimal antithrombotic therapy following mitral valve repair (MVr) is still a matter of debate. Therefore, we evaluated the rate of thromboembolic and bleeding complications of two antithrombotic prevention strategies: vitamin K antagonists (VKA) versus aspirin. Consecutive patients who underwent MVr between 2004 and 2016 at three Dutch hospitals were evaluated for thromboembolic and bleeding complications during three postoperative months. The primary endpoint was the combined incidence of thromboembolic and bleeding complications to determine the net clinical benefit of VKA strategy as compared with aspirin...
August 21, 2018: Journal of Thrombosis and Thrombolysis
Phillip Weeks, Adam Sieg, Indranee Rajapreyar, Sriram Nathan, Marwan Jumean, Manish Patel, Rajko Radovancevic, Biswajit Kar, Igor Gregoric
Pump thrombosis remains a serious complication of implantable ventricular assist device therapy and is associated with increased risk of morbidity and mortality. Optimal management strategies remain controversial and are guided largely by limited literature and expert opinion. Medical management of pump thrombosis, including the use of direct thrombin inhibitors, has been associated with mixed results. The purpose of this study is to report the outcomes associated with bivalirudin therapy in LVAD patients with suspected pump thrombosis...
August 17, 2018: Journal of Thrombosis and Thrombolysis
Veronica Raco, Tania Ahuja, David Green
Idarucizumab, a fully humanized Fab antibody fragment, is indicated for reversal of dabigatran's anticoagulant activity. Idarucizumab neutralizes the anticoagulant effects of dabigatran by binding to dabigatran and its metabolite. In the full analysis of 503 patients, idarucizumab fully reversed the anticoagulant effect of dabigatran in more than 98% of patients. Real-world clinical experience with idarucizumab for dabigatran reversal remains limited. We report 11 real-world clinical cases in which idarucizumab was administered for dabigatran reversal in the setting of bleed (bleeding cohort n = 5) or emergent procedure (emergent procedure cohort, n = 6)...
August 17, 2018: Journal of Thrombosis and Thrombolysis
Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Tarek Haykal, Sahar Ahmed, Mustafa Hassan, Ghassan Bachuwa, Mohammed Al Qasmi, Deepak L Bhatt
Tenecteplase is a genetically mutated variant of alteplase with superior pharmacodynamic and pharmacokinetic properties. However, its efficacy and safety in acute ischemic strokes are limited. Hence, we conducted a study to evaluate the efficacy and safety of tenecteplase compared with alteplase in acute ischemic stroke. Electronic databases were searched for randomized clinical trials (RCTs) comparing tenecteplase with alteplase in acute ischemic stroke patients eligible for thrombolysis. We evaluated various efficacy and safety outcomes using random-effects models for both pairwise and Bayesian network meta-analyses along with meta-regression analyses...
August 16, 2018: Journal of Thrombosis and Thrombolysis
Panagiotis Karyofyllis, Dimitris Tsiapras, Varvara Papadopoulou, Michael D Diamantidis, Paraskevi Fotiou, Eftychia Demerouti, Vassilis Voudris
Pulmonary hypertension (PH), a serious disorder with a high morbidity and mortality rate, is known to occur in a number of unrelated systemic diseases. β-Thalassaemia, among other haematological disorders, develop PH which is not an infrequent finding and worsens the prognosis. Haemolysis, iron overload and hypercoagulable state are among the main pathogenetic mechanisms. Haemoglobinopathies and congenital haemolytic anaemia constitute a unique patients population more predisposed to developing chronic thromboembolic pulmonary hypertension (CTEPH)...
August 7, 2018: Journal of Thrombosis and Thrombolysis
Nijole Bernaitis, Tony Badrick, Andrew K Davey, Julia Crilly, Shailendra Anoopkumar-Dukie
Warfarin has long been the most widely prescribed oral anticoagulant. Introduction of non-vitamin K oral anticoagulants (NOACs) has provided anticoagulant options but also presented the potential challenge of transitioning between agents. Changes from NOACs to warfarin are particularly problematic with delays to therapeutic effect and limited real-world data regarding the impact on warfarin control. The aim of this study was to investigate the frequency of switching anticoagulants and the effect on warfarin control...
August 3, 2018: Journal of Thrombosis and Thrombolysis
Takanari Kitazono, Yasuo Ikeda, Masakatsu Nishikawa, Satoshi Yoshiba, Kenji Abe, Akira Ogawa
This randomized double-blind crossover study aimed to investigate the influence of cytochrome P450 (CYP) 2C19 polymorphisms on the antiplatelet effects of prasugrel in patients with non-cardioembolic stroke treated with clopidogrel. Patients received clopidogrel 75 mg/day for > 4 weeks. Subsequently, patients received prasugrel 3.75 mg/day (group A; n = 64) or 2.5 mg/day (group B; n = 65) for 4 weeks followed by a 4 week switched-dose regimen. To assess the influence of CYP2C19 polymorphisms, patients were classified as extensive metabolizers (EMs), intermediate metabolizers (IMs), and poor metabolizers (PMs)...
August 3, 2018: Journal of Thrombosis and Thrombolysis
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