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extended thromboprophylaxis

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https://www.readbyqxmd.com/read/28905172/n-terminal-pro-b-type-natriuretic-peptide-and-the-risk-of-stroke-among-patients-hospitalized-with-acute-heart-failure-an-apex-trial-substudy
#1
Gerald Chi, James L Januzzi, Serge Korjian, Yazan Daaboul, Samuel Z Goldhaber, Adrian F Hernandez, Russell D Hull, Alex Gold, Alexander T Cohen, Robert A Harrington, C Michael Gibson
BACKGROUND: Among patients hospitalized with acute heart failure (HF), the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in short-term stroke prediction remains unclear. METHODS: In the APEX trial, 7513 patients hospitalized for an acute medical illness were randomized to receive either extended-duration betrixaban (80 mg once daily for 35-42 days) or standard-of-care enoxaparin (40 mg once daily for 10 ± 4 days) for venous thromboprophylaxis...
September 13, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28846822/extended-pharmacologic-thromboprophylaxis-in-oncologic-liver-surgery-is-safe-and-effective
#2
Bradford J Kim, Ryan W Day, Catherine H Davis, Nisha Narula, Michael H Kroll, Ching-Wei D Tzeng, Thomas A Aloia
BACKGROUND: The incidence of venous thromboembolism remains high after liver surgery. OBJECTIVE: To evaluate the safety and efficacy of extended pharmacologic thromboprophylaxis in liver surgery for the prevention of venous thromboembolism (VTE). PATIENT/METHODS: From August 2013 to April 2015, 124 patients who underwent liver resection for malignancy were placed on an extended pharmacologic thromboprophylaxis protocol. Intraoperative VTE prophylaxis included Thrombo-Embolic Deterrent hose and sequential compression devices...
August 28, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28808888/has-time-come-for-the-use-of-direct-oral-anticoagulants-in-the-extended-prophylaxis-of-venous-thromboembolism-in-acutely-ill-medical-patients-yes
#3
Walter Ageno
Betrixaban is a direct factor Xa inhibitor with a renal excretion of only approximately 5-7%. On June 23rd 2017, it became the first direct oral anticoagulant to receive Food and Drug Administration approval for the prevention of venous thromboembolism in acutely ill medical patients, and the first anticoagulant agent to be approved for extended-duration thromboprophylaxis after hospital discharge in this setting. Approval followed the results of the APEX trial, a phase III clinical trial comparing betrixaban (80 mg) administered for 35-42 days with enoxaparin (40 mg) administered for 10 ± 4 days...
August 14, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28808782/thromboembolic-events-following-splenectomy-risk-factors-prevention-management-and-outcomes
#4
Amihai Rottenstreich, Geffen Kleinstern, Galia Spectre, Nael Da'as, Esther Ziv, Yosef Kalish
BACKGROUND: Thromboembolic events following splenectomy are not uncommon. However, the role of thromboprophylaxis and risk factors for thrombosis, as well as the clinical course and outcomes, are not well characterized. METHODS: A retrospective review of individuals who underwent splenectomy between January 2006 and December 2015 in two university hospitals. RESULTS: Overall, 297 patients underwent splenectomy [open splenectomy (n = 199), laparoscopic splenectomy (n = 98)]...
August 14, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28762617/effect-of-extended-duration-thromboprophylaxis-on-venous-thromboembolism-and-major-bleeding-among-acutely-ill-hospitalized-medical-patients-a-bivariate-analysis
#5
Gerald Chi, Samuel Z Goldhaber, John M Kittelson, Alexander G G Turpie, Adrian F Hernandez, Russell D Hull, Alex Gold, John T Curnutte, Alexander T Cohen, Robert A Harrington, C Michael Gibson
BACKGROUND: Among acutely ill hospitalized medical patients, extended-duration thromboprophylaxis reduces venous thromboembolism (VTE), but some pharmacologic strategies have been associated with greater risks of major bleeding, thereby offsetting the net clinical benefit (NCB). METHODS: To assess the risk-benefit profile of anticoagulation regimens, a previously described bivariate method that does not assume a linear risk-benefit tradeoff and can accommodate different margins for efficacy and safety was performed to simultaneously assess efficacy (symptomatic VTE) and safety (major bleeding) based on data from four randomized controlled trials of extended-duration (30 to 46 days) versus standard-duration (6 to 14 days) thromboprophylaxis among 28,227 patients (EXCLAIM, ADOPT, MAGELLAN, and APEX trials)...
August 1, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28761749/antithrombotic-therapy-for-prophylaxis-and-treatment-of-venous-thromboembolism-in-patients-with-cancer-review-of-the-literature-on-current-practice-and-emerging-options
#6
REVIEW
Cihan Ay, Pieter Willem Kamphuisen, Giancarlo Agnelli
The treatment of cancer-associated venous thromboembolism (VTE) is difficult because cancer patients with VTE on anticoagulation are at an increased risk of bleeding compared with patients without VTE. This review summarises the evidence supporting the current standard of care and emerging treatment options. In difficult-to-treat subpopulations, where clinical data are often lacking, this review also provides the best clinical practice strategies based on the available data. The use of therapeutic doses of parenteral anticoagulants in patients with cancer-associated VTE for at least 3 to 6 months is supported by the current clinical data...
2017: ESMO Open
https://www.readbyqxmd.com/read/28737553/complications-after-body-contouring-surgery-in-postbariatric-patients
#7
Alejandra García Botero, Miguel García Wenninger, Dario Fernández Loaiza
INTRODUCTION: Over recent years, body contouring procedures in postbariatric patients have been in exponentially growing demand resulting in high complication rates rendering a variety of ciphers in the literature. OBJECTIVE: The purpose of this study is to determine the complication rate in patients who have undergone body contouring surgery after bariatric surgery between June 2012 and March 2015 at Hospital de San José. METHODS: A cohort study including 153 individuals who underwent a total of 198 body contouring procedures after massive weight loss following bariatric surgery was conducted...
July 22, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28650573/factors-associated-with-thromboembolic-events-following-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#8
Amihai Rottenstreich, Yosef Kalish, Geffen Kleinstern, Almog Ben Yaacov, Joseph Dux, Aviram Nissan
BACKGROUND AND OBJECTIVES: We investigated the risk factors, incidence, and role of thromboprophylaxis in the development of thrombosis following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). METHODS: We reviewed data of patients with CRS/HIPEC in three hospitals. RESULTS: Overall, 192 patients underwent CRS/HIPEC during 2007-2016. Mechanical (thigh-length pneumatic compression stockings) and pharmacologic thromboprophylaxis (40 mg enoxaparin daily, starting 12 h before surgery until discharge) was provided for all patients; and 116 (60...
June 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28640324/new-paradigms-in-venous-thromboprophylaxis-of-medically-ill-patients
#9
Alex C Spyropoulos, Gary E Raskob
Acutelly-ill hospitalised medical patients are at risk of venous thromboembolism (VTE), both in-hospital and in the immediate post-discharge period, and mortality from VTE is thought to be particularly high in this patient population. However, despite previous mandates from international antithrombotic guidelines such as those of the American College of Chest Physicians (ACCP) for the "universal" use of thromboprophylaxis in hospitalised medical patients, global audits suggest that implementation of thromboprophylaxis continues to be challenging because of the perceived higher risk of bleeding and lower risk of VTE than that reported in clinical trials...
August 30, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28617144/the-risk-of-stroke-among-acutely-ill-hospitalized-medical-patients-lessons-from-recent-trials-on-extended-duration-thromboprophylaxis
#10
Jolanta Marszalek, Sara Mehrsefat, Gerald Chi
Data from recent randomized controlled trials indicate that the incidence of stroke among acutely ill medical patients is unexpectedly high and approximates 1% at 90 days. Preliminary data suggest that betrixaban may reduce ischemic stroke in patients without atrial fibrillation. There is an unmet demand for stroke risk stratification schemes targeting hospitalized medical patients. The prognostic value of biomarkers such as natriuretic peptides and D-dimer in predicting short-term stroke remains uncertain...
June 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28579855/thromboprophylaxis-with-apixaban-in-patients-undergoing-major-orthopedic-surgery-meta-analysis-and-trial-sequential-analysis
#11
REVIEW
Daniel Caldeira, Filipe B Rodrigues, Fausto J Pinto, Joaquim J Ferreira, João Costa
BACKGROUND: Venous thromboembolism (VTE) is a potentially fatal complication of orthopedic surgery, and until recently, few antithrombotic compounds were available for postoperative thromboprophylaxis. The introduction of the non-vitamin K antagonists oral anticoagulants (NOAC), including apixaban, has extended the therapeutic armamentarium in this field. Therefore, estimation of NOAC net clinical benefit in comparison with the established treatment is needed to inform clinical decision making...
2017: Clinical Medicine Insights. Blood Disorders
https://www.readbyqxmd.com/read/28479450/perception-of-chemical-venous-thromboprophylaxis-for-oncologic-lung-resections-among-thoracic-surgeons
#12
Rafael D Malgor, Thomas V Bilfinger, John Blebea, Harry Ma, Shirliejean R Arnold
BACKGROUND: Controversies on chemical venous thromboembolic (VTE) prophylaxis in patients undergoing lung resection for malignancy exist. The available guidelines on VTE do not specifically address its prophylaxis in patients undergoing oncologic lung resections. The goal of this survey was to evaluate the perception of VTE prophylaxis among thoracic surgeons performing these operations. METHODS: A self-reported online survey was distributed to 267 active members of the General Thoracic Surgical Club between July and September 2015...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28342641/procedure-specific-risks-of-thrombosis-and-bleeding-in-urological-cancer-surgery-systematic-review-and-meta-analysis
#13
REVIEW
Kari A O Tikkinen, Samantha Craigie, Arnav Agarwal, Philippe D Violette, Giacomo Novara, Rufus Cartwright, Richard Naspro, Reed A C Siemieniuk, Bassel Ali, Leyla Eryuzlu, Johanna Geraci, Judi Winkup, Daniel Yoo, Michael K Gould, Per Morten Sandset, Gordon H Guyatt
CONTEXT: Pharmacological thromboprophylaxis involves balancing a lower risk of venous thromboembolism (VTE) against a higher risk of bleeding, a trade-off that critically depends on the risks of VTE and bleeding in the absence of prophylaxis (baseline risk). OBJECTIVE: To provide estimates of the baseline risk of symptomatic VTE and bleeding requiring reoperation in urological cancer surgery. EVIDENCE ACQUISITION: We identified contemporary observational studies reporting symptomatic VTE or bleeding after urological procedures...
March 23, 2017: European Urology
https://www.readbyqxmd.com/read/28284738/procedure-specific-risks-of-thrombosis-and-bleeding-in-urological-non-cancer-surgery-systematic-review-and-meta-analysis
#14
REVIEW
Kari A O Tikkinen, Samantha Craigie, Arnav Agarwal, Reed A C Siemieniuk, Rufus Cartwright, Philippe D Violette, Giacomo Novara, Richard Naspro, Chika Agbassi, Bassel Ali, Maha Imam, Nofisat Ismaila, Denise Kam, Michael K Gould, Per Morten Sandset, Gordon H Guyatt
CONTEXT: Pharmacological thromboprophylaxis involves a trade-off between a reduction in venous thromboembolism (VTE) and increased bleeding. No guidance specific for procedure and patient factors exists in urology. OBJECTIVE: To inform estimates of absolute risk of symptomatic VTE and bleeding requiring reoperation in urological non-cancer surgery. EVIDENCE ACQUISITION: We searched for contemporary observational studies and estimated the risk of symptomatic VTE or bleeding requiring reoperation in the 4 wk after urological surgery...
March 9, 2017: European Urology
https://www.readbyqxmd.com/read/28267480/the-safety-and-efficacy-of-full-versus-reduced-dose-betrixaban-in-the-acute-medically-ill-vte-venous-thromboembolism-prevention-with-extended-duration-betrixaban-apex-trial
#15
RANDOMIZED CONTROLLED TRIAL
C Michael Gibson, Rim Halaby, Serge Korjian, Yazan Daaboul, Douglas F Arbetter, Megan K Yee, Samuel Z Goldhaber, Russel Hull, Adrian F Hernandez, Shiao-Ping Lu, Olga Bandman, Janet M Leeds, Alex Gold, Robert A Harrington, Alexander T Cohen
BACKGROUND: The APEX trial assessed the safety and efficacy of extended-duration thromboprophylaxis using betrixaban versus standard dosing of enoxaparin among hospitalized, acutely ill medical patients. The 80-mg betrixaban dose was halved to 40 mg among subjects with severe renal insufficiency and those receiving a concomitant strong P-glycoprotein inhibitor. METHODS: This analysis assessed the pharmacokinetics, efficacy, and safety of full- (80 mg) and reduced-dose (40 mg) betrixaban relative to enoxaparin in the APEX trial...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28243988/fotrocan-delphi-consensus-statement-regarding-the-prevention-and-treatment-of-cancer-associated-thrombosis-in-areas-of-uncertainty-and-low-quality-of-evidence
#16
P Jimenez-Fonseca, A Carmona-Bayonas, C Calderon, J Fontcuberta Boj, C Font, R Lecumberri, M Monreal, A J Muñoz Martín, R Otero, A Rubio, P Ruiz-Artacho, C Suarez Fernández, E Colome, P Pérez Segura
INTRODUCTION: Decision-making in cancer-related venous thromboembolism (VTE) is often founded on scant lines of evidence and weak recommendations. The aim of this work is to evaluate the percentage of agreement surrounding a series of statements about complex, clinically relevant, and highly uncertain aspects to formulate explicit action guidelines. MATERIALS AND METHODS: Opinions were based on a structured questionnaire with appropriate scores and were agreed upon using a Delphi method...
August 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28203409/practice-patterns-in-venous-thromboembolism-vte-prophylaxis-in-thoracic-surgery-a-comprehensive-canadian-delphi-survey
#17
John Agzarian, Lori-Ann Linkins, Laura Schneider, Waël C Hanna, Christian J Finley, Colin Schieman, Marc De Perrot, Mark Crowther, James Douketis, Yaron Shargall
BACKGROUND: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. METHODS: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28197755/direct-oral-anticoagulants-for-extended-duration-thromboprophylaxis-in-hospitalized-medically-ill-patients-are-we-there-yet
#18
Majed S Al Yami, Osamah M Alfayez, Sawsan M Kurdi, Razan Alsheikh
Despite a recommended 7-10 days of thromboprophylaxis, medically ill patients remain at increased risk of developing venous thromboembolism (VTE) after hospital discharge. Here, we present a contemporary review on the efficacy and safety of extended-duration thromboprophylaxis with direct oral anticoagulants (DOACs) in hospitalized medically ill patients. A search of publication and trial databases of controlled trials conducted from 2010 to 2016 using the key terms apixaban, rivaroxaban, and betrixaban showed three phase III trials that met our search criteria...
February 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28152776/utilization-and-effectiveness-of-extended-duration-thromboprophylaxis-after-high-risk-abdominopelvic-cancer-surgery
#19
Ling Chen, Soledad Jorge, William M Burke, Ana Tergas, June Hou, Jim Hu, Alfred I Neugut, Cande Ananth, Dawn L Hershman
62 Background: Extended-duration thromboprophylaxis for 4 weeks after discharge has been demonstrated to reduce venous thromboembolic events (VTE) in cancer patients undergoing abdominopelvic surgery and is recommended in national guidelines. We examined the utilization and effectiveness of extended-duration low molecular weight heparin prophylaxis in high-risk cancer patients after surgery. METHODS: We analyzed patients with colon, ovarian, and uterine cancer who underwent surgery from 2009-2013 and who were recorded in the MarketScan database...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28078350/efficacy-and-safety-of-extended-thromboprophylaxis-for-medically-ill-patients-a-meta-analysis-of-randomised-controlled-trials
#20
Francesco Dentali, Nicola Mumoli, Domenico Prisco, Andrea Fontanella, Matteo Nicola Dario Di Minno
Compelling evidence suggests that the risk of pulmonary embolism (PE) and deep-vein thrombosis (DVT) persists after hospital discharge in acutely-ill medical patients. However, no studies consistently supported the routine use of extended-duration thromboprophylaxis (ET) in this setting. We performed a meta-analysis to assess efficacy and safety of ET in acutely-ill medical patients. Efficacy outcome was defined by the prevention of symptomatic DVT, PE, venous thromboembolism (VTE) and VTE-related mortality...
February 28, 2017: Thrombosis and Haemostasis
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