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https://www.readbyqxmd.com/read/28215696/recurrent-venous-thrombosis-under-rivaroxaban-and-carbamazepine-for-symptomatic-epilepsy
#1
Claudia Stöllberger, Josef Finsterer
BACKGROUND: The direct oral anticoagulant (DOAC) rivaroxaban, an oral Factor Xa inhibitor, is increasingly used as an alternative to vitamin-K-antagonists (VKAs). Absorption and elimination of DOACs are dependent on the permeability glycoprotein (P-gp) efflux transporter protein system, and DOACs are substrates of the hepatic cytochrome P 450 3A4 (CYP3A4) enzymes. Therefore, drug-interactions may occur when DOACs are administered with drugs affecting the activity of P-gp or CYP3A4 systems...
February 3, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28196509/point-of-care-testing-for-emergency-assessment-of-coagulation-in-patients-treated-with-direct-oral-anticoagulants
#2
Matthias Ebner, Ingvild Birschmann, Andreas Peter, Charlotte Spencer, Florian Härtig, Joachim Kuhn, Gunnar Blumenstock, Christine S Zuern, Ulf Ziemann, Sven Poli
BACKGROUND: Point-of-care testing (POCT) of coagulation has been proven to be of great value in accelerating emergency treatment. Specific POCT for direct oral anticoagulants (DOAC) is not available, but the effects of DOAC on established POCT have been described. We aimed to determine the diagnostic accuracy of Hemochron® Signature coagulation POCT to qualitatively rule out relevant concentrations of apixaban, rivaroxaban, and dabigatran in real-life patients. METHODS: We enrolled 68 patients receiving apixaban, rivaroxaban, or dabigatran and obtained blood samples at six pre-specified time points...
February 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28170419/determination-of-rivaroxaban-in-patient-s-plasma-samples-by-anti-xa-chromogenic-test-associated-to-high-performance-liquid-chromatography-tandem-mass-spectrometry-hplc-ms-ms
#3
Priscilla Bento Matos Derogis, Livia Rentas Sanches, Valdir Fernandes de Aranda, Marjorie Paris Colombini, Cristóvão Luis Pitangueira Mangueira, Marcelo Katz, Adriana Caschera Leme Faulhaber, Claudio Ernesto Albers Mendes, Carlos Eduardo Dos Santos Ferreira, Carolina Nunes França, João Carlos de Campos Guerra
Rivaroxaban is an oral direct factor Xa inhibitor, therapeutically indicated in the treatment of thromboembolic diseases. As other new oral anticoagulants, routine monitoring of rivaroxaban is not necessary, but important in some clinical circumstances. In our study a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was validated to measure rivaroxaban plasmatic concentration. Our method used a simple sample preparation, protein precipitation, and a fast chromatographic run...
2017: PloS One
https://www.readbyqxmd.com/read/28147712/evaluation-of-the-anticoagulant-potential-of-polysaccharide-rich-fractions-extracted-from-macroalgae
#4
Amandine Adrien, Delphine Dufour, Stanislas Baudouin, Thierry Maugard, Nicolas Bridiau
The aim of this study was to evaluate the potential anticoagulant activity of sulphated polysaccharide-containing extracts of six french edible marine macroalgae. Aqueous extracts of brown (Himanthalia elongata, Laminaria digitata, Ascophyllum nodosum, Fucus vesiculosus), green (Ulva lactuca) and red (Chondrus crispus) macroalgae were prepared and their biochemical properties were determined, including major biomolecules, sulphate and ash contents. The anticoagulant activity of each extract was investigated using different scales from the specific antithrombin-dependent pathway (anti-Xa and anti-IIa) to the intrinsic and/or common (Activated Partial Thromboplastin Time, APTT), extrinsic (Prothrombin Time, PT) or common (Thrombin Time, TT) anticoagulant pathways, and compared with those of commercial anticoagulants, heparin and Lovenox®...
February 1, 2017: Natural Product Research
https://www.readbyqxmd.com/read/28108019/goal-directed-enoxaparin-dosing-provides-superior-chemoprophylaxis-against-deep-vein-thrombosis
#5
Tammy R Kopelman, Jarvis W Walters, James N Bogert, Usmaan Basharat, Paola G Pieri, Karole M Davis, Asia N Quan, Sydney J Vail, Melissa A Pressman
INTRODUCTION: Optimal enoxaparin dosing for deep venous thrombosis (DVT) prophylaxis remains elusive. Prior research demonstrated that trauma patients at increased risk for DVT based upon Greenfield's risk assessment profile (RAP) have DVT rates of 10.8% despite prophylaxis. The aim of this study was to determine if goal directed prophylactic enoxaparin dosing to achieve anti-Xa levels of 0.3-0.5IU/ml would decrease DVT rates without increased complications. MATERIALS AND METHODS: Retrospective review of trauma patients having received prophylactic enoxaparin and appropriately timed anti-Xa levels was performed...
November 3, 2016: Injury
https://www.readbyqxmd.com/read/28062209/thromboelastogram-does-not-detect-pre-injury-anticoagulation-in-acute-trauma-patients
#6
Jawad T Ali, Mitchell J Daley, Nina Vadiei, Zachary Enright, Joseph Nguyen, Sadia Ali, Jayson D Aydelotte, Pedro G Teixeira, Thomas B Coopwood, Carlos Vr Brown
PURPOSE: Thromboelastography (TEG) has been recommended to characterize post-traumatic coagulopathy, yet no study has evaluated the impact of pre-injury anticoagulation (AC) on TEG variables. We hypothesized patients on pre-injury AC have a greater incidence of coagulopathy on TEG compared to those without AC. METHODS: This retrospective chart review evaluated all trauma patients admitted to an urban, level one trauma center from February 2011 to September 2014 who received a TEG within the first 24h...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28060970/-evaluation-of-oral-anticoagulation-with-rivaroxaban-in-patients-with-new-onset-non-valvular-atrial-fibrillation
#7
Víctor Neira, Ramón Corbalán, Jaime Pereira, Olga Panes, Bernardita Garayar, Andrés Aizman, Silvana Llevaneras, Luis Villarroel
BACKGROUND: Atrial fibrillation (AF) generates a hypercoagulable state with an increased thrombin generation and raised levels of thrombin-antithrombin complexes, which results in a high risk of stroke and thromboembolism. AIM: To evaluate the anticoagulant effect of rivaroxaban by anti-Xa factor activity and its correlation with thrombin-antithrombin complexes, thrombin generation and prothrombin time in patients newly diagnosed with non-valvular AF. PATIENTS AND METHODS: Prospective study in patients with indication of anticoagulation...
September 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28052451/a-clinical-study-on-low-molecular-weight-heparin-infusion-as-anticoagulation-for-nocturnal-home-haemodialysis
#8
Steve Siu-Man Wong, Wai-Yan Lau, Man-Luen Ng, Shuk-Yin Chan, So-Fan Chan, Ping-Kwan Chan, Ching-Kit Wan, Yuk-Lun Cheng
AIM: This study was conducted to evaluate low-molecular weight heparin (LMWH) as anticoagulation for nocturnal home haemodialysis (NHHD). Whilst its longer half-life may cause drug accumulation in frequent dialysis, the essential need of a supplementary intra-dialytic bolus for the sleeping patients also renders LMWH's use impractical. METHODS: The recruited patients, who were on alternate-day 8-hour haemodialysis, were randomized to receive either nadroparin or unfractionated heparin (UFH) for a week...
January 4, 2017: Nephrology
https://www.readbyqxmd.com/read/28043992/direct-oral-anticoagulants-and-heparins-laboratory-values-and-pitfalls-in-bridging-therapy
#9
Thomas Eller, Tobias Flieder, Vanessa Fox, Tatjana Gripp, Marcus Dittrich, Joachim Kuhn, Susanne Alban, Cornelius Knabbe, Ingvild Birschmann
OBJECTIVES: The three direct oral anticoagulants (DOACs) dabigatran, apixaban and rivaroxaban are now widely used in clinical practice. For patients requiring perioperative interruption of DOACs, heparin bridging is still under discussion. Here we show, for the first time, the influence of concomitantly used DOACs and heparins on laboratory assays. METHODS: For spiking experiments, 10 healthy donors and nine patients treated with DOACs were investigated. The measurement of DOACs and heparins was performed with routine methods on the ACL TOP [HEMOCLOT(®) direct thrombin inhibitor (CoaChrom Diagnostica, Austria), COAMATIC(®) Heparin (Chromogenix, USA) calibrated with rivaroxaban, apixaban, unfractionated heparin (UFH) and low molecular weight heparin (LMWH), additionally PT reagent RecombiPlasTin 2G and aPTT reagent SynthASil (Instrumentation Laboratory, Germany)] and the DOACs were additionally quantified with liquid chromatography-mass spectrometry...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28017463/monitoring-of-anti-xa-activity-and-factors-related-to-bleeding-events-a-study-in-japanese-patients-with-nonvalvular-atrial-fibrillation-receiving-rivaroxaban
#10
Teruhiro Sakaguchi, Hiroyuki Osanai, Yosuke Murase, Hideki Ishii, Yoshihito Nakashima, Hiroshi Asano, Susumu Suzuki, Mikito Takefuji, Yasuya Inden, Kazuyoshi Sakai, Toyoaki Murohara, Masayoshi Ajioka
BACKGROUND: Anti-Xa activity (AXA) in patients with nonvalvular atrial fibrillation (NVAF) and relationship to bleeding events remains unclear. METHODS: We evaluated AXA in 94 patients at both trough and peak rivaroxaban concentrations. Rivaroxaban dosage was determined according to creatinine clearance (CrCl): 10 and 15mg once daily for patients with CrCl 15-49 and CrCl ≥50mL/min, respectively. AXA value distribution and its association with bleeding events were examined in enrolled subjects...
December 22, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27987359/effects-of-apixaban-on-prothrombin-time-activated-partial-thromboplastin-time-and-anti-xa-assays-a-european-survey
#11
Tuukka A Helin, Anja Pakkanen, Riitta Lassila, Lotta Joutsi-Korhonen
No abstract text is available yet for this article.
December 17, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27983747/laboratory-and-clinical-monitoring-of-direct-acting-oral-anticoagulants-what-clinicians-need-to-know
#12
Susan E Conway, Andrew Y Hwang, Charles D Ponte, John G Gums
The direct acting oral anticoagulants (DOACs), including dabigatran, rivaroxaban, apixaban, and edoxaban, have favorable pharmacokinetic and pharmacodynamic properties and equal or superior efficacy and an improved safety profile compared with warfarin. Noted shortcomings with DOACs are shorter half-lives requiring stricter adherence, lack of standardized laboratory monitoring, lack of anticoagulation reversal agents, and loss of routine coagulation monitoring leading to fewer patient-clinician interactions...
December 16, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27982558/optimal-duration-of-anticoagulation-in-patients-with-unprovoked-venous-thromboembolism-the-impact-of-the-novel-anticoagulants
#13
Paolo Prandoni, Marta Milan, Lucia Sarolo, Ezio Zanon, Franca Bilora
Once anticoagulation is stopped, the risk of recurrent venous thromboembolism (VTE) over years approaches 50% of all patients with a first episode of unprovoked VTE. The persistence of residual vein thrombosis at ultrasound assessment has consistently been shown to increase the risk, as do persistently high values of D-Dimer. Although the latest international guidelines suggest indefinite anticoagulation for most patients with the first episode of unprovoked VTE, strategies that incorporate the assessment of residual vein thrombosis and D-dimer have the potential to identify a substantial proportion of subjects in whom anticoagulation can be safely discontinued...
December 16, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27919873/managing-transitions-from-oral-factor-xa-inhibitors-to-unfractionated-heparin-infusions
#14
Andrew C Faust, Dave Kanyer, Ann K Wittkowsky
PURPOSE: Published evidence regarding the effects of oral factor Xa inhibitors on anticoagulation monitoring tests is reviewed with a focus on monitoring concerns that can arise during transitions to i.v. heparin therapy. SUMMARY: Assays that measure inhibition of factor Xa activity (i.e., anti-Xa assays) are widely used in U.S. institutions to monitor i.v. heparin therapy and, in some cases, for monitoring other types of anticoagulation therapy. Clinicians have raised concerns that the use of anti-Xa assays to monitor heparin levels in hospitalized patients who must be transitioned from oral factor Xa inhibitor therapy to i...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27913536/reversal-of-direct-oral-anticoagulants-a-practical-approach
#15
Andrew W Shih, Mark A Crowther
Direct oral anticoagulants (DOACs) have at least noninferior efficacy compared with other oral anticoagulants and have ancillary benefits, including overall better safety profiles, lack of the need for routine monitoring, rapid onset of action, and ease of administration. Reversal of these agents may be indicated in certain situations such as severe bleeding and for perioperative management. DOAC-associated bleeding should be risk stratified: patients with moderate or severe bleeding should have the DOAC discontinued and reversal strategies should be considered...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913481/anti-xa-monitoring-of-low-molecular-weight-heparin-in-adult-patients-with-cancer
#16
Lisa Baumann Kreuziger, Michael Streiff
A 68-year-old man developed a right femoral vein deep vein thrombosis and bilateral pulmonary embolism while receiving chemotherapy for stage IV prostate cancer. His creatinine at diagnosis is 1.4 mg/dL, with an estimated clearance of 63 mL/min. In patients with cancer, should low-molecular-weight heparin treatment be dosed according to weight, or adjusted using anti-Xa levels?
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27887785/thromboelastography-teg%C3%A2-demonstrates-that-tinzaparin-4500-international-units-has-no-detectable-anticoagulant-activity-after-caesarean-section
#17
S Griffiths, C Woo, V Mansoubi, A Riccoboni, A Sabharwal, S Napier, M Columb, M Laffan, G Stocks
BACKGROUND: Low molecular weight heparin is routinely used for thromboprophylaxis in pregnancy and the puerperium. Consensus guidelines recommend waiting 10-12h after administration of a thromboprophylactic dose of low molecular weight heparin before performing a neuraxial block or removing an epidural catheter. Thromboelastography (TEG®) has been reported to be sensitive to the effects of enoxaparin 4h after administration. The purpose of this study was to use TEG to examine coagulation changes in the first 10h after a thromboprophylactic dose of tinzaparin in an attempt to ratify the current consensus guidelines about timing of neuraxial blockade and epidural catheter removal...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27861430/the-use-of-recombinant-antithrombin-iii-in-pediatric-and-neonatal-ecmo-patients
#18
Deanna R Todd Tzanetos, John Myers, Terri Wells, Dan Stewart, Jeffrey J Fanning, Janice E Sullivan
A retrospective review of 77 pediatric and neonatal extracorporeal membranous oxygenation (ECMO) patients who received recombinant antithrombin III (ATIII) for ATIII activity greater than 80% was conducted. Anticoagulation management was per institutional protocol. An ATIII activity greater than 80% was targeted. Diagnosis, reason for ECMO cannulation, blood product usage, heparin dosing, ATIII activity and doses, thrombotic and bleeding complications, hours on ECMO, and mortality were recorded. We calculated patient-level summary statistics and assessed differences between groups using χ tests (categorical variables) and Wilcoxon rank sum tests (continuous variables)...
January 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27856667/protocolled-redefinition-of-the-therapeutic-range-for-unfractionated-heparin-lost-in-translation
#19
Karlien L M Coene, Fedde van der Graaf, Daan van de Kerkhof
BACKGROUND: Protocolled treatment with unfractionated heparin (UFH) is a subject of ongoing debate. Even though international guidelines prescribe calibration of the activated partial thromboplastin time (aPTT) to 0.3 to 0.7 U/mL anti-Xa activity to establish an UFH therapeutic range, evidence for this approach remains scarce. In this study, we evaluated different strategies to delineate the UFH therapeutic range and analyzed the effects on patient therapeutic classification. METHODS: In 109 patient samples, the aPTT was measured with 2 different reagents, both of which used mechanical clot detection...
November 16, 2016: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/27850894/1258-thromboprophylaxis-using-anti-xa-levels-in-obese-critically-ill-patients-a-retrospective-study
#20
Joaquin Cagliani, Kosuma Nio, Wenchen Wu, Candace Smith, Jayoung Park, Horacio Rilo, Jeffrey Nicastro, Rafael Barrera
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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