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https://www.readbyqxmd.com/read/29768983/anticoagulation-monitoring-under-ecmo-support-a-comparative-study-between-the-activated-coagulation-time-and-the-anti-xa-activity-assay
#1
Clément Delmas, Aemilia Jacquemin, Fanny Vardon-Bounes, Bernard Georges, Felipe Guerrero, Nicolas Hernandez, Bertrand Marcheix, Thierry Seguin, Vincent Minville, Jean-Marie Conil, Stein Silva
PURPOSE: Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)-a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29752330/a-small-step-closer-but-not-yet-there-oral-anti-xa-agents-and-the-treatment-of-cancer-associated-venous-thromboembolism
#2
Andrew D Leavitt
No abstract text is available yet for this article.
May 2018: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/29746314/impact-of-anticoagulation-and-circuit-technology-on-complications-during-extracorporeal-membrane-oxygenation
#3
Robert A Niebler, Hinah Parker, George M Hoffman
The objective of this study is to evaluate the impact a change in anticoagulation protocol and circuit technology had on bleeding and thrombotic complications in patients supported on extracorporeal membrane oxygenation (ECMO). A retrospective review at a tertiary, academic pediatric intensive care unit was undertaken. The anticoagulation protocol changed from targeting an activated clotting time (ACT) to anti-Xa level. Significant changes in the ECMO circuit were undertaken concurrently. One-hundred and fifty-two ECMO runs in 129 patients in the ACT target group were compared with 122 ECMO runs in 101 patients in the anti-Xa target group...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29718586/measurement-of-rivaroxaban-concentrations-demonstrates-lack-of-clinical-utility-of-a-pt-dpt-and-aptt-test-in-estimating-levels
#4
I Thom, G Cameron, D Robertson, H G Watson
INTRODUCTION: Rivaroxaban concentrations were measured in 127 inpatient samples using an HPLC-MS/MS assay. METHODS: We compared this measurement with a calibrated anti-Xa assay and performed PT, aPTT and dilute PT tests to assess the value of clot-based assays in clinical decision-making. RESULTS: The correlation between the anti-Xa assay and the HPLC-MS/MS at therapeutic concentrations was strong (R2  = 0.98). The PT, RecombiPlasTin 2G, and aPTT, Actin FS, showed a linear dose-response but poor correlation (R2  = 0...
May 2, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29709361/partial-thromboplastin-time-is-more-predictive-of-bleeding-than-anti-xa-levels-in-heparinized-pediatric-patients-after-cardiac-surgery
#5
Olubunmi O Oladunjoye, Lynn A Sleeper, Asha G Nair, Cameron C Trenor, Christina VanderPluym, John N Kheir, Sitaram M Emani
OBJECTIVES: Anticoagulation with unfractionated heparin (UFH) after pediatric cardiac surgery can be monitored using either activated partial thromboplastin time (aPTT) or anti-factor Xa activity (anti-Xa). However, correlation of bleeding with either of these laboratory values has not been established. We sought to determine the correlation between bleeding events and aPTT and anti-Xa in patients who undergo anticoagulation after congenital heart surgery. METHODS: We prospectively studied pediatric patients treated with UFH after cardiac surgery over an 11-month period...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29708890/antithrombotic-drugs-in-cardiovascular-medicine-a-year-in-review
#6
Homam Ibrahim, Matthew Rondina, Frederick G P Welt
PURPOSE OF REVIEW: To provide an up to date review of the most recent randomized clinical trials in the field of antithrombotic drugs for cardiovascular diseases. RECENT FINDINGS: In 2017, low-dose anti-Xa treatment added to aspirin proved to be more efficacious than either treatment alone in patients with stable atherosclerotic disease despite the increase in nonfatal bleeding events. Furthermore, anticoagulation strategy during coronary interventions was again tested in a registry-based trial and showed comparable efficacy and safety between heparin alone and bivalirudin...
April 27, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29696409/valvular-heart-disease-and-pregnancy
#7
REVIEW
Emily S Lau, Nandita S Scott
With improving reproductive assistive technologies, advancing maternal age, and improved survival of patients with congenital heart disease, valvular heart disease has become an important cause of morbidity and mortality in pregnant women. In general, stenotic lesions, even those in the moderate range, are poorly tolerated in the face of hemodynamic changes of pregnancy. Regurgitant lesions, however, fare better due to the physiologic afterload reduction that occurs. Intervention on regurgitant valve preconception follows the same principles as a non-pregnant population...
April 26, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29669995/pharmacokinetic-and-tissue-distribution-of-fucoidan-from-fucus-vesiculosus-after-oral-administration-to-rats
#8
Olga N Pozharitskaya, Alexander N Shikov, Natalya M Faustova, Ekaterina D Obluchinskaya, Vera M Kosman, Heikki Vuorela, Valery G Makarov
Fucus vesiculosus L., known as bladderwrack, belongs to the brown seaweeds, which are widely distributed throughout northern Russia, Atlantic shores of Europe, the Baltic Sea, Greenland, the Azores, the Canary Islands, and shores of the Pacific Ocean. Fucoidan is a major fucose-rich sulfated polysaccharide found in Fucus ( F. ) vesiculosus . The pharmacokinetic profiling of active compounds is essential for drug development and approval. The aim of the study was to evaluate the pharmacokinetics and tissue distribution of fucoidan in rats after a single-dose oral administration...
April 18, 2018: Marine Drugs
https://www.readbyqxmd.com/read/29623883/evaluation-of-the-coagulometer-sta-r-max-%C3%A2-stago-for-routine-coagulation-parameters
#9
Justine Brulé, Thomas Sinegre, Bruno Pereira, Marc G Berger, Anne-Françoise Serre-Sapin, Aurélien Lebreton
The STA R Max® is a fully automated multiparameter coagulometer using clotting (viscosity-based detection system), chromogenic and immunologic assays. STA R Max® is equipped with an innovative software (STA Coag Expert® ) designed to assist laboratory in accreditation. The aim of this study was to evaluate its performances for the certification according to ISO 15189 quality standard in the haemostasis unit of our university hospital. The following tests were evaluated: prothrombin time (PT), activated partial thromboplastin time (aPTT), kaolin cephalin clotting time (KCCT), fibrinogen, anti-Xa assay and D-dimers...
April 1, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29614520/risk-factors-for-higher-than-expected-residual-rivaroxaban-plasma-concentrations-in-real-life-patients
#10
Alexander Kaserer, Andreas Schedler, Alexander Jetter, Burkhardt Seifert, Donat R Spahn, Philipp Stein, Jan-Dirk Studt
INTRODUCTION:  Rivaroxaban (RXA) is a direct oral factor Xa (Xa) antagonist with a short half-life and a fast onset and offset of effect. Before elective surgery, discontinuation is recommended with an interval of at least > 24 hours. In clinical practice, this is, however, not always sufficient to achieve a residual RXA plasma concentration deemed appropriate for surgery, defined as ≤ 50 mcg/L. Our study aimed at identifying factors associated with a higher-than-expected residual RXA plasma concentration in a large group of real-life patients...
April 3, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29592538/enoxaparin-dosing-at-extremes-of-weight-literature-review-and-dosing-recommendations
#11
Jamie Sebaaly, Kelly Covert
OBJECTIVE: To review the literature on both thromboprophylaxis and treatment of venous thromboembolism (VTE) with enoxaparin in low- and high-body-weight patients and to make dosing and monitoring recommendations in these patient populations. DATA SOURCES: A search using PubMed was conducted (1995 to January 2018) using the following key words: enoxaparin, body weight, AND thromboprophylaxis, or AND treatment. Additional references were identified from a review of citations...
March 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29571622/comparison-between-activated-clotting-time-and-anti-activated-factor-x-activity-for-the-monitoring-of-unfractionated-heparin-therapy-in-patients-with-aortic-aneurysm-undergoing-an-endovascular-procedure
#12
Benjamin Dieplinger, Margot Egger, Christian Luft, Franz Hinterreiter, Thomas Pernerstorfer, Meinhard Haltmayer, Thomas Mueller
OBJECTIVE: Current guidelines recommend administration of unfractionated heparin (UFH) and measurement of activated clotting time (ACT) during endovascular procedures. The aim of this study was to compare ACT and anti-activated factor X (anti-Xa) measurements for monitoring of UFH therapy during an aortic endograft procedure and to assess the association of peak ACT and peak anti-Xa activity with periprocedural bleeding. METHODS: We retrospectively studied 104 patients with aortic aneurysm undergoing endovascular procedures with repeated coagulation measurements...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29566413/rivaroxaban-a-new-treatment-paradigm-in-the-setting-of-vascular-protection
#13
Rupert Bauersachs, Faiez Zannad
The pathophysiology of atherosclerosis involves a diseased endothelium, lipid accumulation and low-grade inflammation. In later stages of coronary artery disease (CAD) and peripheral arterial disease (PAD), plaque rupture may induce atherothrombosis caused by fibrin formation and platelet activation, leading to vessel occlusion with subsequent organ damage such as myocardial infarction, stroke or limb ischaemia. Because of the high disease burden associated with CAD and PAD, there is a need for continuous vascular protection beyond currently available treatments including antiplatelet agents...
March 22, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29559752/anticoagulation-management-during-first-five-days-of-infant-pediatric-extracorporeal-life-support
#14
Kirk R Bingham, Jeffrey B Riley, Gregory J Schears
Anticoagulation during infant-pediatric extracorporeal life support (ECLS) has been a topic of study for many years, but management of anticoagulation is still only partially understood. Adequate anticoagulation during ECLS is imperative for successful outcomes and understanding the individual variables that play part is crucial for properly implementing anticoagulation management strategies. The purpose of our study was to compare the relationships between the variables of activated partial thromboplastin time (aPTT), activated clotting time, international normalized ratio, bleeding, thrombus formation, kaolin + heparinase thromboelastograph alpha angle, kaolin thromboelastograph reaction time (KTEG R-time), heparin dose rates (HDR), antithrombin (AT), anti-Xa, bivalirudin dose rate, argatroban dose rate, interventions, and transfusions...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29538002/anti-xa-activity-in-oral-factor-xa-inhibitor-treated-patients-with-atrial-fibrillation-and-a-higher-risk-of-bleeding-a-pilot-study
#15
Matej Samoš, Tomáš Bolek, Lucia Stančiaková, Ingrid Škorňová, Peter Bánovčin, František Kovář, Ján Staško, Peter Galajda, Peter Kubisz, Marián Mokáň
: The number of patients with nonvalvular atrial fibrillation (NV-AF) who require long-term anticoagulation and also have a higher risk of bleeding is increasing. Recently, there is no information regarding real on-treatment anti-Xa activity in patients with NV-AF and a higher risk of bleeding who receive oral factor Xa inhibitors. The aim of this study was to determine trough and peak anti-Xa activity in these patients. This single-centre pilot study enrolled 41 patients with NV-AF and a higher risk of bleeding defined as Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly score at least 3 points...
June 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29503117/assessment-of-heparin-anticoagulation-measured-using-i-stat-and-hemochron-activated-clotting-time
#16
Andrew Maslow, Alison Chambers, Tracey Cheves, Joseph Sweeney
OBJECTIVE: Adequate anticoagulation, measured using activated clotting time (ACT), is important during vascular and cardiac surgeries. Unfractionated heparin is the most common anticoagulant used. The purpose of this analysis was to compare the i-STAT ACT (iACT) to the Hemochron ACT (hACT), both of which were then compared to anti-factor Xa (anti-Xa) assay, a representation of heparin level and activity. DESIGN: Prospective study. SETTING: Tertiary care cardiovascular center...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29486103/screening-test-for-direct-oral-anticoagulants-with-the-dilute-russell-viper-venom-time
#17
Jackie Pratt, Philip Crispin
OBJECTIVES: To evaluate the dilute Russell viper venom time (DRVVT) for the detection of direct-acting oral anticoagulants (DOACs) and to investigate the effect of DOACS on coagulation assays. METHODS: Patients with DOACs and controls had plasma levels determined by an anti-Xa assay and dilute thrombin clotting time (TCT). Levels were correlated with the DRVVT as well as TCT, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, protein C, protein S and antithrombin levels...
February 27, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29452290/lean-body-weight-is-the-best-scale-for-venous-thromboprophylaxis-algorithm-in-severely-obese-patients-undergoing-bariatric-surgery
#18
Bénédicte Gaborit, Pierre-Antoine Moulin, Thierry Bege, Sandrine Boullu, Clara Vincentelli, Olivier Emungania, Pierre-Emmanuel Morange, Stéphane Berdah, Joe-Elie Salem, Anne Dutour, Corinne Frere
Severely obese patients undergoing bariatric surgery (BS) are at increased risk for venous thromboembolism (VTE). How standard low molecular weight heparin (LMWH) regimen should be adapted to provide both sufficient efficacy and safety in this setting is unclear. We aimed to compare the influence of four body size descriptors (BSD) on peak anti-Xa levels in BS obese patients receiving LMWH fixed doses to identify which one had the greatest impact. One hundred and thirteen BS obese patients [median body mass index (BMI), 43...
May 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29436886/anti-xa-based-dose-changes-during-low-molecular-weight-heparin-anticoagulation-for-mechanical-prosthetic-heart-valves-during-pregnancy
#19
Eleanor Snape, Jecko Thachil, Bernard Clarke, Sarah Vause
No abstract text is available yet for this article.
February 13, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29423936/population-pharmacokinetics-of-enoxaparin-in-early-stage-of-paediatric-liver-transplantation
#20
Mehdi Oualha, Christophe Chardot, Dominique Debray, Fabrice Lesage, Annie Harroche, Sylvain Renolleau, Jean-Marc Treluyer, Saïk Urien
AIMS: Preventing post-liver transplantation (LT) hepatic artery and portal vein thrombosis includes enoxaparin administration. Enoxaparin pharmacokinetics (PK) has not been investigated in children following LT. We described an enoxaparin PK model in 22 children the first week following LT. METHODS: Anti-Xa activity time-courses were analysed using a nonlinear mixed effects approach with Monolix version 2016R. RESULTS: Anti-Xa activity time-courses were well described by a one-compartment model with first order absorption and elimination...
February 8, 2018: British Journal of Clinical Pharmacology
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