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https://www.readbyqxmd.com/read/29126301/coagulation-testing-in-the-core-laboratory
#1
William E Winter, Sherri D Flax, Neil S Harris
Primary hemostasis begins with endothelial injury. VWF, produced by endothelial cells, binds to platelets and links them to subendothelial collagen. Platelet-derived ADP and thromboxane activate non-adhered platelets via their GPIIb/IIIa receptors, allowing these platelets to participate in platelet aggregation. Secondary hemostasis is initiated with the binding of factor VII to extravascular tissue factor (TF). Factors II, VII, IX and X are vitamin K-dependent factors. The role of vitamin K is to assist in the addition of gamma carboxylate groups to glutamic acids in the "GLA" domains of these factors...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29120972/comparison-of-anti-xa-and-activated-partial-thromboplastin-time-monitoring-for-heparin-dosing-in-vascular-surgery-patients-a-single-center-retrospective-study
#2
Elsie Rizk, Allison D Wilson, Michelle U Murillo, David R Putney, Bcps-Aq Cardiology
BACKGROUND: Vascular surgery patients often require anticoagulation with intravenous unfractionated heparin monitored via anti-Xa levels or the activated partial thromboplastin time (aPTT). This study compares the two monitoring strategies in terms of major bleeding events in the vascular surgery population. METHODS: This was a single center, retrospective study that included patients treated with a pharmacy-managed heparin protocol monitored by either anti-Xa or aPTT after vascular surgery...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/29112549/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-patients-with-preexisting-coagulation-disorders-and-after-severe-perioperative-bleeding
#3
Aamer Ahmed, Sibylle Kozek-Langenecker, François Mullier, Sue Pavord, Cedric Hermans
: In patients with inherited bleeding disorders undergoing surgery, we recommend assessment of individual risk for venous thromboembolism, taking into account the nature of the surgery and anaesthetic, type and severity of bleeding disorder, age, BMI, history of thrombosis, the presence of malignancy and other high-risk comorbidities. Venous thromboembolism risk should be balanced against the increased bleeding risk associated with anticoagulant use in patients with known bleeding disorders (Grade 1C). In these patients undergoing major surgery, we recommend against routine postoperative use of pharmacological thromboprophylaxis, especially for patients with haemophilia A and B (Grade 1B)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112546/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-surgery-in-the-obese-patient
#4
Linas Venclauskas, Almantas Maleckas, Juan I Arcelus
: A systematic literature search was performed and patients were selected as obese patients undergoing bariatric surgery or obese patients undergoing nonbariatric surgical procedures. In addition, patients were stratified according to low risk of venous thromboembolism and high risk of venous thromboembolism (age >55 years, BMI >55 kg m, history of venous thromboembolism, venous disease, sleep apnoea, hypercoagulability or pulmonary hypertension). Prophylaxis of venous thromboembolism was analysed depending on the type of modality: compression devices of the lower extremities (including intermittent pneumatic compression and graduated compression stockings), pharmacological prophylaxis or inferior vena cava filters...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112545/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-intensive-care
#5
Jacques Duranteau, Fabio Silvio Taccone, Peter Verhamme, Walter Ageno
: Venous thromboembolism is a common and potentially life-threatening complication that occurs in 4 to 15% of patients admitted to ICUs despite the routine use of pharmacological prophylaxis. We therefore recommend an institution-wide protocol for the prevention of venous thromboembolism (Grade 1B). The routine use of ultrasonographic screening for deep vein thrombosis is not recommended when thromboprophylactic measures are in place (Grade 1B), as the detection of asymptomatic deep vein thrombosis may prompt therapeutic anticoagulation that may increase bleeding risk but has no proven reduction of clinically significant thrombotic events...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29088922/the-role-of-tinzaparin-in-oncology
#6
Evangelos P Dimakakos, Ioannis Vathiotis, Konstantinos Syrigos
Current guidelines recommend low-molecular-weight heparin treatment in patients with cancer with established venous thromboembolism (VTE). The aim of this article was to study the pharmacological properties and effectiveness of tinzaparin in patients with cancer as well as its potential anticancer properties. A search of PubMed and ScienceDirect databases up to March 2016 was carried out to identify published studies that detect the properties and use of tinzaparin in oncology. Protamine sulfate partially (60% to 65%) neutralized tinzaparin's anti-Xa activity...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29081908/utility-and-correlation-of-known-anticoagulation-parameters-in-the-management-of-pediatric-ventricular-assist-devices
#7
Ajay K Bhatia, Mouhammad Yabrodi, Mallory Carroll, Silvia Bunting, Kirk Kanter, Kevin O Maher, Shriprasad R Deshpande
AIM: To assess utility and correlation of known anticoagulation parameters in the management of pediatric ventricular assist device (VAD). METHODS: Retrospective study of pediatric patients supported with a Berlin EXCOR VAD at a single pediatric tertiary care center during a single year. RESULTS: We demonstrated associations between activated thromboplastin time (aPTT) and R-thromboelastography (R-TEG) values (rs = 0.65, P < 0.001) and between anti-Xa assay and R-TEG values (rs = 0...
September 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29071333/association-of-anti-factor-xa-guided-dosing-of-enoxaparin-with-venous-thromboembolism-after-trauma
#8
Charles A Karcutskie, Arjuna Dharmaraja, Jaimin Patel, Sarah A Eidelson, Anish B Padiadpu, Arch G Martin, Gabriel Lama, Edward B Lineen, Nicholas Namias, Carl I Schulman, Kenneth G Proctor
Importance: The efficacy of anti-factor Xa (anti-Xa)-guided dosing of thromboprophylaxis after trauma remains controversial. Objective: To assess whether dosing of enoxaparin sodium based on peak anti-Xa levels is associated with the venous thromboembolism (VTE) rate after trauma. Design, Setting, and Participants: Retrospective review of 950 consecutive adults admitted to a single level I trauma intensive care unit for more than 48 hours from December 1, 2014, through March 31, 2017...
October 25, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29063899/clinicians-related-determinants-of-anticoagulation-therapy-and-prophylaxis-in-nigeria
#9
Raphael Anakwue, Theresa Nwagha, Ogba J Ukpabi, Ndudim Obeka, Emmanuel Onwubuya, Uwa Onwuchekwa, Benjamin Azubuike, Innocent Okoye
BACKGROUND: Thromboembolic and hypercoagulable diseases are common life-threatening but treatable problems in hospital practice. Fortunately, anticoagulation is an efficacious management practice indicated for arterial, venous, and intracardiac thromboembolism. Clinicians in developing countries may have gaps in their knowledge of anticoagulation therapy/prophylaxis which could affect their clinical decision. OBJECTIVES: The study examined the knowledge and attitude of clinicians to anticoagulation therapy/prophylaxis in some tertiary hospitals in Nigeria...
October 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/29047306/comparison-of-anti-xa-activity-in-patients-receiving-apixaban-or-rivaroxaban
#10
David A Bookstaver, Kimberly Sparks, Brandon S Pybus, Dustin K Davis, Sean R Marcsisin, Jason C Sousa
BACKGROUND: There is no established method for monitoring the anticoagulant effects of apixaban and rivaroxaban. Linear correlation between serum levels and anti-Xa activity has been shown, with r(2) ranging from 0.88 to 0.99. However, there are minimal data in patients receiving apixaban 5 mg twice daily or rivaroxaban 20 mg once daily. OBJECTIVE: To evaluate the anti-Xa activity and serum levels at those doses and compare the trough anti-Xa activity. METHODS: This was a single-center prospective study,approved by the institutional review board...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29046616/comparison-of-three-different-anti-xa-assays-in-major-orthopedic-surgery-patients-treated-with-direct-oral-anticoagulant
#11
Makoto Ikejiri, Hideo Wada, Shine Tone, Hiroki Wakabayashi, Masahiro Hasegawa, Takeshi Matsumoto, Naoki Fujimoto, Norikazu Yamada, Masaaki Ito, Kaname Nakatani, Akihiro Sudo
BACKGROUND: Measurement of edoxaban plasma concentration has been gathering attention in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE). METHODS: The anti-Xa activity was measured one hour after edoxaban intake using 3 different assays in 200 patients after major orthopedic surgery. RESULTS: The anti-Xa activities on Day 8 were significantly higher than those on Day 4 and those on Day 4 were significantly higher than those on Day 1...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28969734/cerebral-venous-sinus-thrombosis-in-a-patient-with-undiagnosed-factor-vii-deficiency
#12
Hira Qadir, Anila Rashid, Salman Naseem Adil
Factor VII (FVII) deficiency is one of the rare inherited bleeding disorders. Thrombosis has been occasionally described in inherited FVII deficiency. Here, we report a young female with undiagnosed FVII deficiency who presented with cerebral venous sinus thrombosis (CVST). Oral contraceptive pill was found to be prothrombotic risk factor. The CVSToccurred in spite of the congenital FVII deficiency indicating that no definitive antithrombotic protection is assured by this defect. Low molecular weight heparin and anti-Xa assay were found to be safe choice of anticoagulation and monitoring, respectively, in this patient...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28962537/population-pharmacokinetics-of-enoxaparin-in-pediatric-patients
#13
Brady S Moffett, YoungNa Lee-Kim, Marianne Galati, Donald Mahoney, Mona D Shah, Jun Teruya, Donald Yee
BACKGROUND: There are no studies evaluating the pharmacokinetics of enoxaparin in the hospitalized pediatric patient population. OBJECTIVE: To characterize the pharmacokinetics of enoxaparin in pediatric patients. METHODS: A retrospective review of inpatients 1 to 18 years of age admitted to our institution who received enoxaparin with anti-factor Xa activity level monitoring was performed. Demographic variables, enoxaparin dosing, and anti-factor Xa activity levels were collected...
September 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28942721/assessment-of-venous-thromboembolism-treatment-in-patients-with-cancer-on-low-molecular-weight-heparin-warfarin-and-the-direct-oral-anticoagulants
#14
Ellen M Uppuluri, Kelly R Burke, Christina Mactal Haaf, Nancy L Shapiro
Background Direct oral anticoagulants (DOACs) are not recommended for venous thromboembolism (VTE) treatment in patients with cancer because their safety and efficacy have not been compared to low molecular weight heparin (LMWH) in large trials. Routine anti-Xa monitoring in cancer patients on LMWH is also not recommended due to limited data correlating anti-Xa levels and outcomes. Objective Compare the safety and efficacy of DOACs to LMWH and warfarin and assess the relationship of anti-Xa monitoring and outcomes in patients with cancer taking LMWH in an urban university setting...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28888219/factor-xa-inhibition-by-rivaroxaban-in-the-trough-steady-state-can-significantly-reduce-thrombin-generation
#15
Shigeo Horinaka, Rie Sugawara, Yutaka Yonezawa, Toshihiko Ishimitsu
AIMS: The aim of the present study was to demonstrate evidence of reduced thrombin generation at the trough plasma rivaroxaban concentration. METHODS: A single-centre, prospective, non-randomised, drug intervention, self-controlled study was conducted in 51 anticoagulation therapy-naïve patients with non-valvular atrial fibrillation. Plasma rivaroxaban concentration was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and anti-factor Xa chromogenic assay...
September 9, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28884611/an-evaluation-of-the-activated-partial-thromboplastin-time-waveform
#16
Takeshi Matsumoto, Hideo Wada, Naoki Fujimoto, Junki Toyoda, Yasunori Abe, Kohshi Ohishi, Yoshiki Yamashita, Makoto Ikejiri, Kei Hasegawa, Kei Suzuki, Hiroshi Imai, Kaname Nakatani, Naoyuki Katayama
The activated partial thromboplastin time (APTT) waveform includes several parameters that are related to various underlying diseases. The APTT waveform was examined in various diseases. Regarding the pattern of APTT waveform, a biphasic pattern of the first or second derivative curve (DC) was observed in patients with hemophilia and patients positive for antiphospholipid (aPL) antibodies or coagulation factor VIII (FVIII) inhibitors. The time of the first and second DC and fibrin formation at 1/2 height were prolonged in patients with hemophilia, patients with inhibitors, patients positive for aPL, patients treated with anti-Xa agents, and patients with disseminated intravascular coagulation (DIC)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28875044/decreased-rivaroxaban-levels-in-a-patient-with-cerebral-vein-thrombosis-receiving-phenytoin
#17
Ana F Becerra, Tomas Amuchastegui, Aldo H Tabares
Combined use of antiepileptic drugs and anticoagulants is common. We describe the first case documenting laboratory interaction between rivaroxaban and phenytoin. A 48-year-old woman was admitted to our hospital due to cerebral venous thrombosis, bilateral pulmonary embolism, and deep vein thrombosis. She came from a small town with difficult access to warfarin monitoring. She was receiving phenytoin 100 mg three times daily (t.i.d.) and started enoxaparin 60 mg twice daily (b.i.d.). An abdominal mass was diagnosed and removed by laparoscopy (gastrointestinal stromal tumor)...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28869359/monitoring-of-hemostatic-abnormalities-in-major-orthopedic-surgery-patients-treated-with-edoxaban-by-aptt-waveform
#18
M Hasegawa, H Wada, S Tone, T Yamaguchi, H Wakabayashi, M Ikejiri, M Watanabe, N Fujimoto, T Matsumoto, K Ohishi, Y Yamashita, N Katayama, A Sudo
INTRODUCTION: An analysis of the activated partial thromboplastin time (APTT) in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE) was carried out. METHODS: The APTT waveform was analyzed in the above patients to monitor edoxaban administration. RESULTS: Of these 99 patients, 12 exhibited deep vein thrombosis, and 25 had massive bleeding. An increased biphasic pattern of the APTT waveform was observed after the administration of edoxaban, but there were no significant differences between the patients with and without complications...
September 4, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28842030/development-of-a-nanostructured-immunosensor-for-early-and-in-situ-detection-of-xanthomonas-arboricola-in-agricultural-food-production
#19
Matías Regiart, Martin Rinaldi-Tosi, Pedro R Aranda, Franco A Bertolino, Jhonny Villarroel-Rocha, Karim Sapag, Germán A Messina, Julio Raba, Martín A Fernández-Baldo
We report a microfluidic electrochemical immunosensor for Xanthomonas arboricola (XA) determination, based on the covalently immobilization of monoclonal anti-XA antibody (anti-XA) on a previously amino functionalized SBA-15 in situ synthesized in the central channel of a glass-poly(dimethylsiloxane) microfluidic immunosensor. The synthetized amino-SBA-15 was characterized by N2 adsorption-desorption isotherm, scanning electron microscopy and infrared spectroscopy. XA was detected by a direct sandwich immunoassay through an alkaline phosphatase (AP) enzyme-labeled anti-XA conjugate...
December 1, 2017: Talanta
https://www.readbyqxmd.com/read/28840739/-rivaroxaban-in-high-risk-patients
#20
Jindřich Špinar, Lenka Špinarová
Blockade of factor Xa becomes a routine part of clinical practice instead of vitamin K blockade with warfarin, providing a more beneficial and safer effect. The main indications are prevention of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, deep vein thrombosis and pulmonary embolism. Rivaroxaban has the largest number of data across high risk patients. Rivaroxaban is an oral selective anti Xa inhibitor with well predictive pharmacokinetics and pharmacodynamics. It inhibits thrombin formation for 24 hours, is well absorbed and biological availability is 80-100 %...
2017: Vnitr̆ní Lékar̆ství
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