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Anticoagulant therapy

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https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#1
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28228977/transient-hemi-lower-limb-ischemia-in-the-newborn-arterial-thrombosis-or-persistent-sciatic-artery
#2
Makiko Kirino, Masayuki Ochiai, Masako Ichiyama, Hirosuke Inoue, Takeshi Kusuda, Tadamune Kinjo, Masataka Ishimura, Shouichi Ohga
Neonatal thromboembolism occurs with various predispositions and triggers. Early diagnosis of the thrombosis is challenging and essential for the therapeutic interventions. We herein report two newborns who presented with transient hemi-lower limb ischemia due to (1) arterial thrombosis or (2) a persistent sciatic artery (PSA). The patient with arterial thrombosis showed elevations of fibrin degradation product and D-dimer and received antithrombin and heparin intravenously. The patient with PSA was immediately assessed by a contrast-enhanced computed tomography because of a transient ischemic episode with no evidence of hypercoagulability...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28228885/omental-flap-transposition-for-inferior-vena-cava-filter-penetration
#3
Junji Yamaguchi, Takamichi Miyamoto, Nobuhiro Hara, Tetsuo Yamaguchi, Tomoyuki Umemoto
A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. The thrombus worsened perioperatively, and the filter could not be retrieved. Since there was lymph node recurrence, the second time operation was performed. During operation, the struts were found to be penetrating the inferior vena cava...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228727/post-operative-bleeding-risk-in-dental-surgery-for-patients-on-oral-anticoagulant-therapy-a-meta-analysis-of-observational-studies
#4
Quan Shi, Juan Xu, Tong Zhang, Bin Zhang, Hongchen Liu
Background and Objective: Minor dental surgery is invasive and hemorrhagic. Thus, in patients treated with anticoagulants, the bleeding risk related to these invasive procedures is concerning. The aim of this meta-analysis is to evaluate this risk by comparing the post-operative bleeding rates of oral anticoagulation treatment (OAT) patients (without interrupted or altered anticoagulant intake) with non-OAT patients. Methods: PubMed, Embase and the Cochrane Library were searched for eligible studies that compared the post-operative (following minor dental surgery) bleeding rates of OAT patients without interrupted or altered therapy with those of non-OAT patients...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28228636/progressive-ischemic-stroke-due-to-thyroid-storm-associated-cerebral-venous-thrombosis
#5
Natsumi Tanabe, Eiji Hiraoka, Masataka Hoshino, Gautam A Deshpande, Kana Sawada, Yasuhiro Norisue, Jumpei Tsukuda, Toshihiko Suzuki
BACKGROUND Cerebral venous thrombosis (CVT) is a rare but fatal complication of hyperthyroidism that is induced by the hypercoagulable state of thyrotoxicosis. Although it is frequently difficult to diagnose CVT promptly, it is important to consider it in the differential diagnosis when a hyperthyroid patient presents with atypical neurologic symptoms. CASE REPORT A 49-year-old Japanese female with unremarkable medical history came in with thyroid storm and multiple progressive ischemic stroke identified at another hospital...
February 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28228467/gender-differences-in-clinical-presentation-and-1-year-outcomes-in-atrial-fibrillation
#6
Renate B Schnabel, Ladislav Pecen, Francisco M Ojeda, Markus Lucerna, Nargiz Rzayeva, Stefan Blankenberg, Harald Darius, Dipak Kotecha, Raffaele De Caterina, Paulus Kirchhof
OBJECTIVES: Our objective was to examine gender differences in clinical presentation, management and prognosis of atrial fibrillation (AF) in a contemporary cohort. METHODS: In 6412 patients, 39.7% women, of the PREvention oF thromboembolic events - European Registry in Atrial Fibrillation, we examined gender differences in symptoms, risk factors, therapies and 1-year incidence of adverse outcomes. RESULTS: Men with AF were on average younger than women (mean±SD: 70...
February 22, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28228434/sagittal-sinus-thrombosis-in-jak2-v617f-mutation-without-overt-myeloproliferative-disorder
#7
Prashant Ramesh Bhand, Supriya Ramesh Karde, Nagabathula Ramesh
We describe a case of a man aged 41 years who presented with a history of generalised headaches for 1 week and an acute episode of tonic-clonic seizures. He had no history of medical illness, was non-smoker, with an extensive family history of haematological disorders. Initial CT brain with contrast did not show any abnormalities in brain parenchyma. X-ray and CT right shoulder showed shoulder dislocation secondary to trauma associated with seizure prior to hospital admission. Subsequently, MRA and MRV brain was arranged, which revealed extensive expansible occlusive filling defect dominating the middle of superior sagittal sinus with left frontal cortical and subcortical acute oedema...
February 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28225642/interventional-management-of-venous-thromboembolism-state-of-the-art
#8
Harish Jarrett, Riyaz Bashir
OBJECTIVE: The purpose of this article is to describe the indications for and approach to catheter-based treatment of acute venous thromboembolism (VTE). CONCLUSION: Catheter-based treatment of VTE is a viable adjunct to anticoagulant therapy and is being rapidly adopted around the United States. Early data suggest that these therapies reduce postthrombotic sequelae and improve quality of life, but bleeding events are still frequent, particularly at low-volume centers...
February 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28224930/incidence-of-severe-renal-dysfunction-among-individuals-taking-warfarin-and-implications-for-non-vitamin-k-oral-anticoagulants
#9
Christina L Fanola, Deirdre Mooney, Andrew J Cowan, Darae Ko, Emily K Sisson, Lori E Henault, Yorghos Tripodis, Elaine M Hylek
BACKGROUND: The purpose of this study is to assess incidence and risk factors for severe renal dysfunction in patients requiring oral anticoagulation to help guide initial drug choice and provide a rational basis for interval monitoring of renal function for patients prescribed non-vitamin K oral anticoagulants. METHODS: Patients on warfarin for atrial fibrillation or venous thromboembolism were consecutively enrolled from January 2007 to December 2010. Baseline kidney function was assessed, and patients were followed to their first decline of kidney function to creatinine clearance<30 mL/min...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28224113/intensity-modulated-radiation-therapy-with-stereotactic-body-radiation-therapy-boost-for-unfavorable-prostate-cancer-a-report-on-3-year-toxicity
#10
Ima Paydar, Abigail Pepin, Robyn A Cyr, Joseph King, Thomas M Yung, Elizabeth G Bullock, Siyuan Lei, Andrew Satinsky, K William Harter, Simeng Suy, Anatoly Dritschilo, John H Lynch, Thomas P Kole, Sean P Collins
BACKGROUND: Recent data suggest that intensity-modulated radiation therapy (IMRT) plus brachytherapy boost for unfavorable prostate cancer provides improved biochemical relapse-free survival over IMRT alone. Stereotactic body radiation therapy (SBRT) may be a less invasive alternative to brachytherapy boost. Here, we report the 3-year gastrointestinal (GI) and genitourinary (GU) toxicities of IMRT plus SBRT boost. MATERIALS AND METHODS: Between March 2008 and September 2012, patients with prostate cancer were treated with robotic SBRT (19...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28224037/tooth-extraction-in-a-patient-after-autologous-skeletal-myoblast-sheet-transplantation-for-severe-dilated-cardiomyopathy
#11
Kohei Okuyama, Yuki Sakamoto, Tomofumi Naruse, Souichi Yanamoto, Masahiro Umeda
The authors describe the first case of tooth extraction in a patient treated with autologous skeletal myocardial sheet transplantation for severe dilated cardiomyopathy. This condition is associated with significant morbidity and mortality that may have identifiable causes or may be idiopathic or inherited. In addition to local disinfection, antimicrobial prophylaxis and continuous anticoagulant therapy during the perioperative period of tooth extraction were needed to prevent infective endocarditis and ensure the success of regenerative therapy of the heart...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28223868/assessment-of-novel-oral-anticoagulant-use-within-a-community-teaching-hospital
#12
Sultan Alghadeer, Lori Hornsby
: Background: Novel oral anticoagulants (NOACs) are considered to be at least as effective and safe as warfarin with several advantages such as predictable pharmacokinetics, allowing for standardized dosing without monitoring, a lack of food interactions and fewer drug interactions; however, their misuse could potentially result in patient harm. Objective: To evaluate the appropriate use of the NOACs within a community teaching hospital. SETTING: A community teaching hospital in the United States...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28222495/reversible-thrombotic-mitral-valve-stenosis-after-transcatheter-mitral-valve-replacement-tmvr-is-life-long-anticoagulation-therapy-necessary
#13
Vladan Hudec, Martin Bena, Panagiotis Artemiou, Ivo Gasparovic, Michal Hulman
We describe a case of reversible thrombotic mitral valve stenosis following a valve-in-ring transcatheter mitral valve replacement. Life-long oral anticoagulation in patients who underwent transcatheter mitral valve replacement might be beneficial.
February 21, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28222250/long-term-treatment-of-cancer-associated-thrombosis-the-choice-of-the-optimal-anticoagulant
#14
REVIEW
I Elalamy, I Mahé, W Ageno, G Meyer
Patients with cancer associated thrombosis (CAT) carry a higher risk of recurrence, bleeding and mortality as compared to non-cancer patients. The specific profile of cancer patients combining frequent co-morbidities, the use of anti-tumoral therapies and the cancer progression itself represent a major therapeutic challenge for choosing a long-term anticoagulant treatment. This review discusses the practical basis of that choice among available drugs for the long-term antithrombotic strategy linked to their pharmacology, mechanism of action, evidence of clinical benefits, advantages and limitations in such a complex clinical context...
February 21, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28220367/routine-placement-of-subdural-drain-after-burr-hole-evacuation-of-chronic-and-subacute-subdural-hematoma-a-contrarian-evidence-based-approach
#15
Laxminadh Sivaraju, Ranjith K Moorthy, Visalakshi Jeyaseelan, Vedantam Rajshekhar
The objective of this paper was to evaluate whether available evidence supporting placement of subdural drain placement after evacuation of chronic subdural haematoma (CSDH) is applicable to a cohort of patients managed by us. In this observational cohort study, clinical follow-up was obtained in 166 patients who underwent burr hole evacuation of CSDH without placement of subdural drain followed by 3 days of bed rest. The primary outcome studied was recurrence requiring reoperation. Factors predicting recurrence were also analysed...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28219692/prevention-of-thromboembolic-complications-in-patients-with-superficial-vein-thrombosis-given-rivaroxaban-or-fondaparinux-the-open-label-randomised-non-inferiority-surprise-phase-3b-trial
#16
Jan Beyer-Westendorf, Sebastian M Schellong, Horst Gerlach, Eberhard Rabe, Jeffrey I Weitz, Katja Jersemann, Kurtulus Sahin, Rupert Bauersachs
BACKGROUND: Superficial-vein thrombosis can lead to deep-vein thrombosis and pulmonary embolism. Rivaroxaban, an oral factor Xa inhibitor, might simplify treatment compared with fondaparinux because it does not require daily subcutaneous injection and is cheaper. We compared efficacy outcomes in patients with superficial-vein thrombosis and additional risk factors given either rivaroxaban or fondaparinux to assess whether rivaroxaban is non-inferior to fondaparinux in the prevention of thromboembolic complications...
February 16, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28219635/direct-oral-anticoagulant-or-warfarin-related-major-bleeding-characteristics-reversal-strategies-and-outcomes-from-a-multi-center-observational-study
#17
Yan Xu, Sam Schulman, Dar Dowlatshahi, Anne M Holbrook, Christopher S Simpson, Lois E Shepherd, Philip S Wells, Antonio Giulivi, Tara Gomes, Muhammad Mamdani, Wayne Khuu, Eliot Frymire, Ana P Johnson
BACKGROUND: Direct oral anticoagulants (DOACs) have expanded the armamentarium for antithrombotic therapy. While DOAC-related major bleeds were associated with favourable outcomes compared to warfarin in clinical trials, warfarin was reversed in <40% of cases, raising concerns about the generalizability of this finding. METHODS: Consecutive patients ≥66 years presenting to five tertiary care hospitals across three cities in Ontario, Canada with diagnoses that included hemorrhage from October 2010 to March 2015...
February 17, 2017: Chest
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#18
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28219057/preventing-continuous-renal-replacement-therapy-induced-hypophosphatemia-an-extended-clinical-experience-with-a-phosphate-containing-solution-in-the-setting-of-regional-citrate-anticoagulation
#19
Valentina Pistolesi, Laura Zeppilli, Francesca Polistena, Maria Itala Sacco, Alessandro Pierucci, Luigi Tritapepe, Giuseppe Regolisti, Enrico Fiaccadori, Santo Morabito
AIMS: To evaluate the efficacy and safety of a commercially available phosphate-containing solution for continuous renal replacement therapy (CRRT) in preventing CRRT-related hypophosphatemia. METHODS: In heart surgery patients undergoing continuous veno-venous haemodiafiltration (CVVHDF) with regional citrate anticoagulation (RCA), we combined an 18 mmol/l citrate solution with a phosphate-containing (1.2 mmol/l) dialysate/replacement fluid evaluating the incidence of hypophosphatemia and the need for parenteral phosphorus supplementation...
February 21, 2017: Blood Purification
https://www.readbyqxmd.com/read/28217657/patient-compliance-with-new-oral-anticoagulants-after-major-orthopaedic-surgery-rivaroxaban-and-dabigatran-compared-with-subcutaneous-injection-of-fondaparinux
#20
Paolo DI Benedetto, Luigi Vetrugno, Dania DE Franceschi, Renato Gisonni, Araldo Causero, Giorgio Della Rocca
PURPOSE: the main purpose of our study was to compare patient compliance with the orally administered new oral anticoagulants (NOCs) dabigatran and rivaroxaban compared with subcutaneously injected fondaparinux after major orthopaedic surgery, and to assess patient preference for the oral vs subcutaneous administration route. METHODS: prophylactic antithrombotic drug therapy with dabigatran (group D; GD, n=32 patients), rivaroxaban (group R; GR, n=38 patients) or fondaparinux (group F; GF, n=30 patients), to prevent deep vein thrombosis, was started immediately after surgery in 100 patients submitted to total hip arthroplasty...
October 2016: Joints
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