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Anticoagulant therapy

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https://www.readbyqxmd.com/read/29777848/effects-on-mortality-and-cardiovascular-events-of-adherence-to-guideline-recommended-therapy-4-years-after-lower-extremity-arterial-revascularization
#1
M Thiney, N Della Schiava, R Ecochard, P Feugier, P Lermusiaux, A Millon, A Long
OBJECTIVES: All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin converting enzyme inhibitors (ACE) or Angiotensin receptor blockers (ARB), and HMG-CoA-reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the current risk for cardiovascular (CV) events and mortality and also to evaluate the effect of pharmacologic treatment on patient's survival, CV events and additional vascular surgery in vascularized LE-PAD patients...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777547/tacrolimus-induced-asymptomatic-thrombotic-microangiopathy-diagnosed-by-laboratory-tests-in-pig-to-rhesus-corneal-xenotransplantation-a-case-report
#2
Jong-Min Kim, Jaeyoung Kim, Se-Hyun Choi, Jun-Seop Shin, Byoung-Hoon Min, Won Young Jeong, Ga-Eul Lee, Min-Sun Kim, Seeun Kwon, Mee Kum Kim, Chung-Gyu Park
Tacrolimus-associated thrombotic microangiopathy (TA-TMA) is a rare complication. TA-TMA is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage due to thrombus. We report asymptomatic TA-TMA diagnosed by laboratory tests in pig-to-rhesus corneal xenotransplantation. Corneal transplantation had been conducted from a wild-type SNU miniature pig to a rhesus macaque. The veterinary records were retrospectively reviewed in this case. The immunosuppressive regimen consisted of rituximab, basiliximab, and IVIg as inductive therapies, and steroids with tacrolimus (0...
May 18, 2018: Xenotransplantation
https://www.readbyqxmd.com/read/29777267/improved-prognosis-and-low-failure-rate-with-anticoagulation-as-first-line-therapy-in-mesenteric-venous-thrombosis
#3
S Salim, M Zarrouk, J Elf, A Gottsäter, O Ekberg, S Acosta
BACKGROUND: Monotherapy with anticoagulation has been considered as first-line therapy in patients with mesenteric venous thrombosis (MVT). The aim of this study was to evaluate outcome, prognostic factors, and failure rate of anticoagulation as monotherapy, and to identify when bowel resection was needed. METHODS: Retrospective study of consecutive patients with MVT diagnosed between 2000 and 2015. RESULTS: The overall incidence rate of MVT was 1...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29776575/optimal-long-term-antithrombotic-treatment-of-patients-with-stable-coronary-artery-disease-and-atrial-fibrillation-oltat-registry
#4
Q Fischer, J L Georges, C Le Feuvre, A Sharma, N Hammoudi, E Berman, S Cohen, I Jolivet, J Silvain, G Helft
BACKGROUND: The optimal long-term antithrombotic treatment of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF) is a challenge in daily practice. We sought to determine the prevalence of hemorrhagic complications and ischaemic events depending on antithrombotic strategy in patients with stable CAD and AF. METHODS: The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of cardiovascular mortality, myocardial infarction and ischaemic stroke...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29776386/impact-of-vkorc1-cyp4f2-and-nqo1-gene-variants-on-warfarin-dose-requirement-in-han-chinese-patients-with-catheter-ablation-for-atrial-fibrillation
#5
Jiao Li, Wenlong Yang, Zhonghui Xie, Kun Yu, Yuhua Chen, Kaijun Cui
BACKGROUND: The anticoagulation of atrial fibrillation catheter ablation during the perioperative stage does matter and should be treated with discretion. We aimed to assess impact of three important genes participating in vitamin K cycle (i.e. VKORC1 rs9923231, CYP4F2 rs2108622 and NQO1 rs1800566) on the daily stable warfarin dose requirement in Sichuan Han Chinese patients with catheter ablation of atrial fibrillation. METHODS: A total of 222 atrial fibrillation patients taking stable warfarin therapy after catheter ablation operation were enrolled in this study...
May 18, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29775794/rebleeding-vs-thromboembolism-after-hospitalization-for-gastrointestinal-bleeding-in-patients-on-direct-oral-anticoagulants
#6
Neil Sengupta, Ariela L Marshall, Blake A Jones, Sandra Ham, Elliot B Tapper
BACKGROUND AND AIMS: Little is known about outcomes of patients hospitalized for gastrointestinal bleeding (GIB) while they are taking direct oral anticoagulants (DOAC). We aimed to determine the frequency at which patients resume DOAC therapy following hospitalization for GIB in a real-world setting, and the risks and benefits. METHODS: We conducted a retrospective analysis of medical claims data from the Truven Health Marketscan Commercial Claims and Encounters Database, from January 1, 2010 through December 31, 2014...
May 15, 2018: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29774146/endoscopic-and-angiographic-management-of-lower-gastrointestinal-bleeding-review-of-the-published-literature
#7
REVIEW
David J Werner, Hendrik Manner, Marc Nguyen-Tat, Roman Kloeckner, Ralf Kiesslich, Nael Abusalim, Johannes W Rey
Lower gastrointestinal bleeding is common and occurs often in elderly patients. In rare cases it is associated with hemorrhagic shock. A large number of such bleedings, which are often caused by colon diverticula, subside spontaneously. Alternatively they can be treated by endoscopic procedures successfully. Given the aging population of our society, the rising incidence of lower gastrointestinal tract bleeding and new anticoagulant therapies, some of the bleedings tend to be severe. Colonoscopy is the established standard procedure for the diagnosis and treatment of lower gastrointestinal bleeding...
April 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29773500/an-analysis-on-distribution-and-inter-relationships-of-biomarkers-under-rivaroxaban-in-japanese-patients-with-non-valvular-atrial-fibrillation-cvi-aro-1
#8
Shinya Suzuki, Takeshi Yamashita, Hidefumi Kasai, Takayuki Otsuka, Koichi Sagara
Prothrombin time (PT) has been widely used for measuring anticoagulation intensity under rivaroxaban therapy, but precise information has not been well established yet. Consecutive 96 non-valvular atrial fibrillation (NVAF) under rivaroxaban between Jan/June, 2015 were recruited. Serum concentration (SC) and PT with 5 representative reagents available in Japan (Neoplastin Plus®, Thromborel S®, Thrombocheck PT®, Thrombocheck PT Plus®, and Recombiplastin®) at 2-4 hours after (peak) and before intake of rivaroxaban (trough) were measured at outpatient clinic in the cardiovascular institute (CVI ARO study 1)...
March 15, 2018: Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29772593/-coagulation-monitoring-and-bleeding-management-in-cardiac-surgery
#9
Berthold Bein, Robert Schiewe
The transfusion of allogeneic blood products is associated with increased morbidity and mortality. An impaired hemostasis is frequently found in patients undergoing cardiac surgery and may in turn cause bleeding and transfusions. A goal directed coagulation management addressing the often complex coagulation disorders needs sophisticated diagnostics. This may improve both patients' outcome and costs. Recent data suggest that coagulation management based on a rational algorithm is more effective than traditional therapy based on conventional laboratory variables such as PT and INR...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770858/-management-of-anticoagulants-in-ophthalmic-surgery-a-survey-among-ophthalmic-surgeons-in-germany
#10
N Feltgen, B Mele, T Dietlein, C Erb, A Eckstein, A Hager, A Heiligenhaus, H Helbig, H Hoerauf, E Hoffmann, D Pauleikhoff, M Schittkowski, B Seitz, C Sucker, S Suffo, U Schaudig, F Tost, S Thurau, P Walter, J Koscielny
INTRODUCTION: As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations. METHODS: A survey was sent to the DOG (German Ophthalmologic Society) divisions and associated surgical organizations to determine the status quo...
May 16, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/29770793/pulmonary-embolism
#11
REVIEW
Menno V Huisman, Stefano Barco, Suzanne C Cannegieter, Gregoire Le Gal, Stavros V Konstantinides, Pieter H Reitsma, Marc Rodger, Anton Vonk Noordegraaf, Frederikus A Klok
Pulmonary embolism (PE) is caused by emboli, which have originated from venous thrombi, travelling to and occluding the arteries of the lung. PE is the most dangerous form of venous thromboembolism, and undiagnosed or untreated PE can be fatal. Acute PE is associated with right ventricular dysfunction, which can lead to arrhythmia, haemodynamic collapse and shock. Furthermore, individuals who survive PE can develop post-PE syndrome, which is characterized by chronic thrombotic remains in the pulmonary arteries, persistent right ventricular dysfunction, decreased quality of life and/or chronic functional limitations...
May 17, 2018: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29770334/optimum-antithrombotic-therapy-in-patients-requiring-long-term-anticoagulation-and-undergoing-percutaneous-coronary-intervention
#12
REVIEW
Nayan Agarwal, Dhruv Mahtta, Cecil A Rambarat, Islam Elgendy, Ahmed N Mahmoud
Management of patients on long-term anticoagulation requiring percutaneous coronary intervention is challenging. Triple therapy with oral anticoagulant and dual antiplatelet therapy is the standard of care. However, there is no strong evidence to support this strategy. There is emerging data regarding the safety and efficacy of dual therapy with oral anticoagulant and single antiplatelet therapy in these patients. In this comprehensive review we highlight available evidence regarding various antithrombotic regimens' efficacy and safety in patient with coronary artery disease undergoing percutaneous coronary intervention with long-term anticoagulation therapy requirements...
2018: BioMed Research International
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
#13
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/29768378/cerebral-infarction-as-initial-presentation-in-stress-cardiomyopathy-case-report-and-literature-review
#14
Qiongying Wang, Heng Yu, Cheng Jiang, Runmin Sun, Miaomiao Qi, Shougang Sun, Guangli Xu, Hongbin Cai, Zhenchang Zhang, Feng Zhao, Xiaoqing Kou, Jing Yu, Feng Bai
RATIONALE: The typical symptoms of stress cardiomyopathy include sudden-onset chest pain and breathlessness or collapse as well as classical symptoms of cardiovascular disease; however, rare reports have described nervous system symptoms as the initial manifestation. Here, we report the case of a young man who presented with a large cerebral infarction as the main clinical symptom of stress cardiomyopathy to increase recognition of the disease. PATIENT CONCERNS: A 28-year-old man was admitted to our hospital for sudden-onset weakness of the right limbs and unconsciousness for 1 day...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768314/medication-administration-delays-in-non-st-elevation-myocardial-infarction-analysis-of-1002-patients-admitted-to-an-academic-medical-center
#15
LeAnn N Denlinger, Ellen C Keeley
Our goal was to assess adherence to American College of Cardiology/American Heart Association guideline-based medical therapy in patients admitted with type I non-ST elevation myocardial infarction (NSTEMI) and to determine factors associated with medication administration delay. We performed a retrospective analysis using data from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry. Baseline patient demographics, 12-lead electrocardiogram (ECG) findings, laboratory values, medications administered and the time they were administered, and in-hospital clinical outcomes were collected...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768161/-practical-aspects-of-anticoagulant-therapy-in-patients-with-atrial-fibrillation-and-arterial-hypertension
#16
Z D Kobalava, A A Shavarov
Atrial fibrillation (AF) represents the most frequent sustained cardiac arrhythmia, the prevalence of AF is 1-2 % in the general population and up to 6 % for population over 80 years. Arterial hypertension (AH) is the commonest background comorbidity in patients with AF. Patients with AF have 3-6‑fold increased risk of ischemic stroke in comparison to that in general population, additionally the presence of AH leads an 2-3‑fold increase in risk of subsequent stroke. Current clinical guidelines recommend long-time anticoagulant treatment for prevention of stroke and thromboembolic complications in majority of patients with confirmed AF...
2018: Kardiologiia
https://www.readbyqxmd.com/read/29768158/-issues-of-antithrombotic-therapy-in-acs-patients-with-atrial-fibrillation
#17
N A Kaydalova, L Y Koroleva, G V Kovaleva, N N Paykova, V P Nosov, A T Volkova, A M Koryazina
The review analyzed current ideas on prevalence and clinical significance of atrial fibrillation following acute coronary syndrome; described modern approaches to administration of antithrombotic therapy; and addressed available clinical studies on the treatment with warfarin and new oral anticoagulants as a part of combination antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome.
2018: Kardiologiia
https://www.readbyqxmd.com/read/29767545/pharmacogenetics-of-novel-oral-anticoagulants-a-review-of-identified-gene-variants-future-perspectives
#18
Adna Ašić, Damir Marjanović, Jure Mirat, Dragan Primorac
Novel oral anticoagulants (NOACs) are becoming a therapy of choice in everyday clinical practice after almost 50 years during which warfarin and related coumarin derivatives were used as the main anticoagulants. Advantages of NOACs over standard anticoagulants include their predictable pharmacodynamics and pharmacokinetics, stable plasma concentrations and less drug-drug and food-drug interactions. However, pharmacogenetics has its place in administration of NOACs, as considerable interindividual variations have been detected...
May 16, 2018: Personalized Medicine
https://www.readbyqxmd.com/read/29766730/-splanchnic-vein-thrombosis
#19
Sylva Lajzová, Radek Kroupa, Alena Buliková, Šárka Bohatá, Barbora Packová, Michal Šenkyřík
Splanchnic vein thrombosis (SVT) represents an unusual manifestation of venous thromboembolism. The etiological factors for SVT can be divided into local and systemic, frequently found concurrently. SVT can be the first presenting symptom in myeloproliferative neoplasms. SVT puts the patients affected in jeopardy of developing the intestinal infarction, impairing the liver function and portal hypertension development with the risk of potentially life-threatening gastrointestinal bleeding. The current guidelines emphasise the role of anticoagulation in acute splanchnic thrombosis...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29766335/ticagrelor-versus-clopidogrel-as-part-of-dual-or-triple-antithrombotic-therapy-a-systematic-review-and-meta-analysis
#20
Ioannis Andreou, Alexandros Briasoulis, Christos Pappas, Ignatios Ikonomidis, Dimitrios Alexopoulos
PURPOSE: Clopidogrel is the standard P2Y12 receptor inhibitor used in patients requiring both antiplatelet therapy and oral anticoagulation (OAC). We investigated the safety and efficacy of ticagrelor as an alternative to clopidogrel in patients on OAC. METHODS: A systematic electronic literature search was performed in MEDLINE, EMBASE, and the Cochrane Library for randomised controlled studies that examined the relative safety and efficacy of clopidogrel versus ticagrelor among patients requiring therapy with antiplatelet agents plus OAC...
May 15, 2018: Cardiovascular Drugs and Therapy
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