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Anticoagulant restart

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https://www.readbyqxmd.com/read/29775794/rebleeding-vs-thromboembolism-after-hospitalization-for-gastrointestinal-bleeding-in-patients-on-direct-oral-anticoagulants
#1
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/29759668/incidence-characteristics-and-clinical-course-of-device-related-thrombus-after-watchman-left-atrial-appendage-occlusion-device-implantation-in-atrial-fibrillation-patients
#2
Shunsuke Kubo, Yukiko Mizutani, Krissada Meemook, Yoshifumi Nakajima, Asma Hussaini, Saibal Kar
OBJECTIVES: This study investigated characteristics and clinical impact of device-related thrombus formation after Watchman device implantation in atrial fibrillation (AF) patients. BACKGROUND: Left atrial appendage occlusion using the Watchman device is an effective alternative to anticoagulation for stroke prevention in AF patients. However, device-related thrombus formation remains an important concern after Watchman implantation. METHODS: From 2006 to 2014, 119 consecutive AF patients underwent Watchman implantation...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29740754/a-practical-guide-on-how-to-handle-patients-with-bleeding-events-while-on-oral-antithrombotic-treatment
#3
REVIEW
M E Gimbel, S C S Minderhoud, J M Ten Berg
Bleeding is a feared complication in patients who are treated with antithrombotic therapy (oral anticoagulation or antiplatelet therapy). Management of antithrombotic therapy after bleeding poses a dilemma where restarting the crucial medication could lead to recurrent bleeding, while interrupting or even discontinuing treatment could increase the thrombotic risk. In this review, we provide recommendations regarding the treatment of patients with a bleeding event while on oral antithrombotic therapy, based on the literature and expert opinion...
May 8, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29688934/perioperative-management-of-the-gynecologic-patient-on-long-term-anticoagulation
#4
Ammon M Fager, Elizabeth Deans, Andra H James
The perioperative management of patients taking antithrombotic or antiplatelet medications is based on an assessment of the individual patient's risk for thrombosis or bleeding, the specific medication involved, and the nature of the planned procedure. This article describes specific strategies for whether and how these medications should be interrupted before gynecologic procedures, when they can be restarted following the procedure, and whether bridging therapy should be considered.
June 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29575675/novel-oral-anticoagulant-use-in-adult-fontan-patients-a-single-center-experience
#5
Justin Georgekutty, Amir Kazerouninia, YunFei Wang, Peter R Ermis, Dhaval R Parekh, Wayne J Franklin, Wilson W Lam
OBJECTIVE: Adult Fontan patients are at increased risk for thrombosis and thromboembolic complications leading to increased morbidity and mortality. Most are prescribed antiplatelet or anticoagulant therapy for thromboprophylaxis; novel oral anticoagulants (NOACs) are uncommonly used given lack of data on their use in this population and generalized concerns regarding Fontan patients' abnormal coagulation. We report the largest single-center experience with the use of NOACs for treatment and prophylaxis of thrombosis and thromboembolism in adult Fontan patients...
March 24, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29572080/restarting-oral-anticoagulant-therapy-after-major-bleeding-in-atrial-fibrillation-a-systematic-review-and-meta-analysis
#6
Marco Proietti, Giulio Francesco Romiti, Imma Romanazzi, Alessio Farcomeni, Laila Staerk, Peter Brønnum Nielsen, Gregory Y H Lip
BACKGROUND: Use of oral anticoagulant (OAC) therapy in atrial fibrillation (AF) is associated with an inherited risk of bleeding. Benefits and risks of OAC restarting after a major bleeding are still uncertain. We aimed to assess effectiveness and safety of restarting OAC in AF patients after a major bleeding event. METHODS: We performed a systematic review and meta-analysis of all studies reporting data about AF patients that sustained a major bleeding, reporting data on restarting or not restarting OAC therapy...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29537417/restarting-oral-anticoagulant-therapy-after-acute-upper-gastrointestinal-bleeding
#7
O M Jolobe
No abstract text is available yet for this article.
December 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29529259/management-of-therapeutic-anticoagulation-in-patients-with-intracerebral-haemorrhage-and-mechanical-heart-valves
#8
Joji B Kuramatsu, Jochen A Sembill, Stefan T Gerner, Maximilian I Sprügel, Manuel Hagen, Sebastian S Roeder, Matthias Endres, Karl Georg Haeusler, Jan Sobesky, Johannes Schurig, Sarah Zweynert, Miriam Bauer, Peter Vajkoczy, Peter A Ringleb, Jan Purrucker, Timolaos Rizos, Jens Volkmann, Wolfgang Müllges, Peter Kraft, Anna-Lena Schubert, Frank Erbguth, Martin Nueckel, Peter D Schellinger, Jörg Glahn, Ulrich J Knappe, Gereon R Fink, Christian Dohmen, Henning Stetefeld, Anna Lena Fisse, Jens Minnerup, Georg Hagemann, Florian Rakers, Heinz Reichmann, Hauke Schneider, Sigrid Wöpking, Albert Christian Ludolph, Sebastian Stösser, Hermann Neugebauer, Joachim Röther, Peter Michels, Michael Schwarz, Gernot Reimann, Hansjörg Bäzner, Henning Schwert, Joseph Claßen, Dominik Michalski, Armin Grau, Frederick Palm, Christian Urbanek, Johannes C Wöhrle, Fahid Alshammari, Markus Horn, Dirk Bahner, Otto W Witte, Albrecht Günther, Gerhard F Hamann, Hannes Lücking, Arnd Dörfler, Stephan Achenbach, Stefan Schwab, Hagen B Huttner
Aims: Evidence is lacking regarding acute anticoagulation management in patients after intracerebral haemorrhage (ICH) with implanted mechanical heart valves (MHVs). Our objective was to investigate anticoagulation reversal and resumption strategies by evaluating incidences of haemorrhagic and thromboembolic complications, thereby defining an optimal time-window when to restart therapeutic anticoagulation (TA) in patients with MHV and ICH. Methods and results: We pooled individual patient-data (n = 2504) from a nationwide multicentre cohort-study (RETRACE, conducted at 22 German centres) and eventually identified MHV-patients (n = 137) with anticoagulation-associated ICH for outcome analyses...
February 24, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29517050/anticoagulation-for-atrial-fibrillation-after-intracranial-hemorrhage-a-systematic-review
#9
REVIEW
Maximiliano A Hawkes, Alejandro A Rabinstein
Background: We summarize the existing evidence on the potential benefit of oral anticoagulation (OAC) in intracerebral hemorrhage (ICH) survivors with nonvalvular atrial fibrillation (NVAF). Methods: Systematic review of the literature to address the following issues: (1) prevalence of NVAF in ICH survivors, (2) current prescription of OAC, (3) factors associated with resumption of OAC, (4) risk of ischemic stroke (IS) and recurrent ICH, and (5) ideal timing for restarting OAC in ICH survivors with NVAF...
February 2018: Neurology. Clinical Practice
https://www.readbyqxmd.com/read/29506580/the-restart-or-stop-antithrombotics-randomised-trial-restart-after-stroke-due-to-intracerebral-haemorrhage-study-protocol-for-a-randomised-controlled-trial
#10
Rustam Al-Shahi Salman, Martin S Dennis, Gordon D Murray, Karen Innes, Jonathan Drever, Lynn Dinsmore, Carol Williams, Philip M White, William N Whiteley, Peter A G Sandercock, Cathie L M Sudlow, David E Newby, Nikola Sprigg, David J Werring
BACKGROUND: For adults surviving stroke due to spontaneous (non-traumatic) intracerebral haemorrhage (ICH) who had taken an antithrombotic (i.e. anticoagulant or antiplatelet) drug for the prevention of vaso-occlusive disease before the ICH, it is unclear whether starting antiplatelet drugs results in an increase in the risk of recurrent ICH or a beneficial net reduction of all serious vascular events compared to avoiding antiplatelet drugs. METHODS/DESIGN: The REstart or STop Antithrombotics Randomised Trial (RESTART) is an investigator-led, randomised, open, assessor-blind, parallel-group, randomised trial comparing starting versus avoiding antiplatelet drugs for adults surviving antithrombotic-associated ICH at 122 hospital sites in the United Kingdom...
March 5, 2018: Trials
https://www.readbyqxmd.com/read/29498571/the-role-of-preoperative-deep-vein-thrombosis-screening-in-neurooncology
#11
Anmol Pandey, Bhaskar Thakur, Florence Hogg, Christian Brogna, Jamie Logan, Roopen Arya, Richard Gullan, Ranjeev Bhangoo, Keyoumars Ashkan
OBJECTIVE Venous thromboembolism (VTE) is a major cause of morbidity in patients undergoing neurosurgical intervention. The authors postulate that the introduction of a routine preoperative deep vein thrombosis (DVT) screening protocol for patients undergoing neurosurgical intervention for brain tumors would result in a more effective diagnosis of DVT in this high-risk subgroup, and subsequent appropriate management of the condition would reduce pulmonary embolism (PE) rates and improve patient outcomes. METHODS The authors conducted a prospective study of 115 adult patients who were undergoing surgical intervention for a brain tumor...
March 2, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29466205/-basic-principles-of-periprocedural-management-of-patients-with-nonvalvular-atrial-fibrillation-receiving-anticoagulant-therapy-the-consensus-document-of-experts-of-the-american-college-of-cardiology
#12
N M Vorobyeva
The article contains an outline of the 2017 ACC Expert Consensus Decision Pathway for Periprocedural Management of Anticoagulation in Patients With Nonvalvular Atrial Fibrillation. This document considers in detail problems of necessity and safety of temporary interrupting of anticoagulation for the period of procedure, main principles of interruption and restarting anticoagulant therapy after procedure, indications to the transitional (bridging) therapy in the periprocedural period, as well as possible strategies of periprocedural management of patients in dependence of risk of bleeding and thromboembolic complications...
February 2018: Kardiologiia
https://www.readbyqxmd.com/read/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#13
Burr Fong, Daniel Novak, Michael Dalley, Gregory Alfred
BACKGROUND: Deep vein thrombosis (DVT) is a common disease that is diagnosed in approximately 1 in 1000 adults annually. Extensive DVT can lead to life- or limb-threatening diagnoses such as phlegmasia cerulea dolens (PCD), phlegmasia alba dolens, and venous gangrene. PCD, also known as massive iliofemoral venous thrombosis, is rare, and a severe complication of DVT. CASE REPORT: We report a case of a 94-year-old bedridden woman with past medical history of dementia, hypertension, pulmonary embolism, DVT, and atrial fibrillation...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29447773/percutaneous-coronary-intervention-and-antiplatelet-therapy-in-patients-with-atrial-fibrillation-receiving-apixaban-or-warfarin-insights-from-the-aristotle-trial
#14
David Kopin, W Schuyler Jones, Matthew W Sherwood, Daniel M Wojdyla, Lars Wallentin, Basil S Lewis, Freek W A Verheugt, Dragos Vinereanu, M Cecilia Bahit, Sigrun Halvorsen, Kurt Huber, Alexander Parkhomenko, Christopher B Granger, Renato D Lopes, John H Alexander
BACKGROUND: We assessed antiplatelet therapy use and outcomes in patients undergoing percutaneous coronary intervention (PCI) during the ARISTOTLE trial. METHODS: Patients were categorized based on the occurrence of PCI during follow-up (median 1.8 years); PCI details and outcomes post-PCI are reported. Of the 18,201 trial participants, 316 (1.7%) underwent PCI (152 in apixaban group, 164 in warfarin group). RESULTS: At the time of PCI, 84% (267) were on study drug (either apixaban or warfarin)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29348918/safety-and-timing-of-resuming-dabigatran-after-major-gastrointestinal-bleeding-reversed-by-idarucizumab
#15
Gian Galeazzo Riario Sforza, Francesco Gentile, Fabio Stock, Francesco Caggiano, Enrica Chiocca, Cristoforo Incorvaia
The recent introduction of direct oral anticoagulants, including rivaroxaban, dabigatran, apixaban, and edoxaban, for the acute treatment and secondary prevention of venous thromboembolism and in atrial fibrillation has been shown to provide greater clinical benefit than oral vitamin K antagonists. However, direct oral anticoagulants are associated with adverse events, the most common being major bleeding; such events require the reversal of the anticoagulant effects by specific agents. In this case report, we describe an 87-year-old female with atrial fibrillation treated with dabigatran who had massive rectal bleeding...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29208464/risk-factors-for-postpolypectomy-bleeding-in-patients-receiving-anticoagulation-or-antiplatelet-medications
#16
David Lin, Roy M Soetikno, Kenneth McQuaid, Chi Pham, Gilbert Doan, Shanshan Mou, Amandeep K Shergill, Ma Somsouk, Robert V Rouse, Tonya Kaltenbach
BACKGROUND AND AIMS: Balancing the risks for thromboembolism and postpolypectomy bleeding in patients requiring anticoagulation and antiplatelet agents is challenging. We investigated the incidence and risk factors for postpolypectomy bleeding on anticoagulation, including heparin bridge and other antithrombotic therapy. METHODS: We performed a retrospective cohort and case control study at 2 tertiary-care medical centers from 2004 to 2012. Cases included male patients on antithrombotics with hematochezia after polypectomy...
December 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29161368/management-of-cardiac-tamponade-in-catheter-ablation-of-atrial-fibrillation-single-centre-15-year-experience-on-5222-procedures
#17
Rikuta Hamaya, Shinsuke Miyazaki, Hiroshi Taniguchi, Shigeki Kusa, Hiroaki Nakamura, Hitoshi Hachiya, Takatsugu Kajiyama, Tomonori Watanabe, Miyako Igarashi, Kenzo Hirao, Yoshito Iesaka
Aims: Cardiac tamponade during atrial fibrillation (AF) ablation is infrequent but potentially fatal. This study aimed to retrospectively investigate the incidence, management, and outcomes of tamponade in large patient series. Methods and results: The study analysed 5222 AF ablation procedures in 3483 patients between 2002 and 2016 under a heparin-bridge anticoagulation protocol. Cardiac tamponade occurred in 51 procedures/patients, and the incidence was 0...
November 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29136562/warfarin-resumption-following-anticoagulant-associated-intracranial-hemorrhage-a-systematic-review-and-meta-analysis
#18
Chatree Chai-Adisaksopha, Alfonso Iorio, Christopher Hillis, Deborah Siegal, Daniel M Witt, Sam Schulman, Mark Crowther
BACKGROUND: This study aims to assess the effect of warfarin resumption in patients who experienced warfarin-associated intracranial hemorrhage (ICH). METHODS: We conducted a systematic review and meta-analysis of studies evaluating the outcomes of adult patients who survived warfarin-associated ICH. We included studies that compared patients who resumed warfarin versus those who did not. RESULTS: Of 3145 studies screened, ten observational studies were included in the final analysis...
December 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29114902/when-should-therapeutic-anticoagulation-be-restarted-following-major-head-and-neck-surgery
#19
Ashok R Jethwa, Samir S Khariwala
No abstract text is available yet for this article.
May 2018: Laryngoscope
https://www.readbyqxmd.com/read/29093592/-persistent-abdominal-pain-caused-by-superior-mesenteric-artery-and-celiac-trunk-dissection-that-does-not-respond-to-conservative-treatment
#20
Óscar Talledo, Lourdes Torres, Horacio Valenzuela, Alejandro Calle, María A Mena, Óscar De La Peña, Diego Lizarzaburu
We report the case of a 32 year old male with recurrent colic abdominal pain due to superior mesenteric artery (SMA) and celiac trunk dissection, which resolved after placing 3 stents in SMA. The patient presented atypical clinical signs and symptoms, which made the diagnosis difficult. Clinical presentation, diagnostic methods and treatment options are discussed. We started with conservative management with pain medication, anticoagulation, antihypertensive drugs and image control, but on the seventh day, after restarting oral ingestion, he presented with abdominal angina, after which we proceeded to endovascular treatment with successful results and with an uneventfully 2 year follow up...
July 2017: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
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