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Unfractionated heparin

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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/28203409/practice-patterns-in-venous-thromboembolism-vte-prophylaxis-in-thoracic-surgery-a-comprehensive-canadian-delphi-survey
#2
John Agzarian, Lori-Ann Linkins, Laura Schneider, Waël C Hanna, Christian J Finley, Colin Schieman, Marc De Perrot, Mark Crowther, James Douketis, Yaron Shargall
BACKGROUND: The incidence of venous thromboembolic events (VTE) after resection of thoracic malignancies can reach 15%, but prophylaxis guidelines are yet to be established. We aimed to survey Canadian practitioners regarding perioperative risk factors for VTE, impact of those factors on extended prophylaxis selection, type of preferred prophylaxis, and timing of initiation and duration of thromboprophylaxis. METHODS: A modified Delphi survey was undertaken over three rounds with thoracic surgeons, thoracic anesthesiologists and thrombosis experts across Canada...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28198064/real-life-practices-for-preventing-venous-thromboembolism-in-multiple-myeloma-patients-a-cohort-study-from-the-french-health-insurance-database
#3
Aurore Palmaro, Marie-Eve Rougé-Bugat, Martin Gauthier, Fabien Despas, Guillaume Moulis, Maryse Lapeyre-Mestre
PURPOSE: The risk of venous thromboembolic event (VTE) in multiple myeloma is particularly increased. Current guidelines recommend systematic VTE prophylaxis with vitamin K antagonists (VKA) or low weight molecular heparin (LWMH) or unfractionated heparin (UFH) in high-risk patients, based on treatment received [e.g. use of IMiDs (thalidomide, lenalidomide and pomalidomide), alkylating agents or erythropoietin] and individual risk factors (e.g. history of VTE). The aim of this study was to describe strategy of VTE prophylaxis and prescribing of other antithrombotic agents during the first 6 months of multiple myeloma therapy, with stratification on IMiD-based regimens and drug and disease-related risk factors...
February 15, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28195640/subcutaneous-unfractionated-heparin-for-the-initial-treatment-of-venous-thromboembolism
#4
REVIEW
Lindsay Robertson, James Strachan
BACKGROUND: Venous thromboembolism (VTE) is a prevalent and serious condition. Its medical treatment requires anticoagulation, usually with either unfractionated or low molecular weight heparin (LMWH). Administration of unfractionated heparin (UFH) is usually intravenous (IV) but can be subcutaneous as well. This is an update of a review first published in 2009. OBJECTIVES: To assess the effects of subcutaneous UFH versus intravenous UFH, subcutaneous LMWH or any other anticoagulant drug for the initial treatment of venous thromboembolism...
February 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28194402/corrigendum-unfractionated-and-low-molecular-weight-heparin-and-the-phosphodiesterase-inhibitors-ibmx-and-cilostazol-block-ex-vivo-equid-herpesvirus-type-1-induced-platelet-activation
#5
Tracy Stokol, Priscila B S Serpa, Muhammad N Zahid, Marjory B Brooks
[This corrects the article on p. 99 in vol. 3, PMID: 27909693.].
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28191514/anticoagulant-therapy-for-non-st-segment-elevation-acute-coronary-syndrome-in-china-a-multi-center-observational-study
#6
Xiao-Huan Gong, Jin-Ming Yu, Yong Mao, Da-Yi Hu
OBJECTIVE: To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS. METHODS: A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI...
April 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28182804/medical-and-economic-burden-of-heparin-induced-thrombocytopenia-a-retrospective-nationwide-inpatient-sample-nis-study
#7
Ranjan Pathak, Vijaya Raj Bhatt, Paras Karmacharya, Madan Raj Aryal, Anthony A Donato
In recent years, US hospitals have switched from use of unfractionated heparin to use of low-molecular-weight heparin, which is associated with lower risk of heparin-induced thrombocytopenia (HIT). In the study reported here, we retrospectively searched the Nationwide Inpatient Sample (NIS) for patients who were at least 18 years old and received a diagnosis of HIT between 2009 and 2011. Our goal was to get an updated perspective on the incidence and economic impact of HIT. We calculated the incidence of HIT overall and in subgroups of patients who underwent cardiac, vascular, or orthopedic surgery...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28182249/fixed-dose-subcutaneous-low-molecular-weight-heparins-versus-adjusted-dose-unfractionated-heparin-for-the-initial-treatment-of-venous-thromboembolism
#8
REVIEW
Lindsay Robertson, Lauren E Jones
BACKGROUND: Low molecular weight heparins (LMWHs) have been shown to be effective and safe in preventing venous thromboembolism (VTE). They may also be effective for the initial treatment of VTE. This is the third update of the Cochrane Review first published in 1999. OBJECTIVES: To evaluate the efficacy and safety of fixed dose subcutaneous low molecular weight heparin compared to adjusted dose unfractionated heparin (intravenous or subcutaneous) for the initial treatment of people with venous thromboembolism (acute deep venous thrombosis or pulmonary embolism)...
February 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28166602/managing-the-precarious-hemostatic-balance-during-extracorporeal-life-support-implications-for-coagulation-laboratories
#9
Anne M Winkler
For the past four decades, extracorporeal life support (ECLS) has been used to treat critically ill adult and pediatric patients with cardiac and/or respiratory failure unresponsive to medical management, and there are increasing numbers of centers performing ECLS for numerous indications worldwide. Despite the progress with advancing technology, hemorrhagic and thrombotic complications occur frequently and are associated with worse outcomes, but the exact cause is often elusive or multifactorial. As a result of the interaction between blood and a nonendothelialized circuit, there is activation of coagulation, fibrinolysis, as well as an increased inflammatory response; thus, anticoagulation of the patient and circuit is necessary...
February 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28160263/effect-of-prolonged-fasting-and-low-molecular-weight-heparin-or-warfarin-therapies-on-2-deoxy-2-18f-fluoro-d-glucose-pet-cardiac-uptake
#10
Assuero Giorgetti, Gavino Marras, Dario Genovesi, Elena Filidei, Antonio Bottoni, Maurizio Mangione, Michele Emdin, Paolo Marzullo
BACKGROUND: Whether anticoagulants other than unfractionated heparin are able to suppress cardiac PET uptake of 2-deoxy-2-[18F]-fluoro-D-glucose (18F-FDG) is unknown. METHODS: One-hundred-seventy-four patients without history and clinical evidence of cardiac dysfunction and/or coronary heart disease underwent a 18F-FDG PET/CT study. All patients were studied with a >12-hours fasting and divided into 2 groups: group-1 without anticoagulant therapy (n:75); group-2 patients on low molecular weight heparin (n:60) or warfarin therapy (n:39)...
February 3, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28153852/effect-of-heparin-on-secondary-brain-injury-in-patients-with-subarachnoid-hemorrhage-an-additional-h-therapy-in-vasospasm-treatment
#11
REVIEW
Markus Bruder, Sae-Yeon Won, Sepide Kashefiolasl, Marlies Wagner, Nina Brawanski, Nazife Dinc, Volker Seifert, Juergen Konczalla
OBJECTIVE: Secondary brain injury leads to high morbidity and mortality rates in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, evidence-based treatment strategies are sparse. Since heparin has various effects on neuroinflammation, microthromboembolism and vasomotor function, our objective was to determine whether heparin can be used as a multitarget prophylactic agent to ameliorate morbidity in SAH. METHODS: Between June 1999 and December 2014, 718 patients received endovascular treatment after rupture of an intracranial aneurysm at our institution; 197 of them were treated with continuous unfractionated heparin in therapeutic dosages after the endovascular procedure...
February 2, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28118750/characterization-of-pf4-heparin-complexes-by-photon-correlation-spectroscopy-and-zeta-potential
#12
Sabrina Bertini, Jawed Fareed, Laura Madaschi, Giulia Risi, Giangiacomo Torri, Annamaria Naggi
Heparin-induced thrombocytopenia (HIT) is associated with antibodies to complexes between heparin and platelet factor 4 (PF4), a basic protein usually found in platelet alpha granules. Heparin-induced thrombocytopenia antibodies preferentially recognize macromolecular complexes formed between positively charged PF4 and polyanionic heparins over a narrow range of molar ratios. The aim of this work was to study the complexes that human PF4 forms with heparins from various species, such as porcine, bovine, and ovine; heparins from various organs, such as mucosa and lung; and different low-molecular-weight heparins (LMWHs) at several stoichiometric ratios to evaluate their sizes and charges by photo correlation spectroscopy and zeta potential measurements...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28115102/non-anticoagulant-effects-of-low-molecular-weight-heparins-in-inflammatory-disorders-a-review
#13
REVIEW
Yishu Yan, Yang Ji, Nan Su, Xiang Mei, Yi Wang, Shanshan Du, Wenming Zhu, Chong Zhang, Yuan Lu, Xin-Hui Xing
Low molecular weight heparins (LMWHs) are produced by chemical or enzymatic depolymerization of unfractionated heparin (UFH). Besides their well-known anticoagulant effects, LMWHs have also been reported to exhibit numerous anti-inflammatory properties. Previous studies have, however, shown that different production processes result in unique structural characteristics of LMWHs. The structural variations may help explain the different therapeutic spectrums in disease treatment for non-anticoagulant effects...
March 15, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28107569/use-of-higher-maximum-doses-and-infusion-rates-compared-with-those-used-in-standard-unfractionated-heparin-therapy-is-associated-with-adequate-anticoagulation-without-increased-bleeding-in-both-obese-and-nonobese-patients-with-cardiovascular-indications
#14
Catherine K Floroff, Nicole M Palm, Daniel H Steinberg, Eric R Powers, Barbara S Wiggins
STUDY OBJECTIVE: To evaluate the time to achieve therapeutic activated partial thromboplastin time (aPTT) values and occurrence of bleeding based on standard unfractionated heparin (UFH) weight-based dosing recommendations compared with an aggressive weight-based UFH dosing strategy using higher maximum doses and infusion rates in both obese and nonobese patients who presented with non-ST-Segment Elevation Myocardial Infarction or unstable angina (NSTEMI/UA) or atrial fibrillation. DESIGN: Retrospective cohort study...
January 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28097621/practice-patterns-of-venous-thromboembolism-prophylaxis-in-underweight-critically-ill-patients-with-neurologic-injury
#15
Kevin Betthauser, Hannah Pope, Mollie Gowan, Theresa Human
PURPOSE: Venous thromboembolism (VTE) prophylaxis in underweight patients with neurologic injury remains unaddressed by guidelines and primary literature. This study aimed to describe VTE prophylaxis strategies employed in this population and compare the impact of underweight and non-obese patients on thrombotic and bleeding events. METHODS: A retrospective review of adults admitted with a diagnosis of neurologic injury to a neurology/neurosurgery intensive care unit (ICU) over 6 years...
January 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#16
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28089863/prevention-of-thrombosis-in-hypercoagulable-patients-undergoing-microsurgery-a-novel-anticoagulation-protocol
#17
Jonas A Nelson, Cyndi U Chung, Andrew R Bauder, Liza C Wu
BACKGROUND: Hypercoagulable conditions are often considered relative contraindications to free flap reconstruction. This paper presents and critically examines a novel anticoagulation regimen developed to address this disease state. METHODS: Hypercoagulable patients who underwent free tissue transfer between 2007 and 2015 were identified. From 2011, all such patients were subjected to a novel anticoagulation protocol involving an intravenous bolus of 2000 U of unfractionated heparin prior to microvascular pedicle anastomosis, followed by a heparin infusion at 500 U/h, which was postoperatively increased to therapeutic levels...
December 18, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28089150/anticoagulant-bridging-in-left-sided-mechanical-heart-valve-patients
#18
E A Hart, R Jansen, T A Meijs, B J Bouma, R K Riezebos, W Tanis, W J P van Boven, V Hindori, N Wiersma, T Dessing, J Westerink, S A J Chamuleau
BACKGROUND: In preparation for an invasive procedure with a high bleeding risk, patients with a mechanical heart valve temporarily have to discontinue their anticoagulant therapy and are usually bridged with either intravenous unfractionated heparin (UFH) or subcutaneous low-molecular-weight heparin (LMWH). In this study we retrospectively analyzed the safety of UFH versus LMWH as bridging strategy in left-sided mechanical heart valve patients. METHODS: We performed a retrospective multicenter study in four surgical centers in The Netherlands...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#19
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28079662/recognition-of-a-thoracic-epidural-hematoma-in-the-setting-of-transient-paralysis-a-case-report
#20
Beth VanderWielen, Lindsay Rubenstein, Marc Shnider, Cindy Ku, Jason Wakakuwa
A 71-year-old woman on aspirin presented for a distal pancreatectomy, splenectomy, and partial colectomy with a T8/9 epidural catheter placed preoperatively in 3 attempts. Prophylactic 5000 units of subcutaneous heparin were given before the procedure. After catheter removal on postoperative day 2, the patient developed transient bilateral lower extremity paralysis, with near complete recovery within 30 minutes. An urgent MRI revealed a T4-T8 epidural hematoma prompting an emergent T3-T8 laminectomy. This case presentation highlights the need for heightened awareness regarding complications related to neuraxial analgesia in patients receiving unfractionated heparin for thromboembolism prophylaxis with concurrent aspirin use...
January 11, 2017: A & A Case Reports
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