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Warfarin bleeding

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https://www.readbyqxmd.com/read/29471572/-cardiovascular-medication-in-elderly-patients
#1
Robert H G Schwinger
Elderly people show increased probability to develop atherosclerotic diseases; in consequence heart failure - most often following coronary heart disease - as well as atrial fibrillation is more common. Following guidelines may lead to polypharmacy, i. e. use of more than 5 drugs daily. Thus, drug interactions as well as side effects become more likely; especially in elderly patients reduced kidney function has to be taken into account. Only drugs which have shown to prolong life or to reduce symptoms in controlled clinical trials should be used...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29468979/potentiation-of-warfarin-associated-with-salsalate-therapy-resulting-in-bleeding
#2
Joseph P Rindone, Chadwick K Mellen
BACKGROUND: Salsalate may offer many advantages over other non-steroidal anti-inflammatory agents in patients taking warfarin, however a drug-drug interaction may occur which has not been reported in the medical literature or by the manufacturer of salsalate. OBJECTIVE: To report a case of warfarin potentiation associated with salsalate treatment, which resulted in bleeding. METHODS: Clinical review of the course of a patient, who was stable on warfarin when salsalate therapy was added for chronic pain...
February 19, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29460334/variation-of-renal-function-over-time-is-associated-with-major-bleeding-in-patients-treated-with-direct-oral-anticoagulants-for-atrial-fibrillation
#3
Cecilia Becattini, Michela Giustozzi, Maria Giovanna Ranalli, Giulio Bogliari, Federica Cianella, Melina Verso, Giancarlo Agnelli, Maria Cristina Vedovati
BACKGROUND: Chronic kidney disease is a risk factor for major bleeding in patients with atrial fibrillation (AF) treated with warfarin. OBJECTIVE: To assess the effect of variations of renal function over time on the risk for major bleeding (MB) during treatment with direct anticoagulants (DOACs) in patients with non-valvular AF. METHODS: Consecutive AF patients were prospectively followed since they received the first DOACs prescription. Estimated glomerular filtration rate (eGFR) was periodically assessed and the incidence of MB recorded...
February 20, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29457323/anticoagulation-knowledge-in-patients-with-atrial-fibrillation-an-australian-survey
#4
Kehinde O Obamiro, Leanne Chalmers, Kenneth Lee, Bonnie J Bereznicki, Luke R E Bereznicki
BACKGROUND: Atrial fibrillation (AF) is the most commonly diagnosed arrhythmia in clinical practice, and is associated with a significant medical and economic burden. Anticoagulants reduce the risk of stroke and systemic embolism by approximately two-thirds compared with no therapy. Knowledge regarding anticoagulant therapy can influence treatment outcomes in patients with AF. OBJECTIVE: To measure the level of anticoagulation knowledge in patients with AF taking oral anticoagulants (OACs), investigate the association between patient-related factors and anticoagulation knowledge, and compare these results in patients taking warfarin and direct-acting oral anticoagulant (DOACs)...
February 19, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29456085/what-is-the-role-of-reversal-agents-in-the-management-of-emergency-department-patients-with-dabigatran-associated-hemorrhage
#5
Bryan D Hayes, Michael E Winters, Steve B Rosenbaum, Mohannad F Allehyani, Gary M Vilke
BACKGROUND: In 2010, the U.S. Food and Drug Administration (FDA) approved dabigatran as the first non-warfarin oral anticoagulant for use in the United States. At the time of FDA approval, there was no antidote or effective treatment for dabigatran-induced hemorrhage. In 2015, the FDA approved idarucizumab for the treatment of dabigatran-induced hemorrhage. The purpose of this clinical practice statement is to evaluate the role of select reversal agents in the management of patients with dabigatran-associated bleeding...
February 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29455567/apixaban-or-rivaroxaban-versus-warfarin-for-treatment-of-submassive-pulmonary-embolism-after-catheter-directed-thrombolysis
#6
Lara M Groetzinger, Taylor J Miller, Ryan M Rivosecchi, Roy E Smith, Mark T Gladwin, Belinda N Rivera-Lebron
BACKGROUND: Little data exist on the use of direct oral anticoagulant (DOAC) factor Xa inhibitors for submassive pulmonary embolism (PE) after catheter-directed thrombolysis (CDT). The objective of this evaluation was to determine whether the transition from parenteral anticoagulation to DOACs for submassive PE after CDT would decrease hospital length of stay (LOS) compared to warfarin. METHODS: A retrospective review of patients diagnosed with submassive PE who underwent CDT was conducted from January 1, 2012, to February 28, 2017...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29450643/variants-in-fix-propeptide-associated-with-vitamin-k-antagonist-hypersensitivity-functional-analysis-and-additional-data-confirming-the-common-founder-mutations
#7
Behnaz Pezeshkpoor, Katrin J Czogalla, Michael Caspers, Ann-Cristin Berkemeier, Kerstin Liphardt, Suvoshree Ghosh, Marco Kellner, Silvia Ulrich, Anna Pavlova, Johannes Oldenburg
One of the most common and unwanted side effects during oral anticoagulant therapy (OAT) is bleeding complications. In rare cases, vitamin K antagonist (VKA)-related bleeding events are associated with mutations affecting the F9 propeptide at amino acid position 37 due to a substitution of alanine to either valine or threonine. Based on our actual cohort of 18 patients, we update the knowledge on this rare phenotype and its origin. A founder mutation for both variants was reconfirmed by haplotype analysis of intronic and extragenic short tandem repeat (STR) polymorphisms with a higher prevalence in Switzerland than in other regions of Europe...
February 15, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29449120/bilateral-phlegmasia-cerulea-dolens-after-warfarin-reversal-for-acute-rectal-bleeding-a-case-report
#8
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...
February 12, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29448895/the-outcome-of-anticoagulation-on-endovenous-laser-therapy-for-superficial-venous-incompetence
#9
Jamie Vatish, Nusrat Iqbal, Viswa Retnasingam Rajalingam, Alok Tiwari
OBJECTIVES: The purpose of this study was to evaluate whether anticoagulation (warfarin or direct oral inhibitors) affected the success of endovenous treatment. METHODS: Patients taking anticoagulation (warfarin or direct oral inhibitors) undergoing endovenous treatment in the form of endovenous laser ablation (EVLA) were matched against controls for sex, age, leg, and vein. Data were collected prospectively between January 2012 and March 2017. The primary endpoint was failure of treatment at 6-week postoperative duplex scan...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29448297/anticoagulant-preferences-and-concerns-among-venous-thromboembolism-patients
#10
Pamela L Lutsey, Keith J Horvath, Lisa Fullam, Stephan Moll, Mary R Rooney, Mary Cushman, Neil A Zakai
BACKGROUND: Warfarin and direct oral anticoagulants (DOACs) are used for the initial treatment and secondary prevention of venous thromboembolism (VTE), and have similar efficacy. Patient concerns and preferences are important considerations when selecting an anticoagulant, yet these are not well studied. METHODS: VTE patients ( n = 519) were surveyed from online sources (clotconnect.org, stoptheclot.org and National Blood Clot Alliance Facebook followers [ n = 495]) and a haematology clinic in Vermont ( n = 24)...
February 15, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29448091/evidence-and-prospective-of-plant-derived-flavonoids-as-antiplatelet-agents-strong-candidates-to-be-drugs-of-future
#11
Harron Khan, Mohammad Jawad, Mohammad Ajmal Kamal, Alessandra Baldi, Jianbo Xiao, Seyed Mohammad Nabavi, Maria Daglia
Platelets are involved in hemostasis, inflammation, and thrombosis processes. Following a vascular damage, the endothelium releases protein factors, allowing the adhesion of subendothelium to platelets. Then platelets are activated, leading to the secretion of biologically-active ligands including thromboxane A2, adenosine diphosphate and serotonin. Aspirin, clopidogrel and warfarin are the most common drugs used to meet the challenges of platelet aggregation. However, these agents face issues with aspirin resistance and bleeding...
February 12, 2018: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/29447781/prediction-of-long-term-net-clinical-outcomes-using-the-timi-af-score-comparison-with-cha-2-ds-2-vasc-and-has-bled
#12
José Miguel Rivera-Caravaca, Vanessa Roldán, María Asunción Esteve-Pastor, Mariano Valdés, Vicente Vicente, Francisco Marín, Gregory Y H Lip
The TIMI-AF score was described to predict net clinical outcomes (NCOs) in atrial fibrillation (AF) patients receiving warfarin. However, this score derived from the ENGAGE AF-TIMI 48 trial, and no external validation exists in real world clinical practice. We tested the long-term predictive performance of the TIMI-AF score in comparison with CHA 2 DS 2 -VASc and HAS-BLED in a 'real-world' cohort of anticoagulated AF patients. METHODS: We included 1156 consecutive AF patients stable on vitamin K antagonist (INR 2...
March 2018: American Heart Journal
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
#13
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/29445000/retroperitoneal-hemorrhage-after-percutaneous-coronary-intervention-incidence-determinants-and-outcomes-as-recorded-by-the-british-cardiovascular-intervention-society
#14
Chun Shing Kwok, Evangelos Kontopantelis, Tim Kinnaird, Jessica Potts, Muhammad Rashid, Ahmad Shoaib, James Nolan, Rodrigo Bagur, Mark A de Belder, Peter Ludman, Mamas A Mamas
BACKGROUND: Retroperitoneal hemorrhage (RH) is a rare bleeding complication of percutaneous coronary intervention, which can result as a consequence of femoral access or can occur spontaneously. This study aims to evaluate temporal changes in RH, its predictors, and clinical outcomes in a national cohort of patients undergoing percutaneous coronary intervention in the United Kingdom. METHODS AND RESULTS: We analyzed RH events in patients who underwent percutaneous coronary intervention between 2007 and 2014...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29444357/safety-of-direct-oral-anticoagulants-versus-warfarin-in-patients-with-chronic-liver-disease-and-atrial-fibrillation
#15
Pavel Goriacko, Keith T Veltri
BACKGROUND: A complication of chronic liver disease (CLD) is the abnormality of coagulation. In clinical practice, this increased risk of bleeding has not been identified as a protective factor against stroke or systemic embolism associated with atrial fibrillation (AF). The objective of this study was to assess the safety of direct oral anticoagulant (DOAC) agents versus warfarin in CLD patients with AF. METHODS: This was a retrospective cohort study of patients with CLD and AF initiated on oral anticoagulants...
February 14, 2018: European Journal of Haematology
https://www.readbyqxmd.com/read/29441984/direct-oral-anticoagulants-in-real-clinical-practice-analysis-of-patient-characteristics-and-prescribing-patterns-in-a-large-teaching-hospital
#16
B Kováčová, J Červeňová
Direct oral anticoagulants (DOACs) became rapidly accepted as an alternative to warfarin in the prevention of stroke in atrial fibrillation and prophylaxis of thromboembolic events. Their safety and efficacy have been well documented in several studies, however, as with any new drug, use in real-world population often reveals risk factors that may affect treatment outcomes. The aim of the study was to determine the prescribing patterns and analyse patient characteristics to identify incidence of selected factors (age, weight, comorbidities and interacting medication) that may affect DOAC safety and efficacy...
September 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29440623/bleeding-complications-related-to-right-heart-catheterization-in-the-setting-of-elevated-inr
#17
Jared Betz, Kelly Jia, Scott Lilly, Konstantinos Marmagkiolis, Ernest L Mazzaferri, Konstantinos Dean Boudoulas
OBJECTIVES: Right heart catheterization (RHC) provides cardiovascular hemodynamic information in a variety of clinical settings. RHC performed in the setting of coagulopathy may have the potential to increase bleeding complications; however, data currently are limited. This study was undertaken to determine bleeding complications during RHC with an elevated international normalized ratio (INR) value. METHODS: A total of 312 patients who underwent RHC were retrospectively studied...
February 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29439477/a-practical-review-of-the-emerging-direct-anticoagulants-laboratory-monitoring-and-reversal-agents
#18
REVIEW
Stephanie A Joppa, Justin Salciccioli, Jill Adamski, Salma Patel, Waldemar Wysokinski, Robert McBane, Farah Al-Saffar, Heidi Esser, Fadi Shamoun
Millions of patients in the United States use anticoagulation for a variety of indications, such as the prevention of stroke in those with atrial fibrillation (AF) and the treatment and prevention of venous thrombosis. For over six decades warfarin was the only available oral anticoagulant, but now several DOACs are available and their use has become more prevalent in recent years. In spite of this increased use, many physicians remain reluctant to prescribe DOACs due to concerns about bleeding and reversibility...
February 11, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29439272/need-of-emergency-surgery-in-elderly-patients-with-upper-gastrointestinal-bleeding-survival-analysis-during-2009-2015
#19
Sami Miilunpohja, Jussi Kärkkäinen, Juha Hartikainen, Johanna Jyrkkä, Tuomo Rantanen, Hannu Paajanen
BACKGROUND/AIMS: The role of emergency surgery is decreasing in the treatment of patients with upper gastrointestinal bleeding (UGIB). We investigated the need of urgent surgery and outcome of elderly UGIB patients who often have cardiovascular comorbidities with antithrombotic medication. METHODS: All consecutive adult patients who received emergency treatment for suspected gastrointestinal bleeding between January 2009 and December 2011 were registered in an electronic database (n = 1,643)...
February 13, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29438571/use-of-non-vitamin-k-oral-anticoagulants-in-people-with-atrial-fibrillation-and-diabetes-mellitus
#20
REVIEW
O Itzhaki, B Zadok, A Eisen
AIMS: To examine the efficacy and safety of non-vitamin K oral anticoagulants in people with both atrial fibrillation and diabetes mellitus. METHODS: We reviewed efficacy and safety data from the warfarin-controlled phase III non-vitamin K oral anticoagulants trials (ARISTOTLE, RE-LY, ROCKET-AF, ENGAGE and AF-TIMI 48) and their post hoc analyses with regard to diabetes status. We also reviewed the updated literature regarding this population. RESULTS: At baseline 20-40% of the participants in the phase III non-vitamin K oral anticoagulants trials had diabetes mellitus at baseline...
February 13, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
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