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anticoagulation in liver disease

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https://www.readbyqxmd.com/read/29331969/temporal-trends-in-antithrombotic-treatment-of-real-world-uk-patients-with-newly-diagnosed-atrial-fibrillation-findings-from-the-garfield-af-registry
#1
Patricia N Apenteng, Haiyan Gao, Fd Richard Hobbs, David A Fitzmaurice
OBJECTIVE: To investigate evolving patterns in antithrombotic treatment in UK patients with newly diagnosed non-valvular atrial fibrillation (AF). DESIGN: Prospective, multicentre, international registry. SETTING: 186 primary care practices in the UK. PARTICIPANTS: 3482 participants prospectively enrolled in four sequential cohorts (cohort 2 (C2) n=830, diagnosed September 2011 to April 2013; cohort 3 (C3) n=902, diagnosed April 2013 to June 2014; cohort 4 (C4) n=850, diagnosed July 2014 to June 2015; cohort 5 (C5) n=900, diagnosed June 2015 to July 2016)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29330279/rare-cause-of-isolated-severe-coagulation-failure-in-cirrhosis-traditional-healing-with-fenugreek
#2
Cyriac A Philips, Philip Augustine
Patients with cirrhosis develop decompensation events during the natural history of the disease that encompass ascites, variceal bleeding, hepatic encephalopathy and jaundice. Coagulation failure, defined using the international normalised ratio, even though not a decompensation event, is important in patients with stratifying cirrhosis into those who require liver transplantation for long-term survival. Isolated coagulation failure in cirrhosis is rare and usually occurs with use of anticoagulants in the setting of vascular diseases...
January 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#3
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29297975/clinical-characteristics-and-treatment-of-pyrrolizidine-alkaloid-related-hepatic-vein-occlusive-disease
#4
Yuzheng Zhuge, Yi Wang, Feng Zhang, Chengkai Zhu, Wei Zhang, Ming Zhang, Qibin He, Jian Yang, Jian He, Jun Chen, Xiaoping Zou
BACKGROUND AND AIMS: Hematopoietic stem cell transplantation related hepatic vein occlusive disease (HSCT-HVOD) has been researched extensively; however, little is known about the clinical features and treatment of pyrrolizidine alkaloid-induced HVOD (PA-HVOD). This retrospective single center study examined the clinical and laboratory characteristics of 108 patients with acute PA-HVOD and explored the efficacy of anticoagulation and TIPS therapy. METHODS: The study included 108 consecutive patients with PA-HVOD between July 2008 and June 2016...
January 3, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29187232/long-term-continuous-renal-replacement-therapy-and-anticoagulation-with-citrate-in-critically-ill-patients-with-severe-liver-dysfunction
#5
Matthias Klingele, Theresa Stadler, Danilo Fliser, Timo Speer, Heinrich V Groesdonk, Alexander Raddatz
BACKGROUND: As of 2009, anticoagulation with citrate was standard practice in continuous renal replacement therapy (CRRT) for critically ill patients at the University Medical Centre of Saarland, Germany. Partial hepatic metabolism of citrate means accumulation may occur during CRRT in critically ill patients with impaired liver function. The aim of this study was to evaluate the actual influence of hepatic function on citrate-associated complications during long-term CRRT. METHODS: In a retrospective study conducted between January 2009 and November 2012, all cases of dialysis therapy performed in the interdisciplinary surgical intensive care unit were analysed...
November 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29171208/real-world-data-and-recommended-dosage-of-non-vitamin-k-oral-anticoagulants-for-korean-patients
#6
REVIEW
Boyoung Joung
Regulatory approvals of non-vitamin K antagonist oral anticoagulants (NOACs) have been based on large randomized phase III trials evaluating dabigatran, rivaroxaban, apixaban, or edoxaban relative to warfarin for atrial fibrillation (AF). The results of the trials showed that all NOACs were at least non-inferior to warfarin in the prevention of stroke/thromboembolism and showed lower rates of intracranial bleeding than those associated with warfarin. However, the trials were designed differently, varied in the inclusion/exclusion criteria, and used either one dose or a low/high dose of the NOAC drug...
October 17, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29161790/-anticoagulation-in-patients-with-liver-cirrhosis
#7
REVIEW
Jae Youn Cheong
Cirrhotic patients have bleeding tendencies due to the lack of coagulation factors and thrombocytopenia. However, decreased levels of procoagulants are also accompanied by decreased levels of natural anticoagulants. However, there have been contrasting reports. It has been reported that patients with cirrhosis are at risk for thrombotic complications, including portal vein thrombosis and venous thromboembolism. Physicians consider active anticoagulation for prophylaxis and treatment of portal vein thrombosis and/or venous thromboembolism in cirrhotic patients with high risk of thrombosis...
November 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/29120909/rivaroxaban-induced-hepatotoxicity-review-of-the-literature-and-report-of-new-cases
#8
Anna Licata, Fania Puccia, Vania Lombardo, Antonietta Serruto, Maria G Minissale, Ilaria Morreale, Lydia Giannitrapani, Maurizio Soresi, Giuseppe Montalto, Piero L Almasio
AIM/OBJECTIVE/BACKGROUND: Direct-acting oral anticoagulant drugs are marketed worldwide for the primary and secondary prevention and treatment of thromboembolic disorders. Rivaroxaban, an oral, direct factor Xa inhibitor, is one of the most used. Rivaroxaban-induced hepatotoxicity is unusual, although a number of adverse reports have recently been reported. Here, we report two new cases of rivaroxaban-induced hepatitis. METHODS: A systematic search of case reports on the MEDLINE database encompassing the years 2008-2016 was carried out...
February 2018: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29102830/prognostic-significance-of-a-prolonged-international-normalized-ratio-in-elderly-patients-in-an-internal-medicine-ward
#9
Galina Plotnikov, Lior Bracha, Shimon Izhakian, Moshe Tishler, Oleg Gorelik
PURPOSE: To investigate clinical characteristics and the prognostic significance of a prolonged international normalized ratio (INR) without obvious cause or anticoagulant treatment, in elderly inpatients. METHODS: Demographic, clinical, and laboratory data, in-hospital death and 30day-mortality were prospectively registered for 100 consecutive patients aged ≥75years admitted to an internal medicine ward for a variety of acute medical disorders, and compared according to normal (≤1...
October 31, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29099334/viscoelastic-monitoring-to-guide-hemostatic-resuscitation-in-liver-transplantation-surgery
#10
Kevin P Blaine, Tetsuro Sakai
Coagulopathic bleeding must be anticipated during liver transplantation (LT) surgery. Patients with end-stage liver disease (ESLD) often present with disease-related hematologic disturbances, including the loss of hepatic procoagulant and anticoagulant clotting factors and thrombocytopenia. Transplantation surgery itself presents additional hemostatic changes, including hyperfibrinolysis. Viscoelastic monitoring (VEM) is often used to provide targeted, personalized hemostatic therapies for complex bleeding states including cardiac surgery and major trauma...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29092916/use-of-oral-anticoagulants-in-combination-with-antiplatelet-s-in-atrial-fibrillation
#11
Caroline Sindet-Pedersen, Laila Staerk, Morten Lamberts, Thomas Alexander Gerds, Jeffrey S Berger, Anders Nissen Bonde, Jannik Langtved Pallisgaard, Morten Lock Hansen, Christian Torp-Pedersen, Gunnar H Gislason, Jonas Bjerring Olesen
OBJECTIVES: To investigate temporal trends in the use of non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in combination with aspirin and/or clopidogrel in patients with atrial fibrillation (AF) following acute myocardial infarction (MI) and/or percutaneous coronary intervention (PCI). METHODS: Using Danish nationwide registries, all patients with AF who survived 30 days after discharge from MI and/or PCI between 22 August 2011 and 30 September 2016 were identified...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#12
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29027774/rational-approach-to-transfusion-in-liver-transplantation
#13
Fuat H Saner, Lasitha Abeysundara, Matthias Hartmann, Susan V Mallett
For over 50 years patients with liver cirrhosis were considered to be at markedly increased risk of bleeding. This dogma was seemingly supported by abnormalities in standard laboratory tests (SLTs), such as the prothrombin time, that were interpreted as indicating a bleeding diathesis. However, publications from the last decade have revealed SLTs to be poor predictors of bleeding and it is now understood that stable patients with cirrhosis have a rebalanced haemostatic system and preserved thrombin generation...
October 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29019809/atrial-fibrillation-and-central-nervous-complications-in-liver-transplanted-hereditary-transthyretin-amyloidosis-patients
#14
Niklas Wange, Intissar Anan, Bo-Göran Ericzon, Johanna Pennlert, Björn Pilebro, Ole B Suhr, Jonas Wixner
BACKGROUND: Central nervous system (CNS) complications are increasingly noted in liver transplanted (LTx) hereditary transthyretin amyloid (ATTRm) amyloidosis patients; this suggests that the increased survival allows for intracranial ATTRm formation from brain synthesised mutant TTR. However, atrial fibrillation (AF), a recognised risk factor for ischemic CNS complications, is also observed after LTx. The aim of the study was to investigate the occurrence of CNS complications and AF in LTx ATTRm amyloidosis patients...
October 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28983679/safety-of-omitting-routine-bleeding-tests-prior-to-image-guided-musculoskeletal-core-needle-biopsy
#15
Yuri Shif, Justin W Kung, Colm J McMahon, Jennifer Ni Mhuircheartaigh, Yu Ching Lin, Megan E Anderson, Jim S Wu
PURPOSE: To evaluate the safety of withholding preprocedure international normalized ratio (INR) and platelet testing in patients undergoing musculoskeletal (MSK) core needle biopsy (CNB). MATERIAL AND METHODS: Initially, a retrospective review of 1,162 consecutive patients undergoing MSK CNB with preprocedural INR and platelet testing was performed. Clinical (age, gender, bleeding disorder, liver disease, anticoagulation use, INR > 2, platelet count <50,000/ul) and biopsy factors (imaging modality, lesion type, biopsy needle gauge, number biopsy samples) were tested for association with bleeding complications...
October 6, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28968197/safety-of-once-or-twice-daily-dosing-of-non-vitamin-k-antagonist-oral-anticoagulants-noacs-in-patients-with-nonvalvular-atrial-fibrillation-a-noac-tr-study
#16
Sadık Volkan Emren, Mehdi Zoghi, Rida Berılgen, İbrahim Halil Özdemir, Oğuzhan Çelik, Nurullah Çetin, Asım Enhoş, Cemal Köseoğlu, Abdurrahman Akyüz, Volkan Doğan, Fatih Levent, Yüksel Dereli, Tolga Doğan, Özcan Başaran, Ilgın Karaca, Özkan Karaca, Yılmaz Ömür Otlu, Çağlar Özmen, Selvi Coşar, Mutlu Sümerkan, Erdal Gürsul, Sinan İnci, Ersel Onrat, Oktay Ergene
Once-daily dosing of non-vitamin K antagonist oral anticoagulants (NOACs) may increase patient adherence to treatment but may also be associated with a higher risk of bleeding. In this study, we investigated the adherence to once- or twice-daily dosing of NOACs and the risk of bleeding in nonvalvular atrial fibrillation (NVAF) patients. This multicenter cross-sectional study, conducted between 1 September 2015 and 28 February 2016, included 2214 patients receiving NOACs for at least 3 months, due to NVAF. Patients receiving once-daily or twice-daily NOAC doses were 1:1 propensity score matched for baseline demographic characteristics and the presence of other diseases...
October 2, 2017: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28931618/predicting-major-bleeding-in-ischemic-stroke-patients-with-atrial-fibrillation
#17
RANDOMIZED CONTROLLED TRIAL
Nina A Hilkens, Ale Algra, Jacoba P Greving
BACKGROUND AND PURPOSE: Performance of risk scores for major bleeding in patients with atrial fibrillation and a previous transient ischemic attack or ischemic stroke is not well established. We aimed to validate risk scores for major bleeding in patients with atrial fibrillation treated with oral anticoagulants after cerebral ischemia and explore the net benefit of oral anticoagulants among bleeding risk categories. METHODS: We analyzed 3623 patients with a history of transient ischemic attack or stroke included in the RE-LY trial (Randomized Evaluation of Long-Term Anticoagulation Therapy)...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28922103/budd-chiari-syndrome
#18
Tomáš Grus, Lukáš Lambert, Gabriela Grusová, Rohan Banerjee, Andrea Burgetová
Budd-Chiari syndrome (BCS) is a rare disease with an incidence of 0.1 to 10 per million inhabitants a year caused by impaired venous outflow from the liver mostly at the level of hepatic veins and inferior vena cava. Etiological factors include hypercoagulable conditions, myeloprolipherative diseases, anatomical variability of the inferior vena cava, and environmental conditions. Survival rates in treated patients range from 42 to 100% depending on the etiology and the presence of risk factors including parameters of Child-Pugh score, sodium and creatinine plasma levels, and the choice of treatment...
2017: Prague Medical Report
https://www.readbyqxmd.com/read/28844514/comparison-of-the-cha2ds2-vasc-chads2-has-bled-orbit-and-atria-risk-scores-in-predicting-non-vitamin-k-antagonist-oral-anticoagulants-associated-bleeding-in-patients-with-atrial-fibrillation
#19
COMPARATIVE STUDY
Xiaoxi Yao, Bernard J Gersh, Lindsey R Sangaralingham, David M Kent, Nilay D Shah, Neena S Abraham, Peter A Noseworthy
The increasing adoption of non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in atrial fibrillation (AF) necessitates a reassessment of bleeding risk scores. Because known risk factors for bleeding are largely the same as for stroke, we hypothesize that stroke risk scores could also be used to identify patients with high bleeding risks. We aimed to compare the performance of 2 stroke risk scores (Congestive Heart failure, hypertension, Age ≥75 [doubled], Diabetes, Stroke [doubled], Vascular disease, Age 65-74, and Sex [female] [CHA2DS2-VASc] and Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled] [CHADS2]) and 3 bleeding risk scores (hypertension, abnormal renal/liver function [1 point each], stroke, bleeding history or predisposition, labile INR, elderly [...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28837506/coagulopathy-in-children-with-liver-disease
#20
Patricia S Kawada, Aisha Bruce, Patti Massicotte, Mary Bauman, Jason Yap
It was thought that a high international normalized ratio predicted bleeding in patients with chronic liver disease (CLD) and patients were "autoanticoagulated." Contrary to this belief, while patients with CLD experienced bleeding, they also developed thromboses. In the last decade, the prevailing literature challenged the idea that an elevated international normalized ratio increased bleeding risk. The global assays of coagulation such as thromboelastography (TEG)/rotational thromboelastometry and thrombin generation assays provide additional insight into coagulation processes...
December 2017: Journal of Pediatric Gastroenterology and Nutrition
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