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anticoagulation in liver disease

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https://www.readbyqxmd.com/read/29776574/incidence-of-bleeding-in-patients-with-atrial-fibrillation-and-advanced-liver-fibrosis-on-treatment-with-vitamin-k-or-non-vitamin-k-antagonist-oral-anticoagulants
#1
Daniele Pastori, Gregory Y H Lip, Alessio Farcomeni, Francesco Del Sole, Angela Sciacqua, Francesco Perticone, Rossella Marcucci, Elisa Grifoni, Pasquale Pignatelli, Francesco Violi
OBJECTIVES: To investigate the incidence of bleeding events in atrial fibrillation (AF) patients treated with vitamin K (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) screened for the presence of liver fibrosis (LF). BACKGROUND: Previous studies provided conflicting results on bleeding risk in AF patients with liver disease on VKAs, and no data on NOACs in this setting are available. METHODS: Post-hoc analysis of a prospective, observational multicentre study including 2330 AF outpatients treated with VKAs (n = 1297) or NOACs (n = 1033)...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29768734/in-vitro-efficacy-of-pro-and-anticoagulant-strategies-in-compensated-and-acutely-ill-patients-with-cirrhosis
#2
Ton Lisman, Simone Kleiss, Vishal C Patel, Caleb Fisher, Jelle Adelmeijer, Sarah Bos, Arjuna Singanayagam, Sidsel Hyldgaard Stoy, Debbie L Shawcross, William Bernal
BACKGROUND & AIMS: A simultaneous decline in pro- and anticoagulant drivers in patients with liver diseases results in a 'rebalanced' hemostatic system, even in acutely ill patients. Nevertheless, both bleeding and thrombotic events are common. Here, we explored efficacy of pro- and antihemostatic strategies in compensated and acutely ill cirrhotics which may be unpredictable given the profound hemostatic changes. METHODS: We tested the effects in vitro of the addition of clinically relevant doses of commonly used pro- and antihemostatic strategies in plasma from healthy individuals (n=30) and patients with compensated (n=18) and acutely decompensated cirrhosis (n=18), and acute-on-chronic liver failure (n=10)...
May 16, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29747837/oral-anticoagulation-in-patients-with-liver-disease
#3
REVIEW
Arman Qamar, Muthiah Vaduganathan, Norton J Greenberger, Robert P Giugliano
Patients with liver disease are at increased risks of both thrombotic and bleeding complications. Many have atrial fibrillation (AF) or venous thromboembolism (VTE) necessitating oral anticoagulant agents (OACs). Recent evidence has contradicted the assumption that patients with liver disease are "auto-anticoagulated" and thus protected from thrombotic events. Warfarin and non-vitamin K-antagonist OACs have been shown to reduce thrombotic events safely in patients with either AF or VTE. However, patients with liver disease have largely been excluded from trials of OACs...
May 15, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29737362/-regional-citrate-anticoagulation-in-renal-replacement-therapy-in-the-intensive-care-station-recommendations-from-the-renal-section-of-the-dgiin-%C3%A3-giain-and-divi
#4
REVIEW
M Schmitz, M Joannidis, D Czock, S John, A Jörres, S J Klein, M Oppert, V Schwenger, J Kielstein, A Zarbock, D Kindgen-Milles, C Willam
BACKGROUND: Regional citrate anticoagulation (RCA) in continuous renal replacement therapy can effectively anticoagulate dialysis circuits without having adverse effects on systemic heparin application. In particular, in continuous renal replacement therapy RCA is well established and represents a safe procedure with longer filter lifetimes and fewer bleeding complications. OBJECTIVES: To provide guidance on the indications, advantages and disadvantages, and use of RCA, current recommendations from the renal section of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
May 8, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29731081/prevalence-of-antiphospholipid-antibody-positivity-and-association-of-pretransplant-lupus-anticoagulant-positivity-with-early-allograft-dysfunction-in-liver-transplantation
#5
H-M Kwon, K-W Jung, Y-J Moon, H-W Jung, Y-S Park, I-G Jun, J-G Song, G-S Hwang
BACKGROUND: Antiphospholipid antibodies (aPL), including anticardiolipin (aCL), anti-β2 -glycoprotein I (anti-β2GPI), and lupus anticoagulant (LA) antibodies, are frequently found in liver cirrhosis and associated with splanchnic vein thrombosis. Although the risk factors of early allograft dysfunction (EAD) are known, the association between EAD and aPL has been poorly investigated. We hypothesized that LA, potent aPL with thrombotic potential, may be associated with EAD development after living donor liver transplantation (LDLT)...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29723040/role-of-the-blood-coagulation-cascade-in-hepatic-fibrosis
#6
Asmita Pant, Anna K Kopec, James P Luyendyk
Liver is the primary source of numerous proteins critical for normal function of the blood coagulation cascade. Because of this, diseases of the liver, particularly when affiliated with severe complications like cirrhosis, are associated with abnormalities of blood clotting. Although conventional interpretation has inferred cirrhosis as a disorder of uniform bleeding risk, it is now increasingly appreciated as a disease wherein the coagulation cascade is precariously rebalanced. Moreover, prothrombotic risk factors are also associated with a more rapid progression of fibrosis in humans, suggesting that coagulation proteases participate in disease pathogenesis...
May 3, 2018: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/29720857/portal-vein-thrombosis-in-cirrhosis-diagnosis-natural-history-and-therapeutic-challenges
#7
REVIEW
Aikaterini Mantaka, Aikaterini Augoustaki, Elias A Kouroumalis, Dimitrios N Samonakis
Portal vein thrombosis (PVT) is a frequent complication in cirrhosis and its prevalence increases with disease severity. Several factors are involved in the development and progression of PVT. The challenge for the management of PVT is the precise evaluation of the bleeding risk as opposed to life-threatening extension of thrombosis. Nevertheless, the impact on the progression and outcome of liver disease is unclear. A critical evaluation of the available data discloses that treating PVT in cirrhotics is safe and effective...
May 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29714004/non-bleeding-adverse-events-with-the-use-of-direct-oral-anticoagulants-a-sequence-symmetry-analysis
#8
Géric Maura, Cécile Billionnet, Joël Coste, Alain Weill, Anke Neumann, Antoine Pariente
INTRODUCTION: Postmarketing pharmacovigilance reports have raised concerns about non-bleeding adverse events associated with direct oral anticoagulants (DOACs), but only limited results are available from large claims databases. OBJECTIVE: The aim of this study was to assess the potential association between DOAC initiation and the onset of four types of non-bleeding adverse events by sequence symmetry analysis (SSA). METHODS: SSA was performed using nationwide data from the French National Healthcare databases (Régime Général, 50 million beneficiaries) to assess a cohort of 386,081 DOAC new users for the first occurrence of four types of non-bleeding outcomes: renal, hepatic, skin outcomes identified by using hospitalization discharge diagnoses, and gastrointestinal outcomes by using medication reimbursement...
April 30, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29694286/primary-nonadherence-to-oral-anticoagulants-in-patients-with-atrial-fibrillation-real-world-data-from-a-population-based-cohort
#9
Clara L Rodriguez-Bernal, Salvador Peiró, Isabel Hurtado, Aníbal García-Sempere, Gabriel Sanfélix-Gimeno
BACKGROUND: Primary nonadherence (not filling a first prescription) is an important yet unstudied aspect of adherence to oral anticoagulant (OAC) therapy. OBJECTIVE: To estimate the rates of primary nonadherence to OACs and determine associated factors in real-world practice. METHODS: This population-based retrospective cohort study set in the Valencia region of Spain (about 5 million inhabitants) included all patients with atrial fibrillation who were newly prescribed OACs during 2011-2014 (N = 18,715)...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29626453/meld-xi-scoring-system-to-predict-outcomes-in-patients-who-undergo-lvad-implantation
#10
Andre Critsinelis, Chitaru Kurihara, Nastasya Volkovicher, Masashi Kawabori, Tadahisa Sugiura, Marcos Manon, Suwei Wang, Andrew B Civitello, Jeffrey A Morgan
BACKGROUND: The use of continuous flow left ventricular assist devices (CF-LVAD) to treat advanced heart failure is increasing. While risk score such as MELD and the HeartMate II Risk Score require the use of INR, many patients are on anticoagulation prior to CF-LVAD implantation. The aim of this study was to evaluate the ability of the Model of End-Stage Liver Disease-eXcluding INR (MELD-XI) scoring system to predict clinical outcomes in patients with advanced heart failure who undergo CF-LVAD implantation...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29600631/-exploring-chinese-medicine-and-western-medicine-group-modules-in-acute-phase-of-ischemic-stroke-disease
#11
Wei Yang, Ming-Quan Li, Yang Li, Lei-Lei Sun, Yan-Ming Xie, Chong-Hui Guo, Yan Zhuang
Under the theoretical guidance of "combination of disease and syndrome, correspondence between syndrome and prescription, and dynamic space-time", 11 135 acute ischemic stroke patients were collected from hospital information system(HIS) of many 3A grade hospitals of traditional Chinese medicine. Complex network analysis was adopted to obtain the core syndrome elements in different periods of acute ischemic stroke patients, and it was found that the core syndrome elements were blood stasis syndrome, phlegm, endogenous wind, Yin deficiency, Qi deficiency, heat, hyperactivity of liver Yang, liver, and kidney of patients in hospital for the first day, and during 8-14 d in hospitalization, the core syndrome elements were blood stasis, phlegm, Yin deficiency, Qi deficiency, endogenous wind, hyperactivity of liver Yang, liver, and kidney...
February 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/29580525/assessment-of-effects-of-phenolic-fractions-from-leaves-and-petals-of-dandelion-in-selected-components-of-hemostasis
#12
Bernadetta Lis, Dariusz Jędrejek, Anna Stochmal, Beata Olas
Aerial parts and roots of Taraxacum officinale (dandelion) have been found to be rich sources of polyphenols, including cinnamic acid derivatives, flavonoids and triterpenoids, which exert different biological activities, such as anti-inflammatory, anticancer and antimicrobial. Additionally, the whole plant is recognized as safe and well tolerated by humans, with no reported adverse effects. Nowadays, dandelion is a commonly available dietary supplement and a component of pharmaceutical preparations used for the treatment of bladder, liver, and spleen...
May 2018: Food Research International
https://www.readbyqxmd.com/read/29562331/the-2018-european-heart-rhythm-association-practical-guide-on-the-use-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation-executive-summary
#13
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain...
March 19, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29562325/the-2018-european-heart-rhythm-association-practical-guide-on-the-use-of-non-vitamin-k-antagonist-oral-anticoagulants-in-patients-with-atrial-fibrillation
#14
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the second update of the original Practical Guide, published in 2013 [Heidbuchel et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF) and have emerged as the preferred choice, particularly in patients newly started on anticoagulation...
March 17, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29519351/non-vitamin-k-antagonist-oral-anticoagulants-and-risk-of-serious-liver-injury
#15
Antonios Douros, Laurent Azoulay, Hui Yin, Samy Suissa, Christel Renoux
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) are relatively new drugs used for stroke prevention in nonvalvular atrial fibrillation (NVAF). However, there are concerns that their use may be associated with hepatotoxic effects. OBJECTIVES: The purpose of this study was to determine whether the use of NOACs is associated with an increased risk of serious liver injury compared with the use of vitamin K antagonists (VKAs) in NVAF patients with and without prior liver disease...
March 13, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29513969/evaluation-of-anticoagulant-effect-of-sulfated-polysaccharide-sps-from-codium-dwarkense-borgesen-in-%C3%AE%C2%BA-carrageenan-induced-hypercoagulable-state-in-wistar-albino-rats
#16
Hiral N Golakiya, Viren N Naik, Hiren N Hirapara, Kalpanaben H Mody, Alpesh P Goswami, Chandrabhanu Tripathi
Our aim of the present study was to evaluate the anticoagulant effect of sulfated polysaccharides (SPS) from Codium dwarkense Bergesen in ic-carrageenan induced hypercoagulable state in Wistar albino rats. 48 Wistar albino rats of either sex were randomly divided into 6 groups - disease control, active control, treatment lowmand high dose and preventive low and high dose. K-Carrageenan (3 mg/kg) single dose intravenously was given in rat tail vein at pre-decided time to produce hypercoagulable state. Baseline, 24, 48 and 72 hours duration blood samples were collected for PT, INR, aPTT, platelet count and fibrinogen level, FDP and D-Dimer measurements...
May 2017: Acta Poloniae Pharmaceutica
https://www.readbyqxmd.com/read/29499644/combined-value-of-left-ventricular-ejection-fraction-and-the-model-for-end-stage-liver-disease-meld-score-for-predicting-mortality-in-patients-with-acute-coronary-syndrome-who-were-undergoing-percutaneous-coronary-intervention
#17
Tuncay Kırıs, Eyüp Avcı, Aykan Çelik
BACKGROUND: The purpose of the study was to investigate whether the addition of left ventricular ejection fraction (LVEF) to the MELD score enhances the prediction of mortality in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: This retrospective study analyzed 846 consecutive patients with ACS undergoing PCI who were not receiving previous anticoagulant therapy. The patients were grouped as survivors or non-survivors...
March 2, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29468795/suboptimal-use-of-pharmacological-venous-thromboembolism-prophylaxis-in-cirrhotic-patients
#18
Linda S Yang, Sumaya Alukaidey, Katherine Croucher, Damian Dowling
BACKGROUND: Cirrhosis was previously perceived as a haemorrhagic disease state due to frequent associations with coagulopathy and bleeding. However, the coagulopathy of cirrhosis is complex with defects in both pro-coagulant and anticoagulant factors. Derangements in common laboratory indices of coagulation do not accurately reflect bleeding risk or protection from thrombotic events. AIM: We aim to assess the rate of pharmacological prophylaxis for VTE among hospital inpatients with cirrhosis and analyse factors associated with prophylaxis being inappropriately withheld...
February 21, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29462053/vitamin-k-antagonists-and-emergencies
#19
Frédéric Lapostolle, Virginie Siguret, Anne-Céline Martin, Claire Pailleret, Bernard Vigué, Yves Zerbib, Karim Tazarourte
The recent emergence of 'non-VKA' oral anticoagulants may have led to some forgetting that vitamin K antagonists (VKA) are by far the most widely prescribed oral anticoagulants worldwide. Consequently, we decided to summarize the information available on them. This paper presents the problems facing emergency physicians confronted with patients on VKAs in 10 points, from pharmacological data to emergency management. Vitamin K antagonists remain preferable in many situations including in the elderly, in patients with extreme body weights, severe chronic kidney or liver disease or valvular heart disease, and in patients taking VKAs with well-controlled international normalized ratios (INRs)...
February 16, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29444357/safety-of-direct-oral-anticoagulants-vs-warfarin-in-patients-with-chronic-liver-disease-and-atrial-fibrillation
#20
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 vs warfarin in CLD patients with AF. METHODS: This was a retrospective cohort study of patients with CLD and AF initiated on oral anticoagulants...
May 2018: European Journal of Haematology
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