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https://www.readbyqxmd.com/read/28339794/short-term-dabigatran-interruption-before-cardiac-rhythm-device-implantation-multi-centre-experience-from-the-re-ly-trial
#1
Vidal Essebag, Riccardo Proietti, David H Birnie, Jia Wang, James Douketis, Benoit Coutu, Ratika Parkash, Gregory Y H Lip, Stefan H Hohnloser, Andrew Moriarty, Jonas Oldgren, Stuart J Connolly, Michael Ezekowitz, Jeff S Healey
Aims: Cardiac implantable electronic device (CIED) surgery is commonly performed in patients with atrial fibrillation (AF). The current analysis was undertaken to compare peri-operative anticoagulation management, bleeding, and thrombotic events in AF patients treated with dabigatran vs. warfarin. Methods and results: This study included 611 patients treated with dabigatran vs. warfarin who underwent CIED surgery during the RE-LY trial. Among 201 warfarin-treated patients, warfarin was interrupted a median of 144 (inter-quartile range, IQR: 120-216) h, and 37 (18...
February 23, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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/28160670/cost-effectiveness-of-the-addition-of-a-comprehensive-ct-scan-to-the-abdomen-and-pelvis-for-the-detection-of-cancer-after-unprovoked-venous-thromboembolism
#3
Kathryn Coyle, Marc Carrier, Alejandro Lazo-Langner, Sudeep Shivakumar, Ryan Zarychanski, Vicky Tagalakis, Susan Solymoss, Nathalie Routhier, James Douketis, Douglas Coyle
IMPORTANCE: Unprovoked venous thromboembolism (VTE) can be the first manifestation of cancer. It is unclear if extensive screening for occult cancer including a comprehensive computed tomography (CT) scan of the abdomen/pelvis is cost-effective in this patient population. OBJECTIVE: To assess the health care related costs, number of missed cancer cases and health related utility values of a limited screening strategy with and without the addition of a comprehensive CT scan of the abdomen/pelvis and to identify to what extent testing should be done in these circumstances to allow early detection of occult cancers...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28075424/managing-challenging-patients-with-venous-thromboembolism-a-practical-case-based-approach
#4
REVIEW
James Douketis, Walter Ageno, Marc Carrier, Clive Kearon
The management of patients with venous thromboembolism (VTE) is a common clinical scenario that, for the most part, involves well‑established, evidence‑based treatment pathways. However, important unanswered clinical questions remain that are the focus of ongoing research. The aim of this narrative review is to provide a practical, case‑based approach to the following clinical scenarios in which therapeutic management pathways are less well established: How long to administer anticoagulation to patients with a first unprovoked VTE? How to manage complex patients with cancer‑associated VTE? When and how to treat patients with splanchnic vein thrombosis? When to use thrombolytic therapy for deep vein thrombosis?...
January 4, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/27900627/extended-duration-versus-short-duration-pharmacological-thromboprophylaxis-in-acutely-ill-hospitalized-medical-patients-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
REVIEW
Aaron Y L Liew, Siavash Piran, John W Eikelboom, James D Douketis
Extended-duration pharmacological thromboprophylaxis, for at least 28 days, is effective for the prevention of symptomatic venous thromboembolism (VTE) in high-risk surgical patients but is of uncertain benefit in hospitalized medical patients. We aimed to evaluate the efficacy and safety of extended-duration thromboprophylaxis in hospitalized medical patients. We conducted a systematic PubMed, Medline and EMBASE literature search until June 2016 and a meta-analysis of randomized controlled trials which compared extended-duration with short-duration thromboprophylaxis in hospitalized medical patients...
April 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27872458/periprocedural-risk-of-bleeding-and-thrombosis-to-bridge-or-not-to-bridge-dr-james-douketis-in-an-interview-with-dr-roman-jaeschke-part-2
#6
James Douketis, Roman Jaeschke
No abstract text is available yet for this article.
October 28, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27872457/bridge-trial-dr-james-douketis-in-an-interview-with-dr-roman-jaeschke-part-1
#7
James Douketis, Roman Jaeschke
No abstract text is available yet for this article.
October 28, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27786333/real-life-treatment-of-venous-thromboembolism-with-direct-oral-anticoagulants-the-influence-of-recommended-dosing-and-regimens
#8
Javier Trujillo-Santos, Pierpaolo Di Micco, Francesco Dentali, James Douketis, José Antonio Díaz-Peromingo, Manuel Jesús Núñez, Inmaculada Cañas, Daniela Mastroiacovo, Marta Saraiva de Sousa, Manuel Monreal
In patients with venous thromboembolism (VTE), the influence on outcome of using direct oral anticoagulants (DOACs) at non-recommended doses or regimens (once vs twice daily) has not been investigated yet. We used the RIETE (Registro Informatizado Enfermedad TromboEmbólica) registry to compare the outcomes in patients with VTE receiving DOACs according to the recommendations of the product label versus in those receiving non-recommended doses and/or regimens. The major outcomes were the rate of VTE recurrences, major bleeding and death during the course of therapy...
January 26, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27766542/the-2016-american-college-of-chest-physicians-treatment-guidelines-for-venous-thromboembolism-a-review-and-critical-appraisal
#9
REVIEW
James Demetrios Douketis
The American College of Chest Physicians recently updated their practice guidelines for the treatment of patients with venous thromboembolism, comprising deep vein thrombosis and pulmonary embolism. The 2016 guidelines represent the tenth iteration of these guidelines, which are widely used, and are considered as the reference standard for practice guidelines related to venous thromboembolism. The objectives of this review are to highlight the key recommendations that are new in these guidelines, to address recommendations that may be considered controversial, and to touch on areas of ongoing research that may better inform some of these recommendations...
December 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27733271/international-clinical-practice-guidelines-including-guidance-for-direct-oral-anticoagulants-in-the-treatment-and-prophylaxis-of-venous-thromboembolism-in-patients-with-cancer
#10
REVIEW
Dominique Farge, Henri Bounameaux, Benjamin Brenner, Francis Cajfinger, Philippe Debourdeau, Alok A Khorana, Ingrid Pabinger, Susan Solymoss, James Douketis, Ajay Kakkar
Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at an increased risk of developing VTE and are more likely to have a recurrence of VTE and bleeding while taking anticoagulants. Management of VTE in patients with cancer is a major therapeutic challenge and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME), established to reduce the global burden of VTE in patients with cancer, published international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis...
October 2016: Lancet Oncology
https://www.readbyqxmd.com/read/27662066/reply-to-dr-lessire-et-al
#11
James Douketis, Sam Schulman, Summer Syed
No abstract text is available yet for this article.
September 22, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27637308/perioperative-management-of-the-direct-oral-anticoagulants-a-case-based-review
#12
REVIEW
Benjamin R Bell, Alex C Spyropoulos, James D Douketis
The periprocedural management of patients on direct oral anticoagulants (DOACs) is a common but potentially challenging clinical problem because there are few prospective studies to guide clinical decisions. Retrospective analyses from randomized trials and observational data suggest that DOACs can be managed in a standardized manner, based on surgical and patient characteristics, that does not result in excess major bleeding or thrombosis. In a case-based manner, this article presents a perioperative DOAC management algorithm and reviews the available and emerging evidence supporting the safety and efficacy of this approach...
October 2016: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/27627817/perioperative-aspirin-for-prevention-of-venous-thromboembolism-the-perioperative-ischemia-evaluation-2-trial-and-a-pooled-analysis-of-the-randomized-trials
#13
RANDOMIZED CONTROLLED TRIAL
John W Eikelboom, Clive Kearon, Gordon Guyatt, Daniel I Sessler, Salim Yusuf, Deborah Cook, James Douketis, Ameen Patel, Andrea Kurz, Rene Allard, Philip M Jones, Rodolfo J Dennis, Thomas W Painter, Sergio D Bergese, Kate Leslie, Duminda N Wijeysundera, Kumar Balasubramanian, Emmanuelle Duceppe, Scott Miller, Johan Diedericks, P J Devereaux
BACKGROUND: The PeriOperative ISchemia Evaluation-2 (POISE-2) trial compared aspirin with placebo after noncardiac surgery. METHODS: The authors randomly assigned 10,010 patients undergoing noncardiac surgery to receive 200 mg aspirin or placebo 2 to 4 h before surgery and then 100 mg aspirin daily or placebo daily for up to 30 days after surgery. Herein, the authors report the effect of aspirin on venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, as well as an updated pooled analysis of randomized trials of antiplatelet therapy for VTE prevention in noncardiac surgery patients...
December 2016: Anesthesiology
https://www.readbyqxmd.com/read/27354153/d-dimer-levels-and-recurrence-in-patients-with-unprovoked-vte-and-a-negative-qualitative-d-dimer-test-after-treatment
#14
C Kearon, S Parpia, F A Spencer, T Baglin, S M Stevens, K A Bauer, S R Lentz, C M Kessler, J D Douketis, S Moll, S Kaatz, S Schulman, J M Connors, J S Ginsberg, L Spadafora, P C Liaw, J I Weitz, J A Julian
BACKGROUND: The rate of recurrent venous thromboembolism (VTE) in patients with a first unprovoked VTE who had a negative qualitative D-dimer test one month after stopping anticoagulant therapy was higher than expected in the D-dimer Optimal Duration Study (DODS). OBJECTIVES: To determine whether quantitative D-dimer levels using a low threshold, age- and sex-specific thresholds, or repeated measurements, would improve identification of patients at low risk of recurrent VTE...
October 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27216797/portal-vein-thrombosis-in-patients-with-cirrhosis-underdiagnosis-and-undertreatment
#15
Aaron Liew, James Douketis
No abstract text is available yet for this article.
December 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26988871/periprocedural-management-of-patients-receiving-a-vitamin-k-antagonist-or-a-direct-oral-anticoagulant-requiring-an-elective-procedure-or-surgery
#16
REVIEW
A C Spyropoulos, A Al-Badri, M W Sherwood, J D Douketis
The periprocedural management of patients receiving chronic therapy with oral anticoagulants (OACs), including vitamin K antagonists (VKAs) such as warfarin and direct OACs (DOACs), is a common clinical problem. The optimal perioperative management of patients receiving chronic OAC therapy is anchored on four key principles: (i) risk stratification of patient-related and procedure-related risks of thrombosis and bleeding; (ii) the clinical consequences of a thrombotic or bleeding event; (iii) discontinuation and reinitiation of OAC therapy on the basis of the pharmacokinetic properties of each agent; and (iv) whether aggressive management such as the use of periprocedural heparin bridging has advantages for the prevention of postoperative thromboembolism at the cost of a possible increase in bleeding risk...
May 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/26974733/restarting-antithrombotics-after-gi-bleeding-was-linked-to-better-outcomes-in-patients-with-af
#17
COMMENT
Geoffrey D Barnes, James D Douketis
No abstract text is available yet for this article.
March 15, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/26916299/urgent-surgery-or-procedures-in-patients-taking-dabigatran-or-warfarin-analysis-of-perioperative-outcomes-from-the-re-ly-trial
#18
James D Douketis, Jeff S Healey, Martina Brueckmann, Mandy Fraessdorf, Alex C Spyropoulos, Lars Wallentin, Jonas Oldgren, Paul Reilly, Michael D Ezekowitz, Stuart J Connolly, Salim Yusuf, John W Eikelboom
BACKGROUND: There is concern about the management of anticoagulated patients with atrial fibrillation (AF) who require an urgent surgery/procedure, especially in those who are receiving a direct oral anticoagulant such as dabigatran. METHODS: We accessed the database from RE-LY, a randomized trial comparing dabigatran (110mg and 150mg twice daily) with warfarin for stroke prevention in AF, to assess patients who had an urgent and elective surgery/procedure. We compared the risk for thromboembolism, major bleeding and mortality according to treatment allocation (dabigatran 110mg or 150mg, or warfarin) or surgery/procedure type (urgent or elective)...
March 2016: Thrombosis Research
https://www.readbyqxmd.com/read/26882272/periprocedural-management-of-direct-oral-anticoagulants-comment-on-the-2015-american-society-of-regional-anesthesia-and-pain-medicine-guidelines
#19
REVIEW
James D Douketis, Summer Syed, Sam Schulman
No abstract text is available yet for this article.
March 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26817957/risk-factors-predictive-of-occult-cancer-detection-in-patients-with-unprovoked-venous-thromboembolism
#20
RANDOMIZED CONTROLLED TRIAL
Ryma Ihaddadene, Daniel J Corsi, Alejandro Lazo-Langner, Sudeep Shivakumar, Ryan Zarychanski, Vicky Tagalakis, Susan Solymoss, Nathalie Routhier, James Douketis, Gregoire Le Gal, Marc Carrier
Risk factors predictive of occult cancer detection in patients with a first unprovoked symptomatic venous thromboembolism (VTE) are unknown. Cox proportional hazard models and multivariate analyses were performed to assess the effect of specific risk factors on occult cancer detection within 1 year of a diagnosis of unprovoked VTE in patients randomized in the Screening for Occult Malignancy in Patients with Idiopathic Venous Thromboembolism (SOME) trial. A total of 33 (3.9%; 95% CI, 2.8%-5.4%) out of the 854 included patients received a new diagnosis of cancer at 1-year follow-up...
April 21, 2016: Blood
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