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UFH rivaroxaban

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https://www.readbyqxmd.com/read/28929298/chronic-kidney-disease-and-anticoagulation-from-vitamin-k-antagonists-and-heparins-to-direct-oral-anticoagulant-agents
#1
REVIEW
Savino Sciascia, Massimo Radin, Karen Schreiber, Roberta Fenoglio, Simone Baldovino, Dario Roccatello
Anticoagulation in patients with impaired kidney function can be challenging since drugs' pharmacokinetics and bioavailability are altered in this setting. Patients with chronic kidney disease (CKD) treated with conventional anticoagulant agents [vitamin K antagonist (VKA), low-molecular weight heparin (LMWH) or unfractionated heparin (UFH)] are at high risk of bleeding events (both non-major and major clinically relevant bleeding). While anticoagulation reduces the risk of thromboembolic events, the co-existing bleeding risk and the fact that the most commonly used anticoagulation agents are eliminated via the kidneys pose additional challenges...
December 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28856946/spontaneous-hit-syndrome-post-knee-replacement-surgery-with-delayed-recovery-of-thrombocytopenia-a-case-report-and-literature-review
#2
Dilli Ram Poudel, Sushil Ghimire, Rashmi Dhital, Daniel A Forman, Theodore E Warkentin
Recently published reports have established a heparin-induced thrombocytopenia (HIT)-mimicking thromboembolic disorder without proximate heparin exposure, called spontaneous HIT syndrome. Although the pathophysiology remains unclear, anti-platelet factor 4 (PF4)/heparin antibodies possibly triggered by exposure to knee cartilage glycosaminoglycans or other non-heparin polyanions found on bacterial surfaces and nucleic acids have been postulated. We present a 53-year-old female receiving antithrombotic prophylaxis with aspirin following right total knee replacement surgery (without perioperative or any previous lifetime heparin exposure) who acutely presented with high-risk pulmonary embolism (PE) and right great saphenous vein thrombophlebitis on postoperative day (POD) 14; her platelet count at presentation was 13 × 10(9)/L...
September 2017: Platelets
https://www.readbyqxmd.com/read/28594426/new-developments-in-anticoagulants-past-present-and-future
#3
Jeffrey I Weitz, Job Harenberg
Thrombosis is a leading cause of death and disability worldwide, and anticoagulants are the mainstay of its prevention and treatment. Starting with unfractionated heparin (UFH) and vitamin K antagonists (VKAs) such as warfarin, the choices of anticoagulants have exploded in the past 20 years. With over 90 % subcutaneous bioavailability, no need for coagulation monitoring and dose adjustment, and a lower risk of heparin-induced thrombocytopenia, low-molecular-weight heparin and fondaparinux have replaced UFH for prevention and initial treatment of venous thromboembolism and for secondary prevention in cancer patients...
June 28, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28525532/the-effects-of-indirect-and-direct-acting-anticoagulants-on-lupus-anticoagulant-assays-a-large-retrospective-study-at-a-coagulation-reference-laboratory
#4
Jansen N Seheult, Michael P Meyer, Franklin A Bontempo, Irina Chibisov
Objectives: To investigate the effects of indirect- and direct-acting anticoagulants on the interpretation of lupus anticoagulant (LAC) assays. Methods: A retrospective database review was performed to identify all LAC panels from November 2012 to November 2015. The positivity rates for three LAC tests were compared among various anticoagulant medications. Results: This analysis included 7,721 LAC panels. Direct oral anticoagulants, warfarin, and unfractionated heparin (UFH) were associated with higher LAC positivity rates compared with patients not receiving documented anticoagulation (83% for argatroban, 58% for dabigatran, 72% for rivaroxaban, 53% for apixaban, 56% for warfarin, and 36% for UFH vs 29% for no anticoagulation, P < ...
June 1, 2017: American Journal of Clinical Pathology
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
#5
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...
May 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28043992/direct-oral-anticoagulants-and-heparins-laboratory-values-and-pitfalls-in-bridging-therapy
#6
Thomas Eller, Tobias Flieder, Vanessa Fox, Tatjana Gripp, Marcus Dittrich, Joachim Kuhn, Susanne Alban, Cornelius Knabbe, Ingvild Birschmann
Objectives: The three direct oral anticoagulants (DOACs) dabigatran, apixaban and rivaroxaban are now widely used in clinical practice. For patients requiring perioperative interruption of DOACs, heparin bridging is still under discussion. Here we show, for the first time, the influence of concomitantly used DOACs and heparins on laboratory assays. Methods: For spiking experiments, 10 healthy donors and nine patients treated with DOACs were investigated. The measurement of DOACs and heparins was performed with routine methods on the ACL TOP [HEMOCLOT ® direct thrombin inhibitor (CoaChrom Diagnostica, Austria), COAMATIC ® Heparin (Chromogenix, USA) calibrated with rivaroxaban, apixaban, unfractionated heparin (UFH) and low molecular weight heparin (LMWH), additionally PT reagent RecombiPlasTin 2G and aPTT reagent SynthASil (Instrumentation Laboratory, Germany)] and the DOACs were additionally quantified with liquid chromatography-mass spectrometry...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27919873/managing-transitions-from-oral-factor-xa-inhibitors-to-unfractionated-heparin-infusions
#7
Andrew C Faust, Dave Kanyer, Ann K Wittkowsky
PURPOSE: Published evidence regarding the effects of oral factor Xa inhibitors on anticoagulation monitoring tests is reviewed with a focus on monitoring concerns that can arise during transitions to i.v. heparin therapy. SUMMARY: Assays that measure inhibition of factor Xa activity (i.e., anti-Xa assays) are widely used in U.S. institutions to monitor i.v. heparin therapy and, in some cases, for monitoring other types of anticoagulation therapy. Clinicians have raised concerns that the use of anti-Xa assays to monitor heparin levels in hospitalized patients who must be transitioned from oral factor Xa inhibitor therapy to i...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/26800365/developing-drugs-for-use-before-during-and-soon-after-percutaneous-coronary-intervention
#8
REVIEW
Giuseppe Gargiulo, Aris Moschovitis, Stephan Windecker, Marco Valgimigli
INTRODUCTION: Percutaneous coronary intervention (PCI) is a milestone for treating coronary artery disease (CAD). Antithrombotic therapy is essential to prevent ischemic complications, including the microvascular no-reflow, while minimizing bleeding events. AREAS COVERED: This overview discusses available and developing drugs for PCI including anticoagulants, antiplatelets and treatment of no-reflow. EXPERT OPINION: For years unfractionated heparin (UFH) has been the unique anticoagulant to be used before and during PCI...
2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/26258975/-acute-and-chronic-anticoagulation-therapy-in-relation-to-joint-replacements
#9
Jaroslav Malý
Thromboembolic disease (TED) is a considerable social and health problem. The solution evidently consists in the prevention of TED in clinical fields, not in the treatment itself. We can assume that effective prevention consequently reduces the cost of the following treatment. A lethal pulmonary embolism (PE) can be the first and the final clinical manifestation in patients with an asymptomatic deep venous thrombosis. This makes the systematic prevention of venous thromboembolism in higher risk patients necessary...
June 2015: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/25948149/acute-phase-treatment-of-vte-anticoagulation-including-non-vitamin-k-antagonist-oral-anticoagulants
#10
REVIEW
Christopher M Hillis, Mark A Crowther
The acute phase of venous thromboembolism (VTE) treatment focuses on the prompt and safe initiation of full-dose anticoagulation to decrease morbidity and mortality. Immediate management consists of resuscitation, supportive care, and thrombolysis for patients with haemodynamically significant pulmonary embolism (PE) or limb-threatening deep-vein thrombosis (DVT). Patients with contraindications to anticoagulants are considered for vena cava filters. Disposition for the acute treatment of VTE is then considered based on published risk scores and the patient's social status, as the first seven days carries the highest risk for VTE recurrence, extension and bleeding due to anticoagulation...
June 2015: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/25925992/peri-procedural-use-of-rivaroxaban-in-elective-percutaneous-coronary-intervention-to-treat-stable-coronary-artery-disease-the-x-plorer-trial
#11
RANDOMIZED CONTROLLED TRIAL
P Vranckx, F W G Leebeek, J G P Tijssen, J Koolen, F Stammen, J-P R Herman, R J de Winter, A W J van T Hof, B Backx, W Lindeboom, S-Y Kim, B Kirsch, M van Eickels, F Misselwitz, F W A Verheugt
Patients on rivaroxaban requiring percutaneous coronary intervention (PCI) represent a clinical conundrum. We aimed to investigate whether rivaroxaban, with or without an additional bolus of unfractionated heparin (UFH), effectively inhibits coagulation activation during PCI. Stable patients (n=108) undergoing elective PCI and on stable dual antiplatelet therapy were randomised (2:2:2:1) to a short treatment course of rivaroxaban 10 mg (n=30), rivaroxaban 20 mg (n=32), rivaroxaban 10 mg plus UFH (n=30) or standard peri-procedural UFH (n=16)...
August 2015: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/25851062/shortened-length-of-hospital-stay-with-rivaroxaban-in-patients-with-symptomatic-venous-thromboembolism-in-japan-the-j-einstein-pulmonary-embolism-and-deep-vein-thrombosis-program
#12
RANDOMIZED CONTROLLED TRIAL
Hiroshi Matsuo, Martin Prins, Anthonie W A Lensing, Emi Watanabe Fujinuma, Yuki Miyamoto, Mariko Kajikawa
BACKGROUND: In Japan, the standard of care for the treatment of pulmonary embolism (PE) and/or deep vein thrombosis (DVT) consists of intravenous unfractionated heparin (UFH) followed by warfarin, which was recently compared with rivaroxaban, an oral factor Xa inhibitor, in randomized trials. AIM: To examine the length of hospital stay in patients with PE and/or DVT receiving rivaroxaban compared to Japanese standard therapy in the Japanese (J)-EINSTEIN PE and DVT program...
June 2015: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/25717286/oral-rivaroxaban-for-japanese-patients-with-symptomatic-venous-thromboembolism-the-j-einstein-dvt-and-pe-program
#13
Norikazu Yamada, Atsushi Hirayama, Hideaki Maeda, Satoru Sakagami, Hiroo Shikata, Martin H Prins, Anthonie Wa Lensing, Masaharu Kato, Junichi Onuma, Yuki Miyamoto, Kazuma Iekushi, Mariko Kajikawa
BACKGROUND: The global EINSTEIN DVT and PE studies compared rivaroxaban (15 mg twice daily for 3 weeks followed by 20 mg once daily) with enoxaparin/vitamin K antagonist therapy and demonstrated non-inferiority for efficacy and superiority for major bleeding. Owing to differences in targeted anticoagulant intensities in Japan, Japanese patients were not enrolled into the global studies. Instead, a separate study of deep vein thrombosis (DVT) and/or pulmonary embolism (PE) in Japanese patients was conducted, which compared the Japanese standard of care with a reduced dose of rivaroxaban...
2015: Thrombosis Journal
https://www.readbyqxmd.com/read/25543899/recent-advances-in-optimal-adjunctive-antithrombotic-therapy-in-stemi-patients-undergoing-primary-angioplasty-an-overview
#14
REVIEW
Giuseppe De Luca, Harry Suryapranata
There has been a considerable effort to improve adjunctive antithrombotic therapies to reperfusion strategies in the treatment of ST-segment elevation Myocardial Infarction (STEMI). Therefore, the aim of this article is to provide a critical and updated overview of recent advances on adjunctive antithrombotic therapies in patients undergoing primary angioplasty for STEMI. Due to very low costs, early Unfractionated Heparin (UFH) plus additional periprocedural administration should still be regarded as the gold standard in antithrombotic therapy, whereas subsequent subcutaneous administration of Low Molecular Weight Heparins (LMWHs) or fondaparinux should be considered, especially in patients at higher risk of thromboembolic complications...
2015: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/25226478/clinical-and-safety-outcomes-associated-with-treatment-of-acute-venous-thromboembolism-a-systematic-review-and-meta-analysis
#15
REVIEW
Lana A Castellucci, Chris Cameron, Grégoire Le Gal, Marc A Rodger, Doug Coyle, Philip S Wells, Tammy Clifford, Esteban Gandara, George Wells, Marc Carrier
IMPORTANCE: Many anticoagulant strategies are available for the treatment of acute venous thromboembolism, yet little guidance exists regarding which drug is most effective and safe. OBJECTIVE: To summarize and compare the efficacy and safety outcomes associated with 8 anticoagulation options (unfractionated heparin [UFH], low-molecular-weight heparin [LMWH], or fondaparinux in combination with vitamin K antagonists); LMWH with dabigatran or edoxaban; rivaroxaban; apixaban; and LMWH alone) for treatment of venous thromboembolism...
September 17, 2014: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/24337310/anticoagulation-during-and-after%C3%A2-acute-coronary-syndrome
#16
REVIEW
I Ahrens, C Bode, A Zirlik
Current antithrombotic therapy in patients with acute coronary syndrome (ACS) comprises antiplatelet and anticoagulant therapy. Dual antiplatelet therapy composed of aspirin plus a third generation P2Y12 inhibitor (prasugrel or ticagrelor) represents the gold standard, while aspirin plus second generation P2Y12 inhibitor (clopidogrel) may be used as an alternative in the presence of contraindications for third generation P2Y12 inhibitors and/or a high risk of bleeding. Unfractionated heparin (UFH) has been the unchallenged mainstay in anticoagulation for ACS for many decades and is still widely used in patients with ACS treated interventionally...
2014: Hämostaseologie
https://www.readbyqxmd.com/read/24177334/update-on-pharmacologic-therapy-for-pulmonary-embolism
#17
REVIEW
Prakash Harikrishnan, Chandrasekar Palaniswamy, Wilbert S Aronow
Warfarin, unfractionated heparin (UFH), and low-molecular-weight heparins are anticoagulants that have been used for treatment of pulmonary embolism. Currently approved drugs for treatment of venous thromboembolism include UFH, enoxaparin, dalteparin, fondaparinux, warfarin, and rivaroxaban. The advent of newer oral anticoagulants such as rivaroxaban, dabigatran, and apixaban has provided us with alternative therapeutic options for long-term anticoagulation. This article will give an overview of the various anticoagulant drugs, use in various clinical scenarios, data supporting their clinical use, and recommendations regarding duration of anticoagulant therapy...
March 2014: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/23067175/-therapeutic-approach-to-the-bleeding-in-association-with-old-and-new-anticoagulants
#18
REVIEW
P Dulíček
There are a several new anticoagulants emerging in the clinical medicine in the last a few years. Rivaroxaban, an oral direct F Xa inhibitor has been already approved in more than 100 countries worldwide, and Dabigatran etexilate, an oral direct thrombin inhibitor is also routinely used in thromboprophylaxis of venous thromboembolism. These agents possess many of the characteristic of the "ideal" anticoagulant but a lack of specific antidotes may be a potentional disadvantage in the therapy of bleeding complications...
July 2012: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/22648489/thromboprophylaxis-in-surgical-and-medical-patients
#19
REVIEW
Silvia Bozzato, Luca Galli, Walter Ageno
Venous thromboembolism (VTE) remains the most common preventable cause of death in hospitalized patients. There is much evidence to show the efficacy of prophylactic strategies to prevent VTE in at-risk hospitalized patients. For example, pharmacological prophylaxis reduces the risk of pulmonary embolism by 75% in general surgical patients and by 57% in medical patients. Thus international guidelines strongly recommend effective preventive strategies for all hospitalized patients defined as moderate to high risk for VTE...
April 2012: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/21773837/comparison-of-unfractionated-heparin-low-molecular-weight-heparin-low-dose-and-high-dose-rivaroxaban-in-preventing-thrombus-formation-on-mechanical-heart-valves-results-of-an-in-vitro-study
#20
COMPARATIVE STUDY
Anja Kaeberich, Iris Reindl, Uwe Raaz, Lars Maegdefessel, Alexander Vogt, Torsten Linde, Ulrich Steinseifer, Elisabeth Perzborn, Baerbel Hauroeder, Michael Buerke, Karl Werdan, Axel Schlitt
Thromboembolism and bleeding after mechanical heart valve replacement are still unsolved problems, particularly for patients requiring anticoagulative bridging therapy. The aim of this study was to investigate whether rivaroxaban, a new oral selective and direct coagulation factor Xa inhibitor, is as effective as enoxaparin and unfractionated heparin (UFH) in preventing thrombus formation on mechanical heart valves using an in vitro system. Blood from healthy male donors was anticoagulated with either UFH, enoxaparin, rivaroxaban at 300 ng/ml, (n = 10 each), or rivaroxaban at 30 ng/ml (n = 3)...
November 2011: Journal of Thrombosis and Thrombolysis
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