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Latest & greatest articles for anticoagulation
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on anticoagulation or other clinical topics then use Trip today.
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Association of Oral Anticoagulants and Proton Pump Inhibitor Cotherapy With Hospitalization for Upper Gastrointestinal Tract Bleeding. Anticoagulant choice and proton pump inhibitor (PPI) cotherapy could affect the risk of upper gastrointestinal tract bleeding, a frequent and potentially serious complication of oral anticoagulant treatment.To compare the incidence of hospitalization for upper gastrointestinal tract bleeding in patients using individual anticoagulants with and without PPI (...) cotherapy, and to determine variation according to underlying gastrointestinal bleeding risk.Retrospective cohort study in Medicare beneficiaries between January 1, 2011, and September 30, 2015.Apixaban, dabigatran, rivaroxaban, or warfarin with or without PPI cotherapy.Hospitalizations for upper gastrointestinal tract bleeding: adjusted incidence and risk difference (RD) per 10 000 person-years of anticoagulant treatment, incidence rate ratios (IRRs).There were 1 643 123 patients with 1 713 183 new
American Society of Hematology 2018 guidelines for management of venous thromboembolism: optimal management of anticoagulation therapy Clinicians confront numerous practical issues in optimizing the use of anticoagulants to treat venous thromboembolism (VTE).These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians and other health care professionals in their decisions about the use of anticoagulants in the management of VTE (...) . These guidelines assume the choice of anticoagulant has already been made.ASH formed a multidisciplinary guideline panel balanced to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation
Impact of anticoagulant choice on hospitalized bleeding risk when treating cancer-associated venous thromboembolism Essentials Bleeding risk by anticoagulant choice for cancer-associated venous thrombosis (CA-VTE) is unknown. 26 894 people with CA-VTE were followed for bleeding in a claims database in the United States. Hospitalized bleeding risk was similar with direct acting oral anticoagulants vs. warfarin. Relative hospitalized bleeding risk varied by cancer type and anticoagulant choice (...) . SUMMARY: Background Direct acting oral anticoagulants (DOACs) are associated with less bleeding than traditional venous thromboembolism (VTE) treatments in the general population but are little studied in cancer-associated VTE (CA-VTE). Objective To determine whether different anticoagulation strategies for CA-VTE have different hospitalized bleeding rates. Patients/Methods We conducted a retrospective study of patients with CA-VTE, diagnosed between 2011 and 2015, in a large administrative database
Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? TAKE-HOME MESSAGE Older adults have a lower risk of any severity of bleeding (includes both major and minor bleeding) when treated with aspirin or clopidogrel compared to warfarin. However, if minor bleeding is excluded, only the subgroup of patients aged 80 years or older demonstrate a lower risk the of major bleeding with antiplatelet agents. Is the Risk of Bleeding (...) Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? EBEM Commentators Cameron Gettel, MD Elizabeth M. Goldberg, MD, ScM Department of Emergency Medicine Alpert Medical School of Brown University Providence, RI Results Commentary Several systematic reviews have previously shown that the risk of bleeding with long-term treatment with aspirin was lower than with warfarin. 2,3 It is common clinical practice to use antiplatelet agents as alternatives
Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation? Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation? - CanadiEM Blood & Clots Series: How do you choose an anticoagulant for stroke prevention in atrial fibrillation? In , by Kerstin de Wit October 23, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed : Expert, health advocate, communicator Case (...) rule which includes the same variables as the CHADS score with a lower age cut-off of 65 (also used in CHADSVASC). There are two ways you can use these sores in the emergency setting. 1. You can use the estimated yearly risk of stroke to inform your patient about the risks and benefits of starting on anticoagulation. Clinical pearl: The simplest way to convert the CHADS2 score into a clinically meaningful concept is (CHADS2 score x 2) = yearly risk of patient having a stroke. For example
Prothrombin Complex Concentrates for Perioperative Vitamin K Antagonist and Non-vitamin K Anticoagulant Reversal Vitamin K antagonist therapy is associated with an increased bleeding risk, and clinicians often reverse anticoagulation in patients who require emergency surgical procedures. Current guidelines for rapid anticoagulation reversal for emergency surgery recommend four-factor prothrombin complex concentrate and vitamin K coadministration. The authors reviewed the current evidence
Effect of Variation in Published Stroke Rates on the Net Clinical Benefit of Anticoagulation for Atrial Fibrillation. Stroke rates in patients with nonvalvular atrial fibrillation (AF) who are not receiving anticoagulant therapy vary widely across published studies; the resulting effect on the net clinical benefit of anticoagulation in AF is unknown.To determine the effect of variation in published AF stroke rates on the net clinical benefit of anticoagulation.Markov model decision analysis (...) . Warfarin was the base case, and non-vitamin K antagonist oral anticoagulants (NOACs) were modeled in a secondary analysis.Community-dwelling adults.33 434 adults with incident AF.Quality-adjusted life-years (QALYs).Of the 33 434 patients, 27 179 had a CHA2DS2-VASc (congestive heart failure, hypertension, age, diabetes, stroke, and vascular disease) score of 2 or more. The population benefit of warfarin anticoagulation for these patients was least using stroke rates from the ATRIA (AnTicoagulation
"HERDOO2" clinical decision rule to guide duration of anticoagulation in women with unprovoked venous thromboembolism. Can I use any d-Dimer? The "HERDOO2 rule" is a prospectively validated clinical decision rule used to identify low-risk women who can safely discontinue anticoagulants after completing 5-12 months of anticoagulant treatment for unprovoked venous thromboembolism. The VIDAS®d-Dimer (DD) assay, a component of the rule, was used in the derivation and validation of the rule at half (...) , -0.004-0.07)).The "HERDOO2 rule" is the only prospectively validated clinical decision rule that can be used to identify low-risk women with unprovoked venous thrombosis who can safely discontinue anticoagulants. An important implementation issue is whether any commercial DD assay can be used in the HERDOO2 rule, and at what cut-point. Our analysis shows that the HemosIL®, Innovance®, Liatest® and Tina-quant® DD assays should not be used in the "HERDOO2" rule due to poor concordance with the VIDAS®
Anticoagulation Top results for anticoagulation - Trip Database or use your Google+ account Liberating the literature ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2 (...) ) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for anticoagulation The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms
Practical Guide to Ablation for Epicardial Ventricular Tachycardia: When to Get Access, How to Deal with Anticoagulation and How to Prevent Complications Epicardial ablation is needed to eliminate ventricular tachycardia (VT) in some patients with nonischaemic cardiomyopathy. The 12-lead electrocardiogram of VT, pre-procedural imaging and endocardial unipolar voltage maps can predict a high likelihood of epicardial substrate and VT. A septal VT substrate may preclude the need for epicardial (...) access and mapping and can be identified with imaging, pacing and voltage mapping. Pericardial access is usually obtained prior to systemic anticoagulation or after reversal of systemic anticoagulation. A unique set of complications can be encountered with epicardial access, mapping and ablation, which include haemopericardium, phrenic nerve injury, damage to major coronary arteries and pericarditis. Anticipating, preventing and, if necessary, managing these complications are paramount for patient
Risks and benefits of direct oral anticoagulants versus warfarin in a real world setting: cohort study in primary care. To investigate the associations between direct oral anticoagulants (DOACs) and risks of bleeding, ischaemic stroke, venous thromboembolism, and all cause mortality compared with warfarin.Prospective open cohort study.UK general practices contributing to QResearch or Clinical Practice Research Datalink.132 231 warfarin, 7744 dabigatran, 37 863 rivaroxaban, and 18 223 apixaban (...) users without anticoagulant prescriptions for 12 months before study entry, subgrouped into 103 270 patients with atrial fibrillation and 92 791 without atrial fibrillation between 2011 and 2016.Major bleeding leading to hospital admission or death. Specific sites of bleeding and all cause mortality were also studied.In patients with atrial fibrillation, compared with warfarin, apixaban was associated with a decreased risk of major bleeding (adjusted hazard ratio 0.66, 95% confidence interval 0.54
Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications Interventional Spine and Pain Procedures in Patients on Anti... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account (...) Procite Reference Manager Save my selection doi: 10.1097/AAP.0000000000000700 CHRONIC AND INTERVENTIONAL PAIN: SPECIAL ARTICLE Free The American Society of Regional Anesthesia and Pain Medicine (ASRA) 2012 survey of meeting attendees showed that existing ASRA anticoagulation guidelines for regional anesthesia were insufficient for their needs. Those surveyed agreed that procedure-specific and patient-specific factors required separate guidelines for pain and spine procedures. In response, a guidelines
A clinical decision support tool for improving adherence to guidelines on anticoagulant therapy in patients with atrial fibrillation at risk of stroke: A cluster-randomized trial in a Swedish primary care setting (the CDS-AF study) Atrial fibrillation (AF) is associated with substantial morbidity, in particular stroke. Despite good evidence for the reduction of stroke risk with anticoagulant therapy, there remains significant undertreatment. The main aim of the current study was to investigate (...) for thromboembolism (according to the CHA2DS2-VASc algorithm) without anticoagulant therapy. The primary endpoint was adherence to guidelines after 1 year. After randomization, there were 22 and 21 primary care clinics in the CDS and control groups, respectively. There were no significant differences in baseline adherence to guidelines regarding anticoagulant therapy between the 2 groups (CDS group 70.3% [5,186/7,370; 95% CI 62.9%-77.7%], control group 70.0% [4,187/6,009; 95% CI 60.4%-79.6%], p = 0.83). After 12
Incident Risk Factors and Major Bleeding in Patients with Atrial Fibrillation Treated with Oral Anticoagulants: A Comparison of Baseline, Follow-up and Delta HAS-BLED Scores with an Approach Focused on Modifiable Bleeding Risk Factors When assessing bleeding risk in patients with atrial fibrillation (AF), risk stratification is often based on the baseline risks. We aimed to investigate changes in bleeding risk factors and alterations in the HAS-BLED score in AF patients. We hypothesized
Blood and Clots Series: When can patients on direct anticoagulants have surgery? Blood and Clots Series: When can patients on direct anticoagulants have surgery? - CanadiEM Blood and Clots Series: When can patients on direct anticoagulants have surgery? In , by Kerstin de Wit April 3, 2018 All the content from the Blood & Clots series can be found . CanMEDS Roles addressed: Professional, Collaborator, Medical expert As a Thrombosis specialist, I am often paged by emergency physicians (...) and orthopedic surgeons requesting anticoagulation reversal in order to facilitate surgery. There are some simple and important points to remember when dealing with this clinical scenario. Case Description It is 8am on Monday morning and you are the orthopedic resident on call today. The night resident asked you to review the 83-year-old woman who presented to the emergency department after falling out of bed during the night. She has an intertrochanteric hip fracture and will require surgical fixation
The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines - Anticoagulation During Cardiopulmonary Bypass CLINICAL PRACTICE GUIDELINES The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines*—Anticoagulation During Cardiopulmonary Bypass Linda Shore-Lesserson, MD, Robert (...) , University of Texas-Southwestern Medical Center, Dallas, Texas; Division of Cardiovascular Perfusion, Medical University of South Carolina, Charleston, South Carolina; Department of Anesthesiology, Saint Anthony Hospital, Lakewood, Colorado; and Department of Cardiothoracic Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina Despite more than a half century of “safe” cardiopulmo- nary bypass (CPB), the evidence base surrounding the conduct of anticoagulation therapy for CPB
Non-Vitamin K Antagonist Oral Anticoagulants and Risk of Serious Liver Injury 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.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
Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: A US Hepatologistâ€™s Perspective 29607296 2019 01 28 2450-131X 6 1 2018 Mar Journal of translational internal medicine J Transl Int Med Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: A US Hepatologist's Perspective. 1-5 10.2478/jtim-2018-0001 Northup Patrick G PG MD Center for the Study of Coagulation in Liver Disease, Division of Gastroenterology and Hepatology, University of Virginia