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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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Blood transfusion and filter set requirements with citrate anticoagulation compared with heparin in renal replacement therapy 28979523 2018 11 13 1751-1437 17 4 2016 Nov Journal of the Intensive Care Society J Intensive Care Soc Blood transfusion and filter set requirements with citrate anticoagulation compared with heparin in renal replacement therapy. 357 10.1177/1751143716647395 Taylor Nick N Department of Intensive Care, Royal Surrey County Hospital, Guildford, UK. Walter Edward E
Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm. Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including stroke and thromboembolism, which in turn contribute to high mortality. Oral anticoagulants (e.g. warfarin) and antiplatelet agents (e.g. aspirin) are the principle oral antithrombotic agents. Many heart failure patients with sinus rhythm take aspirin because coronary artery (...) disease is the leading cause of heart failure. Oral anticoagulants have become a standard in the management of heart failure with atrial fibrillation. However, a question remains regarding the appropriateness of oral anticoagulants in heart failure with sinus rhythm. This update of a review previously published in 2012 aims to address this question.To assess the effects of oral anticoagulant therapy versus antiplatelet agents for all-cause mortality, non-fatal cardiovascular events and risk of major
Practice Patterns and Outcomes Associated With Use of Anticoagulation Among Patients With Atrial Fibrillation During Sepsis Atrial fibrillation (AF) during sepsis is associated with an increased risk of ischemic stroke during hospitalization, but risks and benefits associated with anticoagulation for AF during sepsis are unclear.To determine clinician practice patterns and patient risk of stroke and bleeding associated with use of anticoagulation for AF during sepsis.A retrospective cohort (...) study using enhanced administrative claims data from approximately 20% of patients hospitalized in the United States July 1, 2010, to June 30, 2013, examined patients with AF during sepsis who did not have additional indications for therapeutic anticoagulation. Propensity score and instrumental variable analyses were used to evaluate risks of in-hospital stroke and bleeding associated with anticoagulation during sepsis.Parenteral anticoagulants administered in doses greater than those used
Anticoagulation therapy and proximal femoral fracture treatment: An update Hip fractures in the elderly population have become a 'disease' with increasing incidence.Most of the geriatric patients are affected by a number of comorbidities.Coagulopathies continue to be a special point of interest for the orthopaedic trauma surgeon, with the management of this high-risk group of patients a hot topic of debate among the orthopaedic community.While a universal consensus on how to manage (...) thromboprophylaxis for this special cohort of patients has not been reached, multiple attempts to define a widely accepted protocol have been published. Cite this article: Ktistakis I, Giannoudis V, Giannoudis PV. Anticoagulation therapy and proximal femoral fracture treatment: an update. EFORT Open Rev 2016;1:310-315. DOI: 10.1302/2058-5241.1.160034.
Trust me, I’m a patient! Managing anticoagulation therapy Trust me, I’m a patient! Managing anticoagulation therapy - Evidently Cochrane Search and hit Go By August 17, 2016 // In this guest blog, David Roberts looks at whether putting patients in control can improve the quality of their anticoagulation therapy. Patients who have a tendency to form blood clots are at a high risk of severe complications such as stroke. They may need to take blood-thinning medication, ‘anticoagulants’, often (...) for the long-term. To avoid complications, the effect of the most common anticoagulant tablet must be monitored with a blood test. Improvements in technology now mean this test can be done within minutes at home, raising the question: can’t clinicians trust patients to monitor their own blood tests and self-manage their treatment? When are clots a problem? When an injury occurs to a blood vessel, a clot forms to prevent torrential blood loss, but clots can form at unwanted sites and unwanted times
Individualising Anticoagulant Therapy in Atrial Fibrillation Patients Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as alternatives to VKAs for the prevention of stroke in patients with non-valvular atrial fibrillation. Four NOACS: dabigatran, apixaban, rivaroxaban and edoxaban, have received regulatory approval in Europe from the European Medicines Agency. Numerous factors can influence the decision to prescribe a NOAC, the most important of which are assessment
Venous Thromboembolism in Cancer: An Update of Treatment and Prevention in the Era of Newer Anticoagulants Cancer patients are at major risk of developing venous thromboembolism (VTE), resulting in increased morbidity and economic burden. While a number of theories try to explain its pathophysiology, its risk stratification can be broadly done in cancer-related, treatment-related, and patient-related factors. Studies report the prophylactic use of thrombolytic agents to be safe and effective
Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants and warfarin in patients with atrial fibrillation: propensity weighted nationwide cohort study. To study the effectiveness and safety of the non-vitamin K antagonist oral anticoagulants (novel oral anticoagulants, NOACs) dabigatran, rivaroxaban, and apixaban compared with warfarin in anticoagulant naïve patients with atrial fibrillation. Observational nationwide cohort study. Three Danish nationwide databases (...) , August 2011 to October 2015. 61 678 patients with non-valvular atrial fibrillation who were naïve to oral anticoagulants and had no previous indication for valvular atrial fibrillation or venous thromboembolism. The study population was distributed according to treatment type: warfarin (n=35 436, 57%), dabigatran 150 mg (n=12 701, 21%), rivaroxaban 20 mg (n=7192, 12%), and apixaban 5 mg (n=6349, 10%). Effectiveness outcomes defined a priori were ischaemic stroke; a composite of ischaemic stroke
Reversal of the anticoagulant effect of dabigatran: idarucizumab Re Rev versal of the anticoagulant effect of ersal of the anticoagulant effect of dabigatr dabigatran: idarucizumab an: idarucizumab Evidence summary Published: 24 May 2016 nice.org.uk/guidance/esnm73 pathways K Ke ey points from the e y points from the evidence vidence The content of this evidence summary was up-to-date in May 2016. See summaries of product characteristics (SPCs), British national formulary (BNF) or the MHRA (...) or NICE websites for up- to-date information. Summary Idarucizumab is the first agent to be licensed in the UK that reverses the anticoagulant effect of a non-vitamin K antagonist oral anticoagulant (NOAC). Its action is specific against the NOAC dabigatran etexilate. In the interim analysis of an ongoing, phase III, uncontrolled, cohort study (RE-VERSE AD; n=90), treatment with a 5 g dose of idarucizumab completely reversed the anticoagulant effect of dabigatran etexilate in adults who had either
Clinical impact of a pharmacist-led inpatient anticoagulation service: a review of the literature Anticoagulant therapies provide management options for potentially life-threatening thromboembolic conditions. They also carry significant safety risks, requiring careful consideration of medication dose, close monitoring, and follow-up. Inpatients are particularly at risk, considering the widespread use of anticoagulants in hospitals. This has prompted the introduction of safety goals (...) for anticoagulants in Canada and the USA, which recommend increased pharmacist involvement to reduce patient harm. The goal of this review is to evaluate the efficacy and safety of pharmacist-led inpatient anticoagulation services compared to usual or physician-managed care.This narrative review includes articles identified through a literature search of PubMed, Embase, and International Pharmaceutical Abstracts databases, as well as hand searches of the references of relevant articles. Full publications
Recurrent venous thromboembolism and abnormal uterine bleeding with anticoagulant and hormone therapy use Women receiving vitamin K antagonists (VKAs) require adequate contraception because of the potential for fetal complications. It is unknown whether the use of hormonal therapy, especially those containing estrogens, is associated with recurrent venous thromboembolism (VTE) during anticoagulation. Despite the absence of data, World Health Organization guidelines state that use of estrogen (...) -containing contraceptives confers an "unacceptable health risk" during established anticoagulation for VTE. We compared the incidences of recurrent VTE and abnormal uterine bleeding with and without concomitant hormonal therapy in women aged <60 years who were receiving anticoagulation with rivaroxaban or enoxaparin/VKA for confirmed VTE. Incidence densities in percentage per year were computed for the on and off estrogen-containing or progestin-only therapy periods. Cox regression models were fitted
Andexanet alfa for acute major bleeding episodes requiring reversal of anticoagulation, including reversal of factor Xa inhibition - first line Andexanet alfa for acute major bleeding episodes requiring reversal of anticoagulation, including reversal of factor Xa inhibition – first line Andexanet alfa for acute major bleeding episodes requiring reversal of anticoagulation, including reversal of factor Xa inhibition – first line NIHR HSRIC Record Status This is a bibliographic record (...) of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation NIHR HSRIC. Andexanet alfa for acute major bleeding episodes requiring reversal of anticoagulation, including reversal of factor Xa inhibition – first line. Birmingham: NIHR Horizon Scanning Research&Intelligence Centre. Horizon Scanning Review. 2016 Authors' objectives Anticoagulants are drugs which prevent the blood from clotting. This can be important for the treatment
Vitamin K, fresh frozen plasma, and platelet transfusion used to arrest progression of intracranial hemorrhage after traumatic brain injury in a patient taking anticoagulant and antiplatelet agents An 89-year-old man fell from stairs and sustained head trauma. He was taking warfarin and aspirin. Upon arrival at our hospital, his Glasgow Coma Scale score was 14. Initial head computed tomography showed small acute subdural hematoma. We immediately administered vitamin K and ordered fresh-frozen (...) progression of traumatic intracranial hemorrhages in this patient taking anticoagulant/antiplatelet agents and may have averted brain surgery.
Anticoagulant therapy for non-ST-segment elevation acute coronary syndrome in China: A multi-center observational study To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS.A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December (...) (UFH), low-molecular-weight heparin (LMWH), fondaparinux, PCI, and single medication was 0.61%, 66.42%, 30.61%, 69.64%, and 70.74%, respectively.Compared with NSTE-MI, UA is featured with better prognosis, less severity, and different outcome. However, in clinical practice, the therapies for NSTE-MI and UA show no differences, which deserves great attention. In China, the most common anticoagulant therapies for NSTE-ACS are single medication, mainly based on LMWH and PCI.
Oral anticoagulation, stroke and thromboembolism in patients with atrial fibrillation and valve bioprosthesis. The Loire Valley Atrial Fibrillation Project Vitamin K antagonists are currently recommended in patients with 'valvular' atrial fibrillation (AF), e. g. those having mitral stenosis or artificial heart valves. We compared thromboembolic risk in patients with 'non valvular' AF and in those with AF and biological valve replacement (valve bioprosthesis). Among 8962 AF patients seen
Anticoagulation, CHADSVASc Score, and Thromboembolic Risk of Cardioversion of Acute Atrial Fibrillation (from the FinCV Study) The efficacy of the anticoagulation in preventing thromboembolic complications (TEC) and the usefulness of the CHA2DS2VASc score for assessing stroke risk during cardioversion of acute atrial fibrillation (AF) are unclear. Thus, our objectives were to assess the ability of the CHA2DS2VASc score to predict TEC and to evaluate the efficacy of anticoagulation (...) in the prevention of TEC in Finnish CardioVersion (FinCV) study. The FinCV is a retrospective, multicenter study of 3,143 patients, who underwent 7,660 cardioversions for acute AF. The value of the CHA2DS2VASc score in predicting TEC was analyzed separately in cardioversions performed without and with anticoagulation. A total of 40 definite TEC (0.6%) occurred after 7,237 successful cardioversions and 1 stroke (0.2%) after 423 unsuccessful procedures. In 5,362 cardioversions performed without anticoagulation
D-dimer and factor VIIa in atrial fibrillation - prognostic values for cardiovascular events and effects of anticoagulation therapy. A RE-LY substudy Coagulation markers may improve monitoring the risk of stroke and bleeding in patients with atrial fibrillation (AF) during anticoagulant treatment. We examined baseline levels of D-dimer and their association with stroke, cardiovascular death and major bleeding in 6,202 AF patients randomised to dabigatran or warfarin in the RE-LY trial (...) to established clinical risk factors improved prediction of stroke/SEE, cardiovascular death and major bleeding (C-index increased from 0.66 to 0.68, 0.71 to 0.73 and 0.66 to 0.67, respectively). Dabigatran provided a greater reduction of D-dimer levels than warfarin regardless of baseline anticoagulant treatment. On-treatment levels of FVIIa were markedly reduced by warfarin (median 12.1-13.8 mU/ml) but significantly higher with dabigatran (median 39.4-49.0 mU/ml) at all-time points. Dabigatran
The SAME-TT2R2 score predicts the quality of anticoagulation control in patients with acute VTE. A real-life inception cohort study The SAMe-TT2R2 score has recently been proposed to predict the quality of vitamin K antagonist (VKA) anticoagulation control in patients with atrial fibrillation. We aimed at investigating whether the score is effective also in patients with venous thromboembolism (VTE). Patients included in the START-Register because started VKA therapy for a recent VTE episode (...) VTE patients those who will have good (score 0-1) or less good (score ≥ 2) VKA anticoagulation control. The score can help decision-making in everyday clinical practice, especially when choosing between VKA and non-vitamin K antagonists direct anticoagulants.
Local Hemostatic Measures Are Enough To Control Bleeding In Implant Patients On Oral Anticoagulation Therapy UTCAT3023, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Local Hemostatic Measures Are Enough To Control Bleeding In Implant Patients On Oral Anticoagulation Therapy Clinical Question In a patient on oral anticoagulation therapy, are local hemostatic measures enough to prevent post-procedural bleeding after (...) implant placement? Clinical Bottom Line Local hemostatic measures are proven to be enough. It is not recommended for patients to be taken off of their anticoagulation therapy before a dental implant surgery. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Madrid/2009 2017 adult patients, 19 included studies Systematic Review of Randomized Control Trials, Controlled Clinical Trials, and Prospective Case