Latest & greatest articles for anticoagulation

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Top results for anticoagulation

601. Trial of different intensities of anticoagulation in patients with prosthetic heart valves. (PubMed)

Trial of different intensities of anticoagulation in patients with prosthetic heart valves. We compared the efficacy and complications of anticoagulation with warfarin in 258 patients with prosthetic heart valves treated with regimens of "moderate intensity" (prothrombin-time ratio, 1.5; international normalized ratio, 2.65) or "high intensity" (prothrombin-time ratio, 2.5; international normalized ratio, 9) in a prospective, randomized study. The two patient groups were followed up for 421 (...) , as compared with 10.1 episodes in the high-intensity group (P less than 0.01). Major bleeding was also more common in the high-intensity group (2.1 episodes per 100 patient-years--including the only two fatal hemorrhages--as compared with 0.95 episode in the moderate-intensity group), but the difference was not statistically significant. We conclude that a moderate anticoagulant effect (prothrombin-time ratio, about 1.5) in patients with a mechanical prosthetic heart valve offers protection equivalent

1990 NEJM

602. Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. (PubMed)

Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. We carried out a placebo-controlled, double-blind, randomized study of the hemostatic effect of tranexamic acid mouthwash after oral surgery in 39 patients receiving anticoagulant agents because of the presence of cardiac valvular stenosis, a prosthetic cardiac valve, or a vascular prosthesis. Surgery was performed with no change in the level of anticoagulant therapy, and treatment (...) with the anticoagulant agent was continued after surgery. Before it was sutured, the operative field was irrigated in 19 patients with 10 ml of a 4.8 percent aqueous solution of tranexamic acid (an inhibitor of fibrinolysis) and in 20 patients with a placebo solution. For seven days thereafter, patients were instructed to rinse their mouths with 10 ml of the assigned solution for two minutes four times a day. There were no significant differences between the two treatment groups in base-line variables, including

1989 NEJM

603. Trial of low-dose aspirin plus dipyridamole versus anticoagulants for prevention of aortocoronary vein graft occlusion. (PubMed)

Trial of low-dose aspirin plus dipyridamole versus anticoagulants for prevention of aortocoronary vein graft occlusion. In a prospective randomised trial, 249 patients who had aortocoronary vein bypass surgery were assigned either to a platelet inhibitory drug regimen or to standard anticoagulant therapy. Treatment was replaced by placebo in half of the patients in each group after 3 months. The platelet inhibitory drug regimen--very low-dose aspirin combined with dipyridamole--was as effective (...) as standard anticoagulant therapy to prevent early and late graft occlusion. Death, myocardial infarction, and severe bleeding occurred significantly more often in patients receiving anticoagulants, whereas mild drug-related gastrointestinal and cerebral side-effects were more common in patients taking platelet inhibitory drugs. Antithrombotic treatment should be continued for at least 1 year after coronary artery bypass graft surgery.

1989 Lancet

604. Randomised comparison of two intensities of oral anticoagulant therapy after tissue heart valve replacement. (PubMed)

Randomised comparison of two intensities of oral anticoagulant therapy after tissue heart valve replacement. After tissue heart valve replacement 108 patients were randomised to standard anticoagulant control with rabbit brain thromboplastin (Dade C reagent, therapeutic range 18-24 s; international normalised ratio 2.5-40) and 102 to a less intensive regimen controlled with human brain thromboplastin (Manchester Comparative Reagent, therapeutic range 26-30 s; INR 2.0-2.25). Treatment (...) complications, all were in the standard treatment group, again a significant difference. The less intensive regimen is thus no less effective and safer than standard anticoagulant therapy in patients with tissue heart valve replacement.

1988 Lancet

605. Influence of postoperative anticoagulant treatment on patient survival after femoropopliteal vein bypass surgery. (PubMed)

Influence of postoperative anticoagulant treatment on patient survival after femoropopliteal vein bypass surgery. To examine whether anticoagulants given after autologous saphenous bypass surgery influenced patient survival 119 patients who received such a graft for obliterative arterial disease were recruited for a controlled clinical trial. Patients were randomly assigned to start, in the second postoperative week, phenprocoumon (60 patients) or no treatment (59 patients). The median duration

1988 Lancet

606. Is a controlled trial of long-term oral anticoagulants in patients with stroke and non-rheumatic atrial fibrillation worthwhile? (PubMed)

Is a controlled trial of long-term oral anticoagulants in patients with stroke and non-rheumatic atrial fibrillation worthwhile? A controlled randomised trial large enough to assess the value of anticoagulating stroke patients in atrial fibrillation would be difficult to conduct in the UK and the results would be applicable to only a small proportion of stroke patients. It would be more worthwhile to organise a trial that also assessed the value of other treatments that are simpler (...) and applicable to all stroke patients. A trial that assessed the value of aspirin and beta-blockers against control in all stroke patients would not cost much more than one restricted to comparing anticoagulants against control in patients with stroke and atrial fibrillation but would provide information of more relevance to the management of patients with stroke in the UK.

1986 Lancet

607. Need for long-term anticoagulant treatment in symptomatic calf-vein thrombosis. (PubMed)

Need for long-term anticoagulant treatment in symptomatic calf-vein thrombosis. The need for oral anticoagulation in patients with calf-vein thrombosis was examined in a randomised study of 51 patients, of whom 23 received warfarin for 3 months and 28 did not. Both groups received an initial course of heparin and all wore compression stockings. Progress was monitored by the use of serial isotope tests and physical examination. Phlebography was repeated if recurrence was suspected. During (...) the first 3 months, 8 patients in the non-warfarin group (29%) had recurrences compared with none in the warfarin group (p less than 0.01). 5 patients had recurrence with proximal extension and 1 patient had a pulmonary embolus. After 1 year, 22 out of 23 patients in the warfarin group had not had a recurrence, compared with 19 out of 28 (p less than 0.02). The findings indicate that oral anticoagulants should be given to all patients with thrombi that produce symptoms. Treatment for 3 months seems

1985 Lancet

608. A controlled comparison of aspirin and oral anticoagulants in prevention of death after myocardial infarction. (PubMed)

A controlled comparison of aspirin and oral anticoagulants in prevention of death after myocardial infarction. Although neither aspirin nor oral anticoagulants have been conclusively shown to reduce mortality in patients surviving myocardial infarction, both have been widely used for that purpose. In the present clinical trial we compared the effects of aspirin (0.5 g given three times a day) and oral-anticoagulant therapy. Of 6908 patients considered for entry, 1303 were randomized (...) to anticoagulant (652) or aspirin (651) an average of 11.4 days after the onset of myocardial infarction and were followed for 6 to 59 months (mean, 29 months). There were 65 deaths in the anticoagulant group and 72 in the aspirin group. The number of patients with reinfarctions was higher in the aspirin group (33 vs. 20). None of these differences were statistically significant. Almost twice as many patients were withdrawn from therapy in the aspirin group. There were 54 per cent more patients

1982 NEJM

609. Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. (PubMed)

Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. We have previously reported that long-term therapy with warfarin is effective for preventing recurrent venous thromboembolism in patients with proximal-vein thrombosis but that there is an appreciable risk of hemorrhage. To determine whether that risk could be reduced without a loss of effectiveness, we randomly allocated 96 patients with proximal-vein thrombosis to a group receiving less intense (...) anticoagulant therapy, with a mean prothrombin time of 26.9 seconds using the Manchester comparative reagent (corresponding Simplastin time, 15 seconds), or a group given more intense therapy, with a mean Simplastin time of 19.4 seconds (corresponding prothrombin time 41 seconds with the Manchester comparative reagent) (P less than 0.001). Two of 47 patients (4 per cent) in the less intensely treated group had hemorrhagic complications, as compared with 11 of 49 patients (22 per cent) in the more intensely

1982 NEJM

610. A double-blind trial to assess long-term oral anticoagulant therapy in elderly patients after myocardial infarction. Report of the Sixty Plus Reinfarction Study Research Group. (PubMed)

A double-blind trial to assess long-term oral anticoagulant therapy in elderly patients after myocardial infarction. Report of the Sixty Plus Reinfarction Study Research Group. In a randomised double-blind multicentre clinical trial the effect of continued oral anticoagulant therapy after a myocardial infarction was assessed in a group of patients over 60 years of age. Half of the 878 patients who had been on anticoagulants ever since their primary myocardial infarction received placebos (...) instead of the anticoagulant; the others continued anticoagulant therapy. All were followed for 2 years. The levels of hypocoagulability reached in the group on anticoagulants were such that, of the registered prothrombin times ('Thrombotest'), 72% were between 107 and 180 s. 2-year total mortality was 13.4% in the placebo group and 7.6% in the group treated with anticoagulants (p = 0.017. 2-year incidence of recurrent myocardial infarction was 15.9% in the placebo group and 5.7% in the anticoagulant

1980 Lancet

611. Failure of antiplatelet and anticoagulant therapy to improve patency of grafts after coronary-artery bypass: a controlled, randomized study. (PubMed)

Failure of antiplatelet and anticoagulant therapy to improve patency of grafts after coronary-artery bypass: a controlled, randomized study. Fifty patients who underwent aortocoronary saphenous-vein bypass-graft surgery were randomly assigned to one of three groups to determine the effects of antiplatelet or anticoagulant therapy on graft patency. Twenty-four patients served as controls; 13 patients received aspirin (325 mg three times a day) and dipyridamole (75 mg three times a day); and 13

1979 NEJM

612. Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction. (PubMed)

Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction. Since the last comprehensive review of anticoagulation in acute myocardial infarction four additional randomized control trials have been reported. The overwhelming majority of all trials favored anticoagulation. Rates of thromboembolism were higher in the control, and hemorrhagic complications in the anticoagulated group. Pooling of all randomized control trials gives mean case fatality rates (...) of 19.6% for the control and 15.4% for the anticoagulated group, a relative reduction of 21% (P less than 0.05 or less than 0.001, depending on the analytic method). Five of six randomized control trials reported "no effect" because the difference favoring anticoagulation was not statistically significant. However, sample sizes in these "negative" papers were too small to protect against missing a 21% reduction in true case fatality rate due to anticoagulation (beta greater than 0.10). All patients

1977 NEJM

613. Anticoagulants in acute myocardial infarction. Results of a cooperative clinical trial. (PubMed)

Anticoagulants in acute myocardial infarction. Results of a cooperative clinical trial. 4578167 1973 09 21 2016 10 17 0098-7484 225 7 1973 Aug 13 JAMA JAMA Anticoagulants in acute myocardial infarction. Results of a cooperative clinical trial. 724-9 eng Clinical Trial Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 0 Anticoagulants 0 Placebos 5Q7ZVV76EI Warfarin 9005-49-6 Heparin 9NEZ333N27 Sodium AIM IM Acute Disease Adult Aged Anticoagulants adverse effects

1973 JAMA

614. Anticoagulant therapy after acute myocardial infarction. Relation of therapeutic benefit to patient's age, sex, and severity of infarction. (PubMed)

Anticoagulant therapy after acute myocardial infarction. Relation of therapeutic benefit to patient's age, sex, and severity of infarction. 4117261 1973 01 05 2016 10 17 0098-7484 222 5 1972 Oct 30 JAMA JAMA Anticoagulant therapy after acute myocardial infarction. Relation of therapeutic benefit to patient's age, sex, and severity of infarction. 541-8 Drapkin A A Merskey C C eng Clinical Trial Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 0 Anticoagulants 0 (...) Placebos 5M7Y6274ZE Phenindione 5Q7ZVV76EI Warfarin 7QID3E7BG7 Dicumarol 9005-49-6 Heparin AIM IM Age Factors Aged Anticoagulants adverse effects therapeutic use Cerebrovascular Disorders mortality Clinical Trials as Topic Diabetes Complications Dicumarol therapeutic use Electrocardiography Female Heart Failure complications Hemorrhage chemically induced Heparin therapeutic use Humans Hypertension complications Male Middle Aged Myocardial Infarction complications drug therapy mortality Phenindione

1973 JAMA

615. Long-term anticoagulant therapy after myocardial infarction. Final report of the Veterans Administration cooperative study. (PubMed)

Long-term anticoagulant therapy after myocardial infarction. Final report of the Veterans Administration cooperative study. 4885975 1969 04 16 2016 10 17 0098-7484 207 12 1969 Mar 24 JAMA JAMA Long-term anticoagulant therapy after myocardial infarction. Final report of the Veterans Administration cooperative study. 2263-7 Ebert R V RV eng Clinical Trial Journal Article Randomized Controlled Trial United States JAMA 7501160 0098-7484 0 Anticoagulants 97C5T2UQ7J Cholesterol AIM IM Anticoagulants

1969 JAMA