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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 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
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
Timing of Anticoagulation for Portal Vein Thrombosis in Liver Cirrhosis: An Italian Internistâ€™s Perspective 29607297 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: An Italian Internist's Perspective. 6-10 10.2478/jtim-2018-0002 Riva Nicoletta N Department of Pathology, University of Malta, Msida, Malta. Ageno Walter W Department of Medicine and Surgery, University
VKORC1 and VKORC1L1 have distinctly different oral anticoagulant dose-response characteristics and binding sites Vitamin K reduction is catalyzed by 2 enzymes in vitro: the vitamin K 2,3-epoxide reductase complex subunit 1 (VKORC1) and its isozyme VKORC1-like1 (VKORC1L1). In vivo, VKORC1 reduces vitamin K to sustain γ-carboxylation of vitamin K-dependent proteins, including coagulation factors. Inhibition of VKORC1 by oral anticoagulants (OACs) is clinically used in therapy and in prevention
Direct Oral Anticoagulants in Addition to Antiplatelet Therapy for Secondary Prevention After Acute Coronary Syndromes: A Systematic Review and Meta-analysis. Patients with acute coronary syndrome (ACS) remain at high risk for experiencing recurrent ischemic events. Direct oral anticoagulants (DOAC) have been proposed for secondary prevention after ACS.To evaluate the safety and efficacy of DOAC in addition to antiplatelet therapy (APT) after ACS, focusing on treatment effects stratified
Direct-Acting Oral Anticoagulants as Prophylaxis Against Thromboembolism in the Nephrotic Syndrome We report 2 cases of apixaban use as prophylaxis against thromboembolism in the nephrotic syndrome (NS), and review the existing literature on direct-acting oral anticoagulant (DOAC) use in this scenario. Our cases appear to be the first reported use of apixaban as prophylaxis against thromboembolism in NS. We report our systematic review of the existing literature on direct-acting oral (...) anticoagulant (DOAC) use in NS, and discuss theoretical issues relevant to their therapeutic use in this clinical scenario. We searched electronic databases such as OVID, EMBASE, PubMed, and CENTRAL, DARE. The search to identify studies and the application of inclusion and exclusion criteria was performed in duplicate independently. We identified 1 pilot randomized study, 3 case reports, and 3 conference proceedings abstracts relating to DOAC use in NS. These reports all pertain to the treatment
The Significance of Drugâ€”Drug and Drugâ€”Food Interactions of Oral Anticoagulation Vitamin K antagonists (VKAs) such as warfarin are the most commonly prescribed oral anticoagulants worldwide. However, factors affecting the pharmacokinetics of VKAs, such as food and drugs, can cause deviations from their narrow therapeutic window, increasing the bleeding or thrombosis risk and complicating their long-term use. The use of direct oral anticoagulants (DOACs) offers a safer and more convenient
Combination of the low anticoagulant heparin CX-01 with chemotherapy for the treatment of acute myeloid leukemia Relapses in acute myelogenous leukemia (AML) are a result of quiescent leukemic stem cells (LSCs) in marrow stromal niches, where they resist chemotherapy. LSCs employ CXCL12/CXCR4 to home toward protective marrow niches. Heparin disrupts CXCL12-mediated sequestration of cells in the marrow. CX-01 is a low-anticoagulant heparin derivative. In this pilot study, we combined CX-01
Ischaemic stroke, haemorrhage, and mortality in older patients with chronic kidney disease newly started on anticoagulation for atrial fibrillation: a population based study from UK primary care. To assess the association between anticoagulation, ischaemic stroke, gastrointestinal and cerebral haemorrhage, and all cause mortality in older people with atrial fibrillation and chronic kidney disease.Propensity matched, population based, retrospective cohort analysis from January 2006 through (...) anticoagulation in the preceding 120 days were excluded, as were patients requiring dialysis and recipients of renal transplants.Receipt of an anticoagulant prescription within 60 days of atrial fibrillation diagnosis.Ischaemic stroke, cerebral or gastrointestinal haemorrhage, and all cause mortality.6977 patients with chronic kidney disease and newly diagnosed atrial fibrillation were identified, of whom 2434 were on anticoagulants within 60 days of diagnosis and 4543 were not. 2434 pairs were matched using
The safety of regional citrate anticoagulation in renal replacement therapy 29456612 2018 11 13 1751-1437 19 1 2018 Feb Journal of the Intensive Care Society J Intensive Care Soc The safety of regional citrate anticoagulation in renal replacement therapy. 86 10.1177/1751143717735749 Hill Simon S Royal Surrey County Hospital, Guildford, UK. Creighton Elaine E Royal Surrey County Hospital, Guildford, UK. Walter Edward E Royal Surrey County Hospital, Guildford, UK. eng Journal Article 2018 02 05
Current evidence of oral anticoagulant reversal: A systematic review Approximately 4-6% of patients treated with oral anticoagulants (OAC) will suffer from major hemorrhage or be in need of urgent surgery necessitating anticoagulant reversal therapy. Several new oral anticoagulants and reversal agents have been introduced that make it difficult for physicians to stay updated on the current evidence of reversal management. This study aims to review the recent literature on oral anticoagulation (...) reversal therapy and to present the current evidence in an easily approachable manner.A systematic literature search was conducted using PubMed and EMBASE to identify the latest publications on both vitamin K antagonist (VKA) and direct oral anticoagulant (DOAC) reversal strategies. All studies on humans who received any acute reversal management of VKA treatment were included, except case studies. Since only two studies on acute reversal of DOAC treatment have been published, clinical trials
Comparative effectiveness of direct oral anticoagulants and warfarin in patients with cancer and atrial fibrillation Randomized clinical trials comparing direct oral anticoagulants (DOACs) to warfarin in cancer patients have not been performed. We evaluated the effectiveness and associated risk of DOACs vs warfarin, as well as comparisons of DOACs, in a large population of cancer patients with nonvalvular atrial fibrillation (AF). Using the MarketScan databases, we identified 16 096 AF patients (...) (mean age, 74 years) initiating oral anticoagulant and being actively treated for cancer between 2010 and 2014. Anticoagulant users were matched by age, sex, enrollment date, and drug initiation date. Study end points were identified with diagnostic codes and included ischemic stroke, severe bleeding, other bleeding, and venous thromboembolism (VTE). Cox regression was used to estimate associations of anticoagulants with study end points. Compared with warfarin, rates of bleeding (hazard ratio [95
Association of Intracerebral Hemorrhage Among Patients Taking Non-Vitamin K Antagonist vs Vitamin K Antagonist Oral Anticoagulants With In-Hospital Mortality. Although non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used to prevent thromboembolic disease, there are limited data on NOAC-related intracerebral hemorrhage (ICH).To assess the association between preceding oral anticoagulant use (warfarin, NOACs, and no oral anticoagulants [OACs]) and in-hospital mortality among
Anticoagulation for the initial treatment of venous thromboembolism in people with cancer. Compared with people without cancer, people with cancer who receive anticoagulant treatment for venous thromboembolism (VTE) are more likely to develop recurrent VTE.To compare the efficacy and safety of three types of parenteral anticoagulants (i.e. fixed-dose low molecular weight heparin (LMWH), adjusted-dose unfractionated heparin (UFH), and fondaparinux) for the initial treatment of VTE in people
Meta-Analysis of the Safety and Efficacy of the Oral Anticoagulant Agents (Apixaban, Rivaroxaban, Dabigatran) in Patients With Acute Coronary Syndrome The significance of adding new oral anticoagulants (NOACs) to antiplatelet therapy in patients with acute coronary syndrome (ACS) is unclear. We conducted a meta-analysis to assess the safety and efficacy of adding NOACs (apixaban, rivaroxaban, and dabigatran) to single antiplatelet agent (SAP) or dual antiplatelet therapy (DAPT) in patients
Less dementia with oral anticoagulation in atrial fibrillation The association between atrial fibrillation (AF) and dementia is well documented, but it is not clear if oral anticoagulant treatment offers protection. The aim of the study is therefore to compare the incidence of new dementia in patients with AF with and without oral anticoagulants, and to explore if there is a difference between novel anticoagulants and warfarin in this respect.Retrospective registry study of all patients (...) with hospital diagnosis of AF and no previous diagnosis of dementia in Sweden between 2006 and 2014. Propensity score matching, falsification endpoints, and analyses according to intention to treat as well as on-treatment principles were used. The study included 444 106 patients and over 1.5 million years at risk. Patients on anticoagulant treatment at baseline was associated with 29% lower risk of dementia than patients without anticoagulant treatment [hazard ratio (HR) 0.71, 95% confidence intervals (95
Pharmacogenetic testing for patients being treated with anticoagulants Final Pharmacogenetic testing/ oral anticoagulants: findings and decision Page 1 of 3 Health Technology Clinical Committee Findings and Decision Topic: Pharmacogenetic testing for patients being treated with oral anticoagulants Meeting date: May 18, 2018 Final adoption: July 13, 2018 Meeting materials and transcript are available on the HTA website. Number and coverage topic: 20180518B - Pharmacogenetic testing for patients (...) being treated with oral anticoagulants HTCC coverage determination: Pharmacogenetic testing for patients being treated with oral anticoagulants is not a covered benefit. HTCC reimbursement determination: Limitations of coverage: N/A Non-covered indicators: N/A Agency contact information: Agency Phone Number Labor and Industries 1-800-547-8367 Public Employees Health Plan 1-800-200-1004 Washington State Medicaid 1-800-562-3022 WA - Health Technology Assessment July 13, 2018 Final Pharmacogenetic