Latest & greatest articles for anticoagulation

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Top results for anticoagulation

381. Reversal of warfarin-induced excessive anticoagulation with recombinant human factor VIIa concentrate. (Abstract)

Reversal of warfarin-induced excessive anticoagulation with recombinant human factor VIIa concentrate. Bleeding associated with warfarin anticoagulation correlates directly to duration and degree of international normalized ratio (INR) elevation above the therapeutic range. Safe and rapid reversal of excessive anticoagulation is occasionally needed to treat or avoid hemorrhagic complications.To evaluate the efficacy and safety of human recombinant factor VIIa (rFVIIa) concentrate in persons (...) of rFVIIa included an INR greater than 10 in high-risk persons (n = 5), clinical hemorrhage (n = 4), and diagnostic or therapeutic procedures (n = 4).Safe, rapid, and effective administration of rFVIIa corrects critically prolonged INRs and can avert or reverse bleeding associated with warfarin anticoagulation.

2002 Annals of Internal Medicine

382. Oral anticoagulation and risk of death: a medical record linkage study. Full Text available with Trip Pro

Oral anticoagulation and risk of death: a medical record linkage study. To study how mortality varies with different degrees of anticoagulation reflected by the international normalised ratio (INR).Record linkage analysis with death hazard estimated as a continuous function of INR.46 anticoagulation clinics in Sweden with computerised medical records.Records for 42 451 patients, 3533 deaths, and 1.25 million INR measurements.Mortality from all causes and from intracranial haemorrhage.Mortality (...) of 2.9, the expected number of deaths would have been 569. Thus at least 500 deaths were associated with a high INR value, but not necessarily caused by the treatment.The excess mortality associated with high INR values supports the use of less intensive treatment and a small therapeutic window, with INR close to 2.2-2.3 irrespective of the indication for anticoagulant treatment. More preventive actions should be taken to avoid episodes of high INR.

2002 BMJ

383. Association between CYP2C9 genetic variants and anticoagulation-related outcomes during warfarin therapy. (Abstract)

Association between CYP2C9 genetic variants and anticoagulation-related outcomes during warfarin therapy. Warfarin is a commonly used anticoagulant that requires careful clinical management to balance the risks of overanticoagulation and bleeding with those of underanticoagulation and clotting. The principal enzyme involved in warfarin metabolism is CYP2C9, and 2 relatively common variant forms with reduced activity have been identified, CYP2C9*2 and CYP2C9*3. Patients with these genetic (...) variants have been shown to require lower maintenance doses of warfarin, but a direct association between CYP2C9 genotype and anticoagulation status or bleeding risk has not been established.To determine if CYP2C9*2 and CYP2C9*3 variants are associated with overanticoagulation and bleeding events during warfarin therapy.Retrospective cohort study conducted at 2 anticoagulation clinics based in Seattle, Wash.Two hundred patients receiving long-term warfarin therapy for various indications during April 3

2002 JAMA

384. Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery

Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery Abdulwadud O 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 (...) Abdulwadud O. Anticoagulation therapy as prophylaxis for prevention of DVT or pulmonary embolism in neurosurgery. Clayton, Victoria: Centre for Clinical Effectiveness (CCE) 2002: 12 Authors' objectives This aim of this critical appraisal was to assess the effectiveness of anticoagulation therapy as prophylaxis for prevention of deep vein thrombosis (DVT) or pulmonary embolism in neurosurgery. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Anticoagulants; Neurosurgery; Pulmonary

2002 Health Technology Assessment (HTA) Database.

385. Testing strategies for diagnosing lupus anticoagulant: decision analysis

Testing strategies for diagnosing lupus anticoagulant: decision analysis Testing strategies for diagnosing lupus anticoagulant: decision analysis Testing strategies for diagnosing lupus anticoagulant: decision analysis Segal J B, Lehmann H P, Petri M, Mueller L, Kickler T S Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed (...) critical assessment on the reliability of the study and the conclusions drawn. Health technology Various testing strategies for the detection of lupus anticoagulant (LA) were considered. The testing strategies were different combinations of three tests: a prolonged activated partial thromboplastin time (aPTT) assay prolonged with negative mixing studies and a platelet neutralisation procedures (PNP) assay that suggested the presence of LA; dilute Russell viper venom times (dRVVT) assays; and tissue

2002 NHS Economic Evaluation Database.

386. A randomised controlled trial of patient self management of oral anticoagulation treatment compared with primary care management

A randomised controlled trial of patient self management of oral anticoagulation treatment compared with primary care management A randomised controlled trial of patient self management of oral anticoagulation treatment compared with primary care management A randomised controlled trial of patient self management of oral anticoagulation treatment compared with primary care management Fitzmaurice D A, Murray E T, Gee K M, Allan T F, Hobbs F D Record Status This is a critical abstract (...) of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Patient self-management of oral anticoagulation treatment (i.e. warfarin) was studied. The self-management approach involved two training sessions of between one and two hours where patients were taught how to test the international

2002 NHS Economic Evaluation Database.

387. Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis

Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis Deciding on anticoagulating the oldest old with atrial fibrillation: insights from cost-effectiveness analysis Desbiens N A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief (...) summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology The health intervention examined in the study was anticoagulation treatment with warfarin in patients with nonrheumatic atrial fibrillation (AF). Type of intervention Treatment. Economic study type Cost-utility analysis. Study population The study population comprised patients aged 65 to 100 years with nonrheumatic AF. Setting

2002 NHS Economic Evaluation Database.

388. Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study. Full Text available with Trip Pro

Differences between perspectives of physicians and patients on anticoagulation in patients with atrial fibrillation: observational study. To determine and compare physicians' and patients' thresholds for how much reduction in risk of stroke is necessary and how much risk of excess bleeding is acceptable with antithrombotic treatment in people with atrial fibrillation.Prospective observational study.Tertiary and peripheral referral centres in Nova Scotia, Canada.63 physicians who were treating

2001 BMJ

389. Clinical predictors of prolonged delay in return of the international normalized ratio to within the therapeutic range after excessive anticoagulation with warfarin. (Abstract)

Clinical predictors of prolonged delay in return of the international normalized ratio to within the therapeutic range after excessive anticoagulation with warfarin. An elevated international normalized ratio (INR) increases the risk for major hemorrhage during warfarin therapy. Optimal management of patients with asymptomatic elevations in INR is hampered by the lack of understanding of the time course of INR decay after cessation of warfarin therapy.To identify predictors of the rate of INR (...) normalization after excessive anticoagulation.Retrospective cohort study.Outpatient anticoagulant therapy unit.Outpatients with an INR greater than 6.0 were identified from August 1993 to September 1998. Patients in whom two doses of warfarin were withheld and a follow-up INR was obtained on the second calendar day were enrolled. No patient received vitamin K(1).The INR was measured 2 days after an INR greater than 6.0 was recorded.Of 633 study patients with an initial INR greater than 6.0, 232 (37%) still

2001 Annals of Internal Medicine

390. Anticoagulants (heparin, low molecular weight heparin and oral anticoagulants) for intermittent claudication. (Abstract)

Anticoagulants (heparin, low molecular weight heparin and oral anticoagulants) for intermittent claudication. Anticoagulant treatment for intermittent claudication might improve functional capacity, and prevent acute cardiovascular complications caused by peripheral obstructive arterial disease.To assess the effects of anticoagulant drugs (heparin, low molecular weight heparin (LMWH) and oral anticoagulants) in patients with intermittent claudication (Fontaine stage II) in terms of improving (...) walking capacity (pain-free walking distance or absolute walking distance), mortality, cardiovascular events, ankle/brachial pressure index, progression to surgery, amputation-free survival and side effects of these drugs.Randomised trials of anticoagulants for intermittent claudication were sought using the search strategy described by the Cochrane Peripheral Vascular Diseases Review Group. Additional trials were sought through: reference lists resulting from this search; recent conference

2001 Cochrane

391. Ticlopidine versus oral anticoagulation for coronary stenting. (Abstract)

Ticlopidine versus oral anticoagulation for coronary stenting. A 2-4 week course of ticlopidine plus aspirin following coronary stenting is considered effective in preventing thrombotic occlusion of the stented vessel and safe in regards to bleeding and peripheral vascular complications. However, rare, although potentially life-threatening haematological complications have been reported with this drug regimen.To evaluate the efficacy and safety of ticlopidine plus aspirin versus oral (...) anticoagulants after coronary stentingElectronic search of the Cochrane Library, Medline, Embase from 1991 to June 1999; references from trials and experts.Randomised controlled trials comparing ticlopidine plus aspirin versus oral anticoagulants (either with or without aspirin) after elective or bail out coronary stenting.Three reviewers assessed trial quality and compiled data on outcomes including: total mortality, non fatal myocardial infarction and revascularization occurring within the first 30 days

2001 Cochrane

392. Oral anticoagulants versus antiplatelet therapy for preventing further vascular events after transient ischaemic attack or minor stroke of presumed arterial origin. (Abstract)

Oral anticoagulants versus antiplatelet therapy for preventing further vascular events after transient ischaemic attack or minor stroke of presumed arterial origin. Patients who are entered in clinical trials after a transient ischaemic attack (TIA) or non disabling ischaemic stroke have an annual risk of important vascular events (death from all vascular causes, non-fatal stroke, or non-fatal myocardial infarction) of between 4 and 11 percent. Aspirin, in a daily dose of 30mg or more, offers (...) only modest protection after cerebral ischaemia: it reduces the incidence of major vascular events by 20 percent at most. Secondary prevention trials after myocardial infarction indicate that treatment with oral anticoagulants is associated with a risk reduction approximately twice that of treatment with antiplatelet therapy.1) To compare the efficacy of oral anticoagulants and antiplatelet therapy in the secondary prevention of vascular events after cerebral ischaemia of presumed arterial origin

2001 Cochrane

393. Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm. (Abstract)

Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm. Morbidity and mortality in patients with symptomatic chronic heart failure is high, it predisposes to stroke and thromboembolism which in turn contribute to high mortality in heart failure.To determine effect of antiplatelet agents when compared to placebo or anticoagulant therapy on death and/or major thromboembolic events in adults with heart failure who are in sinus rhythm.Systematic search of electronic (...) databases (MEDLINE, EMBASE, DARE). Abstracts from cardiology meetings and reference lists of relevant papers were searched. Authors of studies were contacted for further information.Randomised parallel group placebo or controlled trials comparing antiplatelet therapy with control or anticoagulation in adults with chronic heart failure in sinus rhythm. Treatment for at least 1 month. To assess any adverse effects cohort study & non-randomised controlled studies were assessed. Orally administered

2001 Cochrane

394. Anticoagulation for heart failure in sinus rhythm. (Abstract)

Anticoagulation for heart failure in sinus rhythm. Patients with chronic heart failure (heart failure) are at risk of thromboembolic events, including stroke, pulmonary embolism and peripheral arterial embolism, whilst coronary ischaemic events also contribute to the progression of heart failure. Long-term oral anticoagulation is established in certain groups, including patients with heart failure and atrial fibrillation but there is wide variation in the indications and use of oral (...) anticoagulation in the broader heart failure population.To determine whether long-term oral anticoagulation reduces total deaths and/or major thromboembolic events in patients with heart failure, when compared to placebo.Reference lists of papers resulting from this search, electronic database searching (MEDLINE, EMBASE, DARE), and abstracts from national and international cardiovascular meetings were studied to identify unpublished studies. Relevant authors of these studies were contacted to obtain further

2001 Cochrane

395. Anticoagulants or antiplatelet therapy for non-rheumatic atrial fibrillation and flutter. (Abstract)

Anticoagulants or antiplatelet therapy for non-rheumatic atrial fibrillation and flutter. Atrial fibrillation (AF) carries a high risk of stroke and other thromboembolic events. Appropriate use of drugs to prevent thromboembolism in patients with AF involves comparing the patient's risk of stroke to the risk of hemorrhage from medication use.To quantify risk of stroke, major hemorrhage and death from using medications that have been rigorously evaluated for prevention of thromboembolism

2001 Cochrane

396. In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage?

In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage? In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage? In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage? Burrows E 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 Burrows E. In patients with cerebral metastases is anticoagulation therapy for thromboembolic disease associated with an increased risk of cerebral haemorrhage? Clayton, Victoria: Centre for Clinical Effectiveness (CCE) 2001: 11 Authors' objectives This aim of this report was to assess the risk of cerebral haemorrhage in patients with cerebral metastases

2001 Health Technology Assessment (HTA) Database.

397. Thrombin-specific anticoagulation with bivalirudin versus heparin in patients receiving fibrinolytic therapy for acute myocardial infarction: the HERO-2 randomised trial. (Abstract)

Thrombin-specific anticoagulation with bivalirudin versus heparin in patients receiving fibrinolytic therapy for acute myocardial infarction: the HERO-2 randomised trial. The combination of fibrinolytic therapy and heparin for acute myocardial infarction fails to achieve reperfusion in 40-70% of patients, and early reocclusion occurs in a substantial number. We did a randomised, open-label trial to compare the thrombin-specific anticoagulant, bivalirudin, with heparin in patients undergoing (...) patients (1.1%) in the heparin group (1.25 [0.95-1.64], p=0.11).Bivalirudin did not reduce mortality compared with unfractionated heparin, but did reduce the rate of adjudicated reinfarction within 96 h by 30%. Small absolute increases were seen in mild and moderate bleeding in patients given bivalirudin. Bivalirudin is a new anticoagulant treatment option in patients with acute myocardial infarction treated with streptokinase.

2001 Lancet Controlled trial quality: predicted high

398. Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis. Warfarin Optimal Duration Italian Trial Investigators. Full Text available with Trip Pro

Three months versus one year of oral anticoagulant therapy for idiopathic deep venous thrombosis. Warfarin Optimal Duration Italian Trial Investigators. In patients with idiopathic deep venous thrombosis, continuing anticoagulant therapy beyond three months is associated with a reduced incidence of recurrent thrombosis during the period of therapy. Whether this benefit persists after anticoagulant therapy is discontinued is controversial.Patients with a first episode of idiopathic proximal deep (...) venous thrombosis who had completed three months of oral anticoagulant therapy (with warfarin, in 97 percent of the cases and acenocoumarol in 3 percent) were randomly assigned to the discontinuation of oral anticoagulants or to their continuation for nine additional months. The primary study outcome was recurrence of symptomatic, objectively confirmed venous thromboembolism during at least two years of follow-up.The primary intention-to-treat analysis showed that of 134 patients assigned

2001 NEJM Controlled trial quality: predicted high

399. Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation

Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation Systematic review of long term anticoagulation or antiplatelet treatment in patients with non-rheumatic atrial fibrillation Taylor F C, Cohen H, Ebrahim S Authors' objectives To examine the benefits and risks of long-term anticoagulation (warfarin (...) ) compared with antiplatelet treatment (aspirin, indobufen) in patients with non-rheumatic atrial fibrillation. Searching The CENTRAL Register on the Cochrane Library, EMBASE, MEDLINE, CINAHL and SIGLE were searched from 1966 to 1999 using the terms 'atherosclerosis', 'atrial fibrillation', 'myocardial infarction' or 'coronary disease' and 'anticoagulation' and a RCT filter (see Other Publications of Related Interest no.1). In addition, the authors checked references in relevant papers and approached key

2001 DARE.

400. Anticoagulants for acute ischaemic stroke. (Abstract)

Anticoagulants for acute ischaemic stroke. Most ischaemic strokes are caused by blood clots blocking an artery in the brain. Clot prevention with anticoagulant therapy could have a significant impact on patient survival, disability and recurrence of stroke.The objective of this review was to assess the effect of anticoagulant therapy in the early treatment of patients with acute ischaemic stroke.We searched the Cochrane Stroke Group trials register (most recent search: March 1999) and consulted (...) MedStrategy (1995). We also contacted drug companies.Randomised trials comparing early anticoagulant therapy (started within two weeks of stroke onset) with control in patients with acute presumed or confirmed ischaemic stroke.Two reviewers independently selected trials for inclusion, assessed trial quality and extracted the data.Twenty-one trials involving 23,427 patients were included. The quality of the trials varied considerably. The anticoagulants tested were standard unfractionated heparin, low

2000 Cochrane