Latest & greatest articles for anticoagulation

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Top results for anticoagulation

521. Evaluation of excessive anticoagulation in a group model health maintenance organization

Evaluation of excessive anticoagulation in a group model health maintenance organization Evaluation of excessive anticoagulation in a group model health maintenance organization Evaluation of excessive anticoagulation in a group model health maintenance organization Lousberg T R, Witt D M, Beall D G, Carter B L, Malone D C 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 Using phytonadione and/or fresh frozen plasma (FFP) versus the conservative management option in the management of patients with excessive anticoagulation. The conservative management was defined as temporary discontinuation of warfarin therapy until the international normalized ratio (INR) falls to within therapeutic range. Type of intervention Secondary

1998 NHS Economic Evaluation Database.

522. Evaluation of a decision support system for initiation and control of oral anticoagulation in a randomised trial. Full Text available with Trip Pro

Evaluation of a decision support system for initiation and control of oral anticoagulation in a randomised trial. To determine whether a computerised decision support system for initiation and control of oral anticoagulant treatment improves quality of anticoagulant control achieved by trainee doctors.Randomised controlled trial.District general hospital in North London.148 inpatients requiring start of warfarin treatment.Management by trainee doctors (to achieve therapeutic range (...) of > or = 2 was not significantly different in the two groups (3 days). Median time to achieve a stable dose was significantly lower in intervention group than in controls (7 days v 9 days, P = 0.01) without excessive overtreatment or undertreatment with anticoagulant. Patients in intervention group spent greater proportion of time in therapeutic range, both as inpatients (59% v 52%) and outpatients (64% v 51%).The computerised decision support system was safe and effective and improved the quality

1997 BMJ Controlled trial quality: uncertain

523. The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts. The Post Coronary Artery Bypass Graft Trial Investigators. Full Text available with Trip Pro

The effect of aggressive lowering of low-density lipoprotein cholesterol levels and low-dose anticoagulation on obstructive changes in saphenous-vein coronary-artery bypass grafts. The Post Coronary Artery Bypass Graft Trial Investigators. Obstructive changes often occur in aortocoronary saphenous-vein bypass grafts because of atherosclerosis and thrombosis. We studied whether aggressive lowering of low-density lipoprotein (LDL) cholesterol levels or low-dose anticoagulation would delay

1997 NEJM Controlled trial quality: uncertain

524. The duration of oral anticoagulant therapy after a second episode of venous thromboembolism. The Duration of Anticoagulation Trial Study Group. (Abstract)

The duration of oral anticoagulant therapy after a second episode of venous thromboembolism. The Duration of Anticoagulation Trial Study Group. A consensus has not been reached about the optimal duration of oral anticoagulant therapy after a second episode of venous thromboembolism.In a multicenter trial, we compared six months of oral anticoagulant therapy with anticoagulant therapy continued indefinitely in patients who had had a second episode of venous thromboembolism. Of 227 patients (...) enrolled, 111 were randomly assigned to six months of anticoagulation and 116 were assigned to receive anticoagulant therapy indefinitely; for both groups, the target international normalized ratio was 2.0 to 2.85. The initial episodes of deep-vein thrombosis (n = 193) and pulmonary embolism (n = 34), as well as recurrent episodes, were all objectively confirmed.After four years of follow-up, there were 26 recurrences of venous thromboembolism that fulfilled the diagnostic criteria, 23 in the group

1997 NEJM Controlled trial quality: uncertain

525. Anticoagulation in spinal surgery: a critical review of the literature

Anticoagulation in spinal surgery: a critical review of the literature Anticoagulation in spinal surgery: a critical review of the literature Anticoagulation in spinal surgery: a critical review of the literature Catre M G Authors' objectives To critically appraise the existing literature regarding thromboprophylaxis in elective spinal surgery. Searching MEDLINE was searched from 1965 to 1995 using the keywords 'anticoagulation', 'DVT' and 'spine', alone and in different combinations (...) from the findings of these studies because of the lack of good scientific evidence. Research: The author states that there is a need for a well-designed randomised, double-blind, placebo-controlled study of anticoagulation in spinal surgery. Bibliographic details Catre M G. Anticoagulation in spinal surgery: a critical review of the literature. Canadian Journal of Surgery 1997; 40(6): 413-419 Indexing Status Subject indexing assigned by NLM MeSH Adolescent; Adult; Anticoagulants /therapeutic use

1997 DARE.

526. Costs and effectiveness of a nurse specialist anticoagulant service

Costs and effectiveness of a nurse specialist anticoagulant service Costs and effectiveness of a nurse specialist anticoagulant service Costs and effectiveness of a nurse specialist anticoagulant service Taylor F C, Gray A, Cohen H, Gaminara L, Ramsay M, Miller 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 A nurse specialist service in anticoagulation treatment. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population Patients referred to anticoagulant clinics for anticoagulation treatment. Setting Institution. The economic study was performed in the UK. Dates to which data relate The authors did not clearly establish the dates to which effectiveness data referred

1997 NHS Economic Evaluation Database.

527. Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials. Full Text available with Trip Pro

Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials. Most randomised trials of anticoagulant therapy for suspected acute myocardial infarction have been small and, in some, aspirin and fibrinolytic therapy were not used routinely. A systematic overview (meta-analysis) of their results is needed, in particular to assess the clinical effects of adding heparin to aspirin.Computer aided searches, scrutiny of reference lists (...) , and inquiry of investigators and companies were used to identify potentially eligible studies. On central review, 26 studies were found to involve unconfounded randomised comparisons of anticoagulant therapy versus control in suspected acute myocardial infarction. Additional information on study design and outcome was sought by correspondence with study investigators.Patients with suspected acute myocardial infarction.No routine aspirin was used among about 5000 patients in 21 trials (including half

1996 BMJ

528. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. (Abstract)

A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. The clinical benefit of coronary-artery stenting performed in conjunction with coronary angioplasty is limited by the risk of thrombotic occlusion of the stent as well as hemorrhagic and vascular complications of intensive anticoagulation. We compared antiplatelet therapy with conventional anticoagulant therapy with respect to clinical outcomes 30 days after coronary-artery (...) stenting.After successful placement of Palmaz-Schatz coronary-artery stents, 257 patients were randomly assigned to receive antiplatelet therapy (ticlopidine plus aspirin) and 260 to receive anticoagulant therapy (intravenous heparin, phenprocoumon, and aspirin). The primary cardiac end point was a composite measure reflecting death from cardiac causes or the occurrence of myocardial infarction, aortocoronary bypass surgery, or repeat angioplasty. The primary noncardiac end point comprised death from

1996 NEJM Controlled trial quality: predicted high

529. A comparison of aspirin and anticoagulation following thrombolysis for myocardial infarction (the AFTER study): a multicentre unblinded randomised clinical trial. Full Text available with Trip Pro

A comparison of aspirin and anticoagulation following thrombolysis for myocardial infarction (the AFTER study): a multicentre unblinded randomised clinical trial. To compare aspirin with anticoagulation with regard to risk of cardiac death and reinfarction in patients who received anistreplase thrombolysis for myocardial infarction.A multicentre unblinded randomised clinical trial.38 hospitals in six countries.1036 patients who had been treated with anistreplase for myocardial infarction were (...) randomly assigned to either aspirin (150 mg daily) or anticoagulation (intravenous heparin followed by warfarin or other oral anticoagulant). The trial was stopped earlier than originally intended because of the slowing rate of recruitment.Cardiac death or recurrent myocardial infarction at 30 days.After 30 days cardiac death or reinfarction, occurred in 11.0% (57/517) of the patients treated with anticoagulation and 11.2% (58/519) of the patients treated with aspirin (odds ratio 1.02, 95% confidence

1996 BMJ Controlled trial quality: predicted high

530. Bleeding risk of combined oral anticoagulant and antiplatelet therapy in cardiovascular disease

Bleeding risk of combined oral anticoagulant and antiplatelet therapy in cardiovascular disease Bleeding risk of combined oral anticoagulant and antiplatelet therapy in cardiovascular disease Bleeding risk of combined oral anticoagulant and antiplatelet therapy in cardiovascular disease Verheugt F W Authors' objectives To assess the safety of combining oral anticoagulant and antiplatelet therapy. Searching EMBASE was searched from 1960 to 1994. [A: The search strategy was not defined. Only (...) papers written in the English language were included]. Study selection Study designs of evaluations included in the review Clinical trials, of which most were randomised, were included. Specific interventions included in the review Combinations of anticoagulants and antiplatelet therapy, compared with either intervention alone or with placebo, namely: acenocoumarin (alone and with aspirin), warfarin (alone or with placebo, aspirin or dipyridamole), aspirin (alone and with warfarin), double placebo

1996 DARE.

531. Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials

Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials Clinical effects of anticoagulant therapy in suspected acute myocardial infarction: systematic overview of randomised trials Collins R, MacMahon S, Flather M, Baigent C, Remvig L, Mortensen S, Appleby P, Godwin J, Yusuf S, Peto R Authors' objectives (...) To determine the effect of early anticoagulation on the mortality and other major clinical events in patients with suspected acute myocardial infarction (MI), and to assess the effect of adding heparin to aspirin. Searching A formal computer-aided literature search was undertaken. Additional materials was located by examining reference lists, and by contacting other investigators and pharmaceutical companies. Study selection Study designs of evaluations included in the review Randomised controlled trials

1996 DARE.

532. Cost-effectiveness of prophylactic anticoagulation prolonged after hospital discharge following general surgery

Cost-effectiveness of prophylactic anticoagulation prolonged after hospital discharge following general surgery Cost-effectiveness of prophylactic anticoagulation prolonged after hospital discharge following general surgery Cost-effectiveness of prophylactic anticoagulation prolonged after hospital discharge following general surgery Sarasin F P, Bounameaux H 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 Prolonged self-administered prophylactic low-dose low-molecular-weight heparin (LMWH) during 4 weeks after hospital discharge versus anticoagulant therapy with heparin started immediately after the first clinically overt venous thromboembolism (VTE). Type of intervention Primary prevention. Economic study type Cost

1996 NHS Economic Evaluation Database.

533. Antithrombotic strategy after total hip replacement: a cost-effectiveness analysis comparing prolonged oral anticoagulants with screening for deep vein thrombosis

Antithrombotic strategy after total hip replacement: a cost-effectiveness analysis comparing prolonged oral anticoagulants with screening for deep vein thrombosis Antithrombotic strategy after total hip replacement: a cost-effectiveness analysis comparing prolonged oral anticoagulants with screening for deep vein thrombosis Antithrombotic strategy after total hip replacement: a cost-effectiveness analysis comparing prolonged oral anticoagulants with screening for deep vein thrombosis Sarasin F (...) P, Bounameaux H 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 Prolonged oral anticoagulant therapy was compared with screening in the prevention of deep vein thrombosis (DVT) after total hip replacement. Type of intervention

1996 NHS Economic Evaluation Database.

534. Atrial fibrillation: restoration and maintenance of sinus rhythm and indications for anticoagulation therapy

Atrial fibrillation: restoration and maintenance of sinus rhythm and indications for anticoagulation therapy Atrial fibrillation: restoration and maintenance of sinus rhythm and indications for anticoagulation therapy Atrial fibrillation: restoration and maintenance of sinus rhythm and indications for anticoagulation therapy Golzari H, Cebul R D, Bahler R C Authors' objectives To review the efficacy and safety of electrical and pharmacological conversion of atrial fibrillation, strategies (...) examined in this context, along with surgical corridor and maze procedures. In addition, antithrombotic therapy is examined, and the effectiveness of warfarin, aspirin and anticoagulants is assessed. Participants included in the review Patients with atrial fibrillation. A small number of studies included patients with fibrillation after cardiac surgery. Outcomes assessed in the review The main outcome was restoration of sinus rhythm. Reduction in incidence of ischaemic stroke and emboli is also

1996 DARE.

535. Costs and effects of long-term oral anticoagulant treatment after myocardial infarction. (Abstract)

Costs and effects of long-term oral anticoagulant treatment after myocardial infarction. To investigate the costs and effects of long-term oral anticoagulant treatment after myocardial infarction.Cost-effectiveness analysis, based on a randomized, double-blind, placebo-controlled trial.Sixty Dutch hospitals.A total of 3404 hospital survivors of acute myocardial infarction randomized within a median period of 4 days after discharge to either oral anticoagulant treatment or placebo. The mean (...) follow-up was 37 months.Oral anticoagulant treatment aimed at a target international normalized ratio of 2.8 to 4.8.Costs of hospital stay during readmissions, costs related to major cardiologic interventions, and costs of oral anticoagulant treatment.The costs of oral anticoagulant treatment were estimated at 394 Dutch guilders (Dfl) per patient-year (Dfl 1 = US $0.58). Placebo patients stayed 18,830 days in the hospital compared with 15,083 days for anticoagulation patients. Average costs per

1995 JAMA Controlled trial quality: predicted high

536. Optimal oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and recent cerebral ischemia. The European Atrial Fibrillation Trial Study Group. Full Text available with Trip Pro

Optimal oral anticoagulant therapy in patients with nonrheumatic atrial fibrillation and recent cerebral ischemia. The European Atrial Fibrillation Trial Study Group. A number of studies have demonstrated the efficacy of oral anticoagulant therapy in reducing the risk of stroke and systemic embolism in patients with nonrheumatic atrial fibrillation. However, both the targeted and the actual levels of anticoagulation differed widely among the studies, and a number of studies failed to report (...) standardized prothrombin-time ratios as international normalized ratios (INRs). We therefore performed an analysis to determine the intensity of oral anticoagulant therapy in nonrheumatic atrial fibrillation that provides the best balance between the prevention of thromboembolism and the occurrence of bleeding complications.We calculated INR-specific incidence rates for both ischemic and major hemorrhagic events occurring in 214 patients who received anticoagulant therapy in the European Atrial

1995 NEJM Controlled trial quality: uncertain

537. A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. Duration of Anticoagulation Trial Study Group. (Abstract)

A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. Duration of Anticoagulation Trial Study Group. The optimal duration of oral anticoagulant therapy after a first episode of venous thromboembolism is still a matter of debate.We performed a multicenter trial comparing six weeks of oral anticoagulant treatment with six months of such therapy in patients who had a first episode of venous thromboembolism. Anticoagulant therapy (...) consisted of warfarin or dicumarol. Of the 902 patients enrolled, 5 were later excluded because they had congenital protein C deficiency; 443 were randomly assigned to receive six weeks of oral anticoagulant therapy with a targeted international normalized ratio (INR) of 2.0 to 2.85, and 454 were randomly assigned to receive six months of such therapy. The initial diagnoses were confirmed by means of venography in cases of deep-vein thromboses (n = 790) and with perfusion-ventilation scanning

1995 NEJM Controlled trial quality: uncertain

538. Outcome analysis of a pharmacist-managed anticoagulation service

Outcome analysis of a pharmacist-managed anticoagulation service Outcome analysis of a pharmacist-managed anticoagulation service Outcome analysis of a pharmacist-managed anticoagulation service Wilt V M, Gums J G, Ahmed O I, Moore L M 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 Prevention of complications, thromboembolic and haemorrhagic events, in patients receiving warfarin pharmacotherapy through monitoring by a pharmacist-managed anticoagulation service. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population Family Practice Medical Group patients receiving warfarin therapy. Setting The study was carried out in a community based population served by the Family

1995 NHS Economic Evaluation Database.

539. Anticoagulation for stroke prevention in chronic non-valvular atrial fibrillation

Anticoagulation for stroke prevention in chronic non-valvular atrial fibrillation Anticoagulation for stroke prevention in chronic non-valvular atrial fibrillation Anticoagulation for stroke prevention in chronic non-valvular atrial fibrillation Green C J, Hadorn D, Kazanjian A Authors' objectives To assess the evidence concerning the outcomes associated with efforts to prevent the occurrence of stroke in patients with chronic non-valvular atrial fibrillation using warfarin sodium. Searching (...) MEDLINE was searched from 1987 to 1994 using the keywords: 'atrial fibrillation', 'anticoagulants', 'aspirin'). Reference lists of retrieved articles were sought. Study selection Study designs of evaluations included in the review Randomised controlled trials (RCTs) on the efficacy of warfarin sodium in the primary prevention of stroke in chronic non-valvular atrial fibrillation were included. Specific interventions included in the review The specific intervention was anticoagulation, i.e. warfarin

1995 DARE.

540. Efficacy and safety of combined anticoagulant and antiplatelet therapy versus anticoagulant monotherapy after mechanical heart-valve replacement: a metaanalysis

Efficacy and safety of combined anticoagulant and antiplatelet therapy versus anticoagulant monotherapy after mechanical heart-valve replacement: a metaanalysis Efficacy and safety of combined anticoagulant and antiplatelet therapy versus anticoagulant monotherapy after mechanical heart-valve replacement: a metaanalysis Efficacy and safety of combined anticoagulant and antiplatelet therapy versus anticoagulant monotherapy after mechanical heart-valve replacement: a metaanalysis Cappelleri J C (...) , Fiore L D, Brophy M T, Deykin D, Lau J Authors' objectives To compare the efficacy and safety of combined oral anticoagulant and antiplatelet therapy versus oral anticoagulants alone after prosthetic heart valve replacement. Searching MEDLINE was searched from January 1966 to September 1994 using the keywords 'heart valve prosthesis', 'anticoagulants' and 'antiplatelet agents'. The reference lists of retrieved papers, review articles, and editorials were examined. Only articles published in English

1995 DARE.