BuscarNoticias sobre Trombosis
-
Study Explores Thrombus Healing by Plaque Type
Thrombus healing in sudden cardiac death victims may depend on the presence of plaque ruptures or erosions, and, in some patients, call for different treatment approaches, according to research published online Oct. 7 in the Journal of the American College of Cardiology.
-
Risk stratification of patients with pulmonary embolism based on pulse rate and D-dimer concentration
We have retrospectively analysed data of 440 consecutive patients with acute PE. Collected data included age, gender, medical history, blood pressure, pulse rate and D-dimer concentration. The variables associated with SAE in the first 10 days in univariate analysis (p<0.15) have been included in a multivariate logistic regression model (backward conditional, p out >0.10).
-
Real-life anticoagulation treatment of atrial fibrillation after catheter ablation: Possible overtreatment of low-risk patients
Catheter ablation provides curative treatment for atrial fibrillation (AF). Data on anticoagulation after the procedure are sparse. We investigated real-life antithrombotic treatment after AF ablation and examined its adherence to current recommendations.
-
Efficacy and safety of fondaparinux versus enoxaparin in patients with acute coronary syndromes treated with glycoprotein IIb/IIIa inhibitors or thienopyridines: results from the OASIS 5 (Fifth Organization to Assess Strategies in Ischemic Syndromes) trial
In patients receiving GP IIb/IIIa inhibitors or thienopyridines, fondaparinux reduces major bleeding and improves net clinical outcome compared with enoxaparin.
-
Cardiovascular risk factors in idiopathic compared to risk-associated venous thromboembolism: A focus on fibrinogen, factor VIII, and high-sensitivity C-reactive protein (hs-CRP)
Our data show that markers of inflammation, such as hs-CRP, fibrinogen, and factor VIII, are at higher levels in patients with idiopathic compared to secondary VTE, supporting the hypothesis that idiopathic VTE and arterial thromboembolism share common risk factors.
-
C-reactive protein and venous thromboembolism. A prospective investigation in the ARIC cohort
In conclusion, this prospective, population-based study suggests elevated CRP is independently associated with increased risk of VTE.
-
Obesity and Cardiovascular Thrombotic Events in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents
The authors concluded that obese patients have a higher risk for long-term cardiovascular thrombotic events following PCI with drug-eluting stents than patients with normal weight.
-
Role of Clopidogrel Loading Dose in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Angioplasty
In patients with STEMI undergoing primary PCI with contemporary anticoagulation regimens, a 600-mg loading dose of clopidogrel may safely reduce 30-day ischemic adverse event rates compared with a 300-mg loading dose.
-
What's New in Total Hip Arthroplasty
Prophylaxis against venous thromboembolism has been mandated by the government, payers, and patient groups. Controversies remain with regard to the ideal agent, timing and duration of administration.
-
Hospital stays could contribute to deep-vein thrombosis
Catching a superbug often tops the list of worries harboured by people going into hospital, but there is a far more serious threat to their welfare that rarely receives the attention that it deserves. Over the past year at least 25,000 NHS inpatients have died from blood clots — five times the number killed by MRSA and Clostridium difficilecombined.
-
Very elderly neglected in stroke prevention
A review in The Lancet Neurology concludes that although very elderly people – those aged over 80 – are particularly susceptible to stroke, they receive fewer vascular prevention interventions than younger people. Emerging data show that the drugs can be very effective in the very elderly in routine clinical practice, the authors point out.
-
Unprovoked pulmonary embolism resulted in greater risk for CV events
When adjusted, the HR for subsequent CV events was not different between patients with and without pulmonary embolism (HR=1.39; 95% CI, 0.83-2.3), according to the researchers. The HR was greatly increased, however, for patients with unprovoked pulmonary embolism vs. patients with provoked pulmonary embolism (HR=2.18; 95% CI, 1.1-4.5) and patients without pulmonary embolism (HR=2.62; 95% CI, 1.4-4.9).
-
New Standard Reduces Heparin Potency
Beginning next week, heparin shipped to hospitals and pharmacies will be about 10% less potent than that currently available, a change that is likely to have clinical implications when the drug is administered as a bolus IV dose, the FDA said today. The loss in potency is the result of new manufacturing controls -- including a new reference standard for the drug's unit dose -- adopted by United States Pharmacopeia (USP), a nonprofit standards-setting organization.
-
Adherence to anticoagulation therapy limited bleeding risk in older patients with AF
According to the researchers, 83 patients died during the follow-up period, with nine of them having hemorrhagic complications. Patients spent a median of 14% of their time below, 71% of their time within and 15% of their time above the intended therapeutic range. Ninety-four patients experienced bleeding complications during follow-up, with 37 patients having major complications and 57 patients having minor complications.
-
Low postoperative DVT or PE risk seen in patients following ankle fracture surgery
The study included nearly 57,000 patients at a mean age 52 years with lateral malleolar, bimalleolar or trimalleolar fractures treated by open reduction internal fixation. The majority of those studied were women. To draw their conclusions, researchers studied: fracture pattern, if the fractures were open or closed, age, gender, patient ethnicity, type of insurance utilized and presence of comorbidities, such as peripheral vascular disease (PVD) or diabetes mellitus.
-
African-Americans at higher risk for clots
Speaking at the Venous Disease Coalition (VDC) Annual Meeting, Dr. Garth Graham from the Office of Minority Health at the Department of Health and Human Services followed up on last year’s Surgeon General’s Call to Action by focusing attention on the African-American population which is at significantly increased risk of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). African-Americans have a significantly higher risk of developing potentially deadly DVT and PE compared with other ethnic populations in the U.S., according to data presented by Dr. Graham.
-
The ExTRACT–TIMI 25 (Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment–Thrombolysis In Myocardial Infarction 25) Study
Based on a U.S. model of health care economics, the strategy of using enoxaparin instead of UFH as adjunctive therapy for fibrinolysis in patients with STEMI is cost effective according to commonly used benchmarks.
-
Incidence and causes of heparin-induced skin lesions
We enrolled 320 patients. In total, 24 patients (7.5%, 95% confidence interval [CI] 4.7%–10.6%) had heparin-induced skin lesions. Delayed-type hypersensitivity reactions were identified as the cause in all 24 patients. One patient with histopathologic evidence of delayed-type hypersensitivity tested positive for antiplatelet-factor 4 antibodies. We identified the following risk factors for heparin-induced skin lesions: a body mass index greater than 25 (odds ratio [OR] 4.6, 95% CI 1.7–15.3), duration of heparin therapy longer than 9 days (OR 5.9, 95% CI 1.9–26.3) and female sex (OR 3.0, 95% CI 1.1–8.8).
-
Improved Oral Anticoagulation After a Dietary Vitamin K–Guided Strategy: A Randomized Controlled Trial
Of 132 subjects randomized, the majority had either a mechanical heart valve (58%) or atrial fibrillation (35%), with similar frequency in each group. Magnitude and direction of INR variation was comparable in the two groups. The vitamin K-directed therapy group achieved target INR more rapidly, being in target range at 90-day follow-up in 75% versus 58% of cases in the dosage-adjustment group (p = 0.04). There was a trend in the same direction at each follow-up point (15, 30, and 60 days). There was also a trend toward less bleeding and use of parenteral vitamin K in the dietary therapy group (1 [1.5%] vs. 7 [11%]; p = 0.06).
-
Antiphospholipid antibodies and risk of myocardial infarction and ischaemic stroke in young women in the RATIO study: a case-control study
Our results suggest that lupus anticoagulant is a major risk factor for arterial thrombotic events in young women, and the presence of other cardiovascular risk factors increases the risk even further.
-
Clot-Busting Therapy Under Review
Even as they digest the latest news on what dose of the clot-dissolving drug Plavix is best during angioplasty, cardiologists are looking at the next generation of clot-busters that could replace Plavix.
-
Cocaine's detrimental effect on the cardiovascular system
Cocaine's effect on the blood components, such as platelets, is very significant and can provoke an increase in clotting and platelet dysfunction, which will cause the arteries surrounding the heart to form plaque, which may rupture leading to a heart attack. These blood clots could also form in the heart in a patient with heart failure and travel to the brain and cause a stroke. Strokes can also occur secondary to a temporary and significant increase in blood pressure. Finally, blood clots could also form in the deep veins in the legs, which could travel to the lungs and cause a pulmonary embolism, which can be lethal.
-
Thought Leader Panel Assesses Anticoagulants Market in the Wake of European Society of Cardiology Conference in New MedPredict? Report
"On the antithrombotics front, the news at ESC was dominated by Boehringer Ingelheim's Pradaxa (dabigatran). Our panel was very favorably impressed by the RE-LY data, but also points out meaningful ways for follow-on antithrombotics to compete in the SPAF (secondary prevention of stroke in patients with atrial fibrillation) market," says Jeff Berk, MedPredict? president. "It is important to realize that SPAF is undertreated today and there will be plenty of room for follow-up drugs, either direct thrombin inhibitors or anti-FXa."
-
PLATO Subset Analysis Confirms Ticagrelor Superiority
The prespecified subset analysis of the PLATO (Study of Platelet Inhibition and Patient Outcomes) trial found that for every 1,000 patients admitted to the hospital with a planned invasive strategy, using ticagrelor instead of clopidogrel for 12 months resulted in 11 fewer deaths, 13 fewer MIs, and six fewer cases of stent thrombosis, said Christopher Cannon, MD, of Brigham and Women's Hospital in Boston.
-
High Factor VIII Levels Independently Predict Venous Thromboembolism in Cancer Patients. The Cancer and Thrombosis Study
FVIII is independently associated with an increased risk of VTE in cancer patients. The association between FVIII and VTE risk declines with increasing age.
-
TRITON-TIMI 38 ECONOMIC SUBSTUDY: Cost-Effectiveness of Prasugrel vs. Clopidogrel from a Prospective Randomized Trial of Patients with ACS Undergoing PCI
Treatment with prasugrel was associated with 36 fewer re-hospitalizations for PCI per 1000 patients as compared with clopidogrel. However, it was associated with 11 more re-hospitalizations for bleeding per 1000 patients as compared with clopidogrel. Including index hospitalization, re-hospitalization, and drug cost, total cost per patient for prasugrel was $26,067 as compared with $26,288 for brand clopidogrel, a saving of $221.
-
TCT: PPIs Safe for Patients Taking Antiplatelets
Concomitant use of clopidogrel (Plavix) and a proton pump inhibitor did not increase the risk of gastrointestinal bleeding or other adverse events, researchers here reported.
-
Abbott stent outperforms but not in diabetics-study
For Xience, the study also showed a 74 percent lower rate of stent thrombosis, or dangerous blood clots. Risk of blood clots has been a chief concern of interventional cardiologists in recent years and has led to some scaling back in the use of drug-eluting stents. Stent thrombosis occurred in 0.3 percent of the Xience patients, compared to 1.1 percent with Taxus.
-
Cook Medical’s Advanced NavAlign™ Delivery System for IVC Filters Adds Procedural Speed, Control and Accuracy
The release of the NavAlign™ delivery system marks the 20th anniversary of Cook’s first IVC filter and further advances the treatment of pulmonary embolism (PE), a life-threatening condition caused by blood clots in the lungs that affects thousands of Americans annually.
-
Women with atrial fibrillation are at significantly higher risk of stroke and death compared to men
Even though the incidence of atrial fibrillation is higher in men than women, a review of past studies and medical literature completed by cardiac experts at Rush University Medical Center shows that women are more likely than men to experience symptomatic attacks, a higher frequency of recurrences, and significantly higher heart rates during atrial fibrillation, which increases the risk of stroke.
-
Recent findings in thromboembolism described by D.M. Beam and colleagues
According to recent research published in the journal Annals of Emergency Medicine, "Immobility predisposes to venous thromboembolism, but this risk may vary, depending on the underlying cause of immobility. This was a prospective, longitudinal outcome study of self-presenting emergency department.
-
Bayer researchers nominated for the “Deutscher Zukunftspreis” awarded by the German Federal President
The team developed the novel oral anticoagulant rivaroxaban (Xarelto®). The three teams on the shortlist for the final decision were announced today at Bellevue Palace by the German Secretary of State, Dr. Gert Haller.
-
Duration of red blood cell storage is associated with increased incidence of deep vein thrombosis and in-hospital mortality in patients with traumatic injuries
In trauma patients transfused [greater than or equal to]5 units of RBCs, transfusion of RBCs [greater than or equal to] 28 days of storage may be associated with deep vein thrombosis and death from multi-organ failure.
-
Improving the quality of life of cancer patients
"If oncologists follow these recommendations in whichever country they practise, I am confident that we will see lower levels of the venous thromboembolic events reported with ESAs in earlier trials,” explained Dr Jim Janinis, Director of the Department of Medical Oncology, Athens Medical Center, Athens, Greece.
-
NHS could save £15M a year by computerising prescription of blood thinners
The cost of oral anticoagulants such as Warfarin is cheaper when prescribed by computer, yet it is still as safe as a dose prescribed by expert health professionals, according to the largest-ever study into the administration of blood thinning drugs.
-
Proton Pump Inhibitors And Clopidogrel Association (PACA)
The results of this small clinical trial indicate that pantoprazole is not associated with a reduction in antiplatelet efficacy when taken along with clopidogrel, as compared with omeprazole, although a third comparison arm with no PPIs would be needed to definitively make this statement. No clinical endpoints were measured in this trial.
-
Image-guided treatment for deep venous thrombosis could improve patients' long-term outcomes
Deep Venous Thrombosis (DVT) is a serious condition that involves the formation of a blood clot inside of a deep vein usually in the legs. A patient with DVT is typically treated with anticoagulants (blood thinners) however researchers have found that image-guided interventional radiology procedures may play a more central role in the long-term treatment of DVT, according to a study published in the October issue of the American Journal of Roentgenology (AJR).
-
Venous thromboembolism in patients receiving multimodality therapy for thoracic malignancies
This study demonstrates that venous thromboembolism events in patients undergoing multimodality therapy for lung malignancies is high and deserves careful consideration.
-
ASCO, NCCN and others call for improving thromboprophylaxis in patients with cancer
Experts from international medical organizations, including the National Comprehensive Cancer Network and the American Society for Clinical Oncology, recently published a call to action and consensus statement stressing the need for thromboprophylaxis in hospitalized patients with cancer and prolonged prophylaxis in high-risk surgical patients.
-
Superficial vein thrombosis linked to DVT risk
About one-quarter of patients with superficial vein thrombosis also may have deep vein thrombosis (DVT), according to a new report. The report followed a study in which doctors in Austria followed 46 consecutive patients with superficial vein thrombosis between November 2006 and June 2007.
-
Optimizing prevention of hospital-acquired (HA) venous thromboembolism (VTE): Prospective validation of a VTE risk assessment model (RAM)
We prospectively validated a VTE risk-assessment/prevention protocol by demonstrating ease of use, good interobserver agreement, and effectiveness. Improved VTE prophylaxis resulted in a substantial reduction in HA VTE.
-
Chilton Memorial Hospital has unique treatment for DVT
For more than five years, cardiologists at Chilton Memorial Hospital have been using a procedure called “pharmaco-mechanical thrombectomy” in which the blood clots are dissolved with medication and vacuumed out using a special device designed for this purpose. It’s a minimally invasive procedure that saves limbs and lives.
-
Should We Be Applying Warfarin Pharmacogenetics to Clinical Practice? No, Not Now
The following are 10 points to remember about applying warfarin pharmacogenetics to clinical practice.
-
Combining Bypass with Carotid Surgery Ups Stroke Risk
"Assuming that 5,000 combined carotid endarterectomies and cardiac operations are performed annually, avoidance of such procedures alone could prevent nearly 500 postoperative strokes per year," they wrote.
-
Prevention of Thrombosis in Ambulatory Patients With Cancer
Thromboembolism, when it occurs, complicates the clinical care of these patients because of the associated morbidity and the need for anticoagulant treatment. It would seem that prevention of venous thromboembolism in these patients would be worthwhile.
-
Venous Thromboembolism in the Hematologic Malignancies
Epidemiologic data allow an estimate of the incidence of venous thromboembolism (VTE) in acute leukemia, lymphomas, and multiple myeloma (MM). In this review, we focus on the epidemiology, pathogenesis, and VTE management in these three hematologic malignancies.
-
Lower risk for recurrent venous thrombosis in women explained by sex-specific risk factors
Men’s increased lifetime risk for recurrence of venous thrombosis may be explained by the younger age of women at time of first venous thrombosis and longer intervals between a provoked first episode and recurrence, according to recently published data.
-
Diagnostic management of clinically suspected acute deep vein thrombosis
This review will discuss the elements currently used in making the clinical diagnosis of DVT. These elements include clinical decision rules and D-dimer testing, different imaging investigations and the appropriate use of these within diagnostic algorithms in patients with clinically suspected DVT.
-
Fondaparinux and the Management of Heparin-Induced Thrombocytopenia: The Journey Continues
The role of fondaparinux in the management of HIT is a therapeutic controversy challenging clinicians today. An open-label, prospective pilot study of 7 patients with acute HIT supports fondaparinux as an alternative anticoagulant. Additionally, a total of 12 patients with HIT from a larger case study and retrospective cohort were successfully treated with fondaparinux.
-
The First Evaluation of a Novel Vitamin K Antagonist, Tecarfarin (ATI-5923), in Patients With Atrial Fibrillation
This is the first study of tecarfarin in patients with atrial fibrillation. It appears that tecarfarin may possess advantages over the currently available standard of care, warfarin, by improving time in therapeutic range. Adequately powered prospective trials are warranted to definitively compare tecarfarin with warfarin in clinical settings for which warfarin is indicated.
-
New Antithrombotic Drugs: Potential for Use in Oncology
There are a number of new antithrombotic agents that have been studied in recent years and will soon be available for certain diseases. They target either activated factor X (ie, factor Xa) or activated thrombin, and some of them have potential therapeutic value in patients with cancer.
-
Acute ST-Segment Elevation Myocardial Infarction Due to a Huge Floating Thrombus Mimicking a Myxoma in the Left Atrium
Acute ST-segment elevation myocardial infarction occurs when the blood supply to a coronary artery is completely interrupted. The most common cause of the abrupt occlusion of a coronary artery is the rupture of a vulnerable atherosclerotic plaque. However, embolisms from any sources can be another cause of abrupt coronary obstruction.
-
Acute Failure of a St. Jude's Prosthetic Aortic Valve: Large Pannus Formation Masked by a Small Thrombus
Pannus formation and valve thrombus can cause prosthetic valve failure. The authors report the case of a 50-year-old woman who presented to the emergency room with decompensated heart failure secondary to mechanical valve dysfunction.
-
Home Therapy of Venous Thrombosis With Long-Term LMWH Versus Usual Care: Patient Satisfaction and Post-Thrombotic Syndrome
The authors concluded that long-term home treatment with tinzaparin or usual care had similar rates of recurrent VTE, death, and bleeding. They opined that the lower observed rate of post-phlebitic syndrome and leg ulcers associated with tinzaparin use could be important, and deserves further study.
-
Targeting the molecular ‘grip’ of thrombosis
Platelets are small cellular fragments which can trigger the development of harmful blood clots, known as thrombi, by aggregating and obstructing blood flow. The strong grip of the platelet receptor glycoprotein Ib on its ligand plasma protein von Willebrand factor has been shown to be a key contributor to this process.
-
Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation: A Randomised Non-inferiority Trial
The study suggests that a strategy for closing the LAA was noninferior to warfarin therapy in terms of the overall primary efficacy endpoint of all stroke, cardiovascular death, and systemic embolism. However, LAA closure was associated with an increased, especially short-term, complication rate compared with warfarin treatment alone.
-
UK body backs limited use of Lilly anti-clot drug
The National Institute of Health and Clinical Excellence (NICE) said on Friday the medicine, sold as Efient in Europe and Effient in the United States, should be considered as an option for some patients undergoing a procedure to clear blocked arteries. But it should only be used in certain higher-risk percutaneous coronary intervention patients, according to the agency's final appraisal determination
-
Bleeding Risk During Oral Anticoagulation in Atrial Fibrillation Patients Older Than 80 Years
These results indicate that the rate of major bleeding complications may be kept acceptably low also in very elderly AF patients on OAT, provided a careful management of anticoagulation is obtained.
-
Natural history of mesenteric venous thrombosis in patients treated with vitamin K antagonists - A multi-centre, retrospective cohort study
In conclusion, patients with MTV seem to have a low risk of recurrent VTE while receiving OAT. This risk appears increased after treatment is stopped.
-
Venous thromboembolic events in hospitalised medical patients
In conclusion, acutely ill medical patients represent a large population vulnerable to the development of VTE during hospitalisation. The number of VTE-related events would be halved with universal thromboprophylaxis. Further efforts focused on improving VTE prevention strategies in hospitalised medical patients are warranted.
-
S' Stands For Surprise: Anticoagulant Plays Unexpected Role In Maintaining Circulatory Integrity
Protein S, a well-known anticoagulant protein, keeps the blood flowing in more than one way, discovered researchers at the Salk Institute for Biological Studies. The protein contributes to the formation and function of healthy blood vessels.
-
Antiphospholipid Syndrome, Microalbuminuria, and Risk of Venous Thromboembolism
The cohort study by Dr Mahmoodi and colleagues1 concluded that microalbuminuria is an independent risk factor for venous thromboembolism (VTE). Although the authors described several limitations to their work, they did not consider an important issue.
-
ESC: Will HotLine? Trials Change Practice?
Taken together results from studies of two investigational drugs and a cardiac resynchronization device could fundamentally alter clinical practice -- but any one of a number of regulatory, economic, or "turf" issues could quash that potential.
-
Bayer Completes Enrollment into Major Phase III Study with Rivaroxaban (ROCKET AF)
The ROCKET AF study is assessing the efficacy and safety of rivaroxaban (Xarelto®) 20 mg once-daily, a novel oral, direct Factor Xa inhibitor, compared to the current standard of care, warfarin, a vitamin K antagonist (VKA) dose-adjusted, for the prevention of stroke and non-CNS systemic embolism in patients with Atrial Fibrillation (AF).
-
The Reduced Anticoagulant Effect of Fondaparinux at Low Antithrombin Levels
In the conventional prophylactic and therapeutic dose range, not only treatment with antithrombin concentrates but also an increase in fondaparinux dose normalizes the anticoagulant effect. A saturation effect is observed at high fondaparinux concentrations. Higher levels of antithrombin lead to an exaggerated effect of fondaparinux on Heptest.
-
Low-molecular-weight heparin thromboprophylaxis in medical-surgical critically ill patients: a systematic review
Low-molecular-weight heparin may be effective for thromboprophylaxis in medical-surgical critically ill patients, but no trials have compared LMWH against an alternative active strategy; thus, LMWH cannot be recommended routinely.
-
Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study
Nadroparin reduces the incidence of thromboembolic events in ambulatory patients with metastatic or locally advanced cancer who are receiving chemotherapy. Future studies should focus on patients who are at a high risk for thromboembolic events.
-
Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials
Proton-pump inhibitors (PPIs) are often prescribed in combination with thienopyridines. Conflicting data exist as to whether PPIs diminish the efficacy of clopidogrel. We assessed the association between PPI use, measures of platelet function, and clinical outcomes for patients treated with clopidogrel or prasugrel.
-
Irbesartan reduces heart failure in patients with quivering heart
In a major international trial, researchers from McMaster? University in Canada, found that the hypertension drug irbesartan reduced the risk of heart failure complications and the combination of stroke, other embolic events and transient ischemic events, also known as ministrokes, in patients with atrial fibrillation.
-
Regulatory questions for Astra, Boehringer drugs
Experts said questions remained about Boehringer's study design and a minor heart attack signal seen with its stroke prevention drug Pradaxa, while AstraZeneca?'s blood thinner Brilinta had failed to prove itself in North American patients.
-
The Net Clinical Benefit of Warfarin Anticoagulation in Atrial Fibrillation
Expected net clinical benefit of warfarin therapy is highest among patients with the highest untreated risk for stroke, which includes the oldest age category. Risk assessment that incorporates both risk for thromboembolism and risk for intracranial hemorrhage provides a more quantitatively informed basis for the decision on antithrombotic therapy in patients with atrial fibrillation.
-
Largest Registry to Date to Provide the First-Ever Picture of the Real Global Burden of Atrial Fibrillation (AF)
The GARFIELD Registry will prospectively follow 50,000 patients newly-diagnosed with AF who are also candidates for anticoagulant therapy to prevent blood clots leading to stroke over a six-year period. GARFIELD is launching in 32 countries in the Americas, Eastern and Western Europe, Asia, Africa and Australia, but will ultimately follow patients from 1,000 centers in 50 countries.
-
High-Dose Plavix Misses Goal But Helps Some In Study
A double dose of popular anti-clotting drug Plavix failed to meet researchers' primary goal of preventing more heart attacks, deaths and strokes than the standard dose -- and it increased the risk of bleeding -- in a large new study of heart patients.
-
ESC: Anticoagulant Cuts Bleeding in Stented Patients
Bivalirudin (Angiomax) reduced bleeding and other cardiovascular events at one year after angioplasty in patients with ST-segment elevation acute myocardial infarction, compared with heparin plus a glycoprotein IIb/IIIa inhibitor, researchers said.
-
Ticagrelor versus Clopidogrel in Patients with Acute Coronary Syndromes
In patients who have an acute coronary syndrome with or without ST-segment elevation, treatment with ticagrelor as compared with clopidogrel significantly reduced the rate of death from vascular causes, myocardial infarction, or stroke without an increase in the rate of overall major bleeding but with an increase in the rate of non–procedure-related bleeding.
-
Dabigatran versus Warfarin in Patients with Atrial Fibrillation
In patients with atrial fibrillation, dabigatran given at a dose of 110 mg was associated with rates of stroke and systemic embolism that were similar to those associated with warfarin, as well as lower rates of major hemorrhage. Dabigatran administered at a dose of 150 mg, as compared with warfarin, was associated with lower rates of stroke and systemic embolism but similar rates of major hemorrhage.
-
Blood Thinner Causes Stroke In Some Dialysis Patients, Study Suggests
The blood thinner warfarin can prevent strokes in most individuals with abnormal heart rhythms, but the drug may have the opposite effect in kidney disease patients on dialysis, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN).
-
New anticoagulants: focus on venous thromboembolism
In the present review, we discuss the pharmacology of new anticoagulants, the key points necessary for interpreting the results of studies on VTE prophylaxis and treatment, the results of clinical trials testing these new compounds and their potential advantages and drawbacks over existing therapies.
-
Heparin for the prevention of venous thromboembolism in general medical patients (excluding stroke and myocardial infarction)
The data from this review support the use of heparin thromboprophylaixs in medical patients presenting with an acute medical illness. Although the analysis found no significant difference in efficacy between LMWH and UFH, it did note differences in the incidence of DVT and clinical PE with a significantly reduced risk of bleeding in favour of LMWH.
-
Tailoring Antiplatelet Therapy Based on Pharmacogenomics
The authors demonstrated that the CYP2C19 polymorphisms were not associated with baseline platelet aggregation or response to aspirin but only affected aggregation in response to clopidogrel. Furthermore, there was a gene-dose effect, because persons heterozygous for the CYP2C19*2 allele had intermediate platelet inhibition after clopidogrel compared with CYP2C19*2 homozygous persons and noncarriers. These observations provide supportive evidence that the association between CYP2C19 and clopidogrel response may be real. Also, because the results of prior candidate gene studies and the current genome-wide association study approach are concordant, the likelihood of the association being true is high.
-
Important role in antithrombotic management
Dr Bereznicki said one of the key ways that pharmacists could help minimise the adverse effects was through the promotion of patient self monitoring – something that, he claimed, would help at least a quarter of people on warfarin.
-
Warfarin-induced skin necrosis
Warfarin-induced skin necrosis is a rare complication of anticoagulant therapy with a high associated morbidity and mortality requiring immediate drug cessation. Cutaneous findings include petechiae that progress to ecchymoses and hemorrhagic bullae. Characteristic dermatopathological findings are diffuse dermal microthrombi with endothelial cell damage and red cell extravasation with progression to full-thickness coagulative necrosis.
-
Association of Cytochrome P450 2C19 Genotype With the Antiplatelet Effect and Clinical Efficacy of Clopidogrel Therapy
We report the first genome-wide association study of clopidogrel response and show that the common loss-of-function CYP2C19*2 variant is a major determinant of ADP-stimulated platelet aggregation. Individuals with this genotype have reduced protection from clopidogrel in preventing cardiovascular disease–related events following PCI.
-
Sex Differences in Mortality Following Acute Coronary Syndromes
A convenience sample of patients pooled from 11 independent, international, randomized ACS clinical trials between 1993 and 2006 whose databases are maintained at the Duke Clinical Research Institute, Durham, North Carolina. Of 136 247 patients, 38 048 (28%) were women; 102 004 (26% women) with ST-segment elevation myocardial infarction (STEMI), 14 466 (29% women) with non-STEMI (NSTEMI), and 19 777 (40% women) with unstable angina.
-
What to do when warfarin therapy goes too far
Warfarin is certainly a lifesaver--but it can also lead to potentially fatal hypocoagulability. Here we recommend best reversal options based on the type of bleed.
-
Why 'Thick' Blood Protects From A Heart Attack
“Thick” blood can cause heart attack and stroke, but also prevent them. Scientists at Heidelberg University Hospital have explained the mechanism of this clinical paradox for the first time on an animal model. Mice with a greater tendency to form blood clots have larger plaques in their vessels, but they are more stable. Thus, there is less risk that these plaques will rupture and obstruct circulation.
-
Prevention of Venous Thromboembolism in Hospitalized Patients With Cancer
Evidence indicates that appropriate thromboprophylaxis is provided to a minority of hospitalized patients with cancer and that targeted educational efforts and computerized prompt systems can increase appropriate use. Guidelines developed by both oncology and thrombosis organizations support the use of thromboprophylaxis in hospitalized patients with cancer. In conclusion, most patients hospitalized with cancer are at high risk of venous thromboembolism, and thromboprophylaxis should be provided in the absence of active bleeding or a high bleeding risk.
-
Thrombolytic therapy for pulmonary embolism
Based on the limited evidence found we cannot conclude whether thrombolytic therapy is better than heparin for pulmonary embolism. More double-blind RCTs, with subgroup analysis of patients presenting with haemodynamically stable acute pulmonary embolism compared to those patients with a haemodynamic unstable condition, are required.
-
Elevated D-dimer levels predict recurrence in patients with idiopathic venous thromboembolism: a meta-analysis.
Elevated d-dimer levels measured 1 month after discontinuation of OAT identify patients with idiopathic VTE at higher risk of recurrence.
-
Salvage of failed free flaps used in head and neck reconstruction
Free flap success rates are in excess of 95%. Vascular occlusion (thrombosis) remains the primary reason for flap loss, with venous thrombosis being more common than arterial occlusion.
-
The Risk of Stent Thrombosis in Patients With Acute Coronary Syndromes Treated With Bare-Metal and Drug-Eluting Stents
Patients undergoing PCI for ACS are at higher risk of early and late stent thrombosis with either BMS or DES. Late stent thrombosis was only seen in patients with ACS who are treated with DES.
-
Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy: 5-Year Results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) Study
This is an interesting study and provides further corroboration to the results of the PROTECT AF trial. AF is a major cause of stroke, and if LAA closure is validated to be superior (or noninferior) to chronic anticoagulation, it could emerge as the preferred therapy for stroke prophylaxis.
-
Tamiflu puts 600,000 at greater risk of a stroke
A Government watchdog is concerned that the anti-swine flu drug can interact with the blood-thinning medication warfarin, which is taken by more than 600,000 people in the UK.
-
Predicting Deep Venous Thrombosis in Pregnancy: Out in “LEFt” Field?
The authors concluded that a low pretest probability on subjective assessment seems to exclude DVT. The authors further opined that three objective variables (LEFt) may improve the accuracy of the diagnosis of DVT in pregnancy. They point out that prospective validation studies are needed.
-
It’s Official: CMS Will Not Reimburse Medicare Recipients for Genetic Warfarin Dxs
According to G-2 Reports, CMS recently concluded in a final decision “there was not enough evidence” to show that pharmacogenomic testing of the CYP2C9 and VKORC1 alleles “to predict responsiveness to the anticoagulant drug improves health outcomes in Medicare beneficiaries.”
-
Should We Be Applying Warfarin Pharmacogenetics to Clinical Practice? No, Not Now
Warfarin has always been problematic, and genetic testing is unlikely to make our job as practitioners easier. Even if genetic analysis is ultimately found to play some role, clinical management of warfarin will continue to be difficult and demanding for those who undertake it. Further study is required before warfarin pharmacogenetic testing can be recommended.
-
Patients Capable Of Self-monitoring Their Anticoagulation Therapy Have Survival Benefit
Patients proficient of self-monitoring their warfarin therapy could fringe benefits from a identical-third reduction in death from all causes, according to a meta-analysis in this week’s issue of The Lancet. However, self-monitoring is not feasible for all patients, and requires denomination and education of befitting candidates, state the authors of the ponder.
-
FDA Renews Nationwide Alert on IV Flush Brand of Heparin or Sodium Chloride Intravenous Catheter Flushes
FDA is reissuing a nationwide alert against the use of all lots of preloaded syringes containing either heparin or sodium chloride intravenous catheter flushes manufactured by the IV Flush, LLC and distributed by Peak Medical Sell, of Rowlett, Texas, because new cases of infections that may associated with the permission of these unapproved and possibly contaminated products have been reported.
-
Factors affecting perioperative blood loss and transfusion rates in primary total joint arthroplasty: a prospective analysis of 1642 patients
Low molecular weight heparins such as dalteparin are the most common form of VTE prophylaxis in Canada. Our results suggest that dalteparin use, timing of tourniquet release and house staff turnover can all influence transfusion rates and/or blood loss in patients undergoing primary total joint arthroplasty. This study also emphasizes that women undergoing THA are at particularly high risk for blood transfusion.
-
No Routine VTE Prophylaxis for Outpatients
Approximately 1 in 5 cancer patients develops VTE over the course of their illness, which is a leading cause of death in this patient population. Although VTE prophylaxis using low-molecular-weight heparin (LMWH) is effective, it increases the risk of bleeding. Routine VTE prophylaxis in the general cancer outpatient population is not recommended by any guidelines committees.
-
In the Pipeline: New Oral Anticoagulants for the Prevention of Venous Thromboembolism
Optimally, anticoagulants used for VTE prophylaxis would have predictable effective oral dosing, not require monitoring, exhibit limited adverse reactions (including bleeding complications), and be readily reversible. Several new anticoagulants are in the final stages of development and may soon be available for the prevention of VTE in the orthopedic population.
-
Fatal Pulmonary Embolism in a Polytraumatized Patient Following Hip Arthroscopy
No guidelines exist for venous thromboembolic disease prophylaxis associated with hip arthroscopy, perhaps because the need for such guidelines has not materialized. This article describes a case of fatal pulmonary embolism associated with hip arthroscopy.
-
Gender Differences Among Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention in the American College of Cardiology-National Cardiovascular Data Registry (ACC-NCDR)
Similar rates of in-hospital mortality were observed for women and men; however, women had higher rates of cardiogenic shock, congestive heart failure, bleeding events, or vascular complications. Rates of subacute stent thrombosis were less among women compared to men (0.43% vs. 0.57%, p = 0.0003).
-
New compounds in the management of venous thromboembolism after orthopedic surgery: focus on rivaroxaban.
Rivaroxaban (Xarelto) is a member of a new class of oral, direct (antithrombin-independent) factor Xa inhibitors, which restrict thrombin generation both in vitro and in vivo.
-
MI reduction after smoking ban is sustained over long term
The reduction in MI hospitalizations observed after a smoke-free law takes effect appears to be sustained over an extended period, according to a new study from Pueblo, CO.
-
The incidence of deep vein thrombosis in women undergoing cesarean delivery
Venous thromboembolism (VTE) is one of the leading causes of maternal mortality in the United States. Cesarean delivery is a known risk factor. This study was to determine the incidence of deep vein thrombosis (DVT) post cesarean delivery.
-
FDA: Doctors Should Look For Alternatives To Blood Clot Drug
The FDA posted a letter to its Web site on Wednesday from Celgene Corp. warning users of blood-clot busting drug Innohep that new findings suggest the drug may lead to death in the elderly.
-
One in 10 stops taking clopidogrel because of "nuisance bleeding"
New observational data highlight the problem of "nuisance bleeding" on clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis) therapy following stent implantation, with as many as 85% of patients experiencing easy bruising, bleeding from small cuts, and minor hemorrhages from broken capillary vessels.
-
Plavix Blood Thinner Effectiveness Influenced By Gene Variants
Two studies of heart patients showed that the blood thinner clopidogrel (brand name Plavix) was less effective in carriers of certain variants of a gene known to affect how the drug prevents blood clots than non-carriers.
-
This year’s most interesting hematology stories
Two articles concerning anticoagulants are worth emphasizing. In February, Kenneth Bauer, MD, editorialized on a new oral anti-Factor Xa agent, rivaroxaban (Xarelto, Bayer/Ortho-McNeil). That it soon may replace parenteral anticoagulants in acute situations, as well as warfarin in more chronic conditions seems likely.
-
West Penn Testing Possible Warfarin Replacement
“Rivaroxaban shows great promise as a replacement for warfarin, a medication that has been the only oral anticoagulant for the last 60 years, and can be difficult to dose correctly,” said Dr. Margaret Kennedy who is the principal investigator in the two trials.
-
Trombocytopenia After Total Knee Arthroplasty
Heparin-induced thrombocytopenia is a serious complication during antithromboembolic prophylaxis caused by anti-heparin/platelet factor 4 (PF4) complex antibodies. It typically arises 3 to 15 days after the beginning of therapy and may result in an increased risk of arterial and venous thromboembolism.
-
Estrogen receptor genotype is associated with risk of venous thromboembolism during tamoxifen therapy
Thromboembolism is a serious complication of tamoxifen therapy in women with breast cancer. Banked DNA from tamoxifen-treated individuals with breast cancer from the Marshfield Clinic Personalized Medicine Research Project, a population-based DNA repository, was tested for association between incidence of tamoxifen-associated thromboembolic events (TTE) and single nucleotide polymorphisms encoding the estrogen receptors 1,2 (ESR1, ESR2) or drug metabolism enzymes cytochrome P450 2D6 (CYP2D6) and aromatase (CYP19)
-
Incidence and clinical implications of venous thromboembolism in advanced colorectal cancer patients: The 'GISCAD-alternating schedule' study findings
VTE is a common complication among advanced colorectal cancer patients and yet this type of toxicity is widely underestimated. In this randomised trial, VTE was the most frequent grade 3/4 toxicity. Use of an intermittent schedule is associated with a reduced risk of developing VTE.
-
Rising prevalence of venous thromboembolism and its impact on mortality among hospitalized inflammatory bowel disease patients
We sought to determine nationwide, population-based trends in rates of venous thromboembolism (VTE) among hospitalized inflammatory bowel disease (IBD) patients in the United States and to determine its mortality and economic impact.
-
Evaluation of a new venom-based clotting assay of protein C
Congenital protein C deficiency significantly increases the risk of venous thromboembolism, a serious and potentially lethal condition. Protein C levels can be determined by chromogenic, clotting and antigenic assays, each type of assay has differences in specificity and sensitivity to protein C deficiency.
-
Quality Improvement Program Enhances Stroke Care
A quality-improvement program increased compliance with guidelines for stroke treatment issued by the American Heart Association and American Stroke Association at nearly 800 hospitals, researchers found.
-
Increased Risk Of DVT But Treatment Lags
"Incredibly, we found as many as 43 per cent of the patients developed postthrombotic syndrome, and one-third of those had moderate to severe cases," said McGill's Dr. Susan R. Kahn, lead author of the study. "The syndrome is characterized by persistent leg pain and swelling, and in severe cases, patients can develop painful leg ulcers which are very difficult to treat.
-
Determinants and Time Course of the Postthrombotic Syndrome After Acute Deep Venous Thrombosis - Abstract
The postthrombotic syndrome occurs frequently after DVT. Patients with extensive DVT and those with more severe postthrombotic manifestations 1 month after DVT have poorer long-term outcomes.
-
Diesel exhaust inhalation increases thrombus formation in man
Inhalation of diesel exhaust increases ex vivo thrombus formation and causes in vivo platelet activation in man. These findings provide a potential mechanism linking exposure to combustion-derived air pollution with the triggering of acute MI.
-
ASH: Thombosis Risk Increased in ITP
Having immune thrombocytopenia purpura (ITP) appears to increase the risk of thrombosis, a British researcher said here. The risk appears to be primarily associated with venous thromboembolic events, he said at the American Society of Hematology meeting.
-
Avoid the clot
PATIENTS going for knee and hip surgeries have to watch out for one possible complication: getting a blood clot that is potentially fatal. In North America now, it's mandatory for such patients to take a blood thinner after the surgery, says Dr Louis Kwong, an orthopaedic surgeon from Harbor-UCLA Medical Center in Torrance, California.
-
Knowledge of Venous Thromboembolism (VTE) prevention among hospitalized patients
Findings suggest that patients require further information on VTE during their hospitalization to enhance their involvement in VTE prevention and recognition, and that the provision of written, patient-directed information could begin to address that lack of involvement. This study also highlights the need to strengthen the nurses' role in providing patient education about VTE.
-
Improving Inpatient Venous Thromboembolism Prophylaxis
The number and types of inpatients given inadequate prophylaxis for venous thromboembolism (VTE) are not known; patients receive less than appropriate prophylaxis with some frequency.
-
New anti-blood clot drug approved
A new palliative care drug was yesterday approved by the agency that determines the medicines made available through the NHS in Scotland. The Scottish Medicines Consortium (SMC) has accepted Xarelto (rivaroxaban), an oral anti-coagulant for the prevention of venous blood clots in adults undergoing elective hip or knee replacement surgery.
-
Pooled Xarelto data underlines superiority over Lovenox
Bayer has presented more positive data on Xarelto which the firm says underlines the superior efficacy of the anticoagulant compared with the current gold standard treatment, Sanofi-Aventis’ Lovenox.
-
ASH: Prophylactic Blood-Thinners Prevent Thromboembolism in Cancer Patients
Prophylactic treatment with a blood-thinner can markedly reduce -- by about 50% -- the rate of thromboembolism in cancer patients undergoing chemotherapy, researchers found. Currently, such prophylaxis is rarely used for ambulatory cancer patients, in whom the rate of thromboembolism is between 4% and 10%...
-
Rivaroxaban Reduces Symptomatic VTE & Death Following Knee or Hip Replacement Surgery by More Than 50% Compared to Enoxaparin in Pooled Analysis of the RECORD Clinical Trial Program
Results from a pre-specified pooled analysis of the RECORD clinical trial program showed that the novel, investigational, oral anticoagulant rivaroxaban was superior to enoxaparin treatment regimens for the prevention of venous thromboembolism (VTE) after total knee or hip replacement surgery. The data also show that rates of major bleeding were low and not statistically different from the comparator.
-
Research Highlights New Approaches to Prevent Blood Clots in Several High-Risk Patient Populations Including Largest Study Ever to Examine Use of Blood-Thinning Medication in Patients With Cancer
The largest study ever to examine the preventive use of blood-thinning medication to help prevent deadly blood clots in patients with cancer undergoing chemotherapy will be presented in a press conference on Sunday, December 7, at 9:30 a.m., during the 50th Annual Meeting of the American Society of Hematology in San Francisco, CA. Additional research being featured at the press conference includes studies that examine the use of three different investigational blood-thinning medications that belong to a new class of therapies called Factor Xa inhibitors.
-
Idiopathic Pulmonary Fibrosis Triples Vascular Risk
Patients with idiopathic pulmonary fibrosis have more than triple the risk of acute coronary syndrome and deep-vein thrombosis, according to a review of primary care data.
-
Prothrombin Time for Detection of Contaminated Heparins
The recent "heparin scandal" resulted from the use of contaminated heparin that caused serious adverse events including death. The contaminant was identified as synthetically oversulfated chondroitin sulfate (OSCS). Despite the missing final proof of a cause-and-effect relationship, OSCS was shown to have pharmacologic effects that may contribute to the observed allergic-type reactions.
-
Hospital patients get DVT exercise video beamed to their bedside
Developed by a physiotherapist at Cambridge University Hospitals NHS Foundation Trust, which runs the hospital, the exercises are designed to help prevent deep vein thrombosis and other complications associated with immobility.
-
A potential thrombus diagnosis reagent based on P-selectin monoclonal antibody SZ-51 light chain
The yield of SZ-LC by the expression and purification method reached above 70 mg/L culture. We found that the nucleotide from 99mTc-SZ-LC was removed quickly through animal kidney, and 99mTc-SZ-LC could bind specifically to the activated human platelet in vitro. More importantly, with this recombinant protein, we successfully detected the fresh thrombus that was induced in dog vein. These results suggested that the recombinant SZ-LC expressed by P. pastoris was functional active and a potential reagent for thrombus diagnosis.
-
Thrombosis patients face greater risks than previously believed
"Incredibly, we found as many as 43 per cent of the patients developed postthrombotic syndrome, and one-third of those had moderate to severe cases," said McGill's Dr. Susan R. Kahn, lead author of the study. "The syndrome is characterized by persistent leg pain and swelling, and in severe cases, patients can develop painful leg ulcers which are very difficult to treat. "Contrary to popular belief, DVT doesn't just affect older people, it can affect adults of all ages," explained Kahn...
-
FDA Requests Label Change for Tinzaparin
After reviewing results of an aborted European study involving tinzaparin (Innohep), a low molecular weight heparin product, the FDA said the drug's label should reflect increased risks for patients 70 and older.
-
Right-atrial floating thrombus attached to the interatrial septum with massive pulmonary embolism diagnosed by echocardiography
The presence of a right-atrium thrombus is considered as an unusual form of thromboembolic disease, with a prevalence of 10–18%. Most of them are located in the right-atria. Its mortality is about 45%. Echocardiography is very important to detect them and to control the effectiveness of the treatment, which can be either conservative or surgical.
-
Transfusing Anemic Cancer Patients Boosts Clot Risk
Giving blood transfusions to treat anemia in cancer patients increases the risk of potentially lethal blood clots, say University of Rochester, N.Y., researchers. But this risk is no greater than other treatments for cancer treatment-related anemia, the scientists said, after having analyzed data on more than 70,500 cancer patients who received transfusions at 60 medical centers from 1995 to 2003.
-
Prediction of Recurrent Venous Thromboembolism by Endogenous Thrombin Potential and D-Dimer
Increased thrombin generation is associated with an increased risk of recurrent venous thromboembolism. We investigated the relation between endogenous thrombin potential (ETP) and risk of recurrent venous thromboembolism and evaluated whether prediction of recurrence can be improved by a combined analysis of ETP and D-dimer.
-
FDA Warning: List of Medical Devices & Diagnostic Products that May Contain Heparin
The FDA updated its heparin recall list to include medical devices and diagnostic products that may contain or be coated with heparin. The FDA does not mean to suggest that all of the products herein have been or are affected by contaminated heparin, but its purpose is to warn consumers of potential products and devices that could be life-threatening if they contain contaminated heparin.
-
Do You Know You're Having a Stroke?
Researchers studied 400 patients who were diagnosed at Mayo Clinic's emergency department with either acute ischemic stroke or a transient ischemic attack (TIA), a temporary interruption of blood flow to part of the brain. Less than half of the patients -- 42 percent -- thought they were having a stroke.
-
Effect of deep vein thrombosis on ischaemia-modified albumin levels
Conclusions: DVT is associated with raised serum IMA levels but IMA levels are not suitable as a diagnostic marker for DVT.
-
Maternal Mortality and Immortality
The majority of maternal deaths in the U.S. are due to pulmonary emboli from blood clots and most often occur in the period after delivery (postpartum). Pregnancy causes an increased risk of pulmonary thromboembolus due to an increase in the ability to coagulate blood.
-
Isolated Gastro-Soleal DVT Can Be Associated With Progressive DVT And Pulmonary Emboli, And Should Be Treated
...He discovered that isolated gastronemial or soleal vein DVT (GSDVT) appears to be associated with pulmonary embolism (PE) and a significant incidence of new ipsilateral and contralateral DVT and as a result should be treated if there is no major cancer operations.
-
Breaking: Incidence, Risk Factors, And Treatment Patterns Revealed For Deep Venous Thrombosis (DVT) In Hospitalized Children
Pediatric venous thromboembolic events (VTEs) are rare but studies suggest that pediatric VTEs are an increasing concern in tertiarycare hospitals due to factors unique to the pediatric population.
-
Primary Factor Influencing Treatment Choice For Subclavian Vein Thrombosis Is Time Since Onset Of Symptoms
Primary subclavian vein thrombosis (also called "effort thrombosis" or Paget-von Schrötter syndrome) refers to thrombosis of the subclavian vein at the junction of the first rib and clavicle, and is often associated with either prolonged or repetitive upper extremity strain in young, healthy, often muscular and athletic patients.
-
Transfusions Increase Clot Risk In Hospitalized Cancer Patients, Scientists Find
Blood transfusions used to treat anemia in patients with cancer are associated with an increased risk of life-threatening blood clots, at a similar rate as other treatments for cancer-induced anemia, according to scientists at the University of Rochester Medical Center.
-
Mechanical Thrombectomy And Thrombolysis In The Treatment Of Acute Limb Ischemia
Etiologies of acute limb ischemia include thrombosis or embolism. With the exception of an embolus, where an embolectomy can quickly restore normal arterial flow, thrombosis of a native artery is associated with a complex occlusion, which includes underlying atherosclerosis.
-
New Approaches To Clot Removal With Lower Extremity DVT Announced At The VEITH Symposium
With the recent recognition that thrombolysis should be considered in first time proximal deep vein thrombosis (DVT), the quest for the best agents and the best delivery systems remains the challenge.
-
Influence of thrombophilia on risk of recurrent venous thromboembolism while on warfarin: results from a randomized trial
We sought to determine whether thrombophilic defects increase recurrent venous thromboembolism (VTE) during warfarin therapy. Six hundred sixty-one patients with unprovoked VTE who were randomized to extended low-intensity (international normalized ratio [INR], 1.5-1.9) or conventional-intensity (INR, 2.0-3.0) anticoagulant therapy were tested for thrombophilia and followed for a mean of 2.3 years.
-
Ultrasound waves aid in rapid treatment of DVT
The use of ultrasound waves for deep vein thrombosis (DVT) may help dissolve blood clots in less time than using clot-busting drugs alone, according to researchers at Emory University. The study will be presented Sunday, Nov. 23, 2008 at the annual VEITHsymposium in New York City.
-
Smoking During Pregnancy Damages Child's Artery
Researchers from The Netherlands found children of mothers who smoked during pregnancy had linings of carotid arteries in the neck that were 13.4 micrometers thicker by young adulthood than offspring whose mothers didn’t smoke.
-
Hospitals making progress on blood clot risk assessments
The all-party parliamentary thrombosis group revealed today that 70 per cent of hospitals are now risk assessing all patients for venous thromboembolism in line with recommendations from chief medical officer Sir Liam Donaldson, published last year.
-
THOUSANDS of patient deaths from blood clots acquired in hospital have been prevented following a Sun campaign.
Ten times more people were dying of hospital-acquired clots than MRSA and other NHS superbugs. But most deaths are easily prevented with £2 blood-thinning jabs or a pill called rivaroxaban. We urged hospitals to identify patients most at risk.
-
Bevacizumab significantly increases venous thromboembolism
The angiogenesis inhibitor bevacizumab (Avastin, Genentech/Roche) significantly increases the risk for venous thromboembolism (VTE), a new meta-analysis concludes. Because the drug is being increasingly used in the routine treatment of cancer patients, the authors suggest that this new finding might merit a black-box warning.
-
OCT imaging suggests low rates of uncovered/malapposed struts following DES for AMI
One of the hottest new technologies in the cardiovascular imaging arena is providing a new point of view in the ongoing debate over the safety of drug-eluting stents (DES) for acute MI. A new study using optical coherence tomography (OCT) suggests that exposed and malapposed stent struts in the setting of acute MI (AMI) are indeed more common with DES than with bare-metal stents, but the problem is relatively rare.
-
Thrombolysis may increase mortality among unlikely candidates with pulmonary embolism
Researchers from the Department of Veterans Affairs Pittsburgh Healthcare System and the University of Pittsburgh in Pennsylvania, and from the University of Lausanne in Switzerland, conducted an analysis to determine the prevalence of thrombolytic therapy and its benefits in patients hospitalized for acute pulmonary embolism.
-
Determinants and Time Course of the Postthrombotic Syndrome after Acute Deep Venous Thrombosis
The postthrombotic syndrome occurs frequently after DVT. Patients with extensive DVT and those with more severe postthrombotic manifestations 1 month after DVT have poorer long-term outcomes.
-
Elevated Levels of C-Reactive Protein Associated With Stent Thrombosis: Presented at AHA
Patients with elevated levels of C-reactive protein (CRP) before they undergo percutaneous coronary intervention (PCI) with stent implantation have a higher risk of developing stent thrombosis and stent-related death...
-
THINRS: Home INR monitoring as effective as clinic-based care
Results of a new randomized comparison shows that weekly home INR monitoring is safe but did not reduce stroke, major bleeds, or death when compared with monthly clinic-based INR testing.
-
A Prospective Randomized Controlled Trial of the Impact of Home INR Testing on Clinical Outcomes–The Home INR Study
A total of 2922 patients from 28 VA hospitals were randomized to PST or conventional testing. At 3-year follow-up, the composite primary endpoint occurred in 7.9% of PST and 8.9% of conventional testing groups (p=not significant). The time to first major event trended in favor of PST (HR 0.87, p=0.10). Time in target range (70% vs. 62%) and patient satisfaction (49 vs. 47 points on the Duke Anticoagulation Satisfaction Score) favored PST.
-
Heartburn drugs harm effectiveness of Plavix-study
Patients taking proton pump inhibitors such as Nexium or Prilosec had a 50 percent higher risk of a major cardiovascular event when also taking clopidogrel, the active ingredient in Bristol-Myers Squibb Co's blood clot preventer Plavix...
-
New factor Xa inhibitor rivaroxaban moves into phase 3 for ACS
The ATLAS ACS-TIMI 46 trial identified two doses of rivaroxaban—2.5 mg and 5 mg twice daily—that will be taken forward into a phase 3 trial, Gibson said. This study is slated to begin next month, will enroll up to 16 000 patients, and is estimated to last around 33 months.
-
Thromboembolism Prophylaxis in End-Stage Renal Disease
This study aimed to identify risk for venous thromboembolism (VTE) and prophylaxis patterns for end-stage renal disease (ESRD) patients admitted through the emergency department (ED).
-
Atrial Fibrillation Found to be Common in Patients With Atherothrombosis, Increases Risk of Cardiovascular Death, Heart Attack and StrokeA significant portion of patients with atherothrombosis also have atrial fibrillation (AF), greatly increasing th
A significant portion of patients with atherothrombosis also have atrial fibrillation (AF), greatly increasing their risk for cardiovascular death, heart attack and stroke, according to new findings from the large, international REACH registry published today in the American Heart Journal. The findings also showed that standard treatments including anticoagulant and antiplatelet therapies are underused in AF patients.
-
FDA Seizes Bad Heparin From Ohio Drugmaker
OSCS contaminant in injectable drug products containing heparin has been linked to multiple adverse events and deaths initially reported to the FDA in January 2008. The seized Celsus Heparin – which had entered the US before the establishment of import controls for the drug – was tested for the presence of OSCS as part of the agency’s recent efforts to inspect and monitor Heparin products.
-
A computer system reduces venous thromboembolism rate amongst hospitalised patients by half
The system evaluates, calculates and annotates on a daily basis the thrombotic risk of all patients hospitalised at the University Hospital as a function of the risk factors that they present. Depending on the risk calculated for a specific patient, the computer system generates an alert that appears on the computer screen of the doctor responsible for this patient.
-
Abrupt oxygen decrease influences thrombosis and bleeding in stenosed and endothelium-injured rabbit carotid arteries
Conclusion: An abrupt decrease in oxygen administration was responsible for an antithrombotic effect. Increase in bleeding time occurred during hypoxia. No clinically relevant variation of any haemostasis parameters was observed.
-
Benefit of Oral Anticoagulant Over Antiplatelet Therapy in Atrial Fibrillation Depends on the Quality of International Normalized Ratio Control Achieved by Centers and Countries as Measured by Time in Therapeutic Range
Conclusions: OAC is more effective than antiplatelet therapy in preventing thromboembolic complications of AF, but only if the TTR is >58%.
-
FDA Warns on Mexican Vanilla
The U.S. Food and Drug Administration (FDA) has just issued a warning about so-called Mexican “vanilla” that has been found to be typically made with a toxic substance called coumarin. The FDA issued the warning this week and is advising consumer not to buy this product.
-
Bleeding into the intraluminal thrombus in abdominal aortic aneurysms is associated with rupture
The site of rupture could be identified in a majority of cases of AAA with routine multislice CT. This study demonstrates an association between the presence of blood in the thrombus as suggested by higher attenuation levels and a crescent sign and AAA rupture. If these findings also predict AAA rupture, remains to be established.
-
Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)
The following are 10 points to remember about these guidelines on the diagnosis and management of acute pulmonary embolism (PE):...
-
Bayer's 'revolutionary' anticoagulant Xarelto launched
Professor Ajay Kakkar is professor of surgical sciences, Barts and the London School of Medicine and Dentistry and director of the Thrombosis Research Institute in London. He comments: "Thrombosis remains a major clinical challenge and today's announcement of the availability of Xarelto provides exciting new opportunities to protect patients from potentially fatal blood clots
-
Common Heart Drugs May Hamper Blood Thinner
Studying 200 people who were taking Plavix after artery-opening procedures and stent placement, the University of Vienna researchers found a higher level of activity of platelets -- the blood cells that can clump together to form blood clots -- in those also taking calcium channel blockers.
-
Osteoporosis Drugs Increase Risk for Heart Problems
People who take bisphosphonates for osteoporosis may be at risk for serious atrial fibrillation (AF), or irregular heartbeats, according to a new study.
-
Don't give kids on drug-thinner natural products: docs
Giving herbs, vitamins and other natural health products to children taking the blood-thinning drug warfarin for congenital heart defects could increase their risk of clots and bleeding, the Canadian Cardiovascular Congress was told Monday.
-
Simplification of the Revised Geneva Score for Assessing Clinical Probability of Pulmonary Embolism
The revised Geneva score is a fully standardized clinical decision rule (CDR) in the diagnostic workup of patients with suspected pulmonary embolism (PE). The variables of the decision rule have different weights, which could lead to miscalculations in an acute setting. We have validated a simplified version of the revised Geneva score.
-
Deep vein thrombosis after monoclonal gammopathy of undetermined significance and multiple myeloma
Patients with multiple myeloma (MM) have an increased risk of deep venous thrombosis (DVT), particularly when treated with immunomodulatory drugs. Recently, 2 small hospital-based studies observed persons with the MM precursor condition, monoclonal gammopathy of undetermined significance (MGUS), to be at increased risk of developing DVT.
-
Adding access blood flow surveillance to clinical monitoring reduces thrombosis rates and costs, and improves fistula patency in the short term: a controlled cohort stu
Our controlled cohort study shows that adding Qa surveillance to monitoring in mature AVFs is associated with a better detection and elective treatment of stenosis, and lower thrombosis rates and access-related costs, although the cumulative access patency was only extended in the first 3 years after fistula maturation. We are aware of the limitations of our study (non-randomization and the possible centre effect) and that further, better-designed trials are needed to arrive at a definitive answer concerning the role of Qa surveillance for fistulae.
-
Exhaust Emissions and Their Dangers
Traffic emissions, for example, are now known to dramatically increase the potential risk of a fatal blood clot known as DVT, or deep vein thrombosis. Asthma, respiratory complications, and even heart or lung disease are also some of the more commonly known health effects of long-term air pollution that are associated with exhaust emissions.
-
DNA research taking guesswork out of finding the 'therapeutic window'
At the top of the list of problem drugs is Warfarin, (Coumadin®), the most widely prescribed anticoagulant. That is why Evgeny Krynetskiy, Ph.D., associate professor and director of the Jayne Haines Center for Pharmacogenomics and Drug Safety, has focused his research efforts on that drug.
-
ODESSA Trial Looks Inside Drug-Eluting Stents With Optical Coherence Tomography (OCT)
OCT is a catheter-based system which provides a high resolution image of the inner artery surfaces (10 microns) and can easily show if stents have been covered by the body's endothelial cells. Theoretically, as long as metal stent struts remain uncovered, healing is delayed and the risk of blood clotting (stent thrombosis) inside the artery is higher.
-
Neointimal formation is reduced after arterial injury in human crp transgenic mice
Elevated CRP levels predict increased incidence of cardiovascular events and poor outcomes following interventions. There is the suggestion that CRP is also a mediator of vascular injury. Transgenic mice carrying the human CRP gene (CRPtg) are predisposed to arterial thrombosis post-injury. We examined whether CRP similarly modulates the proliferative and hyperplastic phases of vascular repair in CRPtg when thrombosis is controlled with daily aspirin and heparin at the time of trans-femoral arterial wire-injury.
-
Rectus sheath hematoma
Rectus sheath hematoma (RSH) is a known complication of anticoagulation therapy and a source of potential morbidity and mortality. Early diagnosis and appropriate treatment may help to prevent complications including hemodynamic instability, the abdominal compartment syndrome or multiorgan dysfunction.
-
Stent Thrombosis, Clinical Events, and Influence of Prolonged Clopidogrel Use After Placement of Drug-Eluting Stent: Data From an Observational Cohort Study of Drug-Eluting Versus Bare-Metal Stents
The authors concluded that, compared with BMS, DES showed a similar risk of overall ST, but a higher risk of very late ST. Clopidogrel continuation beyond 1 year did not appear to reduce ST and clinical events.
-
PREPARE: Proximal embolic protection with aspiration improves immediate ST-segment resolution
The use of an embolic-protection and aspiration device proximal to the lesion in primary PCI results in better immediate microvascular flow in ST-segment-elevation MI (STEMI) patients compared with primary PCI alone, a new study has shown. There was no difference in ST-segment resolution between the two treatments at two hours, nor was there a difference in myocardial blush grade or clinical outcomes at 30 days between the two arms.
-
Bleeding complications during warfarin treatment in primary healthcare centres compared with anticoagulation clinics
There was no difference in bleeding complications between patients monitored at primary healthcare centres and specialized anticoagulation clinics. Age was continuously and independently associated with bleeding risk. These study data indicate the need to exercise caution in treatment of the elderly.
-
New Remedies to Treat Blood Clots Are Near: Big Drug Makers Aim to Reduce Drawbacks of Existing Medicines
Drugs currently used to prevent blood clots, also known as thrombosis, are effective and sell well but have problems. One popular treatment is difficult to dose and introduces risks when taken with other medicines and some foods. Another is an injectable, making long-term therapy difficult.
-
Older Donors Lead to Late Hepatic Artery Thrombosis in Liver Recipients: Presented at ACS
Results show that the risk of HAT increased with each increasing decade of life of the donor. There was no significant risk if the donor was less than 50 years old, while the relative risk was 1.35 for donors in their 50s and 1.52 for donors in their 60s. Donors older than 70 years produced a relative risk of HAT of 1.61 for the recipients (all risk values were significant, P < .001).
-
Left atrial volume index predicts risk of first ischemic stroke
An elevated left atrial volume index (LAVI) is associated with an increased risk of first ischemic stroke and subsequent mortality, according to a report in the October issue of the Mayo Clinic Proceedings. "Left atrial volume is a barometer, a reflection of chronic increase in atrial pressure, which accounts for the increase in thrombus formation (increased stroke risk),"...
-
PRoximal Embolic Protection in Acute MI and Resolution of ST-Elevation
This study is similar to other studies, which have indicated that of the mechanical thrombectomy devices, thrombus aspiration devices may be associated with a clinical benefit and more complete STR compared with primary PCI alone, whereas embolic protection devices have a neutral effect on these outcomes.
-
Bone Quality in Children may be Compromised by Therapy With Vitamin K-Antagonists
The major outcome of the study was that children undergoing long-term oral anticoagulant therapy presented higher levels of inactive osteocalcin, indicative of poor vitamin K status. Moreover, bone resorption markers were enhanced whereas bone formation markers and vitamin D levels were lower in comparison to the control group. Additionally, more than half of the examined children in the patients group showed signs of osteopenia, which means their bone mineral density was lower than normal.
-
Blood Clots in Children and Young Adults
Deep-vein thrombosis (blood clots in the veins of the body; also called DVT) and pulmonary embolism blood clots in the lungs; also called PE) can occur at any age. Although blood clots occur more commonly in adults, about 1 in 10,000 children will be affected. The first month of life (especially in premature and other hospitalized infants) and the teenage years appear to be times of greatest risk for young people to develop blood clots.
-
IgA antiphospholipid antibodies are an independent risk factor for thromboses
Antiphospholipid antibodies (lupus anticoagulant, anti-cardiolipin and anti-β2-glycoprotein I antibodies, mostly IgG isotype) are strong risk factors for thrombosis. Because a paucity of information on IgA isotype exists in the literature, we retrospectively evaluated the thrombotic significance of IgA antiphospholipid antibodies.
-
No increased risk, but no MI/mortality benefit with DES, experts cautiously conclude
Leaders of some of the more provocative drug-eluting-stent (DES) trials and registries of the past few years now seem to cautiously agree that DES likely do not increase mortality compared with bare-metal stents, but none were convinced that the newer devices might actually provide a mortality benefit across the board.
-
First-in-human data with novel polymer-coated stent: No thrombosis at 12 months
Promising first-in-human data with a new cobalt-chromium stent coated with a novel polymer suggest that the device eliminates the risk of potential late stent thrombosis. Investigators reported no cases of stent thrombosis at 12 months in patients implanted with the stent, as well as no adverse clinical events, despite stopping dual antiplatelet therapy at 30 days.
-
Vulnerable plaque may be easier to detect through new imaging technology
Research results indicate that optical coherence tomography (OCT), a newly evolving imaging method, may be the best tool available to detect vulnerable plaque in coronary arteries. The findings will be presented at the 20th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).
-
Antiphospholipid Syndrome (APS)
Most importantly, it causes an abnormal blood clot. A blood clot in medical terms is called a thrombosis (two or more blood clots are called thromboses). The most common clots are deep within the legs (deep venous thrombosis or DVT). The leg becomes swollen and painful in most cases. When a blood clot breaks loose and floats away to lodge elsewhere, it is called an embolus. Blood clots from a DVT can travel to the lungs and damage or kill parts of the lung. These are called pulmonary emboli.
-
Risk factors of abdominal venous thrombosis
Their result indicate that hereditary and acquired risk factors play an important role in etiopathogenesis of abdominal venous hrombosis. Acquired risk factors are significantly more common in patients with SVT while hereditary risk factors are similar in patients with BCS and SVT.
-
Massage Therapy in the Relief of Cancer Pain.
There are contraindications to massage. Patients with DVT (Deep Vein Thrombosis) should be handled carefully because Pulmonary Emboli may develop as a result of the massage therapy (Stephenson et al 2000).
-
Warfarin warning: Shortfalls in anticoagulation for AF up risks of ICH and embolic stroke
Most patients with atrial fibrillation (AF) aren't getting prescriptions for warfarin, and of those who are on warfarin, most aren't being anticoagulated to the proper therapeutic extent; their international normalized ratios (INRs) are frequently outside the recommended range of 2.0 to 3.0, which puts them at significantly increased risk of intracranial hemorrhage or embolic stroke…
- Page:
- 1
- 2
© 2009, Bayer Schering Pharma AG