Search Results
Results 451 - 500 of 1298
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Alberts Mark J - - 2008
The landmark CHARISMA study attempted to show that combination therapy with aspirin plus clopidogrel was superior to aspirin alone in a mixed population of patients with known vascular disease or those with risk factors for vascular disease. Although the study was negative for the combined group, a re-analysis of the ...
Montalescot Gilles - - 2008
AIMS: To determine the relationship between anticoagulation levels during percutaneous coronary intervention, and ischaemic events and bleeding. METHODS AND RESULTS: A sub-analysis from the STEEPLE trial was conducted. Pre-defined target anticoagulation levels were achieved in 86% of patients receiving enoxaparin, compared with 20% receiving unfractionated heparin (UFH) (P < 0.001). ...
- - 2008
BACKGROUND: Vitamin K antagonists, the current standard treatment for prophylaxis against stroke and systemic embolism in patients with atrial fibrillation, require regular monitoring and dose adjustment; an unmonitored, fixed-dose anticoagulant regimen would be preferable. The aim of this randomised, open-label non-inferiority trial was to compare the efficacy and safety of ...
Schulman S - - 2008
BACKGROUND AND OBJECTIVE: Resumption of oral anticoagulation after surgery may result in a different maintenance dose of warfarin than before the procedure. Knowledge of the clinical determinants of postoperative response could help avoid excessive anticoagulation in sensitive patients or avoid extended delays in achieving a therapeutic level in resistant patients. ...
Margheri Massimo - - 2008
Anticoagulant and thrombolytic therapies are a mainstay in the management of acute pulmonary embolism (PE), especially when hemodynamic compromise is present. However, systemic drugs cannot achieve timely and effective treatment of acute PE in all patients. In such a setting, mechanical removal of thrombus from the pulmonary circulation holds the ...
Johnson Samuel G - - 2008
BACKGROUND: The use of antiplatelet therapy in combination with oral anticoagulants remains controversial. The objective of this study was to estimate and compare the incidence of adverse and coronary event rates between patients receiving warfarin monotherapy or warfarin and antiplatelet combination therapy. METHODS: This was a retrospective, longitudinal, pharmacoepidemiologic analysis. ...
Pabinger I - - 2008
BACKGROUND: Prothrombin complex concentrate (PCC) can substantially shorten the time needed to reverse antivitamin K oral anticoagulant therapy (OAT). OBJECTIVES. To determine the effectiveness and safety of emergency OAT reversal by a balanced pasteurized nanofiltered PCC (Beriplex P/N) containing coagulation factors II, VII, IX, and X, and anticoagulant proteins C ...
Garcia David A - - 2008
BACKGROUND: Significant uncertainty surrounds the treatment of patients who must discontinue warfarin sodium therapy before an invasive procedure. In part, the uncertainty results from the lack of published information about the risk of thromboembolism associated with short-term warfarin therapy interruption. We aimed to assess the frequency of thromboembolism and bleeding ...
Audebert Heinrich J - - 2008
BACKGROUND: Oral anticoagulation is highly effective for secondary prevention of cardioembolic strokes in patients with atrial fibrillation (AF). There are no studies investigating timing and complications of different strategies for initiation of oral anticoagulation after acute stroke or transient ischaemic attack (TIA). METHODS: Patients of ten community hospitals participating in ...
Hart Robert G - - 2008
BACKGROUND: Aspirin offers modest reduction in stroke in patients with atrial fibrillation. Whether combination of aspirin with clopidogrel offers additional protection is unclear. METHODS: Post-hoc subgroup analysis of 593 participants with a history of atrial fibrillation in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) ...
Zeymer Uwe - - 2008
OBJECTIVES: We sought to assess the effect of clopidogrel on one-year ischemic events in unselected patients with NSTEMI. METHODS: We analysed data of consecutive patients with acute NSTEMI treated with aspirin or aspirin plus clopidogrel, who were prospectively enrolled in the ACOS registry. RESULTS: A total of 4290 patients were ...
Iorio A - - 2008
Current understanding of oral anticoagulant treatment and related intracerebral haemorrhage remains rather limited as compared to that of spontaneous intracerebral haemorrhage. Although intracerebral haemorrhage is the most serious complication of oral anticoagulant treatment, standardized treatment guidelines are still lacking. The currently employed treatments are aimed at normalization of the iatrogenic ...
Chan Kwan-Leung - - 2008
BACKGROUND: In a recent clinical trial, aspirin therapy was initiated approximately 34 days after the onset of symptoms but did not reduce the risk of embolism in patients with endocarditis. However, it is possible that aspirin used early in the course of the disease may be beneficial. The purpose of ...
Bruce David - - 2008
INTRODUCTION: Major blood loss can often be life-threatening and is most commonly encountered in the settings of surgery and trauma. Patients receiving anticoagulant therapy are also at increased risk of bleeding. We investigated the use of a prothrombin complex concentrate (PCC; Beriplex P/N, CSL Behring, Marburg, Germany) to treat severe ...
Bounameaux Henri - - 2008
Treatment of acute deep vein thrombosis and pulmonary embolism-often denominated together as venous thromboembolism (VTE)- consists of parenteral administration of heparin (usually low-molecular-weight heparin or alternatively unfractionated heparin or fondaparinux) overlapped and followed by oral vitamin K antagonists that are administered for a certain period (usually 3 to 12 months). ...
Morimoto Yoshinari - - 2008
PURPOSE: We examined hemostatic management for tooth extraction in patients maintained on oral antithrombotic therapy. PATIENTS AND METHODS: Subjects comprised 270 patients, with 134 receiving warfarin alone, 49 receiving warfarin with additional antiplatelet drugs, and the remaining 87 receiving antiplatelet drugs alone. In patients administered warfarin alone, international normalized ratio ...
Willms Lisa - - 2008
This article reviews the efficacy and safety of warfarin to prevent tunneled cuffed catheter (TCC) thrombosis in the hemodialysis population. Literature searches of PubMed, EMBASE, the Cochrane Library and Google Scholar were performed until April 1, 2007. Bibliographies of relevant articles were reviewed for additional publications. Minidose (1 mg/day) warfarin ...
Rubboli Andrea - - 2008
Dual antiplatelet treatment with aspirin and clopidogrel is recommended after coronary stenting (PCI-S). There is scant evidence defining optimal post-PCI-S antithrombotic therapy in patients with atrial fibrillation (AF) in whom oral anticoagulation (OAC) is mandated. To evaluate the safety and efficacy of the antithrombotic strategies for this population, we conducted ...
Walker Cameron - - 2008
DESIGN: A randomised controlled trial (RCT) was carried out. INTERVENTION: Patients scheduled for dental extraction were randomly divided into four groups: no suturing with either discontinued anticoagulants (group 1) or continued warfarin (group 2); and suturing with either discontinued anticoagulants (group 3) or continued warfarin (group 4). The international normalised ...
Cundiff David Keith - - 2008
In vitro studies and anecdotal clinical reports have suggested that clinically significant rebound hypercoagulability may occur after discontinuation of oral anticoagulants (OACs), such as vitamin K antagonists and ximelagatran, for venous thromboembolism (VTE). Assess the extent to which rebound hypercoagulability-related VTE recurrences occur in the 2 months following discontinuation of ...
Salaun Pierre-Yves - - 2008
OBJECTIVE: To assess whether guidelines for the management of suspected PE, recommending that ventilation/perfusion (V/Q) scintigraphy should be followed by other imaging in case of non-diagnostic result, and interpreted along with the clinical probability, are applied in daily practice. DESIGN: Two-year audit study. SETTING: Tertiary hospital in France. PARTICIPANTS: All ...
Ray Charles E CE - - 2008
PURPOSE: To perform a systemic review to determine the effect of anticoagulation on the rates of venous thromboembolism (pulmonary embolus, deep venous thrombosis, inferior vena cava (IVC) filter thrombosis) following placement of an IVC filter. METHODS: A comprehensive computerized literature search was performed to identify relevant articles. Data were abstracted ...
van Leeuwen Y - - 2008
BACKGROUND: Variability in the intensity of anticoagulant therapy is considered a risk factor for complications, but it is unclear how best to quantify variability. OBJECTIVE: We evaluated the association of three methods to measure variability with complications of oral anticoagulant therapy. METHODS: We conducted a nested case-control study within a ...
D'Ayala Marcus - - 2008
The benefit of intravenous heparin as an anticoagulant to avoid thrombotic complications during angioaccess surgery for hemodialysis is unknown. We prospectively randomized 115 consecutive patients referred to our institution for permanent hemodialysis access to receive systemic anticoagulation or no anticoagulation during angioaccess surgery. Patient demographics, comorbid conditions, procedure time, complications, ...
Hope William W - - 2007
BACKGROUND: Postoperative pulmonary embolism (PE) remains a major health concern. The purpose of our study was to evaluate our experience with postoperative PE. METHODS: We retrospectively reviewed the medical records of patients who had a postoperative PE at our institution. RESULTS: Our study included 115 patients. Prophylaxis was administered preoperatively ...
Holden Rachel M - - 2008
BACKGROUND AND OBJECTIVES: Few studies have examined risk factors for hemorrhage in hemodialysis patients. The contribution of warfarin and antiplatelet agent exposure to the incidence of first major bleeding episodes in hemodialysis patients was determined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Retrospective chart review was performed in eligible hemodialysis patients. Incidence ...
Wazni Oussama M - - 2007
BACKGROUND: The best approach to management of anticoagulation before and after atrial fibrillation ablation is not known. METHODS AND RESULTS: We compared outcomes in consecutive patients undergoing pulmonary vein antrum isolation for persistent atrial fibrillation. Early in our practice, warfarin was stopped 3 days before ablation, and a transesophageal echocardiogram ...
Schwartz Neil E - - 2007
Antiplatelet medications are the agents of choice for secondary prevention of noncardioembolic ischemic strokes. Multiple clinical trials have proven their reliable albeit modest clinical benefits and relatively good safety profile. The most commonly recommended antiplatelet agents for secondary stroke prevention in North America and Europe are aspirin, clopidogrel, and the ...
Schneider M - - 2007
BACKGROUND: The use of trisodium-citrate for regional anticoagulation of the extracorporal circuit during renal replacement therapy (RRT) has received increased interest, particularly in critically ill patients with increased risk of bleeding. Continuous renal replacement therapies are the most extensively investigated and used procedures in this regard. However, when patients recover ...
Rosencher N - - 2007
We propose recommendations to reduce the risk of haemorrhagic events associated with regional anaesthesia in patients treated with newer anticoagulants after orthopaedic surgery. The risk/benefit ratio should be individualised for each patient according to the type and dose of anticoagulant, the type of regional anaesthesia and patient risk factors. Neuraxial ...
Amitrano Lucio - - 2007
OBJECTIVES AND METHODS: Splanchnic vein thrombosis (SVT), not associated with cancer or liver cirrhosis, is a rare event and scanty data are available on its natural history, long-term prognosis, and treatment. In this study 121 SVT patients consecutively seen from January 1998 to December 2005 were included and 95 of ...
Simons R - - 2007
Peri-operative guidelines exist for neuraxial anaesthesia and anticoagulant therapy. We describe the use of thromboelastography to assess the coagulation status of a patient with moderate renal impairment who had been receiving enoxaparin and was being managed in accordance with current recommendations. This report demonstrates that current guidelines for discontinuing treatment ...
Dixon A J - - 2007
BACKGROUND: The aim was to identify risk factors for postoperative bleeding following skin cancer surgery. METHODS: This was a prospective study of 5950 skin lesions excised in 2394 patients. No patient stopped taking aspirin or warfarin unless the international normalized ratio (INR) exceeded 3.0. RESULTS: The rate of postoperative bleeding ...
Heiner Jared G - - 2008
PURPOSE: Advanced age is considered a risk factor for complications in patients receiving intravesical bacillus Calmette-Guérin (BCG) therapy. However, there is no clear delineation of BCG-related complication rates relative to patient age. MATERIALS AND METHODS: We reviewed the clinical course of 58 consecutive men receiving maintenance BCG therapy from December ...
Van Ha Thuong G - - 2008
The purpose of this study was to review the use, safety, and efficacy of retrievable inferior vena cava (IVC) filters in their first 5 years of availability at our institution. Comparison was made with permanent filters placed in the same period. A retrospective review of IVC filter implantations was performed ...
Seshadri T - - 2008
BACKGROUND: Inferior vena cava (IVC) filters are an alternative management strategy to anticoagulation in patients with venous thromboembolism (VTE). However, an IVC filter has its own inherent risks and complications and may not be the best management strategy. The aims of this study were to evaluate our institution's practice of ...
Haran Michal Z - - 2007
The prothrombin time/International Normalized Ratio is an accurate parameter for following most warfarin-treated patients. However, it reflects mostly factor VII levels, and significant disproportionate alterations in other vitamin K-dependent factors may not be reflected properly. We report a rare case of a woman who developed arterial thrombosis whilst receiving therapeutic ...
Crowther Mark A - - 2007
Inferior vena cava (IVC) filters, both retrievable and permanent, are indicated for the prevention of pulmonary embolism (PE) in patients contraindicated for anticoagulant therapy, in those with anticoagulant therapy complications, and perhaps for those with recurrent PE despite therapeutic anticoagulation. Because of the lack of randomized controlled trials (only 1 ...
Rubboli A - - 2007
Dual antiplatelet treatment of aspirin and a thienopyridine (either ticlopidine or clopidogrel) is the standard of care in patients undergoing coronary artery stenting (PCI-S). Such treatment however, is not generally applicable in patients with concomitant indication for vitamin K antagonists (VKA), in whom therefore the optimal treatment is currently undefined. ...
Agnelli Giancarlo - - 2008
Currently available anticoagulants are effective in reducing the recurrence rate of venous thromboembolism (VTE). However, anticoagulant treatment is associated with an increased risk for bleeding complications. Thus, anticoagulation has to be discontinued when benefit of treatment no longer clearly outweigh its risks. The duration of anticoagulant treatment is currently framed ...
Hart Robert G - - 2008
Clinical trials during the past 20 years have revolutionized the antithrombotic management of atrial fibrillation. Based on consideration of 30 randomized trials involving 29,017 participants, adjusted-dose warfarin remains the most efficacious prophylaxis against stroke for atrial fibrillation patients at moderate-to-high risk (compared with antiplatelet agents, warfarin reduces stroke by about ...
Kaatz Scott - - 2008
BACKGROUND: Anticoagulation management services or clinics have been recommended as the preferred method in the long-term management of oral anticoagulation with vitamin K antagonists and have been shown to increase the time patients spend in the therapeutic range. This surrogate marker of the quality of anticoagulation control is a well ...
- - 2007
BACKGROUND: The extended use of vitamin K antagonists for prophylaxis against venous thromboembolism is often constrained by risk-benefit limitations and inconvenience. We evaluated the efficacy and safety of a 6-month extension of prophylaxis against recurrent venous thromboembolism with idraparinux in patients who had initially received 6 months of prophylaxis with ...
Caraco Y - - 2008
Warfarin anticoagulation effect is characterized by marked variability, some of which has been attributed to CYP2C9 polymorphisms. This study prospectively examines whether a priori knowledge of CYP2C9 genotype may improve warfarin therapy. Patients were randomly assigned to receive warfarin by a validated algorithm ("control", 96 patients) or CYP2C9 genotype-adjusted algorithms ...
Perrio Michael J - - 2007
INTRODUCTION: A modified prescription-event monitoring (PEM) study was conducted to examine the safety of the introduction of the metered dose inhaler (MDI) Flixotide Evohaler (fluticasone with the propellant HFA 134a). METHODS: Patients were identified from the first NHS prescriptions dispensed in England for Flixotide Evohaler. Postal questionnaires were sent to ...
Drews Thorsten - - 2007
The anticoagulation treatment of children on pulsatile assist devices was studied. The results of 40 children (group A) on mechanical circulatory support with the formerly used anticoagulation treatment were compared with 32 children (group B) on assist devices treated with a new anticoagulation regime. In groups A and B, respectively, ...
Dayani Pouya N - - 2007
PURPOSE: To evaluate the safety of intravitreal Macugen (OSI/Eyetech, New York, New York, USA) injections among patients receiving warfarin anticoagulation. DESIGN: Retrospective chart review. METHODS: A search was conducted for patients treated with intravitreal Macugen for choroidal neovascularization resulting from age-related macular degeneration (AMD). Inclusion criteria included patients receiving warfarin ...
Lorenz Reinhard - - 2007
The present prospective study was designed to evaluate the effectiveness and safety of prothrombin complex concentrate (PCC) for emergency reversal of oral anticoagulation with phenprocoumon, a long-acting coumarin. Patients were eligible for study entry if they required emergency reversal of phenprocoumon anticoagulation because they needed invasive surgical or diagnostic procedures ...
Kuderer Nicole M - - 2007
BACKGROUND: Preclinical evidence suggests that anticoagulants, in particular the low-molecular-weight heparins (LMWH), exert an antitumor effect, whereas clinical trials have reported conflicting results. The authors conducted a comprehensive, systematic review and meta-analysis of the evidence from randomized controlled trials (RCTs), to evaluate the impact of anticoagulants on survival and safety ...
Hong Yu-Cheng - - 2007
Acute cardiac tamponade requires urgent diagnosis and treatment. We report a case involving a 70-year-old man who was receiving warfarin treatment for 12 years following mitral valve replacement. The international normalised ratio (INR) was checked and echocardiography performed regularly in the clinic. The last INR was 2.1, checked 2 weeks ...
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