Thrombosis research
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Thrombosis research · Aug 2020
Review Meta AnalysisThrombosis risk associated with COVID-19 infection. A scoping review.
Infection by the 2019 novel coronavirus (COVID-19) has been reportedly associated with a high risk of thrombotic complications. So far information is scarce and rapidly emerging. ⋯ A number of pressing issues were identified by this review, including defining the true incidence of VTE in COVID patients, developing algorithms to identify those susceptible to develop thrombotic complications and severe disease, determining the role of biomarkers and/or scoring systems to stratify patients' risk, designing adequate and feasible diagnostic protocols for PE, establishing the optimal thromboprophylaxis strategy, and developing uniform diagnostic and reporting criteria.
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Thrombosis research · Jul 2020
Review Meta AnalysisClinical practice guidelines for the treatment and prevention of cancer-associated thrombosis.
The risk of venous thromboembolism (VTE) is increased in patients with cancer and is greatest in those with cancers of the pancreas, stomach, brain, lung and ovary, late stage disease and in those undergoing treatment including chemotherapy, hormonal therapy, or surgery. VTE in patients with cancer is associated with a variety of adverse consequences including an increased risk of VTE recurrence, major bleeding, and early mortality. A VTE risk score for ambulatory patients receiving cancer chemotherapy has been extensively validated and has been used to select high risk patients for thromboprophylaxis trials. ⋯ Several clinical practice guidelines addressing VTE in patients with malignant disease have been updated including those from the American Society of Clinical Oncology (ASCO). The addition of DOACs as an option for the management of VTE in patients with cancer is the latest major change to previous guidelines issued by these organizations. The updated recommendations from these guidelines are summarized in this review.
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Thrombosis research · Jul 2019
Meta AnalysisRisk of venous and arterial thrombosis in non-surgical patients receiving systemic tranexamic acid: A systematic review and meta-analysis.
Antifibrinolytic agents such as tranexamic acid (TXA) are commonly used as adjunctive therapies to prevent and treat excessive bleeding. In non-surgical settings, TXA is known to reduce bleeding related mortality. However, impact of TXA use on thrombosis is uncertain. ⋯ In our systematic review and meta-analysis, the use of tranexamic acid reduced all-cause mortality without increased risk of venous or arterial thrombotic complications.
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Thrombosis research · May 2019
ReviewVenous thromboembolism and cancer: Current and future role of direct-acting oral anticoagulants.
Approximately one-fifth of all cases of venous thromboembolism (VTE) are related to cancer and anticoagulant treatment in these patients has remained a challenge. Cancer patients with VTE are at increased risk of developing recurrent VTE compared to patients without cancer, but also have a higher risk of major bleeding. In these patients, low molecular weight heparins (LMWHs) have been shown to be more effective and as safe as vitamin K-antagonists (VKAs) for the treatment of VTE. ⋯ Data from two randomized trials comparing DOACs vs. LMWH have recently been published. In the present review, we will provide three clinically relevant questions on the use of DOACs in patients with cancer and VTE and provide an overview on recent evidence on this topic: 1) are DOACs a treatment option for the prevention of VTE in cancer patients?; 2) what is the place for DOACs in patients with cancer-associated VTE?; 3) should I use DOACs for the extended treatment of cancer-related VTE?.
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Thrombosis research · Apr 2019
Meta AnalysisThe safest and most efficacious route of tranexamic acid administration in total joint arthroplasty: A systematic review and network meta-analysis.
Blood loss in Total Joint Arthroplasty can be significant and often under-estimated. This study aims to investigate the safety and efficacy of different routes of tranexamic acid (TXA) administration in reducing blood transfusion after Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA). The secondary aim is to find the safest and most efficacious route and dose of TXA. ⋯ All forms of TXA administration showed significantly lower transfusion rate compared to control. There is a trend towards better efficacy with intra-venous and topical. In patients with higher risk of thrombosis, physicians may consider topical alone for its best safety profile.