Thrombosis research
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Thrombosis research · Mar 2016
ReviewIncreased bleeding risk in patients with aortic valvular stenosis: From new mechanisms to new therapies.
Aortic stenosis (AS), the most prevalent acquired valvular disease in the adults that requires invasive treatment, coexists with coagulopathy, resulting in bleeding in approximately 20% of patients. In the current review, we summarize the available knowledge on the mechanisms underlying the bleeding tendency observed in AS, and discuss potential compensatory mechanisms preventing most patients with severe AS from experiencing bleeding. ⋯ Both surgical valve replacement and transcatheter aortic valve implantation are discussed. Finally, we discuss current treatment recommendations in AS related bleeding.
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Thrombosis research · Oct 2015
Review Meta AnalysisSafety and efficacy of direct oral anticoagulants compared to warfarin for extended treatment of venous thromboembolism -a systematic review and meta-analysis.
To examine and compare the safety and efficacy of extended treatment with dabigatran, apixaban, rivaroxaban and warfarin in patients with unprovoked venous thromboembolism. ⋯ Extended treatment with both warfarin and DOACs are effective in preventing recurrent VTE and does not increase the risk of major bleeding, but increases the risk of NMCRB.
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Thrombosis research · Sep 2015
Review Meta AnalysisTreatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants.
Low-molecular-weight heparin (LMWH) and vitamin K antagonists (VKA) are current treatment options for cancer patients suffering from acute venous thromboembolism (VTE). The role of direct-acting oral anticoagulants (DOACs) for the treatment of VTE in cancer patients, particular in comparison with the current standard of care which is LMWH, remains unclear. In this network meta-analysis, we compared the relative efficacy and safety of LMWH, VKA, and DOAC for the treatment of cancer-associated VTE. ⋯ Austrian Science Fund (FWF-SFB-54).
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Thrombosis research · Jul 2015
ReviewDirect Oral Anticoagulants (DOACs) in the Laboratory: 2015 Review.
Direct oral anticoagulant therapies, including direct anti-Xa and thrombin inhibitors have recently been introduced and may have advantages over vitamin K antagonists such as warfarin. This review describes briefly the clinical utility and mechanism of action of these agents. Detailed information is provided on effect of these agents on routine assays including the APTT and PT as well as their impact on specialty laboratory assays. Also included are the use of drug specific assays and a discussion of alternative methods to determine relative drug concentration, such as evaluating drug calibrators in APTT and PT assays and using heparin calibrated anti-Xa assays to measure direct Xa inhibitors.
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Thrombosis research · Feb 2015
ReviewThe use of aspirin for primary and secondary prevention in venous thromboembolism and other cardiovascular disorders.
Cardiovascular disease (CVD) includes a number of conditions such as myocardial infarction, coronary heart disease, stroke, and venous thromboembolism. CVD is a leading health problem worldwide and a major cause of mortality, morbidity, and disability; it is also associated with high healthcare costs. The incidence of CVD is predicted to increase in the forthcoming years, and thus it is crucial that physicians are aware of the benefits and limitations of the available therapies to ensure patients receive optimized treatment. ⋯ The benefits of aspirin are well documented and supported by data from robust clinical trials for CVD conditions, such as acute coronary syndrome and stroke prevention in patients with atrial fibrillation. However, the clinical benefits of aspirin are less clear for other conditions, namely for primary prevention of venous thromboembolism after major orthopaedic surgery, particularly in comparison with newer drugs such as the direct oral anticoagulants. This article provides an outline of the current guidelines and a critical assessment of the efficacy and safety data supporting the recommendations for the use of aspirin in the treatment and prevention of venous thromboembolism and other cardiovascular disorders.