Anticoagulants: Agents that prevent clotting.Lupus Coagulation Inhibitor: An antiphospholipid antibody found in association with systemic lupus erythematosus (LUPUS ERYTHEMATOSUS, SYSTEMIC;), ANTIPHOSPHOLIPID SYNDROME; and in a variety of other diseases as well as in healthy individuals. In vitro, the antibody interferes with the conversion of prothrombin to thrombin and prolongs the partial thromboplastin time. In vivo, it exerts a procoagulant effect resulting in thrombosis mainly in the larger veins and arteries. It further causes obstetrical complications, including fetal death and spontaneous abortion, as well as a variety of hematologic and neurologic complications.Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide.Blood Coagulation: The process of the interaction of BLOOD COAGULATION FACTORS that results in an insoluble FIBRIN clot.Prothrombin Time: Clotting time of PLASMA recalcified in the presence of excess TISSUE THROMBOPLASTIN. Factors measured are FIBRINOGEN; PROTHROMBIN; FACTOR V; FACTOR VII; and FACTOR X. It is used for monitoring anticoagulant therapy with COUMARINS.Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation.Partial Thromboplastin Time: The time required for the appearance of FIBRIN strands following the mixing of PLASMA with phospholipid platelet substitute (e.g., crude cephalins, soybean phosphatides). It is a test of the intrinsic pathway (factors VIII, IX, XI, and XII) and the common pathway (fibrinogen, prothrombin, factors V and X) of BLOOD COAGULATION. It is used as a screening test and to monitor HEPARIN therapy.Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents.Acenocoumarol: A coumarin that is used as an anticoagulant. Its actions and uses are similar to those of WARFARIN. (From Martindale, The Extra Pharmacopoeia, 30th ed, p233)Heparin: A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.Factor Xa: Activated form of factor X that participates in both the intrinsic and extrinsic pathways of blood coagulation. It catalyzes the conversion of prothrombin to thrombin in conjunction with other cofactors.Phenindione: An indandione that has been used as an anticoagulant. Phenindione has actions similar to WARFARIN, but it is now rarely employed because of its higher incidence of severe adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p234)4-Hydroxycoumarins: Substances found in many plants, containing the 4-hydroxycoumarin radical. They interfere with vitamin K and the blood clotting mechanism, are tightly protein-bound, inhibit mitochondrial and microsomal enzymes, and are used as oral anticoagulants.Antithrombins: Endogenous factors and drugs that directly inhibit the action of THROMBIN, usually by blocking its enzymatic activity. They are distinguished from INDIRECT THROMBIN INHIBITORS, such as HEPARIN, which act by enhancing the inhibitory effects of antithrombins.Blood Coagulation Tests: Laboratory tests for evaluating the individual's clotting mechanism.Thrombin Time: Clotting time of PLASMA mixed with a THROMBIN solution. It is a measure of the conversion of FIBRINOGEN to FIBRIN, which is prolonged by AFIBRINOGENEMIA, abnormal fibrinogen, or the presence of inhibitory substances, e.g., fibrin-fibrinogen degradation products, or HEPARIN. BATROXOBIN, a thrombin-like enzyme unaffected by the presence of heparin, may be used in place of thrombin.International Normalized Ratio: System established by the World Health Organization and the International Committee on Thrombosis and Hemostasis for monitoring and reporting blood coagulation tests. Under this system, results are standardized using the International Sensitivity Index for the particular test reagent/instrument combination used.Thromboembolism: Obstruction of a blood vessel (embolism) by a blood clot (THROMBUS) in the blood stream.Protein S: The vitamin K-dependent cofactor of activated PROTEIN C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S; (PROTEIN S DEFICIENCY); can lead to recurrent venous and arterial thrombosis.Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process.Hemorrhage: Bleeding or escape of blood from a vessel.Heparin, Low-Molecular-Weight: Heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism.Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation.beta-Alanine: An amino acid formed in vivo by the degradation of dihydrouracil and carnosine. Since neuronal uptake and neuronal receptor sensitivity to beta-alanine have been demonstrated, the compound may be a false transmitter replacing GAMMA-AMINOBUTYRIC ACID. A rare genetic disorder, hyper-beta-alaninemia, has been reported.Thrombosis: Formation and development of a thrombus or blood clot in the blood vessel.Prothrombin: A plasma protein that is the inactive precursor of thrombin. It is converted to thrombin by a prothrombin activator complex consisting of factor Xa, factor V, phospholipid, and calcium ions. Deficiency of prothrombin leads to hypoprothrombinemia.Thrombin: An enzyme formed from PROTHROMBIN that converts FIBRINOGEN to FIBRIN.Antiphospholipid Syndrome: The presence of antibodies directed against phospholipids (ANTIBODIES, ANTIPHOSPHOLIPID). The condition is associated with a variety of diseases, notably systemic lupus erythematosus and other connective tissue diseases, thrombopenia, and arterial or venous thromboses. In pregnancy it can cause abortion. Of the phospholipids, the cardiolipins show markedly elevated levels of anticardiolipin antibodies (ANTIBODIES, ANTICARDIOLIPIN). Present also are high levels of lupus anticoagulant (LUPUS COAGULATION INHIBITOR).Vitamin K: A lipid cofactor that is required for normal blood clotting. Several forms of vitamin K have been identified: VITAMIN K 1 (phytomenadione) derived from plants, VITAMIN K 2 (menaquinone) from bacteria, and synthetic naphthoquinone provitamins, VITAMIN K 3 (menadione). Vitamin K 3 provitamins, after being alkylated in vivo, exhibit the antifibrinolytic activity of vitamin K. Green leafy vegetables, liver, cheese, butter, and egg yolk are good sources of vitamin K.Thrombophlebitis: Inflammation of a vein associated with a blood clot (THROMBUS).Phenprocoumon: Coumarin derivative that acts as a long acting oral anticoagulant.Venous Thrombosis: The formation or presence of a blood clot (THROMBUS) within a vein.Antithrombin III: A plasma alpha 2 glycoprotein that accounts for the major antithrombin activity of normal plasma and also inhibits several other enzymes. It is a member of the serpin superfamily.Antibodies, Antiphospholipid: Autoantibodies directed against phospholipids. These antibodies are characteristically found in patients with systemic lupus erythematosus (LUPUS ERYTHEMATOSUS, SYSTEMIC;), ANTIPHOSPHOLIPID SYNDROME; related autoimmune diseases, some non-autoimmune diseases, and also in healthy individuals.Antibodies, Anticardiolipin: Antiphospholipid antibodies found in association with systemic lupus erythematosus (LUPUS ERYTHEMATOSUS, SYSTEMIC;), ANTIPHOSPHOLIPID SYNDROME; and in a variety of other diseases as well as in healthy individuals. The antibodies are detected by solid-phase IMMUNOASSAY employing the purified phospholipid antigen CARDIOLIPIN.Thrombophilia: A disorder of HEMOSTASIS in which there is a tendency for the occurrence of THROMBOSIS.Blood Coagulation Disorders: Hemorrhagic and thrombotic disorders that occur as a consequence of abnormalities in blood coagulation due to a variety of factors such as COAGULATION PROTEIN DISORDERS; BLOOD PLATELET DISORDERS; BLOOD PROTEIN DISORDERS or nutritional conditions.Venous Thromboembolism: Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream.Administration, Oral: The giving of drugs, chemicals, or other substances by mouth.Pulmonary Embolism: Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.Heparin Antagonists: Coagulant substances inhibiting the anticoagulant action of heparin.Thromboplastin: Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation.Factor X: Storage-stable glycoprotein blood coagulation factor that can be activated to factor Xa by both the intrinsic and extrinsic pathways. A deficiency of factor X, sometimes called Stuart-Prower factor deficiency, may lead to a systemic coagulation disorder.Hirudins: Single-chain polypeptides of about 65 amino acids (7 kDa) from LEECHES that have a neutral hydrophobic N terminus, an acidic hydrophilic C terminus, and a compact, hydrophobic core region. Recombinant hirudins lack tyr-63 sulfation and are referred to as 'desulfato-hirudins'. They form a stable non-covalent complex with ALPHA-THROMBIN, thereby abolishing its ability to cleave FIBRINOGEN.Factor V: Heat- and storage-labile plasma glycoprotein which accelerates the conversion of prothrombin to thrombin in blood coagulation. Factor V accomplishes this by forming a complex with factor Xa, phospholipid, and calcium (prothrombinase complex). Deficiency of factor V leads to Owren's disease.Coagulants: Agents that cause clotting.beta 2-Glycoprotein I: A 44-kDa highly glycosylated plasma protein that binds phospholipids including CARDIOLIPIN; APOLIPOPROTEIN E RECEPTOR; membrane phospholipids, and other anionic phospholipid-containing moieties. It plays a role in coagulation and apoptotic processes. Formerly known as apolipoprotein H, it is an autoantigen in patients with ANTIPHOSPHOLIPID ANTIBODIES.Dicumarol: An oral anticoagulant that interferes with the metabolism of vitamin K. It is also used in biochemical experiments as an inhibitor of reductases.Activated Protein C Resistance: A hemostatic disorder characterized by a poor anticoagulant response to activated protein C (APC). The activated form of Factor V (Factor Va) is more slowly degraded by activated protein C. Factor V Leiden mutation (R506Q) is the most common cause of APC resistance.Atrial Fibrillation: Abnormal cardiac rhythm that is characterized by rapid, uncoordinated firing of electrical impulses in the upper chambers of the heart (HEART ATRIA). In such case, blood cannot be effectively pumped into the lower chambers of the heart (HEART VENTRICLES). It is caused by abnormal impulse generation.Factor Va: Activated form of factor V. It is an essential cofactor for the activation of prothrombin catalyzed by factor Xa.Hemostasis: The process which spontaneously arrests the flow of BLOOD from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements (eg. ERYTHROCYTE AGGREGATION), and the process of BLOOD COAGULATION.Fibrinolytic Agents: Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.Platelet Aggregation Inhibitors: Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.Rodent Control: The reduction or regulation of the population of noxious, destructive, or dangerous rodents through chemical, biological, or other means.Pipecolic AcidsThiophenesEnoxaparin: Low-molecular-weight fragment of heparin, having a 4-enopyranosuronate sodium structure at the non-reducing end of the chain. It is prepared by depolymerization of the benzylic ester of porcine mucosal heparin. Therapeutically, it is used as an antithrombotic agent. (From Merck Index, 11th ed)Vitamin K Epoxide Reductases: OXIDOREDUCTASES which mediate vitamin K metabolism by converting inactive vitamin K 2,3-epoxide to active vitamin K.Protein C Deficiency: An absence or deficiency in PROTEIN C which leads to impaired regulation of blood coagulation. It is associated with an increased risk of severe or premature thrombosis. (Stedman's Med. Dict., 26th ed.)Aspirin: The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)Dermatan Sulfate: A naturally occurring glycosaminoglycan found mostly in the skin and in connective tissue. It differs from CHONDROITIN SULFATE A (see CHONDROITIN SULFATES) by containing IDURONIC ACID in place of glucuronic acid, its epimer, at carbon atom 5. (from Merck, 12th ed)Heparin Cofactor II: A sulfated plasma protein with a MW of approximately 66kDa that resembles ANTITHROMBIN III. The protein is an inhibitor of thrombin in plasma and is activated by dermatan sulfate or heparin. It is a member of the serpin superfamily.Benzimidazoles: Compounds with a BENZENE fused to IMIDAZOLES.Pyridones: Pyridine derivatives with one or more keto groups on the ring.Protein S Deficiency: An autosomal dominant disorder showing decreased levels of plasma protein S antigen or activity, associated with venous thrombosis and pulmonary embolism. PROTEIN S is a vitamin K-dependent plasma protein that inhibits blood clotting by serving as a cofactor for activated PROTEIN C (also a vitamin K-dependent protein), and the clinical manifestations of its deficiency are virtually identical to those of protein C deficiency. Treatment with heparin for acute thrombotic processes is usually followed by maintenance administration of coumarin drugs for the prevention of recurrent thrombosis. (From Harrison's Principles of Internal Medicine, 12th ed, p1511; Wintrobe's Clinical Hematology, 9th ed, p1523)Cardiolipins: Acidic phospholipids composed of two molecules of phosphatidic acid covalently linked to a molecule of glycerol. They occur primarily in mitochondrial inner membranes and in bacterial plasma membranes. They are the main antigenic components of the Wassermann-type antigen that is used in nontreponemal SYPHILIS SERODIAGNOSIS.Antithrombin III Deficiency: An absence or reduced level of Antithrombin III leading to an increased risk for thrombosis.Hematoma: A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue.Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically.Dalteparin: A low-molecular-weight fragment of heparin, prepared by nitrous acid depolymerization of porcine mucosal heparin. The mean molecular weight is 4000-6000 daltons. It is used therapeutically as an antithrombotic agent. (From Merck Index, 11th ed)Sea Cucumbers: A class of Echinodermata characterized by long, slender bodies.Lupus Erythematosus, Systemic: A chronic, relapsing, inflammatory, and often febrile multisystemic disorder of connective tissue, characterized principally by involvement of the skin, joints, kidneys, and serosal membranes. It is of unknown etiology, but is thought to represent a failure of the regulatory mechanisms of the autoimmune system. The disease is marked by a wide range of system dysfunctions, an elevated erythrocyte sedimentation rate, and the formation of LE cells in the blood or bone marrow.Coumarins: Synthetic or naturally occurring substances related to coumarin, the delta-lactone of coumarinic acid.PolysaccharidesStroke: A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)Arthropod Proteins: Proteins synthesized by organisms belonging to the phylum ARTHROPODA. Included in this heading are proteins from the subdivisions ARACHNIDA; CRUSTACEA; and HORSESHOE CRABS. Note that a separate heading for INSECT PROTEINS is listed under this heading.Hypoprothrombinemias: Absence or reduced levels of PROTHROMBIN in the blood.Antithrombin Proteins: An endogenous family of proteins belonging to the serpin superfamily that neutralizes the action of thrombin. Six naturally occurring antithrombins have been identified and are designated by Roman numerals I to VI. Of these, Antithrombin I (see FIBRIN) and ANTITHROMBIN III appear to be of major importance.Factor VIIa: Activated form of factor VII. Factor VIIa activates factor X in the extrinsic pathway of blood coagulation.Hemorrhagic Disorders: Spontaneous or near spontaneous bleeding caused by a defect in clotting mechanisms (BLOOD COAGULATION DISORDERS) or another abnormality causing a structural flaw in the blood vessels (HEMOSTATIC DISORDERS).Seaweed: Multicellular marine macroalgae including some members of red (RHODOPHYTA), green (CHLOROPHYTA), and brown (PHAEOPHYTA) algae. They are widely distributed in the ocean, occurring from the tide level to considerable depths, free-floating (planktonic) or anchored to the substratum (benthic). They lack a specialized vascular system but take up fluids, nutrients, and gases directly from the water. They contain CHLOROPHYLL and are photosynthetic, but some also contain other light-absorbing pigments. Many are of economic importance as FOOD, fertilizer, AGAR, potash, or source of IODINE.Factor VIIIa: Activated form of factor VIII. The B-domain of factor VIII is proteolytically cleaved by thrombin to form factor VIIIa. Factor VIIIa exists as a non-covalent dimer in a metal-linked (probably calcium) complex and functions as a cofactor in the enzymatic activation of factor X by factor IXa. Factor VIIIa is similar in structure and generation to factor Va.Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability.Factor VII: Heat- and storage-stable plasma protein that is activated by tissue thromboplastin to form factor VIIa in the extrinsic pathway of blood coagulation. The activated form then catalyzes the activation of factor X to factor Xa.Coagulation Protein Disorders: Hemorrhagic and thrombotic disorders resulting from abnormalities or deficiencies of coagulation proteins.Fibrin: A protein derived from FIBRINOGEN in the presence of THROMBIN, which forms part of the blood clot.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Fibrinolysis: The natural enzymatic dissolution of FIBRIN.Embolism: Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Fibrin Fibrinogen Degradation Products: Soluble protein fragments formed by the proteolytic action of plasmin on fibrin or fibrinogen. FDP and their complexes profoundly impair the hemostatic process and are a major cause of hemorrhage in intravascular coagulation and fibrinolysis.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.MorpholinesWhole Blood Coagulation Time: The time required by whole blood to produce a visible clot.Blood Preservation: The process by which blood or its components are kept viable outside of the organism from which they are derived (i.e., kept from decay by means of a chemical agent, cooling, or a fluid substitute that mimics the natural state within the organism).Recurrence: The return of a sign, symptom, or disease after a remission.Heparinoids: Heparin derivatives. The term has also been used more loosely to include naturally occurring and synthetic highly-sulphated polysaccharides of similar structure. Heparinoid preparations have been used for a wide range of applications including as anticoagulants and anti-inflammatories and they have been claimed to have hypolipidemic properties. (From Martindale, The Extra Pharmacopoeia, 30th, p232)CitratesBlood Specimen Collection: The taking of a blood sample to determine its character as a whole, to identify levels of its component cells, chemicals, gases, or other constituents, to perform pathological examination, etc.Heparitin Sulfate: A heteropolysaccharide that is similar in structure to HEPARIN. It accumulates in individuals with MUCOPOLYSACCHARIDOSIS.Postoperative Hemorrhage: Hemorrhage following any surgical procedure. It may be immediate or delayed and is not restricted to the surgical wound.Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides see GLYCEROPHOSPHOLIPIDS) or sphingosine (SPHINGOLIPIDS). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system.Cerebral Hemorrhage: Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA.Hematoma, Subdural: Accumulation of blood in the SUBDURAL SPACE between the DURA MATER and the arachnoidal layer of the MENINGES. This condition primarily occurs over the surface of a CEREBRAL HEMISPHERE, but may develop in the spinal canal (HEMATOMA, SUBDURAL, SPINAL). Subdural hematoma can be classified as the acute or the chronic form, with immediate or delayed symptom onset, respectively. Symptoms may include loss of consciousness, severe HEADACHE, and deteriorating mental status.Ancrod: An enzyme fraction from the venom of the Malayan pit viper, Agkistrodon rhodostoma. It catalyzes the hydrolysis of a number of amino acid esters and a limited proteolysis of fibrinogen. It is used clinically to produce controlled defibrination in patients requiring anticoagulant therapy. EC 3.4.21.-.Phaeophyta: A division of predominantly marine EUKARYOTA, commonly known as brown algae, having CHROMATOPHORES containing carotenoid PIGMENTS, BIOLOGICAL. ALGINATES and phlorotannins occur widely in all major orders. They are considered the most highly evolved algae because of their well-developed multicellular organization and structural complexity.Intracranial Embolism and Thrombosis: Embolism or thrombosis involving blood vessels which supply intracranial structures. Emboli may originate from extracranial or intracranial sources. Thrombosis may occur in arterial or venous structures.Pregnancy Complications, Hematologic: The co-occurrence of pregnancy and a blood disease (HEMATOLOGIC DISEASES) which involves BLOOD CELLS or COAGULATION FACTORS. The hematologic disease may precede or follow FERTILIZATION and it may or may not have a deleterious effect on the pregnant woman or FETUS.Chromogenic Compounds: Colorless, endogenous or exogenous pigment precursors that may be transformed by biological mechanisms into colored compounds; used in biochemical assays and in diagnosis as indicators, especially in the form of enzyme substrates. Synonym: chromogens (not to be confused with pigment-synthesizing bacteria also called chromogens).Heart Valve Prosthesis: A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material.Disseminated Intravascular Coagulation: A disorder characterized by procoagulant substances entering the general circulation causing a systemic thrombotic process. The activation of the clotting mechanism may arise from any of a number of disorders. A majority of the patients manifest skin lesions, sometimes leading to PURPURA FULMINANS.Ancylostoma: A genus of nematode intestinal parasites that consists of several species. A. duodenale is the common hookworm in humans. A. braziliense, A. ceylonicum, and A. caninum occur primarily in cats and dogs, but all have been known to occur in humans.Protein C Inhibitor: A member of the serpin family of proteins that is found in plasma and urine. It is dependent on heparin and is able to inhibit activated PROTEIN C; THROMBIN; KALLIKREIN; and other SERINE ENDOPEPTIDASES.Serine Proteinase Inhibitors: Exogenous or endogenous compounds which inhibit SERINE ENDOPEPTIDASES.Perioperative Care: Interventions to provide care prior to, during, and immediately after surgery.Recombinant Proteins: Proteins prepared by recombinant DNA technology.Glycoproteins: Conjugated protein-carbohydrate compounds including mucins, mucoid, and amyloid glycoproteins.AzetidinesEdetic Acid: A chelating agent that sequesters a variety of polyvalent cations such as CALCIUM. It is used in pharmaceutical manufacturing and as a food additive.Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation.Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products.Bleeding Time: Duration of blood flow after skin puncture. This test is used as a measure of capillary and platelet function.Salivary Proteins and Peptides: Proteins and peptides found in SALIVA and the SALIVARY GLANDS. Some salivary proteins such as ALPHA-AMYLASES are enzymes, but their composition varies in different individuals.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Factor IX: Storage-stable blood coagulation factor acting in the intrinsic pathway. Its activated form, IXa, forms a complex with factor VIII and calcium on platelet factor 3 to activate factor X to Xa. Deficiency of factor IX results in HEMOPHILIA B (Christmas Disease).Heparin Lyase: An enzyme of the isomerase class that catalyzes the eliminative cleavage of polysaccharides containing 1,4-linked D-glucuronate or L-iduronate residues and 1,4-alpha-linked 2-sulfoamino-2-deoxy-6-sulfo-D-glucose residues to give oligosaccharides with terminal 4-deoxy-alpha-D-gluc-4-enuronosyl groups at their non-reducing ends. (From Enzyme Nomenclature, 1992) EC 4.2.2.7.Benzylamines: Toluenes in which one hydrogen of the methyl group is substituted by an amino group. Permitted are any substituents on the benzene ring or the amino group.Factor IXa: Activated form of factor IX. This activation can take place via the intrinsic pathway by the action of factor XIa and calcium, or via the extrinsic pathway by the action of factor VIIa, thromboplastin, and calcium. Factor IXa serves to activate factor X to Xa by cleaving the arginyl-leucine peptide bond in factor X.Strongylida: An order of nematodes of the subclass SECERNENTEA. Characteristics include an H-shaped excretory system with two subventral glands.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Receptors, Thrombin: A family of proteinase-activated receptors that are specific for THROMBIN. They are found primarily on PLATELETS and on ENDOTHELIAL CELLS. Activation of thrombin receptors occurs through the proteolytic action of THROMBIN, which cleaves the N-terminal peptide from the receptor to reveal a new N-terminal peptide that is a cryptic ligand for the receptor. The receptors signal through HETEROTRIMERIC GTP-BINDING PROTEINS. Small synthetic peptides that contain the unmasked N-terminal peptide sequence can also activate the receptor in the absence of proteolytic activity.Annexin A5: A protein of the annexin family isolated from human PLACENTA and other tissues. It inhibits cytosolic PHOSPHOLIPASE A2, and displays anticoagulant activity.Hemostatics: Agents acting to arrest the flow of blood. Absorbable hemostatics arrest bleeding either by the formation of an artificial clot or by providing a mechanical matrix that facilitates clotting when applied directly to the bleeding surface. These agents function more at the capillary level and are not effective at stemming arterial or venous bleeding under any significant intravascular pressure.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Cobra Venoms: Venoms from snakes of the genus Naja (family Elapidae). They contain many specific proteins that have cytotoxic, hemolytic, neurotoxic, and other properties. Like other elapid venoms, they are rich in enzymes. They include cobramines and cobralysins.Viper Venoms: Venoms from SNAKES of the viperid family. They tend to be less toxic than elapid or hydrophid venoms and act mainly on the vascular system, interfering with coagulation and capillary membrane integrity and are highly cytotoxic. They contain large amounts of several enzymes, other factors, and some toxins.Antidotes: Agents counteracting or neutralizing the action of POISONS.Abortion, Habitual: Three or more consecutive spontaneous abortions.Factor VIII: Blood-coagulation factor VIII. Antihemophilic factor that is part of the factor VIII/von Willebrand factor complex. Factor VIII is produced in the liver and acts in the intrinsic pathway of blood coagulation. It serves as a cofactor in factor X activation and this action is markedly enhanced by small amounts of thrombin.Thrombocytopenia: A subnormal level of BLOOD PLATELETS.Protamines: A group of simple proteins that yield basic amino acids on hydrolysis and that occur combined with nucleic acid in the sperm of fish. Protamines contain very few kinds of amino acids. Protamine sulfate combines with heparin to form a stable inactive complex; it is used to neutralize the anticoagulant action of heparin in the treatment of heparin overdose. (From Merck Index, 11th ed; Martindale, The Extra Pharmacopoeia, 30th ed, p692)Blood Coagulation Factor Inhibitors: Substances, usually endogenous, that act as inhibitors of blood coagulation. They may affect one or multiple enzymes throughout the process. As a group, they also inhibit enzymes involved in processes other than blood coagulation, such as those from the complement system, fibrinolytic enzyme system, blood cells, and bacteria.Hirudin Therapy: Use of HIRUDINS as an anticoagulant in the treatment of cardiological and hematological disorders.Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug.Vena Cava Filters: Mechanical devices inserted in the inferior vena cava that prevent the migration of blood clots from deep venous thrombosis of the leg.Galactans: Polysaccharides composed of repeating galactose units. They can consist of branched or unbranched chains in any linkages.Platelet Activation: A series of progressive, overlapping events, triggered by exposure of the PLATELETS to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug.Glycosaminoglycans: Heteropolysaccharides which contain an N-acetylated hexosamine in a characteristic repeating disaccharide unit. The repeating structure of each disaccharide involves alternate 1,4- and 1,3-linkages consisting of either N-acetylglucosamine or N-acetylgalactosamine.Annexins: Family of calcium- and phospholipid-binding proteins which are structurally related and exhibit immunological cross-reactivity. Each member contains four homologous 70-kDa repeats. The annexins are differentially distributed in vertebrate tissues (and lower eukaryotes) and appear to be involved in MEMBRANE FUSION and SIGNAL TRANSDUCTION.Crotalid Venoms: Venoms from snakes of the subfamily Crotalinae or pit vipers, found mostly in the Americas. They include the rattlesnake, cottonmouth, fer-de-lance, bushmaster, and American copperhead. Their venoms contain nontoxic proteins, cardio-, hemo-, cyto-, and neurotoxins, and many enzymes, especially phospholipases A. Many of the toxins have been characterized.Cerebrovascular Disorders: A spectrum of pathological conditions of impaired blood flow in the brain. They can involve vessels (ARTERIES or VEINS) in the CEREBRUM, the CEREBELLUM, and the BRAIN STEM. Major categories include INTRACRANIAL ARTERIOVENOUS MALFORMATIONS; BRAIN ISCHEMIA; CEREBRAL HEMORRHAGE; and others.Complement Inactivator Proteins: Serum proteins that negatively regulate the cascade process of COMPLEMENT ACTIVATION. Uncontrolled complement activation and resulting cell lysis is potentially dangerous for the host. The complement system is tightly regulated by inactivators that accelerate the decay of intermediates and certain cell surface receptors.Autoantibodies: Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them.Plasma: The residual portion of BLOOD that is left after removal of BLOOD CELLS by CENTRIFUGATION without prior BLOOD COAGULATION.Sinus Thrombosis, Intracranial: Formation or presence of a blood clot (THROMBUS) in the CRANIAL SINUSES, large endothelium-lined venous channels situated within the SKULL. Intracranial sinuses, also called cranial venous sinuses, include the superior sagittal, cavernous, lateral, petrous sinuses, and many others. Cranial sinus thrombosis can lead to severe HEADACHE; SEIZURE; and other neurological defects.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Sulfuric Acid Esters: Organic esters of sulfuric acid.Oral Surgical Procedures: Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Hexadimethrine Bromide: A synthetic polymer which agglutinates red blood cells. It is used as a heparin antagonist.Nadroparin: A heparin fraction with a mean molecular weight of 4500 daltons. It is isolated from porcine mucosal heparin and used as an antithrombotic agent. (From Merck Index, 11th ed)Intracranial Hemorrhages: Bleeding within the SKULL, including hemorrhages in the brain and the three membranes of MENINGES. The escape of blood often leads to the formation of HEMATOMA in the cranial epidural, subdural, and subarachnoid spaces.Platelet Count: The number of PLATELETS per unit volume in a sample of venous BLOOD.Chondroitin Sulfates: Derivatives of chondroitin which have a sulfate moiety esterified to the galactosamine moiety of chondroitin. Chondroitin sulfate A, or chondroitin 4-sulfate, and chondroitin sulfate C, or chondroitin 6-sulfate, have the sulfate esterified in the 4- and 6-positions, respectively. Chondroitin sulfate B (beta heparin; DERMATAN SULFATE) is a misnomer and this compound is not a true chondroitin sulfate.Platelet Aggregation: The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS.Pregnancy Complications, Cardiovascular: The co-occurrence of pregnancy and a cardiovascular disease. The disease may precede or follow FERTILIZATION and it may or may not have a deleterious effect on the pregnant woman or FETUS.1-Carboxyglutamic Acid: Found in various tissues, particularly in four blood-clotting proteins including prothrombin, in kidney protein, in bone protein, and in the protein present in various ectopic calcifications.Protein Binding: The process in which substances, either endogenous or exogenous, bind to proteins, peptides, enzymes, protein precursors, or allied compounds. Specific protein-binding measures are often used as assays in diagnostic assessments.Sulfates: Inorganic salts of sulfuric acid.Hematology: A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues.Molecular Sequence Data: Descriptions of specific amino acid, carbohydrate, or nucleotide sequences which have appeared in the published literature and/or are deposited in and maintained by databanks such as GENBANK, European Molecular Biology Laboratory (EMBL), National Biomedical Research Foundation (NBRF), or other sequence repositories.Platelet Factor 4: A CXC chemokine that is found in the alpha granules of PLATELETS. The protein has a molecular size of 7800 kDa and can occur as a monomer, a dimer or a tetramer depending upon its concentration in solution. Platelet factor 4 has a high affinity for HEPARIN and is often found complexed with GLYCOPROTEINS such as PROTEIN C.Clinical Trials as Topic: Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.Structure-Activity Relationship: The relationship between the chemical structure of a compound and its biological or pharmacological activity. Compounds are often classed together because they have structural characteristics in common including shape, size, stereochemical arrangement, and distribution of functional groups.Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Kinetics: The rate dynamics in chemical or physical systems.Receptor, PAR-1: A thrombin receptor subtype that couples to HETEROTRIMERIC GTP-BINDING PROTEINS resulting in the activation of a variety of signaling mechanisms including decreased intracellular CYCLIC AMP, increased TYPE C PHOSPHOLIPASES and increased PHOSPHOLIPASE A2.Vitamin K 1: A family of phylloquinones that contains a ring of 2-methyl-1,4-naphthoquinone and an isoprenoid side chain. Members of this group of vitamin K 1 have only one double bond on the proximal isoprene unit. Rich sources of vitamin K 1 include green plants, algae, and photosynthetic bacteria. Vitamin K1 has antihemorrhagic and prothrombogenic activity.Agkistrodon: A genus of venomous snakes of the subfamily Crotalinae. Twelve species of this genus are found in North and Central America and Asia. Agkistrodon contortrix is the copperhead, A. piscivorus, the cottonmouth. The former is named for its russet or orange-brown color, the latter for the white interior of its mouth. (Goin, Goin, and Zug, Introduction to Herpetology, 3d ed, p336; Moore, Poisonous Snakes of the World, 1980, p75)Thrombolytic Therapy: Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.Elapidae: A family of extremely venomous snakes, comprising coral snakes, cobras, mambas, kraits, and sea snakes. They are widely distributed, being found in the southern United States, South America, Africa, southern Asia, Australia, and the Pacific Islands. The elapids include three subfamilies: Elapinae, Hydrophiinae, and Lauticaudinae. Like the viperids, they have venom fangs in the front part of the upper jaw. The mambas of Africa are the most dangerous of all snakes by virtue of their size, speed, and highly toxic venom. (Goin, Goin, and Zug, Introduction to Herpetology, 3d ed, p329-33)Thienopyridines: Heterocyclic compounds that contain 4H,5H,6H,7H-thieno[2,3-c]pyridine as part of their structure.Fibrinopeptide A: Two small peptide chains removed from the N-terminal segment of the alpha chains of fibrinogen by the action of thrombin during the blood coagulation process. Each peptide chain contains 18 amino acid residues. In vivo, fibrinopeptide A is used as a marker to determine the rate of conversion of fibrinogen to fibrin by thrombin.Sulfotransferases: Enzymes which transfer sulfate groups to various acceptor molecules. They are involved in posttranslational sulfation of proteins and sulfate conjugation of exogenous chemicals and bile acids. EC 2.8.2.Phlebography: Radiographic visualization or recording of a vein after the injection of contrast medium.Drugs, Investigational: Drugs which have received FDA approval for human testing but have yet to be approved for commercial marketing. This includes drugs used for treatment while they still are undergoing clinical trials (Treatment IND). The main heading includes drugs under investigation in foreign countries.Drug Substitution: The practice of replacing one prescribed drug with another that is expected to have the same clinical or psychological effect.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Ischemic Attack, Transient: Brief reversible episodes of focal, nonconvulsive ischemic dysfunction of the brain having a duration of less than 24 hours, and usually less than one hour, caused by transient thrombotic or embolic blood vessel occlusion or stenosis. Events may be classified by arterial distribution, temporal pattern, or etiology (e.g., embolic vs. thrombotic). (From Adams et al., Principles of Neurology, 6th ed, pp814-6)Thrombelastography: Use of a thrombelastograph, which provides a continuous graphic record of the physical shape of a clot during fibrin formation and subsequent lysis.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining PROTEIN CONFORMATION.Intracranial Hemorrhage, Traumatic: Bleeding within the SKULL induced by penetrating and nonpenetrating traumatic injuries, including hemorrhages into the tissues of CEREBRUM; BRAIN STEM; and CEREBELLUM; as well as into the epidural, subdural and subarachnoid spaces of the MENINGES.Aptamers, Nucleotide: Nucleotide sequences, generated by iterative rounds of SELEX APTAMER TECHNIQUE, that bind to a target molecule specifically and with high affinity.Pyrazoles: Azoles of two nitrogens at the 1,2 positions, next to each other, in contrast with IMIDAZOLES in which they are at the 1,3 positions.Antifibrinolytic Agents: Agents that prevent fibrinolysis or lysis of a blood clot or thrombus. Several endogenous antiplasmins are known. The drugs are used to control massive hemorrhage and in other coagulation disorders.Heart Diseases: Pathological conditions involving the HEART including its structural and functional abnormalities.Helminth Proteins: Proteins found in any species of helminth.Factor V Deficiency: A deficiency of blood coagulation factor V (known as proaccelerin or accelerator globulin or labile factor) leading to a rare hemorrhagic tendency known as Owren's disease or parahemophilia. It varies greatly in severity. Factor V deficiency is an autosomal recessive trait. (Dorland, 27th ed)

Inherited prothrombotic risk factors and cerebral venous thrombosis. (1/5820)

Fifteen patients with cerebral venous thrombosis were ascertained retrospectively. Their case notes were reviewed, and stored or new blood was assayed for factor V Leiden (FVL) mutation, prothrombin gene mutation 20201A, and 5,10 methylene tetrahydrofolate reductase (MTHFR) C677T mutation. A clinical risk factor was identified in 13 patients--the oral contraceptive pill (5), puerperium (1), HRT (1), mastoiditis (1), dehydration (1), lumbar puncture and myelography (1), carcinoma (1), lupus anticoagulant (2). In addition, two patients had the FVL mutation and five (one of whom also had the FVL mutation) were homozygous for the MTHFR mutation. The latter showed a higher than expected frequency compared to 300 healthy controls from South Wales (OR 3.15.95% Cl 1.01-9.83). No patient had the prothrombin 20201A mutation. Two patients died and three had a monocular visual deficit following anticoagulation (13) or thrombolytic (2) treatment, but there was no association between the presence of a primary prothrombotic risk factor and outcome. These results confirm the importance of investigating patients for both clinical predisposing factors and primary prothrombotic states.  (+info)

Anticoagulant heparan sulfate precursor structures in F9 embryonal carcinoma cells. (2/5820)

To understand the mechanisms that control anticoagulant heparan sulfate (HSact) biosynthesis, we previously showed that HSact production in the F9 system is determined by the abundance of 3-O-sulfotransferase-1 as well as the size of the HSact precursor pool. In this study, HSact precursor structures have been studied by characterizing [6-3H]GlcN metabolically labeled F9 HS tagged with 3-O-sulfates in vitro by 3'-phosphoadenosine 5'-phospho-35S and purified 3-O-sulfotransferase-1. This later in vitro labeling allows the regions of HS destined to become the antithrombin (AT)-binding sites to be tagged for subsequent structural studies. It was shown that six 3-O-sulfation sites exist per HSact precursor chain. At least five out of six 3-O-sulfate-tagged oligosaccharides in HSact precursors bind AT, whereas none of 3-O-sulfate-tagged oligosaccharides from HSinact precursors bind AT. When treated with low pH nitrous or heparitinase, 3-O-sulfate-tagged HSact and HSinact precursors exhibit clearly different structural features. 3-O-Sulfate-tagged HSact hexasaccharides were AT affinity purified and sequenced by chemical and enzymatic degradations. The 3-O-sulfate-tagged HSact hexasaccharides exhibited the following structures, DeltaUA-[6-3H]GlcNAc6S-GlcUA-[6-3H]GlcNS3(35)S+/-6S-++ +IdceA2S-[6-3H]Glc NS6S. The underlined 6- and 3-O-sulfates constitute the most critical groups for AT binding in view of the fact that the precursor hexasaccharides possess all the elements for AT binding except for the 3-O-sulfate moiety. The presence of five potential AT-binding precursor hexasaccharides in all HSact precursor chains demonstrates for the first time the processive assembly of specific sequence in HS. The difference in structures around potential 3-O-sulfate acceptor sites in HSact and HSinact precursors suggests that these precursors might be generated by different concerted assembly mechanisms in the same cell. This study permits us to understand better the nature of the HS biosynthetic pathway that leads to the generation of specific saccharide sequences.  (+info)

Warfarin therapy: evolving strategies in anticoagulation. (3/5820)

Warfarin is the oral anticoagulant most frequently used to control and prevent thromboembolic disorders. Prescribing the dose that both avoids hemorrhagic complications and achieves sufficient suppression of thrombosis requires a thorough understanding of the drug's unique pharmacology. Warfarin has a complex dose-response relationship that makes safe and effective use a challenge. For most indications, the dose is adjusted to maintain the patient's International Normalized Ratio (INR) at 2 to 3. Because of the delay in factor II (prothrombin) suppression, heparin is administered concurrently for four to five days to prevent thrombus propagation. Loading doses of warfarin are not warranted and may result in bleeding complications. Interactions with other drugs must be considered, and therapy in elderly patients requires careful management. Current dosing recommendations are reviewed, and practical guidelines for the optimal use of warfarin are provided.  (+info)

Exosites 1 and 2 are essential for protection of fibrin-bound thrombin from heparin-catalyzed inhibition by antithrombin and heparin cofactor II. (4/5820)

Assembly of ternary thrombin-heparin-fibrin complexes, formed when fibrin binds to exosite 1 on thrombin and fibrin-bound heparin binds to exosite 2, produces a 58- and 247-fold reduction in the heparin-catalyzed rate of thrombin inhibition by antithrombin and heparin cofactor II, respectively. The greater reduction for heparin cofactor II reflects its requirement for access to exosite 1 during the inhibitory process. Protection from inhibition by antithrombin and heparin cofactor II requires ligation of both exosites 1 and 2 because minimal protection is seen when exosite 1 variants (gamma-thrombin and thrombin Quick 1) or an exosite 2 variant (Arg93 --> Ala, Arg97 --> Ala, and Arg101 --> Ala thrombin) is substituted for thrombin. Likewise, the rate of thrombin inhibition by the heparin-independent inhibitor, alpha1-antitrypsin Met358 --> Arg, is decreased less than 2-fold in the presence of soluble fibrin and heparin. In contrast, thrombin is protected from inhibition by a covalent antithrombin-heparin complex, suggesting that access of heparin to exosite 2 of thrombin is hampered when ternary complex formation occurs. These results reveal the importance of exosites 1 and 2 of thrombin in assembly of the ternary complex and the subsequent protection of thrombin from inhibition by heparin-catalyzed inhibitors.  (+info)

Sperm chemotaxis. (5/5820)

Communication between spermatozoa and egg before contact by chemotaxis appears to be prevalent throughout the animal kingdom. In non-mammalian species, sperm chemotaxis to factors secreted from the egg is well documented. In mammals, sperm chemotaxis to follicular factors in vitro has been established in humans and mice. The attractants of female origin in non-mammalian species are heat-stable peptides or proteins of various sizes, or other small molecules, depending on the species. Species specificity of the attractants in non-mammalian species may vary from high species specificity, through specificity to families with no specificity within a family, to absence of specificity. The mammalian sperm attractants have not been identified but they appear to be heat-stable peptides. The claim that progesterone is the attractant for human spermatozoa has failed to be substantiated, neither have claims for other mammalian sperm attractants been verified. The molecular mechanism of sperm chemotaxis is not known. Models involving modulation of the intracellular Ca2+ concentration have been proposed for both mammalian and non-mammalian sperm chemotaxis. The physiological role of sperm chemotaxis in non-mammalian species appears to differ from that in mammals. In non-mammalian species, sperm chemotaxis strives to bring as many spermatozoa as possible to the egg. However, in mammals, the role appears to be recruitment of a selective population of capacitated ('ripe') spermatozoa to fertilize the egg.  (+info)

Nonanticoagulant heparin prevents coronary endothelial dysfunction after brief ischemia-reperfusion injury in the dog. (6/5820)

BACKGROUND: Coronary endothelial dysfunction after brief ischemia-reperfusion (IR) remains a clinical problem. We investigated the role of heparin and N-acetylheparin, a nonanticoagulant heparin derivative, in modulating coronary endothelial function after IR injury, with an emphasis on defining the role of the nitric oxide (NO)-cGMP pathway in the heparin-mediated effect. METHODS AND RESULTS: Male mongrel dogs were surgically instrumented, and the effects of both bovine heparin and N-acetylheparin on coronary endothelial vasomotor function, expressed as percent change from baseline flow after acetylcholine challenge, were studied after 15 minutes of regional ischemia of the left anterior descending artery (LAD) followed by 120 minutes of reperfusion. In dogs treated with placebo (saline), coronary vasomotor function was significantly (P+info)

Ex vivo evaluation of a Taylor-Couette flow, immobilized heparinase I device for clinical application. (7/5820)

Efficient and safe heparin anticoagulation has remained a problem for continuous renal replacement therapies and intermittent hemodialysis for patients with acute renal failure. To make heparin therapy safer for the patient with acute renal failure at high risk of bleeding, we have proposed regional heparinization of the circuit via an immobilized heparinase I filter. This study tested a device based on Taylor-Couette flow and simultaneous separation/reaction for efficacy and safety of heparin removal in a sheep model. Heparinase I was immobilized onto agarose beads via cyanogen bromide activation. The device, referred to as a vortex flow plasmapheretic reactor, consisted of two concentric cylinders, a priming volume of 45 ml, a microporous membrane for plasma separation, and an outer compartment where the immobilized heparinase I was fluidized separately from the blood cells. Manual white cell and platelet counts, hematocrit, total protein, and fibrinogen assays were performed. Heparin levels were indirectly measured via whole-blood recalcification times (WBRTs). The vortex flow plasmapheretic reactor maintained significantly higher heparin levels in the extracorporeal circuit than in the sheep (device inlet WBRTs were 1. 5 times the device outlet WBRTs) with no hemolysis. The reactor treatment did not effect any physiologically significant changes in complete blood cell counts, platelets, and protein levels for up to 2 hr of operation. Furthermore, gross necropsy and histopathology did not show any significant abnormalities in the kidney, liver, heart, brain, and spleen.  (+info)

Randomized, placebo-controlled trial of anticoagulant treatment with low-molecular-weight heparin for cerebral sinus thrombosis. (8/5820)

BACKGROUND AND PURPOSE: Treatment of cerebral sinus thrombosis with heparin is controversial. We conducted a double-blind, placebo-controlled multicenter trial to examine whether anticoagulant treatment improves outcome in patients with sinus thrombosis. METHODS: Patients were randomized between body weight-adjusted subcutaneous nadroparin (180 anti-factor Xa units/kg per 24 hours) and matching placebo for 3 weeks (double-blind part of trial), followed by 3 months of oral anticoagulants for patients allocated nadroparin (open part). Patients with cerebral hemorrhage caused by sinus thrombosis were also included. RESULTS: Sixty patients were enrolled, and none were lost to follow-up. In 1 patient the diagnosis proved wrong after randomization. After 3 weeks, 6 of 30 patients (20%) in the nadroparin group and 7 of 29 patients (24%) in the placebo group had a poor outcome, defined as death or Barthel Index score of <15 (risk difference, -4%; 95% CI, -25 to 17%; NS). After 12 weeks, 4 of 30 patients (13%) in the nadroparin group and 6 of 29 (21%) in the placebo group had a poor outcome, defined as death or Oxford Handicap Score of >/=3 (risk difference, -7%; 95% CI, -26% to 12%; NS). There were no new symptomatic cerebral hemorrhages. One patient in the nadroparin group had a major gastrointestinal hemorrhage, and 1 patient in the placebo group died from clinically suspected pulmonary embolism. CONCLUSIONS: Patients with cerebral sinus thrombosis treated with anticoagulants (low-molecular-weight heparin followed by oral anticoagulation) had a favorable outcome more often than controls, but the difference was not statistically significant. Anticoagulation proved to be safe, even in patients with cerebral hemorrhage.  (+info)

292568030 - EP 1101110 A1 2001-05-23 - METHOD AND APPARATUS FOR DETERMINING ANTICOAGULANT THERAPY FACTORS - [origin: CA2339006A1] A method and apparatuses are disclosed for determining an anticoagulant therapy factor (ATF), a corrected anticoagulant therapy factor and a modifie d anticoagulant therapy factor, all selectively used for monitoring oral anticoagulant therapy to help prevent excessive bleeding or deleterious bloo d clots that might otherwise occur before, during or after surgery. The anticoagulant therapy factor, the corrected anticoagulant therapy factor, an d a modified anticoagulant therapy factor are based upon disclosed methods for determining the fibrinogen tranformation rate which, in turn, is dependent o n a maximum acceleration point for fibronogen conversion.[origin: CA2339006A1] A method and apparatuses are disclosed for determining an anticoagulant therapy factor (ATF), a corrected anticoagulant therapy factor and a modifie d anticoagulant therapy factor, all selectively used
Deep vein thrombosis (DVT) remains a life-threatening complication of arthroplasty. It remains controversial for anticoagulation strategies after total hip arthroplasty (THA). A randomized double-blind study was conducted to determine whether prophylactic anticoagulation was efficient reduce DVT after THA. subjects who underwent uncemented THA were assigned to prophylactic anticoagulation group or non- prophylactic anticoagulation group. Patients were followed up 3 months later after surgery. DVT was tested by contrast venography. Investigator also used logistic regression analysis with variable selection for obtaining the prediction model of DVT. DVT after THA was affected by personal (age) and clinical factors (mechanical compression, duration of surgery). THA with short duration of surgery did not require prophylactic anticoagulation ...
Adherence to oral anticoagulant therapy in secondary stroke prevention – impact of the novel oral anticoagulants Sebastian Luger,1 Carina Hohmann,2 Daniela Niemann,1 Peter Kraft,3 Ignaz Gunreben,3 Tobias Neumann-Haefelin,2 Christoph Kleinschnitz,3 Helmuth Steinmetz,1 Christian Foerch,1 Waltraud Pfeilschifter1 1Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, 2Department of Neurology, Klinikum Fulda gAG, Fulda, 3Department of Neurology, University Hospital Würzburg, Würzburg, Germany Background: Oral anticoagulant therapy (OAT) potently prevents strokes in patients with atrial fibrillation. Vitamin K antagonists (VKA) have been the standard of care for long-term OAT for decades, but non-VKA oral anticoagulants (NOAC) have recently been approved for this indication, and raised many questions, among them their influence on medication adherence. We assessed adherence to VKA and NOAC in secondary stroke prevention. Methods: All patients treated from October 2011 to
The clinical situations include how to initiate and monitor NOAC use, how to measure the anticoagulant effect if needed in specific situations, switching between anticoagulants, ensuring compliance, patients with chronic kidney disease and management of bleeding complications.. NOACs remove the regular monitoring of anticoagulation level that was required for the vitamin K antagonists. But Professor Heidbuchel said: "Compliance is very important for the novel anticoagulant drugs because they have a very short half-life. That means that if you dont take them you will not be protected by anticoagulation and are at greater risk of thromboembolic events.". The document provides tips on how to improve compliance. These include educating patients about the drugs short half-life, and that small minor bleeding such as a nose bleed will stop by itself and patients should continue taking the drug. Compliance can also be improved with a pre-specified follow up scheme.. The guide does not cover the ...
Oral anticoagulant therapy is the mainstay of stroke prevention in patients with atrial fibrillation; it is highly effective at reducing stroke risk, but its use can be limited by increased risk of bleeding. As new oral anticoagulants are available, barriers to optimal use of oral anticoagulation therapy warrant consideration by healthcare professionals and administrators who are seeking to optimize the quality of care for patients with atrial fibrillation.
Denmark MedicalResearch.com: What is the background for this study? What are the main findings?. Response: Atrial fibrillation increases a persons risk of ischemic strokes up to 5-fold. Oral anticoagulation therapy lowers this risk effectively (,60%) and is therefore recommended for patients with atrial fibrillation and at least 1-2 other risk factors for stroke.. Our study show, that oral anticoagulation therapy is still underused in patients with atrial fibrillation - even after a stroke event. In stroke survivors with atrial fibrillation, oral anticoagulation therapy were associated with better outcomes than no oral anticoagulation therapy. MedicalResearch.com: What should readers take away from your report?. Response: Oral anticoagulation therapy is effective (and safe) as secondary stroke prophylaxis in patients with atrial fibrillation.. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: Treatment rates with oral anticoagulation ...
https://www.futuremarketinsights.com/reports/sample/REP-GB-10058. Direct Oral Anticoagulants: Market Dynamics. Adoption of direct oral anticoagulants over the exciting alternative to warfarin and is used for the first line choice of treatment for venous thromboembolism and atrial fibrillation which is expected to spur the global direct oral anticoagulants market. Growing approval from the FDA and CE mark for the direct oral anticoagulants will further boost the direct oral anticoagulants market in the near future. Rising cases of thrombosis which is the major cause of morbidity and mortality in various parts of the world is expected to further drive the direct oral anticoagulants market in the forecast period.. However, some factors which might restraint the growth of the direct oral anticoagulants include high cost when compared to warfarin and shorter acting dose which makes it important not to miss any doses. Furthermore, stringent regulations for development of drug is expected to restraint ...
Oral anticoagulant therapy for patients who are at risk of developing blood clotting problems is used by between 400,000-600,000 Canadians annually. The use of this drug represents the most common cause of patient adverse medical outcomes due to medical errors. Furthermore, many patients have adverse outcomes using these drugs because physicians are not able to predict which patients are likely to have bleeding outcomes. Much effort has gone into developing ways to predict which patients are at risk of clotting but almost no work has gone into ways of predicting which patients would be at high risk of bleeding. This information is required to balance off the risk-benefits and to enable physicians and patients to understand the risks and benefits of taking these medications. Our study will develop a tool that can be used to predict bleeding risk in patients taking oral anticoagulant therapy. It will enable more informed decision making by both physicians and patients and will result in better ...
Antithrombotic medications reduce thromboembolic events by inhibiting platelet aggregation and coagulation. Antiplatelet drugs and oral anticoagulants are examples of antithrombotic medications and are among the most commonly prescribed drugs in both primary and secondary care.1 Clinicians are familiar with their use, however antiplatelets and oral anticoagulants are the drug classes most commonly implicated in adverse drug reactions occurring both in the community and in hospital.23 Increasing numbers of patients have an indication for combination antiplatelet and oral anticoagulant therapy. For example, more than one million people in the UK have atrial fibrillation, of whom approximately one third also have an indication for antiplatelet therapy as secondary prevention.4 Despite the need to understand the balance between benefit and risk, there are limited randomised data investigating antithrombotic co-prescription. Current guidelines are therefore based on expert opinion and the ...
hospitalizations, the excess risk attributable to anticoagulant therapy remained significant after the multivariate adjustment [IRR = 3.94 CI, 95% CI (1.06-14.69), p=0.041]. Finally, there was also a tendency to an increased risk of repeated hospitalizations of ischemic cause in anticoagulated patients [IRR = 5.80, 95% CI (0.86-39.0), p=0.071].. Anticoagulation and recurrent bleeding. There was a tendency of a higher frequency of total hemorrhages and also major hemorrhages in anticoagulated patients [1.93 vs 1.11 (p=0.113) and 1.05 vs 0.32 (p=0.051)]. After multivariate adjustment, we observed a tendency toward an increased risk of recurrent bleeding in the anticoagulated patients [IRR = 4.43, 95% CI (0.94-20.81), p=0.059]. Regarding major bleeding, although the differences were ostensible, these did not become statistically significant [IRR= P13.38, 95% CI (0.47-382.68), p,0.129)].. Time in therapeutic range (TRT) and hemorrhagic events in anticoagulated patients. Our anticoagulated patients ...
A total of 41 RCTs with 38,645 patients were included in the analysis, among which 2,654 were randomized to HDB tirofiban, 6,752 to abciximab, 1,669 to eptifibatide, 16,500 to heparin, and 11,070 to bivalirudin. Mean age was 64±11 years, 75% were male, 91% were treated with stenting, 71% with clopidogrel, 46% presented with STEMI, and 74% for ACS. As seen in Figure 1, tirofiban was associated with a significant reduction in all-cause mortality compared with eptifibatide or heparin. There was no difference among the GPI therapies for other outcomes including MI, MACE, and major bleeding. However, abciximab was associated with greater risk of thrombocytopenia (p,0.01). Bivalirudin was associated with less major and minor bleeding compared with a GPI anticoagulation strategy. ...
Atrial fibrillation affects millions of patients in the United States and imparts a five-fold increase in stroke risk, as compared to the general population.1 Oral anticoagulation is the mainstay of treatment for thromboprophylaxis in atrial fibrillation patients. Until recently, vitamin K antagonists (warfarin in the US) were the sole option for patients at moderate to high risk for stroke or systemic embolism. Now there are several novel oral anticoagulants (NOAC) available in the US as alternatives to warfarin, with good evidence for their efficacy and safety.2-4 While dabigatran, rivaroxaban, and apixaban have been approved for use, there is little practical and even less published experience with these drugs in common clinical situations that require transitions onto or off of NOACs. We aim to discuss the risk of temporary interruptions, the possible hazard of transitioning from one anticoagulant to another, the pharmacokinetic properties of NOACs, and the data around bridging with oral ...
Title: Pharmacological Strategies for Inhibition of Thrombin Activity. VOLUME: 14 ISSUE: 12. Author(s):S. Alban. Affiliation:Pharmazeutisches Institut,Christian-Albrechts-Universitat zu Kiel, Gutenbergstr. 76, 24118 Kiel,Germany.. Keywords:Glycosaminoglycans, low molecular weight heparins, fondaparinux, pentasaccharides, SR123781A, direct thrombin inhibitors, direct factor Xa inhibitors, dabigatran, rivaroxaban. Abstract: For decades, the options for therapeutic anticoagulation were limited to unfractionated heparin (UFH) and vitamin K antagonists (VKA), and their well-known limitations had to be accepted. With the introduction of the various LMWHs, the short-term anticoagulation could be much improved. The heparins delivered the proof of concept that FXa and thrombin represent suitable targets for therapeutic anticoagulation. Consequently, the search for new anticoagulants focus on inhibitors of thrombin or FXa. Apart from the VKA, the anticoagulants presently available or in an advanced stage ...
Update on Anticoagulants Jay Gaddy, MD, PhD Indiana Hemophilia & Thrombosis Center Indianapolis, Indiana None Disclosures Overview General discussion of anticoagulants New oral anticoagulants (NOACs) and
Only 53.0% of patients in the study at high risk of stroke were using oral anticoagulants. This proportion increased only slightly in the years 2007-2010. At the same time, higher than expected usage was found in the low-risk groups: 32.1% of people with CHADS2 = 0 and 23.0% with CHA2DS2VASc = 0. While anticoagulation may be appropriate for some of these individuals (for example, those with valvular disease), this suggests that use of these algorithms has still to become established. CHADS2 was first proposed over a decade ago, while CHA2DS2-VASc was introduced much more recently.. The estimated high-risk population increases when more inclusive definitions of hypertension are used. The authors considered the safest to be C, which increases the proportion identified from 56.9% to 65.9%. The additional inclusion of those with raised blood pressure levels (definition D) may be unreliable, particularly given the recent emphasis on home, rather than office-based measurements for diagnosis.23 About ...
The study was stopped early because of clear evidence of superiority of oral anticoagulation therapy. There were 165 primary events in patients on oral anticoagulation therapy (annual risk 3·93%) and 234 in those on clopidogrel plus aspirin (annual risk 5·60%; relative risk 1·44 (1·18-1.76; p=0.0003). Patients on oral anticoagulation therapy who were already receiving this treatment at study entry had a trend towards a greater reduction in vascular events (relative risk 1·50, 95% CI 1·19-1·89) and a significantly (p=0·03 for interaction) lower risk of major bleeding with oral anticoagulation therapy (1.30; 0.94-1.79) than patients not on this treatment at study entry (1·27, 0·85-1·89 and 0·59, 0·32-1·08, respectively ...
Background Real-world studies on anticoagulants are mostly performed on health insurance databases, limited to reported events, and sometimes far from every-day issues in family practice. We assess the presence of data for safe monitoring of oral anticoagulants in general practice, and compare patients knowledge of taking an anticoagulant between vitamin K antagonists (VKA) and direct anticoagulants (DOAC), and the general practitioners perception of their adherence to anticoagulation. Methods The CACAO study is a national cohort study, conducted by general practitioners on ambulatory patients under oral anticoagulant. In the first phase, investigators provided safety data available from medical records at inclusion. They also evaluated patients knowledge about anticoagulation and graded their perception of patients adherence. Results Between April and December 2014, 463 general practitioners included 7154 patients. Renal and hepatic function tests were respectively unavailable in 109 (7.5%) and
This certificate program is a comprehensive program designed to provide pharmacists with the basic knowledge and skills necessary to care for patients taking anticoagulation therapies. By completing this course, pharmacists can earn 22 hours of continuing education credit while becoming certified in anticoagulation management. The Anticoagulation Certificate Program is conducted in two parts: the self-study and live training seminar. To earn a certificate of achievement, participants must successfully complete all components of the program.. PROGRAM OUTCOME: With expanded use of anticoagulant agents, the number of patients receiving these drugs has increased dramatically. Safe and effective anticoagulation must include a number of key components to avoid complications. These include careful patient assessment, an understanding of the clotting cascade and mechanisms of action of anticoagulant therapies, a detailed focus on factors which influence therapy and knowledge of current guidelines. This ...
Intracranial hemorrhage (ICH) is the most feared and devastating complication of oral anticoagulant therapy. When an ICH occurs, the patients situation hinges on the balance between how great is the embolic risk while not receiving anticoagulants, and how big is the threat of the hemorrhage if the anticoagulant effect is not reversed promptly. Although several studies which compared the use of different reversal agents failed to demonstrate any improvement in prognosis and survival, at the present moment the consensus seem to be that anticoagulation should be rapidly reversed after an ICH. The second question to be answered is whether and when should be oral anticoagulation treatment restarted. Although the risk of thromboembolism in patients off anticoagulation seems to be higher than the risk of ICH recurrence, there is a marked paucity of prospective large studies on the real risk of ICH recurrence when OAC is resumed, paucity that probably emphasizes the ethical challenge of prescribing ...
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The study indicated that, after accounting for differences in baseline characteristics, there were no apparent differences in outcomes between patients who were and were not prescribed oral anticoagulants. There was also no relationship between the CHA2DS2-VASc score and the probability that patients had filled a prescription for an oral anticoagulant, and ultimately no evidence that the CHA2DS2-VASc risk score can effectively indicate the potential benefits of systemic oral anticoagulants for patients initiating hemodialysis with preexisting Afib.. Additional research is necessary to further guide using anticoagulants in this population.. For more information, read the research poster (which was presented at ASN) here.. ...
Dabigatran and rivaroxaban are 2 novel oral anticoagulant agents that have been shown to be safe and effective for the treatment and prophylaxis of VTE and for the prevention of stroke in atrial fibrillation. Following these results, both drugs were registered for VTE prevention despite the lack of information on the proper method to neutralize their anticoagulant activity. Findings from this study, the first conducted in humans, indicate that a nonactivated PCC immediately reverses the effect of full-dose rivaroxaban in healthy individuals but not dabigatran at the PCC dose used in this study.. Prothrombin complex concentrate (Cofact) was chosen as a method of reversal for both rivaroxaban and dabigatran for the following reasons. It contains 4 coagulation factors, namely factors II (prothrombin), VII, IX, and X, that stimulate thrombin formation, thereby potentially bypassing the anticoagulant effect of both drugs. The assessment of the reversal of the anticoagulant effects was based on ...
Oral anticoagulants (OACs) are indicated for the treatment of thrombosis and in the prevention of thromboembolism.1 This includes the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE), prevention of thrombosis in medically ill and postsurgical patients, and the prevention of thromboembolic stroke in atrial fibrillation. Patients using OACs are likely to be seen in the emergency department (ED) for the same reasons as other individuals of similar age and health, but also because all anticoagulant therapies carry a risk of treatment-related bleeding that, if it occurs, may require emergent evaluation and treatment.1-4. The vitamin K antagonist (VKA) warfarin (eg, Coumadin, Bristol-Myers Squibb, New York, New York, USA) has been the standard OAC for ,50 years, with ,30 million prescriptions written annually in the USA alone.5 As well as the increased bleeding risk common to anticoagulants, the complex and variable pharmacokinetics and pharmacodynamics of warfarin create the ...
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Background: Intravascular clotting and low viscosity of the blood are two extremes of blood pathology that can result in serious consequences threatening the patients life. Medical conditions that trigger blood clotting need to be dealt with so as not to end into the serious complication of this disorder. Replaced heart valve is a treatment that activates the coagulation pathway. Anticoagulation therapy becomes a necessity in these patients. In spite of the beneficial effect of warfarin as a blood anticoagulant drug, high anticoagulation may lead to bleeding and low anticoagulation may lead to thrombosis in these patients. Therefore, the drug must be kept under tight control because it has a narrow therapeutic range. The successful management policy of a patient on anticoagulation therapy is essentially a team work including the combined activities of the medical personnel in charge and the patient him/herself. The patient can be involved through education by implementing a structured ...
Protein S (PS) is a vitamin K-dependent anticoagulant that acts as a cofactor to activated protein C (APC). To date PS has not been shown to possess anticoagulant activity in the absence of APC. In this study, we have developed monoclonal antibody to protein S and used to purify the protein to homogeneity from plasma. Affinity purified protein S (PSM), although identical to the conventionally purified protein as judged by SDS-PAGE, had significant anticoagulant activity in the absence of APC when measured in a factor Xa recalcification time. Using SDS-PAGE we have demonstrated that prothrombin cleavage by factor Xa was inhibited in the presence of PSM. Kinetic analysis of the reaction revealed that PSM competitively inhibited factor Xa mediated cleavage of prothrombin. PS preincubated with the monoclonal antibody, acquired similar anticoagulant properties. These results suggest that the interaction of the monoclonal antibody with PS results in an alteration in the protein exposing sites that mediate the
Importance: Although non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used to prevent thromboembolic disease, there are limited data on NOAC-related intracerebral hemorrhage (ICH). Objective: To assess the association between preceding oral anticoagulant use (warfarin, NOACs, and no oral anticoagulants [OACs]) and in-hospital mortality among patients with ICH. Design, Setting, and Participants: Retrospective cohort study of 141 311 patients with ICH admitted from October 2013 to December 2016 to 1662 Get With The Guidelines-Stroke hospitals. Exposures: Anticoagulation therapy before ICH, defined as any use of OACs within 7 days prior to hospital arrival. Main Outcomes and Measures: In-hospital mortality. Results: Among 141 311 patients with ICH (mean [SD] age, 68.3 [15.3] years; 48.1% women), 15 036 (10.6%) were taking warfarin and 4918 (3.5%) were taking NOACs preceding ICH, and 39 585 (28.0%) and 5783 (4.1%) were taking concomitant single and dual antiplatelet agents, ...
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Background The indications for continuous oral anticoagulant treatment, the target interval and the procedures for withdrawing treatment have changed in the last 10 years.
Anticoagulants Meaning in Malayalam, Anticoagulants in Malayalam, Anticoagulants Malayalam Equivalent, English to Malayalam Free Dictionary : Malayalam to English Free Dictionary : Meaning of Anticoagulants in Malayalam : Online Malayalam English Free Dictionary Online രണ്ട് ലക്ഷത്തിലധികം വാക്കുകളും അവയുടെ അർത്ഥങ്ങളും വ്യാഖ്യാനങ്ങളുമുള്ള നിഘണ്ടു ഇംഗ്ലീഷ് - മലയാളം, മലയാളം - മലയാളം നിഘണ്ടു. The biggest and fastest English-Malayalam, Malayalam-Malayalam Dictionary with hundred thousands of words and definitions
Novel oral anticoagulants offer equivalent or improved therapeutic profiles compared with warfarin, with less risk of bleeding, no interactions with food, and no need for routine laboratory monitoring. Caution must be exercised in using these drugs in certain patient populations, for example, renal insufficiency, those receiving additional antithrombotic therapy, those with questionable compliance, children, and those with a high risk of gastrointestinal bleeding. One of the novel oral anticoagulants, rivaroxaban, is a direct Factor Xa inhibitor, used to reduce risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism ...
The possibility that a hypercoagulable state (thrombotic rebound) may follow anticoagulant therapy1 continues to arouse interest. In a group of patients with various disorders thrombo-embolic complications occurred particularly in the first month after stopping the anticoagulant for three days or more because of bleeding, but were distributed randomly over many months when therapy was withdrawn permanently for other reasons.2 In another study, in patients with non-haemorrhagi strokes due to cerebrovascular disease, the incidence of further non-fatal attacks was significantly increased after gradual withdrawal of anticoagulants over one month,3 although comparison with a control group showed that anticoagulants were quite ineffective in preventing such recurrences.4 5 On the other hand no withdrawal effect was found in two studies of patients with ischaemic heart disease,6 7 or in the incidence of venous thrombosis in a series of injured persons.8. ...
What is the treatment for a pulmonary embolism?. Anticoagulant treatment. Anticoagulation is often called thinning the blood. It alters certain chemicals in the blood to stop clots forming so easily. It doesnt dissolve the clot either. Anticoagulation prevents a PE from getting larger, and prevents any new clots from forming. Anticoagulation treatment is usually started immediately (as soon as a PE is suspected) in order to prevent the clot worsening, while waiting for test results.. Anticoagulation medication comes in two forms: injections and tablets The injectable form is heparin (or similar injections called low molecular weight heparins (LMWH)). A new drug called fondaparinux sodium can be given by injection in some circumstances, either to prevent VTE or treat a PE or DVT. The tablets or syrup are called warfarin. They all belong to the group known as oral anticoagulants.. Anticoagulant treatment is continued until three months after a PE in most cases. Sometimes longer treatment is ...
SUMMARY Antithrombotic drugs are among the most commonly used drugs in medicine and are generally separated into anticoagulants, fibrinolytic agents, and platelet inhibitors based on their primary mechanism of action. For many decades, warfarin, which acts by inhibiting vitamin K action, was the only oral anticoagulant available. Vitamin K antagonists have a prolonged effect, unpredictable pharmacokinetics, and require monitoring, but warfarin was widely used for prevention and treatment. The introduction of novel targeted oral anticoagulants has changed the landscape of anticoagulation. Rivaroxaban, apixaban, and edoxaban are novel oral inhibitors of factor Xa, whereas dabigatran is an orally available inhibitor of thrombin. Unfractionated heparin and the low-molecular-weight heparins are the most commonly used rapidly acting parenteral anticoagulants; they inhibit activated serine proteases through antithrombin. One synthetic agent in this class, fondaparinux, is specific for inhibition of ...
Global Anticoagulants Market Outlook to 2020 - Demand for Patented NOACs with Prevalence of Cardiac Diseases to Drive Global Market" provides a comprehensive analysis of the anticoagulants market. The report includes the cumulative revenue generated by the market players from the sales of anticoagulants, including both generic and patented drugs at manufacturers price and market share contributed by the sales of heparin, NOACs, Vitamin K Antagonists, and Injectable Direct Inhibitors in the total anticoagulants market. Further, the market in the study is differentiated on the basis of route of administration into oral and injectable. The market is also segmented by four geographical regions across the globe - North America, Europe, Asia Pacific, and Rest of the World. Detailed snapshot on key regions of the Market which includes North America, Europe, and Asia Pacific is included in the report to elucidate facts about the market in detail. The study also highlights the detailed information about ...
TY - JOUR. T1 - Position Paper on laboratory testing for patients on direct oral anticoagulants. A Consensus Document from the SISET, FCSA, SIBioC and SIPMeL. AU - Tripodi, Armando. AU - Ageno, Walter. AU - Ciaccio, Marcello. AU - Legnani, Cristina. AU - Lippi, Giuseppe. AU - Manotti, Cesare. AU - Marcucci, Rossella. AU - Moia, Marco. AU - Morelli, Benedetto. AU - Poli, Daniela. AU - Steffan, Agostino. AU - Testa, Sophie. PY - 2018/9. Y1 - 2018/9. N2 - Although direct oral anticoagulants (DOAC) do not require dose-adjustment on the basis of laboratory test results, the measurement of their anticoagulant effect is useful in special situations. This position paper issued by the Italian Scientific Societies that are mainly involved in the management of patients on DOAC is aimed at providing guidance to care-givers on which tests should be used and the situations in which testing is useful. The guidance is based on the data from the literature so far available and/or on consensus among ...
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To address this controversy in context, each trial involving bivalirudin and primary PCI must be examined in detail. The large (N=3602) HORIZONS Acute Myocardial Infarction (AMI) trial examined a strategy of potent antithrombin alone (bivalirudin) compared with a combination of heparin with mandatory intravenous antiplatelet therapy (glycoprotein inhibition) in a large international trial (N=3602).16 The heparin arm of this trial is strikingly different from the antithrombin arms of PAMI and CADILLAC-heparin was weight-based, infusions were stopped after the PCI, sheaths were removed early, closure devices and radial access were possible, and all patients received dual oral antiplatelet therapy. In this context, bivalirudin provided similar ischemic outcomes to a heparin/GPI strategy and a marked reduction in bleeding complications. On the other hand, acute stent thrombosis rates clearly favored the heparin/GPI strategy: (0.3 versus 1.3%, P,0.001). Given the dichotomy of this trials findings, ...
Results In total, 25 patients were included. The majority were men (sex ratio (M/F)=1.27). Median age was 59 years (range 21-80). 19 cases of deep venous thrombosis, 4 of pulmonary embolisms and 3 of catheter associated thrombosis were diagnosed. As an initial treatment (first 5-10 days) of established VTE, 23 patients were treated with low molecular weight heparin (LMWH). Tinzaparin was prescribed in 22 cases. 2 patients received vitamin K antagonists (VKA). One of these 2 patients did not reach the target international normalised ratio (INR) range. Therefore, LMWH was substituted for VKA. For early maintenance and long term treatment, LMWH was used in 23 patients. The 2 other patients suffered from heparin induced thrombocytopenia during the initial treatment. As a result, LMWH was replaced by VKA. Duration of anticoagulation therapy varied from 2 to 18 months. 6 patients had complications of their VTE during treatment: 3 cases of VTE extension, 2 relapses and 1 case of pulmonary embolism. ...
Venous thromboembolism (VTE) remains a substantial clinical and health-economic burden worldwide and effective anticoagulant treatment is necessary immediately after VTE is suspected to reduce short- and long-term VTE related morbidity and mortality. For decades, low molecular weight heparin (LMWH), fondaparinux and Vitamin K antagonists (VKAs) have been the standard of anticoagulant therapy for VTE patients but these treatment options had clinically relevant drawbacks and limitations. The introduction of non-VKA oral anticoagulants (NOACs) that specifically inhibit either thrombin or factor Xa have resolved many of these drawbacks because these new compounds exhibit a rapid onset and offset of action, fewer food and drug interactions and a predictable anticoagulant effect ...
The most serious and common adverse side effect associated with anticoagulant are increased risk of bleeding, both nonmajor and major bleeding events.[36] Risk of bleeding is dependent on the class of anticoagulant agent used, patients age, and pre-existing health conditions. Warfarin has an estimated Incidence of bleeding of 15-20% per year and life-threatening bleeding rate of 1-3% per year.[37] Newer non-vitamin K antagonist oral anticoagulants appear to have fewer life-threatening bleeding events compared to warfarin.[38][39] Additionally, patients aged 80 years or more may be especially susceptible to bleeding complications, with a rate of 13 bleeds per 100 person-years.[40] Bleeding risk is especially important to consider in patients with renal impairment and NOAC therapy due to the fact that all NOACs, to some extent, are excreted by the kidneys.[41] Thus, patients with renal impairment may be at higher risk of increased bleeding.[42] Nonhemorrhagic adverse events are less common than ...
The incidence of venous thromboembolism including pulmonary embolism and deep vein thrombosis is increasing in Korea. As the use of vitamin K antagonists is increased, the risk of anticoagulant-related intracranial hemorrhage(ICH) is emphasized. Anticoagulant-related ICH in patients with anticoagulation therapy is approximately 0.2% per year occurred. There is no study about anticoagulant-related ICH in Korea. We retrospectively reviewed the records of ICH patients at Soonchunhyang University Hospital, Seoul, Korea, from 1 January 2004 to 31 December 2012. We divided into two groups depending on whether the administration of warfarin. The primary outcome was 30-day mortality. Secondary outcomes were the ways for reversal of hemorrhage and overall outcomes. ICH hopitalizations were in 3,232 patients. Except exclusion criteria (n=721), among total 2,511 patients, the warfarin-associated ICH occurred in 50 patients(2.0%). The 30-day mortality in warfarin-associated ICH patients was 40% compared ...
Although warfarin has long been the standard treatment for venous thromboembolism (VTE) and thomboprophylaxis in atrial fibrillation (AF), the need for its frequent monitoring, potential drug interactions, and narrow therapeutic window made it far from ideal. Since 2009, NOACs have become viable alternative agents owing to their more predictable and safer pharmacological profiles. NOACs include…
[Major thromboembolic complications during oral anticoagulant therapy. Importance of level of anticoagulation].: The probability of suffering a major thromboemb
Astellas Pharma has announced it is shutting down global development of darexaban maleate, a direct factor Xa inhibitor, after an acute coronary syndrome study revealed a higher bleeding risk associat
TY - JOUR. T1 - A systematic review of patient‐reported outcomes associated with the use of direct‐acting oral anticoagulants. AU - Afzal, Saima. AU - Hasan, Syed Shahzad. AU - Babar, Zaheer-Ud-Din. PY - 2019/12/1. Y1 - 2019/12/1. N2 - AimsPatient‐reported outcomes (PROs) are a distinctive method of evaluating patient response to health care or treatment. This systematic review aimed to analyse the impact of PROs in patients on direct oral anticoagulant (DOAC) treatment, prescribed for any indication (e.g. venous thromboembolism treatment or atrial fibrillation) using controlled trials (CT) and real‐world observational studies (OS).MethodsA systematic search of articles was conducted according to PRISMA guidelines using databases, with the last update in November 2018. The Cochrane Collaboration tool for assessing bias in randomized CTs and the Newcastle‐Ottawa Scale adapted for cross‐sectional studies were used. Outcomes evaluated were related to health‐related quality of life ...
What are the options?. For stable outpatients starting anticoagulant therapy, the two most common options for oral therapy would be Warfarin (bridged with 5-7 days of Low Molecular Weight Heparin subcutaneous injections) or a Direct Oral Anticoagulant (Dabigatran, Rivaroxaban, or Apixaban). Most articles written about oral anticoagulant therapy for VTE over the past 5 years have some iteration of a table describing the properties of the DOACs (this is a good example here) 1.. A few other factors help determine whether your patient is a good candidate for a DOAC 2:. ...
in reply: Dr. Hamrick raises some interesting and important points regarding the risk of anticoagulation and the risk of falls in patients with chronic atrial fibrillation. Dr. Hamrick correctly points out that warfarin (Coumadin) therapy provides an important advantage of stroke prevention. However, the main evidence cited in Hamricks letter regarding the risk attributable to falls is a decision analysis,1 not a primary evidence study or meta-analysis. Another important consideration is the assumptions that went into the decision analysis. The risk of stroke was estimated to be 6 percent, while the risk of subdural hematoma was estimated at 0.00023 per year, or a 1.4 relative risk from falling. These numbers appear to be at the extremes of possible estimates. Furthermore, the risk of falls was computed using elderly patients in community dwelling settings who were at no particular increased risk of falls. Finally, the article1 did not consider any serious bleeding consequences except subdural ...
Direct-Acting Oral Anticoagulants drug therapy update. 1.5 hours CE. Accredited for pharmacists, technicians (ACPE). Meets ANCC & AANP criteria nurse practitioners.
If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patients written consent to publication and send them to the editorial office before submitting your response [Patient consent forms] ...
Global Anticoagulants Market Research Report 2017" Purchase This Report by calling ResearchnReports.com at +1-888-631-6977.. This research report on Anticoagulants provides detailed analysis on the main growth prospects and challenges in the market. This research study is expected to guide the new and existing key players in the market in making current business decisions in order to sustain in the rigid competition of the Anticoagulants market. This report will give an acute understanding of business strategies, latest and upcoming developments, market study, competitive players and many more. Their revenue share, contact information and detailed SWOT analysis is also available.. For more inquiry before Purchase: https://www.researchnreports.com/enquiry_before_buying.php?id=71194. An additional regional data of the key geographic segments with respect to Anticoagulants market is explained in detail. This gives an idea about which region is leading in this particular market helping make better ...
OXFORD, England - Patients on oral anticoagulant therapy who self-monitor their prothrombin time with hand-held devices and adjust the dose on their own have lower rates of death and thromboembolism,
Coagulation factor III/Tissue Factor antibody [CLB/TF-5] (FITC) (coagulation factor III, tissue factor) for FACS. Anti-Coagulation factor III/Tissue Factor mAb (GTX43752) is tested in Human samples. 100% Ab-Assurance.
Tirofiban anticoagulant drug molecule. Stylized skeletal formula (chemical structure): Atoms are shown as color-coded circles: hydrogen (hidden), carbon (grey), nitrogen (blue), oxygen (red), sulfur (yellow). - Stock Image F018/3222
In the main analysis, after age 87, NCB associated with warfarin decreased below 0.10 lifetime QALYs while NCB associated with apixaban did not decrease below 0.10 lifetime QALYs until after age 92," the researchers report. "In sensitivity analyses, over a 3-year horizon, removing competing risks of death resulted in higher NCB (at 90 years, median difference using warfarin 0.010 QALYs [95% CI, 0.009-0.013], median difference using apixaban 0.025 QALYs [95% CI, 0.024-0.026 ...
Effect of New Oral Anticoagulants on Prescribing Practices for Atrial Fibrillation in Older Adults. This retrospective observational cohort study of 6,568 people with atrial fibrillation aged 75 years and older shows increased NOAC use over 5 years, with no change in warfarin in warfarin usage. Overall, fewer than 45% of participants were prescribed an anticoagulant; with consistently lower use in people aged 90 and older. A number of factors increased the likelihood of being prescribed NOACs, including younger age, white race, female sex, higher haemoglobin, higher creatinine clearance, hypertension, stroke or transient ischemic attack, no history of intracranial haemorrhage, and a modified HAS-BLED score of less than 3.. J Am Geriatr Soc. 2017;65(11):2405-2412.. Association Between Calcium or Vitamin D Supplementation and Fracture Incidence in Community-Dwelling Older Adults. In this systematic review and meta-analysis of 33 randomised clinical trials (n=51,145), the use of supplements that ...
OBJECTIVE To improve the standard of managing anticoagulant treatment and provide a basis for therapeutic quality control. DESIGN Implementation of a comprehensive computerised system for decision support. SETTING Three anticoagulation clinics in South Warwickshire. SUBJECTS Patients in South Warwickshire receiving anticoagulant treatment from September 1988 to March 1989. MAIN OUTCOME MEASURE International normalised ratio was measured and recorded at each visit. RESULTS 688 Patients visits were analysed statistically, and a 38% improvement was achieved in the results of international normalised ratios falling within the recommended therapeutic ranges of the British Society for Haematology. CONCLUSIONS The implementation of a computerised anticoagulation support system resulted in better management of patients. The system provides a basis for uniform management of treatment and a common platform for national or international trials.
[125 Pages Report] Check for Discount on Global Oral Anticoagulants Sales Market Report 2016 report by QYResearch Group. Notes: Sales, means the sales volume of Oral Anticoagulants Revenue,...
Context: The clinical introduction of new oral anticoagulants (NOACs) has stimulated the development of tests to quantify the effects of these drugs and manage complications associated with their use. Until recently, the only treatment choices for the prevention of venous thromboembolism in orthopedic surgical patients, as well as for stroke and systemic embolism in patients with atrial fibrillation, were vitamin K antagonists, antiplatelet drugs, and unfractionated and low-molecular-weight heparins. With the approval of NOACs, treatment options and consequent diagnostic challenges have expanded. Objective: To study the utility of thromboelastography (TEG) in monitoring and differentiating between 2 currently approved classes of NOACs, direct thrombin inhibitors (dabigatran) and factor Xa inhibitors (rivaroxaban and apixaban). Design: Blood samples from healthy volunteers were spiked with each NOAC in both the presence and absence of ecarin, and the effects on TEG were evaluated. Results: Both ...
While new oral anticoagulants may have certain advantages to warfarin, they also have disadvantages. Providers must be aware of the potential risks.
Anticoagulants are mainly categorized as herapins, warfarin, low molecular weight heparins (LMWHs), factor Xa inhibitors, and direct thrombin inhibitors (D
Anticoagulants and antiplatelet agents are widely used in the prophylaxis and management of thromboembolic and cardiovascular diseases. Gastrointestinal bleeding is a well-known complication of these agents. Modification of anticoagulant and antiplat
Background and Rationale: Residual platelet reactivity is a predictor of cardiovascular adverse events in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary interventions (PCI). In addition to patient factors and antiplatelet therapy, the choice of anticoagulant determines the risk for periprocedural ischemic and bleeding events. The ideal anticoagulant would demonstrate a fast onset, effective anticoagulation, and controlable reversibility. REG1 consisting of pegnivacogin, a RNA-aptamer direct factor IXa inhibitor, and anivamersen, its specific, and titratable active control agent meets these requirements. We examined whether inhibition of factor IXa with pegnivacogin affects platelet reactivity in vitro and in vivo in healthy volunteers and in a subset of patients with ACS undergoing PCI from the phase IIb RADAR trial (NCT00932100).. Methods and Results: For the in vitro study, blood from healthy volunteers was spiked with pegnivacogin (50µg/ml) and ADP-induced ...
The discovery of oral anticoagulants began in 1924, when Schofield linked the death of grazing cattle from internal hemorrhage to the consumption of spoiled swe
Heparin: Heparin is anticoagulant medication that is prescribed to people with leg-clotting problems. It is also used to prevent strokes, help in high-risk pregnancies and other conditions. Patients cannot take this drug by mouth. It must be administered through the veins or under the skin. Although it is administered by medical professionals, patients can self-administer the medication. This drug can cause bruising, pain or redness in the injection site. The drug cannot be taken with other anticoagulants, aspirin or antihistamines. Patients must tell their doctor about any other medications they are taking prior to taking heparin ...
Anticoagulant medications are commonly used for the prevention and treatment of thromboembolism. Although highly effective, they are also associated with significant bleeding risks. Numerous individua
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They found that the severity of the disease was reduced by both warfarin (see figure below) and rivoraxaban. In contrast, despite effective anticoagulation, starting after the initiation of the disease had no effect on the course of the EAE (i.e. no effect when used as a therapeutic regimen rather than a preventative one). One explanation is that the effect of anticoagulation is small, which is only apparent in the preventative setting but is diluted in the therapeutic setting. Another explanation is that the mechanisms of the disease after onset are very much different to those at the start, which is also likely to be true. A key feature of the MS disease onset is the loss of blood brain barrier (BBB) integrity, which allows the influx of immune cells into the brain. Thrombin is known to interrupt BBB integrity, and the protective effect of anticoagulation may be explained by the low thrombin activity preserving the BBB integrity. ...
They found that the severity of the disease was reduced by both warfarin (see figure below) and rivoraxaban. In contrast, despite effective anticoagulation, starting after the initiation of the disease had no effect on the course of the EAE (i.e. no effect when used as a therapeutic regimen rather than a preventative one). One explanation is that the effect of anticoagulation is small, which is only apparent in the preventative setting but is diluted in the therapeutic setting. Another explanation is that the mechanisms of the disease after onset are very much different to those at the start, which is also likely to be true. A key feature of the MS disease onset is the loss of blood brain barrier (BBB) integrity, which allows the influx of immune cells into the brain. Thrombin is known to interrupt BBB integrity, and the protective effect of anticoagulation may be explained by the low thrombin activity preserving the BBB integrity. ...
Pre-injury use of anticoagulant and antiplatelet medications is increasingly more common in older adults (55 years and older) with head trauma. Rapid diagnosis...
Millions of people regularly take anticoagulant or antiplatelet medications (sometimes called "blood thinners") to help prevent heart attack and stroke, and to manage a variety of medical conditions including cardiac arrhythmia and stent placement. While these drugs have proven, life-saving benefits, they can also cause side effects such as increased bleeding. So it may be a cause for concern if youre taking one of them and you need to have a dental procedure.. Anticoagulants are among the more widely used pharmaceuticals today, particularly for heart patients. Some common prescription anticoagulants include heparin, warfarin (Coumadin and generics), clopidogrel (Plavix) and dabigatran etexilate (Pradaxa). Regular aspirin and NSAIDS (like Advil) also have anticoagulant properties. The purpose of anticoagulant medications is to keep the blood from clotting (clumping together) as readily as it normally does; this reduces the chance of a clot forming inside a blood vessel, which could lead to a ...
Millions of people regularly take anticoagulant or antiplatelet medications (sometimes called "blood thinners") to help prevent heart attack and stroke, and to manage a variety of medical conditions including cardiac arrhythmia and stent placement. While these drugs have proven, life-saving benefits, they can also cause side effects such as increased bleeding. So it may be a cause for concern if youre taking one of them and you need to have a dental procedure.. Anticoagulants are among the more widely used pharmaceuticals today, particularly for heart patients. Some common prescription anticoagulants include heparin, warfarin (Coumadin and generics), clopidogrel (Plavix) and dabigatran etexilate (Pradaxa). Regular aspirin and NSAIDS (like Advil) also have anticoagulant properties. The purpose of anticoagulant medications is to keep the blood from clotting (clumping together) as readily as it normally does; this reduces the chance of a clot forming inside a blood vessel, which could lead to a ...
Millions of people regularly take anticoagulant or antiplatelet medications (sometimes called "blood thinners") to help prevent heart attack and stroke, and to manage a variety of medical conditions including cardiac arrhythmia and stent placement. While these drugs have proven, life-saving benefits, they can also cause side effects such as increased bleeding. So it may be a cause for concern if youre taking one of them and you need to have a dental procedure.. Anticoagulants are among the more widely used pharmaceuticals today, particularly for heart patients. Some common prescription anticoagulants include heparin, warfarin (Coumadin and generics), clopidogrel (Plavix) and dabigatran etexilate (Pradaxa). Regular aspirin and NSAIDS (like Advil) also have anticoagulant properties. The purpose of anticoagulant medications is to keep the blood from clotting (clumping together) as readily as it normally does; this reduces the chance of a clot forming inside a blood vessel, which could lead to a ...
Vein injury such as with a broken bone or surgery (such as hip or knee replacement).Anticoagulants, commonly referred to as blood thinners, are substances that prevent or reduce coagulation of blood, prolonging the clotting time.Subsequently, a medical device that was used during the ROCKET-AF clinical trial for Xarelto, the INRatio, was recalled by its manufacturer, Alere Inc.. Help About Wikipedia Community portal Recent changes Contact page.Injuries set the process in motion and result in a chain chemical reaction involving several factors that lead to the formation of thrombin, an enzyme responsible for the ultimate formation of blood clots.The American Heart Association explains how certain people congenital heart defects need to take anticoagulants (blood-thinners).Antiplatelet and anticoagulant therapies are at the heart of preventing recurrent strokes ...
AbstractBackgroundDue to limited evidence, it is unclear whether postoperative anticoagulation therapy may lead to higher success rates for microvascular free-flap surgery in the head and neck. This review evaluated whether postoperative anticoagulation therapy can lead to a better result in head an
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Control of anticoagulant treatment was studied in 250 patients. One hundred and fifty patients receiving long-term anticoagulant treatment (group 1) were studied for 52 weeks and the remaining 100 (group 2) for 12 weeks after discharge from hospital. The desired British correlated ratio range was 2.5-3.3, and a range of 2.3-3.5 was classified as satisfactory. In group 1 a satisfactory ratio was obtained for 70% of the study period and 120 of the 150 patients were maintained within this range for over 60% of the time. In group 2 only half of the patients were maintained within the satisfactory range and for 50% of the study period or less. The time and effort expended in therapeutic control were more than most clinics could afford, and the results for group 2 were disappointing. The standard of long-term anticoagulant treatment should be improved by continuous review of control and by "therapeutic quality control." ...
Anticoagulants assay - posted in Hematology: Hi,We would like to compare a protein with other anticoagulants to check its anticoagulant function.Does anybody else has protocol, know whaat method should I use or where can find a good protocol? Any help would be greatly appreciated. Xfu
Radcliffe Cardiology article authored by Nuria Sans covering topics - Oral anticoagulation, atrial fibrillation, new oral anticoagulants & on other cardiology field
Over the past five years, there has been a tremendous increase in the number of patients presenting to hospitals with traumatic brain injury. The bulk of these injuries occur in the elderly, and a rapidly growing number of them are taking anticoagulants for management of their medical comorbidities. Although there is a growing body of literature addressing this issue, many practical questions remained unanswered. This is due to the lack of randomized controlled studies of the clinical problems involved. And given the ethical issues of obtaining consent for them, there likely never will be.. An interdisciplinary group of Austrian experts was convened last year to consider the most common questions asked about TBI and concomitant anticoagulant use. They reviewed the existing literature from 2007 to 2018 and combined it with their own expertise to construct some initial answers to those questions.. Over the course of my next few posts, Ill dig into each of the questions and review their suggested ...
Do not stop taking Xarelto without talking to the doctor who prescribes it for you.. Table 8 displays the overall results for the primary composite endpoint and its components.Figure 4: Time to First Occurrence of Stroke (any type) or Non-CNS Systemic Embolism by Treatment Group (Intent-to-Treat Population).Hepatobiliary disorders: jaundice, cholestasis, hepatitis (including hepatocellular injury).See the end of this leaflet for a complete list of ingredients in Xarelto.The studies excluded patients undergoing staged bilateral total hip replacement, patients with severe renal impairment defined as an estimated creatinine clearance.Switching from Anticoagulants other than Warfarin to Xarelto - For patients currently receiving an anticoagulant other than warfarin, start Xarelto 0 to 2 hours prior to the next scheduled evening administration of the drug (e.g., low molecular weight heparin or non-warfarin oral anticoagulant) and omit administration of the other anticoagulant.In the RECORD clinical ...
Anticoagulants are commonly prescribed to prevent blood clots in the heart, leg veins and lungs, especially in patients with a history of atrial fibrillation,
Anticoagulant therapy can be used for the prevention and treatment of thromboembolic disorders. (CY Koh, RM Kini, unpublished observations). We also established the system of action of the novel anticoagulant proteins complicated, hemextin through the venom of Ringhals cobra (venom was size-fractionated by Superdex 30 column (Fig. 1A). Three main peaks were acquired and the protein eluted in maximum 3 contained mainly 3FTxs. Using the curiosity of isolating the anticoagulant protein from 3FTx family members, top 3 was further fractionated on the C18 RP-HPLC column. Person fractions had been lyophilized and their inhibitory actions on FX activation from the extrinsic tenase complicated were analyzed. The approximated percent inhibition of every small fraction and elution account (Fig. 1B) shows the current presence of many extrinsic tenase complicated inhibitors. 873697-71-3 IC50 873697-71-3 IC50 Many peaks included an assortment of different protein and additional purification by different ...
Non-Vitamin K oral anticoagulation (NOAC) is widely used as an alternative to warfarin for stroke prevention in atrial fibrillation and management of venous thromboembolism.
Our systematic review of randomized controlled trials of direct head-to-head comparisons of adjusted-dose warfarin with antiplatelet drugs, abstracted in this issue (1), showed no significant benefit for vascular deaths (odds ratio [OR] 0.86, 95% CI 0.63 to 1.17) or combined fatal and nonfatal vascular events (OR 0.79, CI 0.61 to 1.02). Our review also highlighted the problems of the Atrial Fibrillation, Aspirin, and Anticoagulation Study (AFASAK)-1 trial of inadequate concealment of randomization, nonblinded assessment of outcomes, and high losses to follow-up (2). This trial showed the largest benefit and was the only trial with a significant effect for its primary trial-defined outcome. Comparison of fatal events provides the most robust evidence of whether anticoagulation is better than aspirin because biased ascertainment is less likely. Meta-analysis provides more adequate power to assess less common, but more certain, fatal outcomes. We feel practitioners would be misguided to base ...
Tens of thousands of patients are potentially being put at risk of a major bleed by being prescribed an antiplatelet without gastroprotection or a non-steroidal anti-inflammatory drug alongside an anticoagulant, NHS figures have shown.
Direct oral anticoagulants offer several advantages over warfarin, but reversal agents for most DOACs are not available, which puts patients at risk if they need emergency surgery or experience breakthrough bleeding. Food and Drug Administration-approved assays that measure DOACs activity also are lacking.
Mark Crowther, MD discusses the results of various analyzes regarding the reversal of direct oral anticoagulants, including PCCs and Tailored Reversal Agents idarucizumab and andexanet alfa., TV Network
Miller AL, Loscalzo J. Miller A.L., Loscalzo J Miller, Amy L., and Joseph Loscalzo.. "Management of Patients Receiving a Direct Oral Anticoagulant." Harrisons Online Updates Kasper D. Kasper D Kasper, Dennis. New York, NY: McGraw-Hill, 2019, http://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=497653§ionid=227114133. ...
Direct oral anticoagulants (DOACs) have distinct bleeding profiles and require individualized management approaches, according to a new review.
The global "Oral Anticoagulant market" research report highlights the need for the up-to-date market data for the business management that will offer.... ...
Tips for anticoagulated patient: Oral anticoagulants are indicated in the long-term prevention of thromboembolic disease. Anticoagulated patient is ...
There were a total of 5 deep and 2 superficial vein thromboses diagnosed at index hospitalization. No patient developed arterial thrombosis. All patients tolerated NOAC and their platelet count normalized before discharge. At 19months of follow-up, 6 patients had died of non-thrombotic causes. There was no bleeding, limb loss or recurrent venous thromboembolism in any patient. ...
Nonvalvular atrial fibrillation (AF) patients who take non-vitamin K oral anticoagulants (NOACs) along with certain other medications are at increased risk for
DOAC more effective in lowering risk of post-procedure VTE without increasing bleeding risk WASHINGTON (Mar 29, 2020) - The direct oral anticoagulant rivaroxaban dramatically cut the likelihood of serious venous thromboembolism (VTE) in people recovering from lower limb orthopedic surgery requiring immobilization in comparison with enoxaparin, another anticoagulant agent, according to research presented at the American C
Dabigatran etexilate, an oral prodrug of the direct thrombin inhibitor dabigatran, and the oral direct inhibitors of factor Xa, rivaroxaban and apixaban, are approved in the United States, Europe, and Canada to prevent stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF). They are also variably licensed for treatment of venous thromboembolism (VTE) and prevention of VTE after major orthopedic surgery (MOS) in certain jurisdictions. We refer to these agents collectively as non-vitamin K oral anticoagulants (NOACs) in this paper. Synonymous terms preferred by other researchers include direct-acting oral anticoagulant agents and new, novel, or target-specific oral anticoagulant agents (1).. Unlike warfarin and other vitamin K antagonists (VKAs), the NOACs are administered in fixed doses and do not require routine laboratory monitoring (2-4). However, measurement of their anticoagulant activity may be desirable in special clinical settings such as bleeding; the ...
Good evidence exists that adjusted-dose warfarin reduces the risk for stroke in patients with nonvalvular atrial fibrillation (1). However, because regular monitoring of the INR is required and because of the risk for hemorrhage, a safer alternative is desirable. Aspirin is safer and more convenient but less effective than warfarin (2, 3). This study was restricted to patients who had at least 1 risk factor for stroke in addition to atrial fibrillation. In these patients, the effects of low-intensity, fixed-dose warfarin plus aspirin were disappointing; the risk for stroke increased, and the risk for major hemorrhage was not reduced. Patients who are at high risk for stroke stand to gain more from treatment than patients at low risk for stroke, and the SPAF III study confirms the benefit of adjusted-dose warfarin for these patients. Increasing evidence supports a target range of 2.0 to 3.0 for the INR. The risk for stroke rises steeply if the INR is , 2, and the risk for hemorrhage rises if it ...
Aims To assess the impact of the introduction of direct oral anticoagulants upon the outcomes from elective electrical cardioversion for atrial fibrillation. Methods This is a retrospective comparison of delay to elective cardioversion with different anticoagulants. The data was gathered from a large regional hospital from January 2013 to September 2017. There were 3 measured outcomes: 1) the time in weeks from referral to the date of attempted electrical cardioversion; 2) the proportion of patients who were successfully cardioverted; and 3) the proportion of patients who remained in sinus rhythm by the 12 week follow-up. Time-to-cardioversion was non-parametrically distributed so was analysed with Kruskal-Wallis testing and Mann-Whitney-U testing. Maintenance of sinus rhythm was analysed using z-testing. Results 1,374 patients were submitted to cardioversion. The referrals for cardioversion were either from primary care or from cardiologists. At the time of cardioversion, 789 cases were
We deserve no credit for the muddied waters of heparin-induced thrombocytopenia terminology. The concept of early, mild, nonimmune, clinically inconsequential heparin-induced thrombocytopenia was advanced years ago as heparin-induced thrombocytopenia type 1 (1). In fact, low platelet counts in some hospitalized patients may often be unrelated to heparin and may be due instead to infection, surgery, other drugs, and stresses. The recommendation to designate this as heparin-associated thrombocytopenia to distinguish it from serious heparin-induced thrombocytopenia (2) has not gained wide favor. Furthermore, separating heparin-induced thrombocytopenia from heparin-induced thrombocytopenia with thrombosis syndrome is artificial and misleading, since isolated heparin-induced ...
Risk factors for deep vein thrombosis and venous thromboembolism Chemotherapy and Radiation Therapy increase the risk of Deep Vein Thrombosis Venous Thromboembolism and Cancer Type Treatment of DVT and Venous Thromboembolism in Patients with Cancer Anticoagulation for DVT thrombophylaxis after hip surgery and knee surgery. Antiphospholipid Syndrome and Venous Thromboembolism Hemorrhagic Complications with Anticoagulation for DVT and Venous Thromboembolism. Hormone replacement therapy and venous thromboembolism Xarelto for Deep Vein Thrombosis - rivaroxaban for DVT Protein C Deficiency and Deep Vein Thrombosis, mutations PROC gene Thrombophilia and Exercise, Smoking Cessation, Avoiding Immobility, Surgery, Oral Contraceptives, Pregnancy. Thrombophilia and Relative Risk for DVT and Venous Thromboembolism. Ways to Reduce Risk of Deep Vein Thrombosis (DVT). What is Travelers DVT (Deep Vein Thrombosis)? Deep Vein Thrombosis is Multifactorial. Three Ways to Diagnose Deep Vein Thrombosis. Are Temporary ...
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TY - JOUR. T1 - Plasma-diluted thrombin time to measure dabigatran concentrations during dabigatran etexilate therapy. AU - Avecilla, Scott T.. AU - Ferrell, Chris. AU - Chandler, Wayne L.. AU - Reyes Gil, Morayma. PY - 2012/4. Y1 - 2012/4. N2 - New anticoagulants, like the orally available direct thrombin inhibitor (DTI) dabigatran etexilate, have recently been introduced into the market for venous thromboembolic prophylaxis and for stroke prevention in atrial fibrillation. While dabigatran has been approved for use without the need for routine therapeutic monitoring, there are clinical scenarios in which monitoring can help guide clinical management. We report herein the application of a recently described plasma-diluted thrombin time (DTI assay) used to monitor intravenous DTI as a useful and easily implemented method to monitor oral DTIs. Copyright. AB - New anticoagulants, like the orally available direct thrombin inhibitor (DTI) dabigatran etexilate, have recently been introduced into the ...
The relationship between bleeding complications and increased mortality after percutaneous coronary intervention (PCI) has been well documented. Bivalirudin is superior to heparin and glycoprotein (GP) IIb/IIIa inhibitors, mainly due to the lower risk of bleeding but comparable rates of ischemic complications (1-3). Three trials presented at the 2014 American College of Cardiology Scientific Sessions raise questions regarding the superiority of bivalirudin in PCI (4-6).. In the HEAT-PPCI (Unfractionated Heparin Versus Bivalirudin in Primary Percutaneous Coronary Intervention) trial, 1,829 patients from a single center with ST-segment elevation myocardial infarction (STEMI) referred for primary PCI were randomized to heparin (70 U/kg bolus) or bivalirudin, with GP IIb/IIIa inhibitor only used for bail out (15.5% vs. 13.5%, p = NS) (4). The majority of the PCI (,80%) were performed transradially. Nearly all patients (99.6%) were pre-loaded with dual antiplatelet therapy; 60% of patients received ...
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Bjork I, Lindahl U., Lindahl (1982)։ «Mechanism of the anticoagulant action of heparin»։ Mol. Cell. Biochem. 48 (3): 161-182։ ... Howell, W H. (1922)։ «Heparin, an anticoagulant.»։ Am. J. Physiol. 63: 434-435 ... Weitz JI (2004)։ «New anticoagulants for treatment of venous thromboembolism»։ Circulation 110 (9 Suppl 1): I19-26։ PMID ... Heparin used as an anticoagulant»։ AnimalResearch.info։ Արխիվացված օրիգինալից 2013-10-23-ին ...
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SNRIs may interact with anticoagulants, like warfarin. Currently, there is more evidence of SSRIs having higher risk of ...
Anticoagulants are drugs used to prevent the formation of blood clots, reducing the risk of stroke, heart attack and pulmonary ... There are also some anticoagulants that come from animals that work by dissolving fibrin. For example, Haementeria ghilianii, ...
Heterologous polyclonal antibodies are obtained from the serum of animals (e.g., rabbit, horse), and injected with the patient's thymocytes or lymphocytes. The antilymphocyte (ALG) and antithymocyte antigens (ATG) are being used. They are part of the steroid-resistant acute rejection reaction and grave aplastic anemia treatment. However, they are added primarily to other immunosuppressives to diminish their dosage and toxicity. They also allow transition to cyclosporin therapy. Polyclonal antibodies inhibit T lymphocytes and cause their lysis, which is both complement-mediated cytolysis and cell-mediated opsonization followed by removal of reticuloendothelial cells from the circulation in the spleen and liver. In this way, polyclonal antibodies inhibit cell-mediated immune reactions, including graft rejection, delayed hypersensitivity (i.e., tuberculin skin reaction), and the graft-versus-host disease (GVHD), but influence thymus-dependent antibody production. As of March 2005, there are two ...
With an ageing population and the widespread use of anticoagulant medications, there is evidence that this historically benign ...
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Some drug classes have been amalgamated from these three principles to meet practical needs. The class of nonsteroidal anti-inflammatory drugs (NSAIDs) is one such example. Strictly speaking, and also historically, the wider class of anti-inflammatory drugs also comprises steroidal anti-inflammatory drugs. These drugs were in fact the predominant anti-inflammatories during the decade leading up to the introduction of the term "nonsteroidal anti-inflammatory drugs". Because of the disastrous reputation that the corticosteroids had got in the 1950s, the new term, which offered to signal that an anti-inflammatory drug was not a steroid, rapidly gained currency.[4] The drug class of "nonsteroidal anti-inflammatory drugs" (NSAIDs) is thus composed by one element ("anti-inflammatory") that designates the mechanism of action, and one element ("nonsteroidal") that separates it from other drugs with that same mechanism of action. Similarly, one might argue that the class of disease-modifying ...
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This reactivation is important as a target of anticoagulant drug warfarin.[4] Vitamin K can be found in green vegetables, such ...
This problem is made worse if anticoagulants such as heparin or citrate are used. The anticoagulant that causes the least ...
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  • While anticoagulant rodenticides revolutionized the rodent pest control industry, they are hazardous to non-target predatory and scavenging birds on a global scale. (usgs.gov)
  • Restrictions on the sale, distribution and packaging of some second- generation anticoagulant rodenticides (e.g., brodifacoum, difethialone, bromadiolone and difenacoum) have been instituted by the US EPA, but do not seem to have successfully reduced exposure and effects in non-target predatory wildlife. (usgs.gov)
  • The risk posed by anticoagulant rodenticides to wildlife is inadequately characterized. (usgs.gov)
  • Results of recent studies with brodifacoum now indicate the potential for latent and protracted effects of combinations of anticoagulant rodenticides encountered by free-ranging raptors residing at the urban-agricultural interface. (usgs.gov)
  • Non-target wildlife, particularly birds of prey, are widely exposed to and acutely poisoned by anticoagulant rodenticides (ARs). (usgs.gov)
  • 8 Finally, Lopes et al provided data for apixaban indicating that interruption of the anticoagulant may be unnecessary in some cases for low risk procedures, and could safely be continued. (acc.org)
  • This advice is limited to people who are not already taking medication that increases the risk of bleeding, for example, an anticoagulant like Coumadin or a nonsteroidal anti-inflammatory drug (Nsaid) like ibuprofen or naproxen. (merriam-webster.com)
  • Additional data on the safety of chronic dosing of the newer oral anticoagulants in renal impairment are awaited. (nih.gov)
  • Newer anticoagulants? (dailystrength.org)
  • I asked her why, and she said that all the newest studies are trending toward the newer anticoagulants - even under those circumstances. (dailystrength.org)
  • About 10% of the patient population suffered from severe renal insufficiency -- a condition which may make them unsuitable for newer oral anticoagulants that are often metabolized in the kidneys, Poli noted. (medpagetoday.com)
  • However, because patients treated with newer oral anticoagulants are younger and healthier, randomized trials are necessary to better understand these unexpected differences in bleeding-related outcomes," the authors concluded. (ajmc.com)
  • Anticoagulants are medication s that prevent the coagulation , or clotting , of blood . (everything2.com)
  • A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for thrombotic disorders. (bionity.com)
  • Taking recommended doses of garlic, without using anticoagulant medication, should not pose an increased risk of bleeding. (positivehealth.com)
  • The Migraine Trust is often asked about the affect of anticoagulants from people who are taking the medication for another health condition and notice a change in their migraine attacks. (migrainetrust.org)
  • Routine, widely available coagulation screening assays-including prothrombin time (PT) and activated partial thromboplastin time (APTT)-don't reliably measure various DOACs' anticoagulant effects. (aacc.org)
  • Perosphere in Danbury, Connecticut, is working on multiple products, including an assay sensitive to all of the approved DOACs, and an accompanying point-of-care device that measures various anticoagulants and reversal agents. (aacc.org)
  • Global Anticoagulants Market In pharmaceutical Sector, With. (mynewsdesk.com)
  • The recently published report titled Global Anticoagulants Market Industry 2018 Market Research Report is an in depth study providing complete analysis of the industry for the period 2018 - 2025. (mynewsdesk.com)
  • It provides complete overview of Global Anticoagulants Market considering all the major industry trends, market dynamics and competitive scenario. (mynewsdesk.com)
  • The Global Anticoagulants Market Industry Report 2018 is an in depth study analyzing the current state of the Global Anticoagulants Market. (mynewsdesk.com)
  • The study on Global Anticoagulants Market provides analysis of China market covering the industry trends, recent developments in the market and competitive landscape. (mynewsdesk.com)
  • Research study on Global Anticoagulants Market also discusses the opportunity areas for investors. (mynewsdesk.com)
  • In terms of geography, North America dominates the global anticoagulants market. (medgadget.com)
  • The increasing aging population is a key driver for the global anticoagulants market. (medgadget.com)
  • However, stringent regulations set by various governments hamper the growth of the global anticoagulants market. (medgadget.com)
  • Moreover, risk of side-effects and complications associated with the usage of oral anticoagulants also hinders growth of the global anticoagulants market. (medgadget.com)
  • Increasing number of mergers and acquisitions of drug manufacturing companies is a key trend of the global anticoagulants market. (medgadget.com)
  • The FDA has tentatively given Teva Pharmaceuticals a nod of approval for its abbreviated new drug application to market the generic version of the anticoagulant injection Argatroban (GlaxoSmithKline) in 100 mg/mL doses. (healthimaging.com)
  • Their intake should be avoided whilst taking anticoagulants or, if coagulability is being monitored, their intake should be kept approximately constant so that anticoagulant dosage can be maintained at a level high enough to counteract this effect without fluctuations in coagulability. (wikipedia.org)
  • I've been looking at internet forums and it seems to be a widespread experience, i.e. no migraine attacks whilst taking anticoagulants. (migrainetrust.org)
  • This is due to increased awareness about therapeutic applications of anticoagulants in disease management in the region. (medgadget.com)
  • When I was still on Eliquis, I asked my hematologist what would happen if my lupus anticoagulant test came back positive, and she said that she would keep me on the Eliquis. (dailystrength.org)
  • When you take anticoagulants, you need to take extra steps to avoid bleeding problems. (healthlinkbc.ca)