Agents that prevent clotting.
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.
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.
The process of the interaction of BLOOD COAGULATION FACTORS that results in an insoluble FIBRIN clot.
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.
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.
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.
Substances used to destroy or inhibit the action of rats, mice, or other rodents.
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)
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.
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.
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)
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.
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.
Laboratory tests for evaluating the individual's clotting mechanism.
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.
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.
Obstruction of a blood vessel (embolism) by a blood clot (THROMBUS) in the blood stream.
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.
Endogenous substances, usually proteins, that are involved in the blood coagulation process.
Bleeding or escape of blood from a vessel.
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.
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.
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.
Formation and development of a thrombus or blood clot in the blood vessel.
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.
An enzyme formed from PROTHROMBIN that converts FIBRINOGEN to FIBRIN.
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).
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.
Inflammation of a vein associated with a blood clot (THROMBUS).
Coumarin derivative that acts as a long acting oral anticoagulant.
The formation or presence of a blood clot (THROMBUS) within a vein.
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.
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.
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.
A disorder of HEMOSTASIS in which there is a tendency for the occurrence of THROMBOSIS.
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.
Obstruction of a vein or VEINS (embolism) by a blood clot (THROMBUS) in the blood stream.
The giving of drugs, chemicals, or other substances by mouth.
Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.
Coagulant substances inhibiting the anticoagulant action of heparin.
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.
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.
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.
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.
Agents that cause clotting.
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.
An oral anticoagulant that interferes with the metabolism of vitamin K. It is also used in biochemical experiments as an inhibitor of reductases.
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.
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.
Activated form of factor V. It is an essential cofactor for the activation of prothrombin catalyzed by factor Xa.
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.
Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.
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.
The reduction or regulation of the population of noxious, destructive, or dangerous rodents through chemical, biological, or other means.
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)
OXIDOREDUCTASES which mediate vitamin K metabolism by converting inactive vitamin K 2,3-epoxide to active vitamin K.
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.)
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)
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)
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.
Compounds with a BENZENE fused to IMIDAZOLES.
Pyridine derivatives with one or more keto groups on the ring.
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)
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.
An absence or reduced level of Antithrombin III leading to an increased risk for thrombosis.
A collection of blood outside the BLOOD VESSELS. Hematoma can be localized in an organ, space, or tissue.
The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically.
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)
A class of Echinodermata characterized by long, slender bodies.
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.
Synthetic or naturally occurring substances related to coumarin, the delta-lactone of coumarinic acid.
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)
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.
Absence or reduced levels of PROTHROMBIN in the blood.
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.
Activated form of factor VII. Factor VIIa activates factor X in the extrinsic pathway of blood coagulation.
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).
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.
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.
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.
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.
Hemorrhagic and thrombotic disorders resulting from abnormalities or deficiencies of coagulation proteins.
A protein derived from FIBRINOGEN in the presence of THROMBIN, which forms part of the blood clot.
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.
The natural enzymatic dissolution of FIBRIN.
Blocking of a blood vessel by an embolus which can be a blood clot or other undissolved material in the blood stream.
Elements of limited time intervals, contributing to particular results or situations.
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.
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.
The time required by whole blood to produce a visible clot.
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).
The return of a sign, symptom, or disease after a remission.
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)
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.
A heteropolysaccharide that is similar in structure to HEPARIN. It accumulates in individuals with MUCOPOLYSACCHARIDOSIS.
Hemorrhage following any surgical procedure. It may be immediate or delayed and is not restricted to the surgical wound.
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.
Bleeding into one or both CEREBRAL HEMISPHERES including the BASAL GANGLIA and the CEREBRAL CORTEX. It is often associated with HYPERTENSION and CRANIOCEREBRAL TRAUMA.
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.
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.-.
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.
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.
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.
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).
A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material.
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.
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.
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.
Exogenous or endogenous compounds which inhibit SERINE ENDOPEPTIDASES.
Interventions to provide care prior to, during, and immediately after surgery.
Proteins prepared by recombinant DNA technology.
Conjugated protein-carbohydrate compounds including mucins, mucoid, and amyloid glycoproteins.
A chelating agent that sequesters a variety of polyvalent cations such as CALCIUM. It is used in pharmaceutical manufacturing and as a food additive.
Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation.
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.
Duration of blood flow after skin puncture. This test is used as a measure of capillary and platelet function.
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.
The relationship between the dose of an administered drug and the response of the organism to the drug.
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.
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).
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
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.
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.
An order of nematodes of the subclass SECERNENTEA. Characteristics include an H-shaped excretory system with two subventral glands.
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.
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.
A protein of the annexin family isolated from human PLACENTA and other tissues. It inhibits cytosolic PHOSPHOLIPASE A2, and displays anticoagulant activity.
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.
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.
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.
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.
Agents counteracting or neutralizing the action of POISONS.
Three or more consecutive spontaneous abortions.
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.
A subnormal level of BLOOD PLATELETS.
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)
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.
Use of HIRUDINS as an anticoagulant in the treatment of cardiological and hematological disorders.
The action of a drug that may affect the activity, metabolism, or toxicity of another drug.
Mechanical devices inserted in the inferior vena cava that prevent the migration of blood clots from deep venous thrombosis of the leg.
Polysaccharides composed of repeating galactose units. They can consist of branched or unbranched chains in any linkages.
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.
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.
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.
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.
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.
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.
Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them.
The residual portion of BLOOD that is left after removal of BLOOD CELLS by CENTRIFUGATION without prior BLOOD COAGULATION.
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.
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.
Organic esters of sulfuric acid.
Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region.
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)
A synthetic polymer which agglutinates red blood cells. It is used as a heparin antagonist.
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)
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.
The number of PLATELETS per unit volume in a sample of venous BLOOD.
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.
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.
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.
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.
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.
Inorganic salts of sulfuric acid.
A subspecialty of internal medicine concerned with morphology, physiology, and pathology of the blood and blood-forming tissues.
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.
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.
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.
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.
Therapy with two or more separate preparations given for a combined effect.
The rate dynamics in chemical or physical systems.
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.
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.
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)
Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.
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)
Heterocyclic compounds that contain 4H,5H,6H,7H-thieno[2,3-c]pyridine as part of their structure.
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.
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.
Radiographic visualization or recording of a vein after the injection of contrast medium.
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.
The practice of replacing one prescribed drug with another that is expected to have the same clinical or psychological effect.
Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.
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)
Use of a thrombelastograph, which provides a continuous graphic record of the physical shape of a clot during fibrin formation and subsequent lysis.
The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.
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.
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.
Nucleotide sequences, generated by iterative rounds of SELEX APTAMER TECHNIQUE, that bind to a target molecule specifically and with high affinity.
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.
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.
Pathological conditions involving the HEART including its structural and functional abnormalities.
Proteins found in any species of helminth.
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)
Widely distributed enzymes that carry out oxidation-reduction reactions in which one atom of the oxygen molecule is incorporated into the organic substrate; the other oxygen atom is reduced and combined with hydrogen ions to form water. They are also known as monooxygenases or hydroxylases. These reactions require two substrates as reductants for each of the two oxygen atoms. There are different classes of monooxygenases depending on the type of hydrogen-providing cosubstrate (COENZYMES) required in the mixed-function oxidation.

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 ...
TY - JOUR. T1 - Review of new oral anticoagulants. AU - Frye, Lindsay. AU - Katz, Heather. AU - Bray, Natasha. AU - Berman, Barry. PY - 2015/5/1. Y1 - 2015/5/1. N2 - New oral anticoagulants have been developed over the past several years. These include the factor Xa inhibitors and direct thrombin inhibitors. These anticoagulants have been tested for safety and efficacy against standard therapies including subcutaneous enoxaparin or oral warfarin. The following is a review of pertinent trials comparing the new oral anticoagulants to standard therapy.. AB - New oral anticoagulants have been developed over the past several years. These include the factor Xa inhibitors and direct thrombin inhibitors. These anticoagulants have been tested for safety and efficacy against standard therapies including subcutaneous enoxaparin or oral warfarin. The following is a review of pertinent trials comparing the new oral anticoagulants to standard therapy.. KW - Anticoagulation. KW - Atrial fibrillation. KW - Deep ...
Background: The objective of this article is to summarize the published literature concerning the pharmacokinetics and pharmacodynamics of oral anticoagulant drugs that are currently available for clinical use and other aspects related to their management.. Methods: We carried out a standard review of published articles focusing on the laboratory and clinical characteristics of the vitamin K antagonists; the direct thrombin inhibitor, dabigatrán etexilate; and the direct factor Xa inhibitor, rivaroxaban.. Results: The antithrombotic effect of each oral anticoagulant drug, the interactions, and the monitoring of anticoagulation intensity are described in detail and discussed without providing specific recommendations. Moreover, we describe and discuss the clinical applications and optimal dosages of oral anticoagulant therapies, practical issues related to their initiation and monitoring, adverse events such as bleeding and other potential side effects, and available strategies for ...
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
Complete blood count (CBC) is used as an index of health status of human and different animals as well as to diagnose a variety of diseases. Therefore, there is a growing need of using the most suitable anticoagulant to obtain the most appropriate hemogram. The present study was designed to assess the effect of different anticoagulants viz. Heparin, Sodium Citrate and EDTA on complete blood count (CBC) in rat with a view to choosing the best suitable candidate among the common anticoagulants. A total of 30 samples out of which 10 were for each type anticoagulant were collected from 10 apparently healthy rats of Long Evans strain. From each rat 6 ml of blood was drawn and subsequently divided into three different test tubes with three different anticoagulants. The samples were analyzed for their complete blood count (TEC, TLC, Hb, Hct, DLC, absolute leukocyte count, Red Cell Indices, RDW-SD, RDWCV, Platelet, MPV, PCT and PDW) using Sysmex XT-1800i Auto hematological analyzer. Results showed a ...
Predictors of new oral anticoagulant drug initiation as opposed to warfarin in elderly adults: a retrospective observational study in Southern Italy Francesca Guerriero,1,* Valentina Orlando,1,* Valeria Marina Monetti,1 Francesca Maria Colaccio,2 Maurizio Sessa,3,4 Cristina Scavone,3 Annalisa Capuanom3,* Enrica Menditto1,* 1Center of Pharmacoeconomics (CIRFF), University of Naples Federico II, Naples, Italy; 2Caserta Local Health Unit, Caserta, Italy; 3Department of Experimental Medicine, Section of Pharmacology, Regional Center of Pharmacovigilance, University of Campania “L. Vanvitelli”, Naples, Italy; 4Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, DK, Denmark *These authors contributed equally to this work Aim: The aim of this study was to assess the predictive role of age, gender, and number and type of co-treatments for new oral anticoagulant (NOAC) vs warfarin prescription in elderly patients naïve for the aforementioned drugs. Materials and
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 ...
TY - JOUR. T1 - The novel anticoagulants. T2 - The surgeons prospective. AU - Shamoun, Fadi E.. AU - Martin, Elvis N.. AU - Money, Samuel R.. PY - 2013/3/1. Y1 - 2013/3/1. N2 - Anticoagulants can complicate the approach to the management of patients undergoing operative interventions. We review new anticoagulants that have been introduced recently to the market or that are undergoing investigations for treatment of nonvalvular atrial fibrillation and venous thromboembolism prophylaxis: Dabigatran, rivaroxaban, apixiban, and edoxaban.. AB - Anticoagulants can complicate the approach to the management of patients undergoing operative interventions. We review new anticoagulants that have been introduced recently to the market or that are undergoing investigations for treatment of nonvalvular atrial fibrillation and venous thromboembolism prophylaxis: Dabigatran, rivaroxaban, apixiban, and edoxaban.. UR - UR - ...
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.
Incidence of Direct Oral Anticoagulant use in patients with non-valvular atrial fibrillation and characteristics of users in six European countries (2008-2015): A cross-national drug utilization ...
Denmark 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. 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.. What recommendations do you have for future research as a result of this work? Response: Treatment rates with oral anticoagulation ... 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 anticoagulants are both one of the most commonly prescribed classes of medication and one associated with the high risk of major complications. This session will focus on the optimal management of this class of medication. It will include discussions of clinically important drug interactions with oral anticoagulants, the role of specialized anticoagulation services, and tips for using vitamin K antagonists.|/p| |p|Dr. Vittorio Pengo will discuss the exclusive use of warfarin treatment in some patient categories despite its decrease after the entry of direct oral anticoagulants (DOACs). The beginning of treatment is of fundamental importance as thrombotic and hemorrhagic complications occur soon after starting treatment as a consequence of poor maintenance of international normalized ratio in the therapeutic range. Dr. Pengo will discuss how to treat an excess or a deficit of anticoagulation after stabilization of treatment, and how to handle bridging therapy in the occasion of surgery or invasive
IMPORTANCE: Deep vein thrombosis (DVT) isolated to the calf veins (distal to the popliteal vein) is frequently detected with duplex ultrasonography and may result in proximal thrombosis or pulmonary embolism (PE).. OBJECTIVE: To evaluate whether therapeutic anticoagulation is associated with a decreased risk for proximal DVT or PE after diagnosis of an isolated calf DVT.. DESIGN, SETTING, AND PARTICIPANTS: All adult patients with ultrasonographic detection of an isolated calf DVT from January 1, 2010, to December 31, 2013, at the Vascular Laboratory of the University of California, Davis, Medical Center were included. Patients already receiving therapeutic anticoagulation and those with a chronic calf DVT, a contraindication to anticoagulation, prior venous thromboembolism within 180 days, or diagnosis of a PE suspected at the time of calf DVT diagnosis were excluded. Data were analyzed from August 18, 2015, to February 14, 2016.. EXPOSURES: Intention to administer therapeutic ...
Here is the fifth and final installment of my series summarizing the Austrian consensus paper on management of TBI patients with intracranial hemorrhage. The previous posts have run the gamut from diagnostic tests to detection of specific drugs to management. Ive covered platelet inhibitors and Vitamin K antagonist reversal in previous posts, and today Ill go over the panels reversal strategies for the direct oral anticoagulant drugs (DOACs).. Q1. Should idarucizumab (Praxbind) always be administered to patients with hemorrhagic TBI who are taking dabigatran (Pradaxa).. Answer: Only in cases where your laboratory is not capable of testing for thrombin time.. If thrombin time (TT) can be measured and is within the normal range, then the drug is not therapeutic and reversal should not be carried out. The consensus statement recommends giving this drug if the TT is prolonged or your lab cannot measure it. Keep in mind that there are very, very few papers on DOAC reversal in trauma patients. Most ...
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 ...
Title:Antiplatelet and Anticoagulation Strategies in the Prevention and Treatment of Ischemic Stroke. VOLUME: 18 ISSUE: 33. Author(s):Howard S. Kirshner. Affiliation:Department of Neurology, A- 0118 Medical Center North, Vanderbilt University School of Medicine, Nashville, TN 37232-2551, USA.. Keywords:Ischemic stroke, secondary stroke prevention, antiplatelet therapy. Abstract:Stroke prevention is highly effective but underutilized in medical care. Lifestyle modification, in the form of diet, exercise, smoking cessation, antihypertensive therapy, close control of diabetes and hyperlipidemia, can prevent most strokes. Selected subgroups can benefit from carotid surgery or stenting, anticoagulation for atrial fibrillation, and antiplatelet therapy. Evidence for these approaches and alternative management strategies are discussed.. ...
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 ...
The mean Anti-Clot Burden and Benefits and SWAN Score was 93% (56/60) and 83% (24.8/30) respectively reflecting high satisfaction with anti-Xa direct oral anticoagulants. 120 patients stated preference for anti-Xa direct oral anticoagulants over warfarin. Leading perceptions driving this was the reduction in frequency of medical contact and fewer bleeding side effects. Thirteen patients (10.3%) experienced an adverse event after the anti-Xa direct oral anticoagulant switch (majority were non-major bleeding) but most remained on anti-Xa direct oral anticoagulant treatment after management options were implemented with continued high satisfaction scores.. ...
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 ...
Warfarin has been the established oral anticoagulant for the last 50 years, being effective in the prevention and treatment of venous and arterial thromboembolic disorders. However, the frequent requirement for INR monitoring, multiple drug and food interactions have fuelled the need for development of new oral anticoagulants. Dabigatran is the first of a series of new oral anticoagulants that are emerging as the successors to warfarin. This new group of anticoagulants is rapidly gaining FDA and NICE approval and has proven non-inferiority to warfarin and viable alternatives to warfarin in the coming years. Given the obvious impact of this on dental treatment in the primary care and hospital setting this article aims to increase familiarisation with this new medicine group.
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 ...
Long-term anticoagulant therapy is the most effective measure to prevent ischemic stroke in patients with Atrial Fibrillation (AF). However, the curre..
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
Long-term oral anticoagulation in patients with atrial fibrillation who are at risk of bleeding may not be safe. In real-world clinical practice settings, many such patients request and insist on withdrawal of oral anticoagulation and even become non-compliant to treatment. Therefore, the authors sought to investigate whether a strategy of ICM-guided assessment of atrial fibrillation burden and optimisation of antiarrhythmic drugs to maintain normal sinus rhythm may allow safe withdrawal and obviate long-term use of oral anticoagulation in high-risk patients.. ...
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 ...
The Anticoagulation Management Clinical Topic Collection gathers the latest guidelines, news, JACC articles, education, meetings and clinical images pertaining to its cardiovascular topical area - all in one place for your convenience.
Non-vitamin K antagonist oral anticoagulants (NOACs) include dabigatran, which inhibits thrombin, and apixaban, betrixaban, edoxaban and rivaroxaban, which inhibit factor Xa. In large clinical trials comparing the NOACs with the vitamin K antagonist (VKA) warfarin, dabigatran, apixaban, rivaroxaban and edoxaban were at least as effective for stroke prevention in atrial fibrillation and for treatment of venous thromboembolism, but were associated with less intracranial bleeding. In addition, the NOACs are more convenient to administer than VKAs because they can be given in fixed doses without routine coagulation monitoring. Consequently, the NOACs are now replacing VKAs for these indications, and their use is increasing. Although, as a class, the NOACs have a favourable benefit-risk profile compared with VKAs, choosing among them is complicated because they have not been compared in head-to-head trials. Therefore, selection depends on the results of the individual trials, renal function, the ...
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 ...
Christina York, PharmD, BCPS Pharmacology Conference April 2016 Objectives Compare current FDA-approved oral anticoagulants Understand practical issues that arise with novel oral anticoagulants Consider
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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TY - JOUR. T1 - Computer-Assisted Dosing of Heparin. T2 - Management With a Pharmacy-Based Anticoagulation Service. AU - Kershaw, Beverly. AU - White, Richard H. AU - Mungall, Dennis. AU - Van Houten, Jeff. AU - Brettfeld, Stefan. PY - 1994/5/9. Y1 - 1994/5/9. N2 - Background: Expert consultation by means of established practice guidelines has been shown to lead to improved accuracy of inpatient anticoagulation therapy, with a reduction in the frequency of hemorrhagic complications. We evaluated a different strategy to improve the accuracy of in-hospital anticoagulation: pharmacybased, computer-assisted dosing of intravenous heparin therapy. Methods: Patients treated with computer-assisted dosing of heparin (N=131) were compared with a randomly selected historical cohort (N=57) in whom heparin therapy was managed by the primary physician. All patients treated by the pharmacy team received a bolus of heparin, 70 U/kg of ideal body weight, except for patients with pulmonary embolism, who received ...
Extracorporeal membrane oxygenation (ECMO) support in acute respiratory failure may be lifesaving, but bleeding and thromboembolic complications are common. The optimal anticoagulation strategy balancing these factors remains to be determined. This retrospective study compared two institutional anticoagulation management strategies focussing on oxygenator changes and both bleeding and thromboembolic events. We conducted a retrospective observational cohort study between 04/2015 and 02/2020 in two ECMO referral centres in Germany in patients receiving veno-venous (VV)-ECMO support for acute respiratory failure for | 24 h. One centre routinely applied low-dose heparinization aiming for a partial thromboplastin time (PTT) of 35-40 s and the other routinely used a high-dose therapeutic heparinization strategy aiming for an activated clotting time (ACT) of 140-180 s. We assessed number of and time to ECMO oxygenator changes, 15-day freedom from oxygenator change, major bleeding events, thromboembolic events
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 ...
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Management of thrombophlebitis: are the new anticoagulant drugs useful?. From time to time, I have to manage patients with thrombophlebitis. The most effective drug for this has been Fondaparinux (a synthetic low molecular weight heparin) which moderates symptoms if given daily for about 6 weeks. Alternatively, low molecular weight heparins may be used for the same duration. This strategy is supported by ACCP Guidelines and by a Cochrane review.. The problem is that these drugs can only be given by daily injections. Many patients are a little reluctant to agree to this regime. In the last decade, several of the newer oral anticoagulant drugs have been licensed for the prevention and treatment of venous thrombo-embolism. I have recommended these to my patients for some time in order to prevent DVT after varicose veins treatments in high risk patients. Published guidelines have not recommended any of this group of drugs for the treatment of thrombophlebitis since no clinical trial had been ...
TY - JOUR. T1 - Safety of Intramuscular Influenza Immunization Among Patients Receiving Long-term Warfarin Anticoagulation Therapy. AU - Raj, G.. AU - Kumar, R.. AU - McKinney, W. P.. PY - 1995/7/24. Y1 - 1995/7/24. N2 - Background: The effect of influenza vaccine on the prothrombin time (PT) among patients taking warfarin is unclear, as previous studies have shown conflicting results and the clinical significance of such a purported effect is uncertain. Moreover, to our knowledge, there are no data confirming the safety of intramuscular injections in patients receiving anticoagulant therapy with regard to possible local hematoma formation. We measured the effect of influenza vaccine on the PT among patients receiving long-term warfarin sodium therapy and evaluated the safety of intramuscular injections among them. Methods: Forty-one adult patients who were receiving anticoagulant therapy were given 0.5 mL of influenza vaccine intramuscularly. Prothrombin time and arm girth were measured at ...
Introduction: Warfarin reduces stroke risk in atrial fibrillation (AF), but increases bleed risk. Frequent testing with dose adjustment is needed to maintain INR levels in the therapeutic range of 2.0-3.0. Novel anticoagulants (NOACs) now challenge warfarin as stroke-preventive therapy for AF. They are available at fixed doses but costlier. Warfarin anticoagulation at a time in therapeutic range (TTR) ≥70% is similarly effective and safe as NOACs. It is unclear whether AF patients with TTR ≥70% will remain stably anticoagulated and avoid the need to switch to a NOAC. We assessed stability of warfarin anticoagulation in AF patients with an initial TTR ≥70% primarily managed by anticoagulation clinics.. Hypothesis: AF patients who achieve TTR ≥70% in the first 6 months of warfarin therapy will maintain high TTR subsequently.. Methods: Within the community-based ATRIA cohort of AF patients, we identified 2521 new warfarin users who continued warfarin therapy over 15 months. We excluded ...
Anticoagulation therapy is an important method of preventing stroke in individuals with atrial fibrillation (AF). Atrial fibrillation is a quivering or irregular heartbeat that can lead to blood clots, stroke, heart failure, and other heart-related complications. Clinical guidelines on AF consistently recommend long-term oral warfarin to treat valvular atrial fibrillation (VAF). However, due to varying risks of blood clots and stroke associated with different types of non-valvular atrial fibrillation NVAF, it is unclear whether direct oral anticoagulant (DOAC) can replace warfarin. Despite a recent increase in evidence on the effectiveness and the importance of anticoagulant therapy in preventing thromboembolic events associated with NVAF, clinical prevention strategies remain complex. Given the complexities associated with clinical use of anticoagulants for patients with NVAF, this review aims to offer guidance on patient anticoagulant use based on current available evidence.
TY - JOUR. T1 - Direct anticoagulant drugs to overcome limitations of vitamin K antagonists. A critical appraisal of data in atrial fibrillation patients. AU - Di Minno, Matteo Nicola Dario. AU - Russolillo, Anna. AU - Di Minno, Alessandro. AU - Camera, Marina. AU - Parolari, Alessandro. AU - Tremoli, Elena. PY - 2013/3. Y1 - 2013/3. N2 - Introduction: The usefulness of anticoagulation in patients with atrial fibrillation (AF) is well known. However, the inherent limitations of vitamin K antagonists (VKAs) have made the development of new oral anticoagulants necessary. Drugs directed against thrombin or the factor Xa are currently available. Areas covered: These molecules, being administered at fixed doses and not requiring laboratory monitoring, overcome one crucial problem associated with the use of VKAs. However, data about the bleeding risk related to the use of these molecules should be further analyzed. Expert opinion: The efficacy of direct anticoagulants (DACs) in AF-related stroke ...
Arterial hypertension (HTN) and atrial fibrillation often coexist and the combination of these two conditions carries an increased risk of stroke. HTN is one of the most important risk factors included in the scores for stoke prediction in atrial fibrillation used to assess the need of anticoagulation, and HTN has also been strictly related to bleeding complications of antithrombotic therapy. Antithrombotic drugs options include vitamin K antagonists, or new oral anticoagulants, recently approved for stroke prevention in nonvalvular atrial fibrillation. More favorable new oral anticoagulant efficacy and safety, compared with warfarin, have been reported in hypertensive patients, making these drugs a first-line choice in this population to prevent cerebrovascular events and reduce the risk of major bleedings. The aim of this review is to explore the relationship among HTN, atrial fibrillation and the risk of stroke and to summarize the evidence on the impact of HTN on the choice of the most ...
BACKGROUND: Four new oral anticoagulants compare favourably with warfarin for stroke prevention in patients with atrial fibrillation; however, the balance between efficacy and safety in subgroups needs better definition. We aimed to assess the relative benefit of new oral anticoagulants in key subgroups, and the effects on important secondary outcomes. METHODS: We searched Medline from Jan 1, 2009, to Nov 19, 2013, limiting searches to phase 3, randomised trials of patients with atrial fibrillation who were randomised to receive new oral anticoagulants or warfarin, and trials in which both efficacy and safety outcomes were reported. We did a prespecified meta-analysis of all 71 683 participants included in the RE-LY, ROCKET AF, ARISTOTLE, and ENGAGE AF-TIMI 48 trials. The main outcomes were stroke and systemic embolic events, ischaemic stroke, haemorrhagic stroke, all-cause mortality, myocardial infarction, major bleeding, intracranial haemorrhage, and gastrointestinal bleeding. We calculated relative
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Before we begin, heres a word on nomenclature. Early on, this next generation of oral anticoagulants was convincingly called NOACs (Novel Oral AntiCoagulants), but these drugs would not be novel forever. An Institute For Safe Medication Practices (ISMP) safety alert noted that NoAC was interpreted as no anticoagulation in a patient at high risk of stroke. The ISMP has designated NoAC a potentially dangerous abbreviation and discourages its use. The acronym DOAC for Direct-Acting Oral Anticoagulant provides a reasonably short, easily pronounced, accurately descriptive abbreviation that distinguishes the class from warfarin, which acts indirectly. Wewill use the term DOAC throughout this issue; but be aware that other acronyms (eg, TSOAC [target-specific oral anticoagulant]) are also found in the literature and may work their way into clinical practice. ...
Until recently, vitamin K antagonists were the only available oral anticoagulants, but with numerous limitations that prompted the introduction of new oral anticoagulants targeting the single coagulation enzymes thrombin (dabigatran) or factor Xa (apixaban, rivaroxaban, and edoxaban) and given in fixed doses without coagulation monitoring. Here we review the pharmacology and the results of clinical trials with these new agents in stroke prevention in atrial fibrillation and secondary prevention after acute coronary syndromes, providing perspectives on their future incorporation into clinical practice. In phase III trials in atrial fibrillation, compared with warfarin, dabigatran etexilate 150 mg B.I.D. reduced the rates of stroke/systemic embolism without any difference in major bleeding; dabigatran etexilate 110 mg B.I.D. had similar efficacy with decreased bleeding; apixaban 5 mg B.I.D. reduced stroke, systemic embolism, and mortality as well as major bleeding; and rivaroxaban 20 mg Q.D. was
BACKGROUND We explored the safety of intravenous thrombolysis (IVT) or intra-arterial treatment (IAT) in patients with ischemic stroke on non-vitamin K antagonist oral anticoagulants (NOACs, last intake ,48 hours) in comparison with patients (1) taking vitamin K antagonists (VKAs) or (2) without previous anticoagulation (no-OAC). METHODS AND RESULTS This is a multicenter cohort pilot study. Primary outcome measures were (1) occurrence of intracranial hemorrhage (ICH) in 3 categories: any ICH (ICHany), symptomatic ICH according to the criteria of the European Cooperative Acute Stroke Study II (ECASS-II) (sICHECASS-II) and the National Institute of Neurological Disorders and Stroke (NINDS) thrombolysis trial (sICHNINDS); and (2) death (at 3 months). Cohorts were compared by using propensity score matching. Our NOAC cohort comprised 78 patients treated with IVT/IAT and the comparison groups of 441 VKA patients and 8938 no-OAC patients. The median time from last NOAC intake to IVT/IAT was 13 hours ...
BACKGROUND: Most treatment of patients at risk for stroke is provided in the ambulatory setting. Although many studies have addressed the proportion of eligible patients with atrial fibrillation (AF) receiving warfarin sodium, few have addressed the quality of their anticoagulation management.
TY - JOUR. T1 - The Role of FEIBA in Reversing Novel Oral Anticoagulants in Intracerebral Hemorrhage. AU - Dibu, Jamil R.. AU - Weimer, Jonathan M.. AU - Ahrens, Christine. AU - Manno, Edward. AU - Frontera, Jennifer A.. PY - 2016/6/1. Y1 - 2016/6/1. N2 - Background: Activated prothrombin complex concentrates factor eight inhibitor bypassing activity (FEIBA) has been recommended for reversing novel oral anticoagulants (NOAC) in the context of intracerebral hemorrhage (ICH), though few clinical studies report its use. Methods: A prospective study of patients with spontaneous ICH was conducted from May 2013 to May 2015. Hospital complications including hemorrhage (gastrointestinal bleeding, anemia requiring transfusion, and surgical site bleeding) and thrombosis (pulmonary embolus, deep vein thrombosis, ischemic stroke, and myocardial infarction) were recorded. All ICH patients underwent baseline head CT and a follow-up stability scan in 6 h. NOAC taken within 48 h of presentation was reversed ...
Background: Patients on long term warfarin treatment can have cerebral ischemic events despite therapeutic levels. We sought to determine unique patient attributes that result in ischemic events on therapeutic warfarin treatment.. Methods: We reviewed the medical records and imaging data of consecutive patients with cerebral ischemic events who were on long term warfarin treatment over a 4 year period. We stratified the patients based on international normalized ratio (2.0-3.0 versus ,2.0) and compared the demographic and clinical characteristics between the two groups of patients.. Results: A total of 163 patients (mean age±SD; 77.3 ± 11.2) on long term warfarin treatment were admitted with cerebral ischemic events (97 ischemic strokes and 40 transient ischemic attacks). The mean age was not different between patients who were sub therapeutic and therapeutic on warfarin (78.2 ±11.6 versus 77.5±10.5, p=0.7). The proportion of patients with hypertension (87.2% versus 84.0%, p=0.6), diabetes ...
Novel Oral Anticoagulants: Comparative Pharmacology and Dental Implications Novel oral anticoagulants (NOACs), direct thrombin inhibitor (dabigatran) and factor Xa inhib..
BACKGROUND: Evidence is conflicting as to the efficacy of direct oral anticoagulation (DOAC) and vitamin K antagonist (VKA) for prevention of myocardial infarction (MI).. OBJECTIVES: This study aimed to investigate the risk of MI associated with the use of apixaban, dabigatran, rivaroxaban, and VKA in patients with atrial fibrillation.. METHODS: Patients with atrial fibrillation were identified using Danish health care registers and stratified by initial oral anticoagulant treatment. Standardized absolute 1-year risks were estimated based on Cox regression for hazard rates of MI hospitalizations and mortality. Reported were absolute risks separately for the oral anticoagulation treatments and standardized to the characteristics of the study population.. RESULTS: Of the 31,739 patients included (median age, 74 years; 47% females), the standardized 1-year risk of MI for VKA was 1.6% (95% confidence interval [CI]: 1.3 to 1.8), apixaban was 1.2% (95% CI: 0.9 to 1.4), dabigatran was 1.2% (95% CI: 1.0 ...
TY - JOUR. T1 - Spontaneous breast hematoma as a complication of anticoagulation therapy requiring angiography and embolization. AU - Dunlap, Robert. AU - Kisner, Carson. AU - Georgiades, Christos S.. AU - Demmert, Andrew. AU - Lyons, Gray R.. PY - 2021/1. Y1 - 2021/1. N2 - Spontaneous breast hematoma is a rare complication of therapeutic anticoagulation therapy with few cases reported in the literature. We present a case of spontaneous breast hematoma resulting in hypotension and symptomatic anemia. Angiography demonstrated multiple sites of hemorrhage within the breast, which was treated with gelatin sponge embolization. This case highlights the role of interventional radiology in the treatment of breast hematoma, as well as reviews the arterial vascular anatomy of the breast.. AB - Spontaneous breast hematoma is a rare complication of therapeutic anticoagulation therapy with few cases reported in the literature. We present a case of spontaneous breast hematoma resulting in hypotension and ...
A retrospective cohort study of oral anticoagulant treatment in patients with acute coronary syndrome and atrial fibrillation ...
According to a recent study that was conducted by researchers at the Department of Clinical Epidemiology at Aarhus University Hospital in Arhus, Denmark, AF patients who suffer from strokes and are taking anticoagulant medications experienced less severe strokes. The study also showed that those patients experienced shorter hospital stays and lower 30-day mortality rates compared to patients that werent taking anticoagulants.. Dr. Sren Johnsen, MD, PhD, from the Department of Clinical Epidemiology at Aarhus University Hospital in Aarhus, Denmark, stated that while AF continues to be a major risk factor for patients suffering from strokes, anticoagulant medications seems to provide the patients with an effective prophylaxis to prevent the strokes. The results of this study were presented at the 8th World Stroke Congress (WSC).. Strokes continue to be a concern for patients with atrial fibrillation. AF is generally treated with prescription anticoagulant drugs like Multaq. While Multaq is an ...
With regards to route of administration, drug interactions and predictability of bioactivity, the new oral anticoagulants (NOACs; direct factor Xa and IIa inhibitors) offer significant advantages over heparins and warfarin therapies. However, concern over serious bleeding, emergency procedures and potential over-dosage is heightened with the current lack of a specific reversal agent. PER977 is a synthetic small molecule rationally designed anticoagulant antidote. Reversal of anticoagulation induced bleeding was demonstrated in a rat tail transection model: weight-matched rats were overdosed with rivaroxaban, edoxaban, dabigatran, or apixaban, resulting in large increases in blood loss volume. PER977 was administered IV and after thirty minutes, blood loss volume was quantified. PER977 significantly decreased bleeding in vivo in rats treated with NOAC (Figure 1a). PT (for edoxaban, rivaroxaban, and apixaban) or aPTT (for dabigatran) and thromboelastography (TEG) (TEG- for edoxaban, Figure 1b) ...
Aguirre, J; Borgeat, A (2013). Drugs for thromboprophylaxis: unfractionated heparin, low molecular weight heparin warfarin, and fondaparinux. In: Llau, Juan. Thromboembolism in Orthopedic Surgery. London: Springer, 53-65. ...
Anticoagulation is not perfect. Among patients receiving low molecular weight heparin for venous thromboembolism, approximately 5% will have a recurrence while still on Coumadin. This was repeated in a second study where 355 patients with first venous thromboembolism received unfractionated heparin that was bridged to coumadin. Most patients were treated for 3 months and recurrent event rate during that time was 4.9%. Risk factors for coumadin failure include cancer, antiphospholipid antibody syndrome and idiopathic as opposed to provoked venous thromboembolism. From a practical standpoint, coumadin failure is most commonly encountered when there is difficulty managing the INR or when patients are not compliant with the medication. This may be even worse with novel anticoagulants. As novel anticoagulants need to be taken every day or twice a day missing a dose may result in anticoagulation failure.. A study published in Thrombosis and Haemostasis in 2013 examined the long-term outcomes of ...
Anticoagulant use in the Queen Elizabeth II Health Sciences Centre is widespread, spanning both medical and surgical disciplines.. Anticoagulant therapy requires monitoring for optimal effect and is associated with a high frequency of complications. In addition, novel antithrombotic agents are becoming widely available, which increases the cost and complexity of anticoagulant therapy.. As a result, a Thrombosis Anticoagulation Program was designed and developed to assist and facilitate effective anticoagulation therapy at the QEII Health Sciences Centre. ...
3.0), consistent with heightened bleeding risk. Physicians periodically assess INR, a globally adopted value that represents the time for blood to clot, with blood tests in patients taking warfarin to monitor and make adjustments to dosing.. Other research has highlighted the difficulty of achieving optimal anticoagulation control using warfarin, but in smaller populations typically treated by hospitals and other specialty settings, said study investigator Harvey W. Kaufman, M.D., senior medical director, Quest Diagnostics. The diagnostic insights derived from our study are unique and important because they reveal the magnitude of the challenges of warfarin therapy in a very large, nationally representative population primarily under treatment by non-hospital community practices, which administer the majority of anticoagulation therapy in the U.S. Afib is a cardiac condition affecting an estimated 2.2 million Americans that can cause blood clots, increasing the risk of strokes and other ...
Disabled Accessibility Guide for Anticoagulant Clinic in Manchester University NHS Foundation Trust providing accessible disability and wheelchair friendly information
Acute venous thromboembolism (deep vein thrombosis [DVT] or pulmonary embolism) is a common disorder with an annual incidence of approximately 1 or 2 cases per 1000 persons in the general population. Standard treatment is limited by the need for parenteral heparin initially, with overlapping administration of a vitamin K antagonist. This presents a challenge to outpatient management, since treatment with a vitamin K antagonist requires laboratory monitoring and dose adjustment and may be complicated by drug and food interactions. After the first year, the annual risk of major bleeding associated with vitamin K antagonists is 1 to 2% and the benefits of continued therapy remains a subject of debate. Rivaroxaban, an orally active, direct factor Xa inhibitor, does not require laboratory monitoring and in RCTs, as a single agent, is as effective as standard therapy, with similar safety, for the treatment of acute venous thromboembolism. Rivaroxaban furthermore has an acceptable risk of bleeding when ...
An 83 year old woman is brought to the emergency department by her care giver who noticed her altered mental status following two episodes of passing black faeces. The woman has a history of ischaemic stroke associated with atrial fibrillation and hypertension and is on dabigatran for stroke prevention. She took her last dose a few hours ago. Computed tomography of the head shows no acute intracranial abnormalities. Abdominal and rectal exams are normal. Her blood pressure is 82/56 mm Hg. The multidisciplinary team in charge of her care arrives to talk with her and her family about antidotes for reversing her anticoagulation.. Direct oral anticoagulants (DOACs) are a relatively new class of oral anticoagulants developed as alternatives to vitamin K antagonists such as warfarin, and are indicated in non-valvular atrial fibrillation and venous thromboembolism (Box 1). ...
Warfarin sodium tablets, USP are contraindicated in women who are pregnant except in pregnant women with mechanical heart valves, who are at high risk of thromboembolism, and for whom the benefits of warfarin sodium may outweigh the risks [see Warnings and Precautions (5.7)]. Warfarin sodium can cause fetal harm. Exposure to warfarin during the first trimester of pregnancy caused a pattern of congenital malformations in about 5% of exposed offspring. Because these data were not collected in adequate and well-controlled studies, this incidence of major birth defects is not an adequate basis for comparison to the estimated incidences in the control group or the U.S. general population and may not reflect the incidences observed in practice. Consider the benefits and risks of warfarin sodium and possible risks to the fetus when prescribing warfarin sodium to a pregnant woman. Adverse outcomes in pregnancy occur regardless of the health of the mother or the use of medications. The estimated ...
TY - JOUR. T1 - Direct Oral Anticoagulants in Chronic Liver Disease. AU - Steuber, Taylor D.. AU - Howard, Meredith L.. AU - Nisly, Sarah A.. PY - 2019/10/1. Y1 - 2019/10/1. N2 - Objective: To review the use of direct oral anticoagulants (DOACs) in patients with chronic liver disease (CLD). Data Sources: A MEDLINE literature search was performed from 1964 through February 2019 using the following search terms: cirrhosis, chronic liver disease, direct oral anticoagulant, and the individual DOACs. Study Selection and Data Extraction: All English-language human trials and reports that examined DOACs for treatment or prevention of venous thromboembolic (VTE) events in patients with CLD were included. Data Synthesis: A total of 6 clinical trials examining the use of DOACs in patients with CLD were identified. All DOACs have been utilized in patients with CLD, with the exception of betrixaban, for prevention of stroke in atrial fibrillation or treatment of VTE (except for treatment of pulmonary ...
This study examined patient characteristics and persistence rates of patients with NVAF newly initiated on OACs between 1 October 2012 and 31 December 2014 in the real-world setting of routine UK clinical practice. Patients newly initiated on OACs in the study period had, overall, a high baseline risk of stroke and bleeding, which varied depending on which OAC was prescribed and whether they were new to therapy. Despite early patterns of persistence changing over time since OAC initiation, comparatively, patients prescribed apixaban showed improved persistence over rivaroxaban, dabigatran and VKAs.. This study provides real-world evidence on the early persistence of apixaban and other OACs in people with NVAF and is the first to provide real-world evidence on the comparative persistence of apixaban in NVAF in the UK.. There are several strengths to this study. The database we have used is a comprehensive, well-validated primary care database from the UK which captures a large population of ...
You should finish with your doctor or primary if you are not sure. The tablet should be bad warfarin cancer treatment water. The ceremonial doses of Loratadine 10 mg Tablets are as has: Adults and warfarin cancers treatment over 12 10mg a. Puppy Adult Dose for Allergic Solon. 1 tablet (5 mg mg) ibid twice a day -or- 1 case (10 mg mg) orally once daily. Suppressive Adult Dose for Nasal Congestion. Oncology patients have a higher rate of VTE recurrences during oral anticoagulant therapy with VKAs and a higher anticoagulation-associated hemorrhagic risk as compared with noncancer patients. Warfarin therapy interacts with many chemotherapy agents, and INR control is difficult to achieve in cancer ‎Cancer and Thrombosis · ‎Treatment of Thrombosis in · ‎Novel Oral Anticoagulants. The association between cancer and venous thromboembolism (VTE) is well established. Importantly, VTE is a significant cause of mortality in cancer patients. Although long-term warfarin (Coumadin(trade mark); ...
Managing patients on oral anticoagulation treatment is time consuming for the primary care provider. The frequent blood testing is disruptive to patients daily lives. Despite considerable time and effort, studies confirm that patients are often outside their prescribed INR range.1, 2 Because of the difficulties of the treatment, many patients who need anticoagulation are not treated.. The search for better methods for managing anticoagulation includes the use of computer decision support by physicians, nurses, or patients to reduce time and costs. The use of such software provides an algorithm, reduces disparities among providers in decision making, and increases adherence with care standards.3 The potential also exists for enhancing pattern recognition in individual patients, which could assist in the detection of interfering drugs or foods.. The study by Fitzmaurice et al is 1 of several that have attempted to verify reduced costs and increased effectiveness of oral anticoagulation treatment ...
Maintaining oral anticoagulation with vitamin K antagonists remains one of the more challenging aspects of medicine. To meet this challenge, the use of both anticoagulation clinics and point-of-care monitors by providers has clearly improved anticoagulation control. Just as diabetic patients have learned that self-monitoring can improve control of their disease, patients undergoing anticoagulation and their providers have learned that self-monitoring using point-of-care prothrombin time devices can improve anticoagulation control (1). Well over 100 000 Europeans and an increasing number of Americans are self-monitoring their oral anticoagulation. Heneghan and colleagues reviewed 14 RCTs of self-monitoring compared with care provided by anticoagulation clinics or the patients primary care physician. Self-monitoring resulted in increased time of INR in the therapeutic range, fewer bleeding and thromboembolic events, and lower mortality. Fewer complications occurred whether patients self-tested ...
Many drugs interact with coumadin and may cause more anticoagulation effect (clofibrate, diazoxide, ethacrynic acid, nalidixic acid, phenylbutazone, salicylates, aspirin, sulfonamides, alcohol, allopurinol, amiodarone, cimetidind, phenytoin, erythromycin, gemfibrozil, propranolol, thyroid drugs) or decreased anticoagulation effect (smoking, estrogens, vitamin K, aluminum hydroxide - antacids, cholestipol, spironolactone). The effects of coumadin must be carefully monitored by a blood test called an INR. Usually this is checked more often at the onset of taking the drug and less often once a steady state has been reached. Therapeutic INR is usually 2 to 3 depending on the condition being treated.. There are naturally occurring substances and foods that reduce platelet aggregation and act as natural blood thinners. In some circumstances the use of a prescription anticoagulant may not be necessary when using these. However, when on a prescription anticaoagulant, caution should be maintained ...
Monitoring IV anticoagulant therapy by the APTT ratio is compromised due to the effects of the lupus anticoagulant and in these ... Lupus anticoagulant[edit]. This is tested for by using a minimum of two coagulation tests that are phospholipid-sensitive, due ... The lupus anticoagulant will inhibit all the contact activation pathway factors (factor VIII, factor IX, factor XI and factor ... Lupus anticoagulant (LAC) antibodies bind to prothrombin, thus increasing its cleavage to thrombin, its active form. ...
Anticoagulants[edit]. Anticoagulation can be used to reduce the risk of stroke from AF. Anticoagulation is recommended in most ... Determining the risk of an embolism causing a stroke is important for guiding the use of anticoagulants. The most accurate ... Coagulation studies (INR/aPTT) are usually performed, as anticoagulant medication may be commenced.[21] ... Warfarin is the recommended anticoagulant choice for persons with valvular atrial fibrillation (atrial fibrillation in the ...
Oxalate is an anticoagulant.. *Light blue: sodium citrate. Citrate is a reversible anticoagulant, and these tubes are used for ... Containers containing anticoagulants[edit]. *Green: sodium heparin or lithium heparin used for plasma determinations in ... The additives may include anticoagulants (EDTA, sodium citrate, heparin) or a gel with density between those of blood cells and ... This is a strong anticoagulant and these tubes are usually used for complete blood counts (CBC). Lavender top tubes are ...
Anticoagulants[edit]. According to expert opinion, for those who are already on anticoagulants, the international normalized ... Anticoagulants should be resumed as soon as possible for those with high cardiovascular risk because although risk of ... and anticoagulants. The gastric mucosa protects itself from gastric acid with a layer of mucus, the secretion of which is ... Direct oral anticoagulants (DOAC) are recommended instead of warfarin as they are more effective in preventing thromboembolism ...
Medicació anticoagulant[modifica]. Els anticoagulants orals com warfarina han estat el pilar de la prevenció dels atacs de ... Algra A; Halkes, PH; Van Gijn, J [et al] «Medium intensity oral anticoagulants versus aspirin after cerebral ischaemia of ... 4,0 4,1 Ressenya de prescripció pràctica NPS 44: Antiagregants plaquetaris i anticoagulants en la prevenció de l'atac de ... Els Anticoagulants orals no es recomanen per a la prevenció d'atac de feridura -qualsevol benefici és compensat pel risc ...
Anticoagulants. Vitamin K antagonists. (inhibit II, VII, IX, X). *Coumarins: Acenocoumarol. *Coumatetralyl ...
Recent administration (within 7 days) of oral anticoagulants or GP IIb/IIIa inhibitors ... but efforts continue to isolate activated protein C mutants that lack anticoagulant properties for potential therapeutic use.[ ...
... is sometimes used in veterinary medicine as an anticoagulant or to relieve pain associated with musculoskeletal ...
... (trade name Nimelan), also known as N-allylnormorphine dinicotinate, dinicotinoylnalorphine, or niconalorphine, is a semisynthetic, mixed opioid agonist-antagonist which is described as a narcotic antagonist but may produce limited analgesia and sedation at higher doses in opioid naive patients (with limited euphoria and dependence liability).[1][2] It is the 3,6-dinicotinate ester of nalorphine, and is therefore the nalorphine analogue of nicomorphine (which is the 3,6-dinicotinate ester of morphine). As nalorphine dinicotinate is only regulated at the Rx (prescription required) drug, it would be legal to possess with a valid prescription should a patient manage to acquire it.[citation needed] ...
Intravenous and oral formulations of acetylcysteine are available for the treatment of paracetamol (acetaminophen) overdose.[13] When paracetamol is taken in large quantities, a minor metabolite called N-acetyl-p-benzoquinone imine (NAPQI) accumulates within the body. It is normally conjugated by glutathione, but when taken in excess, the body's glutathione reserves are not sufficient to deactivate the toxic NAPQI. This metabolite is then free to react with key hepatic enzymes, thereby damaging liver cells. This may lead to severe liver damage and even death by acute liver failure. In the treatment of acetaminophen overdose, acetylcysteine acts to maintain or replenish depleted glutathione reserves in the liver and enhance non-toxic metabolism of acetaminophen.[14] These actions serve to protect liver cells from NAPQI toxicity. It is most effective in preventing or lessening hepatic injury when administered within 8-10 hours after overdose.[14] Research suggests that the rate of liver toxicity ...
The action of this class of anticoagulants may be reversed by administering vitamin K for the duration of the anticoagulant's ... The label in Dutch states, in part: Contains an anticoagulant with prolonged activity. Antidote Vitamin K1. ... They are used as anticoagulant medications in the prevention of thrombosis, and in pest control, as rodenticides. ... Anisindione, fluindione, and phenindione are oral anticoagulant medicines with actions similar to warfarin. However, the ...
An opioid antagonist, or opioid receptor antagonist, is a receptor antagonist that acts on one or more of the opioid receptors. Naloxone and naltrexone are commonly used opioid antagonist drugs which are competitive antagonists that bind to the opioid receptors with higher affinity than agonists but do not activate the receptors. This effectively blocks the receptor, preventing the body from responding to opioids and endorphins. Some opioid antagonists are not pure antagonists but do produce some weak opioid partial agonist effects, and can produce analgesic effects when administered in high doses to opioid-naive individuals. Examples of such compounds include nalorphine and levallorphan. However, the analgesic effects from these specific drugs are limited and tend to be accompanied by dysphoria, most likely due to additional agonist action at the κ-opioid receptor. As they induce opioid withdrawal effects in people who are taking, or have recently used, opioid full agonists, these drugs are ...
Anticoagulants: Coadministration may prolong prothrombin time.. *Aspirin: Fenoprofen Cl may be increased; coadministration is ...
It is an anticoagulant for blood samples for CBC/FBEs, where the EDTA chelates the calcium present in the blood specimen, ... Banfi, G; Salvagno, G. L; Lippi, G (2007). "The role of ethylenediamine tetraacetic acid (EDTA) as in vitro anticoagulant for ...
Anticoagulants. Vitamin K antagonists. (inhibit II, VII, IX, X). *Coumarins: Acenocoumarol. *Coumatetralyl ...
Interactions: Oral anticoagulants; rifampin. [...] U.S. Treatments: Conjugated estrogens are commonly prescribed for menopausal ...
Anticoagulants (blood thinners). Lofepramine may inhibit the metabolism of certain anticoagulants leading to a potentially ...
Anticoagulants (e.g. Warfarin, Coumadin) or clopidogrel (Plavix) are often additionally prescribed following formation of a ...
... and other anticoagulants. These compounds in their saliva are especially effective on birds. Birds are their preferred prey ...
Arora N, Goldhaber SZ (2006). "Anticoagulants and transaminase elevation". Circulation. 113 (15): e698-702. doi:10.1161/ ...
Prior to the introduction of direct factor Xa inhibitors, warfarin was the only oral anticoagulant for over 60 years, and ... Direct factor Xa inhibitors (xabans) are anticoagulants (blood thinning drugs), used to both treat and prevent blood clots in ... Andexanet alfa, a specific antidote to reverse the anticoagulant activity of direct Xa inhibitors in the event of major ... Chen, Ashley; Stecker, Eric; Warden, Bruce A. (7 July 2020). "Direct Oral Anticoagulant Use: A Practical Guide to Common ...
Daly AK, King BP (May 2003). "Pharmacogenetics of oral anticoagulants". Pharmacogenetics. 13 (5): 247-52. doi:10.1097/00008571- ...
Anticoagulants have been used. Low-dose aspirin has been used as an antiplatelet drug. Treatment strategies are being ...
... , sold under the brand name Coumadin among others,[1] is a medication that is used as an anticoagulant (blood thinner). ... Alternative anticoagulantsEdit. In some countries, other coumarins are used instead of warfarin, such as acenocoumarol and ... Several types of anticoagulant drugs offering the efficacy of warfarin without a need for monitoring, such as dabigatran, ... S-warfarin is 2-5 times more potent than the R-isomer in producing an anticoagulant response.[14] Both the enantiomers of ...
AnticoagulantsEdit. Main articles: Antiplatelet drug and Anticoagulant. Anticoagulants and anti-platelet agents are amongst the ... Of the anticoagulants, warfarin (and related coumarins) and heparin are the most commonly used. Warfarin affects the vitamin K- ... Protein C is a major physiological anticoagulant. It is a vitamin K-dependent serine protease enzyme that is activated by ... PT results are often reported as ratio (INR value) to monitor dosing of oral anticoagulants such as warfarin. ...
AnticoagulantsEdit. Main articles: Antiplatelet drug and Anticoagulant. Anticoagulants and anti-platelet agents are amongst the ... Of the anticoagulants, warfarin (and related coumarins) and heparin are the most commonly used. Warfarin affects the vitamin K- ... Soff GA (March 2012). "A new generation of oral direct anticoagulants". Arteriosclerosis, Thrombosis, and Vascular Biology. 32 ... Protein C is a major physiological anticoagulant. It is a vitamin K-dependent serine protease enzyme that is activated by ...
... (trade name Bevyxxa) is an oral anticoagulant drug which acts as a direct factor Xa inhibitor. Betrixaban is FDA ... Sobieraj-Teague, M.; O'donnell, M.; Eikelboom, J. (2009). "New Anticoagulants for Atrial Fibrillation". Seminars in Thrombosis ...
Anticoagulants Anticoagulants exhibit variable interactions; monitoring coagulation indices is recommended to achieve the ...
"New parenteral anticoagulants in development". Therapeutic Advances in Cardiovascular Disease. 5 (1): 33-59. doi:10.1177/ ...
She's Being Treated with Anticoagulants." The Seattle Times. December 31, 2012. Retrieved August 30, 2016, from HighBeam ...
Anticoagulants and antiplatelet drugs are a type of medication that is used to eliminate or reduce the risk of blood clots by ... Anticoagulant and Antiplatelet Drugs. Medically reviewed by Aleah Rodriguez, PharmD - Written by Tricia Kinman - Updated on ... Anticoagulants and antiplatelet drugs eliminate or reduce the risk of blood clots. Theyre often called blood thinners, but ... Both antiplatelets and anticoagulants work to prevent clots in your blood vessels, but they work in different ways. ...
Anticoagulant and antiplatelet drugs are blood thinners. They reduce risk of heart attacks and help keep blood clots from ... Anticoagulants and Drug-Food Interactions (National Jewish Health) * Blood Thinner Pills: Your Guide to Using Them Safely ( ... What Are Anticoagulants and Antiplatelet Agents? (American Heart Association) - PDF * What You Need to Know When Taking ... Anticoagulants (National Institutes of Health) * Heparin (National Institutes of Health ...
... anticoagulant drug, anticoagulant agent (en); مميع دم, Anticoagulant, مضادات تخثر (ar); противзасирувач, антикоагуланс, ... anticoagulant (fr); Anticoagulant (ro); Antikoagulant (et); 抗凝劑 (zh-hk); anticoagulante (pt); Антикоагулянты (ru); ... anticoagulant chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. ... Media in category "Anticoagulants". The following 47 files are in this category, out of 47 total. ...
... mandate usage of anticoagulants to facilitate a successful and safe procedure. This chapter reviews commonly used anticoagulant ... 9.3 Classes of Anticoagulant. Several classes of anticoagulant regimens are available. Each of these is discussed in detail ... As a rule of thumb, if a patient has been on therapy, then a "booster" dose of the anticoagulant is recommended. On the other ... The most widely used test to measure the anticoagulant effect of high doses of heparin (levels at which the aPTT would be " ...
Takeyama E, et al. Oesophageal submucosal hematoma after flow diverter embolization with favourable outcome treated by discontinuing postoperative antiplatelet therapy for only three days: a case report. JA Clinical Reports 5: 2, No. 1, Dec 2019. Available from: URL: -JapanCrossRefGoogle Scholar ...
Anticoagulants in Myocardial Infarction. Br Med J 1953; 1 doi: (Published 16 May 1953 ...
Renal profiles of anticoagulants.. Harder S1.. Author information. 1. University Hospital, Frankfurt am Main, Germany. [email protected] ... Anticoagulants are widely used to prevent and treat venous thromboembolism, prevent stroke in atrial fibrillation, and manage ... Renal impairment is a risk factor for bleeding and thrombosis during anticoagulant therapy and can influence the balance ... Additional data on the safety of chronic dosing of the newer oral anticoagulants in renal impairment are awaited. ...
Anticoagulants in Coronary Thrombosis. Br Med J 1947; 2 doi: (Published 06 December ...
Anticoagulants achieve their effect by suppressing the synthesis or function of various clotting factors that are normally ... Anticoagulant, any drug that, when added to blood, prevents it from clotting. ... Anticoagulants are also used in drawing and storing blood.. Anticoagulants generally are of two types: heparin, which is given ... Anticoagulant, any drug that, when added to blood, prevents it from clotting. Anticoagulants achieve their effect by ...
Classification of anti-coagulants  ::  Classification of anti-coagulants  : IN - VIVO DRUGS : PARENTERAL ANTICOAGULANTS: ... Oral anticoagulants :  Oral anticoagulants  Here, we are focusing mainly on WARFARIN………………………. 1. M.O.A OF WARFARIN :: 1. M. ... ANTI-COAGULANTS : A BRIEF OUTLOOK: ANTI-COAGULANTS : A BRIEF OUTLOOK PRESENTED BY: VISHNU.R.NAIR PHARM-D THIRD YEAR NATIONAL ... DEFINITION OF ANTICOAGULANTS  ::  DEFINITION OF ANTICOAGULANTS  : " Drugs, that are used to reduce the COAGULABILITY ( ...
I will be retested for lupus anticoagulant in a few months. Ive been on eliquis since it happened, and Im worried that if I do ... After having a pe, I will be retested for lupus anticoagulant in a few months. Ive been on eliquis since it happened, and Im ... When I was still on Eliquis, I asked my hematologist what would happen if my lupus anticoagulant test came back positive, and ... I asked her why, and she said that all the newest studies are trending toward the newer anticoagulants - even under those ...
New Anticoagulants. The new parenteral and oral anticoagulants are discussed separately. With each agent, the pharmacology is ... Classification of established anticoagulants and new anticoagulants that were recently licensed for use or are in advanced ... New Parenteral Anticoagulants. The pharmacological characteristics of the new parenteral anticoagulants that are in advanced ... Potential Advantages of New Anticoagulants. Although the need for new parenteral anticoagulants is less pressing than that for ...
Cautions about anticoagulants. Cautions for anticoagulants include the following:. *Anticoagulants increase the risk of ... This is not a complete list of anticoagulants.. How do anticoagulants work?. Anticoagulants prevent blood clots from forming in ... Why are anticoagulants used?. Anticoagulants are used to treat and prevent problems caused by blood clots. These problems ... What are some examples of anticoagulants?. Here are some examples of anticoagulants. For each item in the list, the generic ...
Cite this: New EHRA Practical Guide on Novel Oral Anticoagulants - Medscape - Mar 29, 2018. ... practical guide on non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) aims to help ...
The authors caution against using an NSAID with oral anticoagulants in patients with atrial fibrillation after finding an ... "This study shows that both with warfarin and the newer anticoagulant dabigatran, you get more bleeding, but you can also get ... "In this post hoc analysis of the RE-LY study, we found that concomitant NSAID use with any anticoagulant increases extracranial ... "This is a very common scenario, because anticoagulants are taken by patients who have AF and those patients are typically ...
Novel oral anticoagulants for heparin-induced thrombocytopenia. J Thromb Thrombolysis. 2016 Aug. 42 (2):172-8. [Medline]. ... Direct-acting oral anticoagulants as emerging treatment options for heparin-induced thrombocytopenia. Ann Pharmacother. 2015 ... Kunk PR, Brown J, McShane M, Palkimas S, Gail Macik B. Direct oral anticoagulants in hypercoagulable states. J Thromb ... Fondaparinux is a synthetic anticoagulant that works by inhibiting factor Xa, a key component involved in blood clotting. It ...
Anticoagulants What is the deal with clots…? Anticoagulation therapy is used a in a number of different types of patients. The ... Anticoagulants. Brand/Generic Drug Names. ardeparin, Lovenox/enoxaparin, heparin, lepirudin, Coumadin/warfarin Common uses. ... Anticoagulants What is the deal with clots…? Anticoagulation therapy is used a in a number of different types of patients. The ... Anticoagulants are medications that prevent the coagulation, or clotting, of blood. Normally, coagulation is a good thing, ...
Significantly, this drug is used as an anticoagulant in humans. So epidemiological data could reveal a protective effect ... Far-fetched? Luigi Bergamaschini and colleagues have already demonstrated that anticoagulants such as heparin can attenuate the ...
Anticoagulants. Class Summary. Controlled therapeutic inhibition of blood clotting by means of appropriate drugs (ie, ... anticoagulants) is indicated for prevention of ischemic stroke in patients with risk factors for thromboembolism, such as ...
Anti Coagulants and AF. deleted_user 10/12/2007. I have just been diagnosed with AF at age 51. I am taking beta bockers but ...
Oral anticoagulants (OACs) are taken by many people in pill or tablet form, and various intravenous anticoagulant dosage forms ... Common anticoagulants include warfarin and heparin. The use of anticoagulants is a decision based upon the risks and benefits ... Anticoagulants are often used to treat acute deep vein thrombosis. People using anticoagulants to treat this condition should ... "Novel anticoagulants". Heart Matters Magazine. British Heart Foundation. Clark NP (November 2018). "Role of the anticoagulant ...
Acting as an anticoagulant. an′ti·co·ag′u·la′tive adj. adj acting to prevent or impair... ... anticoagulant. (redirected from Anti-coagulants). Also found in: Thesaurus, Medical, Encyclopedia. an·ti·co·ag·u·lant. (ăn′tē- ... anticoagulant medication, decoagulant. dicoumarol, dicumarol - an anticoagulant drug that has now been largely replaced by ... Anti-coagulants - definition of Anti-coagulants by The Free Dictionary ...
Novel oral anticoagulants heading for the clinic wont entirely eliminate the food, drug, and supplement interactions that have ... Novel oral anticoagulants heading for the clinic wont entirely eliminate the food, drug, and supplement interactions that have ... Source Reference: Walenga JM, Adiguzel C "Drug and dietary interactions of the new and emerging oral anticoagulants" Int J Clin ... Source Reference: Wrigley J, et al "Novel oral anticoagulants: the potential relegation of vitamin K antagonists in clinical ...
Direct oral anticoagulants are characterized by rapid onset of action and short half-lives2. Depending on the anticoagulant, ... Direct oral anticoagulants variably affect standard clot-based assays. *Idarucizumab has recently been approved by the US Food ... Direct oral anticoagulants and the bleeding patient. Brendan Wood, Michelle Sholzberg and Alun Ackery ... Direct oral anticoagulants variably affect standard clot-based assays. All three drugs cause variable test results. This may ...
"In the last 20 years it has become evident that the use of oral anticoagulants in patients with atrial fibrillation was ... "Our study shows that very old and frail patients with atrial fibrillation clearly benefit from the old oral anticoagulants ... "The clinical dilemma faced by physicians and patients is anticoagulant-related hemorrhage, which also increases with age." ... a condition which may make them unsuitable for newer oral anticoagulants that are often metabolized in the kidneys, Poli noted ...
Anticoagulant definition is - a substance that hinders the clotting of blood : blood thinner. How to use anticoagulant in a ... Share anticoagulant Post the Definition of anticoagulant to Facebook Share the Definition of anticoagulant on Twitter ... Encyclopedia article about anticoagulant. Comments on anticoagulant What made you want to look up anticoagulant ... Dictionary Entries near anticoagulant. anticlotting anticly antic masque anticoagulant anticodon anticoincidence anticold ...
This is accomplished with taking anticoagulant drugs or blood thinners. Decreasing stroke risk. Anticoagulants have been ... But the anticoagulant effect of warfarin must be carefully monitored with periodic blood tests. If the effect is too small, it ... Those who do not use anticoagulants are largely unprotected from the high risk of life-altering strokes, even if they take ... It is important to understand, however, that most of the bleeding associated with anticoagulants is not life-threatening; in ...
... when lupus anticoagulant testing is ordered, and what the results of lupus anticoagulant testing might mean ... Lupus anticoagulant testing is a series of tests used to detect lupus anticoagulant (LA) in the blood. LA is an autoantibody ... anticoagulation therapy may have false-positive results for lupus anticoagulant. Warfarin (COUMADIN®) anticoagulant therapy may ... moderate to severe thrombocytopenia may develop in patients receiving anticoagulant (heparin) therapy for lupus anticoagulant- ...
New Anticoagulants for AF Results of a new meta-analysis indicate that for patients with atrial fibrilation, treatment with one ... Anticoagulant dosing in obesity should be individualized and drug-specific. July 15, 2013By Katie S. Buehler PharmD BCPS, ... New oral anticoagulants increase risk for GI bleeding. July 25, 2013By Christine Blank ... Anticoagulant use predicts survival in metastatic prostate cancer. May 01, 2013By Alice Goodman ...
Both words in the term "lupus anticoagulant" can be misleading: Most patients with a lupus anticoagulant do not actually have ... lupus anticoagulant and a history of thrombosis should be considered candidates for indefinite treatment with anticoagulants. ... Testing for lupus anticoagulant can also be indicated by a prolonged aPTT test that is unexplained. An aPTT is generally ... The term "anticoagulant" accurately describes its function in vitro. However in vivo, it functions as a procoagulant. The main ...
  • Anticoagulants such as heparin or warfarin (also called Coumadin) slow down your body's process of making clots. (
  • Some of the more established anticoagulants, such as the low-molecular-weight heparins, warfarin, and fondaparinux, are contraindicated for use in patients with severe renal impairment. (
  • Warfarin , a coumarin derivative and the most commonly used oral anticoagulant, is rapidly and almost completely absorbed. (
  • ORAL ANTICOAGULANTS: COUMARIN DERIVATIVES: Bishydroxycoumarin (Dicumarol) Warfarin sodium Acenocoumarol (Nicoumalone) Ethyl biscoumacetate 2. (
  • The results of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) trial, which compared dabigatran etexilate with warfarin for stroke prevention in patients with AF, demonstrate that the new oral anticoagulants have the potential to be more effective and safer than VKAs. (
  • VKAs, such as warfarin, represent the only orally active anticoagulants that are licensed for long-term use. (
  • Warfarin works to anticoagulant in a different way that heparin. (
  • Warfarin is an oral anticoagulant. (
  • The anticoagulant warfarin (Coumadin, Jantoven) is used to prevent blood clots from forming or to prevent existing clots from getting larger. (
  • Explain to interested patients that several new anticoagulant medications are currently being evaluated as alternatives to warfarin. (
  • Novel oral anticoagulants heading for the clinic won't entirely eliminate the food, drug, and supplement interactions that have been so problematic with warfarin (Coumadin), according to a review article. (
  • The three candidates farthest along in development -- dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban -- do offer advantages in rapid onset of action and predictable anticoagulant effects without the narrow therapeutic range of warfarin, according to Jeanine M. Walenga, PhD, and Cafer Adiguzel, MD, both of Loyola University Medical Center in Maywood, Ill. (
  • But "considering the extensive food and drug interactions observed with oral warfarin, caution should be taken in clinical practice with these new oral anticoagulants," they wrote in the June issue of the International Journal of Clinical Practice . (
  • Nevertheless, the editorialists wrote, "The novel oral anticoagulants, requiring little or no monitoring, may well replace warfarin in the future," particularly in atrial fibrillation, for venous thromboembolic prophylaxis and treatment, and for secondary prevention after acute coronary syndromes. (
  • More than 40 case reports have been collected by drug-monitoring agencies that showed in some patients being prescribed coumarin anticoagulants, especially warfarin, that the International Normalised Ratio (INR) increased after they began taking glucosamine, which indicated an increase in the coagulation time. (
  • But the anticoagulant effect of warfarin must be carefully monitored with periodic blood tests. (
  • Results of a new meta-analysis indicate that for patients with atrial fibrilation, treatment with one of the new oral anticoagulants rather than warfarin is more effective for preventing stroke and less risky in terms of intracranial bleeding. (
  • Cardiologists are increasingly bypassing the anticoagulant warfarin in favor of rivaroxaban, a more-expensive alternative with fewer side effects, according to the IMS NPA Weekly. (
  • For the past 60 years, vitamin K antagonists such as warfarin sodium have been the only available oral anticoagulant medications. (
  • Patients who orally ingest a TSOAC are actively anticoagulated within several hours and, because the half-life of TSOACs is considerably shorter than that of warfarin, most of the anticoagulant effect will typically wear off within 1-2 days. (
  • One of the first anticoagulants, warfarin, was initially approved as a rodenticide. (
  • Common anticoagulants include warfarin and heparin. (
  • Newer non-vitamin K antagonist oral anticoagulants appear to have fewer life-threatening bleeding events compared to warfarin. (
  • After she had a blood clot she was put on warfarin for six months, but at the end of the course she was not given any anticoagulants despite being at risk of a stroke. (
  • Warfarin sodium is an anticoagulant medication. (
  • What do anticoagulants like warfarin do? (
  • There is strong evidence for the older medications (i.e., warfarin, antiplatelet agents), as well as limited evidence for the newer direct-acting oral anticoagulants medications that, for most patients, it is not necessary to alter anticoagulation or antiplatelet therapy prior to dental intervention. (
  • The oral anticoagulants are a class of pharmaceuticals that act by antagonizing the effects of vitamin K . Examples include warfarin . (
  • Novel oral anticoagulants are safer than Vitamin K antagonists (warfarin) in respect to the occurrence of bleeding, especially in terms of intracranial hemorrhage. (
  • In the event of a blood clot requiring treatment, she says that NOACs work more quickly than warfarin and don't require overlapping of medications, whereas warfarin needs to overlap with a shortacting anticoagulant , such as lowmolecular-weight heparin, for about five days until warfarin takes effect. (
  • With the recommendation of usage of novel oral anticoagulants (NOAC) by International guidelines in line with their established safety, efficacy and compliance, we expect decrease of warfarin use at a CAGR of negative 3. (
  • CHICAGO -- Patients with atrial fibrillation who start treatment with a new oral anticoagulant may spend more on their medication than if they were prescribed generic warfarin, but their overall health care costs could be the same, based on an analysis of health care expense records for more than 4,500 U. (
  • The mainstay in the anticoagulant class for many years has been the vitamin K antagonist warfarin (Coumadin). (
  • Examples of anticoagulants include heparin and warfarin (Coumadin). (
  • 6] Warfarin has a narrow therapeutic range[7] and therefore, international normalized ratio (INR) blood levels are frequently monitored especially if it is taken together with natural products, some of which have anticoagulant and anti-platelet properties. (
  • Extra caution is taken when individuals, who take dietary supplements, add on prescribed anticoagulant medication (e.g. warfarin, aspirin) because this combination may increase the risk of bleeding. (
  • To investigate, Jung-Im Shin, MD, PhD (Johns Hopkins University) and her colleagues examined 2010-2017 information from the electronic health records of 3206 patients with atrial fibrillation who used direct oral anticoagulants and similar 3206 patients with atrial fibrillation who used the conventional anticoagulant warfarin. (
  • In patients without CKD, the risk of bleeding and benefits of preventing ischemic stroke between direct oral anticoagulant and warfarin use were similar. (
  • On the other hand, patients with CKD who took direct oral anticoagulants had 23% higher risk of bleeding compared with those on warfarin, but similar benefits from prevention of ischemic stroke. (
  • We also found that direct oral anticoagulant use was linked with a higher risk of bleeding compared to warfarin use in patients with CKD. (
  • Direct oral anticoagulant (DOAC) drugs-Xarelto (rivaroxaban), Eliquis (apixaban) Pradaxa (dabigatran etexilate), and Savaysa (edoxaban)-are alternatives to warfarin for prevention of blood clots and stroke in patients at risk of deep venous thrombosis, pulmonary embolism, and post-surgical clots. (
  • These poisons contain warfarin and hydroxycoumadin as main anticoagulants and they require multiple feedings that take several days to kill a rodent. (
  • The Quest Diagnostics Health Trends™ study by researchers at Quest Diagnostics (NYSE: DGX), Boston University School of Medicine and Lenox Hill Hospital is the largest to examine the efficacy of treatment with the anticoagulant warfarin in patients with Afib in primary-care practices and other non-hospital care settings in the United States. (
  • Despite the introduction of new anticoagulants in recent years, warfarin (brand name Coumadin) continues to be the most commonly prescribed, with about 33 million prescriptions written in 2012 in the United States. (
  • Our study's findings suggest the United States healthcare system could potentially improve the quality of warfarin treatment by adopting provisions that direct individuals with atrial fibrillation to specialists or generalists with significant experience with warfarin and other anticoagulant therapies, such as is practiced in specialized anticoagulation centers. (
  • Warfarin, an oral vitamin K antagonist (VKA) approved in the early 1950s, has ruled the anticoagulant market for nearly six decades. (
  • The huge market potential, combined with the significant shortcomings of heparins and warfarin, drives the quest for development of new anticoagulants that are well tolerated, effective and easy to use. (
  • Six of the eight trials used aspirin as the antiplatelet agent, and six of the eight trials used warfarin as the anticoagulant. (
  • Other types of novel anticoagulants may be similar to warfarin in terms of their interactions with other drugs. (
  • For several decades, anticoagulant options for the treatment and prevention of thrombosis have been limited mainly to agents such as unfractionated heparin and oral vitamin K antagonists, such as warfarin. (
  • Those drugs administered for prophylaxis or treatment of thromboembolic disorders are heparin , which inactivates thrombin and several other clotting factors and which must be administered parenterally and the oral anticoagulants ( warfarin , dicumarol and congeners) which inhibit the hepatic synthesis of vitamin k dependent clotting factors . (
  • International guidelines recommend direct oral anticoagulants (DOACs) over warfarin to prevent stroke for most patients with atrial fibrillation (AF). (
  • There are several reports of patients with migraine entering remission after receiving treatment with anticoagulants such as heparin or warfarin. (
  • A questionnaire survey of 400 patients in Spain on anticoagulation treatment (i.e. warfarin or a similar agent) identified 66 migraine sufferers, and two thirds of this group reported a subjective improvement in the severity and frequency of their migraine after starting anticoagulants (Morales-Asín F et al. (
  • There is one randomised, unblinded, crossover study of 19 migraine patients where a warfarin like anticoagulant (acenocoumarol) was compared to propranolol treatment over two 12 week periods (Wammes-van der Heijden EA et al. (
  • Anticoagulants are widely used to prevent and treat venous thromboembolism, prevent stroke in atrial fibrillation, and manage acute coronary syndrome. (
  • BARCELONA, Spain - A new version of the European Heart Rhythm Association (EHRA) practical guide on non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) aims to help physicians navigate various new data - including some just presented last month in the United States - but also a more complex clinical landscape. (
  • Concomitant use of nonsteroidal anti-inflammatory drugs (NSAIDs) and oral anticoagulants in patients with atrial fibrillation (AF) increases the risk for major bleeding and stroke, according to a new analysis of the RE-LY trial. (
  • Controlled therapeutic inhibition of blood clotting by means of appropriate drugs (ie, anticoagulants) is indicated for prevention of ischemic stroke in patients with risk factors for thromboembolism, such as atrial fibrillation. (
  • Our study shows that very old and frail patients with atrial fibrillation clearly benefit from the 'old' oral anticoagulants when their treatment is adequately managed," Poli said at the annual meeting of the European Society of Cardiology (ESC). (
  • In the last 20 years it has become evident that the use of oral anticoagulants in patients with atrial fibrillation was associated with a 67% reduction of the risk of ischemic stroke. (
  • We have concluded for all of the anticoagulants used in atrial fibrillation that the benefit of preventing strokes outweighs the increased risk of bleeding. (
  • Importantly, only about half of the 3 million U.S. patients with atrial fibrillation use anticoagulants. (
  • Data from a real-world analysis provided an early view of hospital readmissions among hospitalized nonvalvular atrial fibrillation (NVAF) patients treated with new oral anticoagulants (NOACs). (
  • Examples of diseases and conditions that require anticoagulant treatment to reduce the risk of blood clots include heart attack , stroke , deep venous thrombosis, pulmonary embolism , and atrial fibrillation . (
  • You might take an anticoagulant if you also have atrial fibrillation or other complications. (
  • Some indications for anticoagulant therapy that are known to have benefit from therapy include: Atrial fibrillation - commonly forms an atrial appendage clot Coronary artery disease Deep vein thrombosis - can lead to pulmonary embolism Ischemic stroke Hypercoagulable states (e.g. (
  • AMSTERDAM - Investigators are reporting widespread underuse of anticoagulant therapy in patients with atrial fibrillation (AF) who are at high risk of stroke, despite the fact that such therapy is known to decrease stroke risk in this population. (
  • New Oral Anticoagulants in Atrial Fibrillation Forever? (
  • In this issue of Circulation , long-term outcome data are presented from the first successful trial with the new oral anticoagulant dabigatran in stroke prevention (Randomized Evaluation of Long-term Anticoagulation Therapy [RE-LY]) in atrial fibrillation. (
  • Effectiveness and safety of non-vitamin K antagonist oral anticoagulants for atrial fibrillation and venous thromboembolism: A systematic review and meta-analyses. (
  • Generally, these anticoagulants are used to treat patients with deep-vein thrombosis (DVT), pulmonary embolism (PE), atrial fibrillation (AF), and mechanical prosthetic heart valves . (
  • More than a half of the patients with atrial fibrillation (AF) are not adequately anti-coagulated, even though in prevention of ischemic stroke in this patient-population, there is strong evidence in favor of oral anticoagulant (OAC) therapy. (
  • Bayer HealthCare announced today that new data from clinical trials and real-world studies to be presented at the American Heart Association (AHA) Scientific Sessions 2014 in Chicago, Il, USA, November 15-19, 2014, will provide important insights regarding the clinical utility of its novel oral anticoagulant Xarelto (rivaroxaban) for stroke prevention in patients with atrial fibrillation (AF). (
  • Direct oral anticoagulants, which are a certain type of blood thinners used to treat atrial fibrillation. (
  • Given that approximately one-quarter of patients with atrial fibrillation have CKD, the real-world safety and effectiveness of direct oral anticoagulants in patients with atrial fibrillation across the spectrum of kidney function is of great public health importance. (
  • Approximately one in two patients with atrial fibrillation (Afib) do not optimally reduce their risk of stroke or bleeding when treated with the most widely prescribed oral-anticoagulant therapy, according to a study published online in Circulation, the journal of the American Heart Association. (
  • The global anticoagulant market is projected to be worth more than $11.2bn by 2015, more than half of this market being for stroke prevention in patients with non-valvular atrial fibrillation (AF). (
  • Oral anticoagulants and antiplatelet agents have proven effective for stroke prevention in most patients at a high risk for vascular events, but primary stroke prevention in patients with nonvalvular atrial fibrillation potentially merits separate consideration because of the suspected cardioembolic mechanism of most strokes in patients with atrial fibrillation. (
  • To characterize the relative effect of long-term oral anticoagulant treatment compared with antiplatelet therapy on major vascular events in patients with nonvalvular atrial fibrillation and no history of stroke or transient ischemic attack (TIA). (
  • We wanted to review trials which have directly compared anticoagulants and antiplatelet agents, to assess whether any anticoagulant regimen offers net advantages over antiplatelet agents, overall or in some particular category of patients (e.g. patients with atrial fibrillation). (
  • A very large new meta-analysis finds a favorable risk-benefit for the new oral anticoagulant drugs in the setting of atrial fibrillation. (
  • Of the new oral anticoagulants, dabigatran etexilate, rivaroxaban, and apixaban are at the most advanced stages of development. (
  • In the last few years, FDA has approved three new oral anticoagulant drugs - Pradaxa (dabigatran), Xarelto (rivaroxaban), and Eliquis (apixaban). (
  • Review properties of newer target-specific oral anticoagulants (TSOACs) such as dabigatran, rivaroxaban, and apixaban. (
  • The patient had been on rivaroxaban (a relatively new oral anticoagulant) as treatment for her DVT before admission, and thus the discontinuation of anticoagulation placed her at high risk for recurrent DVT or pulmonary embolism. (
  • All new oral anticoagulants (rivaroxaban, apixaban, dabigatran) are safer than VKA, in regards to intracranial bleeding, where apixaban, and dabigatran (lower dose 110mg b.i.d.) are again safer than VKA in all major bleedings (Table 1). (
  • Draw samples 3 to 4 hours after oral rivaroxaban administration to measure peak anticoagulant effect. (
  • The rivaroxaban assay measures circulating levels of rivaroxaban based on its anticoagulant action. (
  • Measuring rivaroxaban concentration will allow dose adjustment to prevent too much anticoagulant effect and risk for bleeding or no anticoagulant action and inadequate therapy. (
  • By measuring Factor Xa inhibition in the test plasma compared with a rivaroxaban standard, the rivaroxaban assay provides a biologic measure of anticoagulant intensity at the time of sampling. (
  • Rivaroxaban (Xarelto) and apixaban (Eliquis) are different drugs, although both have a similar mechanism of anticoagulant action. (
  • Novel oral anticoagulants in development: Dabigatran, Rivaroxaban, and Apixaban. (
  • Early next year an FDA panel will review a new drug from Merck and a new indication for Xarelto (rivaroxaban), Johnson & Johnson's highly successful new oral anticoagulant. (
  • Follow-up testing is performed to confirm or exclude the presence of lupus anticoagulant. (
  • If results indicate the presence of lupus anticoagulant, testing is usually repeated about 12 weeks later to confirm that it is still present, especially for individuals being tested for APS. (
  • Lupus-sensitive aPTT, of which many variants exist, but have the common feature of having a greater sensitivity of becoming prolonged in the presence of lupus anticoagulant compared to a regular aPTT. (
  • The relationship between late-onset seizures and the presence of lupus anticoagulant is discussed. (
  • They were evaluated for the presence of lupus anticoagulant (LA). RESULTS: Eleven patients (27.5%) were LA positive at the time of diagnosis. (
  • Dr. Warren Silberman, DO delivers a microlearning lesson on the safe aeromedical use of new oral anticoagulants for Deep Vein Thrombosis (DVT) and other conditions. (
  • Anticoagulants are often used to treat acute deep vein thrombosis . (
  • In that version of the guideline, VKA or LMWH therapy was preferred over the two available "new oral anticoagulant drugs" for the long-term treatment of pulmonary embolism or deep vein thrombosis. (
  • 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. (
  • The Coagulation Laboratory now offers testing to monitor Apixaban (Eliquis) a new oral-acting anticoagulant drug. (
  • Anticoagulants and antiplatelet drugs eliminate or reduce the risk of blood clots. (
  • There are side effects associated with anticoagulant or antiplatelet drugs, and some can be serious. (
  • Tell all of your healthcare providers that you're taking an anticoagulant or antiplatelet, as well as any other drugs. (
  • Your doctor may recommend that you stop taking your antiplatelet or anticoagulant drugs for a period before and after the procedure. (
  • When taking anticoagulant and antiplatelet drugs, follow the instructions your doctor's instructions and call your doctor if you miss a dose. (
  • Classification of anti-coagulants  : IN - VIVO DRUGS : PARENTERAL ANTICOAGULANTS: HEPARINS: High molecular weight Heparins : Unfractionated heparin (UFH) 2. (
  • Anticoagulants are drugs that help keep your blood from clotting easily. (
  • Anticoagulants are drugs that decrease the ability of the blood to clot, or coagulate. (
  • She was treated with blood thinners and anticoagulant drugs, and after 10 days was released to a rehabilitation center. (
  • This is accomplished with taking anticoagulant drugs or 'blood thinners. (
  • We have been asked if FDA should approve anticoagulant drugs that do not have a reversal agent. (
  • Anticoagulants are closely related to antiplatelet drugs and thrombolytic drugs by manipulating the various pathways of blood coagulation. (
  • Specifically, antiplatelet drugs inhibit platelet aggregation (clumping together), whereas anticoagulants inhibit specific pathways of the coagulation cascade, which happens after the initial platelet aggregation and ultimately leads to formation of fibrin and stable aggregated platelet products. (
  • Specifically, antiplatelet drugs inhibit platelet aggregation (clumping together), whereas anticoagulants inhibit the coagulation cascade by clotting factors that happens after the initial platelet aggregation. (
  • Grapefruit interferes with some anticoagulant drugs, increasing the amount of time it takes for them to be metabolized out of the body, and so should be eaten only with caution when on anticoagulant drugs. (
  • TEL AVIV (MarketWatch) -- Nuvelo Inc., nuvo the San Carlos, Calif., developer of drugs to treat cardiovascular conditions and cancer, reported Phase II proof-of-concept data for rNAPc2, an anticoagulant. (
  • Anticoagulants are drugs that interfere with your blood's natural ability to clot in response to an injury. (
  • The pharmacist has a significant role in keeping updated with these new anticoagulant drugs, educating patients about their drugs, and the importance of adhering to their anticoagulant therapy. (
  • anticoagulants and antiplatelet drugs. (
  • Traditional anticoagulants and antiplatelets have witnessed a significant drop in market due to the decline in the development of new drugs, expiration of patents, availability of alternatives, such as thrombin inhibitors and low-priced generic drugs. (
  • Antithrombotic/Anticoagulant Drugs: Techs and Global Markets (PHM119B) analyzes the market size of anticoagulants by revenue at manufacturers' sales levels, including low molecular weight heparins and oral anticoagulants, as well as breakdowns of antiplatelets and thrombin inhibitors. (
  • What drugs may interact with anticoagulants? (
  • The 2012 guideline used the term new oral anticoagulant drugs to refer in general to direct inhibitors of thrombin or factor Xa. (
  • Blood-thinning drugs, such as anticoagulants and antiplatelet agents, can potentially prevent arteries from being blocked, or prevent them re-blocking. (
  • Research shows that a novel anticoagulant may be less likely to interact with other drugs. (
  • The global market for antithrombotic/anticoagulant drugs should reach $27.3 billion by 2021 from $18.9 billion in 2016 at a compound annual growth rate (CAGR) of 7.6%, from 2016 to 2021. (
  • This report is a comprehensive business tool designed to provide an in-depth look at antithrombotic/anticoagulant drugs for various cardiovascular applications. (
  • Maggie Fox, CNN , "Blood clots fill lungs of black coronavirus victims, study finds," 27 May 2020 In the early 1990s, Van Beek helped develop the D-dimer blood test that's used around the world to monitor clot formation in patients, including those with Covid-19, and to dose them with heparin and other anticoagulant medications. (
  • As a class of medications, anticoagulants are used in therapy for thrombotic disorders. (
  • My procedure nurses love it as they can cross check any individual procedure with any anticoagulant or antiplatelet medications," tweeted Samer Narouze, MD, PhD, shortly after the app's release. (
  • Without the anticoagulant/antiplatelet medications, these patients are at higher risk for blood clot development, which could result in thromboembolism, stroke, or myocardial infarction (MI). (
  • Anticoagulants are medications that interfere with the body's ability to perform the third part of this process, going through the clotting cascade and creating the fibrin mesh. (
  • Although all randomized clinical trials of direct oral anticoagulants have excluded patients with severe kidney dysfunction, these medications have been approved by the US Food and Drug Administration for use in patients with advanced kidney disease. (
  • Anticoagulants, commonly referred to as "blood thinners", are medications that interfere with the body's natural blood clotting mechanism. (
  • Although it is found most frequently in those with autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) and HIV, the lupus anticoagulant may also be seen chronically or temporarily in those with infections or cancers and in those who are taking certain medications, such as phenothiazines, chlorpromazine, procainamide, and fansidar. (
  • Renal impairment is a risk factor for bleeding and thrombosis during anticoagulant therapy and can influence the balance between the safety and efficacy of such agents. (
  • Other drawbacks include their potential for accumulation in patients with renal impairment, the lack of an antidote, and the risk of catheter thrombosis when these agents are used as the sole anticoagulant in patients undergoing percutaneous coronary intervention (PCI). (
  • The main indication for testing for lupus anticoagulant is a suspected antiphospholipid syndrome, whose main manifestations are blood clots (thrombosis) in both arteries and veins as well as pregnancy-related complications such as miscarriage, stillbirth, preterm delivery, and severe preeclampsia. (
  • In a suspected antiphospholipid syndrome, lupus anticoagulant is generally tested in conjunction with anti-apolipoprotein antibodies and anti-cardiolipin antibodies, and diagnostic criteria require one clinical event (i.e. thrombosis or pregnancy complication) and two positive blood test results spaced at least three months apart that detect at least one of the three types of antibodies. (
  • Treatment for a lupus anticoagulant is usually undertaken in the context of documented thrombosis, such as extremity phlebitis or dural sinus vein thrombosis. (
  • Patients with a well-documented (i.e., present at least twice) lupus anticoagulant and a history of thrombosis should be considered candidates for indefinite treatment with anticoagulants. (
  • Mesenteric venous thrombosis If the bowel does not have any injury, in all likelihood the patient will have to take anticoagulants for three, six months or so to prevent the formation of thrombi. (
  • Anticoagulants are given to people to stop thrombosis (blood clotting inappropriately in the blood vessels). (
  • The lupus anticoagulant is one of three types of test for antiphospholipid syndrome, associated with an increased risk of thrombosis . (
  • In this post hoc analysis of the RE-LY study, we found that concomitant NSAID use with any anticoagulant increases extracranial risk particularly, as well as stroke risk in patients with AF," he said of the study, published July 9 in the Journal of the American College of Cardiology . (
  • Anticoagulants are used for preventing ischemic stroke (the most common type of stroke) and ministroke. (
  • Anticoagulants have been known for many years to produce a striking (more than 50%) decrease in the rate of stroke, but they also prevent clotting in locations and situations where clotting is desirable. (
  • Anticoagulants lower the risk of problems caused by blood clots, such as stroke. (
  • The findings were released at the European Society of Cardiology (ESC) Congress 2013 and represent one-year outcomes from the ongoing Global Anticoagulant Registry in the Field (GARFIELD), which is the largest prospective database tracking AF patients at increased stroke risk. (
  • The new data are from the first of five GARFIELD cohorts and include 10,614 adult patients who were diagnosed with non-valvular AF within the past six weeks and had at least one additional risk factor for stroke, which renders them eligible for anticoagulant therapy for stroke prevention. (
  • Four direct-acting oral anticoagulants have been approved for marketing in the U.S. for use in patients to prevent or treat DVT and PE, or reduce the risk of stroke and systemic embolism in patients with NVAF. (
  • For many years, doctors thought the risk of bleeding for a patient on anticoagulants or antiplatelets and undergoing a dental procedure far exceeded the risk of stroke. (
  • It is the most commonly prescribed long-term anticoagulant therapy and reduces the risk of stroke by more than 60 per cent in patients with AF. (
  • Treatment with anticoagulants offers no net advantages over antiplatelet agents in patients with acute ischaemic stroke. (
  • Anticoagulants offered no net advantages over antiplatelet agents in acute ischaemic stroke. (
  • To assess: (1) the effectiveness of anticoagulants compared with antiplatelet agents in acute ischaemic stroke, and (2) whether the addition of anticoagulants to antiplatelet agents offers any net advantage over antiplatelet agents alone. (
  • Truly unconfounded, randomised-controlled trials comparing anticoagulants with antiplatelet agents, or anticoagulants and antiplatelet agents with antiplatelet agents alone, given within 14 days of onset of presumed or confirmed ischaemic stroke. (
  • Rapidly acting parenteral anticoagulants, such as heparin, are used for the prevention and initial treatment of thromboembolism and during revascularization procedures, 1 whereas the slower-acting vitamin K antagonists (VKAs) are used for long-term therapy. (
  • In a meta-analysis, fewer incidents of major bleeding were reported with direct oral anticoagulants than with vitamin K antagonists. (
  • Although characterised as investigational agents, in the Guidelines for AF from 2010 ( 1 ), the new oral anticoagulants (NOAC) have ultimately been considered as preferable to Vitamin K antagonists (VKA). (
  • Recent innovations and the emergence of novel thrombin inhibitors have led to the decline of traditional anticoagulants such as heparin and Vitamin K antagonists, as well. (
  • Both antiplatelets and anticoagulants work to prevent clots in your blood vessels, but they work in different ways. (
  • What are Anticoagulants and Antiplatelets? (
  • Therefore, the anticoagulants or antiplatelets should be stopped several days before the procedure. (
  • In fact, a review of recent literature could not find a single instance where a patient died or suffered a disabling injury as a result of bleeding because they were kept on their anticoagulants or antiplatelets for a dental procedure. (
  • The global market is segmented into anticoagulants, antiplatelets and thrombin inhibitors. (
  • Anticoagulants are medication s that prevent the coagulation , or clotting , of blood . (
  • A group of pharmaceuticals called anticoagulants can be used in vivo as a medication for thrombotic disorders. (
  • Taking recommended doses of garlic, without using anticoagulant medication, should not pose an increased risk of bleeding. (
  • 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. (
  • Another type of anticoagulant is the direct thrombin inhibitor . (
  • Thrombin inhibitors are anticoagulants that inhibit the enzyme thrombin. (
  • v) anticoagulant derivatives of thrombin. (
  • 2 The introduction of low-molecular-weight heparin (LMWH) and fondaparinux has simplified parenteral anticoagulant therapy, and these agents have replaced heparin for many indications. (
  • Doctors should tell their patients with AF who are receiving anticoagulant therapy not to use over-the-counter pain killers," Ezekowitz said. (
  • The frequent use of anticoagulant therapy in surgical patients, particularly orthopedic and heart surgeries means that health care providers should have a relatively good and in-depth understanding of anticoagulants, why they are used and what they do. (
  • To analyze the demographic and clinical characteristics of patients on chronic anticoagulant therapy (CAT) admitted because of a hip fracture secondary to a fall, and to compare with patients not receiving CAT. (
  • If tests indicate that there is a bleeding disorder, the patient will stay forever in therapy with anticoagulants. (
  • When we decide to treat AF-patients with anticoagulant therapy, our utmost care is given to diminishing the risk of bleeding complications. (
  • There are recommendations how to start and follow up the therapy with NOAC, how to measure the anticoagulant effect of NOAC, drug interactions and pharmacokinetics, how to deal with dosing errors, management of bleeding complications, planned surgical interventions and also switching between anticoagulant regimens. (
  • Optimal oral anticoagulant therapy requires careful consideration of patient's needs and an understanding of the efficacy, safety, pharmacokinetics of the anticoagulants, and the methods used to measure their effects. (
  • Many other industrialized countries outperform the U.S. in anticoagulant control, perhaps due to more specialized management centers and their support of patient self-management," said investigator Jack Ansell, M.D., a specialist in anticoagulant therapy in New York. (
  • According to the guideline, research indicates that despite the lack of specific reversal agents for NOACs, the risk of a fatal bleed in patients treated with these anticoagulants "appears to be no higher" than for patients taking VKA therapy. (
  • Lee said patient factors, including the cost of treatment and a preference for once-daily therapy, should also influence the choice of an anticoagulant regimen. (
  • Despite being more durable than bioprosthetic valves, mechanical heart valves are often not chosen because of the requirement for lifelong anticoagulant therapy. (
  • The use of anticoagulants is a decision based upon the risks and benefits of anticoagulation. (
  • Non-VKA oral anticoagulants (NOACs) have now widely reached the lucrative market of anticoagulation. (
  • Reversal of anticoagulation and management of bleeding in patients on anticoagulants. (
  • New oral anticoagulants simplify greatly the anticoagulation regime: fixed daily dosage, wide therapeutic window, no need of monitoring and no food interaction. (
  • Unfractionated heparin (UFH) is an injectable anticoagulant that is widely used when rapid anticoagulation is required. (
  • New study findings suggest the need for caution in prescribing direct oral anticoagulants in patients with CKD. (
  • Patients taking the new generation of oral anticoagulants are associated with a significantly higher risk of gastrointestinal bleeding, according to a study published in the July 2013 issue of Gastroenterology. (
  • The newer oral anticoagulants that inhibit factor IIa or factor Xa have more predictable pharmacokinetics, fewer drug and diet interactions, and no need for routine laboratory monitoring and dose adjustments. (
  • Anticoagulants inhibit the formation of blood clots and are commonly prescribed for patients with Afib. (
  • This chapter reviews commonly used anticoagulant regimens used for PCI with tailored guidance for the acute setting, in particular primary PCI for ST-elevation myocardial infarction (STEMI). (
  • Anticoagulants, commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time. (
  • Anticoagulants , commonly referred to as blood thinners , are chemical substances that prevent or reduce coagulation of blood , prolonging the clotting time . (
  • Anticoagulants are commonly used in rat and mouse poisons, and are one of the most commonly used household poisons, accounting for a large number of accidental poisoning in cats. (
  • What are some examples of commonly prescribed anticoagulant medicines? (
  • Indeed, there is considerable controversy concerning the best type of blood thinner to use: aspirin or stronger blood thinners called anticoagulants. (
  • New York Times , "Aspirin, the Original Wonder Drug," 9 Mar. 2020 Hirudin, the anticoagulant in leech saliva, is unrivalled in its strength, according to Kvist. (
  • Patients with stents who receive oral anticoagulants do not need aspirin. (
  • However, the combination of low-dose anticoagulant and aspirin seemed to offer benefits over aspirin alone, and the combination should be investigated further. (
  • For instance, aspirin does not seem to interact with a novel anticoagulant. (
  • Anticoagulants are used to treat and prevent problems caused by blood clots. (
  • Anticoagulants prevent blood clots from forming in your blood vessels and heart. (
  • Anticoagulants do not dissolve clots but may prevent existing clots from becoming larger and causing more serious problems. (
  • Jason Gale, Fortune , "Doctors warn of emerging COVID-19 symptom: dangerous blood clots," 5 May 2020 In some patients, physicians are reporting a blood-clotting complication that does not respond to anticoagulants . (
  • Despite getting anticoagulants , the patient was still developing clots in various parts of his body. (
  • An anticoagulant helps your body control how fast your blood clots, which helps prevent unwanted clots from forming inside your arteries, veins, or heart during certain medical conditions and during long periods of physical inactivity. (
  • An anticoagulant also helps prevent new clots from forming. (
  • Anticoagulants are medicines used to treat or prevent blood clots by thinning your blood. (
  • Oral anticoagulant and antiplatelet agents are prescribed for individuals who are at high risk for or who have had thromboembolic events (e.g., blood clots). (
  • Lupus anticoagulant is a protein that increases the risk of developing blood clots in both the veins and arteries. (
  • Anticoagulants slow clotting, thereby reducing fibrin formation and preventing clots from forming and growing. (
  • Heparin and CPD are both anticoagulants to prevent blood clots from forming. (
  • Blood thinners or anticoagulants are medicines that help prevent blood clots from forming. (
  • This article (1) outlines the limitations of established parenteral and oral anticoagulants, (2) describes the potential advantages of the new agents, (3) briefly reviews the pharmacology and clinical trial results with new anticoagulants in advanced stages of development, and (4) provides perspective on the opportunities and challenges with the new parenteral and oral anticoagulants. (
  • The clinical dilemma faced by physicians and patients is anticoagulant-related hemorrhage, which also increases with age. (
  • People using anticoagulants to treat this condition should avoid using bed rest as a complementary treatment because there are clinical benefits to continuing to walk and remaining mobile while using anticoagulants in this way. (
  • 5 New oral anticoagulants have recently been developed, tested, and introduced in clinical practice. (
  • Direct oral anticoagulants may predispose patients with chronic kidney disease (CKD) to drug accumulation and a greater risk of bleeding events, stated study published in Clinical Journal of the American Society of Nephrology (CJASN). (
  • BCC Research reveals in its new report that a variety of novel antithrombotic/anticoagulants offer better pharmacological and clinical profiles than those associated with traditional therapies. (
  • A variety of novel anticoagulants with improved pharmacologic and clinical profiles are in development, offering benefits over traditional therapies. (
  • Researchers report that they have found a possible link between the anticoagulant drug Pradaxa and intracerebral hemorrhage (brain bleeding). (
  • 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. (
  • All anticoagulant assay requests MUST include the name of the drug that is being monitored. (
  • Lupus anticoagulant testing is a series of tests used to detect lupus anticoagulant (LA) in the blood. (
  • It is recommended that two tests be used to detect lupus anticoagulant. (
  • Thus, one or more of the following tests are generally performed to detect lupus anticoagulant if a high suspicion remains, and/or specify lupus anticoagulant as the cause of an abnormal mixing test: Phospholipid-sensitive functional clotting testing, such as the dilute Russell's viper venom time, or the Kaolin clotting time. (
  • Heparin-induced hemorrhage may be reversed with the antagonist protamine , a positively charged protein that has a high affinity for heparin's negatively charged molecules, thus neutralizing the drug's anticoagulant effect. (
  • This has spurred development of novel anticoagulants that offer more specific activity on the coagulation cascade, predictable pharmacodynamics and pharmacokinetics, simpler dosing regimens and few or no laboratory monitoring requirements. (
  • Factor Xa (needs to be a l/c a) Factor Xa is an enzyme present at the pivotal point in the coagulation cascade where extrinsic and intrinsic pathways converge, making it an attractive target for anticoagulants. (
  • A potential downside to the use of NOACs-the lack of reversal agents-became less critical last fall after FDA approved the licensing of a monoclonal antibody product that counteracts the anticoagulant effects of dabigatran. (
  • Wellesley, Mass., Sep 14, 2016 - An aging global population and the increasing worldwide prevalence of cardiovascular disease have created new opportunities for antithrombotic/anticoagulant drug products. (
  • The second type of anticoagulant is deadlier. (
  • This second type of anticoagulant kills rodents in a single serving dose rather than over time. (
  • 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. (
  • I've been looking at internet forums and it seems to be a widespread experience, i.e. no migraine attacks whilst taking anticoagulants. (
  • Several classes of anticoagulant regimens are available. (
  • Multivitamins that do not interact with clotting are available for patients on anticoagulants. (
  • Lupus anticoagulant is an immunoglobulin that binds to phospholipids and proteins associated with the cell membrane. (
  • It prolongs the aPTT test, as well as several other related tests, because the lupus anticoagulant binds to phospholipids and the reagents (chemicals) used in performing the aPTT test contain phospholipids. (
  • Protamine sulfate only partly neutralizes the anticoagulant activity of LMWH and has no effect on that of fondaparinux. (
  • citation needed] However, only about 60 per cent of patients with lupus anticoagulants have a both a prolonged APTT and APTT mix, making it unsuitable as the only test in case of a high suspicion of the antiphospholipid syndrome. (
  • Hexagonal (II) phase phospholipid neutralization, wherein such phospholipids specifically neutralize lupus anticoagulant, so a normalization of aPTT after adding it specifically indicates the presence lupus anticoagulants. (
  • Lupus anticoagulants are antibodies against substances in the lining of cells. (
  • Most often, lupus anticoagulants and aPL are found in people with diseases such as systemic lupus erythematosus (SLE). (
  • Lupus anticoagulants (LA) are one of the criteria antibodies but calibration plasmas are unavailable and they are detected by inference based on antibody behaviour in a medley of coagulation-based assays. (
  • While anticoagulant rodenticides revolutionized the rodent pest control industry, they are hazardous to non-target predatory and scavenging birds on a global scale. (
  • 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. (
  • The risk posed by anticoagulant rodenticides to wildlife is inadequately characterized. (
  • 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. (
  • Non-target wildlife, particularly birds of prey, are widely exposed to and acutely poisoned by anticoagulant rodenticides (ARs). (
  • Anticoagulant solutions used for the preservation of stored whole blood and blood fractions are acid citrate dextrose (ACD), citrate phosphate dextrose (CPD), citrate phosphate dextrose adenine (cPDA 1) and heparin . (
  • anticoagulants used to prevent clotting of blood specimens for laboratory analysis are heparin and several substances that make calcium ions unavailable to the clotting process , including edta (ethylenediaminetetraacetic acid ), citrate, oxalate and fluoride . (
  • More recently, target-specific oral anticoagulants (TSOACs) have become available for the treatment and prevention of thromboembolism and currently make up approximately 20% of new anticoagulant prescriptions. (
  • 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. (
  • When you take anticoagulants, you need to take extra steps to avoid bleeding problems. (