1,721,378 research outputs found
Duration of anticoagulation and risk of recurrent thromboembolism in carriers of factor V Leiden or prothrombin mutation
No full textJ Thromb Haemost. 2008 Dec;6(12):2223-4. Epub 2008 Oct 1.
Duration of anticoagulation and risk of recurrent thromboembolism in carriers of
factor V Leiden or prothrombin mutation.
Prandoni P, Tormene D, Spiezia L, Pesavento R, Simioni P.
Comment in
J Thromb Haemost. 2008 Dec;6(12):2225-6.
PMID: 18983490 [PubMed - indexed for MEDLINE
Idraparinux: review of its clinical efficacy and safety for prevention andtreatment of thromboembolic disorders.
No full text1. Expert Opin Investig Drugs. 2008 May;17(5):773-7.
Idraparinux: review of its clinical efficacy and safety for prevention and
treatment of thromboembolic disorders.
Prandoni P, Tormene D, Perlati M, Brandolin B, Spiezia L.
Department of Medical and Surgical Sciences, Thromboembolism Unit, University of
Padua, 35128 - Padua, Italy. [email protected]
BACKGROUND: Idraparinux is a synthetic pentasaccharide that binds to antithrombin
with high affinity. In view of its long half-life, it is suitable for once-a-week
administration.
OBJECTIVE: To review the evidence favoring the use of idraparinux for the acute
and long-term treatment of patients with venous thromboembolism (VTE) and for the
prevention of thromboembolic events in patients with atrial fibrillation (AF).
METHODS: All preclinical and clinical studies carried out with the use of
idraparinux were sought through electronic searches of MEDLINE from January 1,
1999 up to December 31, 2007.
RESULTS: The administration of idraparinux in subcutaneous fixed doses of 2.5 mg
once weekly was found to be as effective and safe as conventional antithrombotic
therapy in the initial treatment of patients with deep vein thrombosis, but less
effective than standard therapy in the initial treatment of patients with primary
pulmonary embolism. During a 6-month extension of thromboprophylaxis, idraparinux
was effective in preventing recurrent VTE but was associated with an increased
risk of bleeding versus placebo. Finally, in patients with AF the long-term
treatment with idraparinux was as effective as vitamin K antagonists, but caused
more bleeding.
CONCLUSIONS: In its current formulation, idraparinux can be recommended only for
the initial treatment of patients with deep vein thrombosis. The bioequipotency
of a biotinylated version of idraparinux (idrabiotaparinux), whose effects can be
reversed by a neutralizing agent (avidin), is under investigation in the
treatment of VTE at present, as is the use of lower doses in patients with AF.
PMID: 18447601 [PubMed - indexed for MEDLINE
Predictive value of D-Dimer test, persistent residual venous thromnbosis, and thrombophilia for venous thromboembolism recurrence
No full textEvolving Knowledge on Primary and Secondary Prevention of Venous Thromboembolism in Carriers of Hereditary Thrombophilia: A Narrative Review
No full textThe association between heritability of venous thromboembolism (VTE) and thrombophilia was first reported clinically in 1956, later followed by the first description of a congenital cause of hypercoagulability-antithrombin deficiency-in 1965. Since then, our knowledge of hereditary causes of hypercoagulability, which may predispose carriers to VTE has improved greatly. Novel genetic defects responsible for severe thrombophilia have been recently identified and we have learned that a wide range of interactions between thrombophilia and other genetic and acquired risk factors are important determinants of the overall individual risk of developing VTE. Furthermore, therapeutic strategies in thrombophilic patients have benefited significantly from the introduction of direct oral anticoagulants. The present review is an overview of the current knowledge on the mechanisms underlying inherited thrombophilia, with a particular focus on the latest achievements in anticoagulation protocols and prevention strategies for thrombosis in carriers of this prothrombotic condition
Prevention and treatment of the chronic thromboembolic pulmonary hypertension
No full textChronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon and late complication of pulmonary embolism resulting from misguided remodelling of residual pulmonary thromboembolic material and small-vessel arteriopathy. CTEPH is the only form of pulmonary hypertension (PH) potentially curable by pulmonary endarterectomy (PEA). Unfortunately, several patients have either an unacceptable risk-benefit ratio for undergoing the surgical intervention or develop persistent PH after PEA. Novel medical and endovascular therapies can be considered for them. The soluble guanylate cyclase stimulator riociguat is recommended for the treatment of patients with inoperable disease or with recurrent/persistent PH after PEA. Other drugs developed for the treatment of other forms of PH, as prostanoids, phosphodiesterase-5 inhibitors and endothelin receptor antagonists have been used in the treatment of CTEPH, with limited benefit. Balloon pulmonary angioplasty is a novel and promising technique and is progressively emerging from the pioneering phase. Highly specialized training level and complex protocols of postoperative care are mandatory to consolidate the technical success of the surgical and endovascular intervention
New insights on the role of direct thrombin inhibitors for the prevention of venous thromboembolism after major orthopaedic surgery.
No full text
Scoring Systems for Estimating Risk of Venous Thromboembolism in Hospitalized Medical Patients
No full textDeep vein thrombosis and pulmonary embolism are associated with considerable morbidity and mortality in hospitalized patients, accounting for up to 10% of hospitalization-related deaths in both surgical and medical patients. Pharmacologic thromboprophylaxis has been demonstrated to be effective, safe, and cost-effective in preventing hospital-acquired venous thromboembolism (VTE) among medical inpatients, and clinician awareness of thrombotic risk promotes prescription of thromboprophylaxis. Guidelines recommend stratification of thrombotic risk for all patients and, unless contraindicated, administration of VTE prophylaxis. Based on several recognized predisposing and exposing risk factors for VTE, several scoring systems have been published in the past 15 years. Borrowing models developed in the surgical setting, recognized risk factors for VTE complications in medical inpatients have been combined in different weighted scores and derived and validated in heterogeneous medical populations. Although the perfect score, balancing thrombotic and hemorrhagic risk, has probably not yet been built, the adoption of an easy-to-use risk assessment model has the potential to support physicians in properly stratifying VTE risk in medical inpatients, tailoring thromboprophylaxis prescription
Heart disease in patients with pulmonary embolism
No full textPurpose of review: Several heart diseases are promoters of left-side cardiac thrombosis and could lead to arterial embolism. The same mechanism may be responsible for right-side cardiac thrombosis and therefore be a direct source of pulmonary embolism. Recent findings: Yasuoka et al. showed a higher incidence of perfusion defects in lung scan in patients with spontaneous echocontrast in the right atrium than in those without it (40% and 7% respectively; P = 0.006). We recently assessed the prevalence of heart diseases in 11.236 consecutive patients older than 60 years discharged from Venetian hospitals with a diagnosis of pulmonary embolism. We observed a higher prevalence of all-cause heart diseases (odds ratio 1.26; 95% confidence interval, 1.13-1.40) in patients with a diagnosis of pulmonary embolism alone (secondary or unprovoked) compared with those discharged with a diagnosis of pulmonary embolism associated with deep vein thrombosis, generating the hypothesis that some specific heart diseases in older patients could themselves be a possible source of pulmonary emboli. Summary: Further prospective studies are required to confirm these findings, which have the potential to open new horizons for the interpretation and management of venous thromboembolic disease. © 2010 Wolters Kluwer Health | Lippincott Williams and Wilkins
- …
