Search results for "Anticoagulation"
Review looks at optimal dosing for rapid reversal of vitamin K antagonists
A fixed-dose regimen of four-factor prothrombin complex concentrate was associated with lower mortality and fewer thromboembolic events compared with a variable-dose regimen, the systematic review and meta-analysis of anticoagulant reversal found.
https://acphospitalist.acponline.org/archives/2024/02/21/review-looks-at-optimal-dosing-for-rapid-reversal-of-vitamin-k-antagonists.htm
21 Feb 2024
Switching to newer oral anticoagulant didn't benefit frail older patients with afib
A randomized trial that switched some frail atrial fibrillation patients from vitamin K antagonists (VKAs) to non-vitamin K oral anticoagulants found that such patients had more bleeding and no decrease in thromboembolic events compared to those who stayed on a VKA.
https://acphospitalist.acponline.org/archives/2023/09/06/switching-to-newer-oral-anticoagulant-didnt-benefit-frail-older-patients-with-afib.htm
6 Sep 2023
Aspirin noninferior to LMWH for prophylaxis after traumatic fractures, trial finds
All-cause mortality at 90 days was similar in hospitalized patients randomized to aspirin versus low-molecular-weight heparin (LMWH), and rates of deep venous thrombosis and pulmonary embolism were also low in both groups.
https://acphospitalist.acponline.org/archives/2023/01/25/aspirin-noninferior-to-lmwh-for-prophylaxis-after-traumatic-fractures-trial-finds.htm
25 Jan 2023
Studies estimate risks of bleeding, death in patients with cancer and atrial fibrillation
One recent study compared the predictive value of the HAS-BLED, ATRIA, and ORBIT scores in patients with cancer and afib, while another looked at clot, bleeding, and mortality risk with warfarin versus a direct-acting oral anticoagulant in patients with both conditions.
https://acphospitalist.acponline.org/archives/2022/12/07/studies-estimate-risks-of-bleeding-death-in-patients-with-cancer-and-atrial-fibrillation.htm
7 Dec 2022
Evidence supporting perioperative management of anticoagulants remains limited
A systematic review and meta-analysis of studies addressing perioperative management of antithrombotic therapy, developed for a clinical practice guideline by the American College of Chest Physicians, found that data were sparse overall.
https://acphospitalist.acponline.org/archives/2022/12/07/evidence-supporting-perioperative-management-of-anticoagulants-remains-limited.htm
7 Dec 2022
LMWH may offer best risk-benefit profile for thromboprophylaxis in medical inpatients
A meta-analysis found that an intermediate dose of low-molecular-weight heparin (LMWH) had the most favorable balance of risk and harms during hospitalization for acute illness, while unfractionated heparin and direct oral anticoagulants had the least.
https://acphospitalist.acponline.org/archives/2022/07/13/lmwh-may-offer-best-risk-benefit-profile-for-thromboprophylaxis-in-medical-inpatients.htm
13 Jul 2022
Review finds 18% mortality in severe DOAC-related bleeding treated with reversal agent
A systematic review looked at 60 studies that evaluated four-factor prothrombin complex concentrates, idarucizumab, or andexanet for the treatment of severe or uncontrolled bleeding in patients on a direct oral anticoagulant (DOAC).
https://acphospitalist.acponline.org/weekly/archives/2021/06/16/4.htm
16 Jun 2021
Decision pathway addresses bleeding in patients on oral anticoagulants
The guidance from the American College of Cardiology covers management of major and minor bleeding in patients treated with direct-acting oral anticoagulants or vitamin K antagonists for any indication.
https://acphospitalist.acponline.org/weekly/archives/2020/07/22/4.htm
22 Jul 2020
Strategies for venous thromboembolism prophylaxis after knee replacement compared
A meta-analysis found that single strategies were more effective than combinations for preventing deep venous thrombosis and that insufficient data were available on the outcomes of pulmonary embolism and major bleeding.
https://acphospitalist.acponline.org/weekly/archives/2019/08/28/4.htm
28 Aug 2019
Bridging with heparin after stroke associated with worse outcomes than not bridging
Both ischemic and bleeding events within 90 days of stroke were more common among patients with nonvalvular atrial fibrillation who received full-dose low-molecular-weight heparin when starting a direct oral anticoagulant or warfarin.
https://acphospitalist.acponline.org/weekly/archives/2019/07/03/2.htm
3 Jul 2019
Apixaban linked to lower risk of serious bleeding compared to warfarin in patients with or without afib
A comparison of direct oral anticoagulants and warfarin found that apixaban had the lowest number needed to treat to avoid one extra major bleed compared to warfarin, while rivaroxaban had the lowest number needed to harm with death from bleeding.
https://acphospitalist.acponline.org/weekly/archives/2018/07/11/3.htm
11 Jul 2018
After ICH, patients on NOACs appear more likely to survive to discharge than those on warfarin
The findings in patients with intracerebral hemorrhage suggest that non–vitamin K antagonist oral anticoagulants may be better than warfarin for patients requiring an anticoagulant with or without concomitant antiplatelet therapy, the authors said.
https://acphospitalist.acponline.org/weekly/archives/2018/01/31/2.htm
31 Jan 2018
ACC releases decision pathway on bleeding in patients on oral anticoagulants
The pathway covers relevant laboratory tests, acute medical and surgical management, need for reversal, and the appropriateness and timing of restarting anticoagulation.
https://acphospitalist.acponline.org/weekly/archives/2017/12/06/1.htm
6 Dec 2017
Enoxaparin and dalteparin similarly effective for VTE prophylaxis in trauma patients
In a U.S. hospital, the low-molecular-weight heparin on the formulary was switched from enoxaparin to dalteparin and then back to enoxaparin, and venous thromboembolism (VTE) rates were compared under these policies.
https://acphospitalist.acponline.org/weekly/archives/2017/08/30/1.htm
30 Aug 2017
Restarting anticoagulation after intracerebral hemorrhage associated with lower thromboembolic risk
A meta-analysis found that more than a third of patients taking an anticoagulant before an intracerebral hemorrhage (ICH) restarted anticoagulation after the ICH, and they had lower rates of thromboembolic events.
https://acphospitalist.acponline.org/weekly/archives/2017/04/26/3.htm
26 Apr 2017
Vitamin K antagonist may mildly increase bleeding, markedly increase thrombosis in patients ages 80 and older
Compared with patients ages 70 to 79 years, those ages 80 to 89 years had a similar risk of bleeding, whereas patients ages 90 years or older had a mildly increased risk of bleeding, a study found. Patients in their 80s and 90s had a markedly higher risk of thrombosis than did patients in their 70s.
https://acphospitalist.acponline.org/weekly/archives/2016/07/13/4.htm
13 Jul 2016
Investigators respond to questions about ROCKET AF
A point-of-care device used to measure the international normalized ratio in the trial's warfarin arm was recalled in 2014 by the FDA due to risk for malfunctions leading to erroneous low readings.
https://acphospitalist.acponline.org/weekly/archives/2016/02/10/2.htm
10 Feb 2016
Restarting anticoagulation after GI bleed associated with reduced mortality in afib
Compared to patients who didn't restart medication, those who restarted oral anticoagulation alone had a significantly increased risk of major bleeding, but the risk of recurrent GI bleeding was not significantly increased.
https://acphospitalist.acponline.org/weekly/archives/2015/11/25/3.htm
25 Nov 2015
Risks and benefits of warfarin for afib differ with severity of kidney disease
In patients with atrial fibrillation and end-stage CKD requiring renal replacement therapy, warfarin use was not associated with any reduction in stroke risk or mortality, but there was an increased risk of major bleeding.
https://acphospitalist.acponline.org/weekly/archives/2015/09/23/4.htm
23 Sep 2015
Bleeding risk lower with aspirin vs. anticoagulation after hip fracture repair, but DVT risk may be higher
The risk of bleeding is lower with aspirin compared to anticoagulants after hip fracture surgery, but the risk of deep vein thrombosis (DVT) may be higher with aspirin, a new analysis found.
https://acphospitalist.acponline.org/weekly/archives/2014/07/30/4.htm
30 Jul 2014