Search results for "Venous thromboembolism."

A review of venous thromboembolism in COVID‐19: A clinical perspective

2021

Abstract Coronavirus disease‐19 (COVID‐19) started in Wuhan, China in December 2019 and spread to all around the world in a short period of time. Hospitalized patients with COVID‐19 mostly could suffer from an abnormal coagulation activation risk with increased venous thrombosis events and a poor clinical course. The reported incidence rates of thrombotic complications in hospitalized COVID‐19 patients vary between 2.6 and 85% (both in non‐critically ill and critically ill patients). The risk of venous thromboembolism is not known in non‐hospitalized patients with COVID‐19. There are numerous studies and guidelines for administration of thromboprophylaxis for COVID‐19 cases. All hospitalize…

Optimal management of hormonal contraceptives after an episode of venous thromboembolism

2019

Optimal management of hormonal contraception in patients with venous thromboembolism (VE) requires an individualized approach considering its potential benefits and complications during and after anticoagulant treatment. Potential benefits include prevention of pregnancy and mitigation of menstrual bleeding that is often worsened after start of anticoagulation therapy. Current evidence suggests that patients may opt for a continuation of (all forms of) hormonal contraception during anticoagulant treatment, provided that they are adequately informed by the treating physicians. Combined oral contraceptives should be stopped before anticoagulant therapy may he discontinued, preferably after th…

Neue orale Antikoagulanzien zur Therapie der venösen Thromboembolie

2011

In the current treatment of venous thromboembolism most patients are treated with vitamin K antagonists (VKA). VKA have many disadvantages including slow onset of action, multiple food and drug interactions and a large inter-individual variability in their efficacy. Recently several alternative oral anticoagulants have been developed, which have several advantages in comparison to VKA. So far two large randomized studies comparing new oral anticoagulants with VKA in patients with venous thromboembolism have been published: the RECOVER study with the oral direct thrombin antagonist dabigatran and the EINSTEIN-DVT study with the oral direct factor Xa-antagonist rivaroxaban. With regard to rec…

Verlängerte Sekundärprophylaxe nach venöser Thromboembolie

2018

Was ist neu? Aktuelle Studien Kurz nach Absetzen der oralen Antikoagulation kommt es zu einem etwa 2- bis 3-fachen Anstieg von VTE-Rezidiven. Das Rezidivrisiko ist besonders hoch nach einer VTE, die ohne identifizierbaren Auslöser aufgetreten war oder wenn nur weiche, unsichere auslösende Risikofaktoren vorlagen, sowie bei fortbestehenden Risikofaktoren, wie z. B. einer Krebserkrankung. Konsensusdokument über auslösende Risikofaktoren für venöse Thromboembolie In einem aktuellen Konsensusdokument wurden die zugrundeliegenden Risikofaktoren definiert und in 3 Gruppen klassifiziert. Direkte orale Antikoagulanzien Eine reduzierte Dosis von DOAK ermöglicht eine wirksame verlängerte Sekundärprop…

Response to Urrego et al

2015

Cancer‐associated venous thromboembolism: Treatment and prevention with rivaroxaban

2020

Abstract Cancer‐associated venous thromboembolism (VTE) is a frequent, potentially life‐threatening event that complicates cancer management. Anticoagulants are the cornerstone of therapy for the treatment and prevention of cancer‐associated thrombosis (CAT); factor Xa–inhibiting direct oral anticoagulants (DOACs; apixaban, edoxaban, and rivaroxaban), which have long been recommended for the treatment of VTE in patients without cancer, have been investigated in this setting. The first randomized comparisons of DOACs against low‐molecular‐weight heparin for the treatment of CAT indicated that DOACs are efficacious in this setting, with findings reflected in recent updates to published guidan…

Relation between Tissue Factor Pathway Inhibitor Activity and Cardiovascular Risk Factors and Diseases in a Large Population Sample.

2021

Abstract Objective Tissue factor pathway inhibitor (TFPI) is a potent anticoagulant protein in the extrinsic coagulation pathway. In the present study, we aim to identify the cardiovascular determinants for total TFPI activity and its association with cardiovascular disease (CVD) and total mortality. Methods Total TFPI activity was assessed in a selection of the population-based Gutenberg Health Study (n = 5,000). Statistical analysis was performed to identify the determinants for total TFPI activity as well as the associations with CVD and mortality. Results Multivariable linear regression analysis identified smoking (β 0.095 [0.054–0.136]) as a positive determinant for total TFPI activity…

Low molecular weight heparins in cancer patients: to treat thromboembolic events, the tumor, or both?

2011

The interrelationship between cancer and thrombosis is well known. Recent data help physicians to optimize the management of thrombotic complications occurring in cancer patients. However, many issues are still uncertain. First, although the development of venous thromboembolism (VTE) in a patient with known cancer is the most common presentation, concerns remain about the optimal duration and dosages of anticoagulants. Questions also arise concerning the need to implement heparin prophylaxis in the course of chemotherapy. Secondly, in some patients, thrombosis precedes the diagnosis of malignancy. In this case, the question is whether or not to screen patients for an occult cancer. Thirdly…

Antithrombotics and new interventions for venous thromboembolism: Exploring possibilities beyond factor IIa and factor Xa inhibition.

2021

Abstract Direct oral anti–activated factor X and antithrombin agents have largely replaced vitamin K antagonists as the standard of care in treatment of venous thromboembolism. However, gaps in efficacy and safety persist, notably in end‐stage renal disease, implantable heart valves or assist devices, extracorporeal support of the circulation, and antiphospholipid syndrome. Inhibition of coagulation factor XI (FXI) emerges as a promising new therapeutic target. Antisense oligonucleotides offer potential advantages as a prophylactic or therapeutic modality, with one dose‐finding trial in orthopedic surgery already published. In addition, monoclonal antibodies blocking activation and/or activ…

Treatment of pulmonary embolism.

2015

International audience; The treatment of pulmonary embolism is going to be deeply modified by the development of Direct Oral Anticoagulants (DOACs). There are currently three anti-Xa factors (rivaroxaban, apixaban, edoxaban) and one anti-IIa factor (dabigatran) labeled by the FDA and the EMA. All these drugs are direct anticoagulant, orally effective, without the need for adaptation to hemostasis test. As kidney excretion is involved for all of them, they are contra-indicated in patients with severe renal failure (creatinine clearance<30mL/min according to Cockcroft & Gault formula). All the anti-Xa factor drugs are metabolized by liver cytochromes and then contra-indicated in case of liver…