SearchThrombosis News Ticker
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FDA: Doctors Should Look For Alternatives To Blood Clot Drug
The FDA posted a letter to its Web site on Wednesday from Celgene Corp. warning users of blood-clot busting drug Innohep that new findings suggest the drug may lead to death in the elderly.
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Plavix Blood Thinner Effectiveness Influenced By Gene Variants
Two studies of heart patients showed that the blood thinner clopidogrel (brand name Plavix) was less effective in carriers of certain variants of a gene known to affect how the drug prevents blood clots than non-carriers.
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This year’s most interesting hematology stories
Two articles concerning anticoagulants are worth emphasizing. In February, Kenneth Bauer, MD, editorialized on a new oral anti-Factor Xa agent, rivaroxaban (Xarelto, Bayer/Ortho-McNeil). That it soon may replace parenteral anticoagulants in acute situations, as well as warfarin in more chronic conditions seems likely.
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West Penn Testing Possible Warfarin Replacement
“Rivaroxaban shows great promise as a replacement for warfarin, a medication that has been the only oral anticoagulant for the last 60 years, and can be difficult to dose correctly,” said Dr. Margaret Kennedy who is the principal investigator in the two trials.
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Trombocytopenia After Total Knee Arthroplasty
Heparin-induced thrombocytopenia is a serious complication during antithromboembolic prophylaxis caused by anti-heparin/platelet factor 4 (PF4) complex antibodies. It typically arises 3 to 15 days after the beginning of therapy and may result in an increased risk of arterial and venous thromboembolism.
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Estrogen receptor genotype is associated with risk of venous thromboembolism during tamoxifen therapy
Thromboembolism is a serious complication of tamoxifen therapy in women with breast cancer. Banked DNA from tamoxifen-treated individuals with breast cancer from the Marshfield Clinic Personalized Medicine Research Project, a population-based DNA repository, was tested for association between incidence of tamoxifen-associated thromboembolic events (TTE) and single nucleotide polymorphisms encoding the estrogen receptors 1,2 (ESR1, ESR2) or drug metabolism enzymes cytochrome P450 2D6 (CYP2D6) and aromatase (CYP19)
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Incidence and clinical implications of venous thromboembolism in advanced colorectal cancer patients: The 'GISCAD-alternating schedule' study findings
VTE is a common complication among advanced colorectal cancer patients and yet this type of toxicity is widely underestimated. In this randomised trial, VTE was the most frequent grade 3/4 toxicity. Use of an intermittent schedule is associated with a reduced risk of developing VTE.
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Rising prevalence of venous thromboembolism and its impact on mortality among hospitalized inflammatory bowel disease patients
We sought to determine nationwide, population-based trends in rates of venous thromboembolism (VTE) among hospitalized inflammatory bowel disease (IBD) patients in the United States and to determine its mortality and economic impact.
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Evaluation of a new venom-based clotting assay of protein C
Congenital protein C deficiency significantly increases the risk of venous thromboembolism, a serious and potentially lethal condition. Protein C levels can be determined by chromogenic, clotting and antigenic assays, each type of assay has differences in specificity and sensitivity to protein C deficiency.
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Quality Improvement Program Enhances Stroke Care
A quality-improvement program increased compliance with guidelines for stroke treatment issued by the American Heart Association and American Stroke Association at nearly 800 hospitals, researchers found.
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Increased Risk Of DVT But Treatment Lags
"Incredibly, we found as many as 43 per cent of the patients developed postthrombotic syndrome, and one-third of those had moderate to severe cases," said McGill's Dr. Susan R. Kahn, lead author of the study. "The syndrome is characterized by persistent leg pain and swelling, and in severe cases, patients can develop painful leg ulcers which are very difficult to treat.
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Determinants and Time Course of the Postthrombotic Syndrome After Acute Deep Venous Thrombosis - Abstract
The postthrombotic syndrome occurs frequently after DVT. Patients with extensive DVT and those with more severe postthrombotic manifestations 1 month after DVT have poorer long-term outcomes.
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Diesel exhaust inhalation increases thrombus formation in man
Inhalation of diesel exhaust increases ex vivo thrombus formation and causes in vivo platelet activation in man. These findings provide a potential mechanism linking exposure to combustion-derived air pollution with the triggering of acute MI.
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ASH: Thombosis Risk Increased in ITP
Having immune thrombocytopenia purpura (ITP) appears to increase the risk of thrombosis, a British researcher said here. The risk appears to be primarily associated with venous thromboembolic events, he said at the American Society of Hematology meeting.
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Avoid the clot
PATIENTS going for knee and hip surgeries have to watch out for one possible complication: getting a blood clot that is potentially fatal. In North America now, it's mandatory for such patients to take a blood thinner after the surgery, says Dr Louis Kwong, an orthopaedic surgeon from Harbor-UCLA Medical Center in Torrance, California.
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Knowledge of Venous Thromboembolism (VTE) prevention among hospitalized patients
Findings suggest that patients require further information on VTE during their hospitalization to enhance their involvement in VTE prevention and recognition, and that the provision of written, patient-directed information could begin to address that lack of involvement. This study also highlights the need to strengthen the nurses' role in providing patient education about VTE.
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Improving Inpatient Venous Thromboembolism Prophylaxis
The number and types of inpatients given inadequate prophylaxis for venous thromboembolism (VTE) are not known; patients receive less than appropriate prophylaxis with some frequency.
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New anti-blood clot drug approved
A new palliative care drug was yesterday approved by the agency that determines the medicines made available through the NHS in Scotland. The Scottish Medicines Consortium (SMC) has accepted Xarelto (rivaroxaban), an oral anti-coagulant for the prevention of venous blood clots in adults undergoing elective hip or knee replacement surgery.
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Pooled Xarelto data underlines superiority over Lovenox
Bayer has presented more positive data on Xarelto which the firm says underlines the superior efficacy of the anticoagulant compared with the current gold standard treatment, Sanofi-Aventis’ Lovenox.
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ASH: Prophylactic Blood-Thinners Prevent Thromboembolism in Cancer Patients
Prophylactic treatment with a blood-thinner can markedly reduce -- by about 50% -- the rate of thromboembolism in cancer patients undergoing chemotherapy, researchers found. Currently, such prophylaxis is rarely used for ambulatory cancer patients, in whom the rate of thromboembolism is between 4% and 10%...
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Rivaroxaban Reduces Symptomatic VTE & Death Following Knee or Hip Replacement Surgery by More Than 50% Compared to Enoxaparin in Pooled Analysis of the RECORD Clinical Trial Program
Results from a pre-specified pooled analysis of the RECORD clinical trial program showed that the novel, investigational, oral anticoagulant rivaroxaban was superior to enoxaparin treatment regimens for the prevention of venous thromboembolism (VTE) after total knee or hip replacement surgery. The data also show that rates of major bleeding were low and not statistically different from the comparator.
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Research Highlights New Approaches to Prevent Blood Clots in Several High-Risk Patient Populations Including Largest Study Ever to Examine Use of Blood-Thinning Medication in Patients With Cancer
The largest study ever to examine the preventive use of blood-thinning medication to help prevent deadly blood clots in patients with cancer undergoing chemotherapy will be presented in a press conference on Sunday, December 7, at 9:30 a.m., during the 50th Annual Meeting of the American Society of Hematology in San Francisco, CA. Additional research being featured at the press conference includes studies that examine the use of three different investigational blood-thinning medications that belong to a new class of therapies called Factor Xa inhibitors.
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Idiopathic Pulmonary Fibrosis Triples Vascular Risk
Patients with idiopathic pulmonary fibrosis have more than triple the risk of acute coronary syndrome and deep-vein thrombosis, according to a review of primary care data.
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Prothrombin Time for Detection of Contaminated Heparins
The recent "heparin scandal" resulted from the use of contaminated heparin that caused serious adverse events including death. The contaminant was identified as synthetically oversulfated chondroitin sulfate (OSCS). Despite the missing final proof of a cause-and-effect relationship, OSCS was shown to have pharmacologic effects that may contribute to the observed allergic-type reactions.
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Hospital patients get DVT exercise video beamed to their bedside
Developed by a physiotherapist at Cambridge University Hospitals NHS Foundation Trust, which runs the hospital, the exercises are designed to help prevent deep vein thrombosis and other complications associated with immobility.
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A potential thrombus diagnosis reagent based on P-selectin monoclonal antibody SZ-51 light chain
The yield of SZ-LC by the expression and purification method reached above 70 mg/L culture. We found that the nucleotide from 99mTc-SZ-LC was removed quickly through animal kidney, and 99mTc-SZ-LC could bind specifically to the activated human platelet in vitro. More importantly, with this recombinant protein, we successfully detected the fresh thrombus that was induced in dog vein. These results suggested that the recombinant SZ-LC expressed by P. pastoris was functional active and a potential reagent for thrombus diagnosis.
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Thrombosis patients face greater risks than previously believed
"Incredibly, we found as many as 43 per cent of the patients developed postthrombotic syndrome, and one-third of those had moderate to severe cases," said McGill's Dr. Susan R. Kahn, lead author of the study. "The syndrome is characterized by persistent leg pain and swelling, and in severe cases, patients can develop painful leg ulcers which are very difficult to treat. "Contrary to popular belief, DVT doesn't just affect older people, it can affect adults of all ages," explained Kahn...
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FDA Requests Label Change for Tinzaparin
After reviewing results of an aborted European study involving tinzaparin (Innohep), a low molecular weight heparin product, the FDA said the drug's label should reflect increased risks for patients 70 and older.
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Right-atrial floating thrombus attached to the interatrial septum with massive pulmonary embolism diagnosed by echocardiography
The presence of a right-atrium thrombus is considered as an unusual form of thromboembolic disease, with a prevalence of 10–18%. Most of them are located in the right-atria. Its mortality is about 45%. Echocardiography is very important to detect them and to control the effectiveness of the treatment, which can be either conservative or surgical.
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Transfusing Anemic Cancer Patients Boosts Clot Risk
Giving blood transfusions to treat anemia in cancer patients increases the risk of potentially lethal blood clots, say University of Rochester, N.Y., researchers. But this risk is no greater than other treatments for cancer treatment-related anemia, the scientists said, after having analyzed data on more than 70,500 cancer patients who received transfusions at 60 medical centers from 1995 to 2003.
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Prediction of Recurrent Venous Thromboembolism by Endogenous Thrombin Potential and D-Dimer
Increased thrombin generation is associated with an increased risk of recurrent venous thromboembolism. We investigated the relation between endogenous thrombin potential (ETP) and risk of recurrent venous thromboembolism and evaluated whether prediction of recurrence can be improved by a combined analysis of ETP and D-dimer.
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FDA Warning: List of Medical Devices & Diagnostic Products that May Contain Heparin
The FDA updated its heparin recall list to include medical devices and diagnostic products that may contain or be coated with heparin. The FDA does not mean to suggest that all of the products herein have been or are affected by contaminated heparin, but its purpose is to warn consumers of potential products and devices that could be life-threatening if they contain contaminated heparin.
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Do You Know You're Having a Stroke?
Researchers studied 400 patients who were diagnosed at Mayo Clinic's emergency department with either acute ischemic stroke or a transient ischemic attack (TIA), a temporary interruption of blood flow to part of the brain. Less than half of the patients -- 42 percent -- thought they were having a stroke.
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Effect of deep vein thrombosis on ischaemia-modified albumin levels
Conclusions: DVT is associated with raised serum IMA levels but IMA levels are not suitable as a diagnostic marker for DVT.
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Maternal Mortality and Immortality
The majority of maternal deaths in the U.S. are due to pulmonary emboli from blood clots and most often occur in the period after delivery (postpartum). Pregnancy causes an increased risk of pulmonary thromboembolus due to an increase in the ability to coagulate blood.
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Isolated Gastro-Soleal DVT Can Be Associated With Progressive DVT And Pulmonary Emboli, And Should Be Treated
...He discovered that isolated gastronemial or soleal vein DVT (GSDVT) appears to be associated with pulmonary embolism (PE) and a significant incidence of new ipsilateral and contralateral DVT and as a result should be treated if there is no major cancer operations.
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Breaking: Incidence, Risk Factors, And Treatment Patterns Revealed For Deep Venous Thrombosis (DVT) In Hospitalized Children
Pediatric venous thromboembolic events (VTEs) are rare but studies suggest that pediatric VTEs are an increasing concern in tertiarycare hospitals due to factors unique to the pediatric population.
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Primary Factor Influencing Treatment Choice For Subclavian Vein Thrombosis Is Time Since Onset Of Symptoms
Primary subclavian vein thrombosis (also called "effort thrombosis" or Paget-von Schrötter syndrome) refers to thrombosis of the subclavian vein at the junction of the first rib and clavicle, and is often associated with either prolonged or repetitive upper extremity strain in young, healthy, often muscular and athletic patients.
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Transfusions Increase Clot Risk In Hospitalized Cancer Patients, Scientists Find
Blood transfusions used to treat anemia in patients with cancer are associated with an increased risk of life-threatening blood clots, at a similar rate as other treatments for cancer-induced anemia, according to scientists at the University of Rochester Medical Center.
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Mechanical Thrombectomy And Thrombolysis In The Treatment Of Acute Limb Ischemia
Etiologies of acute limb ischemia include thrombosis or embolism. With the exception of an embolus, where an embolectomy can quickly restore normal arterial flow, thrombosis of a native artery is associated with a complex occlusion, which includes underlying atherosclerosis.
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New Approaches To Clot Removal With Lower Extremity DVT Announced At The VEITH Symposium
With the recent recognition that thrombolysis should be considered in first time proximal deep vein thrombosis (DVT), the quest for the best agents and the best delivery systems remains the challenge.
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Influence of thrombophilia on risk of recurrent venous thromboembolism while on warfarin: results from a randomized trial
We sought to determine whether thrombophilic defects increase recurrent venous thromboembolism (VTE) during warfarin therapy. Six hundred sixty-one patients with unprovoked VTE who were randomized to extended low-intensity (international normalized ratio [INR], 1.5-1.9) or conventional-intensity (INR, 2.0-3.0) anticoagulant therapy were tested for thrombophilia and followed for a mean of 2.3 years.
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Ultrasound waves aid in rapid treatment of DVT
The use of ultrasound waves for deep vein thrombosis (DVT) may help dissolve blood clots in less time than using clot-busting drugs alone, according to researchers at Emory University. The study will be presented Sunday, Nov. 23, 2008 at the annual VEITHsymposium in New York City.
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Smoking During Pregnancy Damages Child's Artery
Researchers from The Netherlands found children of mothers who smoked during pregnancy had linings of carotid arteries in the neck that were 13.4 micrometers thicker by young adulthood than offspring whose mothers didn’t smoke.
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Hospitals making progress on blood clot risk assessments
The all-party parliamentary thrombosis group revealed today that 70 per cent of hospitals are now risk assessing all patients for venous thromboembolism in line with recommendations from chief medical officer Sir Liam Donaldson, published last year.
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THOUSANDS of patient deaths from blood clots acquired in hospital have been prevented following a Sun campaign.
Ten times more people were dying of hospital-acquired clots than MRSA and other NHS superbugs. But most deaths are easily prevented with £2 blood-thinning jabs or a pill called rivaroxaban. We urged hospitals to identify patients most at risk.
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Bevacizumab significantly increases venous thromboembolism
The angiogenesis inhibitor bevacizumab (Avastin, Genentech/Roche) significantly increases the risk for venous thromboembolism (VTE), a new meta-analysis concludes. Because the drug is being increasingly used in the routine treatment of cancer patients, the authors suggest that this new finding might merit a black-box warning.
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OCT imaging suggests low rates of uncovered/malapposed struts following DES for AMI
One of the hottest new technologies in the cardiovascular imaging arena is providing a new point of view in the ongoing debate over the safety of drug-eluting stents (DES) for acute MI. A new study using optical coherence tomography (OCT) suggests that exposed and malapposed stent struts in the setting of acute MI (AMI) are indeed more common with DES than with bare-metal stents, but the problem is relatively rare.
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Thrombolysis may increase mortality among unlikely candidates with pulmonary embolism
Researchers from the Department of Veterans Affairs Pittsburgh Healthcare System and the University of Pittsburgh in Pennsylvania, and from the University of Lausanne in Switzerland, conducted an analysis to determine the prevalence of thrombolytic therapy and its benefits in patients hospitalized for acute pulmonary embolism.
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Determinants and Time Course of the Postthrombotic Syndrome after Acute Deep Venous Thrombosis
The postthrombotic syndrome occurs frequently after DVT. Patients with extensive DVT and those with more severe postthrombotic manifestations 1 month after DVT have poorer long-term outcomes.
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Elevated Levels of C-Reactive Protein Associated With Stent Thrombosis: Presented at AHA
Patients with elevated levels of C-reactive protein (CRP) before they undergo percutaneous coronary intervention (PCI) with stent implantation have a higher risk of developing stent thrombosis and stent-related death...
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THINRS: Home INR monitoring as effective as clinic-based care
Results of a new randomized comparison shows that weekly home INR monitoring is safe but did not reduce stroke, major bleeds, or death when compared with monthly clinic-based INR testing.
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A Prospective Randomized Controlled Trial of the Impact of Home INR Testing on Clinical Outcomes–The Home INR Study
A total of 2922 patients from 28 VA hospitals were randomized to PST or conventional testing. At 3-year follow-up, the composite primary endpoint occurred in 7.9% of PST and 8.9% of conventional testing groups (p=not significant). The time to first major event trended in favor of PST (HR 0.87, p=0.10). Time in target range (70% vs. 62%) and patient satisfaction (49 vs. 47 points on the Duke Anticoagulation Satisfaction Score) favored PST.
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Heartburn drugs harm effectiveness of Plavix-study
Patients taking proton pump inhibitors such as Nexium or Prilosec had a 50 percent higher risk of a major cardiovascular event when also taking clopidogrel, the active ingredient in Bristol-Myers Squibb Co's blood clot preventer Plavix...
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New factor Xa inhibitor rivaroxaban moves into phase 3 for ACS
The ATLAS ACS-TIMI 46 trial identified two doses of rivaroxaban—2.5 mg and 5 mg twice daily—that will be taken forward into a phase 3 trial, Gibson said. This study is slated to begin next month, will enroll up to 16 000 patients, and is estimated to last around 33 months.
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Thromboembolism Prophylaxis in End-Stage Renal Disease
This study aimed to identify risk for venous thromboembolism (VTE) and prophylaxis patterns for end-stage renal disease (ESRD) patients admitted through the emergency department (ED).
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Atrial Fibrillation Found to be Common in Patients With Atherothrombosis, Increases Risk of Cardiovascular Death, Heart Attack and StrokeA significant portion of patients with atherothrombosis also have atrial fibrillation (AF), greatly increasing th
A significant portion of patients with atherothrombosis also have atrial fibrillation (AF), greatly increasing their risk for cardiovascular death, heart attack and stroke, according to new findings from the large, international REACH registry published today in the American Heart Journal. The findings also showed that standard treatments including anticoagulant and antiplatelet therapies are underused in AF patients.
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FDA Seizes Bad Heparin From Ohio Drugmaker
OSCS contaminant in injectable drug products containing heparin has been linked to multiple adverse events and deaths initially reported to the FDA in January 2008. The seized Celsus Heparin – which had entered the US before the establishment of import controls for the drug – was tested for the presence of OSCS as part of the agency’s recent efforts to inspect and monitor Heparin products.
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A computer system reduces venous thromboembolism rate amongst hospitalised patients by half
The system evaluates, calculates and annotates on a daily basis the thrombotic risk of all patients hospitalised at the University Hospital as a function of the risk factors that they present. Depending on the risk calculated for a specific patient, the computer system generates an alert that appears on the computer screen of the doctor responsible for this patient.
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Abrupt oxygen decrease influences thrombosis and bleeding in stenosed and endothelium-injured rabbit carotid arteries
Conclusion: An abrupt decrease in oxygen administration was responsible for an antithrombotic effect. Increase in bleeding time occurred during hypoxia. No clinically relevant variation of any haemostasis parameters was observed.
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Benefit of Oral Anticoagulant Over Antiplatelet Therapy in Atrial Fibrillation Depends on the Quality of International Normalized Ratio Control Achieved by Centers and Countries as Measured by Time in Therapeutic Range
Conclusions: OAC is more effective than antiplatelet therapy in preventing thromboembolic complications of AF, but only if the TTR is >58%.
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FDA Warns on Mexican Vanilla
The U.S. Food and Drug Administration (FDA) has just issued a warning about so-called Mexican “vanilla” that has been found to be typically made with a toxic substance called coumarin. The FDA issued the warning this week and is advising consumer not to buy this product.
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Bleeding into the intraluminal thrombus in abdominal aortic aneurysms is associated with rupture
The site of rupture could be identified in a majority of cases of AAA with routine multislice CT. This study demonstrates an association between the presence of blood in the thrombus as suggested by higher attenuation levels and a crescent sign and AAA rupture. If these findings also predict AAA rupture, remains to be established.
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Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)
The following are 10 points to remember about these guidelines on the diagnosis and management of acute pulmonary embolism (PE):...
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Bayer's 'revolutionary' anticoagulant Xarelto launched
Professor Ajay Kakkar is professor of surgical sciences, Barts and the London School of Medicine and Dentistry and director of the Thrombosis Research Institute in London. He comments: "Thrombosis remains a major clinical challenge and today's announcement of the availability of Xarelto provides exciting new opportunities to protect patients from potentially fatal blood clots
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Common Heart Drugs May Hamper Blood Thinner
Studying 200 people who were taking Plavix after artery-opening procedures and stent placement, the University of Vienna researchers found a higher level of activity of platelets -- the blood cells that can clump together to form blood clots -- in those also taking calcium channel blockers.
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Osteoporosis Drugs Increase Risk for Heart Problems
People who take bisphosphonates for osteoporosis may be at risk for serious atrial fibrillation (AF), or irregular heartbeats, according to a new study.
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Don't give kids on drug-thinner natural products: docs
Giving herbs, vitamins and other natural health products to children taking the blood-thinning drug warfarin for congenital heart defects could increase their risk of clots and bleeding, the Canadian Cardiovascular Congress was told Monday.
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Simplification of the Revised Geneva Score for Assessing Clinical Probability of Pulmonary Embolism
The revised Geneva score is a fully standardized clinical decision rule (CDR) in the diagnostic workup of patients with suspected pulmonary embolism (PE). The variables of the decision rule have different weights, which could lead to miscalculations in an acute setting. We have validated a simplified version of the revised Geneva score.
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Deep vein thrombosis after monoclonal gammopathy of undetermined significance and multiple myeloma
Patients with multiple myeloma (MM) have an increased risk of deep venous thrombosis (DVT), particularly when treated with immunomodulatory drugs. Recently, 2 small hospital-based studies observed persons with the MM precursor condition, monoclonal gammopathy of undetermined significance (MGUS), to be at increased risk of developing DVT.
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Adding access blood flow surveillance to clinical monitoring reduces thrombosis rates and costs, and improves fistula patency in the short term: a controlled cohort stu
Our controlled cohort study shows that adding Qa surveillance to monitoring in mature AVFs is associated with a better detection and elective treatment of stenosis, and lower thrombosis rates and access-related costs, although the cumulative access patency was only extended in the first 3 years after fistula maturation. We are aware of the limitations of our study (non-randomization and the possible centre effect) and that further, better-designed trials are needed to arrive at a definitive answer concerning the role of Qa surveillance for fistulae.
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Exhaust Emissions and Their Dangers
Traffic emissions, for example, are now known to dramatically increase the potential risk of a fatal blood clot known as DVT, or deep vein thrombosis. Asthma, respiratory complications, and even heart or lung disease are also some of the more commonly known health effects of long-term air pollution that are associated with exhaust emissions.
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DNA research taking guesswork out of finding the 'therapeutic window'
At the top of the list of problem drugs is Warfarin, (Coumadin®), the most widely prescribed anticoagulant. That is why Evgeny Krynetskiy, Ph.D., associate professor and director of the Jayne Haines Center for Pharmacogenomics and Drug Safety, has focused his research efforts on that drug.
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ODESSA Trial Looks Inside Drug-Eluting Stents With Optical Coherence Tomography (OCT)
OCT is a catheter-based system which provides a high resolution image of the inner artery surfaces (10 microns) and can easily show if stents have been covered by the body's endothelial cells. Theoretically, as long as metal stent struts remain uncovered, healing is delayed and the risk of blood clotting (stent thrombosis) inside the artery is higher.
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Neointimal formation is reduced after arterial injury in human crp transgenic mice
Elevated CRP levels predict increased incidence of cardiovascular events and poor outcomes following interventions. There is the suggestion that CRP is also a mediator of vascular injury. Transgenic mice carrying the human CRP gene (CRPtg) are predisposed to arterial thrombosis post-injury. We examined whether CRP similarly modulates the proliferative and hyperplastic phases of vascular repair in CRPtg when thrombosis is controlled with daily aspirin and heparin at the time of trans-femoral arterial wire-injury.
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Rectus sheath hematoma
Rectus sheath hematoma (RSH) is a known complication of anticoagulation therapy and a source of potential morbidity and mortality. Early diagnosis and appropriate treatment may help to prevent complications including hemodynamic instability, the abdominal compartment syndrome or multiorgan dysfunction.
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Stent Thrombosis, Clinical Events, and Influence of Prolonged Clopidogrel Use After Placement of Drug-Eluting Stent: Data From an Observational Cohort Study of Drug-Eluting Versus Bare-Metal Stents
The authors concluded that, compared with BMS, DES showed a similar risk of overall ST, but a higher risk of very late ST. Clopidogrel continuation beyond 1 year did not appear to reduce ST and clinical events.
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PREPARE: Proximal embolic protection with aspiration improves immediate ST-segment resolution
The use of an embolic-protection and aspiration device proximal to the lesion in primary PCI results in better immediate microvascular flow in ST-segment-elevation MI (STEMI) patients compared with primary PCI alone, a new study has shown. There was no difference in ST-segment resolution between the two treatments at two hours, nor was there a difference in myocardial blush grade or clinical outcomes at 30 days between the two arms.
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Bleeding complications during warfarin treatment in primary healthcare centres compared with anticoagulation clinics
There was no difference in bleeding complications between patients monitored at primary healthcare centres and specialized anticoagulation clinics. Age was continuously and independently associated with bleeding risk. These study data indicate the need to exercise caution in treatment of the elderly.
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New Remedies to Treat Blood Clots Are Near: Big Drug Makers Aim to Reduce Drawbacks of Existing Medicines
Drugs currently used to prevent blood clots, also known as thrombosis, are effective and sell well but have problems. One popular treatment is difficult to dose and introduces risks when taken with other medicines and some foods. Another is an injectable, making long-term therapy difficult.
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Older Donors Lead to Late Hepatic Artery Thrombosis in Liver Recipients: Presented at ACS
Results show that the risk of HAT increased with each increasing decade of life of the donor. There was no significant risk if the donor was less than 50 years old, while the relative risk was 1.35 for donors in their 50s and 1.52 for donors in their 60s. Donors older than 70 years produced a relative risk of HAT of 1.61 for the recipients (all risk values were significant, P < .001).
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Left atrial volume index predicts risk of first ischemic stroke
An elevated left atrial volume index (LAVI) is associated with an increased risk of first ischemic stroke and subsequent mortality, according to a report in the October issue of the Mayo Clinic Proceedings. "Left atrial volume is a barometer, a reflection of chronic increase in atrial pressure, which accounts for the increase in thrombus formation (increased stroke risk),"...
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PRoximal Embolic Protection in Acute MI and Resolution of ST-Elevation
This study is similar to other studies, which have indicated that of the mechanical thrombectomy devices, thrombus aspiration devices may be associated with a clinical benefit and more complete STR compared with primary PCI alone, whereas embolic protection devices have a neutral effect on these outcomes.
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Bone Quality in Children may be Compromised by Therapy With Vitamin K-Antagonists
The major outcome of the study was that children undergoing long-term oral anticoagulant therapy presented higher levels of inactive osteocalcin, indicative of poor vitamin K status. Moreover, bone resorption markers were enhanced whereas bone formation markers and vitamin D levels were lower in comparison to the control group. Additionally, more than half of the examined children in the patients group showed signs of osteopenia, which means their bone mineral density was lower than normal.
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Blood Clots in Children and Young Adults
Deep-vein thrombosis (blood clots in the veins of the body; also called DVT) and pulmonary embolism blood clots in the lungs; also called PE) can occur at any age. Although blood clots occur more commonly in adults, about 1 in 10,000 children will be affected. The first month of life (especially in premature and other hospitalized infants) and the teenage years appear to be times of greatest risk for young people to develop blood clots.
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IgA antiphospholipid antibodies are an independent risk factor for thromboses
Antiphospholipid antibodies (lupus anticoagulant, anti-cardiolipin and anti-β2-glycoprotein I antibodies, mostly IgG isotype) are strong risk factors for thrombosis. Because a paucity of information on IgA isotype exists in the literature, we retrospectively evaluated the thrombotic significance of IgA antiphospholipid antibodies.
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No increased risk, but no MI/mortality benefit with DES, experts cautiously conclude
Leaders of some of the more provocative drug-eluting-stent (DES) trials and registries of the past few years now seem to cautiously agree that DES likely do not increase mortality compared with bare-metal stents, but none were convinced that the newer devices might actually provide a mortality benefit across the board.
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First-in-human data with novel polymer-coated stent: No thrombosis at 12 months
Promising first-in-human data with a new cobalt-chromium stent coated with a novel polymer suggest that the device eliminates the risk of potential late stent thrombosis. Investigators reported no cases of stent thrombosis at 12 months in patients implanted with the stent, as well as no adverse clinical events, despite stopping dual antiplatelet therapy at 30 days.
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Vulnerable plaque may be easier to detect through new imaging technology
Research results indicate that optical coherence tomography (OCT), a newly evolving imaging method, may be the best tool available to detect vulnerable plaque in coronary arteries. The findings will be presented at the 20th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).
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Antiphospholipid Syndrome (APS)
Most importantly, it causes an abnormal blood clot. A blood clot in medical terms is called a thrombosis (two or more blood clots are called thromboses). The most common clots are deep within the legs (deep venous thrombosis or DVT). The leg becomes swollen and painful in most cases. When a blood clot breaks loose and floats away to lodge elsewhere, it is called an embolus. Blood clots from a DVT can travel to the lungs and damage or kill parts of the lung. These are called pulmonary emboli.
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Risk factors of abdominal venous thrombosis
Their result indicate that hereditary and acquired risk factors play an important role in etiopathogenesis of abdominal venous hrombosis. Acquired risk factors are significantly more common in patients with SVT while hereditary risk factors are similar in patients with BCS and SVT.
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Massage Therapy in the Relief of Cancer Pain.
There are contraindications to massage. Patients with DVT (Deep Vein Thrombosis) should be handled carefully because Pulmonary Emboli may develop as a result of the massage therapy (Stephenson et al 2000).
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Warfarin warning: Shortfalls in anticoagulation for AF up risks of ICH and embolic stroke
Most patients with atrial fibrillation (AF) aren't getting prescriptions for warfarin, and of those who are on warfarin, most aren't being anticoagulated to the proper therapeutic extent; their international normalized ratios (INRs) are frequently outside the recommended range of 2.0 to 3.0, which puts them at significantly increased risk of intracranial hemorrhage or embolic stroke…
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When Improper Administration of Anticoagulants Causes Injuries to Patients
Anticoagulants do not have the capacity to break up existing clots. Their focus is on prevention. The most common anticoagulants used in Heparin. It has been found that sixty percent of life-threatening or lethal medication errors involve intravenous drugs such as Heparin.
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Risk of Hemodialysis Graft Thrombosis: Analysis of Monthly Flow Surveillance.
Flow and change in flow are inaccurate predictors of thrombosis. Many thromboses are not predicted, and intervention based on surveillance likely yields many unnecessary procedures. Thus, this study does not support routine application of surveillance to prevent thrombosis.
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Pulmonary Embolism Incidence Is Increasing With Use of Spiral Computed Tomography
The authors concluded that the incidence of PE is increasing with increasing CT use, whereas the severity of illness and the mortality from PE are decreasing. They conclude that this suggests earlier diagnosis is the cause of the changes seen.
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The Importance of Clinical Probability Assessment in Interpreting a Normal d-Dimer in Patients With Suspected Pulmonary Embolism
Our findings indicate that it is of utmost importance to first examine the patient and assess the clinical probability, after which the d-dimer concentration can be taken into account, in order to prevent physicians from being influenced by a normal d-dimer test result when they evaluate the clinical probability of PE. Patients with a likely clinical probability should undergo further testing, regardless of the d-dimer test outcome.
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Serial 2-Point Ultrasonography Plus D-Dimer vs. Whole-Leg Color-Coded Doppler Ultrasonography for Diagnosing Suspected Symptomatic Deep Vein Thrombosis: A Randomized Controlled Trial
Conclusions: A strategy of serial S2PU is equivalent to WLU for management of symptomatic patients with suspected lower extremity DVT.
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Systematic Review: D-Dimer to Predict Recurrent Disease after Stopping Anticoagulant Therapy for Unprovoked Venous Thromboembolism
In patients who have completed at least 3 months of anticoagulation for a first episode of unprovoked VTE and after approximately 2 years of follow-up, a negative D-dimer result was associated with a 3.5% annual risk for recurrent disease, whereas a positive D-dimer result was associated with an 8.9% annual risk for recurrence.
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Elective PCI possible without "safety net" of anticoagulation
Low-risk patients with uncomplicated lesions can have elective PCI safely performed using dual antiplatelet therapy without systemic anticoagulation, the so-called coronary intervention "safety net," according to the results of the Coronary Interventions Antiplatelet-Based Only (CIAO) study.
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