Thrombosis research
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Thrombosis research · Sep 2015
Review Meta AnalysisTreatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants.
Low-molecular-weight heparin (LMWH) and vitamin K antagonists (VKA) are current treatment options for cancer patients suffering from acute venous thromboembolism (VTE). The role of direct-acting oral anticoagulants (DOACs) for the treatment of VTE in cancer patients, particular in comparison with the current standard of care which is LMWH, remains unclear. In this network meta-analysis, we compared the relative efficacy and safety of LMWH, VKA, and DOAC for the treatment of cancer-associated VTE. ⋯ Austrian Science Fund (FWF-SFB-54).
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Thrombosis research · Sep 2015
Clinical TrialReliability of thromboelastometry for detecting the safe coagulation threshold in patients taking acenocoumarol after elective heart valve replacement.
Reversal of anticoagulation can be needed in patients undergoing heart valve surgery. ROTEM® has been correlated with international normalized ratio (INR) in patients on warfarin but not with patients on acenocoumarol. This study investigates the reliability of ROTEM® for detecting INR values below the 1.5 threshold in patients on acenocoumarol therapy. ⋯ Our preliminary results suggest that CT≥84seconds in the EXTEM ROTEM® test is a feasible method for predicting an insufficient reversion of oral anticoagulant therapy in patients taking acenocoumarol after elective heart valve surgery.
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Thrombosis research · Sep 2015
Controlled Clinical TrialPreoperative platelet aggregation predicts perioperative blood loss and rethoracotomy for bleeding in patients receiving dual antiplatelet treatment prior to coronary surgery.
Patients scheduled for coronary artery bypass graft surgery (CABG) are commonly treated with clopidogrel. We sought to assess the relation between preoperative platelet aggregation and bleeds in CABG patients on clopidogrel. ⋯ Patients on aspirin and clopidogrel <5days before CABG who had preoperative ADP-induced platelet aggregation ≥50% have bleeding risk similar to those receiving aspirin monotherapy. Reduced platelet reactivity to ADP can predict postoperative bleeding in CABG patients on dual antiplatelet therapy.
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Thrombosis research · Sep 2015
Mechanisms of hypercoagulability in nephrotic syndrome associated with membranous nephropathy as assessed by thromboelastography.
Thromboelastography (TEG) was performed to assess potential hypercoagulability in Nephrotic syndrome (NS) patients with membranous nephropathy (MN) and to explore correlated factors contributing to hypercoagulable status ⋯ MN patients tend to be more hypercoagulable than normal and MCD patients. Hypercoagulability in MN patients involves the whole thrombotic processes acceleration (activated intrinsic pathway, fibrinogen, platelet function and fibrin-platelet interaction), whereas hypercoagulable state in MCD patients may be that the coagulation factors are not fully activated. Greater efforts should be made to prevent hypercoagulability especially for MN patients with severe hypoalbuminemia.
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Thrombosis research · Sep 2015
Extracellular histone H3 levels are inversely correlated with antithrombin levels and platelet counts and are associated with mortality in sepsis patients.
Sepsis is a leading cause of death worldwide. Extracellular histones are cytotoxic compounds mediating death in murine sepsis and circulating nucleosome levels predict mortality in human inflammation and sepsis. Whether or not circulating extracellular histone H3 correlates with other plasma parameters and/or ICU scoring systems has not been completely established, nor if levels of circulating extracellular histones can be used as predictive markers for clinical outcome in sepsis. ⋯ We conclude that circulating H3 levels correlate with mortality in sepsis patients and inversely correlate with antithrombin levels and platelet counts.