Thrombosis research
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Thrombosis research · May 2016
Differential contributions of platelets and fibrinogen to early coagulopathy in a rat model of hemorrhagic shock.
The mechanisms of early traumatic-induced coagulopathy are not well understood. Our aim was to examine the role of platelets and fibrinogen to early coagulopathy in the rat after hemorrhagic shock. ⋯ Hypocoagulopathy following severe hemorrhage and shock in the rat appeared to involve a two-step process of platelet dysfunction followed by fibrinogen impairment, possibly linked to progressive endothelial dysfunction.
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Thrombosis research · Apr 2016
ReviewIncidental venous thromboembolic events in cancer patients: what we know in 2016.
Cancer patients are at high risk of venous thromboembolism (VTE). Previous reports on the epidemiology and incident of thrombotic complications in cancer patients are based upon documented symptomatic events. ⋯ Recent studies focusing on the findings of incidental PE when compared to symptomatic PE find no significant difference in pulmonary distribution of clots, incidence of VTE recurrence or survival in these patients. Based upon these studies, current guidelines recommend treatment for incidental PE as recommended for symptomatic PE.
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Thrombosis research · Apr 2016
ReviewManagement of recurrent venous thromboembolism in cancer patients.
Cancer is one the most prevalent risk factors in patients diagnosed with deep vein thrombosis or pulmonary embolism. Patients with cancer and venous thromboembolism have a higher risk of mortality when compared to patients with cancer without venous thromboembolism and a higher risk of recurrent thrombosis when compared with patients with venous thromboembolism without cancer. This increased risk of recurrence is not only observed after anticoagulant treatment is stopped, but also during anticoagulant treatment. ⋯ In general, patients should firstly be assessed for treatment compliance, for the occurrence of heparin-induced thrombocytopenia, and for the presence of mechanical compression from tumour masses. Possible strategies include switching to a different anticoagulant drug, in particular from vitamin K antagonists to low molecular weight heparin; increasing the dose of the anticoagulant drug; or inserting an inferior vena cava filter. The results of recent registries show that the current approach to cancer patients with recurrent venous thromboembolism in routine clinical practice is highly heterogeneous.
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Thrombosis research · Apr 2016
OC-12 - Peri operative venous thromboembolism prophylaxis in gynaecological cancer patients. A survey of current practice.
Gynaecological cancer is associated with some of the highest rates of venous thromboembolism (VTE) with some subtypes of ovarian cancer associated with rates as high as 20%. VTE prophylaxis is an important part of post-operative management in gynaecological cancer patient care. Despite the evidence base and guidelines recommending extended VTE prophylaxis for patients undergoing major cancer surgery, adherence to best practice guidelines has been found to be low. ⋯ In conclusion, the adherence to current guidelines for VTE prophylaxis in the peri-operative period for gynaecological oncology patients is still poor. Awareness needs to be raised in order to decrease the morbidity/mortality of VTE in this high risk group of patients. The adoption of multidiscplinary approach to manage gynaecological cancer patients, which includes the involvment of thrombosis specialist, may reduce post operative VTE rates and improve cancer care.
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Thrombosis research · Apr 2016
OC-11 - Anticoagulation therapy in selected cancer patients at risk of recurrence of venous thromboembolism.
Venous thromboembolism (VTE) in cancer patients is an increasingly frequent clinical problem. The overall impact of VTE on cancer patients can be considerable. Targeted patient selection by identifying patients with clinically significant recurrent VTE may have wider health economic benefits whilst reducing patient risk through over-treatment. In the UK, dalteparin is one licensed anticoagulant for the extended treatment and prevention of recurrence of VTE in cancer patients. Rivaroxaban is a highly selective direct Factor Xa inhibitor with oral bioavailability. ⋯ select-d is the first randomised trial for treatment of VTE, investigating the direct oral anticoagulants vs a low molecular weight heparin in patients with cancer. The results will support optimal treatment for this key patient group and are eagerly awaited.