Thrombosis research
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Thrombosis research · Mar 2015
Preoperative hypofibrinogenemia is associated with increased intraoperative bleeding in ruptured abdominal aortic aneurysms.
Ruptured abdominal aortic aneurysm (rAAA) is associated with coagulopathy and intraabdominal hemorrhage. Fibrinogen acts as a key coagulation factor and has previously been suggested as a biomarker for increased perioperative bleeding in other surgical areas. The aim of the present study was to investigate fibrinogen and standard laboratory parameters and their association to preoperative hemodynamic status, intraoperative bleeding (IOB), and outcome in treatment of rAAA. ⋯ Low preoperative fibrinogen concentration was significantly associated with preoperative hypotension and increased intraoperative bleeding in patients with rAAA. Patients in hemodynamic shock with blood pressure <70 mmHg had an associated fibrinogen concentration of less than 1.5 g/L. A fibrinogen concentration less than 1.5 g/L was associated with a ten-fold increased risk of intraoperative hemorrhage of more than 2000 ml.
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Thrombosis research · Mar 2015
More efficient reversal of dabigatran inhibition of coagulation by activated prothrombin complex concentrate or recombinant factor VIIa than by four-factor prothrombin complex concentrate.
The number of patients on antithrombotic treatment due to atrial fibrillation and venous thromboembolism is increasing fast due to an aging population. A growing proportion will be treated with novel oral anticoagulants, the first in clinical use was the direct oral thrombin inhibitor dabigatran (Pradaxa®). A small percentage of the patients on dabigatran will experience serious bleeding or be in need of urgent surgery. ⋯ APCC doubled initial clot growth velocity, although even more in the absence of dabigatran. In conclusion, APCC and rFVIIa, but not PCC, seem to reverse, at least partially, some effects of dabigatran on coagulation parameters. Systematic evaluation of case reports, registries and, ultimately, randomized clinical trials are needed to elucidate potential benefit for patients.
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Thrombosis research · Mar 2015
Prevalence and risk factors of atherothrombotic events among 1054 hemophilia patients: a population-based analysis.
Reports on the prevalence and risk factors of atherothrombotic events (AEs) are conflicting in persons with hemophilia (PWH). ⋯ The study indicated the prevalence of AEs among PWH was comparable to that of the general population. AEs appeared at an earlier age among PWH. COPD, hypertension, and hyperlipidemia were risk factors for AEs. PWH who needed replacement therapy may have a lower risk of AEs.
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Thrombosis research · Mar 2015
Inflammatory bowel disease increases the risks of deep vein thrombosis and pulmonary embolism in the hospitalized patients: a nationwide cohort study.
We conducted a nationwide, population-based cohort study to evaluate the effects of inflammatory bowel disease (IBD) on the risks of developing deep vein thrombosis (DVT) and pulmonary embolism (PE) in Taiwan. ⋯ The risks of DVT and PE are significantly higher in IBD patients.
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Thrombosis research · Mar 2015
Hypercoagulability detected by whole blood thromboelastometry (ROTEM®) and impedance aggregometry (MULTIPLATE®) in obese patients.
Obesity has been associated with hypercoagulability and to increased risk of both arterial and venous thromboembolic events. Many different and complex changes in plasma coagulation factors have been described in patients with obesity. The aim of this case-control study is to evaluate hypercoagulability in a group of overweight and obese subjects by whole blood rotation thromboelastometry (ROTEM®) and impedance aggregometry (Multiplate®). ⋯ A relationship between hypercoagulability detected by whole blood thromboelastometry and aggregometry and increased fat mass is shown. Hypercoagulability also correlated with inflammatory markers. Point-of-care tests can be used to assess the degree of hypercoagulability and hyperaggregability in obese patients. Wider studies are needed to confirm our observations.