Thrombosis research
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Thrombosis research · Sep 2014
ReviewCase fatality of bleeding and recurrent venous thromboembolism during, initial therapy with direct oral anticoagulants: a systematic review.
The frequency and case fatality of venous thromboembolism (VTE) and major bleeding during the initial 3 months of therapy in those treated for symptomatic VTE with either direct oral anticoagulants (DOACs) or vitamin K antagonists (VKA) are important clinically relevant outcomes. We sought to measure it during the initial months of anticoagulation for symptomatic VTE. ⋯ DOACs are attractive alternatives to VKAs for initial treatment of symptomatic VTE, with lower frequency and case fatality for major bleeding. However, the incremental safety benefit of DOACs over VKAs is small, with large numbers needed to treat.
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Thrombosis research · Sep 2014
Increased risk of venous thromboembolism in patients with dermatomyositis/polymyositis: a nationwide cohort study.
The number of previous studies on the risk of venous thromboembolism (VTE) in patients with dermatomyositis/polymyositis (DM/PM) is limited. Therefore, we conducted a nationwide retrospective cohort study to investigate the effects of DM/PM on the risk of VTE. ⋯ The risk of VTE is significantly higher in DM/PM patients than in non-DM/PM patients.
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Thrombosis research · Sep 2014
Follow-up after four-year quality improvement program to prevent inferior limb deep vein thrombosis in intensive care unit.
Deep vein thrombosis (DVT) is a life-threatening complication in intensive care unit (ICU) patients and DVT incidence is used as a marker of quality care. In our ICU an educational program for implementation of DVT prophylaxis and ultrasound screening resulted in a remarkable decrease in DVT incidence which fell from 11.6% to 4.7%. The aim of this paper is to investigate a 4-year long persistent quality improvement of DVT prophylaxis obtained through the implementation of our educational intervention. ⋯ The direct involvement of ICU clinicians and nurses in the application of DVT prophylaxis and in DVT diagnosis markedly contributed to maintain a low DVT incidence over time, despite the high turnover of patients.
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Thrombosis research · Sep 2014
Thrombotic safety of prothrombin complex concentrate (Beriplex P/N) for dabigatran reversal in a rabbit model.
In vivo animal data have shown prothrombin complex concentrate (PCC) to be effective in preventing bleeding induced by excessive plasma levels of the direct thrombin inhibitor dabigatran. This animal model study was designed to determine the risk of thrombosis associated with administration of a PCC (Beriplex P/N) to reverse dabigatran-induced bleeding. ⋯ In this animal study, thrombosis after PCC administration could be prevented in the presence of dabigatran. PCC reversed dabigatran-induced excessive bleeding while retaining protective anticoagulatory activity of dabigatran.
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Thrombosis research · Sep 2014
SAR216471, an alternative to the use of currently available P2Y₁₂ receptor inhibitors?
P2Y12 antagonism is a key therapeutic strategy in the management and prevention of arterial thrombosis. The objective of this study was to characterize the pharmacodynamic (PD) and pharmacokinetic (PK) properties of SAR216471, a novel P2Y12 receptor antagonist. SAR216471 blocks the binding of 2MeSADP to P2Y12 receptors in vitro (IC50=17 nM). ⋯ By comparison, ED50 values for clopidogrel, prasugrel and ticagrelor were 6.3, 0.35 and 2.6 mg/kg, respectively. Finally, the anti-hemostatic effect of SAR216471 and its competitors was investigated in a rat tail bleeding model, revealing a favorable safety profile of SAR216471. Together, these findings have established a reliable antiplatelet profile of SAR216471, and support its potential use in clinical practice as an alternative to currently available P2Y12 receptor antagonists.