Thrombosis research
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Thrombosis research · May 2012
Association of blood transfusion and venous thromboembolism after colorectal cancer resection.
Red blood cell (RBC) transfusion is a common event in the perioperative course of patients undergoing surgery. Transfused blood can disrupt the balance of coagulation factors and modulates the inflammatory cascade. Since inflammation and coagulation are tightly coupled, we postulated that RBC transfusion may be associated with the development of venous thromboembolic phenomena. We queried the American College of Surgeons' National Surgical Quality Improvement Program (ACS NSQIP) database to examine the relationship between intraoperative blood transfusion and development of venous thromboembolism (VTE) in patients undergoing colorectal resection for cancer. ⋯ In this study of 21943 patients undergoing colorectal resection for cancer, blood transfusion is associated with increased risk of VTE. Malignancy and surgery are known prothrombotic stimuli, the subset of patients receiving intraoperative RBC transfusion are even more at risk for VTE, emphasizing the need for sensible use of transfusions and rigorous thromboprophylaxis regimens.
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Thrombosis research · May 2012
Practice GuidelinePrevention of venous thromboembolism in patients with cancer: guidelines of the Italian Society for Haemostasis and Thrombosis (SISET)(1).
Prevention of venous thromboembolism (VTE) in cancer patients remains controversial in most clinical settings. ⋯ Results of the systematic literature review and an explicit approach to consensus techniques have led to recommendations for the most clinically important issues in the prevention of VTE in cancer patients.
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Thrombosis research · Apr 2012
Multicenter StudyVenous thromboembolism prophylaxis in medical ICU patients in Asia (VOICE Asia): a multicenter, observational, cross-sectional study.
The VOICE Asia study aimed to establish the mode of thromboprophylaxis in medical patients admitted to intensive care units (ICU), and to describe the epidemiology of patients at high-risk of venous thromboembolism (VTE) and of patients who were prescribed low molecular weight heparin (LMWH). ⋯ There is substantial underestimation of VTE risk and non-adherence to guidelines for thromboprophylaxis in medical ICU patients in participating Asian countries. This emphasizes the need for increasing awareness about optimum VTE risk assessment and improved implementation of appropriate thromboprophylaxis in at-risk medical ICU patients.
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Thrombosis research · Apr 2012
Comparative StudyIn vitro study of the anticoagulant effects of edoxaban and its effect on thrombin generation in comparison to fondaparinux.
Edoxaban, an oral direct factor Xa (FXa) inhibitor, is in Phase III development for prevention and treatment of thromboembolic disorders. Fondaparinux is an approved indirect FXa inhibitor. This study compared the effects of edoxaban and fondaparinux on thrombin generation (TG) using the calibrated automated thrombogram (CAT). Secondary objectives included evaluation of edoxaban and inhibition of coagulation parameters (prothrombin time [PT], activated partial thromboplastin time [aPTT]), anti-FXa activity and clotting times. ⋯ TG evaluation by the CAT method, coagulation tests, and anti-FXa and clotting assays demonstrated concentration-dependent effects of edoxaban. The PT and aPTT prolongation are reagent dependent; correction of PT ratio by international normalized ratio does not reduce variability in response. The greater effect of edoxaban vs. fondaparinux may be related to the broader activity of direct FXa inhibitors compared with indirect FXa inhibitors.