Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
-
Clin. Appl. Thromb. Hemost. · Jan 2012
Clinical TrialVenous thromboembolism pharmacy intervention management program with an active, multifaceted approach reduces preventable venous thromboembolism and increases appropriate prophylaxis.
Two concepts relating to venous thromboembolism (VTE) prevention have recently emerged-"appropriate" prophylaxis and "preventable" VTE. We evaluated whether a human alert, as part of a pharmacy intervention program, can increase appropriate prophylaxis and decrease preventable symptomatic VTE in hospitalized patients. This prospective study with retrospective data collection was conducted utilizing data from 1879 patients in 2006 as a control cohort. ⋯ The rate of appropriate prophylaxis increased from 23.8% in 2006 to 37.9% in 2007 (odds ratio 1.8; 95% confidence interval [CI] = 1.6-2.1; P < .0001). Preventable VTE incidence was reduced by 74% (95% CI = 44%-88%) from 18.6 to 4.9 per 1000 patient discharges in 2006 and 2007, respectively (P = .0006). In conclusion, a pharmacy-led multifaceted intervention can significantly increase the rates of appropriate prophylaxis and significantly reduce the incidence of preventable VTE in hospitalized patients.
-
Clin. Appl. Thromb. Hemost. · Jan 2012
Clinical TrialInteraction between MMP-9 gene polymorphisms and smoking in relation to myocardial infarction in a Uighur population.
Matrix metalloproteinase 9 (MMP-9) plays a pivotal role in early atherosclerosis, vascular remodeling, and development of arterial plaque rupture. The potentially functional MMP-9 gene polymorphism may contribute to the susceptibility of myocardial infarction (MI). We aimed to investigate the association between the interaction of 2 single-nucleotide polymorphisms ([SNPs] -1562C>T and R279Q) of the MMP-9 gene and smoking with MI in a Uighur population of China. ⋯ There findings suggest that MMP-9 -1562C>T polymorphism could be associated with the susceptibility to MI. Another SNP (R279Q) polymorphism was not significantly associated with MI. The -1562C>T or R279Q polymorphism of MMP-9 gene and smoking have a synergistic effect and are significantly associated with the risk of MI in Chinese Uighur population, respectively.
-
Clin. Appl. Thromb. Hemost. · Jan 2012
Clinical TrialEarly coagulopathy in patients with ruptured abdominal aortic aneurysm.
Ruptured abdominal aortic aneurysm (AAA) is associated with a high mortality despite surgical management. Earlier reports indicate that a major cause of immediate intraoperative death in patients with ruptured AAA is related to hemorrhage due to coagulopathy. Acidosis is, besides hypothermia and hemodilution, a possible cause of coagulopathy. ⋯ Furthermore, in our patients with shock due to ruptured AAA only 2 of 12 deaths were due to coagulopathy and bleeding. Indeed, our results show a relatively high incidence of thrombosis-related causes of death in patients with ruptured AAA, indicating a relation to an activated coagulation in these patients. These findings indicate that modern emergency management of ruptured AAA has improved in the attempt to prevent fatal coagulopathy.