Abstract：
BACKGROUND:Critical care patients are prone to venous thromboembolism (VTE) and, thus, pharmacological thromboprophylaxis is generally advised. Low-molecular weight heparins (LMWHs) have become the drug of choice in ICU patients, since their predictable and reproducible dose response. Monitoring their pharmacological effect is not usually necessary except in special occasions (i.e. with obese or renal failure patients), where anti-FXa level measuring is recommended. However, there is neither recommendation of adequate anti-FXa levels in critically ill patients nor is it known whether peak or trough level should be measured. The aim of this systematic review was to evaluate the recommended LMWH doses, and the reasons to monitor anti-FXa levels. METHODS:We searched MEDLINE, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.com to identify all potentially relevant studies. Prospective studies done in critically ill patients were included if at least one anti-FXa level (i.e. peak or trough) after any specified LMWH thromboprophylaxis dose was measured. RESULTS:Total 18 eligible studies including 1644 patients were included. There was a wide variation in the median peak anti-FXa levels (<0.1-0.35IU/ml). Trough levels were generally low. Of note, none of the studies detected any correlation with bleeding events and anti-FXa levels. Low trough level increased incidence of DVT in one study only. CONCLUSION:Based on the current literature, no definite conclusions can be drawn on targeted anti-FXa level in critically ill patients when using LMWH thromboprophylaxis.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Vahtera A,Vaara S,Pettilä V,Kuitunen Adoi
10.1016/j.thromres.2015.12.016subject
Has Abstractpub_date
2016-03-01 00:00:00pages
10-6eissn
0049-3848issn
1879-2472pii
S0049-3848(15)30231-0journal_volume
139pub_type
杂志文章,meta分析abstract：:Bleeding events are a common adverse effect in oral anticoagulation that frequently depend on the duration and intensity of treatment. Major bleeding events, particularly intracerebral hemorrhages, are a serious complication in cases that require the rapid reversal of anticoagulation. Urgent correction of the coagulat...
journal_title：Thrombosis research
pub_type： 杂志文章,评审
doi：10.1016/s0049-3848(99)00085-7
更新日期：1999-08-15 00:00:00
abstract：BACKGROUND:Coagulopathy is a major cause of early death when arsenic trioxide (As(2)O(3)) therapy fails. In addition to the procoagulant properties of blast cells, the cytotoxic therapy may contribute to the coagulation disorders. The aim of the present study was to evaluate the possible impact of As(2)O(3) on membrane...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2011.01.003
更新日期：2011-05-01 00:00:00
abstract：BACKGROUND:Administrative data can be used to identify venous thromboembolism (VTE) and major bleeding (MB) events. However, the validity of this data in emergency room discharge records in Canada is unknown. METHODS:We conducted a single-institution retrospective chart re-abstraction study in London, Canada. We ident...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2015.10.035
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:In sepsis, activation of coagulation and inhibition of fibrinolysis lead to microvascular thrombosis. Thus, clot stability might be a critical issue in the development of multiple organ dysfunction syndrome. Activated FXIII (FXIIIa) forms stable fibrin clots by covalently cross-linking fibrin monomers. Theref...
journal_title：Thrombosis research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.thromres.2006.02.003
更新日期：2007-01-01 00:00:00
abstract：:The in vitro and in vivo pharmacological properties of two oversulfated dermatan sulfate (DS) derivatives, S-DS1 and S-DS2, containing 2 and 3.7 sulfate groups/disaccharide unit respectively were compared to those of the parent DS (1 sulfate group/disaccharide unit). In a purified system the ability of S-DS1 and of S-...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(88)90094-1
更新日期：1988-10-15 00:00:00
abstract：OBJECTIVE:The present cohort study was performed to investigate the impact of the factor 5 rs6025 [F5] and the factor 2 rs1799963 [F2] mutations on high-titer inhibitor development [HRI] in patients with severe/moderate-severe hemophilia A [HA]. PATIENTS AND METHODS:216 patients with F8<2% born between 1980 and 2011 w...
journal_title：Thrombosis research
pub_type： 杂志文章,多中心研究
doi：10.1016/j.thromres.2014.01.005
更新日期：2014-04-01 00:00:00
abstract：INTRODUCTION:There is some controversy regarding the effect of CYP2C19 polymorphism on clinical outcome in patients with dual antiplatelet therapy. Chronic kidney disease (CKD) is associated with increased risk of cardiovascular event, but the association between the possession of CYP2C19 loss-of-function (LOF) alleles...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2014.07.039
更新日期：2014-11-01 00:00:00
abstract：:The concentration of tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1) and the complex of t-PA and PAI-1 (t-PA-PAI-1 complex) were measured using an enzyme immunoassay, where the first antibody was monoclonal antibody against PAI-1 and the second one was polyclonal anti-t-PA Fab' antibody....
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(89)90392-7
更新日期：1989-09-01 00:00:00
abstract：:The role of Protein C in combined factor V/VIII deficiency was examined by reducing the Protein C concentration using warfarin therapy in a patient with the combined deficiency. The factor VIII deficiency was like Hemophilia-A, with deficiency of VIII:C and VIII:C(Ag), but normal VIIIR:Ag and VIIIR:cof. The factor V d...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(84)90188-9
更新日期：1984-12-15 00:00:00
abstract：:It has been suggested that plasma low density lipoprotein (LDL) may affect platelet and leukocyte activity and the release of biologically active eicosanoids which may contribute to the pathogenesis of coronary heart disease. To evaluate the possible biological effects of LDL further we have studied platelet aggregati...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(93)90032-j
更新日期：1993-02-15 00:00:00
abstract：:Indirect genetic diagnosis using polymorphic DNA markers can be useful in large-scale screening programs, which is technically simpler, more rapid and amenable. The main objective of this study was to test the informativeness of two common intragenic markers (TaqI and XmnI) in Iranian haemophilia B families to detect ...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2004.03.009
更新日期：2004-01-01 00:00:00
abstract：:Highly purified bovine von Willebrand protein (vWP) has been studied with two complementary techniques. Light scattering measurements on different samples give weight average molecular weights in the range from 7 to 13 million, radius of gyration between 75 and 140 nm and diffusion coefficient near 4.15 X 10(-8) cm2/s...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(85)90289-0
更新日期：1985-11-15 00:00:00
abstract：INTRODUCTION:Systemic embolism is the most serious complication of cardioversion of atrial fibrillation (AF) and the immediate post-cardioversion period is associated with increased risk for thrombus formation. For this reason, treatment with vitamin K antagonist (VKA) is recommended for patients with AF. No informatio...
journal_title：Thrombosis research
pub_type： 杂志文章,多中心研究
doi：10.1016/j.thromres.2011.08.031
更新日期：2012-05-01 00:00:00
abstract：:It has been suggested that unstable angina at rest, like acute myocardial infarction, might be associated with a thrombotic process. In order to study the hypothesis that myocardial ischemia during exercise could also be associated with an activation of blood coagulation and/or fibrinolysis, we investigated the presen...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(92)90222-v
更新日期：1992-01-01 00:00:00
abstract：:Tissue factor is an ubiquitous membrane-anchored glycoprotein that initiates blood coagulation by forming a complex with circulating factors VII and VIIa. Under normal circumstances, endothelial cells do not express tissue factor but, in some pathological situations, when the endothelium or the monocytes are exposed t...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(94)90086-8
更新日期：1994-01-15 00:00:00
abstract：:Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), presents a large clinical burden. Prompt, effective and sustained anticoagulation is vital because of the risk of recurrent events, including life-threatening PE, and complications such as post-thrombotic syndrome and chro...
journal_title：Thrombosis research
pub_type： 杂志文章,评审
doi：10.1016/j.thromres.2014.05.013
更新日期：2014-08-01 00:00:00
abstract：INTRODUCTION:Dermatan sulfate, a sulfated glycosaminoglycan, acts as an anticoagulant by accelerating the inhibition of thrombin by heparin cofactor II. MATERIALS AND METHODS:A low molecular mass dermatan sulfate was obtained by peroxy-radical depolymerization from a parent dermatan sulfate. Chemical characterization ...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2007.09.001
更新日期：2008-01-01 00:00:00
abstract：:The three main components involved in thrombosis and haemostasis are thrombin, platelets, and plasmin. Almost all inhibitors of thrombosis are focused either on the inhibition of thrombin or on the inhibition of platelets. We designed a construct using the fibrinolytic activity of staphylokinase, fused via a cleavable...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(97)00277-6
更新日期：1997-12-01 00:00:00
abstract：:It is known that a low-molecular-weight heparin (LMWH) is more effective than unfractionated heparin in unstable angina/non-Q-wave myocardial infarction (UA/NQMI) and the platelet GPIIb/IIIa receptors play an important role in acute myocardial infarction (AMI). Therefore, enoxaparin might have a similar advantage over...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(01)00242-0
更新日期：2001-05-01 00:00:00
abstract：:Antithrombin (AT) is a serpin capable of trapping thrombin (IIa) in a stable and covalent complex. Complex formation is prevented by leukocyte elastase (LE) cleavage near the AT reactive centre. We mutated the known LE cleavage sites of AT to explore the possibility of producing an LE-resistant AT molecule. Initially,...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(97)00228-4
更新日期：1997-10-15 00:00:00
abstract：BACKGROUND:Clinical and epidemiological studies have associated selective COX-2 inhibitors with an increased risk of cardiovascular events. There are no clinical studies on the possible effects of these drugs on secondary hemostasis. The hypothesis for this study is that the use of selective COX-2 inhibitors could affe...
journal_title：Thrombosis research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.thromres.2009.01.017
更新日期：2009-06-01 00:00:00
abstract：BACKGROUND:Early aspirin treatment is widely used to inhibit platelet activity and to reduce morbidity and mortality in patients presenting with an acute myocardial infarction or a stroke. A number of different aspirin formulations have been used for this purpose; however, a comparison of their effectiveness in inhibit...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2005.10.001
更新日期：2006-01-01 00:00:00
abstract：:There is growing evidence on the superior efficacy and safety of low molecular weight heparins (LMWHs) over unfractionated heparin (UFH) for the treatment of both venous and arterial thromboembolism. Heparin exerts its function by potentiating antithrombin and by mobilizing tissue factor pathway inhibitor (TFPI) into ...
journal_title：Thrombosis research
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0049-3848(98)00079-6
更新日期：1998-08-15 00:00:00
abstract：:Previous studies have indicated that the skin bleeding time test does not accurately reflect visceral bleeding time (BT). The present study examines the predictive value of the skin bleeding time for brain bleeding tendency. Sixteen Sprague-Dawley rats were divided into equal groups. The first group (controls) underwe...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(94)90282-8
更新日期：1994-12-15 00:00:00
abstract：:Four monoclonal antibodies have been produced, which are specific for the Ca2+ or Sr2(+)-induced conformation of human factor IX. Certain, but not all, gamma-carboxy-glutamic acid residues in factor IX are involved in the epitope expression together with the conformation stabilized by the adjacent region of Gla-domain...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(90)90306-w
更新日期：1990-06-15 00:00:00
abstract：:Changes in cytoplasmic free calcium in response to epinephrine in combination with other agonists were studied in human platelets loaded with the fluorescent calcium indicator, quin 2. In the presence of 1mM external calcium, epinephrine augmented the increase in cytoplasmic free calcium in response to collagen or thr...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/0049-3848(87)90153-8
更新日期：1987-05-15 00:00:00
abstract：INTRODUCTION:Pulmonary embolism (PE) has a high morbidity and mortality. Hence it is important to recognize factors associated with higher risk of adverse outcomes in hemodynamically stable patients. Heart-type fatty acid binding protein (H-FABP) is a novel marker evaluated in recent years for prognosis in acute PE. Ou...
journal_title：Thrombosis research
pub_type： 杂志文章,meta分析
doi：10.1016/j.thromres.2014.10.007
更新日期：2015-01-01 00:00:00
abstract：:Resveratrol (3, 4', 5-trihydroxystilbene), a natural polyphenol, is found in some plants that are used in human nutrition. Grapes are a major source for resveratrol, and a significant amount can also be found in red wine. Several experimental studies have demonstrated biological properties of resveratrol, especially i...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/s0049-3848(02)00273-6
更新日期：2002-08-15 00:00:00
abstract：INTRODUCTION:Antiphospholipid syndrome (APS) is a pro-thrombotic autoimmune disease that affects different vascular beds, with potential risk for recurrence. Systemic lupus erythematosus (SLE), specific autoantibodies profile and atherogenic disorders have been described as risk factors for the occurrence of first thro...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2015.10.029
更新日期：2015-12-01 00:00:00
abstract：INTRODUCTION:Venous thromboembolism (VTE) prophylaxis guidelines for non-surgical patients recommend VTE- and bleeding risk assessment to guide prophylactic strategies. These recommendations differ between guidelines and implementation is suboptimal. Assessing a guideline's implementability characteristics helps predic...
journal_title：Thrombosis research
pub_type： 杂志文章
doi：10.1016/j.thromres.2018.05.028
更新日期：2018-08-01 00:00:00
