Abstract:
:Experience with tranexamic acid, an indirect fibrinolytic inhibitor, started as soon as it was released from Shosuke Okamoto's lab in the early 1960s. It was first prescribed to females with heavy menstrual blood loss and to patients with hereditary bleeding disorders. Soon the indications were widened to elective surgery because of its blood saving effects. Contraindications are few, most important is ongoing venous or arterial thrombosis and allergy to tranexamic acid, and the doses has to be reduced in renal insufficiency. In randomized controlled trials, however, patients with other risk factors are excluded as well (patients with history of cardiovascular disease, thromboembolism, bleeding diathesis, renal failure with creatinine >250μmol/L, pregnancy, and patients on treatment with anticoagulants). Recent meta-analyses of several randomized controlled trials in orthopedic arthroplasty have shown that tranexamic acid reduces peri- and postoperative blood loss, blood transfusion requirements and reoperations caused by bleedings. In general, the preoperative dose was 10-15mg/kg i.v. (or 1g), followed or not, by one or two doses, some as continuous infusion i.v. To validate relationship between dose and effect more data are needed. No evidence was found of increased thromboembolic accidents or other adverse events in the patients on tranexamic acid compared to the control groups. In major cardiac surgery tranexamic acid has been used in a large number of controlled trials with various dosing schemes in which the highest dosages seem to be associated with neurotoxicity; therefore a maximum total dose of 100mg/kg especially in patients over 50years of age is recommended by ISMICS (International Society for Minimally Invasive Cardiothoracic Surgery). Other indications for tranexamic acid are reviewed here as well. In recent years the extensive trial in severe trauma with massive bleedings using tranexamic acid was presented, CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) comprising more than 20,000 patients. It showed that the survival was increased when tranexamic acid was given early after the accident compared to placebo; further studies are taking place is this field to get more information. Of utmost importance is the ongoing WOMAN (World Maternal Antifibrinolytic) a randomized, double-blind, placebo controlled trial among 15,000 with clinical diagnosis of postpartum haemorrhage bearing in mind that each year a large number of women in low and middle income countries, die from causes related to childbirth. In summary, we consider tranexamic acid is a drug of great value to reduce almost any kind of bleeding, it is cheap and convenient to use and has principally few contraindications. It may be added, that tranexamic acid is included in the WHOs list of essential medicines.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Tengborn L,Blombäck M,Berntorp Edoi
10.1016/j.thromres.2014.11.012subject
Has Abstractpub_date
2015-02-01 00:00:00pages
231-42issue
2eissn
0049-3848issn
1879-2472pii
S0049-3848(14)00621-5journal_volume
135pub_type
杂志文章,评审abstract:INTRODUCTION:Viscoelastometry enables rapid evaluation of coagulopathy in settings such as cardiac surgery but may be influenced by red cell concentration. METHODS:In order to study the effects of supra-physiological red cell concentrations on viscoelastometry, we compared ROTEM® viscoelastometry and plasma coagulatio...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2013.07.006
更新日期:2013-08-01 00:00:00
abstract::Disseminated intravascular coagulation (DIC) is a severe complication of septic shock. Polymorphonuclear neutrophils (PMNs) may play a key role in septic shock-induced DIC via the release of neutrophils extracellular traps (NETs). NETs capture invading pathogens, but also act as a pro-coagulant surface at the interfac...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2019.09.036
更新日期:2019-11-01 00:00:00
abstract::This study focused on the clinical outcomes in multiple myeloma (MM) patients with venous thromboembolism (VTE) who received low-molecular-weight heparin (dalteparin) therapy. Changes in D-dimer levels before and after VTE were also evaluated. Among 549 patients treated with various chemotherapeutic agents, a total of...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2015.09.021
更新日期:2015-11-01 00:00:00
abstract::When a purified myeloma protein with the ability to inhibit fibrin polymerization was preincubated with sheep anti-human F(ab')2 antibodies, there was a marked reduction of the ability to prolong the thrombin clotting time, while anti-Fc antibodies had only a slight effect. A monoclonal immunoglobulin which shortens t...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(85)90284-1
更新日期:1985-11-15 00:00:00
abstract::Central venous catheter-related thrombosis (CRT) is a complication seen in patients requiring long-term intravenous access. Treatment of CRT is not standardized and international guidelines for treatment are based on extrapolation of evidence from lower extremity thrombosis. We performed a systematic review of the lit...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2015.08.020
更新日期:2015-12-01 00:00:00
abstract::Factor IX Nagoya 3 (IX Nagoya 3) is a natural mutant of factor IX recognized in a patient with moderately severe hemophilia B. The patient had 0.60 units/ml of factor IX antigen and 2-5% of clotting activity. IX Nagoya 3 was purified from the patient's plasma by immunoaffinity chromatography with an anti-factor IX mon...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90109-p
更新日期:1990-11-15 00:00:00
abstract::The need for anticoagulation in dialysis patients is common and the incidence of venous thromboembolism (VTE) and atrial fibrillation in this population is high. While direct data are lacking on the management of anticoagulation in dialysis patients, careful weighing of risks and benefits on the basis of evidence from...
journal_title:Thrombosis research
pub_type: 杂志文章,实务指引
doi:10.1016/j.thromres.2005.03.031
更新日期:2006-01-01 00:00:00
abstract::Pergularain e I, a cysteine protease with thrombin-like activity, was purified by ion exchange chromatography from the latex of Pergularia extensa. Its homogeneity was characterized by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), native PAGE and reverse-phase high-performance liquid chromatogr...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2009.10.002
更新日期:2010-03-01 00:00:00
abstract:INTRODUCTION:Increased levels of circulating tissue factor (TF)-positive microvesicles (MVs) may increase the risk of thrombosis. Indeed, TF-positive MVs are detected in plasma of patients with various types of diseases. In this study, we measured levels of MV TF activity in non-cancer severely ill patients and cancer ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2018.03.001
更新日期:2018-05-01 00:00:00
abstract::Activated factor X (FXa) and thrombin can up-regulate gene expression of connective tissue growth factor (CTGF/CCN2) on fibroblasts. Since tissue factor (TF) is expressed on these cells, we hypothesized that they may assemble the prothrombinase complex leading to CTGF/CCN2 upregulation. In addition, the effect of thro...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2011.08.009
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:To validate the diagnostic criteria for disseminated intravascular coagulation (DIC) established by the Japanese Association for Acute Medicine (JAAM) at an early stage of trauma and to evaluate the hypothesis that the JAAM criteria can diagnose DIC with a higher sensitivity than the International Society ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2009.06.036
更新日期:2009-12-01 00:00:00
abstract::Preanalytical and biological variability both have strong influences on test results of coagulation. Beyond age and gender, increasing emphasis is now being given to a variety of demographic and lifestyle variables, including ethnicity, smoking, diet, and exercise, which should be taken into account when interpreting ...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2008.04.010
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:The purpose of the present study was to study the concept of aspirin resistance or non-responsiveness by investigating the response to long-term aspirin therapy in patients with a former acute myocardial infarction (AMI). MATERIALS AND METHODS:Patients with an AMI (n=202) randomly assigned to aspirin 160 ...
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(02)00405-x
更新日期:2002-10-01 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:INTRODUCTION:To evaluate the pathogenetic role of tissue factor (TF), tissue factor pathway inhibitor (TFPI), and neutrophil elastase in acute respiratory distress syndrome (ARDS), as well as to test the hypothesis that TFPI levels modified by neutrophil activation are not sufficient to prevent TF-dependent intravascul...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/s0049-3848(03)00151-8
更新日期:2003-01-25 00:00:00
abstract::To explore social aspects of asymptomatic carriership of factor V Leiden mutation (FVL) and how carriers have experienced procedure of screening for FVL, we have performed a qualitative study using semi-structured interviews. Seventeen carriers of FVL without history of venous thromboembolism (VTE) were interviewed. C...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/j.thromres.2004.02.002
更新日期:2004-01-01 00:00:00
abstract::Platelet aggregate size was determined with a newly-developed platelet aggregometer, PA-100 (KOWA), which can quantitatively evaluate the size and number of platelet aggregates by means of the particle counting method based upon light scattering. Epinephrine-induced platelet aggregation consists of two phases, the for...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(96)00026-6
更新日期:1996-03-01 00:00:00
abstract::Urokinase-type plasminogen activator (uPA) plays a central role in many aspects of cellular regulation, such as fibrinolysis, cell migration, and metastasis. The uPA induction by inflammatory stimuli such as IL-1, TNFalpha, and lipopolysaccharide (LPS) has been reported in a number of human cells. We examined the effe...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(99)00174-7
更新日期:2000-03-01 00:00:00
abstract::Platelet prothrombin converting activity was measured in a system using washed human platelets and purified coagulation factors Xa, Va and prothrombin. Exposure of platelet prothrombin converting activity evoked by collagen or the combined action of collagen and thrombin was effectively inhibited when a collagen deriv...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(85)90065-9
更新日期:1985-02-01 00:00:00
abstract::Clinically unsuspected pulmonary embolism (UPE) is frequently diagnosed in cancer patients undergoing routine computed tomography scans for staging purposes or treatment response evaluation. The reported incidence of UPE ranges from 1% to 5% which probably represents an underestimation. A significant proportion of can...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/S0049-3848(14)50028-X
更新日期:2014-05-01 00:00:00
abstract::The immunoglobulin superfamily member EMMPRIN (CD147) plays an important role in a number of organ systems, including the cardiovascular system. Here we review the contemporary understanding of EMMPRIN and EMMPRIN-associated sequelae in the course of atherosclerosis. A significant body of data documents the pivotal ro...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2013.04.017
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:Inherited thrombophilia has been associated with unexplained recurrent pregnancy loss (RPL) and stillbirth. This thrombotic tendency can manifest as thrombotic lesions in the placenta, and may lead to abortion and stillbirth. The aim of our case-control study was to investigate the prevalence of FVL and FI...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2005.06.005
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Edoxaban is an oral, once-daily direct factor Xa (FXa) inhibitor. Although rapidly cleared, strategies to reverse edoxaban-mediated effects on anticoagulation are needed in cases of excessive bleeding or emergency. This study evaluated the effect of two prohemostatic agents, recombinant factor VIIa (rFVIIa...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2014.07.036
更新日期:2014-10-01 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::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::This prospective randomized study investigated the influence of normotensive and hypotensive general anesthesia on platelet aggregability, intraoperative blood loss and parameters of plasmatic coagulation during extensive orthognathic surgery. A total of 30 patients were randomly allocated for either normotensive anes...
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(01)00316-4
更新日期:2001-08-01 00:00:00
abstract::Lipoprotein-Associated Coagulation Inhibitor (LACI) is a factor Xa dependent inhibitor of the factor VII(a)/Tissue Factor catalytic complex. Deduced from partial cDNA sequence, LACI's amino acid sequence has recently been reported. Northern blot analysis showed LACI cDNA hybridizes to RNAs of 1.4 and 4.0 kb in size. T...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(89)90454-4
更新日期:1989-07-01 00:00:00
abstract::The thrombolytic efficacy of recombinant tissue-type plasminogen activator (tPA) in the presence and absence of a thromboxane synthase inhibitor was studied in a model of femoral artery thrombosis in the anesthetized rabbit. The thrombus was formed by injection of thrombin and whole blood into an isolated segment of t...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(88)90022-9
更新日期:1988-12-01 00:00:00
abstract:INTRODUCTION:Warfarin is the most widely prescribed vitamin K antagonist and in the United States and Europe more than 10 million people are currently in long-term oral anticoagulant treatment. This study aims to retrospectively validate a dynamic statistical model providing dosage suggestions to patients in warfarin t...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2013.12.042
更新日期:2014-03-01 00:00:00
abstract:INTRODUCTION:Remote ischaemic conditioning (RIC) has been shown to prevent platelet activation during ablation for atrial fibrillation. RIC has also been associated with more postoperative transfusion in the off-pump coronary artery bypass graft surgery (OPCAB) patients. We evaluated the effects of RIC on coagulation f...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2020.01.004
更新日期:2020-03-01 00:00:00