Abstract：
:Certain patient populations (pregnancy, cancer, renal impairment, and obesity) may be at higher risk of adverse events during low molecular weight heparin (LMWH) therapy and may benefit from anti-Xa monitoring. Yet, evidence supporting a standardized approach to anti-Xa monitoring correlated to clinical outcomes is lacking. Patients with at least one documented anti-Xa level and receiving LMWH within a 6-month period were identified. In a 6-month period, 224 adult LMWH patients with 359 anti-Xa levels were identified. Anti-Xa monitoring was most commonly performed in patients with active cancer receiving venous thromboembolism (VTE) treatment doses (57.4%) or obese patients receiving VTE prophylaxis (48.1%). Anti-Xa monitoring during renal impairment and pregnancy were infrequent (0.9% and 1.8%, respectively). Most (71.9%) anti-Xa levels were therapeutic, but only 45% were drawn correctly in relation to LMWH administration time. Compared to those with therapeutic anti-Xa levels, patients with out-of-range levels were four times as likely to receive a LMWH therapy change (odds ratio, 4.16; 95% confidence interval, 2.53-6.84). However, when levels were supratherapeutic or subtherapeutic, the LMWH doses remained unchanged in one-third to one-half of patients, respectively. Anti-Xa monitoring was most commonly performed in patients with cancer or obesity and was more common with VTE prophylaxis dosing. The majority of levels were therapeutic, indicating that anti-Xa monitoring may be unnecessary even in high-risk patient populations. Many out-of-range anti-Xa levels did not prompt a change in LMWH therapy. Further research is still needed to determine if anti-Xa- guided LMWH dosing improves clinical outcomes.
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Lin A,Vazquez SR,Jones AE,Witt DMdoi
10.1007/s11239-019-01920-ysubject
Has Abstractpub_date
2019-11-01 00:00:00pages
623-628issue
4eissn
0929-5305issn
1573-742Xpii
10.1007/s11239-019-01920-yjournal_volume
48pub_type
杂志文章abstract：:Amniotic fluid embolism (AFE) is a catastrophic condition in the peripartum period and still remains as a leading cause of maternal death. Although over 80% of cases of AFE cases are accompanied by coagulopathy, the pathology of disseminated intravascular coagulation is not well understood not only because of its rari...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-020-02237-x
更新日期：2020-07-29 00:00:00
abstract：:Intravenous (IV) thrombolysis is the treatment in ischemic stroke, but only the minority of patients receive this medication. The primary objective of this study was to explore the reasons associated with the decision not to offer IV thrombolysis to stroke patients admitted to the Stroke Unit (SU). We conducted a retr...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-016-1406-8
更新日期：2016-11-01 00:00:00
abstract：:Background: Thrombolytic therapy has been shown to reduce mortality in select patients with acute myocardial infarction (AMI). The determinants of eligibility for therapy are changing as more information about the safety and efficacy of thrombolytic therapy is obtained. In the United States, there is some concern that...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/BF01062578
更新日期：1995-01-01 00:00:00
abstract：:The current, global situation regarding the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic and its potentially devastating clinical manifestations, i.e. coronavirus disease 2019 (COVID-19), took the world by storm, as millions of people have been infected worldwide and more than 1,600,000 patien...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,评审
doi：10.1007/s11239-020-02374-3
更新日期：2021-01-15 00:00:00
abstract：:We sought to determine the diagnostic value of a D-dimer test for myocardial infarction (MI). The prospective cohort study was carried in the ED of a university hospital. All included patients were tested for D-dimer and cardiac troponin I (cTnI) on ED admission and additional cTnI 6 h later. AMI was retrospectively c...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-010-0469-1
更新日期：2010-11-01 00:00:00
abstract：:The objective of this study were to assess the impact of a quality assurance effort on the door-to-needle time and the choice of thrombolytic agent for the management of acute myocardial infarction in the emergency department. The study design involved a prospective collection of data on a series of consecutive patien...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1023/A:1008834230015
更新日期：1998-05-01 00:00:00
abstract：:Fibrinolysis is regulated by the thrombin/thrombin-activatable fibrinolysis inhibitor (TAFI) system. Thus, anticoagulants and inhibitors of TAFI are expected to accelerate fibrinolysis. The combined effects of an anticoagulant and a TAFIa inhibitor on fibrinolysis remain unknown. The aim of this study was to evaluate ...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-019-01929-3
更新日期：2020-01-01 00:00:00
abstract：:Patients with carotid atherosclerosis, especially the elderly population, take antithrombotic medicine regularly. However, no previous meta-analysis has focused on one of the possible side effects of such drugs, namely intraplaque hemorrhage (IPH). To determine whether antiplatelet drugs or anticoagulants are associat...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,meta分析
doi：10.1007/s11239-019-01865-2
更新日期：2019-07-01 00:00:00
abstract：:Unfractionated heparin (UFH) plasma protein binding and elimination might be impaired in patients with chronic kidney disease (CKD-defined as creatinine clearance <60 ml/min). It is currently unknown at which UFH bolus dose persistent prolongation of activated partial thromboplastin time (aPTT) occurs in ST-segment el...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 临床试验,杂志文章
doi：10.1007/s11239-015-1255-x
更新日期：2016-04-01 00:00:00
abstract：:Recent evidence indicates that endothelial progenitor cells (EPCs) have an important role in the process of repair following vascular injury, and that platelets mediate their recruitment to sites of injury. Platelets and EPCs can interact and bind directly. However, there is limited information on the effect of platel...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-010-0514-0
更新日期：2010-11-01 00:00:00
abstract：:The stability of an arterial thrombus, determined by its structure and ability to resist endogenous fibrinolysis, is a major determinant of the extent of infarction that results from coronary or cerebrovascular thrombosis. There is ample evidence from both laboratory and clinical studies to suggest that in addition to...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,评审
doi：10.1007/s11239-018-1641-2
更新日期：2018-05-01 00:00:00
abstract：:The optimal antithrombotic therapy for patients undergoing TAVI with concomitant indication for oral anticoagulation remains unclear. In this high-risk population group, there is a paucity of data with regards to the use of DOACs. In the present study we compared long-term clinical outcomes of TAVI patients requiring ...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-019-01968-w
更新日期：2020-07-01 00:00:00
abstract：:Plasminogen plays an important role in fibrinolysis as well as wound healing, cell migration, tissue modeling and angiogenesis. Congenital plasminogen deficiency is a rare autosomal recessive disorder that leads to the development of thick, wood-like pseudomembranes on mucosal surfaces, mostly seen in conjunctivas nam...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,评审
doi：10.1007/s11239-016-1416-6
更新日期：2017-01-01 00:00:00
abstract：INTRODUCTION:While the CURE trial demonstrated the benefits of clopidogrel in acute coronary syndromes, patients receiving glycoprotein IIb/IIIa antagonists were excluded. Given the frequent coadministration of these two medications, we sought to examine their interaction and their combined effect on platelet inhibitio...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-004-0170-3
更新日期：2004-08-01 00:00:00
abstract：:Cardiac disease following radiation therapy represents a major consideration in the treatment of a variety of malignancies. Damage to the heart can manifest in a variety of pathologies including ischemic cardiac disease, cardiomyopathy, valvular dysfunction, arrhythmias, and pericarditis. This damage has been shown to...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,评审
doi：10.1007/s11239-020-02303-4
更新日期：2020-10-08 00:00:00
abstract：:Rivaroxaban is a direct factor Xa inhibitor, which is rapidly absorbed in the upper gastrointestinal (GI) tract. In large trials, it has been shown to be effective and safe in VTE treatment. However, in these trials patients with morbid obesity were not reported and it is unknown if the standard dosage of 20 mg rivaro...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-013-0891-2
更新日期：2013-11-01 00:00:00
abstract：:Venous ulcers are the most severe manifestation of post-thrombotic syndrome (PTS). We have previously demonstrated that formation of compact fibrin clots resistant to lysis is observed in patients following deep-vein thrombosis (DVT) who developed PTS. The current study investigated whether unfavourable fibrin clot pr...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-019-01914-w
更新日期：2019-11-01 00:00:00
abstract：:Multiple clinical risk prediction tools for hospital acquired venous thromboembolism (HA-VTE) have been developed. The objectives of this study were to develop and assess the feasibility of data extraction from Electronic Medical Records (EMR) from an enterprise database warehouse (EDW) and to test the validity of a p...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-020-02158-9
更新日期：2020-11-01 00:00:00
abstract：:The goal of platelet function testing in the catheterization laboratory is to provide information about the platelet contributions to the risk of thrombotic or hemorrhagic events and optimization of anti-platelet therapy for percutaneous interventions. We present several illustrative cases in which platelet monitoring...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1023/a:1011228817265
更新日期：2001-04-01 00:00:00
abstract：:Stroke and other thromboembolic events are mainly caused by emboli from heart, aorta and other arteries. In this paper we describe a group of 5 middle-aged patients suffering from emboli caused by large thrombi in the aorta. Since the development of giant thrombi under high flow conditions in the aorta is a pathophysi...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-012-0775-x
更新日期：2013-02-01 00:00:00
abstract：:Aspirin (acetylsalicylic acid) is one of the main therapeutics in prevention of thrombo-embolic vascular events. Its efficiency is proved in the prevention of cardiovascular events. However, antiplatelet effect of aspirin is not absolute in all patients and some patients experience thrombo-embolic events despite aspir...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,评审
doi：10.1007/s11239-006-9043-2
更新日期：2007-06-01 00:00:00
abstract：:Drug-eluting stents (DES) reduce the incidence of in-stent restenosis (ISR) after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Whether the use of biomarkers might be of utility to identify patients who remain at risk for DES ISR after primary PCI has never been exami...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s11239-012-0706-x
更新日期：2012-08-01 00:00:00
abstract：:Peripherally inserted central catheters (PICCs) for central venous access are frequently used in patients with hematological malignancies. Their use may be complicated by upper extremity deep venous thrombosis (UEDVT). Additionally, hematological patients are frequently thrombocytopenic and the optimal management of U...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-020-02040-8
更新日期：2020-04-01 00:00:00
abstract：:In patients with active cancer and acute venous thromboembolism (VTE), the low-molecular-weight-heparin (LMWH) dalteparin is more effective than vitamin K antagonist (VKA) in reducing the risk of recurrent venous thromboembolism (rVTE) without increasing the risk of bleeding. However, the relative benefit of LMWH vers...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1007/s11239-019-01833-w
更新日期：2019-05-01 00:00:00
abstract：:Hyperhomocysteinemia (HHcy) affects haemostasis and shifts its balance in favour of thrombosis. In vitro and in vivo studies suggested that HHcy may impair fibrinolysis either by influencing the plasma levels of fibrinolytic factors or by altering the fibrinogen structure. We investigated the influence of mild HHcy le...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 临床试验,杂志文章
doi：10.1007/s11239-013-0981-1
更新日期：2014-07-01 00:00:00
abstract：:Several autopsy studies showed microthrombi in pulmonary circulation of severe COVID-19 patients. The major limitation of these investigations is that the autopsy provided static information. Some of these alterations could be secondary to the disseminated intravascular coagulation (DIC) observed as the final standard...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-020-02245-x
更新日期：2020-11-01 00:00:00
abstract：:It has been reported that platelet expression and plasma levels of soluble P-selectin are increased in patients with unstable coronary artery syndromes. However, the origin of soluble P-selectin remains unknown. We sought to determine whether platelet expression of P-selectin correlates with plasma levels in the popul...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1023/a:1018738502654
更新日期：2000-08-01 00:00:00
abstract：:Pump thrombosis remains a serious complication of implantable ventricular assist device therapy and is associated with increased risk of morbidity and mortality. Optimal management strategies remain controversial and are guided largely by limited literature and expert opinion. Medical management of pump thrombosis, in...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-018-1725-z
更新日期：2018-11-01 00:00:00
abstract：:Stroke and venous thromboembolism (VTE) are serious and preventable thrombotic events in patients with atrial fibrillation (AF) and who undergo surgery or hospitalization, respectively. Nevertheless, thromboprophylaxis remains greatly underused. The National Quality Forum, the Agency for Healthcare Research and Qualit...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章,评审
doi：10.1007/s11239-013-0874-3
更新日期：2014-01-01 00:00:00
abstract：INTRODUCTION:Recent investigations show that activated factor VII, the primary enzyme in the extrinsic pathway of blood coagulation, exerts additional extra-coagulant functions, such as apoptosis and angiogenesis. On the basis of these recent acquisitions, the present study was aimed to evaluate activated factor VII in...
journal_title：Journal of thrombosis and thrombolysis
pub_type： 杂志文章
doi：10.1007/s11239-006-8969-8
更新日期：2006-10-01 00:00:00
