Active online assessment of patients using new oral anticoagulants: bleeding risk, compliance, and coagulation analysis.

Abstract:

:Clinicians prescribing new oral anticoagulants (OACs; dabigatran, rivaroxaban, and apixaban) should be aware of the exclusion criteria related to bleeding risks defined in published clinical studies. At least a quarter of patients currently using warfarin have an exclusion criterion that may prevent easy transition to the new OACs. In the summary of product characteristics for dabigatran, as an example, the target populations appear generalized. Due to fixed dosing and predictable pharmacology, routine laboratory monitoring of new OACs is deemed unnecessary. Under special circumstances, however, understanding the extent of thrombin or factor (F) Xa inhibition may aid in evaluating compliance and handling emergency interventions, bleeding complications, or overdoses. Although commonly available global coagulation-time assessments (prothrombin time and activated partial thromboplastin time) are insensitive, they may assist clinical management by indicating a severe accumulation of OACs; moreover, a normal thrombin time (TT) excludes a thrombin-inhibitor effect. In particular circumstances, specific assays (diluted TT, Ecarin clotting time, anti-FIIa or anti-FXa activity) may quantify the anticoagulant effect, but therapeutic ranges for dose adjustment are not yet established. Laboratory results are also influenced by clinical situation: e.g. bleed (consumption of coagulation factors) versus postoperative state (activation of coagulation). Without specific antidotes and evidence-based treatment strategies, new OACs are clinically worrisome in patients with impaired renal or liver function. Postmarketing surveillance and recording of bleeding complications (ICD-10 D68.32) are therefore of major importance.

journal_name

Semin Thromb Hemost

authors

Salmela B,Joutsi-Korhonen L,Armstrong E,Lassila R

doi

10.1055/s-0031-1300948

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

23-30

issue

1

eissn

0094-6176

issn

1098-9064

journal_volume

38

pub_type

杂志文章,评审
  • Anticoagulant factor concentrates in disseminated intravascular coagulation: rationale for use and clinical experience.

    abstract::Natural inhibitors of coagulation, in other words, antithrombin (AT), the protein C system, and tissue factor pathway inhibitor (TFPI), play an important role in controlling the activation of coagulation during disseminated intravascular coagulation (DIC). Furthermore, they may not only influence coagulation but also ...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2001-18871

    authors: de Jonge E,van der Poll T,Kesecioglu J,Levi M

    更新日期:2001-12-01 00:00:00

  • The nontreatment of childhood ITP (or "the art of medicine consists of amusing the patient until nature cures the disease").

    abstract::The management of childhood acute idiopathic thrombocytopenic purpura is controversial, with recent guidelines highlighting the lack of suitable evidence upon which to base management decisions. Three European centers have used an expectant policy and results over the past decade demonstrate that this is safe and conv...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2001-15256

    authors: Bolton-Maggs PH,Dickerhoff R,Vora AJ

    更新日期:2001-06-01 00:00:00

  • Comprehensive Assessment of the Hemostatic System in Polycystic Ovarian Syndrome.

    abstract::Polycystic ovarian syndrome (PCOS) affects 12 to 19% of women and has reproductive and metabolic features (endothelial dysfunction, increased diabetes, and cardiovascular risk factors). It also appears to have altered coagulation and fibrinolysis with a prothrombotic state with epidemiological evidence of increased ve...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 临床试验,杂志文章

    doi:10.1055/s-0035-1564837

    authors: Burchall GF,Piva TJ,Linden MD,Gibson-Helm ME,Ranasinha S,Teede HJ

    更新日期:2016-02-01 00:00:00

  • Comparison of recombinant human thrombin and plasma-derived human alpha-thrombin.

    abstract::Bleeding can be a serious complication of surgery, and topical thrombin is widely used as an adjunct to hemostasis in diverse surgical settings. The potent hemostatic properties of thrombin derive from its ability to activate platelets directly to aggregate and adhere to damaged vessels and to catalyze the formation s...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2006-939558

    authors: Bishop PD,Lewis KB,Schultz J,Walker KM

    更新日期:2006-04-01 00:00:00

  • Detection of aspirin resistance by PFA-100: prevalence and aspirin compliance in patients with chronic stable angina.

    abstract::Most acute coronary syndromes result from a platelet-rich occlusion of the coronary arteries. Antiplatelet drugs are of proven efficacy in preventing myocardial infarction, unstable angina, and stroke. However, not all patients on aspirin (ASA) benefit. We studied the phenomenon of aspirin resistance with a simple and...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-2005-916677

    authors: Crowe B,Abbas S,Meany B,de Haan J,Cahill MR

    更新日期:2005-01-01 00:00:00

  • Management of venous thrombosis and pulmonary embolism after gynecological surgery.

    abstract::We experienced 23 cases of venous thrombosis after gynecological surgery for the past 12 years at Tokyo Women's Medical University Hospital, representing 0.345 % of all patients. Eighteen of the 23 cases had deep venous thrombosis (DVT) including five cases followed by pulmonary embolism (PE), and five cases had PE wi...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-2007-996036

    authors: Adachi T,Nakabayashi M,Takeda Y

    更新日期:1998-01-01 00:00:00

  • Differences between bone marrow and lung endothelial cells.

    abstract::To elucidate the mechanisms by which hematopoietic progenitor cells selectively lodge in bone marrow, we established endothelial cell lines derived from bone marrow and lung and then examined the transendothelial migration of hematopoietic progenitor cells by using cells was examined by a Transwell migration assay. He...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-2007-995854

    authors: Imai K,Kobayashi M

    更新日期:1998-01-01 00:00:00

  • The spectrum of coagulation abnormalities in thyroid disorders.

    abstract::The hemostatic balance is a complex system where the delicate equilibrium is regulated by several factors including hormones. A variety of endocrine disorders have been reported to be associated with coagulation abnormalities, ranging from mild laboratory changes to clinically relevant thrombotic or bleeding manifesta...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0030-1270065

    authors: Vescovi PP,Favaloro EJ,Lippi G,Garofano M,Montagnana M,Manzato F,Franchini M

    更新日期:2011-02-01 00:00:00

  • Inhibitors in hemophilia A: advances in elucidation of inhibitory mechanisms and in inhibitor management with bypassing agents.

    abstract::Development of inhibitory antibodies (inhibitors) to factor VIII (FVIII) is the most serious adverse event in replacement therapy of hemophilia A patients. The etiology and management of this condition remain major challenges for both researchers and clinicians. In the present review, we discuss recent advances in und...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0029-1245106

    authors: Ananyeva NM,Lee TK,Jain N,Shima M,Saenko EL

    更新日期:2009-11-01 00:00:00

  • Protective Effects of Statins Administration in European and North American Patients Infected with COVID-19: A Meta-analysis.

    abstract::Severe acute respiratory syndrome coronavirus 2 has spread rapidly throughout the world, becoming an overwhelming global health emergency. The array of injuries caused by this virus is broad and not limited to the respiratory system, but encompassing also extensive endothelial and systemic tissue damage. Since statins...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-0040-1722307

    authors: Onorato D,Pucci M,Carpene G,Henry BM,Sanchis-Gomar F,Lippi G

    更新日期:2021-01-22 00:00:00

  • Clinical significance of hypertriglyceridemia.

    abstract::Available data suggest that elevated triglyceride levels in plasma, associated with increased VLDL or chylomicron remnants, are associated with premature coronary artery atherosclerosis. Whether this is a direct effect or as a result of the association of hypertriglyceridemia with decreased HDL as well as decreased LD...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2007-1002768

    authors: Schaefer EJ,McNamara JR,Genest J Jr,Ordovas JM

    更新日期:1988-04-01 00:00:00

  • The statins: multifunctional antithrombotic and antineoplastic drugs.

    abstract::Statins are approved by the Food and Drug Administration (FDA) for the treatment of hypercholesterolemia and have shown remarkable activity in preventing cardiovascular morbidity and mortality. The versatility of statins is increasingly being appreciated, however, and lowering cholesterol is only one attribute among m...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2003-40964

    authors: Splichal JE,Stamm JA,Ornstein DL

    更新日期:2003-06-01 00:00:00

  • To mix or not to mix in lupus anticoagulant testing? That is the question.

    abstract::Mixing patient and normal plasma has been used for many years to assist with making decisions on which direction to proceed for further investigation of abnormally prolonged coagulation tests, namely, either individual coagulation factor measurement or the search for circulating anticoagulants. Mixing tests, however, ...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0032-1304717

    authors: Tripodi A

    更新日期:2012-06-01 00:00:00

  • Monitoring Antiplatelet Therapy.

    abstract::The increasing use of antiplatelet therapy, particularly aspirin and oral P2Y12 inhibitors, in the prevention and management of arterial thrombosis, has stimulated extensive pharmacodynamic studies and research into tailored antiplatelet regimens. Many different methodologies have been studied for monitoring antiplate...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0036-1597298

    authors: Orme R,Judge HM,Storey RF

    更新日期:2017-04-01 00:00:00

  • Evaluation of hematologic alterations associated with daily administration of low molecular weight heparin (Mono-Embolex) for a 12-week period.

    abstract::The long-term success rate of coronary angioplasty is only 50 to 70% due to restenosis. The pathophysiologic mechanism of this event is mainly mediated by smooth muscle cell proliferation. To some extent, it can be inhibited by heparin. The introduction of LMWHs allows for prophylaxis against restenosis on an outpatie...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:

    authors: Lojewski B,Bacher P,Iqbal O,Walenga JM,Hoppensteadt DA,Leya F,Fareed J

    更新日期:1993-01-01 00:00:00

  • The role of individual risk factors in anticoagulant-associated hemorrhages.

    abstract::Hemorrhagic complications during therapy with anticoagulant drugs have long been considered as simply and directly related to overdosage. Yet, such adverse events have also been observed in patients correctly anticoagulated, i.e., within the therapeutic range, thus demonstrating that the predictive value of laboratory...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:

    authors: Toulemonde F

    更新日期:1996-01-01 00:00:00

  • Women with thrombophilia: assessing the risks for thrombosis with oral contraceptives or hormone replacement therapy.

    abstract::Women with inherited or acquired thrombophilia are at increased risk for venous thromboembolism (VTE) when they use oral contraceptives (OCs) of either the second or third generation. For women who are heterozygous for Factor V Leiden, the risk is probably 28 to 50 of 10,000 women-years compared to 2 to 5 of 10,000 ye...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:

    authors: Waselenko JK,Nace MC,Alving B

    更新日期:1998-01-01 00:00:00

  • Stimulation of cell surface plasminogen activation by heparin and related polyionic substances.

    abstract::The functional operation of the cell surface pro-u-PA and plasminogen activating system has previously been shown to depend on the assembly of u-PA receptors, plasminogen binding sites, and their respective ligands at the focal adhesions of cell extensions. We now show that additional factors operate that affect the p...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-2007-1002610

    authors: Stephens RW,Pöllänen J,Tapiovaara H,Woodrow G,Vaheri A

    更新日期:1991-07-01 00:00:00

  • Point-of-care testing in critically ill patients.

    abstract::Point-of-care (POC) testing in hemostasis has experienced a significant increase in the spectrum of available tests and the number of tests performed. Short turn-around time and observation of rapid changes in test results are facilitated. The quality control process in POC testing must encompass a preanalytic (collec...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0035-1544184

    authors: Fries D,Streif W

    更新日期:2015-02-01 00:00:00

  • Anti-factor H autoantibody-associated hemolytic uremic syndrome: review of literature of the autoimmune form of HUS.

    abstract::Non-Shiga toxin-associated hemolytic uremic syndrome (atypical HUS) is a rare form of thrombotic microangiopathy that associates hemolytic anemia, thrombocytopenia, and acute renal failure. The disease has been demonstrated to be linked with a complement alternative pathway dysregulation due to genetic defects but als...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0030-1262885

    authors: Dragon-Durey MA,Blanc C,Garnier A,Hofer J,Sethi SK,Zimmerhackl LB

    更新日期:2010-09-01 00:00:00

  • Congenital amegakaryocytic thrombocytopenia: clinical presentation, diagnosis, and treatment.

    abstract::Congenital amegakaryocytic thrombocytopenia (CAMT, MIM #604498) is a rare inherited bone marrow failure syndrome presenting as isolated hypomegakaryocytic thrombocytopenia at birth without other characteristic physical anomalies. Most of the patients develop a severe aplastic anemia and trilineage cytopenia during the...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1291377

    authors: Ballmaier M,Germeshausen M

    更新日期:2011-09-01 00:00:00

  • Coagulation-associated enhancement of fibrinolytic activity via a neutralization of PAI-1 activity.

    abstract::Total fibrinolytic activity in the vasculature is finely tuned by the balance between tissue plasminogen activator and plasminogen activator inhibitor type 1 (PAI-1). Although PAI-1 targets plasminogen activators, it also reacts with other serine proteases such as thrombin and factor Xa. The latter was shown to intera...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2000-9801

    authors: Urano T,Ihara H,Suzuki Y,Takada Y,Takada A

    更新日期:2000-01-01 00:00:00

  • Anticoagulation with recombinant hirudin and danaparoid sodium in pediatric patients.

    abstract::Patients receiving heparin are at risk of developing heparin-induced thrombocytopenia (HIT). Whereas in HIT I only reversible mild thrombocytopenia occurs within the first days of heparin treatment, HIT II may lead to potentially life-threatening thromboembolic events. Pediatric patients suffering from HIT II have bee...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2002-35285

    authors: Severin T,Zieger B,Sutor AH

    更新日期:2002-10-01 00:00:00

  • Chemical derivatization as a strategy to study structure-activity relationships of glycosaminoglycans.

    abstract::Sulfated glycosaminoglycans (GAGs) are amenable to a number of chemical modifications that modulate their biological activity. N-sulfate groups can be exposed and N-acylated (usually N-acetylated), specific O-sulfate groups can be removed, and free hydroxyl groups (either preexisting in the original GAG or exposed by ...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2002-34302

    authors: Casu B,Naggi A,Torri G

    更新日期:2002-08-01 00:00:00

  • New insights into the role of erythrocytes in thrombus formation.

    abstract::The role of erythrocytes in thrombus formation has previously been regarded as passive by their influence on rheology. Erythrocytes are known, due to their abundance and size, to push platelets to the vascular wall (laminar shearing). This results in an increased platelet delivery at the vascular wall enabling platele...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0033-1363470

    authors: Du VX,Huskens D,Maas C,Al Dieri R,de Groot PG,de Laat B

    更新日期:2014-02-01 00:00:00

  • Prognostic Scores for Acute Pulmonary Embolism.

    abstract::Rapid and accurate risk stratification is critical in determining the optimal treatment strategy for patients with acute pulmonary embolism (PE). Early identification of patients with normal blood pressure and a favorable prognosis (low-risk PE) might select a subset of patients for outpatient treatment, which is asso...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-0036-1597287

    authors: Morillo R,Moores L,Jiménez D

    更新日期:2017-07-01 00:00:00

  • Shear-, Sound-, and Light-Sensitive Nanoparticles for Thrombolytic Drug Delivery.

    abstract::Thrombotic diseases, as potentially induced by blood clots or vascular embolization, frequently occur with high rates of mortalities worldwide. Current drug thrombolysis, a primary clinical therapy, may increase fatal risk of hemorrhage when thrombolysis agents become systemically distributed. Given current thrombolys...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-0039-1688490

    authors: Qu S,Ding X

    更新日期:2020-07-01 00:00:00

  • Low-molecular-weight heparin and cancer.

    abstract::Heparin is a familiar anticoagulant drug with properties that may impede tumor growth; it modifies properties of cells that contribute to malignant dissemination such as angiogenesis, growth factor and protease activity, immune function, proliferation, and gene expression. Heparin has antitumor effects in animal model...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章,评审

    doi:10.1055/s-2000-9499

    authors: Zacharski LR,Ornstein DL,Mamourian AC

    更新日期:2000-01-01 00:00:00

  • Protective action of polyelectrolytes on endothelium.

    abstract::These results show that heparin and dextran sulfate protect endothelial cells from oxygen-free radicals. Heparan sulfate and dermatan sulfate showed mild protection when measuring cell viability but none when examining the presence of LDH in media. These GAGs are obviously not as effective as heparin and dextran sulfa...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:

    authors: Hiebert L,Liu JM

    更新日期:1991-01-01 00:00:00

  • Structure and function studies of factor XIIIa by x-ray crystallography.

    abstract::The three-dimensional structures of several forms of the factor XIII A subunit have been determined using single crystal x-ray diffraction methods. Our crystallographic studies have provided the first detailed structural view of the factor XIII A subunit and information that is useful for understanding transglutaminas...

    journal_title:Seminars in thrombosis and hemostasis

    pub_type: 杂志文章

    doi:10.1055/s-2007-999035

    authors: Yee VC,Le Trong I,Bishop PD,Pedersen LC,Stenkamp RE,Teller DC

    更新日期:1996-01-01 00:00:00