Abstract:
BACKGROUND:Use of antiplatelet therapy in combination with oral anticoagulants remains controversial. The purpose of this article is to review current consensus recommendations for antithrombotic therapy, to evaluate risks for bleeding among patients taking combination antithrombotic therapy, and lastly to review single-center data from Kaiser Permanente Colorado detailing clinical outcomes associated with combination therapy. METHODS:This was a retrospective, longitudinal pharmacoepidemiologic review. Adult patients receiving warfarin managed by a clinical pharmacy service who had documented antiplatelet (aspirin, clopidogrel, and/or dipyridamole) use (combination therapy cohort) or non-use (monotherapy cohort) were identified as of September 30, 2005. Utilizing integrated, electronic medical records, anticoagulation-related adverse events (death, hemorrhage, thrombosis) and coronary events were identified during a six-month follow-up (October 2005 through March 2006). Proportions of events were compared between cohorts. Independent associations between the cohorts and the outcomes were assessed with adjustment for potential confounding factors. RESULTS:Data from 2,560 monotherapy and 1,623 combination therapy patients were analyzed. Patients in the combination therapy cohort were more likely to have had anticoagulation-related hemorrhages (4.2% vs. 2.0%, unadjusted p<0.001). With adjustment, combined warfarin and antiplatelet use was independently associated with hemorrhagic (OR=2.75; 95% CI 1.44, 5.28) but not coronary (OR=0.99; 95% CI 0.37, 2.62) events. CONCLUSIONS:At the population level, the hemorrhagic risk associated with warfarin therapy combined with antiplatelet therapy appears to outweigh the benefits. These findings suggest that clinicians carefully consider risks and benefits when prescribing antiplatelet therapy for patients taking warfarin who do not meet evidence-based criteria for that approach.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Johnson Sdoi
10.1016/j.thromres.2008.08.011subject
Has Abstractpub_date
2008-01-01 00:00:00pages
S7-11eissn
0049-3848issn
1879-2472pii
S0049-3848(08)00332-0journal_volume
123 Suppl 1pub_type
杂志文章,评审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::Interaction with circulating platelets is considered an important virulent mechanism for Staphylococcus aureus (S. aureus) bacteria to induce endocarditis, a severe infectious disease with high incidence of systemic thrombosis. It therefore represents an important target for pharmacological intervention. In this study...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2004.11.016
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Minimizing bleeding and transfusion is desirable given its cost, complexity and potential for adverse events. Concerns have been heightened by recent data demonstrating that bleeding events may predict worse outcomes and by warnings about the safety of erythropoietic stimulating agents. Prior small studies s...
journal_title:Thrombosis research
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.thromres.2008.09.015
更新日期:2009-03-01 00:00:00
abstract::The relationship between platelet aging and early markers of membrane activation have not been defined clearly. Activation markers expressed during prolonged storage are similar if not identical to those that appear after exposure to thrombin. Using flow cytometry, we investigated platelet membrane expression of CD62P...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(98)00173-x
更新日期:1999-02-15 00:00:00
abstract::Defibrotide (D) was labelled with 125I or with 32P. The radiolabelled compounds ([125I]-Defibrotide ([125I]-D), [32P]-Defibrotide ([32P]-D) retained the same profibrinolytic activity, in vitro, as the parent drug, suggesting that the labelling procedures had not modified the pharmacological properties of D and hence t...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(95)00213-8
更新日期:1996-01-01 00:00:00
abstract::Systemic autoimmune diseases are characterised by the development of a relatively narrow spectrum of autoantibodies. These are of considerable diagnostic value. In addition, in some diseases, including anti-phospholipid syndrome, these autoantibodies can be directly pathogenic. Understanding how these autoantibodies a...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2004.06.037
更新日期:2004-01-01 00:00:00
abstract::In the present study a new clotting assay for the detection of an increased resistance of coagulation factor V against degradation by activated protein C (Factor V Leiden mutation, FVLM) was evaluated. The Factor V (Leiden) Test (Gradipore, North Ryde NSW, Australia) is based on the dilute Russell Viper Venom Time (DR...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(99)00090-0
更新日期:1999-10-15 00:00:00
abstract::This study investigates the effect on human platelet function of two sesquiterpene lactones from Arnica montana L., helenalin (H) and 11 alpha,13-dihydrohelenalin (DH). Both compounds inhibited collagen-induced platelet aggregation, thromboxane formation and 5-hydroxytryptamine secretion in a concentration-dependent m...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90151-2
更新日期:1990-03-15 00:00:00
abstract::Central venous catheters (CVC) have revolutionized the care of patients requiring long-term venous access. With increasing use of CVCs, the incidence of catheter-related thrombosis (CRT) has been on the rise. CRT constitutes 10% of all deep venous thromboses (DVT) in adults and 50-80% of all DVTs among children. The i...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2020.01.017
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Anticoagulated patients are often seen unnecessarily in the emergency department (ED) for epistaxis, leading to increased healthcare costs. Patients are often unaware of preventative and management techniques for handling epistaxis in the home. METHODS:In 2016, the Michigan Anticoagulation Quality Improveme...
journal_title:Thrombosis research
pub_type: 信件
doi:10.1016/j.thromres.2021.01.007
更新日期:2021-01-16 00:00:00
abstract::One of the major pathogens of periodontitis, Porphyromonas gingivalis (P. gingivalis), has the ability to aggregate human platelets. To investigate the interaction between P. gingivalis and human platelets in platelet rich plasma (PRP), platelet aggregation was measured by an aggregometer based on laser light scatteri...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2008.03.011
更新日期:2008-01-01 00:00:00
abstract::The protease inhibitor, aprotinin, has been examined for its ability to inhibit urokinase and tissue-type plasminogen activators at pH 7.4 in assays utilizing pyroGlu-Gly-Arg-p-nitroanilide and H-D-Ile-Pro-Arg-p-nitroanilide as substrates, respectively. Aprotinin inhibited both two-chain low molecular weight urokinase...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(88)90252-6
更新日期:1988-03-15 00:00:00
abstract::A Ca++-ionophore, ionomycin, increased the volume of human platelets suspended in a Ca++-containing buffer. This change in cell volume was dependent upon ionomycin and extracellular Ca++ concentrations, suggesting that the volume change occurs when the intracellular Ca++ reaches a certain level (greater than uM as det...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90197-k
更新日期:1990-01-01 00:00:00
abstract::Reproducible disseminated intravascular coagulation in rabbits was provoked by two intravenous injections 24 hours apart of endotoxin from Salmonella enteritidis. There were mild symptoms of DIC before the second injection which considerably increased thereafter. In detail there was a sharp drop of the platelet count ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(93)90029-n
更新日期:1993-02-01 00:00:00
abstract::To demonstrate that human alpha-thrombin is effectively inactivated by human antithrombin III (AT) during the production of a fibrin clot we measured the amount of alpha-thrombin activity which can be recovered from a clot generated from purified human proteins. We discovered that 0.05-0.07% of the original alpha-thro...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(93)90234-f
更新日期:1993-03-01 00:00:00
abstract::Tissue factor (TF) is a transmembrane protein which, in complex with factor (F)VIIa, initiates blood coagulation. Numerous studies have determined TF epitopes and individual amino acids which play an important role in the TF/FVIIa complex formation and its activity towards natural substrates. However the subject of ce...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2012.02.022
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Predictors of venous thromboembolism (VTE) after trauma are uncertain. OBJECTIVE:To identify independent predictors of VTE after acute trauma. METHODS:Using Rochester Epidemiology Project (REP) resources, we identified all Olmsted County, MN residents with objectively-diagnosed incident VTE within 92days a...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2016.03.026
更新日期:2016-08-01 00:00:00
abstract::Beta-thromboglobulin (beta-TG) is a platelet-specific protein present in the alpha-granules and secreted into the surrounding medium on cell activation. The sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of platelet releasate after inhibition of metalloproteinases with ethyleneglycol-bis-(beta-a...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(02)00135-4
更新日期:2002-05-15 00:00:00
abstract:BACKGROUND:Variability in platelet response to clopidogrel and its clinical relevance have been well described. However, the underlying mechanisms remain unclear. Recently, the T744C polymorphism of the P2Y12 receptor gene has been associated with enhanced platelet aggregation in healthy volunteers, suggesting a possib...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2007.01.012
更新日期:2007-01-01 00:00:00
abstract::Increased fibrinolytic activity is a well recognized constant finding observed during cardiopulmonary bypass (CPB). The purpose of the present work was to study and estimate the factors involved in the plasminogen activation and prekallikrein-kallikrein systems in a population of adult patients undergoing open heart s...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(92)90018-6
更新日期:1992-09-01 00:00:00
abstract::Mass-Length ratio of fibrin fibres (microT and microP) derived independently from turbidity and permeability respectively, in networks made in fibrinogen solution and plasma, have been compared under similar conditions of clotting. Amount of fibrinogen conversion to fibrin was similar in both systems when high thrombi...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(87)90193-9
更新日期:1987-02-01 00:00:00
abstract:INTRODUCTION:No data are available regarding appropriate strategies for the transition of patients undergoing total hip or knee replacement (THR/TKR) surgery from subcutaneous low molecular weight heparin (LMWH) to rivaroxaban. This study determined the pharmacodynamic effects of rivaroxaban on the first day of adminis...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.thromres.2012.07.014
更新日期:2012-11-01 00:00:00
abstract::Protein C has been measured by three different assays (antigenic, amidolytic and chronometric) in 27 end-stage renal insufficient patients before and after hemodialysis. Protein C levels have been compared with other coagulation inhibitors (antithrombin III, protein S) and fibrinolytic parameters. Baseline anticoagula...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(93)90055-s
更新日期:1993-03-15 00:00:00
abstract::A tritium-labelled low molecular weight heparin fragment with an average molecular weight of 4000-6000 (Fragmin), was fractionated into its high and low affinity forms for antithrombin. The fractions obtained were injected into rabbits, and the plasma half-life (t1/2) volume of distribution (Vd), area under the curve ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(87)90345-8
更新日期:1987-10-01 00:00:00
abstract:INTRODUCTION:Circulating microparticles support thrombin generation. The aim of this study is to determine the indirect microparticle activity and the parameters of thrombin generation in healthy infants. MATERIALS AND METHODS:A total of 85 infants who were brought to follow-up visits were taken into the study. Blood ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2013.11.011
更新日期:2014-02-01 00:00:00
abstract:INTRODUCTION:Endothelial dysfunction plays an essential role in the pathogenesis of sepsis. The study aimed to illustrate the associations between the dynamic change (from day 1 to day 7) in biomarker concentration of endothelial dysfunction and outcomes in severe sepsis and septic shock in the intensive care unit (ICU...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2018.09.059
更新日期:2018-11-01 00:00:00
abstract::We constructed a new factor IX expression vector containing a full length factor IX cDNA. The Moloney Murine Leukemia Virus (MoMLV)-based retroviral vector pLRNL was cloned with the entire coding region of human factor IX down stream of the promoter of Rous sarcoma virus, giving rise to the construct pL9RNL. The GP+E ...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(93)90038-p
更新日期:1993-02-15 00:00:00
abstract:INTRODUCTION:Thrombosis is one of the most frequent adverse events after cardiac catheterization, which can be reduced by anticoagulation with unfractionated heparin (UFH) in both children and adults. Low molecular weight heparin (LMWH) might possibly offer advantages. Laboratory signs of thrombin generation during ped...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/j.thromres.2003.09.020
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:The Cilostazol Stroke Prevention Study found that cilostazol, a phosphodiesterase 3 inhibitor, can reduce the risk of subsequent stroke in Japanese patients with cerebral infarction. Here, we measured the effects of cilostazol in vitro on shear-induced platelet aggregation, an important mechanism of thromb...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2006.05.005
更新日期:2007-01-01 00:00:00
abstract::The effect of dalteparin, a low molecular weight heparin, on severely antithrombin III (ATIII)-decreased disseminated intravascular coagulation (DIC) model was compared with that of unfractionated heparin (heparin). The DIC model in rabbits was produced by continuous infusion of thrombin in combination with bolus inje...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(95)00191-s
更新日期:1995-12-01 00:00:00