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Journal articles on the topic 'Anticoagulant antivitamine K'

Author: Grafiati

Published: 18 May 2024

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1

Mahwish, Nayesha, Laxminarayana Kurady Bairy, and Sureshkumar Srinivasamurthy. "Antivitamins: A Silver Lining in the Era of Antimicrobial Resistance." Journal of Pharmacology and Pharmacotherapeutics 13, no. 1 (March 2022): 5–13. http://dx.doi.org/10.1177/0976500x221080378.

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Antivitamins are compounds that negate the biological effects of vitamins. They have been successfully exploited for the development of various classes of drugs. In the early 19th century, the antifolate prontosil was developed for the treatment of puerperal fever. Since then, numerous other antifolates have been used to treat a wide range of infections. Antifolates, such as methotrexate, are potent anticancer agents and antivitamin K, such as warfarin, are used as anticoagulants. Despite several years of research, most antivitamin-based drugs are limited to vitamin K and B9, and the development of antagonists for other vitamins is still in the nascent stage. In the era of antimicrobial resistance, antivitamins can be considered as a promising alternative to develop newer antimicrobials and are worth exploring further. This review discusses key antivitamins at different stages of development which have potential utility as antibiotic drug candidates. The summary of studies of antivitamins in clinical development is also narrated.

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2

Blin, P., C. Dureau-Pournin, R. Lassalle, A. Abouelfath, K. Le Lay, G. de Pouvourville, C. Droz-Perroteau, and N. Moore. "Ressources consommées et coûts associés des patients traités par anticoagulant oral direct ou antivitamine K dans la fibrillation auriculaire non valvulaire." Revue d'Épidémiologie et de Santé Publique 64 (December 2016): S309—S310. http://dx.doi.org/10.1016/j.respe.2016.10.051.

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3

Foletti, Mauro, Thomas Schmutz, Yvan Fleury, Jean-Luc Magnin, Christophe Le Terrier, and Youcef Guechi. "Bleeding on oral anticoagulants: overview of reversal strategies." Swiss Medical Weekly 153, no. 2 (February 20, 2023): 40036. http://dx.doi.org/10.57187/smw.2023.40036.

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Oral anticoagulants (antivitamin K, direct oral anticoagulants) are routinely prescribed for the prevention or treatment of thromboembolic events, and many patients are now on long-term anticoagulant therapy. However, this complicates the management of urgent surgical conditions or major bleeding. Various strategies have been developed to reverse the anticoagulant effect and this narrative review provides an overview of the wide range of therapies currently available.

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4

Bavozet, Florent, and Isabelle Mahé. "Relais d’un traitement anticoagulant oral par antivitamine K en ambulatoire dans le cadre d’un acte invasif ou de chirurgie programmée. Enquête de pratique auprès de médecins généralistes." La Presse Médicale 43, no. 7-8 (July 2014): e221-e231. http://dx.doi.org/10.1016/j.lpm.2013.12.016.

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5

DIACONU, Camelia, Giorgiana DEDIU, Mădălina ILIE, and Mihaela Adela IANCU. "Treatment with new oral anticoagulants in the family medicine practice." Romanian Journal of Medical Practice 10, no. 4 (December 31, 2015): 329–32. http://dx.doi.org/10.37897/rjmp.2015.4.4.

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Vitamin K antagonists represented for more than 50 years the only oral anticoagulant treatment option, though encumbered by numerous food and drug interactions, with direct impact on the safety and efficacy of this treatment. The frequent complications of anticoagulant treatment with vitamin K antagonists led to the need for the emergence of new oral anticoagulants (NOAC). The main NOACs used today are dabigatran, rivaroxaban and apixaban. NOAC have a number of advantages over antivitamin K anticoagulants: fewer drug interactions, no food interactions, rapid onset of the anticoagulant action, rapid clearance, no need for INR monitoring. NOAC therapy must be individualized according to patient age, comorbidities and medical history, renal function, concomitant medications. Given that clinical experience with NOAC is still limited in practice, physicians (including family physicians) must monitor these patients and need to pay attention and report any side effects.

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6

Bokarev, Igor N. "Anticoagulants today." Clinical Medicine (Russian Journal) 94, no. 1 (February 19, 2016): 5–9. http://dx.doi.org/10.18821/0023-2149-2016-94-1-5-9.

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7

Poenou, Géraldine, Marco Heestermans, Ludovic Lafaie, Sandrine Accassat, Nathalie Moulin, Alexandre Rodière, Bastien Petit, Cécile Duvillard, Patrick Mismetti, and Laurent Bertoletti. "Inhibition of Factor XI: A New Era in the Treatment of Venous Thromboembolism in Cancer Patients?" International Journal of Molecular Sciences 24, no. 19 (September 22, 2023): 14433. http://dx.doi.org/10.3390/ijms241914433.

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Direct oral anticoagulants against activated factor X and thrombin were the last milestone in thrombosis treatment. Step by step, they replaced antivitamin K and heparins in most of their therapeutic indications. As effective as the previous anticoagulant, the decreased but persistent risk of bleeding while using direct oral anticoagulants has created space for new therapeutics aiming to provide the same efficacy with better safety. On this basis, drug targeting factor XI emerged as an option. In particular, cancer patients might be one of the populations that will most benefit from this technical advance. In this review, after a brief presentation of the different factor IX inhibitors, we explore the potential benefit of this new treatment for cancer patients.

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8

Anguas-Gracia, Ana, Ana Belén Subirón-Valera, Beatriz Rodríguez-Roca, Ángel Gasch-Gallén, Isabel Antón-Solanas, and Fernando Urcola-Pardo. "Sense of Coherence and Quality of Life in Patients Treated with Antivitamin K Oral Anticoagulants: A Cross-Sectional Study." International Journal of Environmental Research and Public Health 18, no. 4 (February 9, 2021): 1668. http://dx.doi.org/10.3390/ijerph18041668.

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The aim of this study was to analyze the correlation between the participants’ self-reported quality of life and their sense of coherence in a sample (n = 85) of patients on treatment with oral antivitamin K anticoagulants. A cross-sectional design was used. The measurement instruments included a questionnaire on sociodemographic variables, the Spanish version of the Abbreviated World Health Organization Quality of Life questionnaire (WHOQOL-BREF), an oral-anticoagulant-treatment-specific quality-of-life questionnaire, and the sense-of-coherence (SOC) scale. We analyzed the correlations between the participants’ characteristics and the results from the quality-of-life and SOC scales. Age, level of education, employment status, living arrangement, and treatment length were the determinants of the quality of life in people treated with oral anticoagulants. We found a significant association between the four domains of the WHOQOL-BREF questionnaire and general treatment satisfaction (p < 0.01); no significant correlations were found between the SOC subscales and the oral-anticoagulant-treatment-specific quality of life in our sample. Women had a worse level of self-management than men. Nursing interventions should be tailored to the needs of the populations on treatment with oral anticoagulants in order to facilitate a higher level of self-management.

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9

Gheorghe, Gabriela Silvia, Andreea Simona Hodorogea, Andrei Cristian Dan Gheorghe, Dragoș Emanuel Popa, Simona Vulpe, Cristina Georgescu, Ruxandra Bănică, et al. "Decision of Anticoagulation in Nonvalvular Atrial Fibrillation in the Real World in the Non-Antivitamin K Anticoagulants Era." Healthcare 10, no. 7 (July 18, 2022): 1333. http://dx.doi.org/10.3390/healthcare10071333.

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Background. Patients with nonvalvular atrial fibrillation (NVAF) have five times higher risk of stroke than the general population. Anticoagulation (ACO) in NVAF is a class I indication after assessing the CHA2DS2-VASc and HAS-BLED scores. However, in the real world, NVAF patients receive less ACO than needed due to patients’ comorbidities that can be assessed by the Charlson comorbidity index (CCI). The use of non-antivitamin K anticoagulants (NOAC) has improved the decision to anticoagulate. Objective. We analyzed the factors influencing the ACO prescribing decision in NVAF patients in the real world and the changes induced by the introduction of NOAC. Method. We carried out an observational retrospective cross-sectional study that included consecutive patients with permanent NVAF and CHA2DS2-VASc ≥ 2, admitted to a community hospital between 2010–2011 (group 1, 286 patients), when only vitamin K antagonists (VKA) were used, and 2018–2019 (group 2, 433 patients), respectively. We calculated CHA2DS2-VASc, HAS-BLED, and CCI and recorded the ACO decision and the use of VKA or NOAC in group 2. We compared the calculated scores between ACO and non-anticoagulated (nonACO) patients in both groups and between groups. Results. A 31.5% share of patients in group 1 and 12.9% in group 2 did not receive ACO despite a CHA2DS2-VASc score ≥ 2. In group 1, nonACO patients had higher HAS-BLED and CCI scores than the ACO patients, but their CHA2DS2-VASc scores were not significantly different. Old age, dementia, severe chronic kidney disease, neoplasia, and anemia were the most frequent reasons not to prescribe anticoagulants. In group 2, more nonACO patients had dementia, diabetes mellitus, and higher HAS-BLED than ACO patients. Moderate-severe CKD, neoplasia with metastasis, liver disease, anemia, and diabetes mellitus were statistically significantly more frequent in nonACO patients from group 1 than those from group 2. In group 2, 55.7% of ACO patients received NOAC. Conclusions. In real-world clinical practice, the decision for anticoagulation in NVAF is influenced by patient age, comorbidities, and risk of bleeding, and many patients do not receive anticoagulants despite a high CHA2DS2-VASc score. The use of NOAC in the past few years has improved treatment decisions. At the same time, the correct diagnosis, treatment, and surveillance of comorbidities have cut down the risk of bleeding and allowed anticoagulant use according to guidelines.

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10

Siguret, V., and I. Gouin-Thibault. "Surveillance des traitements anticoagulants : dérivés hépariniques et antivitamine K." EMC - Biologie Médicale 7, no. 2 (June 2012): 1–11. http://dx.doi.org/10.1016/s2211-9698(12)56847-0.

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11

Bokarev, Igor N., and T. B. Kondrat’eva. "New anticoagulants in clinical practice. Effectiveness and problems." Clinical Medicine (Russian Journal) 94, no. 5 (June 20, 2016): 383–87. http://dx.doi.org/10.18821/0023-2149-2016-94-5-383-387.

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We analyze the effectiveness of new oral anticoagulants and antivitamins K for the treatment of patients with venous problems, atrial fibrillation, and acute coronary syndrome with reference to advantages of this therapy and methods of prevention of complications of these conditions.

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12

Tadsaoui, Samira, M. Mahir, N. Tirizite, A. Mahmoud, B. Boutakioute, M. Ouali Idrissi, N. Cherif Idrissi El Ganouni, A. Hamri, Y. Narjis, and R. Benelkhaiat. "Haemorrhagic Cholecystitis Complicated by Rupture of the Gallbladder with Hemoperitoneum." SAS Journal of Medicine 9, no. 03 (March 30, 2023): 222–24. http://dx.doi.org/10.36347/sasjm.2023.v09i03.016.

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We report the case of a 56-year-old diabetic and hypertensive patient, taking antivitamin K for a cardiopathy complicated by a chronic pulmonary heart, who presented an acute cholecystitis with a hypovolaemic shock. The abdominal CT scan showed a ruptured lithiasis hemocholecysis with medium-sized hemoperitoneum and the patient was operated on,the gallbladder was distended containing a lot of stones and it was perforated at the fundus with a large hemoperitoneum containing stones. The procedure consisted of cholecystectomy, haemostasis and evacuation of the haemoperitoneum. Hemocholecyst is a rare complication of anticoagulant treatments. The presence of gallbladder stones promotes intravesicular bleeding. The usual complication is the vesicular perforation. In spite of its rarity, haemocholecyst should be suspected when an anticoagulants treatedpatient presents symptoms of acute cholecystitis with or without haemorrhagic shock.

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13

Vacheron, André. "Recommandations concernant les traitements anticoagulants par les antivitamines K." Bulletin de l'Académie Nationale de Médecine 188, no. 5 (May 2004): 867–68. http://dx.doi.org/10.1016/s0001-4079(19)33739-2.

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14

Bounhoure, Jean-Paul. "Prescription et suivi d’un traitement anticoagulant par les antivitamines K." Bulletin de l'Académie Nationale de Médecine 197, no. 8 (November 2013): 1561–71. http://dx.doi.org/10.1016/s0001-4079(19)31207-5.

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15

Rey, A., M. Deppenweiler, A. Berroneau, K. Martin-Latry, and D. Breilh. "Compétences des patients vis-à-vis de leur traitement anticoagulant oral par antivitamines K et anticoagulants oraux directs." Le Pharmacien Hospitalier et Clinicien 50, no. 2 (June 2015): 219–24. http://dx.doi.org/10.1016/j.phclin.2014.11.006.

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16

Satger, Bernadette, Sophie Blaise, Michèle Fontaine, Jacqueline Yver, Benoît Allenet, Magali Baudrant, Gilles Pernod, and Jean-Luc Bosson. "Éducation thérapeutique des patients traités par anticoagulants oraux antivitamines K." La Presse Médicale 38, no. 12 (December 2009): 1780–87. http://dx.doi.org/10.1016/j.lpm.2009.07.019.

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17

Testa, Sophie, Oriana Paoletti, Anke Zimmermann, Laura Bassi, Silvia Zambelli, and Emilia Cancellieri. "The Role of Anticoagulation Clinics in the Era of New Oral Anticoagulants." Thrombosis 2012 (October 14, 2012): 1–6. http://dx.doi.org/10.1155/2012/835356.

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Anticoagulation Clinics (ACs) are services specialized in management of patients on anticoagulant treatment. At present, ACs manage patients chiefly on antivitamin K antagonists (AVKs), but patient population has already changed in the last few years, because of an increase of treatments with other anticoagulant drugs, which require different management systems. The strong increase in the number of patients at AC, mainly on long-term treatment, has determined the development of web management, through telemedicine systems, improving the quality of life and maintaining the same clinical quality levels. New oral anticoagulants (NOAs) have shown to be as effective as AVK antagonists in stroke prevention in atrial fibrillation and for treatment of venous thromboembolism in addition to VTE prophylaxis in orthopaedic surgery, when administered at a fixed dose, but patient adherence and compliance are crucial for good quality treatment. At present, lacking data from the real world, an oversimplification of treatment with NOAs could cause unjustified risks for patients and also a possible future underuse of good drugs. For these reasons the vigilance must be high and ACs can have a crucial role in defining which is the best management for NOA patients and how to do it, as it happened for AVKs.

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18

Pautas, E., A. Monti, and A. Breining. "Farmacología clínica comparada de los anticoagulantes orales: antivitamina K y anticoagulantes orales directos." EMC - Tratado de Medicina 20, no. 3 (September 2016): 1–5. http://dx.doi.org/10.1016/s1636-5410(16)79460-8.

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19

Wenker Dabiri, Cécilia, and Jean Perdrix. "Les anticoagulants directs supérieurs aux antivitamines K chez nos patients âgés?" Revue Médicale Suisse 19, no. 851 (2023): 2226. http://dx.doi.org/10.53738/revmed.2023.19.851.2226.

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20

Antovic, J., and Tat'yana B. Kondratieva. "Methods to monitor the therapy oral anticoagulants: the current problems." Clinical Medicine (Russian Journal) 96, no. 2 (April 27, 2018): 101–5. http://dx.doi.org/10.18821/0023-2149-2018-96-2-101-105.

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Oral anticoagulants antivitamin-K (ОАС - AVК) are highly effective drugs that prevent the development of venous thrombosis, stroke in atrial fibrillation. Routine monitoring is not recommended for DOAC. If measurements are necessary LC-MS/MS is the gold standard. The classical coagulation assays, PT-INR and aPTT, have no or very limited utility. The absence of the ability of simple laboratory tests in emergent or urgent surgery or procedures still remains unresolved.

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Marottoli, Vincenzo, Antonio Ciampa, Luig Iannaccone, Vincenzo Brancaccio, and Paul R. J. Ames. "Monitoring antivitamin K anticoagulants in antiphospholipid syndrome: A challenge in quality." Atherosclerosis 256 (January 2017): 146–47. http://dx.doi.org/10.1016/j.atherosclerosis.2016.10.041.

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22

Vigué, B., and C. M. Samama. "Prise en charge hémostatique des hémorragies cérébrales sous anticoagulants oraux." Médecine Intensive Réanimation 28, no. 5 (August 20, 2019): 363–70. http://dx.doi.org/10.3166/rea-2019-0113.

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L’hématome intracrânien spontané a un pronostic clinique sévère. Le devenir des patients dépend de l’efficacité de la prise en charge initiale. L’importance du saignement, le volume de l’hématome et son évolution sont les facteurs principaux qui contrôlent mortalité et morbidité. Les traitements anticoagulants oraux, antivitamines K (AVK) et anticoagulants oraux directs (AOD), favorisent l’expansion de l’hématome. La correction rapide de l’hémostase permet le contrôle partiel de l’hématome. Alors que la réversion des AVK par les concentrés de complexe prothrombinique (CCP) a fait l’objet de recommandations bien diffusées, l’attitude thérapeutique reste peu codifiée avec les AOD, alliant l’utilisation de l’idarucizumab pour le dabigatran et des CCP pour les anti-Xa qui n’ont, pour l’instant, pas d’antidote.

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23

Lara, Juan Carlos Palomo, Joan Carles March-Cerdà, José Antonio Ponce-Blandón, Manuel Pabón-Carrasco, and Nerea Jiménez-Picón. "Effectiveness and Health Outcomes of Collaborative Nurse Prescribing for Patients Anticoagulated with Antivitamin K in Primary Care: A Study Protocol." Healthcare 12, no. 3 (January 30, 2024): 347. http://dx.doi.org/10.3390/healthcare12030347.

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The development of collaborative nurse prescribing (NP) in Andalusia (Spain) in 2018 gives us the opportunity to measure the impact of this practice. Scientific evidence indicates that prescribing is not more costly when performed by nurses and, in fact, is more economical in some cases. The aim of this study is to determine the effects of NP on the effectiveness, health outcomes and adverse events related to prescribing including in the follow-up of patients treated with antivitamin K oral anticoagulants in primary care (PC) by nurses. The design is a randomized clinical trial. The population comprises 1208 anticoagulated patients in 2019. The sample size calculation considers an alpha error of 0.05, a power of 99% and an effect size of 0.5, resulting in 127 users per group. Therefore, a total sample of 254 participants is needed. However, as the project intends to treat patients it will include the universal sample that meets the criteria in the two health centers participating in the study, with 575 participants in total. Data collection was carried out in the PC District of the Alamillo-San Jerónimo Clinical Management Unit of Sevilla for one year from January 2020. Data analysis is performed using the SPSS Statistics 25 package. We intend to study if nurse collaborative prescription in the follow-up and management of patients taking antivitamin K oral anticoagulants in PC is as effective as the traditional approach to follow-ups carried out by a family physician.

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Pastori, Daniele, Sandro Parrotto, Tommasa Vicario, Mirella Saliola, Ivano Mezzaroma, Francesco Violi, and Pasquale Pignatelli. "Reply to: “Monitoring antivitamin K anticoagulants in antiphospholipid syndrome: A challenge in quality”." Atherosclerosis 256 (January 2017): 148–49. http://dx.doi.org/10.1016/j.atherosclerosis.2016.11.014.

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25

Munteanu, Sabrina Nicoleta, Andreea Raluca Cozac-Szőke, Simona Mocan, Tania Mihaela Zait, Răzvan Iacob Rus, Răzvan Emil Petri, and Anca Negovan. "Predictors of anemia without active bleeding signs in patients referred for endoscopy." Acta Marisiensis - Seria Medica 69, no. 3 (September 1, 2023): 187–94. http://dx.doi.org/10.2478/amma-2023-0036.

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Abstract Objective: The objective of the present study is to clarify the value of clinic, endoscopic, and histologic variables that may predict anemia in patients performing esophagogastroduodenoscopy for gastrointestinal complaints in the absence of bleeding signs or lower digestive disease. Methods: This study included 654 patients referred for endoscopy that were divided based on biological parameters performed in the same day in the study group (306 patients diagnosed with anemia) and the control group (348 patients without anemia). Results: Anemia is frequent in elderly patients, especially in the presence of premalignant gastric lesions, and it is associated with multiple comorbidities. In two multivariate regression models antivitamin K oral anticoagulants were found to be independently associated with anemia (p = 0.01), but not with antiplatelet therapy, or with non-antivitamin K anticoagulants. Multiple regression models support that epigastric pain and heartburn are inversely associated with anemia, while weight loss remained an independent predictor for simultaneous anemia and premalignant lesions. Non-infectious chronic gastritis (p<0.001) is an independent predictor for anemia and premalignant gastric lesions, increasing the odds of anemia by 2.2 times, while reactive gastropathy is inversely associated. Gastric erosions and ulcer remained independent predictors for concomitant anemia and premalignant lesions. Conclusions: Chronic inactive gastritis and premalignant gastric histologic lesions are predictors for anemia in endoscopic population, while active H. pylori infection is not. Dyspeptic symptoms, epigastric pain (p<0.001,OR 0.2-0.5) and heartburn (p<0.001,OR 0.07-0.3) are inversely associated with anemia alone or associated with premalignant gastric lesions.

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26

Miftode, Ionela-Larisa, Angela Moloce, Radu-Stefan Miftode, and Viviana Onofrei. "Antithrombotic treatment in COVID-19 – from theory to practical approach." Romanian Journal of Infectious Diseases 24, no. 3 (September 30, 2021): 131–36. http://dx.doi.org/10.37897/rjid.2021.3.1.

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Although initially considered a strictly respiratory pathology, the novel coronavirus disease-19 (COVID-19) has emerged as a significant prothrombotic trigger, inducing hypercoagulable status and increased risk of thrombotic events. This is due to a plethora of mechanisms, either from inflammation-induced endothelial dysfunction, overexpression of procoagulant molecules doubled by down-regulation of physiological antithrombotic pathways, or from an exagerated response to otherwise normal procoagulant stimuli. This complex association of factors define the concept of immunothrombosis, which can be influenced by several antithrombotic medications. Despite the lack of an „universal” guideline, the general consensus is to recommend antithrombotic treatment in COVID-19 patients, but its administration should take into account the patient’s clinical status, comorbidities or the other previous indications for antithrombotic treatment. This precaution is due to the multiple drug interactions with antivirals or other molecules used in COVID-19. Concerning anticoagulant treatment, heparins are the optimal choice, compared to antivitamins K and direct oral anticoagulants (DOACs), because they exhibit the most protective effects doubled by the least interactions with other substances. Hospitalized patients should receive prophylactic doses of anticoagulation, but not for the prevention of arterial thrombosis, unless they have a previous indication such as atrial fibrillation or prosthetic valve. It is generally recommended that patients on chronic anticoagulant or antiplatelet therapy for other conditions will continue their prescribed medication, here including special categories such as pregnant women. However, non-hospitalized patients with mild forms of the disease should not be initiated anticoagulant and antiplatelet therapy unless they have other indication. Continuation of prophylaxis after discharge is a matter of debate, the existing data suggesting it may be considered in those patients at high risk for venous thromboembolism (VTE) and/or who had a moderate-severe form of the disease, always assessing the bleeding risk. Further data from extensive studies are required in order to standardize the antithrombotic approach in COVID-19 patients.

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Nakayama, Satoshi, and Naoya Murashima. "Acute Portal Vein Thrombosis Treated with Recombinant Human Soluble Thrombomodulin Combined with Antithrombin III." Case Reports in Medicine 2020 (April 13, 2020): 1–4. http://dx.doi.org/10.1155/2020/8268016.

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Portal vein thrombosis is a major complication associated with liver cirrhosis. In cirrhotic patients, a decrease in procoagulant and anticoagulant factors and an unstable balance between them is observed, and a relative decrease in the activation of anticoagulant drivers is one of the main causes of portal vein thrombosis (PVT). Herein, we report a case of acute portal thrombosis associated with liver cirrhosis and treated with a recombinant form of soluble thrombomodulin (thrombomodulin alpha, TM-α) in combination with antithrombin III. TM-α was administered in accordance with the dosage and route of administration for disseminated intravascular coagulation therapy and resulted in dissolution of PVT with a gradual decrease in D-dimer levels. No adverse events were observed during the course of treatment. In the future, in addition to conventional anticoagulation therapy using heparin or antivitamin K drugs, novel therapies targeting protein C activation using a recombinant form of soluble thrombomodulin may play an important role in the treatment of acute PVT.

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28

Ben Ameur, Ons, Salma Naija, and Sana Ben Amor. "Récidive des accidents vasculaires cérébraux ischémiques (AVCI) malgré les anticoagulants de type antivitamines k(AVK)." Revue Neurologique 178 (April 2022): S85. http://dx.doi.org/10.1016/j.neurol.2022.02.318.

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29

Lafuente-Lafuente, Carmelo, Christel Oasi, and Joël Belmin. "Les traitements anticoagulants oraux chez les personnes âgées : faut-il encore prescrire des antivitamines K ?" La Presse Médicale 48, no. 2 (February 2019): 154–64. http://dx.doi.org/10.1016/j.lpm.2018.11.010.

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30

Lefebvre, Sébastien, Benoit Rannou, Stéphane Besse, Etienne Benoit, and Virginie Lattard. "Origin of the gender differences of the natural resistance to antivitamin K anticoagulants in rats." Toxicology 344-346 (February 2016): 34–41. http://dx.doi.org/10.1016/j.tox.2016.02.002.

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31

Dan, Gheorghe-Andrei, and Adrian Catalin Buzea. "Stroke Prevention in Atrial Fibrillation — The Use of NOACs in Everyday Clinical Practice." European Cardiology Review 10, no. 2 (2015): 76. http://dx.doi.org/10.15420/ecr.2015.10.2.76.

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Non-antivitamin K oral anticoagulants (NOACs) have recently emerged as a new class of antithrombotic drugs. Four large-scale, randomised controlled trials (RCT) accredited dabigatran, rivaroxaban and edoxaban with evident advantages for stroke prevention in atrial fibrillation (AF) compared with warfarin. The superiority concerns not only the manageability but also the antithrombotic efficacy and safety. Aspects of real-life clinical experience with NOAC for stroke prevention in AF are analysed in an attempt to underline some practical differences. If at present the individualisation of the NOAC class drugs is still a subject of debate it is probable that in the near future we will be able to adapt the drug and dosages to individual patient’s profile.

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32

Balahura, Ana Maria, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, and Gheorghe Andrei Dan. "Pulmonary thromboembolism in an emergency hospital: Are our patients different?" Romanian Journal of Internal Medicine 55, no. 4 (December 1, 2017): 237–44. http://dx.doi.org/10.1515/rjim-2017-0026.

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Abstract Introduction. Pulmonary thromboembolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. Material and methods. We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 – December 2016). Patients with acute PTE were identified by a database search of the diagnostic codes of all discharge diagnoses. Demographic, clinical and paraclinical tests data was retrieved from medical records. Results. 221 patients (48.87% male, mean age 61.76 years (range 21-94 years)) were diagnosed with PTE in our hospital (0.31% of all hospitalizations). Dyspnea was the most frequent symptom reported (78.9%), followed by pleuritic chest pain (23.9%) and unilateral leg pain (15.8%). Upon presentation, 12.6% of patients had high-risk PTE. Up to 72.8% of patients had at least one thrombotic risk factor, while cancer (14%) was the most frequent amongst them. The mean length of hospitalization was 10.3 ± 4.6 days. Unfractioned heparin (UFH) was the preferred anticoagulant during hospital stay (73.7%, p < 0.001). Vitamin K antagonists (AVK) were the preferred anticoagulant (71.7%, p < 0.001) after discharge, whereas non-antivitamin K oral anticoagulants (NOAC) were recommended in 26.3% of patients. Thrombolysis was used in 18 (8.4%) cases. Mortality was 0.9%. Younger patients more frequently associated thrombophilia or a previous thromboembolic event and clinical signs of DVT at presentation. Older patients associated more frequently a history of hospitalization for heart failure or atrial fibrillation during the previous 3 months and a history of cancer. The clinical presentation in older patients was more severe, with higher PESI scores (103.6 ± 33.4 vs. 55.5 ± 17.9, p<0.001) and a longer hospital stay (10.7 ± 4.7 vs. 9.2 ± 3.9, p = 0.03). The type of anticoagulant treatment did not differ depending on age. Conclusion. In our emergency hospital, PTE is a relatively rare cause of hospitalization; the rate is, however, comparable with other major hospitals. Dyspnea and pleuritic chest pain was the clinical presentation dyad. UFH was the preferred anticoagulant for in-hospital treatment while AVK was the preferred option for long term treatment and recurrence prophylaxis; however an increasing number of patients are prescribed NOAC. In older patients clinical severity was higher upon presentation, hospitalization duration was increased and cancer was more frequently associated. Younger patients associated more frequently a primary hypercoagulable state and recurrent thromboembolism. Mortality rate was low during hospitalization, comparable with that seen in other studied populations.

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Blottiere, Louise, and Natacha Berge. "Fiche pratique pour les patients : Antivitamines K, anticoagulants oraux directs et ramadan : les conseils du CREATIF." Sang Thrombose Vaisseaux 35, no. 3 (June 2023): 117. http://dx.doi.org/10.1684/stv.2023.1251.

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Pham, Truong-Thanh, and Patrick Saudan. "[b]Anticoagulants[/b] de type antivitamines K : effets délétères potentiels chez les patients avec une IRC." Revue Médicale Suisse 8, no. 330 (2012): 462–65. http://dx.doi.org/10.53738/revmed.2012.8.330.0462.

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Hodroge, Ahmed, Christiane Longin-Sauvageon, Isabelle Fourel, Etienne Benoit, and Virginie Lattard. "Biochemical characterization of spontaneous mutants of rat VKORC1 involved in the resistance to antivitamin K anticoagulants." Archives of Biochemistry and Biophysics 515, no. 1-2 (November 2011): 14–20. http://dx.doi.org/10.1016/j.abb.2011.08.010.

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Fareau, S., K. Baumstarck, L. Chiche, A. Farcet, C. Molines, P. Auquier, and F. Retornaz. "Évaluation de la qualité de vie des patients âgés en fibrillation atriale sous anticoagulants au long cours : antivitamine K versus Anticoagulants oraux directs." La Revue de Médecine Interne 36 (June 2015): A175—A176. http://dx.doi.org/10.1016/j.revmed.2015.03.212.

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Vall Vargas, Alba, Albert Altes Hernandez, Anna Arnau, Mireia Constans Cots, Albert Gallart Fernández-Puebla, and María Ángeles de Juan Pardo. "Effectiveness of a self-management programme in the treatment of antivitamin K oral anticoagulants. A feasibility study." Medicina Clínica (English Edition) 154, no. 10 (May 2020): 388–93. http://dx.doi.org/10.1016/j.medcle.2019.06.026.

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Vall Vargas, Alba, Albert Altes Hernandez, Anna Arnau, Mireia Constans Cots, Albert Gallart Fernández-Puebla, and María Ángeles de Juan Pardo. "Eficacia de un programa de autocontrol en el tratamiento con anticoagulantes orales antivitamina K. Estudio de factibilidad." Medicina Clínica 154, no. 10 (May 2020): 388–93. http://dx.doi.org/10.1016/j.medcli.2019.06.016.

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Stoichitoiu, Laura Elena, Larisa Pinte, Marius Ioan Balea, Valentin Nedelcu, Camelia Badea, and Cristian Baicus. "Anticoagulant protein S in COVID-19: low activity, and associated with outcome." Romanian Journal of Internal Medicine 58, no. 4 (December 1, 2020): 251–58. http://dx.doi.org/10.2478/rjim-2020-0024.

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AbstractIntroduction. COVID-19 disease was associated with both thrombo-embolic events and in-situ thrombi formation in small vessels. Antiphospholipidic antibodies were found in some studies.Aim. Assessment of protein S activity in patients with COVID-19 as a cause of this prothrombotic state, and of the association of protein S activity with worse outcome.Methods. All patients admitted for COVID-19 disease in a university hospital between 15th of May and 15th of July 2020 were prospectively enrolled into this cohort study. Patients treated with antivitamin K anticoagulants and with liver disease were excluded. All patients had protein S activity determined at admission. The main outcome was survival, while secondary outcomes were clinical severity and lung damage.Results. 91 patients were included, of which 21 (23.3%) died. Protein S activity was decreased in 65% of the patients. Death was associated with lower activity of protein S (median 42% vs. 58%, p < 0.001), and the association remained after adjustment for age, inflammation markers and ALAT. There was a dose-response relationship between protein S activity and clinical severity (Kendall_tau coefficient = –0.320, p < 0.001; Jonckheere-Terpstra for trend: p < 0.001) or pulmonary damage on CT scan (Kendall_tau coefficient = –0.290, p < 0.001; Jonckheere-Terpstra for trend: p < 0.001). High neutrophil count was also independently associated with death (p = 0.002).Conclusion. Protein S activity was lower in COVID-19 patients, and its level was associated with survival and disease severity, suggesting that it may have a role in the thrombotic manifestations of the disease.

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Denoël, Paule, Jacques Vanderstraeten, Pierre Mols, and Thierry Pepersack. "Could Some Geriatric Characteristics Hinder the Prescription of Anticoagulants in Atrial Fibrillation in the Elderly?" Journal of Aging Research 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/693740.

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Several studies have reported underprescription of anticoagulants in atrial fibrillation (AF). We conducted an observational study on 142 out of a total of 995 consecutive ≥75 years old patients presenting AF (14%) when admitted in an emergency unit of a general hospital, in search of geriatric characteristics that might be associated with the underprescription of anticoagulation therapy (mostly antivitamin K at the time of the study). The following data was collected from patients presenting AF: medical history including treatment and comorbidities, CHADS2score, ISAR scale (frailty), Lawton’s scale (ADL), GDS scale (mood status), MUST (nutrition), and blood analysis (INR, kidney function, and albumin). Among those patients for who anticoagulation treatment was recommended (73%), only 61% were treated with it. In the group with anticoagulation therapy, the following characteristics were observed more often than in the group without such therapy: a recent (≤6 months) hospitalization and medical treatment including digoxin or based on >3 different drugs. Neither the value of the CHADS2score, nor the geriatric characteristics could be correlated with the presence or the absence of an anticoagulation therapy. More research is thus required to identify and clarify the relative importance of patient-, physician-, and health care system-related hurdles for the prescription of oral anticoagulation therapy in older patients with AF.

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Boccalon, H., A. Bura Rivière, J. P. Cambus, P. Mismetti, and S. Laporte. "Comparaison de deux méthodes de gestion d'un traitement antivitamine K: clinique des anticoagulants (CAC) versus suivi conventionnel: étude randomisée de 1005 patients." Journal des Maladies Vasculaires 32 (September 2007): 59–60. http://dx.doi.org/10.1016/j.jmv.2007.06.049.

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Lévesque, H., and J. Y. Borg. "Les centres de suivi et de conseil des traitements anticoagulants : un outil pour diminuer le nombre de complications hémorragiques des antivitamines K." La Revue de Médecine Interne 24, no. 2 (February 2003): 75–77. http://dx.doi.org/10.1016/s0248-8663(02)00019-x.

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Gibert, P., S. Mazière, I. Trinh, M. Mallaret, B. Allenet, J. Calop, and G. Gavazzi. "Révélation tardive de la potentialisation de l’activité anticoagulante des antivitamines K par le miconazole bioadhésif (LORAMYC®) : à propos de trois cas." La Revue de Médecine Interne 31 (December 2010): S465—S466. http://dx.doi.org/10.1016/j.revmed.2010.10.273.

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Gerenton, B., V. Moris, H. Shipkov, P. J. Regnard, and D. Guillier. "Évaluation du risque de saignement postopératoire en chirurgie de la main sans interruption des anticoagulants de type AntiVitamines K (AVK), étude rétrospective." Annales de Chirurgie Plastique Esthétique 64, no. 2 (April 2019): 189–94. http://dx.doi.org/10.1016/j.anplas.2018.09.005.

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Godon, Alexandre. "Prise en charge périopératoire de la fracture du col du fémur en urgence sous anticoagulants et antiagrégants plaquettaires : gestion des antivitamines K." Anesthésie & Réanimation 6, no. 6 (November 2020): 589–92. http://dx.doi.org/10.1016/j.anrea.2020.09.002.

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Demelo-Rodríguez, Pablo, Francisco Galeano-Valle, and Jorge del Toro-Cervera. "Comparación de las características de pacientes con enfermedad tromboembólica venosa tratados con anticoagulantes orales directos frente a antivitamina K: estudio observacional prospectivo." Medicina Clínica 155, no. 3 (August 2020): 131–32. http://dx.doi.org/10.1016/j.medcli.2019.05.020.

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Ayastuy, Izaro Arriola, Asier Iglesias Prieto, Ana Martínez Muñoz, Jessica Wong Seoane, Myriam Salillas Santos, Diego Pizarro Obregón, Helena Sustatxa Pérez del Palomar, and Óscar García Regata. "604 - CARACTERÍSTICAS DE LOS PACIENTES CON FIBRILACIÓN AURICULAR NO VALVULAR ANTICOAGULADA CON ANTIVITAMINA K EN UNA PLANTA DE MEDICINA INTERNA DE UN HOSPITAL TERCIARIO." Revista Clínica Española 223 (November 2023): S929—S930. http://dx.doi.org/10.1016/s0014-2565(23)01133-5.

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Garcia Ruiz, Maria Almudena, Francisco Jose Romero Martinez, Estefania Morente Constantin, Margarita Gomez Morales, and Manuel Jurado. "Continued Use of Tinzaparin at Therapeutic Doses for Prophylaxis of Venous Thromboembolism in Patients with Intolerance to Antivitamins K." Blood 126, no. 23 (December 3, 2015): 4735. http://dx.doi.org/10.1182/blood.v126.23.4735.4735.

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Abstract OBJECTIVES The low molecular weight heparins (LMWH) are typically administered at fixed doses like thromboprophylaxis or at doses adjusted to the weight of the patient in order to obtain a therapeutic effect. Generally they do not require laboratory monitoring, although it could be considered in special situations (renal failure, extreme weights, pregnant women). The LMWH do not affect the APTT, so it has been proposed to determine the anti-factor Xa activity when it is necessary to monitor its effect. The anti-factor Xa activity should be determined approximately 4 hours after sc administration of the LMWH that it is employed, concurring with the peak of activity. The therapeutic range of the anti-factor Xa activity is between 0.6 and 1 IU / mL when LMWH is administered every 12 hours. At single daily dose is less clear, although it seems that lies above 1 IU / mL. Nowadays, LMWH are the anticoagulant of choice during pregnancy. Numerous in vitro and in vivo studies have shown the existence of an antineoplastic effect of heparin. LMWH is commonly used for prolonged treatment of thrombosis associated with cancer. METHODS The main aim of our study is to evaluate the efficacy of tinzaparin sodium at therapeutic doses in preventing VTE in renal failure, active cancer and/or patients with contraindications to oral anticoagulation. The dose has been therapeutic and adjusting it has been made in terms of anti-factor Xa levels obtained monthly. Hemorrhagic or thrombotic complications and other possible side effects have been assessed. Until now, a total of 70 patients, 42 men and 28 women aged between 30 and 95 years old, have received tinzaparin sodium treatment. The main reason of anticoagulation are: atrial fibrillation and atrial flutter (with or without valve disease), VTE (with or without thrombophilia), stroke and transient ischemic attacks and mechanical prosthetic aortic and mitral valves (some of the patients carrying a double metal prosthesis). There was 1 resistance and 1 allergic reaction to anti-vitamin K. 4 of the patients were pregnant and 14 had renal failure. Prior to initiation of therapy, analytical determinations were performed, including: blood count, blood coagulation and biochemistry to assess renal function (urea and creatinine). 20 patients (14 were anticoagulated by atrial fibrillation, 2 for bearing a mechanical aortic prosthesis and 4 because of DVT, 1 of which had also a TEP) had active cancer or were in remission from their neoplasia (3 multiple myeloma, 1 LAM, 1 CMML, 4 renal tumors, 1 lung cancer, 5 prostate cancers, 1 hepatocellular carcinoma, 2 colon cancer, 1 endometrial adenocarcinoma and 1 retroperitoneal leiomyosarcoma). 1 with MDS was treated with LMWH because he had intra- and extrahepatic portal vein thrombosis. RESULTS Some of the patients had received prior treatment with anti-vitamin K (INR objective depending on pathology) but, in other cases, the low molecular weight heparin was the only treatment since the beginning of their anticoagulation. All the patients had received 175 IU / Kg of Tinzaparin Sodium once a day as initial dose, then the dose was adjusted according to the anti-factor Xa levels. They were controlled until 31/07/2015. In terms of side effects, 8 patients presented complications: 3 mucosal bleeding, 2 episodes of stroke in a patient, hemoptysis, deep vein thrombosis and 2 bleeding at the puncture site of heparin, which have not required discontinuation of therapy. When these complications occurred, we proceeded to the corresponding heparin dose adjustment based on new determinations of anti-factor Xa. CONCLUSIONS Although only in 70 cases, the results obtained confirm the efficacy, safety and cost-effectiveness of the continuous use of LMWH. Determination of anti-factor Xa levels are considered very useful for dose adjustment parameter. In our study, tinzaparin sodium has proved to be very useful in preventing venous thromboembolism associated or not with cancer, in patients with conditions requiring anticoagulation and presenting contraindications to the use of anti-vitamin K. The results obtained have demonstrated that tinzaparin is safe and, most likely, further studies will provide valuable confirmation data to support the use of low molecular weight heparins in the prolonged treatment of patients who require oral anticoagulation and can not receive it. Disclosures No relevant conflicts of interest to declare.

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Iliuta, Luminita, Andreea Andronesi, Georgiana Camburu, and Marius Rac-Albu. "Enoxaparin versus Unfractionated Heparin for the Perioperative Anticoagulant Therapy in Patients with Mechanical Prosthetic Heart Valve Undergoing Non-Cardiac Surgery." Medicina 58, no. 8 (August 18, 2022): 1119. http://dx.doi.org/10.3390/medicina58081119.

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Background and Objectives: Immediate postoperative anticoagulation regimens in patients with mechanical prosthetic valves undergoing non-cardiac surgery are clear only for unfractionated heparin (UH), whereas the few low-molecular-weight heparin (LMWH) trials available to date concern the use of Enoxaparin in general/orthopedic surgery. We performed a single-center real-world data study comparing the efficacy and safety of LMWH—Enoxaparin (E)— and UH during the perioperative period in non-cardiac surgical procedures in patients with mechanical prosthetic valve replacement in the mitral, aortic, or tricuspid positions. Materials and Methods: We enrolled 380 patients, who received E or UH together with oral anticoagulation with antivitamin K (acenocoumarol) until they achieved an optimal International Normalized Ratio (INR). Objective assessment of E efficacy included the following: normal value for all the parameters of ultrasound prosthetic functioning, no early thrombosis of the prosthesis, and rapid achievement of target INR with a decreased period of subcutaneous anticoagulation. Subjective assessment included the following: clinical improvement with decreased immobilization and in-hospital stay, fewer gluteal ulcerations, and fewer postoperative depression and anxiety episodes. Results: Comparing with UH, anticoagulation with E was more effective (p < 0.0001 and p = 0.02). The probability of death was smaller in the E group compared with the UH group. No major hemorrhagic event was reported. Mild bleeding episodes and thrombocytopenia were more common in the UH group. Patient’s compliance and quality of life were better with E due to shortened hospitalization, decreased need for testing of coagulation (every 6 h for UH), better dosing (SC every 12 h for E versus continuous infusion for UH), shortened immobilization during the immediate postoperative period with subsequent improvement in the psychological status, as well as due to lack of significant side effects. Conclusions: Taking into consideration the improved efficiency and safety, as well as all the supplementary advantages, such as no need for anticoagulation monitoring, the ease of administration, and reduced duration of hospitalization, E should be seen as an attractive alternative for anticoagulation which deserves further investigation.

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de Haro, J., S. Bleda, C. Varela, C. Cañibano, and F. Acin. "¿Son los nuevos anticoagulantes orales iguales a las antivitaminas K para la isquemia aguda de los miembros inferiores? Revisión sistemática de la evidencia." Angiología 68, no. 2 (March 2016): 123–26. http://dx.doi.org/10.1016/j.angio.2015.09.002.

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