Revista de Gastroenterología de México, Journal Year: 2024, Volume and Issue: unknown
Published: Dec. 1, 2024
European Journal of Clinical Investigation, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 14, 2025
Abstract Background Hospitalisation offers an opportunity for medication review and correction, yet it has received little attention. We aimed to evaluate oral anticoagulant (OAC) use in patients with atrial fibrillation at hospital admission discharge determine whether hospitalisation improves care. Methods conducted observational study the Royal Hobart Hospital, Australia, fibrillation. The appropriateness of stroke‐prevention therapy was evaluated using Australian guidelines. Factors associated correcting inappropriate OAC were identified multiple logistic regression. Results Among 902 patients, 47.1% ( n = 425) receiving admission. most common errors included lack (58.6%, 249) underdosing direct‐acting OACs (15.5%, 66). assessed 844 patients; 73.8% appropriate (versus 53.8% p < .001)). Specifically, 49.0% 191) corrected. Correction more likely admitted stroke (adjusted odds ratio [aOR]: 16.93, 95% CI: 1.31–218.48) or cardiology wards (aOR: 4.10, 1.94–8.64), if bleeding occurred during 4.01, 1.07–14.99). Conversely, rivaroxaban .23, .11–.51) having a medium high risk (ORBIT score ≥3) .46, .25–.84) decreased likelihood correction. Conclusion improved appropriateness; however, 51.0% continued without An intervention that enhances care team is warranted.
Language: Английский
Citations
1
Hämostaseologie, Journal Year: 2025, Volume and Issue: 45(01), P. 089 - 101
Published: Feb. 1, 2025
Abstract Based on clinical trials that have been conducted and published in the past decade, direct oral anticoagulants (DOACs) are increasingly being used as an antithrombotic treatment children with venous thrombotic events to prevent at risk. In this review, current indications standards for initiation of DOACs summarized primary secondary prevention risk developing thromboses based randomized controlled (RCT). Similarly, underlying cardiac disease portrayed RCT findings. Lastly, available real-world data reviewed use pediatric patients a focus higher both thrombosis bleeding who were primarily excluded from RCTs. contribute largely evolving individualization care children, but at-risk patient populations remain underrepresented regarding DOAC experience, such preterm infants, severe renal or hepatic disease. Real-world observational studies registries will continue be necessary establish DOACs' effectiveness safety everyday use.
Language: Английский
Citations
1
Videosurgery and Other Miniinvasive Techniques, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 15, 2025
IntroductionThe prevalence and risk factors of portal vein thrombosis (PVT) were largely unclear increasing studies reported conflicting results. AimThe current study aimed to evaluate the PVT following hepatectomy through a systematic review meta-analysis Materials methods A comprehensive literature search was conducted across multiple databases identify relevant studies.Prospective retrospective reporting on included.The Newcastle-Ottawa Scale (NOS) used assess quality, random-effects model analyze factors. ResultsA total 15 involving 5,145 patients, included in metaanalysis.The pooled 9% (95% CI, 7%-12%)with substantial heterogeneity (I² = 93.1%).Subgroup analyses revealed that prospective larger sample sizes associated with lower rates.PVT higher among patients undergoing simultaneous splenectomy hepatectomy.Liver cirrhosis (OR, 5.18; 95% 1.85-14.47),portal resection 5.07; 2.20-11.66),and right-sided 6.26; 1.80-21.76)were significant for PVT. ConclusionsPortal is notable complication hepatectomy, an overall 9%.Specific including liver cirrhosis, resection, significantly increase
Language: Английский
Citations
0
Acta Clinica Belgica, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 11
Published: Feb. 21, 2025
Patients with liver disease experience complex haemostatic changes leading to a state of 'rebalanced haemostasis' that may shift towards bleeding or thrombosis due complications like kidney dysfunction, bacterial infection, acute-on-chronic failure. Traditional coagulation tests inadequately capture haemostasis in cirrhosis, whereas advanced assays thrombin generation assay and viscoelastic testing offer better insights but remain limited clinical outcome prediction guiding pre-procedural prophylaxis.Contrary the traditional view cirrhosis as disorder, recent evidence highlights paradox higher venous thromboembolism incidence hospitalised cirrhotic patients. Misconceptions about 'auto-anticoagulation' concerns anticoagulation safety hinder consistent thromboprophylaxis. Emerging data suggest low molecular weight heparin is safe effective patients, supporting more evidence-based For thrombotic events conditions atrial fibrillation, therapeutic recommended, additional benefits, such attenuating fibrosis portal hypertension. However, not established core therapy given disease.Bleeding remains significant challenge management focusing on specific aetiologies, including hypertension procedural injuries. In planning, there trend unnecessary blood product use, often based an assumed risk. Rational planning should minimize transfusions, optimise modifiable risks, include plan for managing potential bleeding.This review aims clarify 'coagulation paradox' promoting nuanced, individualized approach chronic disease.
Language: Английский
Citations
0
Medical Clinics of North America, Journal Year: 2025, Volume and Issue: unknown
Published: March 1, 2025
Language: Английский
Citations
0
JHEP Reports, Journal Year: 2025, Volume and Issue: unknown, P. 101399 - 101399
Published: March 1, 2025
Language: Английский
Citations
0
Cureus, Journal Year: 2025, Volume and Issue: unknown
Published: March 27, 2025
Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, significantly increases risk of thromboembolism and stroke. Its coexistence with valvular heart disease (VHD) further complicates management due to elevated risks thromboembolism, bleeding, mortality. This review explores pathophysiology AF its interaction VHD, focusing on diagnostic tools like echocardiography stratification scores such as CHA2DS2-VASc HAS-BLED. Vitamin K antagonists (VKAs) remain cornerstone anticoagulation therapy in high-risk VHD populations, particularly patients mechanical valves or moderate-to-severe mitral stenosis (MS). VKAs have demonstrated proven efficacy reducing thromboembolic events these subgroups, supported by decades clinical evidence. However, their use requires frequent international normalized ratio (INR) monitoring is associated higher bleeding risks, posing challenges long-term management. Despite limitations, are indispensable populations lack robust evidence supporting safety direct oral anticoagulants (DOACs) groups. Ongoing trials, RIVER trial, aim evaluate role DOACs VHD. current guidelines continue recommend standard care for patients. In contrast, offer significant advantages non-valvular selected populations. Their predictable pharmacokinetics, fewer dietary restrictions, lower intracranial hemorrhage make them a preferred choice many Landmark trials meta-analyses, including RE-LY, ROCKET-AF, ARISTOTLE, certain subgroups. contraindicated those MS, insufficient potential events. Evolving from leading societies emphasize individualized approaches collaborative decision-making therapy. While patients, essential Future advancements, factor XIa inhibitors, hold promise improving outcomes complex provides comprehensive framework clinicians navigate complexities ensuring evidence-based, patient-centered care.
Language: Английский
Citations
0
Revista de Gastroenterología de México (English Edition), Journal Year: 2025, Volume and Issue: unknown
Published: April 1, 2025
Language: Английский
Citations
0
Revista de Gastroenterología de México (English Edition), Journal Year: 2025, Volume and Issue: unknown
Published: April 1, 2025
Language: Английский
Citations
0
Liver International, Journal Year: 2025, Volume and Issue: 45(6)
Published: April 29, 2025
ABSTRACT Splanchnic vein thrombosis (SVT) can be associated with liver cirrhosis or prothrombotic conditions, including myeloproliferative disorders, intra‐abdominal inflammation, solid cancers surgery. While anticoagulation therapy improves outcomes in noncirrhotic patients and reduces all‐cause mortality cirrhotic populations, its safety a history of portal hypertension (PH)‐related bleeding is less clear. This systematic review examines the impact anticoagulant on rebleeding risk SVT PH‐related bleeding. A meta‐analysis were conducted according to PRISMA guidelines. comprehensive search PubMed, Web Science Scopus was performed for studies published up September 2024. Studies included if they compared receiving versus those not anticoagulants. The primary outcome cumulative incidence rebleedings. Of 2853 identified studies, five (186 participants) met inclusion criteria: two randomised controlled trials (RCTs) three observational studies. significantly lower group at 17.10% [95% CI 17.02, 17.19] control 40.00% 39.90, 40.09]. overall odds ratio (OR) from 0.15 0.04, 0.52], indicating reduced risk, while OR RCTs 0.84 0.31, 2.32], showing nonsignificant trend. Anticoagulant may reduce bleeding, but further high‐quality are needed.
Language: Английский
Citations
0