scholarly journals Direct oral anticoagulants for extended thromboprophylaxis in medically ill patients: meta-analysis and risk/benefit assessment

2018 ◽  
Vol Volume 9 ◽  
pp. 25-34 ◽  
Author(s):  
Majed Al Yami ◽  
Sawsan Kurdi ◽  
Ivo Abraham
Keyword(s):  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Benefit Assessment ◽  
Medically Ill ◽  
Risk Benefit Assessment ◽  
Medically Ill Patients

The use of direct oral anticoagulants for extended duration thromboprophylaxis in medically ill patients: a systematic review and meta-analysis

2019 ◽  
Vol 48 (3) ◽  
pp. 422-429 ◽  
Author(s):  
Reema A. Alshouimi ◽  
Shahad M. Al Rammah ◽  
Mohammed Y. Alzahrani ◽  
Hisham A. Badreldin ◽  
Majed S. Al Yami ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Medically Ill ◽  
Extended Duration ◽  
Medically Ill Patients

Prevention of Venous Thromboembolism in Acutely Ill Medical Patients: A New Era

2021 ◽  
Vol 42 (02) ◽  
pp. 308-315
Author(s):  
Kira MacDougall ◽  
Alex C. Spyropoulos
Keyword(s):  
Venous Thromboembolism ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Preventive Strategy ◽  
Medical Patients ◽  
New Era ◽  
Medically Ill ◽  
Increased Risk ◽  
Medically Ill Patients ◽  
Patient Subgroups

AbstractVenous thromboembolism (VTE) is the leading preventable cause of death in hospitalized patients and data consistently show that acutely ill medical patients remain at increased risk for VTE-related morbidity and mortality in the post-hospital discharge period. Prescribing extended thromboprophylaxis for up to 45 days following an acute hospitalization in key patient subgroups that include more than one-quarter of hospitalized medically-ill patients represents a paradigm shift in the way hospital-based physicians think about VTE prevention. Advances in the field of primary thromboprophylaxis in acutely-ill medical patients using validated VTE and bleeding risk assessment models have established key patient subgroups at high risk of VTE and low risk of bleeding that may benefit from both in-hospital and extended thromboprophylaxis. The direct oral anticoagulants betrixaban and rivaroxaban are now U.S. Food and Drug Administration-approved for in-hospital and extended thromboprophylaxis in medically ill patients and provide net clinical benefit in these key subgroups. Coronavirus disease-2019 may predispose patients to VTE due to excessive inflammation, platelet activation, endothelial dysfunction, and hemostasis. The optimum preventive strategy for these patients requires further investigation. This article aims to review the latest concepts in predicting and preventing VTE and discuss the new era of extended thromboprophylaxis in hospitalized medically ill patients.

scholarly journals New Paradigms of Extended Thromboprophylaxis in Medically Ill Patients

2020 ◽  
Vol 9 (4) ◽  
pp. 1002 ◽  
Author(s):  
Kira MacDougall ◽  
Alex C Spyropoulos
Keyword(s):  
Health Care Providers ◽  
Selection Criteria ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Care Providers ◽  
Medically Ill ◽  
Patient Selection Criteria ◽  
Net Clinical Benefit ◽  
Medically Ill Patients ◽  
Patient Subgroups

Extended thromboprophylaxis given to medically ill patients for up to 45 days following an acute hospitalization remains an emerging topic among many hospital-based health care providers. Recent advancements in the field of extended thromboprophylaxis using risk stratification and careful patient selection criteria have led to an improved safety profile of direct oral anticoagulants (DOACs) and established net clinical benefit when given to key patient subgroups at high risk of venous thromboembolism (VTE) and low risk of bleeding. The Food and Drug Administration (FDA) has now approved the DOACs betrixaban and rivaroxaban for both in-hospital and extended thromboprophylaxis in medically ill patients in these key subgroups, which represents more than one-quarter of hospitalized medically ill patients. This has potential to significantly reduce VTE-related morbidity and mortality for these patients. Emerging data also supports reductions in the risk of arterial thromboembolism in medically ill patients with extended thromboprophylaxis post-hospital discharge using DOACs. This article aims to review the most recent concepts of predicting and preventing VTE and to discuss emerging paradigms of extended thromboprophylaxis in hospitalized medically ill patients utilizing an individualized, risk-adapted approach.

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