A krónikus antikoaguláns-kezelés gyakorlati kérdései Covid-19-pandémia idején

2021 ◽  
Vol 31 (5-6) ◽  
pp. 177-182
Author(s):  
András Komócsi
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Coagulation System ◽  
Social Distancing ◽  
Risk Of Bleeding ◽  
The Social ◽  
High Incidence ◽  
Coronavirus Infection ◽  
Direct Anticoagulants

Coronavirus infection has a multiple im­pact on the coagulation system and anti­coagulant therapies. Patients admitted with COVID-19 have un­usually high incidence of coagulation ab­normalities. The incidence of atrial fibrillation (AF) seems also to be more frequent among COVID-19 out- and especially in-patients. Among COVID-19 patients receiving oral anticoagulant therapy, for minimizing the risk of bleeding or thromboembolic complications there should also be considered the renal and hepatic functions and drug-drug interactions of oral anticoagulant and COVID-19 therapy. In case of direct anticoagulants, in addition to the benefits of better safety, more favorable treatment ad­he­rence, and fixed dosing, the use of this class of drugs does not require laboratory mo­nitoring of efficacy, which may be of exp­licit benefit in terms of social distancing and health network burdens. This study reviews the possible interactions of drugs used for viral infection and anticoagulation, and in addition to the issues of coagulopathy associated with COVID-19, we discuss also the concerning difficulties of continued anticoagulant therapy related to the social distancing measures.

scholarly journals Oral anticoagulant therapy in a patient with CHA₂DS₂-VASc score 1

ABOUTOPEN ◽  
2018 ◽  
Vol 4 (1) ◽  
pp. 202-206
Author(s):  
Stefania Cherubini ◽  
Andrea Ciolli
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Oral Anticoagulants ◽  
Acid Therapy ◽  
Risk Of Bleeding ◽  
Male Patients ◽  
Maximum Protection ◽  
Current Guidelines ◽  
Excessive Risk

Controlled studies of new oral anticoagulants (NOACs) in patients with atrial fibrillation have included above all patients at high risk of stroke, providing solid evidence on the benefits of anticoagulant therapy with such drugs in male patients with CHA2DS2-VASc score ≥2 and in women with a score of ≥3. Although estimates of stroke risk in patients with lower scores predominantly come from studies in patients not receiving NOAC, in many of these subjects anticoagulant therapy still seems able to provide clinical benefit. The current guidelines therefore recommend oral anticoagulant therapy in patients with CHA2DS2-VASc ≥1 in men and ≥2 in women. However, the use of this therapy must be carefully weighted with the expected reduction in the risk of stroke, the risk of bleeding and the patient's preferences. The paradygmatic case of a patient with CHA2DS2-VASc score 1 is reported in which acetylsalicylic acid therapy is substituted with dabigatran 150 mg / day in order to guarantee the patient maximum protection against the risk of stroke, without exposing him to an excessive risk of bleeding (Cardiology).

scholarly journals THE ENDOVASCULAR PREVENTION OF THROMBOEMBOLISM IN ATRIAL FIBRILLATION

2018 ◽  
pp. 104-114
Author(s):  
Rami N. Al-Ayyubi ◽  
Evgeny V. Merkulov ◽  
Andrey S. Tereschenko ◽  
Dmitry V. Pevzner ◽  
Natalia S. Zhukova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
High Risk ◽  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Drug Prevention ◽  
Thromboembolic Events ◽  
Risk Of Bleeding ◽  
Prevention Of Thromboembolic Events

The article dwells upon the various strategies for prevention of thromboembolic events in patients with atrial fibrillation. The main focus is put on the endovascular strategies for prevention of tromboembolism. In recent years, the endovascular strategies for the prevention of thromboembolic events in patients with atrial fibrillation, who have contraindications to oral anticoagulant therapy, are increasingly gaining popularity and find evidence of its safety for the prevention of thromboembolism. The patients with AF with a high risk of bleeding is the most interesting category for studying. The large studies confirm the effectiveness of non-drug prevention of thromboembolic events as compared to the anticoagulant therapy in these patients.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

Relationship Between Total Prothrombin, Native Prothrombin and the International Normalized Ratio (INR)

1992 ◽  
Vol 68 (02) ◽  
pp. 160-164 ◽  
Author(s):  
P J Braun ◽  
K M Szewczyk
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Inverse Relationship ◽  
Low Dose ◽  
Oral Anticoagulant Therapy ◽  
International Normalized Ratio ◽  
Antigen Assay ◽  
Dose Oral ◽  
Anticoagulated Patients ◽  
Sensitive Method

SummaryPlasma levels of total prothrombin and fully-carboxylated (native) prothrombin were compared with results of prothrombin time (PT) assays for patients undergoing oral anticoagulant therapy. Mean concentrations of total and native prothrombin in non-anticoagulated patients were 119 ± 13 µg/ml and 118 ± 22 µg/ml, respectively. In anticoagulated patients, INR values ranged as high as 9, and levels of total prothrombin and native prothrombin decreased with increasing INR to minimum values of 40 µg/ml and 5 µg/ml, respectively. Des-carboxy-prothrombin increased with INR, to a maximum of 60 µg/ml. The strongest correlation was observed between native prothrombin and the reciprocal of the INR (1/INR) (r = 0.89, slope = 122 µg/ml, n = 200). These results indicated that native prothrombin varied over a wider range and was more closely related to INR values than either total or des-carboxy-prothrombin. Levels of native prothrombin were decreased 2-fold from normal levels at INR = 2, indicating that the native prothrombin antigen assay may be a sensitive method for monitoring low-dose oral anticoagulant therapy. The inverse relationship between concentration of native prothrombin and INR may help in identification of appropriate therapeutic ranges for oral anticoagulant therapy.

Acute priapism in a patient with unstable hemoglobin Perth and Factor V Leiden under effective oral anticoagulant therapy

2001 ◽  
Vol 2 (3) ◽  
pp. 210-211 ◽  
Author(s):  
Emmanuel Gyan ◽  
Stéphane Darre ◽  
Brigitte Jude ◽  
Nathalie Cambier ◽  
Jean-Loup Demory ◽  
...  
Keyword(s):  
Anticoagulant Therapy ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Factor V Leiden ◽  
Factor V ◽  
Unstable Hemoglobin
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