Anticoagulation in chronic liver disease - ScienceDirect
The purpose of this outpatient clinic is to: Manage and simplify the patient’s anticoagulation daily dosage schedule, Monitor and evaluate the patient, and Enhance the patient’s understanding of the purpose and process of anticoagulation therapy.
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In a multicenter, randomized, open-label trial, we assigned, in a 1:1:1 ratio, patients 16 to 60 years of age who had had a recent stroke attributed to PFO, with an associated atrial septal aneurysm or large interatrial shunt, to transcatheter PFO closure plus long-term antiplatelet therapy (PFO closure group), antiplatelet therapy alone (antiplatelet-only group), or oral anticoagulation (anticoagulation group) (randomization group 1). Patients with contraindications to anticoagulants or to PFO closure were randomly assigned to the alternative noncontraindicated treatment or to antiplatelet therapy (randomization groups 2 and 3). The primary outcome was occurrence of stroke. The comparison of PFO closure plus antiplatelet therapy with antiplatelet therapy alone was performed with combined data from randomization groups 1 and 2, and the comparison of oral anticoagulation with antiplatelet therapy alone was performed with combined data from randomization groups 1 and 3.
It is uncertain whether bridging anticoagulation is necessary for patients with atrial fibrillation who need an interruption in warfarin treatment for an elective operation or other elective invasive procedure. We hypothesized that forgoing bridging anticoagulation would be noninferior to bridging with low-molecular-weight heparin for the prevention of perioperative arterial thromboembolism and would be superior to bridging with respect to major bleeding.
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4. Healey JS, Eikelboom J, Douketis J, et al. Periprocedural bleeding and thromboembolic events with dabigatran compared with warfarin: results from the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) randomized trial. ;126:-[Erratum, Circulation 2012;126(10):e160.]
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3. Gallego P, Apostolakis S, Lip GY. Bridging evidence-based practice and practice-based evidence in periprocedural anticoagulation. ;126:-
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8. Douketis JD, Johnson JA, Turpie AG. Low-molecular-weight heparin as bridging anticoagulation during interruption of warfarin: assessment of a standardized periprocedural anticoagulation regimen. ;164:-
Proper usage of the word anticoagulation.
2. Piazza G, Goldhaber SZ. Periprocedural management of the chronically anticoagulated patient: critical pathways for bridging therapy. ;2:-
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Third, the observed rate of major bleeding in the bridging group (3.2%, with no instances of fatal bleeding) may be considered to be modest. However, our bridging protocol was designed to minimize bleeding, and the higher rates of bleeding reported in other studies of bridging anticoagulation probably reflect resumption of bridging therapy too soon after operations with a high bleeding risk or a lack of standardized bridging protocols.
Anticoagulation Therapy Management Program - …
13. Wysokinski WE, McBane RD, Daniels PR, et al. Periprocedural anticoagulation management of patients with nonvalvular atrial fibrillation. ;83:-