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Comparison of 4-factor fixed dose versus 4-factor weight-based dose prothrombin complex concentrate for emergent warfarin reversal: a systematic review and meta-analysis.
Clin Exp Emerg Med
January 2025
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Objectives: The objective of this systematic review and meta-analysis is to evaluate the efficacy, safety, time to INR reversal, total volume of 4-factor prothrombin complex concentrate (PCC) administered of fixed-dose versus weight-based dosing strategies in patients requiring urgent warfarin reversal, with specific focus on clinical outcomes such as hemostatic efficacy, thromboembolic events, and mortality rates.
Methods: A comprehensive systematic review was conducted using the PubMed, Embase, and Cochrane databases from inception through October 2023. We searched for randomized clinical trials or observational studies that compared efficacy or safety outcomes of fixed-dose vs.
Assessment of Hypercoagulability in Splanchnic Vein Thrombosis by Measurement of the Hemostasis Enzymes Thrombin and Activated Protein C.
Int J Mol Sci
December 2024
Institute of Experimental Hematology and Transfusion Medicine, University Hospital Bonn, 53127 Bonn, Germany.
Splanchnic vein thrombosis (SVT), which is particularly prevalent in myeloproliferative neoplasms (MPNs), has a multifactorial pathomechanism involving the anticoagulant protein C (PC) pathway. To better characterize the hypercoagulable state in SVT we assessed its key enzymes thrombin and activated PC (APC). The study population included 73 patients with SVT, thereof 36 MPN+, confirmed by bone marrow biopsy, 37 MPN-, and 30 healthy controls.
View Article and Find Full Text PDFThromboelastography may assess the effect of anticoagulation reversal in intracranial hemorrhage.
J Stroke Cerebrovasc Dis
January 2025
Department of Neurology, University of Iowa College of Medicine; Department of Epidemiology, University of Iowa College of Public Health; Department of Neurosurgery, University of Iowa College of Medicine.
Article Synopsis
- Intracranial hemorrhage (ICH) is a serious risk for patients on oral anticoagulants, and there's a need for biomarkers to evaluate the effectiveness of reversal agents like activated prothrombin complex concentrate (aPCC).
- A study was conducted in an emergency department with adult patients experiencing factor Xa inhibitor-related ICH to assess changes in thromboelastography (TEG) following aPCC reversal.
- Results showed a significant decrease in TEG R-time shortly after aPCC administration, but it returned to baseline levels by 12 and 24 hours, suggesting TEG R-time could be a valuable biomarker to monitor anticoagulation effects in these patients.
Association between Clot Waveform Analysis Parameters and the Severity of Liver Cirrhosis.
Thromb Haemost
January 2025
Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Background: Clot waveform analysis (CWA) provides a global assessment of hemostasis and may be useful for patients with cirrhosis with complex hemostatic abnormalities. This study aimed to assess the association between prothrombin time (PT-) and activated partial thromboplastin time (aPTT-) based CWA parameters and cirrhosis severity and prospectively evaluate the role of CWA in predicting mortality and acute decompensation (AD) over 1 year.
Methods: This prospective study included adult patients with cirrhosis between June 2021 and December 2023 at Chulalongkorn University Hospital.
An Analysis of the Association of Whole Blood Transfusion With the Development of Acute Respiratory Distress Syndrome.
Crit Care Med
January 2025
Department of Anesthesiology, University of Colorado School of Medicine, Aurora, CO.
Objectives: To determine the association of whole blood and other blood products (components, prothrombin complex concentrate, and fibrinogen concentrate) with the development of acute respiratory distress syndrome (ARDS) among blood recipients.
Design: Retrospective cohort study.
Setting: American College of Surgeons Trauma Quality Improvement Program (TQIP) database between 2020 and 2021.
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