69 results match your criteria: "Canada J.I.W.; CirQuest Labs and the University of Tennessee Health Science Center[Affiliation]"
Pregnancy-Associated Venous Thromboembolism: Insights from GARFIELD-VTE.
TH Open
January 2021
University College London, London, United Kingdom.
Article Synopsis
- The study focuses on pregnancy-associated venous thromboembolism (PA-VTE), which is a significant cause of maternal mortality, examining women under 45 and comparing them to those with nonpregnancy-associated VTE (NPA-VTE).
- Women with PA-VTE were generally younger, had a lower incidence of pulmonary embolism, and a higher occurrence of left-sided deep vein thrombosis compared to NPA-VTE patients.
- Both groups used various treatments, including parenteral therapy and vitamin K antagonists, with similar rates of all-cause mortality, recurrent VTE, and major bleeding, though uterine bleeding was the most common complication overall.
Anticoagulation for Patients with Venous Thromboembolism: When is Extended Treatment Required?
TH Open
October 2020
Vascular Medicine and Haemostasis, Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium.
The need for extended venous thromboembolism (VTE) treatment beyond 3 to 6 months is usually determined by balancing the risk of recurrence if treatment is stopped against the risk of bleeding from continuing treatment. The risk of recurrence, and in turn the decision to extend, can be determined through the nature of the index event. Patients with VTE provoked by surgery or trauma (major transient risk factors) are recommended to receive 3 months of anticoagulation therapy because their risk of recurrence is low, whereas patients with VTE provoked by a major persistent risk factor, such as cancer, or those considered to have "unprovoked" VTE, are recommended to receive an extended duration of therapy based on an established high risk of recurrence.
View Article and Find Full Text PDFHypercoagulability and coronavirus disease 2019-associated hypoxemic respiratory failure: Mechanisms and emerging management paradigms.
J Trauma Acute Care Surg
December 2020
From the Department of Medicine (C.H.Y.), Division of Emergency Medicine, University of Toronto, Toronto; Thrombosis and Atherosclerosis Research Institute (C.H.Y., J.I.W., N.V., P.C.L., A.F.-R., P.Y.K.), Hamilton; Department of Critical Care (C.H.Y., K.S.), Lakeridge Health Corporation, Oshawa; Department of Medicine (K.d.W., J.I.W., P.C.L., A.F.-R., P.Y.K.), McMaster University, Hamilton, Ontario, Canada; Department of Anesthesiology (J.H.L.), Critical Care, and Surgery, Duke University School of Medicine, Durham, North Carolina; Department of Biochemistry and Biomedical Sciences (J.I.W.), McMaster University, Hamilton; and Department of Critical Care Medicine (K.S.), Queen's University, Kingston, Ontario, Canada.
Dual Pathway Inhibition for Vascular Protection in Patients with Atherosclerotic Disease: Rationale and Review of the Evidence.
Thromb Haemost
August 2020
Research and Development Pharmaceuticals, Bayer AG, Wuppertal, Germany.
Despite advances in secondary prevention strategies in patients with cardiovascular disease, the residual risk of recurrent atherothrombotic events remains high. Dual-antiplatelet therapy is the standard of care for secondary prevention in patients with acute coronary syndrome (ACS), whereas single antiplatelet therapy, generally with aspirin, is the standard of care for secondary prevention in stable patients with coronary artery disease (CAD), peripheral artery disease (PAD), or cerebrovascular disease. However, atherosclerotic plaque disruption not only triggers platelet activation but also results in thrombin generation because of tissue factor exposure.
View Article and Find Full Text PDFVariation in the Association between Antineoplastic Therapies and Venous Thromboembolism in Patients with Active Cancer.
Thromb Haemost
May 2020
Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, King's College London, London, United Kingdom.
Background: Venous thromboembolism (VTE) is a major cause of death in cancer patients. Although patients with cancer have numerous risk factors for VTE, the relative contribution of cancer treatments is unclear.
Objective: The objective of this study is to evaluate the association between cancer therapies and the risk of VTE.
Thromboprophylaxis with Rivaroxaban in Acutely Ill Medical Patients with Renal Impairment: Insights from the MAGELLAN and MARINER Trials.
Thromb Haemost
March 2020
Janssen Research and Development LLC, Raritan, New Jersey, United States.
Patients with renal impairment are at higher risk of thrombosis and bleeding than those with normal renal function. The optimal rivaroxaban dose for thromboprophylaxis in acutely ill medical patients with renal impairment is unknown. MARINER and MAGELLAN were multicenter, randomized clinical trials of rivaroxaban in acutely ill medical patients.
View Article and Find Full Text PDFIsolated Distal Deep Vein Thrombosis: Perspectives from the GARFIELD-VTE Registry.
Thromb Haemost
October 2019
Thrombosis Research Institute, University College London, London, United Kingdom.
Isolated distal deep vein thrombosis (IDDVT) represents up to half of all lower limb DVT. This study investigated treatment patterns and outcomes in 2,145 patients with IDDVT in comparison with those with proximal DVT (PDVT; = 3,846) and pulmonary embolism (PE; = 4,097) enrolled in the GARFIELD-VTE registry. IDDVT patients were more likely to have recently undergone surgery (14.
View Article and Find Full Text PDFMechanistic Basis for the Differential Effects of Rivaroxaban and Apixaban on Global Tests of Coagulation.
TH Open
April 2018
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Rivaroxaban and apixaban are both small molecules that reversibly inhibit factor Xa. Compared with rivaroxaban, apixaban has minimal effects on the prothrombin time and activated partial thromboplastin time. To investigate this phenomenon, we used a factor Xa-directed substrate in a buffer system.
View Article and Find Full Text PDFUpper Extremity DVT versus Lower Extremity DVT: Perspectives from the GARFIELD-VTE Registry.
Thromb Haemost
August 2019
Thrombosis Research Institute and University College London, London, United Kingdom.
Upper extremity deep vein thrombosis (UEDVT) is less common than lower extremity DVT (LEDVT) and consequently less well characterized. This study compared clinical characteristics and 1-year outcomes between 438 UEDVT patients and 7,602 LEDVT patients recruited in the GARFIELD-VTE registry. UEDVT patients were significantly more likely to have a central venous catheter than those with LEDVT (11.
View Article and Find Full Text PDFCombination Antiplatelet and Oral Anticoagulant Therapy in Patients With Coronary and Peripheral Artery Disease.
Circulation
April 2019
Thrombosis and Atherosclerosis Research Institute and McMaster University, Hamilton, Canada (J.I.W.).
Antiplatelet therapy is the mainstay for the treatment of acute and chronic arterial disease involving the coronary and peripheral beds. However, questions remain about optimal antithrombotic therapy for long-term treatment of chronic vascular disease. The observation that dual antiplatelet therapy with acetylsalicylic acid and clopidogrel was associated with lower thrombotic event rates than acetylsalicylic acid monotherapy in patients with acute coronary syndromes and those undergoing percutaneous coronary intervention changed the treatment paradigm.
View Article and Find Full Text PDFAntibody-Based Ticagrelor Reversal Agent in Healthy Volunteers.
N Engl J Med
May 2019
From the Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston (D.L.B.); the Department of Emergency Medicine, Thomas Jefferson University, Philadelphia (C.V.P.); McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada (J.I.W.); CirQuest Labs and the University of Tennessee Health Science Center, Memphis (L.K.J.); and PhaseBio Pharmaceuticals, Malvern, PA (S.X., S.E.A., B.R.U., M.C.M., J.S.L.).
Background: Ticagrelor is an oral P2Y inhibitor that is used with aspirin to reduce the risk of ischemic events among patients with acute coronary syndromes or previous myocardial infarction. Spontaneous major bleeding and bleeding associated with urgent invasive procedures are concerns with ticagrelor, as with other antiplatelet drugs. The antiplatelet effects of ticagrelor cannot be reversed with platelet transfusion.
View Article and Find Full Text PDFSynergy of Dual Pathway Inhibition in Chronic Cardiovascular Disease.
Circ Res
February 2019
McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada (J.I.W., J.W.A.E.).
Although acetylsalicylic acid is of proven benefit for secondary prevention in patients with cardiovascular disease, the risk of recurrent ischemic events remains high. Intensification of antithrombotic therapy with more potent antiplatelet drugs, dual antiplatelet therapy, or vitamin K antagonists further reduces the risk of major adverse cardiovascular events compared with acetylsalicylic acid alone but increases the risk of bleeding without reducing mortality. In patients with prior coronary artery disease or peripheral arterial disease the COMPASS (Cardiovascular Outcomes for People Using Anticoagulation Strategies) trial revealed that compared with acetylsalicylic acid alone, dual pathway inhibition with low-dose rivaroxaban (2.
View Article and Find Full Text PDFOverview of Therapeutic Approaches for Cholesterol Lowering and Attenuation of Thrombosis for Prevention of Atherothrombosis.
Circ Res
February 2019
Knight Cardiovascular Institute, Center for Preventive Cardiology, Oregon Health and Science University, Portland (S.F.).
The double-blind, randomized, AMPLIFY trial compared 6 months' treatment with apixaban (10 mg twice daily for 7 days and 5 mg twice daily thereafter) versus conventional treatment (subcutaneous enoxaparin [1 mg/kg twice daily for ≥ 5 days] overlapped and followed by warfarin [international normalized ratio = 2.0-3.0]) in patients with acute venous thromboembolism (VTE).
View Article and Find Full Text PDFComment on model-based meta-analysis to evaluate optimal doses of direct oral factor Xa inhibitors in atrial fibrillation patients.
Blood Adv
November 2018
Clinical Pharmacometrics, Bayer AG, Wuppertal, Germany.
Effect of Different Doses of Acetylsalicylic Acid on the Antithrombotic Activity of Clopidogrel in a Mouse Arterial Thrombosis Model.
Arterioscler Thromb Vasc Biol
October 2018
From the Department of Medicine, McMaster University, Hamilton, Ontario, Canada (R.N., N.V., J.Z., J.I.W., P.L.G.).
Objective- Dual-antiplatelet therapy with acetylsalicylic acid and a P2Y antagonist, such as clopidogrel, is the standard of care for acute coronary syndromes. However, the drugs have divergent effects on the formation of cAMP, an inhibitory second messenger. Thus, by inhibiting the synthesis of prostacyclin, acetylsalicylic acid reduces cAMP formation, whereas clopidogrel potentiates it.
View Article and Find Full Text PDFRivaroxaban for Thromboprophylaxis after Hospitalization for Medical Illness.
N Engl J Med
September 2018
From the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Feinstein Institute for Medical Research, and the Department of Medicine, Anticoagulation and Clinical Thrombosis Services, Northwell Health at Lenox Hill Hospital (A.C.S.), and the Cardiovascular Institute, Mount Sinai Medical Center (J.L.H.) - all in New York; the Department of Medicine and Surgery, University of Insubria, Varese, Italy (W.A.); the Stanford Stroke Center, Stanford University Medical Center, Stanford (G.W.A.), and the University of California at Davis, Sacramento (G.A.M.) - both in California; the Department of Medicine, Intermountain Medical Center, and Department of Medicine, University of Utah, Salt Lake City (C.G.E.); Division of Cardiology, University of Colorado School of Medicine, and CPC Clinical Research, Aurora (W.R.H.); Département Hospitalo-Universitaire FIRE (Fibrose Inflammation Remodelage), University Paris Diderot, Assistance Publique-Hôpitaux de Paris, and INSERM Unité 1148, Paris (P.G.S.); Imperial College, Royal Brompton Hospital, London (P.G.S.); McMaster University and the Thrombosis and Atherosclerosis Research Institute - both in Hamilton, ON, Canada (J.I.W.); Janssen Research and Development, Raritan (E.S., E.S.B.), and the Thrombosis and Hematology Therapeutic Area, Clinical Development, Pharmaceuticals, Bayer U.S., Whippany (T.E.S.) - both in New Jersey; and the College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City (G.E.R.).
Background: Patients who are hospitalized for medical illness remain at risk for venous thromboembolism after discharge, but the role of extended thromboprophylaxis in the treatment of such patients is a subject of controversy.
Methods: In this randomized, double-blind trial, medically ill patients who were at increased risk for venous thromboembolism on the basis of a modified International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) score of 4 or higher (scores range from 0 to 10, with higher scores indicating a higher risk of venous thromboembolism) or a score of 2 or 3 plus a plasma d-dimer level of more than twice the upper limit of the normal range (defined according to local laboratory criteria) were assigned at hospital discharge to either once-daily rivaroxaban at a dose of 10 mg (with the dose adjusted for renal insufficiency) or placebo for 45 days. The primary efficacy outcome was a composite of symptomatic venous thromboembolism or death due to venous thromboembolism.
Antiplatelet therapy in the management of atherothrombosis: recent clinical advances.
Blood Adv
July 2018
Department of Medicine and Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, ON, Canada.
Linking Endogenous Factor Xa Activity, a Biologically Relevant Pharmacodynamic Marker, to Edoxaban Plasma Concentrations and Clinical Outcomes in the ENGAGE AF-TIMI 48 Trial.
Circulation
October 2018
TIMI Study Group, Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (E.M.A., E.B., D.M., C.T.R., R.P.G.).
Background: We previously reported exogenous antifactor Xa (FXa) activity as a pharmacokinetic surrogate marker for edoxaban plasma concentrations. Inhibition of endogenous FXa activity is a more biologically relevant pharmacodynamic measure of edoxaban activity. Here we describe the value of endogenous FXa activity as a pharmacodynamic marker linking edoxaban concentrations and clinical outcomes in the ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction Study 48).
View Article and Find Full Text PDFRivaroxaban for Stroke Prevention after Embolic Stroke of Undetermined Source.
N Engl J Med
June 2018
From the Departments of Medicine-Neurology (R.G.H., M.S., A.S.), Health Research Methods, Evidence, and Impact (S.I.B.), Pathology and Molecular Medicine (G. Pare), and Medicine-Cardiology (S.J.C.), Population Health Research Institute (B.S., P.S., E.T.), and the Thrombosis and Atherosclerosis Research Institute and McMaster University (J.I.W.), Hamilton, ON, the Vancouver Stroke Program, University of British Columbia, Vancouver (O.R.B.), and Sunnybrook Health Sciences Centre, University of Toronto, Toronto (C.J.) - all in Canada; Bayer, Wuppertal (H.M.), Klinik für Neurologie, Charité-Universitätsmedizin Berlin (M.E.), and Bayer (B.K.), Berlin, and Bayer, Leverkusen (C.P.) - all in Germany; the Department of Neurology, University of Pennsylvania, Philadelphia (S.E.K.), and Janssen Research and Development, Spring House (G. Peters) - both in Pennsylvania; Bayer U.S., Pharmaceuticals Clinical Development Thrombosis, Whippany, NJ (S.D.B.); Clínica Alemana de Santiago, Santiago, Chile (P.L.); the Department of Neurology and Stroke Center, Beijing Tiantan Hospital, Beijing (Yongjun Wang, Yilong Wang); Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona (A.D.); Pirogov Russian National Research Medical University, Moscow (N.S.); International Clinical Research Center and Neurology Department, St. Anne's University Hospital, Brno, Czech Republic (R.M.); Centro Hospitalar e Universitário de Coimbra, Hospitais da Universidade de Coimbra, Coimbra, Portugal (L.C.); the Department of Clinical Sciences (Neurology), Lund University, and the Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund (A.L.), and the Department of Clinical Neuroscience-Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg (T.T.) - all in Sweden; Instituto Nacional de Neurología y Neurocirugía, Mexico City (A.A.); Hospital St. John of God, Sigmund Freud Private University, Medical Faculty, Vienna (W.L.); the 2nd Department of Neurology, Institute of Psychiatry and Neurology, and the Department of Pharmacology, Medical University of Warsaw, Warsaw, Poland (A.C.); the Department of Internal Medicine, University Hospital Basel, Basel, Switzerland (J.E.); Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo (R.J.G.); Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris-Diderot, Sorbonne Paris Cité University, Paris (P.A.); Institute for Neurological Research-Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia, Buenos Aires (S.F.A.); the Department of Neurology, Helsinki University Central Hospital, Helsinki (T.T.); Imperial College London, London (R.V.); Medical School, University of Western Australia, and Sir Charles Gairdner Hospital, Perth, Australia (G.J.H.); the Department of Human Neurosciences, Sapienza University of Rome, Rome (D.T.); the Department of Neurology, Semmelweis University, Budapest, Hungary (D.B.); International University of Health and Welfare, Sanno Hospital and Sanno Medical Center, Tokyo (S.U.); the Department of Medicine, University of Thessaly, Larissa, Greece (G.N.); Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea (B.-W.Y.); the Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels (R.B.); the Department of Neurology, ZorgSaam Hospital, Terneuzen, the Netherlands (R.B.); Institute of Neuroscience and Psychology, University of Glasgow, Queen Elizabeth University Hospital, Glasgow, United Kingdom (K.W.M.); Shaare Zedek Medical Center, Jerusalem (N.B.); the Department of Neurology, Selcuk University, Konya, Turkey (S.O.); Health Research Board Clinical Research Facility, National University of Ireland, Galway (M.J.O.); Tiervlei Trial Centre and Head of Internal Medicine Karl Bremer Hospital, Bellville, South Africa (M.M.D.V.B.); and Baylor College of Medicine, Houston (W.F.P.).
Background: Embolic strokes of undetermined source represent 20% of ischemic strokes and are associated with a high rate of recurrence. Anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, may result in a lower risk of recurrent stroke than aspirin.
Methods: We compared the efficacy and safety of rivaroxaban (at a daily dose of 15 mg) with aspirin (at a daily dose of 100 mg) for the prevention of recurrent stroke in patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source.
Gastrointestinal Bleeding With Edoxaban Versus Warfarin: Results From the ENGAGE AF-TIMI 48 Trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction).
Circ Cardiovasc Qual Outcomes
May 2018
TIMI Study Group, Division of Cardiovascular Medicine and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (C.T.R., F.N., E.M.A., E.B., R.P.G.).
Background: The ENGAGE AF-TIMI 48 trial (Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction) compared higher-dose edoxaban regimen (HD-ER) and lower-dose edoxaban regimen with well-managed warfarin in 21 105 patients with atrial fibrillation. The risk factors and clinical impact of gastrointestinal bleeding (GIB) in this trial have not been described in detail.
Methods And Results: This analysis was undertaken to identify risk factors for major GIB (MGIB) and compare the severity and outcomes of GIB with edoxaban and warfarin.
The optimal duration of anticoagulation for venous thromboembolism (VTE) is uncertain. In this prespecified analysis, we used data from 2 randomized trials, which compared once-daily rivaroxaban (20 mg or 10 mg) with aspirin (100 mg) or placebo for extended VTE treatment to estimate the risk of recurrence according to baseline risk factor profiles. Index VTE events were centrally classified as unprovoked, or provoked by major transient or persistent, or minor transient or persistent risk factors, and rates of recurrence at 1 year were calculated.
View Article and Find Full Text PDFPulmonary embolism (PE) studies used direct oral anticoagulants (DOACs) with or without initial heparin. We aimed to (1) evaluate if PE patients benefit from initial heparin; (2) describe patient characteristics in the DOAC studies; and (3) investigate whether the anatomical extent of PE correlates with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, cause of PE, and recurrence rate. Our methods were (1) an indirect meta-analysis comparing the recurrence risk in DOAC-treated patients with or without initial heparin to those patients given heparin/vitamin K antagonist (VKA).
View Article and Find Full Text PDF2017 Scientific Sessions Sol Sherry Distinguished Lecture in Thrombosis: Factor XI as a Target for New Anticoagulants.
Arterioscler Thromb Vasc Biol
February 2018
From the Department of Medicine (J.I.W., J.C.F.) and Department of Biochemistry and Biomedical Sciences (J.I.W.), McMaster University, Hamilton, Ontario, Canada; and Thrombosis and Atherosclerosis Research Institute (J.I.W., J.C.F.), Hamilton, Ontario, Canada.
The goal of anticoagulant therapy is to attenuate thrombosis without compromising hemostasis. Although the direct oral anticoagulants are associated with less intracranial hemorrhage than vitamin K antagonists, bleeding remains their major side effect. Factor XI has emerged as a promising target for anticoagulants that may be safer than those currently available.
View Article and Find Full Text PDFEdoxaban for the Treatment of Cancer-Associated Venous Thromboembolism.
N Engl J Med
February 2018
From the University of Oklahoma Health Sciences Center, College of Public Health, Oklahoma City (G.E.R.); the Department of Vascular Medicine, Academic Medical Center, University of Amsterdam (N.E., H.R.B.), and ITREAS, Academic Research Organization (A.S.) - both in Amsterdam; the Department of Vascular Medicine and Hemostasis, University Hospitals Leuven, Leuven, Belgium (P.V.); Ottawa Hospital Research Institute, Ottawa (M.C.), London Health Sciences Centre-Victoria Hospital, London, ON (M.J.K.), University Health Network, University of Toronto, Toronto (E.Y.), and McMaster University and the Thrombosis and Atherosclerosis Research Institute, Hamilton, ON (J.I.W.) - all in Canada; the Department of Medicine and Aging Sciences, University G. D'Annunzio, Chieti, Italy (M.D.N.); the Department of Medicine, Division of Hematology, University of Washington, Seattle (D.G.); Daiichi Sankyo Pharma Development, Basking Ridge, NJ (M.A.G., M.F.M., M.S., G.Z.); Thrombosis Research Institute and University College London, London (A.K.K.); the Department of Respiratory Disease, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris (G.M.); the Department of Internal Medicine, Division of Hematology, Ohio State University Wexner Medical Center, Columbus (T.-F.W.); and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston (J.I.Z.).
Background: Low-molecular-weight heparin is the standard treatment for cancer-associated venous thromboembolism. The role of treatment with direct oral anticoagulant agents is unclear.
Methods: In this open-label, noninferiority trial, we randomly assigned patients with cancer who had acute symptomatic or incidental venous thromboembolism to receive either low-molecular-weight heparin for at least 5 days followed by oral edoxaban at a dose of 60 mg once daily (edoxaban group) or subcutaneous dalteparin at a dose of 200 IU per kilogram of body weight once daily for 1 month followed by dalteparin at a dose of 150 IU per kilogram once daily (dalteparin group).