No abstract available.
Anticoagulants ; Hematologic Agents ; Atrial Fibrillation

The causes of ischemic stroke are widely diverse, ranging from large artery atherosclerosis to cardioembolism, and it is important to use preventive therapy toward the goal reducing the future risk of recurrent ischemic stroke, myocardial infarction, and vascular death. Antithrombotic therapy is one of the fundamental medical approaches for secondary prevention of ischemic stroke, which is broadly divided into two general categories, those that exert their effect via platelet inhibition (antiplatelet agents), and those that influence various factors in the clotting cascade (anticoagulants). In general, the clinical guidelines recommend antiplatelet agents for patients with non-cardioembolic stroke, while anticoagulants is indicated for patients with presumed or proven cardioembolic stroke. Many clinical trials have attempted to test the efficacy and safety of antithrombotics in ischemic stroke. This review will discuss on currently available antithrombotic agents that have demonstrated efficacy for secondary prevention of ischemic stroke.
Anticoagulants ; Arteries ; Atherosclerosis ; Blood Platelets ; Fibrinolytic Agents ; Humans ; Myocardial Infarction ; Platelet Aggregation Inhibitors ; Secondary Prevention* ; Stroke*

Humans ; Cardiovascular Diseases/drug therapy* ; Fibrinolytic Agents/therapeutic use* ; Hemorrhage ; Anticoagulants ; Platelet Aggregation Inhibitors

Humans ; Cardiovascular Diseases/drug therapy* ; Fibrinolytic Agents/therapeutic use* ; Hemorrhage ; Anticoagulants ; Platelet Aggregation Inhibitors

Anticoagulant agents are used to reduce the risk of thromboembolic complications in patients with atrial fibrillation or deep vein thrombosis. Several new generation of oral anticoagulants have been approved. These novel oral anticoagulants (NOACs) include direct thrombin inhibitors, dabigatra etexilate, and the direct factor Xa inhibitors, rivaroxaban, apixaban and edoxaban. This review evaluates NOACs-related gastrointestinal bleeding and summarizes the ideal management strategies based on the guideline suggested by American Society for Gastrointestinal Endoscopy.
Anticoagulants* ; Antithrombins ; Atrial Fibrillation ; Endoscopy ; Endoscopy, Gastrointestinal ; Factor Xa Inhibitors ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Rivaroxaban ; Thromboembolism ; Venous Thrombosis

BACKGROUNDWhether an addition of OAC to double antiplatelet therapy for patients with an indication of chronic oral anticoagulation undergoing PCI-S may improve clinical outcomes is still debated. This meta-analysis aimed to update and re-compare the benefits and risks of triple antithrombotic therapy (TT) with double anti-platelet therapy (DAPT) after in patients who requiring oral anticoagulation after percutaneous coronary interventions with stenting (PCI-s).

METHODSTen reports of observational retrospective or prospective studies were retrieved, including a total of 6296 patients, follow-up period ranging from 1 year to 2 years.

RESULTSBaseline characteristics were similar in both groups. The main finding of this study is the overall incidence of major adverse cardiovascular events (MACE), myocardial infarction (MI) and stent thrombosis was comparable between two groups. Patients with TT was associated with significant reduction in ischemic stroke (OR: 0.27; 95%CI: 0.13 - 0.57; P = 0.0006) as compared to DAPT. We reaffirmed triple therapy significantly increased the risk of major bleeding (OR: 1.47; 95%CI: 1.22 - 1.78; P < 0.0001) and minor bleeding (OR: 1.55; 95%CI: 1.07 - 2.24; P = 0.02).

CONCLUSIONSTriple therapy is more efficacious in reducing the occurrence of ischemic stroke in PCI-s patients with an indication of chronic oral anticoagulation (OAC), compared with DAPT. However, it significantly increased major and minor risk of bleeding. It is imperative that further prospective randomized controlled trials are required to defne the best therapeutic strategy for patients with an indication of chronic OAC undergoing PCI-s.

Aged ; Anticoagulants ; therapeutic use ; Drug Therapy, Combination ; Female ; Fibrinolytic Agents ; administration & dosage ; Humans ; Male ; Middle Aged ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors ; administration & dosage ; Publication Bias ; Stents

Acute Coronary Syndrome/drug therapy* ; Anticoagulants/therapeutic use* ; Coronary Disease/drug therapy* ; Drug Therapy, Combination ; Fibrinolytic Agents/therapeutic use* ; Humans ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors/therapeutic use*

Anticoagulants/therapeutic use* ; Atrial Fibrillation/drug therapy* ; Coronary Artery Disease/surgery* ; Drug Therapy, Combination ; Fibrinolytic Agents/therapeutic use* ; Humans ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors/therapeutic use*

BACKGROUND: Carefully using a totally implanted vascular access device and regular check-up of its condition in children who suffer with malignancy is very important. This study was performed to determine the complications related to using this device, according to the patient's age, gender and diagnosis, and the time from port insertion. METHODS: We retrospectively studied 77 patients with malignancy (46 males and 31 females, age: 0.1~18 years, mean age: 7.8 years) and they were treated with a totally implanted vascular access device (chemoport) from January 1996 to May 2007 in Kyungpook National University Hospital, Korea. We assessed the symptoms and radiologic findings, conducted blood tests and doppler USG; we found several complications and compared them according the patients' age, gender and diagnosis. RESULTS: Among the 77 cases with a totally implanted vascular access device (chemoport), 14 cases had complications related to the chemoport. Infections were detected in 8 cases. 6 of them had infections related to the chemoport after 4~7 months from the port-insertion. After port removal and treatment with broad spectrum antibiotics, their symptoms such as fever and swelling were improved. Disconnection of the port was detected in 2 cases after 2 months and 22 months from port-insertion, respectively. These ports were successfully removed by cardiac catheterization. Rotation of the port was detected in one case after 9 months from port-insertion: the rotated port was removed. Obstruction with thrombus was detected in 3 cases, after 7~16 months from port-insertion: this condition was treated with thrombolytic agents such urokinase and t-PA (tissue plasminogen activator), or surgical removal of the blood clot in the port site. CONCLUSION: To reduce the complications related to the totally implanted vascular access (device), such as infection, thrombosis and disconnection, we should carefully use this device and also regularly check its function and position. After completion of chemotherapy, removal of the port as soon as possible should be considered. If a complication is detected, then we should manage it immediately.
Anti-Bacterial Agents ; Cardiac Catheterization ; Cardiac Catheters ; Child ; Female ; Fever ; Fibrinolytic Agents ; Hematologic Tests ; Humans ; Korea ; Male ; Plasminogen ; Retrospective Studies ; Thrombosis ; Urokinase-Type Plasminogen Activator ; Vascular Access Devices

From January 1997 to January 1998, there were 21 patients with chronic myelogenous leukemia who admitted to the Clinical Department, National Institute of Hematology and Blood Transfusion, B¹ch Mai Hospital. Mean age of patients was 42.85 for men and 38.12 for women. Among these patients, splenomegaly was observed in 100% of patients. Hyperleukocytosis, hyperthrombocytemia, erythrocytopenia, and hyperuricemia all were measured. 94% of patients were positive with Philadelphia chromosome
Leukemia ; Hydroxyurea ; Hematologic Agents ; diagnosis