scholarly journals Dental Extraction Can Be Performed Safely in Patients on Aspirin Therapy: A Timely Reminder

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Gaurav Verma
Keyword(s):  
Bleeding Complication ◽  
Tooth Extraction ◽  
Case Reports ◽  
Aspirin Therapy ◽  
Bleeding Complications ◽  
Thromboembolic Events ◽  
Excessive Bleeding ◽  
Risk Of Bleeding ◽  
Theoretical Risk ◽  
Timely Reminder

Cardiac patients on aspirin therapy may require extractions for their diseased teeth. It is a common practice among physicians and treating surgeons to stop aspirin prior to tooth extraction because of fear of bleeding complications. This practice often predisposes the patient to adverse thromboembolic events. This practice is based on theoretical risk of bleeding and on isolated case reports of excessive bleeding with aspirin therapy. The current consensus and recommendations are in favor of continuing aspirin therapy during simple tooth extraction as the bleeding complication incidence is very less and if it occurs can be controlled efficiently with local hemostasis measures.

Genetic Modulation of Oral Anticoagulation with Warfarin

2000 ◽  
Vol 84 (11) ◽  
pp. 775-778 ◽  
Author(s):  
Donatella Colaizzo ◽  
Giovanna D’Andrea ◽  
Vincenzo Brancaccio ◽  
Antonio Ciampa ◽  
Elvira Grandone ◽  
...  
Keyword(s):  
Bleeding Complication ◽  
Bleeding Complications ◽  
Gene Variants ◽  
Risk Of Bleeding ◽  
Cyp2c9 Gene ◽  
Small Doses ◽  
Local Bleeding ◽  
Estimated Risk ◽  
Adjusted Dose ◽  
Anticoagulation Intensity

SummaryCytochrome P450 CYP2C9 gene variants have been associated with hyperresponsiveness to small doses of warfarin and a higher bleeding complication rate. The aim of this study was to investigate whether CYP2C9 gene variants affect doses of drug prescribed to acquire the target anticoagulation intensity and the occurence of bleeding complications. In a cohort of 180 patients followed up at one specialized clinic from the start of the anticoagulation with warfarin, we have investigated whether CYP2C9 gene variants have affected doses of drug prescribed to acquire the target anticoagulation intensity and the incidence of bleeding complications.The adjusted dose required of warfarin was higher among patients with the CYP2C9*1 haplotype (5.6 mg) than those of patients carrying the CYP2C9*2 (4.7 mg; p = 0.007, Scheffé’s test) or the CYP2C9*3 haplotype (4.0 mg; p <0.001, Scheffé’s test). The occurrence of bleeding complications was more frequent among patients with the CYP2C9*2 and/or the CYP2C9*3 haplotype than in carriers of the CYP2C9*1 haplotype (OR: 2.57; 95% CI: 1.16–5.73). An interaction between the presence of local bleeding sources and the CYP2C9*2 and/or the CYP2C9*3 haplotype was observed (p <0.001). Patients with both local sites of potential bleeding and CYP2C9*2 and/or the CYP2C9*3 haplotype had the higher estimated risk of bleeding (OR: 12.81; 95% CI: 2.86–57.26).CYP2C9 gene variants modulate the anticoagulant effect of the dose of warfarin prescribed. The incidence of bleeding complications in CYP2C9*2 and CYP2C9*3 carriers was significantly higher than that in noncarriers and interacted with the presence of local bleeding sources.

scholarly journals Complications of Hysterectomy in Women with Von Willebrand Disease.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3399-3399
Author(s):  
Andra H James ◽  
Evan R Myers ◽  
Chad Cook ◽  
Ricardo Pietrobon
Keyword(s):  
Case Reports ◽  
Postoperative Bleeding ◽  
Case Series ◽  
The United States ◽  
Von Willebrand Disease ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Bleeding Complications ◽  
Risk Of Bleeding ◽  
Von Willebrand

Abstract Background: Case reports and small case series suggest that women with von Willebrand disease (VWD) are at a very high risk of bleeding complications with hysterectomy. Because the procedure may be beneficial to women who suffer from heavy menstrual bleeding, an understanding of the true risks involved is essential for appropriate decision making. Objectives: To estimate the incidence of bleeding and other complications in women with VWD who undergo hysterectomy. Methods: The United States Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality for the years 1988–2004 was queried for all hysterectomies for nonmalignant conditions. Data were analyzed based on the NIS sampling design. Bivariate analyses were used to examine the differences between women with and without VWD. Multivariate analysis was used to adjust for potential confounders among women who underwent hysterectomy for heavy menstrual bleeding. Results: 545 of the 1,358,133 hysterectomies were to women with VWD. Women with VWD were significantly more likely to experience intraoperative and postoperative bleeding (2.75% versus 0.89%, p < 0.001) and require transfusion (7.34% versus 2.13%, p < 0.001) than women without VWD. One woman with VWD died (odds ratio = 28.49). Conclusions: While the risk of bleeding complications from hysterectomy in women with VWD is smaller than previously reported, women with VWD did experience significantly more bleeding complications than women without VWD. Nonetheless, for women who have completed childbearing, the risks of hysterectomy may be acceptable.

scholarly journals Dabigatran-Induced Spontaneous Hemopericardium and Cardiac Tamponade

2017 ◽  
Vol 44 (5) ◽  
pp. 370-372 ◽  
Author(s):  
Qurat-ul-ain Jelani ◽  
Ram Gordon ◽  
Adam Schussheim
Keyword(s):  
Atrial Fibrillation ◽  
Bleeding Complication ◽  
Unusual Case ◽  
Thromboembolic Events ◽  
Nonvalvular Atrial Fibrillation ◽  
Reversal Agent ◽  
Risk Of Bleeding ◽  
Patient Status ◽  
Novel Oral Anticoagulant ◽  
Newer Anticoagulants

Four novel oral anticoagulant agents are currently available for the prevention and treatment of thromboembolic events in patients with nonvalvular atrial fibrillation. We present an unusual case of spontaneous hemopericardium and tamponade in an 87-year-old man with atrial fibrillation who was taking one such agent, dabigatran, as thromboprophylaxis. Our case highlights both a rare bleeding complication of dabigatran use and the effectiveness of idarucizumab, its newly approved reversal agent. Especially in elderly patients, we recommend that clinicians evaluate risk factors, closely monitor patient status, and consider alternatives to the newer anticoagulants when the risk of bleeding is high.

Potential Drug Interactions Between Cannabinoids and Its Derivatives and Oral Anticoagulants

2021 ◽  
pp. 001857872098543
Author(s):  
McKenzie Paduch ◽  
Angela R. Thomason
Keyword(s):  
Drug Interactions ◽  
English Language ◽  
Case Reports ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Thromboembolic Events ◽  
Potential Drug ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Potential Risks

The increase use of cannabidiol containing products poses potential risks with high-alert medications such as oral anticoagulants. To review the use of cannabidiol and its’ derivatives with oral anticoagulants, searches (2005-May 2020) were performed by PubMed, Google Scholar, and ClinicalTrials.gov. Articles were limited to English-language only. The results yielded 4 case reports evaluating the potential drug interactions between cannabinoids and its’ derivatives and oral anticoagulants. These case reports show the potential for drug interactions when using warfarin and cannabidiol containing products. At time of publication, there were no published articles on drug interactions between cannabidiol and the direct oral anticoagulants. Further research is needed to conclude drug interactions are associated with an increased risk of bleeding or thromboembolic events in these patients.

Protamine use in transcarotid artery revascularization is associated with lower risk of bleeding complications without higher risk of thromboembolic events

2020 ◽  
Vol 72 (6) ◽  
pp. 2079-2087 ◽  
Author(s):  
Patric Liang ◽  
Raghu L. Motaganahalli ◽  
Mahmoud B. Malas ◽  
Grace J. Wang ◽  
Jens Eldrup-Jorgensen ◽  
...  
Keyword(s):  
Lower Risk ◽  
Bleeding Complications ◽  
Thromboembolic Events ◽  
Risk Of Bleeding

Current Studies of Aspirin as an Anticancer Agent and Strategies to Strengthen its Therapeutic Application in Cancer

2020 ◽  
Vol 26 ◽  
Author(s):  
Phuong H.L. Tran ◽  
Beom-Jin Lee ◽  
Thao T.D. Tran
Keyword(s):  
Anticancer Agent ◽  
Mechanisms Of Action ◽  
Aspirin Therapy ◽  
Therapeutic Application ◽  
Cancer Treatments ◽  
Anticancer Properties ◽  
Cancer Management ◽  
Risk Of Bleeding ◽  
The Past ◽  
Inflammatory Drugs

: Aspirin has emerged as a promising intervention in cancer in the past decade. However, there are existing controversies regarding the anticancer properties of aspirin as its mechanism of action has not been clearly defined. In addition, the risk of bleeding in the gastrointestinal tract from aspirin is another consideration that requires medical and pharmaceutical scientists to work together to develop more potent and safe aspirin therapy in cancer. This review presents the most recent studies of aspirin with regard to its role in cancer prevention and treatment demonstrated by highlighted clinical trials, mechanisms of action as well as approaches to develop aspirin therapy best beneficial to cancer patients. Hence, this review provides readers with an overview of aspirin research in cancer that covers not only the unique features of aspirin, which differentiates aspirin from other non-steroidal anti-inflammatory drugs (NSAIDs), but also strategies that can be used in the development of drug delivery systems carrying aspirin for cancer management. These studies convey optimistic messages on continuing efforts of scientist on the way of developing an effective therapy for even patients with a low response to current cancer treatments.

scholarly journals Point of care diagnostic of hypercoagulability and platelet function in COVID-19 induced acute respiratory distress syndrome: a retrospective observational study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Johannes Herrmann ◽  
Quirin Notz ◽  
Tobias Schlesinger ◽  
Jan Stumpner ◽  
Markus Kredel ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Observational Study ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Platelet Function ◽  
Distress Syndrome ◽  
Point Of Care ◽  
Retrospective Observational Study ◽  
Bleeding Complications ◽  
Thromboembolic Events

Abstract Background Coronavirus disease 2019 (COVID-19) associated coagulopathy (CAC) leads to thromboembolic events in a high number of critically ill COVID-19 patients. However, specific diagnostic or therapeutic algorithms for CAC have not been established. In the current study, we analyzed coagulation abnormalities with point-of-care testing (POCT) and their relation to hemostatic complications in patients suffering from COVID-19 induced Acute Respiratory Distress Syndrome (ARDS). Our hypothesis was that specific diagnostic patterns can be identified in patients with COVID-19 induced ARDS at risk of thromboembolic complications utilizing POCT. Methods This is a single-center, retrospective observational study. Longitudinal data from 247 rotational thromboelastometries (Rotem®) and 165 impedance aggregometries (Multiplate®) were analysed in 18 patients consecutively admitted to the ICU with a COVID-19 induced ARDS between March 12th to June 30th, 2020. Results Median age was 61 years (IQR: 51–69). Median PaO2/FiO2 on admission was 122 mmHg (IQR: 87–189), indicating moderate to severe ARDS. Any form of hemostatic complication occurred in 78 % of the patients with deep vein/arm thrombosis in 39 %, pulmonary embolism in 22 %, and major bleeding in 17 %. In Rotem® elevated A10 and maximum clot firmness (MCF) indicated higher clot strength. The delta between EXTEM A10 minus FIBTEM A10 (ΔA10) > 30 mm, depicting the sole platelet-part of clot firmness, was associated with a higher risk of thromboembolic events (OD: 3.7; 95 %CI 1.3–10.3; p = 0.02). Multiplate® aggregometry showed hypoactive platelet function. There was no correlation between single Rotem® and Multiplate® parameters at intensive care unit (ICU) admission and thromboembolic or bleeding complications. Conclusions Rotem® and Multiplate® results indicate hypercoagulability and hypoactive platelet dysfunction in COVID-19 induced ARDS but were all in all poorly related to hemostatic complications..

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