scholarly journals Periprocedural heparin bridging in patients receiving oral anticoagulation: a systematic review and meta-analysis

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Jing Wen Yong ◽  
Li Xia Yang ◽  
Bright Eric Ohene ◽  
Yu Jie Zhou ◽  
Zhi Jian Wang
2018 ◽  
Vol 41 (7) ◽  
pp. 767-774 ◽  
Author(s):  
Norman C. Wang ◽  
Matthew D. Sather ◽  
Aliza Hussain ◽  
Andrew D. Althouse ◽  
Evan C. Adelstein ◽  
...  

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Faizan Khan ◽  
Miriam Kimpton ◽  
Tobias Tritschler ◽  
Grégoire Le Gal ◽  
Brian Hutton ◽  
...  

Abstract Background The optimal duration of anticoagulation after a first unprovoked venous thromboembolism (VTE) remains controversial. Deciding to stop or continue anticoagulant therapy indefinitely after completing 3 to 6 months of initial treatment requires balancing the long-term risk of recurrent VTE if anticoagulation is stopped against the long-term risk of major bleeding if anticoagulation is continued. However, knowledge of the long-term risk for major bleeding events during extended anticoagulation in this patient population is limited. We plan to conduct a systematic review and meta-analysis to quantify the risk for major bleeding events during extended oral anticoagulation in patients with first unprovoked VTE. Methods Electronic databases including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials will be systematically searched with the assistance of an information specialist (from inception to March 1, 2019) to identify randomized controlled trials and prospective cohort studies reporting major bleeding during extended oral anticoagulation in patients with first unprovoked VTE, who have completed at least 3 months of initial anticoagulant therapy. Study selection, risk of bias assessment, and data extraction will be performed independently by at least two investigators. The number of major bleeding events and person-years of follow-up will be used to calculate the rate (events per 100 person-years) with its 95% confidence interval for each study cohort, during clinically relevant time periods of extended anticoagulant therapy. Results will be pooled using random effect meta-analysis. Discussion The planned systematic review and meta-analysis will provide reliable estimates of the risk for major bleeding events during extended anticoagulation. This information will help inform patient prognosis and assist clinicians with balancing the risks and benefits of treatment to guide management of unprovoked VTE. Systematic review registration PROSPERO CRD42019128597.


The Lancet ◽  
2006 ◽  
Vol 367 (9508) ◽  
pp. 404-411 ◽  
Author(s):  
C Heneghan ◽  
P Alonso-Coello ◽  
JM Garcia-Alamino ◽  
R Perera ◽  
E Meats ◽  
...  

2014 ◽  
Vol 30 (8) ◽  
pp. 879-887 ◽  
Author(s):  
Daniel Caldeira ◽  
Maria José Loureiro ◽  
João Costa ◽  
Fausto J. Pinto ◽  
Joaquim J. Ferreira

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Catiane Costa Viana ◽  
Marcus Fernando da Silva Praxedes ◽  
Waleska Jaclyn Freitas Nunes de Sousa ◽  
Frederico Bartolazzi ◽  
Mayara Sousa Vianna ◽  
...  

Introduction: Sex-differences in the quality of oral anticoagulation control have been reported,although with controversial evidence. Our hypothesis was that sex would be associated withoral anticoagulation control. We performed a systematic review and meta-analysis to investigatethis association. Methods: We searched for studies on MEDLINE, BVS, CINAHL, EMBASE,Cochrane and Web of Science. We included observational and experimental studies withparticipants aged >18 years of both sexes, on oral anticoagulation with warfarin or othercoumarin derivatives indicated for long-term use. The outcome of interest was time intherapeutic range (TTR), calculated by the Rosendaal method. We synthesized data from theselected studies and developed the meta-analysis. Odds ratios (OR) for binary variables andmean differences (MD) for continuous variables were pooled using the random-effects modelswith estimation via the DerSimonian-Laird method. Results: Thirteen studies with 89,745patients (45.08% women) were included. Nine studies were assessed in the meta-analysis frombinary variables (OR=0.89; 95% CI=0.80, 1.00; z=-1.96; p=0.05; I 2 =74%) (Fig. 1) and fourstudies with continuous variables (MD=-3.02; 95% CI=-4.43, -1.62; z=-4.22; p<0.0001; I 2 =0%)(Fig. 2). The pooled estimates indicated that women were associated with lower TTR than men. Fig. 1 Analysis of sex effect on oral anticoagulation control. Fig. 2 Analysis of sex effect on oral anticoagulation control. In conclusion, this systematic review showed that the female sex was associated with lowerTTR than male sex. Our results suggest the need for innovative strategies to improve healthcarefocused on women.


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