scholarly journals Anticoagulation Treatment for Patients with Coronavirus disease 2019 (COVID-19) and its clinical effectiveness in 2020: A meta-analysis study

2021 ◽  
Author(s):  
Jingyi Ge ◽  
Yingmin Ma ◽  
Zhipeng Wu ◽  
Jiawei Jin ◽  
Xiao Sun
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Risk ◽  
Cochrane Library ◽  
Vein Thrombosis ◽  
Therapeutic Anticoagulation ◽  
Significant Difference ◽  
Current Outbreak ◽  
Prophylactic Anticoagulation ◽  
And Control ◽  
Deep Vein

Abstract Objective To better inform efforts to treat and control the current outbreak with effective anticoagulant treatment strategies for coronavirus disease 2019 (Covid-19) patients. Methods We searched Cochrane Library, Pubmed, EMBASE, MEDLINE, SCIEXPANDED, Web of Science, Google Scholar, CNKI (Chinese Database), WanFang (Chinese Database), CBM (Chinese Database), VIP (Chinese Database) for studies published from November 1st 2019 to October 1, 2020, and we searched references of identified articles. Studies were reviewed for methodological quality. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Publication bias was assessed using funnel plot. Results Fourteen studies involving 7,681 patients were included. We meta-analyzed the bleeding, deep vein thrombosis and pulmonary embolism risk between no anticoagulation and prophylactic anticoagulation, and found no significant difference. The same trend occurred in the comparison between with and without anticoagulation. However, when compared with no anticoagulation, both prophylactic anticoagulation (OR = 0.80, 95%CI: 0.69–0.93) and therapeutic anticoagulation (OR = 0.91, 95%CI: 0.80–1.05) had lower risk of mortality. Furthermore, the risk of overall bleeding among patients with therapeutic anticoagulation was 3.11 times (95% CI: 2.29–4.24) than that of patients with prophylactic anticoagulation, on the contrary, therapeutic anticoagulation had lower risk of deep vein thrombosis than prophylactic anticoagulation (OR = 0.34, 95%CI: 0.19–0.63). Conclusions Among Covid-19 patients, preventive and therapeutic anticoagulation were more beneficial than no anticoagulation for reducing mortality risk. The result will inform healthcare providers and public health policy makers in their efforts to treat and control the current outbreak.

scholarly journals Pharmacomechanical Thrombectomy Versus Catheter-Directed Thrombolysis for Iliofemoral Deep Vein Thrombosis: A Meta-Analysis of Clinical Trials

2019 ◽  
Vol 25 ◽  
pp. 107602961882119 ◽  
Author(s):  
Tao Tang ◽  
Linyi Chen ◽  
Jinhui Chen ◽  
Tong Mei ◽  
Yongming Lu
Keyword(s):  
Clinical Trials ◽  
Deep Vein Thrombosis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Minor Bleeding ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference ◽  
Deep Vein

Early catheter-directed thrombolysis (CDT) for deep vein thrombosis (DVT) can reduce postthrombotic morbidity. Pharmacomechanical thrombolysis (PMT) is a new therapy that can be selected for the treatment of iliofemoral deep vein thrombosis (IFDVT). We performed a meta-analysis of clinical trials comparing PMT versus CDT for treatment of acute IFDVT. Literature on this topic published between January 1, 1990, and June 1, 2018, was identified using PubMed, Embase, Cochrane Library, and Web of Science. Six trials were included in the meta-analysis. Compared to CDT, PMT significantly reduced the Villalta score ( P = .007; I2 = 0%), thrombus score ( P = .01; I2 = 0%), the duration in the hospital ( P = .03; I2 = 64%), and thrombolysis time ( P < .00001, I2 = 0%). There was no significant difference in valvular incompetence events ( P = .21; I2 = 0%), minor bleeding events ( P = .59; I2 = 0%), stent events ( P = .09; I2 = 24%), and clot reduction grade I events ( P = .16; I2 = 43%) between PMT and CDT. Subgroup analysis was performed by dividing the clot reduction grade I events group into PMT plus CDT versus CDT group and significant differences were found ( P = .03, I2 = 0%) as well as for PMT alone versus CDT group ( P = .88, I2 = 37%). This meta-analysis shows that PMT reduces the severity of postthrombotic syndrome (PTS), thrombus score, duration in hospital, and thrombolysis time compared to CDT. More specifically, PMT plus CDT reduces clot reduction grade I events. No significant difference in valvular incompetence events, stent events, and minor bleeding events were found when PMT was compared to CDT.

Combination Prophylaxis versus Pharmacologic Prophylaxis Alone for Preventing Deep Vein Thrombosis in Hip Surgery

2016 ◽  
Vol 26 (6) ◽  
pp. 561-566
Author(s):  
Feng-Fei Lin ◽  
Chao-Hui Lin ◽  
Bin Chen ◽  
Ke Zheng
Keyword(s):  
Deep Vein Thrombosis ◽  
Hip Surgery ◽  
Cochrane Library ◽  
Comparative Efficacy ◽  
Compression Stockings ◽  
Pharmacological Prophylaxis ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Pharmacologic Prophylaxis ◽  
Deep Vein

Purpose To evaluate the comparative efficacy and safety of combination pharmacologic and graduated compression stockings (GCS) prophylaxis versus pharmacological prophylaxis alone for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in hip surgery. Methods Relevant publications indexed in PubMed, Cochrane Library, Embase, Web of Science, Wanfang Data, CNKI and Sinomed (CBM) were identified. Appropriate articles identified from the reference lists of the above searches were also reviewed. Results Significant differences in the rate of distal DVT were observed between combination prophylaxis and pharmacological groups. When data from Fredin 1989 was excluded no significant difference in the rate of distal DVT was seen between groups. No significant difference in the rate of proximal DVT or PE was observed between combination and pharmacologic prophylaxis groups. Conclusions A combination of pharmacological prophylaxis and GCS can decrease distal DVT in the lower extremity when compare to pharmacological prophylaxis alone, but it is not useful in decreasing proximal DVT and PE. If we use currently recommended pharmacologic prophylaxis it is not necessary to combine this with GCS.

P6461The long-term clinical comparisons of symptomatic patients of pulmonary embolism with and those without deep vein thrombosis: from the COMMAND VTE Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Murata ◽  
Y Yamashita ◽  
T Morimoto ◽  
H Amano ◽  
T Takase ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Acute Phase ◽  
Clinical Presentation ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Severe Clinical Presentation ◽  
Recurrent Vte ◽  
Deep Vein

Abstract Background Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), has significant morbidity and mortality. Acute PE, in particular, is fatal if we miss it, and symptomatic patients of PE sometimes have concomitant DVT. Purpose This study compared the risk of mortality in symptomatic patients of PE with and those without DVT in the long term. Methods The COMMAND VTE Registry is a multicenter registry enrolling consecutive 3027 patients with acute symptomatic VTE objectively confirmed by imaging examination or by autopsy among 29 centers in Japan between January 2010 and August 2014. Patients with both PE and DVT (N=1334) were regarded as PE patients, and the current study population consisted of 1715 PE patients and 1312 DVT patients. Results There were 1203 symptomatic patients of PE, including 381 without and 822 with DVT. In our cohort, the mean age was 67.9±14.9 years, 63% was female, 44% had hypertension, 12% diabetes mellitus, 5% history of VTE. There were 20% of active cancer. Baseline characteristics were well matched except for dyslipidemia (18% vs. 23%, p=0.021) and atrial fibrillation (8% vs. 5%, p=0.045). Patients without DVT had a more severe clinical presentation compared to those with DVT, including hypoxemia, shock and arrest. Moreover, Initial parenteral anticoagulation therapy in the acute phase was administered less frequently in patients without DVT (89% vs. 96%, P=0.0001). Two groups received thrombolysis (20% vs. 26%, P=0.18) and mechanical supports (Ventilator 14% vs. 5%, p<0.001, PCPS 5% vs. 3%, p<0.001, respectively). During follow-up, 93 (8%) patients experienced recurrent VTE events and 98 (8%) major bleeding events, and 323 (27%) patients died. The most frequent cause of death was cancer (11%). There were a significant differences in the cumulative incidences of all-cause death between the groups (32% vs. 24%, P=0.006), whereas there was significant difference in VTE-related death (13% vs. 4%, p<0.001). Estimated freedom rates from death for patients of PE without and those with DVT were as follows: 88% vs 99% at 10-day, 86% vs 95% at 1-month, 75% vs 83% at 1-year, and 64% vs 71% at 5-year, respectively. Landmark analysis Conclusions In symptomatic patients of PE, there was a difference in mortality between groups, but no difference in recurrent VTE. Patients without DVT had a more severe clinical presentation compared to those with DVT, and many VTE-related deaths in the acute phase. The one-month mortality rate differed statistically between groups, but there was no significant difference in long-term survival beyond one month. Most of deaths were due to underlying diseases, mainly cancer, and less commonly due to VTE in the long term. Acknowledgement/Funding Research Institute for Production Development, Mitsubishi Tanabe Pharma Corporation

Comparative Study of Deep Vein Thrombosis Recanalization Using Doppler Ultrasound in Different Post-Treatment Intervals in Traumatic Patients

2022 ◽  
Author(s):  
Nazanin Farshchian ◽  
Negin Farshchian ◽  
Parisa Bahrami Kamangar
Keyword(s):  
Deep Vein Thrombosis ◽  
Doppler Ultrasound ◽  
Statistical Tests ◽  
Significance Level ◽  
Sonographic Diagnosis ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
High Incidence ◽  
Deep Vein ◽  
Comparative Examination

Deep vein thrombosis (DVT) is a prevalent vascular disease characterized by pelvic and limb deep vein thrombophlebitis, and it has a high incidence in traumatic patients. Contrary to older studies, recent research has reported that recanalization in DVT is not a slow process. The present study aimed at the comparative examination of DVT recanalization with Doppler ultrasound in different intervals following treatment with heparin or enoxaparin. This prospective study was conducted on all traumatic patients hospitalized in Imam Reza Hospital of Kermanshah, Iran, with the clinical and sonographic diagnosis of DVT in limb veins. Doppler ultrasound was performed two weeks, one month, and three months following treatment in order to examine recanalization. Data were analyzed using statistical tests in SPSS16 at the significance level of <0.05. Based on Doppler ultrasound, a significant difference was found between the degree of recanalization in patients aged <45 years and those aged >45 years, between male and female patients, and between different DVT locations (P<0.05). After three months of treatment with heparin and enoxaparin, the degree of recanalization was increased in DVT. Moreover, it was found that Doppler ultrasound is a useful tool for the diagnosis of recanalization in patients with DVT.

scholarly journals Prophylactic anticoagulant therapy decreases the incidence of deep vein thrombosis in patients with solid tumors: A systematic review and meta-analysis

2017 ◽  
Vol 7 (1) ◽  
pp. 35
Author(s):  
Yunjiao Zhou ◽  
Gong Yang ◽  
Chenglei Huang
Keyword(s):  
Systematic Review ◽  
Deep Vein Thrombosis ◽  
Solid Tumors ◽  
Risk Ratio ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Bleeding Events ◽  
Vein Thrombosis ◽  
And Control ◽  
Deep Vein

It is not well understood the efficacy and safety of primary deep vein thrombosis (DVT) prophylaxis of anticoagulants in patients with solid tumors. This systematic review and meta-analysis of randomized controlled trials (RCT) determines the relative ratio of primary DVT, survival rate and bleeding events among patients with solid tumors treated with anticoagulants or placebo. Comprehensive literature searches were conducted through the Pubmed, Ovid MEDLINE and EMBASE databases published from January 1st, 1993 to December 31st, 2015. Statistical analysis was performed by RevMan 5.0 software. For DVT events, therisk ratio in 16 trials between the prophylactic and control patients was statistically significant at 0.45 [0.36-0.58]; for major bleeding events, the risk ratio in 18 trials between the prophylactic and control patients was not statistically significant at 1.33 [0.99-1.79], while that in 15 trials with clinically relevant non-major bleeding was statistically significant at 1.83 [1.46-2.30]; the risk ratio for the mortality rate of patients with solid tumors in 16 trials was not statistically significant at 0.97 [0.93-1.02]. Inconclusion, the risk ratio in this meta-analysis showed a significantly reduced incidence of DVT with anticoagulant use. Treatment to patients who had solid tumors with prophylactic anticoagulants enhanced the incidence rate of non-major bleeding but has no significant impact on the incidence rate of major bleeding. No significant differences were found in the mortality outcomes between anticoagulant and non-anticoagulant groups.

scholarly journals Massive Pulmonary Embolism after a Short Episode of Physical Restraint in an Adolescent Psychiatric Patient

2019 ◽  
Vol 08 (04) ◽  
pp. 247-250 ◽  
Author(s):  
Alexander Leibold ◽  
Michael Melter ◽  
Christian Doerfler ◽  
Samra Alikadic ◽  
Markus Zimmermann ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Psychiatric Patients ◽  
Physical Restraint ◽  
Massive Pulmonary Embolism ◽  
Additional Risk ◽  
Vein Thrombosis ◽  
Prophylactic Anticoagulation ◽  
Deep Vein ◽  
Major Adverse Events ◽  
Short Episode

AbstractMedical restraints, when used for short periods of time, can pose additional risk for deep vein thrombosis in adolescent psychiatric patients. The problem is often unrecognized, and there is a lack of awareness of this potential risk. However, as associated major adverse events may result in fatal outcomes, an individual patient's risk for deep vein thrombosis should be assessed and prophylactic anticoagulation may be indicated.

Optimization of ascending phlebography of the leg for screening of deep vein thrombosis in thromboprophylactic trials

1997 ◽  
Vol 38 (2) ◽  
pp. 320-326 ◽  
Author(s):  
P. Kälebo ◽  
B.-A. Anthmyr ◽  
B. I. Eriksson ◽  
B. E. Zachrisson
Keyword(s):  
Deep Vein Thrombosis ◽  
Screening Method ◽  
Clinical Suspicion ◽  
Vein Thrombosis ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Venous Filling ◽  
Anterior Tibial ◽  
Deep Vein ◽  
Better Than

Purpose: Comparison of 2 phlebographic techniques in achieving adequacy of deep venous filling. Material and Methods: Sixty consecutive patients with a clinical suspicion of deep vein thrombosis (DVT) were examined by 2 different techniques, A according to GREITZ and B according to LEA THOMAS. All deep veins were scored according to a protocol as DVT, normal or inadequate. Venous evaluability and DVT rates were compared. Bilateral phlebograms according to the A-technique from 92 asymptomatic patients in a different trial were reviewed to allow comparison with the symptomatic subjects. Results: the A-technique resulted in a significantly higher degree of overall evalu-able patients compared to the B-technique, 95% vs 47%. A vein-by-vein analysis showed that the A-technique was significantly better than the B-technique in filling the gastrocnemius muscular (82% vs 38%), anterior tibial (85% vs 43%), and deep femoral (28% vs 18%) veins. No significant difference was found in the other veins. the DVT rates were 42% and 40% respectively for the A- and B-techniques. About 94% of the phlebograms in the asymptomatic patients were adequate. Conclusion: the A-technique resulted in better venous opacification and would seem to be a more suitable screening method for asymptomatic persons.

Metabolic Syndrome and the Incidence of Symptomatic Deep Vein Thrombosis Following Total Knee Arthroplasty

2009 ◽  
Vol 36 (10) ◽  
pp. 2298-2301 ◽  
Author(s):  
RAJIV GANDHI ◽  
FAHAD RAZAK ◽  
PEGGY TSO ◽  
J. RODERICK DAVEY ◽  
NIZAR N. MAHOMED
Keyword(s):  
Metabolic Syndrome ◽  
Deep Vein Thrombosis ◽  
Symptomatic Deep Vein Thrombosis ◽  
Joint Registry ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Total Knee ◽  
Prophylactic Anticoagulation ◽  
Relationship Of ◽  
Deep Vein

Objective.We asked if patients with metabolic syndrome undergoing total knee replacement (TKR) have an increased risk for symptomatic deep vein thrombosis (DVT) at 3 months followup.Methods.We reviewed 1460 patients from our joint registry undergoing primary, unilateral TKR between 1998–2006. Demographic variables of age, sex, comorbidity, and education were retrieved. Metabolic syndrome was defined as body mass index above 30 kg/m2, diabetes, hypertension, and hypercholesterolemia. Logistic regression was used to examine the relationship of metabolic syndrome on the incidence of DVT.Results.The overall incidence of symptomatic DVT was 4.4% (65/1460). Patients with metabolic syndrome had an increased incidence of DVT compared to those without metabolic syndrome (15.5% vs 3.4%). Adjusted analysis showed that the risk of symptomatic DVT in patients with metabolic syndrome was 3.2 times [odds ratio 3.2, 95% CI (1.0,15.4), p = 0.04] the risk in those without metabolic syndrome.Conclusion.Hospital protocols developed for prophylactic anticoagulation following TKR should give special consideration to patients with metabolic syndrome.

All I want for coagulation

2011 ◽  
Vol 56 (4) ◽  
pp. 183-187 ◽  
Author(s):  
K P Nunn ◽  
M R Bridgett ◽  
M R Walters ◽  
I Walker
Keyword(s):  
Deep Vein Thrombosis ◽  
Cochrane Library ◽  
Evidence Based ◽  
Compression Stockings ◽  
Vein Thrombosis ◽  
Dvt Prophylaxis ◽  
Clinical Encounters ◽  
Santa Claus ◽  
The Cochrane Library ◽  
Deep Vein

Evidence-based medicine underpins modern practice of medicine. This paper describes a fictional consultation between Santa Claus and a doctor regarding deep vein thrombosis (DVT) prophylaxis, giving a review of the evidence for DVT prophylaxis in travellers while exposing the difficulty in applying evidence to atypical clinical encounters. Medline and the Cochrane Library were searched, and guidelines reviewed. Keywords used were DVT, thromboembolism, deep vein thrombosis and air travel-related venous thromboembolism. All relevant studies found, have been included in this review, with additional studies identified from the references in these articles. In conclusion, compression stockings, with or without a one-off dose of either aspirin or heparin, are the most evidence-based approaches for prophylaxis in someone with established risk factors for DVT prior to a long-haul flight. Simple exercises should also be encouraged.

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