scholarly journals Comparison of Novel Oral Anticoagulants and Vitamin K Antagonists in Patients With Cerebral Venous Sinus Thrombosis on Efficacy and Safety: A Systematic Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Hongjie Li ◽  
Meiling Yao ◽  
Songjie Liao ◽  
Jingyan Chen ◽  
Jian Yu
Keyword(s):  
Vitamin K ◽  
Sinus Thrombosis ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Novel Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Venous Sinus Thrombosis ◽  
Significant Difference

Vitamin K antagonists (VKAs) are guideline-suggested subacute anticoagulants for cerebral venous sinus thrombosis (CVST), although there is potential hemorrhage risk in clinical use. In the last decade, novel oral anticoagulants (NOACs) have been applied as an alternative to VKAs in some kinds of thromboembolic diseases. Whether NOACs could replace VKAs in CVST treatment remains unclear. We conducted a comparison between the two types of medicines on efficacy and safety for the treatment of CVST based on the present clinical evidence from a literature search. Six studies [four retrospective studies, one prospective study, and 1 randomized clinical trial (RCT)] including 398 patients were included. Data suggested no significant difference between NOACs and VKAs in terms of recurrence of venous thrombotic events (VTEs) or death [risk ratio (RR) = 0.34, 95% confidence interval (CI) 0.06–1.98], partial recanalization (RR = 0.97, 95% CI 0.93–1.14), and overall hemorrhage events (RR = 0.86, 95% CI 0.47–1.58). In conclusion, the application of NOACs for CVST is similar to that of VKAs in terms of efficacy and safety.

scholarly journals Case Report: Cerebral Venous Sinus Thrombosis and COVID-19 Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Manasa Anipindi ◽  
Amanda Scott ◽  
Li Joyce ◽  
Salman Wali ◽  
Mark Morginstin
Keyword(s):  
Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Oral Anticoagulants ◽  
Endothelial Activation ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Initial Symptom ◽  
Venous Sinus Thrombosis ◽  
High Index Of Suspicion ◽  
The Brain

Coronavirus disease-2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus). Coronavirus disease-2019 (COVID-19) was declared a pandemic in March 2020 and has changed our lives in many ways. This infection induces a hypercoagulable state leading to arterial and venous thrombosis, but the exact pathophysiology of thrombosis is unknown. However, various theories have been postulated including excessive cytokine release, endothelial activation, and disseminated intravascular coagulation (DIC). We present a patient diagnosed with cerebral venous sinus thrombosis (CVST) with COVID-19 infection. A 66-year-old man presented to a hospital for evaluation of persistent headaches. He tested positive for COVID-19, and MRI of the brain and CT venogram revealed CVST. He was started on heparin drip in the hospital and transitioned to oral anticoagulants at the time of discharge. His headaches improved with treatment. Even though headache is the most frequent and initial symptom of cerebral venous thrombosis, it is rarely the only symptom. A high index of suspicion is therefore required to diagnose CVST especially if the patient presents with a simple complaint like a headache. Common complaints can delay the diagnosis leading to disease progression. Considering the high mortality rates in patients diagnosed with CVST, we suggest the importance of knowing the association between COVID-19 infection and CVST, especially in susceptible patients.

scholarly journals Efficacy and safety of novel oral anticoagulants versus vitamin K antagonists in the treatment of venous thromboembolism

2018 ◽  
Vol 13 (3) ◽  
pp. 273
Author(s):  
Maodi Xu ◽  
Qingquan Xue ◽  
Zhichen Pu ◽  
Zijing Wu ◽  
Haitang Xie
Keyword(s):  
Venous Thromboembolism ◽  
Vitamin K ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
New Oral Anticoagulants ◽  
Novel Oral Anticoagulants ◽  
Efficacy And Safety ◽  
Bleeding Events ◽  
The Difference

<p>The aim of this meta-analysis was to systematically evaluate the efficacy and safety of novel oral anticoagulants and vitamin K antagonists in the treatment of venous thromboembolism. A total of 6 studies met the inclusion criteria and a total of 19,350 patients with venous thromboembolism were included. Among them, rivaroxaban (3 RCTs, n=90/3,449/4,832); dabigatran (2 RCTs, n=200/2,539); edoxaban (1 RCT, n=8,240). The results of meta-analysis showed that the total bleeding rate after treatment with the vitamin K antagonist group was higher than with the new oral anticoagulant group (OR=0.82, 95% confidence interval 0.75-0.90, p&lt;0.0001), and the difference was highly statistically significant. Overall, new oral anticoagulants are compara-ble to vitamin K antagonists, but new oral anticoagulants can reduce the occurrence of bleeding events and the safety was superior to vitamin K antagonists.</p>

scholarly journals Clinical associations, biological risk factors and outcomes of cerebral venous sinus thrombosis

2016 ◽  
Vol 44 (6) ◽  
pp. 1454-1461 ◽  
Author(s):  
Hafize Nalan Gunes ◽  
Burcu Gokce Cokal ◽  
Selda Keskin Guler ◽  
Tahir Kurtulus Yoldas ◽  
Umit Yavuz Malkan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sinus Thrombosis ◽  
Cerebral Venous Sinus Thrombosis ◽  
Venous Sinus ◽  
Common Symptom ◽  
Venous Sinus Thrombosis ◽  
Hospitalization Period ◽  
Wide Range ◽  
Significant Difference ◽  
Clinical Associations

Objective Cerebral venous sinus thrombosis (CVST) is a rare cerebrovascular disease affecting young adults. The majority of the patients are female. The aim of this study is to assess the clinical associations, risk factors and outcomes of the patients with CVST. Methods The data of 75 patients with CVST admitted to our hospital between 2006 and 2016 were reviewed. Demographic and clinical features and the thrombophilic risk factors of the patients were recorded. The localizations of the thrombi were determined and modified Rankin score at the time of onset and discharge were calculated. Results The majority of our patients (78.7%) were female. Median age was 35 years (16–76). The most common symptom was headache (86.7%). In 82.6% of our patients, inherited or acquired risk factors for thrombosis were detected. Transverse sinus was the most common site of thrombosis followed by sigmoid and superior sagittal sinuses. Two thirds of the patients had involvement of multiple sinuses. The patients with the involvement of sagittal sinus had better disability at the time of admittance ( p = 0.013) while the number of involved sinuses was correlated worse disability ( p = 0.015). The neurologic states in the majority of the patients were improved by the end of the hospitalization period ( p = 0.001). There was no significant difference in disability score at discharge between men and women ( p = 0.080). No patient with CVST died in the hospitalization period. Conclusions This study is one of the largest cohort studies on CVST in our region. The results of the study disclosed that CVST had wide range of clinical manifestations and non-specific symptoms at the beginning. For that reason, in especially high risk groups for thrombosis, the diagnosis of CVST should be kept in mind.

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