Browsing by Subject "anticoagulation"

Sort by: Order: Results:

Now showing items 1-6 of 6
  • Paciaroni, Maurizio; Angelini, Filippo; Agnelli, Giancarlo; Tsivgoulis, Georgios; Furie, Karen L.; Tadi, Prasanna; Becattini, Cecilia; Falocci, Nicola; Zedde, Marialuisa; Abdul-Rahim, Azmil H.; Lees, Kennedy R.; Alberti, Andrea; Venti, Michele; Acciarresi, Monica; Altavilla, Riccardo; D'Amore, Cataldo; Mosconi, Maria G.; Cimini, Ludovica A.; Bovi, Paolo; Carletti, Monica; Rigatelli, Alberto; Cappellari, Manuel; Putaala, Jukka; Tomppo, Liisa; Tatlisumak, Turgut; Bandini, Fabio; Marcheselli, Simona; Pezzini, Alessandro; Poli, Loris; Padovani, Alessandro; Masotti, Luca; Vannucchi, Vieri; Sohn, Sung-Il; Lorenzini, Gianni; Tassi, Rossana; Guideri, Francesca; Acampa, Maurizio; Martini, Giuseppe; Ntaios, George; Karagkiozi, Efstathia; Athanasakis, George; Makaritsis, Kostantinos; Vadikolias, Kostantinos; Liantinioti, Chrysoula; Chondrogianni, Maria; Mumoli, Nicola; Consoli, Domenico; Galati, Franco; Sacco, Simona; Carolei, Antonio; Tiseo, Cindy; Corea, Francesco; Ageno, Walter; Bellesini, Marta; Silvestrelli, Giorgio; Ciccone, Alfonso; Scoditti, Umberto; Denti, Licia; Mancuso, Michelangelo; Maccarrone, Miriam; Orlandi, Giovanni; Giannini, Nicola; Gialdini, Gino; Tassinari, Tiziana; De Lodovici, Maria Luisa; Bono, Giorgio; Rueckert, Christina; Baldi, Antonio; Toni, Danilo; Letteri, Federica; Giuntini, Martina; Lotti, Enrico M.; Flomin, Yuriy; Pieroni, Alessio; Kargiotis, Odysseas; Karapanayiotides, Theodore; Monaco, Serena; Baronello, Mario M.; Csiba, Laszlo; Szabo, Lilla; Chiti, Alberto; Giorli, Elisa; Del Sette, Massimo; Imberti, Davide; Zabzuni, Dorjan; Doronin, Boris; Volodina, Vera; Pd-Mer, Patrik Michel; Vanacker, Peter; Barlinn, Kristian; Pallesen, Lars P.; Kepplinger, Jessica; Deleu, Dirk; Melikyan, Gayane; Ibrahim, Faisal; Akhtar, Naveed; Gourbali, Vanessa; Yaghi, Shadi; Caso, Valeria (2019)
    Background The relationship between different patterns of atrial fibrillation and early recurrence after an acute ischaemic stroke is unclear. Purpose In a prospective cohort study, we evaluated the rates of early ischaemic recurrence after an acute ischaemic stroke in patients with paroxysmal atrial fibrillation or sustained atrial fibrillation which included persistent and permanent atrial fibrillation. Methods In patients with acute ischaemic stroke, atrial fibrillation was categorised as paroxysmal atrial fibrillation or sustained atrial fibrillation. Ischaemic recurrences were the composite of ischaemic stroke, transient ischaemic attack and symptomatic systemic embolism occurring within 90 days from acute index stroke. Results A total of 2150 patients (1155 females, 53.7%) were enrolled: 930 (43.3%) had paroxysmal atrial fibrillation and 1220 (56.7%) sustained atrial fibrillation. During the 90-day follow-up, 111 ischaemic recurrences were observed in 107 patients: 31 in patients with paroxysmal atrial fibrillation (3.3%) and 76 with sustained atrial fibrillation (6.2%) (hazard ratio (HR) 1.86 (95% CI 1.24-2.81)). Patients with sustained atrial fibrillation were on average older, more likely to have diabetes mellitus, hypertension, history of stroke/ transient ischaemic attack, congestive heart failure, atrial enlargement, high baseline NIHSS-score and implanted pacemaker. After adjustment by Cox proportional hazard model, sustained atrial fibrillation was not associated with early ischaemic recurrences (adjusted HR 1.23 (95% CI 0.74-2.04)). Conclusions After acute ischaemic stroke, patients with sustained atrial fibrillation had a higher rate of early ischaemic recurrence than patients with paroxysmal atrial fibrillation. After adjustment for relevant risk factors, sustained atrial fibrillation was not associated with a significantly higher risk of recurrence, thus suggesting that the risk profile associated with atrial fibrillation, rather than its pattern, is determinant for recurrence.
  • Mustanoja, Satu; Metso, Tiina M.; Putaala, Jukka; Heikkinen, Noora; Haapaniemi, Elena; Salonen, Oili; Tatlisumak, Turgut (2015)
    BackgroundCervical artery dissection (CeAD) patients with or without stroke are frequently treated with either antiplatelet agents or vitamin K antagonists (VKAs), but few data are reported on the use of nonvitamin K oral anticoagulants (NOACs). MethodsBetween November 2011 and January 2014, we recorded data from patients with a stroke due to vertebral (VAD) or internal carotid artery dissection (ICAD). Patients using oral anticoagulants were included in the study and were divided into two treatment groups: patients using NOACs and those using VKAs. Excellent outcome was defined on modified Rankin Scale (mRS) 1 at 6months. ResultsOf 68 stroke patients (67% male; median age 45 [39-53]), six (8.8%; two with VAD and four with ICAD) were treated with NOACs: three with direct thrombin inhibitor dabigatran and three with direct factor Xa inhibitor rivaroxaban. National Institutes of Health Stroke Scale score at baseline was 4 (3-7) in the NOAC versus 2 (1-7) in the VKA groups. Complete recanalization at 6months was seen in most patients in the NOAC (n=5; 83%) and VKA (n=34; 55%) groups. All the patients using NOACs had mRS 1 at 6months and none had an intracerebral hemorrhage (ICH). In the VKA group most patients (n=48; 77%) had mRS 1, one patient (1.7%) had an ICH and one died. ConclusionsIn this small, consecutive single-center patient sample treating ischemic stroke patients with CeAD with NOACs did not bring up safety concerns and resulted in similar, good outcomes compared to patients using VKAs.
  • Itäinen-Strömberg, Saga; Hekkala, Anna-Mari; Aro, Aapo L.; Vasankari, Tuija; Airaksinen, Kari Eino Juhani; Lehto, Mika (2020)
    Background Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used in patients with atrial fibrillation (AF) undergoing elective cardioversion (ECV). The aim was to investigate the use of NOACs and warfarin in ECV in a real-life setting and to assess how the chosen regimen affected the delay to ECV and rate of complications. Methods Consecutive AF patients undergoing ECVs in the city hospitals of Helsinki between January 2015 and December 2016 were studied. Data on patient characteristics, delays to cardioversion, anticoagulation treatment, acute ( Results Nine hundred patients (59.2% men; mean age, 68.0 +/- 10.0) underwent 992 ECVs, of which 596 (60.0%) were performed using NOACs and 396 (40.0%) using warfarin. The mean CHA(2)DS(2)-VASc score was 2.5 (+/- 1.6). In patients without previous anticoagulation treatment, NOACs were associated with a shorter mean time to cardioversion than warfarin (51 versus. 68 days, respectively; p <.001). Six thromboembolic events (0.6%) occurred: 4 (0.7%) in NOAC-treated patients and 2 (0.5%) in warfarin-treated patients. Clinically relevant bleeding events occurred in seven patients (1.8%) receiving warfarin and three patients (0.5%) receiving NOACs. Anticoagulation treatment was altered for 99 patients (11.0%) during the study period, with the majority (88.2%) of changes from warfarin to NOACs. Conclusions In this real-life study, the rates of thromboembolic and bleeding complications were low in AF patients undergoing ECV. Patients receiving NOAC therapy had a shorter time to cardioversion and continued their anticoagulation therapy more often than patients on warfarin.
  • Isokuortti, Harri; Iverson, Grant L.; Posti, Jussi P.; Ruuskanen, Jori O.; Brander, Antti; Kataja, Anneli; Nikula, Milaja; Öhman, Juha; Luoto, Teemu M. (2021)
    Background: Serotonergic antidepressants may predispose to bleeding but the effect on traumatic intracranial bleeding is unknown.Methods: The rate of intracranial bleeding in patients with antidepressant medication was compared to patients not antidepressants in a cohort of patients with acute head injury. This association was examined by using a consecutive cohort of head trauma patients from a Finnish tertiary center emergency department (Tampere University Hospital, Tampere, Finland). All consecutive (2010-2012) adult patients (n = 2,890; median age = 58; male = 56%, CT-positive = 22%, antithrombotic medication users = 25%, antidepressant users = 10%) who underwent head CT due to head trauma in the emergency department were included.Results: Male gender, GCS
  • Taanila, Anette (Helsingfors universitet, 2017)
    Cancer patients have a manifold risk of suffering from both thrombotic events and anticoagulation-related bleeding complications. For this reason, knowledge of their adequate medication is crucial. The aims of this study were to find out are guidelines being followed regarding the treatment of venous thromboembolisms. The emphasis was on the anticoagulation therapy of cancer patients, but also non-cancer patients were analyzed as controls. Data was collected from the clinical information system Uranus CGI. All patient records (with the diagnostic codes I26.0, I67.6, I74.3, I80*, I81*, I83*, K55, N28.0, 022.3) in the hospital district of Helsinki and Uusimaa (Jorvi, Meilahti, Peijas, Lohja, Porvoo, Tammisaari and Hyvinkää hospitals) during the time period 1.1.2014- 29.4.2016 were reviewed. Statistical analysis was performed using the IBM SPSS Statistics and Microsoft Excel computer softwares. The study included 1667 patients, out of whom 163 (9.8%) had active cancer. The recommendation of using low molecular weight heparins as the primary anticoagulants for patients with malignancies has been practiced. More research is necessary in order to find the optimal duration for treatment of, especially, isolated calf muscle venous thromboses and cancer patients' superficial thrombophlebitides.