ITEMS IN AFP WITH KEYWORD:
The American College of Chest Physicians provides recommendations for the use of anticoagulant medications for several indications that are important in the primary care setting. Warfarin, a vitamin K antagonist, is recommended for the treatment of venous thromboembolism and for the prevention of st...
How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional superiority trials.
Aug 1, 2011 Issue
Self-Monitoring and Self-Management of Anticoagulation Therapy [Cochrane for Clinicians]
Self-monitoring and self-management of long-term oral anticoagulation therapy reduce the risks of thromboembolism, all-cause mortality, and minor hemorrhage for appropriately selected patients.
A previous venous thromboembolism is the most important risk factor for predicting recurrence of the condition. Several studies have shown that routine testing for inherited thrombophilias is not helpful in predicting the risk of recurrence or altering treatment decisions, and therefore is not cost-...
Mar 15, 2010 Issue
Predicting the Risk of Bleeding in Patients Taking Warfarin [Point-of-Care Guides]
When considering anticoagulation therapy in patients with atrial fibrillation or venous thromboembolism (VTE), physicians and patients must balance the benefits of anticoagulation with the risk of bleeding, particularly major bleeding complications. For example, in patients who are at high risk of b...
Jul 1, 2009 Issue
Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer [Cochrane for Clinicians]
Although LMWH appears to be more effective than oral anticoagulants in the prevention of recurrent VTE, this does not translate into a survival benefit. LMWH and oral anticoagulants have the same reported adverse events of bleeding and thrombocytopenia.
Apr 1, 2009 Issue
Heparins for Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction [Cochrane for Clinicians]
Compared with standard therapy with aspirin, the use of heparin does not reduce mortality, the need for revascularization, and recurrent angina. Heparin does reduce the occurrence of myocardial infarction (MI; number needed to treat [NNT] = 33), defined as “typical chest pain associated with the app...
Is weight-based unfractionated heparin as good as weight-based low-molecular-weight heparin for outpatient treatment of venous thromboembolism? Even though this study was underpowered to prove equivalence, treatment with subcutaneous unfractionated heparin is a viable option.
Compared with antiplatelet therapy, oral anticoagulation significantly reduces stroke at an average follow-up of one to three years, but does not reduce mortality. Intracranial or extracranial hemorrhage is more common with anticoagulation and must be weighed against its therapeutic benefit.
The Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy provides guidelines for outpatient management of anticoagulation therapy. The ACCP guidelines recommend short-term warfarin therapy, with the goal of maintaining an International Normalized ...