Vitamin K antagonists (VKA) have been the standard for the treatment and prevention of thromboembolism in patients with atrial fibrillation, venous thromboembolism and prosthetic heart valves for more than 50 years. In 2004, more than 30 million prescriptions for warfarin were written in the United States (1). VKA are subject to significant dietand drug-drug interactions; therefore, it is not s...

BACKGROUND Intracranial haemorrhage (ICH) is a serious and potentially fatal complication of oral anticoagulant therapy (OAT). Prothrombin complex concentrates (PCCs) produce a rapid and effective reversal of OAT effects, but little evidence exists on their efficacy and safety in the management of ICH in patients on OAT. AIM To evaluate the efficacy and safety of PCCs for the rapid reversal o...

Author details 1Haemostasis Research Unit, Centre for Haemostasis and Thrombosis, Department of Haematology and Oncology, Guy’s and St Thomas’ Hospital & NHS Trust Foundation, King’s College London School of Medicine, 1st Floor, North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH, UK. 2Institute of Anesthesiology, University Hospital Zurich, CH-8091 Zurich, Switzerland. 3De...

BACKGROUND Fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC) reverse oral anticoagulants. We compared PCC and FFP intraoperative administration in patients undergoing heart surgery with cardiopulmonary bypass (CPB). METHODS Forty patients [with international normalized ratio (INR)≥ 2·1] assigned semi-urgent cardiac surgery were randomized to receive either FFP (n = 20) or P...

Stroke Notes nial CT at 09: 43 revealed an ICH of 17 ml volume (fig. 1 a). We immediately administered 1,500 units of prothrombin complex concentrates (PCC) within 15 min. However, despite an INR of 1.5 the patient deteriorated within 1 h. CT at 10: 59 revealed an expansion of the hematoma to a volume of 84 ml (fig. 1 b). At this time, we also detected a spot sign within the hemorrhage on CTA s...

Acquired haemophilia (AH) is a severe bleeding diathesis that affects both males and females. It is caused by suddenly appearing autoantibodies that interfere with coagulation factor VIII (FVIII) activity. Although some conditions such as autoimmune diseases, cancer and puerperium seem likely to induce AH, in more than half of the observed cases autoantibodies to FVIII are idiopathic. The clini...

BACKGROUND In people with haemophilia, therapeutic clotting agents might be recognised as a foreign protein and induce anti-FVIII antibodies, known as 'inhibitors'. Drugs insensitive to such antibodies, either recombinant or plasma-derived, are called factor VIII "by-passing" agents and used for treatment of bleeding in people with inhibitors. OBJECTIVES To determine the clinical effectivenes...