BACKGROUND The role of transesophageal echocardiography (TEE) in the evaluation of acute stroke patients is still ill-defined. We conducted a prospective observational study to find the prevalence of TEE findings that indicate anticoagulation as beneficial, in acute ischemic stroke patients without indication for anticoagulation based on clinical, electrocardiographic and transthoracic echocard...

Anticoagulation is highly effective in preventing stroke due to atrial fibrillation, but numerous studies have demonstrated low utilization of anticoagulation for these patients. Assessment of clinicians' attitudes on this topic indicate that fear of intracerebral hemorrhage (ICH), rather than appreciation of anticoagulation benefits, largely drives clinical decision-making for treatment with a...

Sixty percent of the patients going for valve replacement opt for mechanical valves and the remaining 40% choose bioprosthetics. Mechanical valves are known to have a higher risk of thrombosis; this risk further varies depending on the type of valve, its position, and certain individual factors. According to current guidelines, long-term anticoagulation is indicated in patients with metallic pr...

1 Schulman, S. (2012). Is the warfarin saga over? J R Coll Physicians Edinb 42, 51-55. 2 Ryan, F., Byrne, S., & O’Shea, S. (2008). Managing oral anticoagulation therapy: improving clinical outcomes. A review. J Clin Pharm Ther 33, 581-590. 3 Eikelboom, J.W., & Hart, R.G. (2012). Antithrombotic therapy for stroke prevention in atrial fibrillation and mechanical heart valves. Am J Hematol 87, S10...

Oral anticoagulation is the standard of care for stroke prevention in atrial fibrillation but falls short of providing an adequate solution to this common threat when considered from both efficacy and safety perspectives. Anticoagulationassociated treatment deficits include major and minor bleeding, refusal of anticoagulation based on anticoagulation risk, lack of medication adherence, personal...

Introduction Regional anticoagulation has been introduced to avoid the complications of systemic anticoagulation. The most diffuse technique for regional anticoagulation is the infusion of citrate, which exerts its anticoagulative effect by chelating calcium, an essential factor of coagulation. Despite being a “regional” anticoagulation technique, a major fraction of the infused citrate reaches...

Oral anticoagulation is pivotal in the management of thromboembolic risk in non-valvular atrial fibrillation (NVAF) patients. Effective anticoagulation is important to avoid major adverse events and medication adherence is central to achieve good anticoagulation control. Non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safe as vitamin K antagonist (VKAs) in NVAF patient...

Management of anticoagulation in elderly patients represents a particularly challenging issue. Indeed, this patient population is at high thromboembolic risk, but also at high hemorrhagic risk. Assessment of the benefit-risk balance of anticoagulation is the key point when decisions are made about introducing and/or continuing such treatments in the individual elderly patient. In order to maxim...

Benefits of pharmacists’ management and intervention regarding anticoagulation therapy management. Pharmacists play an essential role in drug adherence and medication management, and this is especially true when it comes to anticoagulation therapy management. Warfarin is widely used to for anticoagulation therapy, but requires careful monitoring and dose adjustment. Since this topic was first a...

Patients with heparin-induced thrombocytopenia (HIT) that require anticoagulation for cardiovascular procedures represent a challenging and high-risk group. Bivalirudin and argatroban have been successfully used as alternative anticoagulants in adult patients with HIT. There have been few experiences published involving the pediatric population and controversy exists regarding the properties an...