Four-Factor Prothrombin Complex Concentrate for Urgent Reversal of Vitamin K Antagonists in Patients With Major Bleeding

Quinlan, Daniel J.; Eikelboom, John W.; Weitz, Jeffrey I.

doi:10.1161/circulationaha.113.005107

Cited by 46 publications

(32 citation statements)

References 18 publications

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“…Prothrombin complex concentrates (PCCs) are a reasonable option [66,67]; nevertheless, data for PCCs are based almost exclusively on laboratory rather than clinical endpoints [68].…”

Section: Dabigatran Etexilate and The Antidotementioning

confidence: 99%

Dabigatran etexilate: appropriate use in patients with chronic kidney disease and in the elderly patients

Molteni

Minno

et al. 2017

Intern Emerg Med

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Dabigatran etexilate (DE) is a direct thrombin inhibitor, which has been approved for the treatment of non-valvular atrial fibrillation (AF), and for the prevention and treatment of venous thromboembolism (VTE). Despite large randomized clinical trials and independent observational studies providing robust data concerning DE safety and efficacy, some physicians still perceive mild-to-moderate renal impairment and old age as a relative contraindication to its use. In this article, we review the available scientific evidence supporting the use of DE in these clinical situations. Patients with AF and chronic kidney disease (CKD) are per se at high risk of stroke, bleeding and mortality. Although there is evidence of clinical benefit of anticoagulation in these patients, anticoagulant therapy requires caution and demands careful clinical monitoring, regardless of the drug used. In patients with no contraindication to its use, the clinical benefit of DE versus warfarin is independent of renal function. The elderly with AF are frequently undertreated because of the perception of high bleeding risk and limited clinical benefit. However, the clinical benefit of anticoagulation is independent of patient age, and age per se should not represent a contraindication to anticoagulation. DE has been extensively studied in the elderly, both in randomized clinical trials and in observational studies: DE 150 mg BID should not be used in patients 80 years of age or older, while DE 110 mg BID is as safe as warfarin. Intracranial haemorrhages reduction by DE compared with warfarin is preserved in the elderly. Therefore, mild and moderate CKD and being elderly should not deter physicians from prescribing DE. Furthermore, the availability of a specific antidote is expected to improve the safety of the use of DE in clinical practice.

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“…Prothrombin complex concentrates (PCCs) are a reasonable option [66,67]; nevertheless, data for PCCs are based almost exclusively on laboratory rather than clinical endpoints [68].…”

Section: Dabigatran Etexilate and The Antidotementioning

confidence: 99%

Dabigatran etexilate: appropriate use in patients with chronic kidney disease and in the elderly patients

Molteni

Minno

et al. 2017

Intern Emerg Med

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show abstract

“…¿Cuáles son las precauciones de seguridad a tener en cuenta del complejo protrombínico? El CCP se considera un fár-maco generalmente seguro a pesar de que en algunos escenarios se han recogido complicaciones, fundamentalmente de tipo trombótico 147 .…”

Section: Administración De Hemostáticosunclassified

“…Asimismo, también deben manejarse con precaución en los pacientes politraumatizados, por su riesgo a desarrollar complicaciones tromboembólicas 143,[147][148][149] .…”

Section: Administración De Hemostáticosunclassified

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Documento multidisciplinar de consenso sobre el manejo de la hemorragia masiva (documento HEMOMAS)

et al. 2015

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“…Prothrombin complex contains the vitamin K dependent coagulation factors II, VII, IX, X, protein C, and protein S. It has been used for the treatment of congenital coagulation disorders and is recommended for reversing oral anticoagulation [1]. Prothrombin complex proteins require Ca 2+ to express their activities.…”

Section: Introductionmentioning

confidence: 99%

Purification of prothrombin complex proteins from human plasma in anion exchange resin using pseudoaffinity chromatography

et al. 2014

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Four-Factor Prothrombin Complex Concentrate for Urgent Reversal of Vitamin K Antagonists in Patients With Major Bleeding

Cited by 46 publications

References 18 publications

Dabigatran etexilate: appropriate use in patients with chronic kidney disease and in the elderly patients

Dabigatran etexilate: appropriate use in patients with chronic kidney disease and in the elderly patients

Documento multidisciplinar de consenso sobre el manejo de la hemorragia masiva (documento HEMOMAS)

Purification of prothrombin complex proteins from human plasma in anion exchange resin using pseudoaffinity chromatography

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