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Bond, Andrew J; Molnar, Frank; Li, Marilyn; Mackey, Marlene C.; Man-Son-Hing, Malcolm

doi:10.1186/1477-9560-3-1

Cited by 45 publications

(6 citation statements)

References 21 publications

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“… 13 The mean age of patients with AF on treatment was much lower than the mean age of similar studies at a primary care setting. 7 , 14 The proportion of the male population on anticoagulation treatment was greater than females, similar to other studies done at tertiary care centers, 6 , 13 but there was a slight female preponderance at primary care centers. 7 …”

Section: Discussionsupporting

confidence: 84%

Anticoagulation Management of Atrial Fibrillation

Nantha

2014

Health Services Research and Managerial Epidemiology

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Objective:To investigate the prevailing level of adherence to a dosing algorithm and a recall schedule and its relationship with the time in therapeutic range (TTR) among patients with atrial fibrillation.Methods:The study was carried out at a regional primary care clinic in Malaysia. Patients on anticoagulation therapy aged older than 18 years were included in the study. The participants have received continuation of their anticoagulation therapy at the primary care clinic for at least 6 months to 1 year after being discharged from a tertiary center. Correlation and multiple regression studies were performed to determine the significance of the predictors of TTR.Results:A majority (217) of patients with atrial fibrillation received anticoagulation therapy at the clinic followed by patients with mitral valve replacement and aortic valve replacement. The mean TTR for patients with atrial fibrillation was 57.6%. General practitioners (GPs) adhered to 75.5% of the dose protocol but fared poorly in adhering to the recall schedule (36.2%). The concordance to the dose algorithm and recall schedule were significantly related to TTR. Multiple regression analysis proved that the concordance to the dose algorithm and recall schedule were important predictors of the level of TTR in patients with atrial fibrillation.Discussion:The study provides preliminary evidence on the relationship between a validated dose algorithm that is integrated with a recall schedule in the control of TTR in patients with atrial fibrillation on anticoagulation treatment. A larger multicenter study is needed to confirm the results of this finding.

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Section: Discussionsupporting

confidence: 84%

Anticoagulation Management of Atrial Fibrillation

Nantha

2014

Health Services Research and Managerial Epidemiology

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“…In a number of studies, sensitivity of platelets to ADP and levels of this agonist in patients with AR revealed to be considerably amplified [ 25 , 85 ]. Moreover, in a randomized cross-over trial, patients with AR turned out to be highly responsive to platelet ADP receptor antagonist [ 86 ].…”

Section: Managementmentioning

confidence: 99%

Aspirin Resistance

Mansour

Taher

Musallam

et al. 2009

Advances in Hematology

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The development of adverse cardiovascular events despite aspirin use has established an interest in a possible resistance to the drug. Several definitions have been set and various laboratory testing modalities are available. This has led to a wide range of prevalence reports in different clinical entities. The etiologic mechanism has been related to clinical, genetic, and other miscellaneous factors. The clinical implications of this phenomenon are significant and warrant concern. Management strategies are currently limited to dosing alteration and introduction of other anitplatelet agents. However, these measures have not met the expected efficacy or safety.

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“…It has been reported that 30–60% of patients can suffer venous events while 15–20% can suffer arterial events while bleeding manifestation is rare. 2 , 5 , 9 , 10 …”

Section: Discussionmentioning

confidence: 99%

Case Report: Heparin-induced thrombocytopenia during COVID-19 outbreak: the importance of scoring system in differentiating with sepsis-induced coagulopathy

et al. 2021

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Background: COVID-19 disease is accompanied by derangement of coagulation with a risk of fatal thromboembolic formation. COVID-19 patients are among those indicative for heparin treatment. Increased heparin administration among COVID-19 patients increased heparin induced-thrombocytopenia's risk with/without thrombocytopenia. Case presentation: We present a 71-year-old male patient who came to the emergency department (ED) with a COVID-19 clinical manifestation that PCR nasopharyngeal swab confirmed. He was assessed to have acute respiratory distress syndrome (ARDS), as shown by rapid progression of hypoxemic respiratory failure and bilateral pulmonary infiltrate. He was then treated with moxifloxacin, remdesivir, dexamethasone, heparin pump, and multivitamins. During admission, his respiratory symptoms got worse, so he transferred to the ICU for NIV support. On the ninth day of admission, he had gross hematuria followed by a rapid fall of platelet count. We used two different scoring systems (4Ts and HEP scoring system) to confirm the diagnosis of heparin-induced thrombocytopenia (HIT). Following the discontinuation of heparin injection, the thrombocyte continued to rise, and hematuria disappeared. Conclusion: Heparin-induced thrombocytopenia is associated with an increased risk of severe disease and mortality among COVID-19 patients. The differential diagnosis of HIT could be difficult among COVID-19 patients as thrombocytopenia can also be caused by infection progression. We use two scoring systems, 4Ts and HEP scoring, that can help us to manage the patient. With good management, we can avoid patient morbidity and mortality.

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Untitled

Cited by 45 publications

References 21 publications

Anticoagulation Management of Atrial Fibrillation

Anticoagulation Management of Atrial Fibrillation

Aspirin Resistance

Case Report: Heparin-induced thrombocytopenia during COVID-19 outbreak: the importance of scoring system in differentiating with sepsis-induced coagulopathy

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