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Apixaban is recommended by the National Institute for Health and Clinical Excellence for the prevention of stroke and systemic embolism in people with non-valvular atrial fibrillation and at least one of the following risk factors: prior stroke or transient ischemic attack, age 75 years or older, diabetes, or symptomatic heart failure.
Compared to the risk of bleeding with warfarin use, direct factor Xa inhibitors have a higher risk of GI bleeding, but lower risk of bleeding in the brain. [2] Other side effects may include stomach upset, dizziness, anemia or increased blood levels of liver enzymes. [2]
A decrease in antiplatelet effect would reduce the risk of bleeding, but increase the thromboembolic risk. [3] Drug toxicity may increase when multiple antiplatelet drugs are used. Gastrointestinal bleeding is a common adverse event seen in many patients.
This can be done using validated bleeding risk scores, such as the HEMORR 2 HAGES or HAS-BLED scores. [37] The HAS-BLED score is recommended in guidelines, to identify the high risk patient for regular review and followup and to address the reversible risk factors for bleeding (e.g. uncontrolled hypertension, labile INRS, excess alcohol use or ...
Commonly used low molecular weight heparins are enoxaparin, dalteparin, nadroparin and tinzaparin. [5] [6] In HIT, the platelet count in the blood falls below the normal range, a condition called thrombocytopenia. However, it is generally not low enough to lead to an increased risk of bleeding.
/ Although this explanation is fairly persuasive, the evidence that the post-study excess stroke risk in rivaroxaban patients was the result of inadequate VKA [vitamin K antagonist] therapy remains somewhat circumstantial. The INRs were not collected as carefully during the post-trial period...
The aim is to determine the optimal therapeutic window to maximize therapeutic benefits while reducing safety concerns like bleeding. Consequently, the major unmet goal of ADP inhibitors is to develop a potent reversible antiplatelet agent with fast onset of action, high levels of antiplatelet activity yet decreased risk of bleedings.
Antithrombin III deficiency (abbreviated ATIII deficiency) is a deficiency of antithrombin III.This deficiency may be inherited or acquired. [1] It is a rare hereditary disorder that generally comes to light when a patient suffers recurrent venous thrombosis and pulmonary embolism, and repetitive intrauterine fetal death (IUFD). [2]