1.Effects of peri-operative bridging with low molecular weight heparins on coagulation during interruption of vitamin K antagonists: A mechanistic study.
Eijgenraam P1, Ten Cate H2, Henskens Y3, van den Ham R4, Ten Cate-Hoek A2. Thromb Res. 2016 Apr;140:59-65. doi: 10.1016/j.thromres.2016.02.019. Epub 2016 Feb 15.
BACKGROUND: Bridging with low molecular weight heparins (LMWH) is used in patients undergoing invasive procedures that require interruption of vitamin K antagonists (VKA). Little is known on the mechanisms underlying observed thrombotic and bleeding events. In this exploratory study we investigated the interactive effects of the co-administration of VKA, LMWH and surgery on coagulation.
2.[Secondary drug toxiderma to acenocoumarol].
Khammassi N1, Kessentini N1. Pan Afr Med J. 2015 Oct 1;22:95. doi: 10.11604/pamj.2015.22.95.7809. eCollection 2015.
3.A New Pharmacogenetic Algorithm to Predict the Most Appropriate Dosage of Acenocoumarol for Stable Anticoagulation in a Mixed Spanish Population.
Tong HY1, Dávila-Fajardo CL2, Borobia AM1,3, Martínez-González LJ4, Lubomirov R3, Perea León LM2, Blanco Bañares MJ5, Díaz-Villamarín X2, Fernández-Capitán C6, Cabeza Barrera J2, Carcas AJ1,3; PGX-ACE Investigators Group. PLoS One. 2016 Mar 15;11(3):e0150456. doi: 10.1371/journal.pone.0150456. eCollection 2016.
There is a strong association between genetic polymorphisms and the acenocoumarol dosage requirements. Genotyping the polymorphisms involved in the pharmacokinetics and pharmacodynamics of acenocoumarol before starting anticoagulant therapy would result in a better quality of life and a more efficient use of healthcare resources. The objective of this study is to develop a new algorithm that includes clinical and genetic variables to predict the most appropriate acenocoumarol dosage for stable anticoagulation in a wide range of patients. We recruited 685 patients from 2 Spanish hospitals and 1 primary healthcare center. We randomly chose 80% of the patients (n = 556), considering an equitable distribution of genotypes to form the generation cohort. The remaining 20% (n = 129) formed the validation cohort. Multiple linear regression was used to generate the algorithm using the acenocoumarol stable dosage as the dependent variable and the clinical and genotypic variables as the independent variables.
4.[Vitamin K antagonists overdose].
Groszek B, Piszczek P. Przegl Lek. 2015;72(9):468-71.
Nowadays, anticoagulant therapy belongs to the most commonly used forms of pharmacotherapy in modern medicine. The most important representatives of anticoagulants are heparins (unfractionated heparin and low-molecular-weight heparin) and coumarin derivatives (vitamin K antagonists--VKA). Next to the many advantages of traditional oral anticoagulants may also have disadvantages. In Poland most often used two VKA: acenocoumarol and warfarin. The aim of the work is the analysis of the causes of the occurrence of bleeding disorders and symptoms of overdose VKA in patients to be hospitalized. In the years 2012 to 2014 were hospitalized 62 patients with overdose VKA (40 women and 22 men). The average age of patients was 75.3 years) and clotting disturbances and/or bleeding. At the time of the admission in all patients a significant increase in the value of the INR was stated, in 22 patients INR result was " no clot detected", on the remaining value of the INR were in the range of 7 to 13.