Thrombus - 2017

Spring 2017, Volume 21 Number 1

Stroke and anticoagulation: the Sheffield experience
Jannat Muen and Gary Pratt
pp 1-5
Atrial fibrillation (AF) is the most common type of sustained cardiac arrhythmia, with an overall prevalence in the UK of 1.6% in women and 2.4% in men. AF poses a significant challenge from a public health perspective, as it is associated with a four- to five-fold increased risk of stroke. The prevalence of AF has increased over the last few decades and, as a result, it is an increasingly important health concern associated with substantial healthcare costs.

Comment: Keep the good ship Thrombus sailing
David A Fitzmaurice
pp 2-2
As Thrombus enters its 21st year, it is with mixed feelings that I take over as Editor from Peter Rose. I am obviously delighted to have the opportunity to continue in the tradition set by Peter of delivering high-quality education in the field of thrombosis and haemostasis, but also disappointed that Peter felt the need to hand over the reins. Having been a member of the Editorial Board since the very first issue, I feel I will be able to maintain the high quality of the publication, albeit perhaps with more of a primary care focus. Similarly, feedback is always welcome (preferably good feedback!) particularly about content and any type of article you may wish to see included in future issues.

Clot slot

pp 5-5
Welcome to 2017 from all the CLOT committee members.

Abstract watch: Developments in stroke
Gary Paterson
pp 6-6
In this regular column, we feature a collection of abstracts that highlight some of the new research in the field of thrombosis, anticoagulation and clotting disorders. Research into this field is diverse and rapidly expanding, and we will endeavour to give you a sample of new findings and trends. We have collated abstracts from a number of peer-reviewed journals. Links to the full articles are provided, although you may need a subscription access to view them.

Measuring direct oral anticoagulant levels: a case series
Hannah Oladokun and Richard Gooding
pp 8-9
Direct oral anticoagulants have all but revolutionised the management of venous thromboembolism. Their ability to directly inhibit activated factor X or thrombin has the benefit of reducing the need for regular blood monitoring – for example, via the international normalised ratio – as well as potentially reducing the risk of bleeding.

Anticoagulation courses

pp 9-9
The University of Warwick is delighted that the National Centre for Anticoagulation Training (NCAT) is now being delivered through Warwick Medical School, led by Professor David A Fitzmaurice.

How can I safely anticoagulate elderly patients at high risk of falls?
Gyongyi Rabai
pp 10-10
The most common indications for anticoagulation are atrial fibrillation and venous thromboembolism. Both become more common as people age, but anticoagulation of the elderly can pose challenges, such as multiple comorbidities, drug interactions, increased risk of falls and altering pharmacokinetics, requiring an assessment of the overall risk–benefit ratio. This FAQ will outline elements that should be considered when deciding whether to anticoagulate elderly patients at high risk of falls.

Managing anticoagulation after a major bleed
Jecko Thachil
pp 11-14
Anticoagulants have transformed the landscape of arterial and venous thromboembolism management. However, one of the major risks associated with their use is bleeding. Although anticoagulants by themselves do not always cause bleeding, they can certainly worsen a bleeding episode which has already occurred. This is the dilemma that healthcare professionals face when they have patients who may have developed a significant gastrointestinal bleed or intracranial haemorrhage. When may it be safe to recommence an anticoagulant drug?

Thrombus was previously supported by Bayer from 2014 to 2016, by Boehringer Ingelheim from 2009 to 2013, by sanofi-aventis from 2007 to 2008 and by Leo Pharma from 1998 to 2006.

The data, opinions and statements appearing in the articles herein are those of the contributor(s) concerned; they are not necessarily endorsed by the sponsor, publisher, Editor or Editorial Board. Accordingly the sponsor, publisher, Editor and Editorial Board and their respective employees, officers and agents accept no liability for the consequences of any such inaccurate or misleading data, opinion or statement.

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ISSN 1369-8117 (Print) ISSN 2045-7855 (Online)