Thrombus - 2016

Laboratory assays for direct oral anticoagulants
Ian Jennings
pp 33-36
There are many arguments and controversies concerning the oral anticoagulant drugs apixaban, dabigatran, edoxaban and rivaroxaban, which have been introduced as alternatives to vitamin K antagonists, such as warfarin.
Comment: To monitor or not to monitor? That is the question
Peter Rose
pp 34-34
The history of anticoagulant therapy is awash with articles and numerous man-hours of research on how best to measure and monitor international normalised ratio levels and how to improve patient safety and efficacy for those on warfarin therapy. Variables, laboratory reagents and analysis ensure this remains a far from perfect science, necessitating highly evolved quality assurance schemes to promote acceptable standards of practice.
FAQ: How should I manage anticoagulation for percutaneous coronary intervention?
Tom Bull and Stephen P Hoole
pp 37-37
Percutaneous coronary intervention (PCI) is used to revascularise patients with obstructive atherosclerotic heart disease. It is performed on full parenteral anticoagulation with unfractionated heparin to prevent catheter-related thrombosis, and dual antiplatelet therapy (DAPT) in the medium–long-term to reduce the risk of stent thrombosis. The duration of DAPT following PCI is a complex decision based on stent type, the nature of the coronary disease and any indications for long-term oral anticoagulation. The European Society for Cardiology has published guidelines to assist this decision.
Abstract watch: Atrial fibrillation/ stroke prevention
Gary Paterson
pp 38-38
In this 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.
Clot slot

pp 39-39
CLOT is delighted to announce it has been invited to present a session at the World Congress of the International Society of Hematology 2017 in Brighton. CLOT is also proud to say that following it’s first session at the conference in Glasgow, it had the best session attendance.
The use of direct oral anticoagulants in clinical practice for patients with atrial fibrillation
Sarah Bond and Sue Rhodes
pp 40-42
The anticoagulation service at the Great Western Hospital in Swindon currently provides counselling and dose adjustment for all patients commencing vitamin K antagonists (VKAs). Management of anticoagulation has been performed in secondary care since 1997. The service also provides discharge planning for inpatients and a telephone advice line for patients and healthcare professionals. The service is managed by one whole time equivalent (WTE) band 7 pharmacist/nurse and coordinated by 3.4 WTE band 6 anticoagulant practitioners with the support of 1.3 WTE band 3 administrators who manage the clinic outpatient appointments, contact patients with warfarin dose changes and assist with calls to the advice line.
Improving the outcomes of deep vein thrombosis: optimising the diagnostic pathway
Pany Koizi, Wendy Hassan, Sharon Edkins, Anand Lokare, Marc Barlow and Annie Young
pp 43-45
Venous thromboembolism (VTE) is estimated to cause 25,000 deaths annually in the UK and is the most frequent cause of preventable death for hospital inpatients. Additionally, patients who survive VTE continue to require the use of healthcare resources. Elective treatment for deep vein thrombosis (DVT) patients is calculated to cost £499 per patient on average, while treatment for emergency DVT patients averages £1941. In the US, treatment for post–thrombotic syndrome, a condition arising in 30% of DVT patients, is estimated to amount to $3,800 per patient in the first year of diagnosis. Another study found that such treatment can reach $7,000 per patient per year.
NCAT news

pp 46-46
After many years at The University of Birmingham, the National Centre for Anticoagulation Training is transferring to the University of Warwick.

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.

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