Article
Hematology
Bethany T. Samuelson Bannow, Vivia Chi, Paul Sochacki, Owen J. T. McCarty, Maureen K. Baldwin, Alison B. Edelman
Summary: The study investigated rates of heavy menstrual bleeding (HMB) in users of rivaroxaban and apixaban, finding an association between rivaroxaban use and the need for medical or surgical intervention for HMB. Most women did not have a documented menstrual history, indicating that many providers do not inquire about menstrual bleeding when initiating anticoagulant therapy. Menstruating women, especially those with a history of HMB, may be at increased risk for HMB requiring medical treatment depending on the type of OAC used.
THROMBOSIS RESEARCH
(2021)
Article
Gastroenterology & Hepatology
Fang Jiang, Chengsheng Ju, Chuan-Guo Guo, Ka Shing Cheung, Bofei Li, Simon Y. K. Law, Wallis C. Y. Lau, Wai K. Leung
Summary: This study investigated the risk of hospitalization for upper gastrointestinal bleeding (UGIB) in patients who had received H. pylori eradication therapy and were newly started on warfarin or DOACs. The results showed that DOACs had a significantly lower risk of UGIB compared to warfarin in H. pylori-eradicated patients. Additionally, there was no significant difference in UGIB risk between H. pylori-eradicated and H. pylori-negative patients newly started on warfarin or DOACs.
Article
Pharmacology & Pharmacy
Allison Cid, Megan E. Smetana, Courtney Hebert, Kelci Coe, Jessica M. Smith
Summary: The aim of this study was to evaluate the effect of concomitant use of fluconazole and direct oral anticoagulants (DOACs) on bleeding risk. The study found that patients receiving a DOAC with fluconazole did not have a significantly increased risk for bleeding at 30 days compared to those receiving a DOAC alone after adjusting for confounding variables.
Article
Hematology
Jan Beyer-Westendorf, Sandra Marten
Summary: DOACs are increasingly used as a replacement for traditional anticoagulants due to advantages such as fewer drug interactions and fixed dosing. However, special considerations, such as heavy menstrual bleeding and embryotoxicity risk during pregnancy, may need to be taken into account for younger female patients receiving DOAC therapy.
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2021)
Review
Medicine, General & Internal
Athanasios Kontogiannis, Alkis Matsas, Serena Valsami, Maria Effrosyni Livanou, Theodoros Panoskaltsis, Panagiotis Christopoulos
Summary: Heavy menstrual bleeding (HMB) is a common condition that affects the quality of life of adolescent and adult women. Primary hemostasis disorders, such as Von Willebrand disease (VWD), can be the underlying cause of HMB. Diagnosing these disorders can be challenging, but a thorough hematologic workup is important for the correct diagnosis. The goal of this study was to provide a comprehensive review of primary hemostasis disorders associated with HMB, serving as a reference guide for further study.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Hematology
Madhvi Rajpurkar, Ayesha Zia, Angela C. Weyand, Ronald Thomas, Sarah H. O'Brien, Lakshmi Srivaths, Peter Kouides
Summary: The study surveyed the patterns of diagnosis and management of AC-RTB in adolescent and young adult females. The results showed low frequency of AC-RTB with variable management strategies, including hormonal therapy and antifibrinolytic therapy.
THROMBOSIS RESEARCH
(2021)
Article
Obstetrics & Gynecology
Felice Petraglia, Marie Madeleine Dolmans
Summary: Iron deficiency and iron deficiency anemia are common among women, especially during the reproductive age. Heavy menstrual bleeding, pregnancy state, and the postpartum period are the major causes. However, despite the high prevalence and impact, iron deficiency and iron deficiency anemia among fertile age women remain underdiagnosed and undertreated.
FERTILITY AND STERILITY
(2022)
Article
Hematology
Myrthe M. A. Toorop, Nienke van Rein, Melchior C. Nierman, Helga W. Vermaas, Menno Huisman, Felix J. M. van der Meer, Suzanne C. Cannegieter, Willem M. Lijfering
Summary: The study found that the inter-individual variability of DOAC concentrations was higher than intra-individual variability, and lower previous VKA dosage and creatinine clearance were associated with higher DOAC trough concentrations.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Review
Biology
Maria Effrosyni Livanou, Alkis Matsas, Serena Valsami, Dimitrios T. Papadimitriou, Athanasios Kontogiannis, Panagiotis Christopoulos
Summary: Clotting Factor deficiencies present a diagnostic and therapeutic challenge, particularly for primary health care providers who are most likely to encounter these patients. Abnormal Uterine Bleeding, specifically Heavy Menstrual Bleeding, is a common manifestation and can lead to life-threatening bleeding in severe cases. Awareness and knowledge among physicians is crucial for proper management and prophylactic treatment options should be considered in some cases.
Editorial Material
Obstetrics & Gynecology
Kalle T. Rytkonen
Summary: The menstrual cycle is a crucial factor in female reproductive health. Mao et al. (2022) recently linked heavy menstrual bleeding to deficient glycolysis. This article summarizes these new findings and highlights the importance of glycolysis and decidualization in endometrial function. It also discusses whether menstrual bleeding should be considered as a primary endometrial disorder inherent to the endometrium or as a secondary endometrial disorder caused by other endometrial conditions.
REPRODUCTIVE SCIENCES
(2023)
Review
Hematology
Lida Kalmanti, Edelgard Lindhoff-Last
Summary: Premenopausal women treated with direct oral anticoagulants may have an increased risk of heavy menstrual bleeding compared with vitamin K antagonists. However, there is a lack of standardized definitions and studies comparing different contraceptive methods. Prospective studies are needed to further investigate the impact of oral anticoagulation on menstrual bleeding and explore potential interventions.
Article
Cardiac & Cardiovascular Systems
Ingrid Skornova, Matej Samos, Tomas Bolek, Alena Kamenistakova, Lucia Stanciakova, Peter Galajda, Jan Stasko, Peter Kubisz, Marian Mokan
Summary: This study revealed a significant difference in anti-IIa and anti-Xa plasma levels in patients with atrial fibrillation experiencing bleeding complications compared with those who tolerated long-term high-dose DOAC therapy without bleeding complications.
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY
(2021)
Article
Obstetrics & Gynecology
Kristen A. Matteson, Josie Valcin, Christina A. Raker, Melissa A. Clark
Summary: This study compared the effectiveness of the levonorgestrel intrauterine system and combined oral contraceptives in improving quality of life for individuals with heavy menstrual bleeding, and found no significant differences between the two treatments.
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
(2023)
Review
Obstetrics & Gynecology
Salvatore Giovanni Vitale, Stefania Saponara, Gilda Sicilia, Marko Klaric, Felice Sorrentino, Maurizio Nicola D'Alterio, Luigi Nappi, Stefano Angioni
Summary: This study demonstrates that hysteroscopic laser myolysis is a safe and effective treatment for heavy menstrual bleeding in premenopausal women, resulting in significant reductions in fibroid size and vascularization.
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
(2023)
Review
Cardiac & Cardiovascular Systems
Sittinun Thangjui, Jakrin Kewcharoen, Ratdanai Yodsuwan, Angkawipa Trongtorsak, Harshith Thyagaturu, Bishesh Shrestha, Amanda R. M. Winans, Edward Bischof
Summary: This study conducted a systematic review and meta-analysis on the efficacy and safety of direct oral anticoagulants (DOAC) compared to vitamin K antagonists (VKA) in morbidly obese patients with atrial fibrillation (AF). The results showed no statistical difference in reducing stroke/systemic embolism between DOAC and VKA. The major bleeding risk was lower in the DOAC groups. Obese patients with AF who used DOACs had a lower risk of stroke/systemic embolism compared to non-obese patients. Obese AF patients using any type of anticoagulant had a lower risk of stroke/systemic embolism compared to normal-weight patients.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Olivia S. Costa, Jan Beyer-Westendorf, Veronica Ashton, Dejan Milentijevic, Kenneth Todd Moore, Thomas J. Bunz, Craig Coleman
Summary: The prescription of rivaroxaban in obese VTE patients was associated with a significantly reduced risk of recurrent VTE compared to warfarin, without affecting major bleeding. These findings remained consistent across different BMI categories.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Review
Oncology
Hanno Riess, Peter Verhamme, Jeffrey I. Weitz, Annie Young, Rupert Bauersachs, Jan Beyer-Westendorf, Mark Crowther, Anthony Maraveyas
Summary: For the treatment of cancer-associated thrombosis (CAT), low-molecular-weight heparin (LMWH) therapy is recommended, especially in those with active cancer to prevent recurrent thrombosis. However, the inconvenience and cost of LMWH therapy often lead patients to switch to oral alternatives. Studies have shown the efficacy and safety of apixaban, edoxaban, and rivaroxaban compared to LMWH therapy for CAT.
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
(2021)
Article
Respiratory System
Stefano Barco, Irene Schmidtmann, Walter Ageno, Toni Anusic, Rupert M. Bauersachs, Cecilia Becattini, Enrico Bernardi, Jan Beyer-Westendorf, Luca Bonacchini, Johannes Brachmann, Michael Christ, Michael Czihal, Daniel Duerschmied, Klaus Empen, Christine Espinola-Klein, Joachim H. Ficker, Candida Fonseca, Sabine Genth-Zotz, David Jimenez, Veli-Pekka Harjola, Matthias Held, Lorenzo Iogna Prat, Tobias J. Lange, Mareike Lankeit, Athanasios Manolis, Andreas Meyer, Thomas Muenzel, Pirjo Mustonen, Ursula Rauch-Kroehnert, Pedro Ruiz-Artacho, Sebastian Schellong, Martin Schwaiblmair, Raoul Stahrenberg, Luca Valerio, Peter E. Westerweel, Philipp S. Wild, Stavros V. Konstantinides
Summary: The study found significant benefits in early discharge and ambulatory oral anticoagulation for low-risk pulmonary embolism patients. Targeted strategies may be needed to improve quality of life in specific patient subgroups.
EUROPEAN RESPIRATORY JOURNAL
(2021)
Article
Hematology
Nils Picker, Agnes Y. Lee, Alexander T. Cohen, Anthony Maraveyas, Jan Beyer-Westendorf, Lorenzo G. Mantovani, Khaled Abdelgawwad, Samuel Fatoba, Inga-Marion Thate-Waschke, Miriam Bach, Thomas Wilke
Summary: This study revealed that in cancer-associated VTE treatment decision making, patients predominantly prioritize route of administration, with a strong preference for oral administration and treatment without dietary restrictions. Patients also showed preferences for shorter distance to treating physician and once-daily dosing.
THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Hematology
Maria A. de Winter, Jannick A. N. Dorresteijn, Walter Ageno, Cihan Ay, Jan Beyer-Westendorf, Michiel Coppens, Frederikus A. Klok, Fares Moustafa, Nicoletta Riva, Pedro C. Ruiz Artacho, Thomas Vanassche, Mathilde Nijkeuter
Summary: The study compared different methods of estimating clinically relevant bleeding risk in patients with CAT, finding that existing risk scores performed poorly while a pragmatic classification based on cancer type provided slightly better estimates. Further improvement may be possible with a new prediction model, but external validation is needed.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Hematology
Edelgard Lindhoff-Last, Ingvild Birschmann, Joachim Kuhn, Simone Lindau, Stavros Konstantinides, Oliver Grottke, Ulrike Nowak-Goettl, Jessica Lucks, Barbara Zydek, Christian Von Heymann, Ariane Suemnig, Jan Beyer-Westendorf, Sebastian Schellong, Patrick Meybohm, Andreas Greinacher, Eva Herrmann
Summary: The pharmacokinetic data of emergency patients under DOAC treatment showed a high variation of anticoagulant concentrations at baseline. Apixaban exhibited a lower median concentration on admission and a longer half-life compared to rivaroxaban.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Hematology
Luise Tittl, Sandra Marten, Christiane Naue, Jan Beyer-Westendorf
Summary: This study provided reassuring long-term outcome data for atrial fibrillation patients receiving rivaroxaban treatment, showing low rates of fatal thromboembolic and bleeding complications over a 5-year follow-up period.
THROMBOSIS RESEARCH
(2021)
Editorial Material
Hematology
Marc Blondon, Jan Beyer-Westendorf
THROMBOSIS RESEARCH
(2021)
Article
Medicine, General & Internal
Mette Sogaard, Flemming Skjoth, Peter Bronnum Nielsen, Jan Beyer-Westendorf, Torben Bjerregaard Larsen
Summary: According to a Danish study, fetal risk was lowest in pregnant women who were unexposed to any medications or exposed to low-molecular-weight heparin (LMWH). Compared to unexposed women, those exposed to vitamin K antagonists (VKA) had an increased risk of preterm and very preterm births, as well as lower mean gestational age and birthweight.
AMERICAN JOURNAL OF MEDICINE
(2022)
Editorial Material
Hematology
Jan Beyer-Westendorf, Ute Scholz
Article
Cardiac & Cardiovascular Systems
Lea Brueckner, Jan Beyer-Westendorf, Oliver Tiebel, Joerg Pietsch
Summary: Direct oral anticoagulants (DOAC) are commonly used in elderly patients with co-morbidities, leading to medical emergencies such as trauma, acute bleeding, or organ failure. A validated toxicology screen of DOAC and argatroban can provide valuable information to emergency physicians, law enforcement, and courts of justice. The HPLC-MS/MS method for simultaneous detection and quantification of various anticoagulants in body fluids fills an important gap in emergency toxicology.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2022)
Article
Clinical Neurology
Hagen B. Huttner, Stefan T. Gerner, Joji B. Kuramatsu, Stuart J. Connolly, Jan Beyer-Westendorf, Andrew M. Demchuk, Saskia Middeldorp, Elena Zotova, Julia Altevers, Frank Andersohn, Mary J. Christoph, Patrick Yue, Leonhard Stross, Stefan Schwab
Summary: This study compared the occurrence of hematoma expansion (HE) and clinical outcomes in patients treated with andexanet alfa or with usual care for factor-Xa inhibitor-related intracerebral hemorrhage (ICH). The results showed that andexanet alfa was associated with a lower rate of HE but did not significantly improve clinical outcomes.
Article
Critical Care Medicine
Olivia S. Costa, Stuart J. Connolly, Mukul Sharma, Jan Beyer-Westendorf, Mary J. Christoph, Belinda Lovelace, Craig I. Coleman
Summary: In this study, the effectiveness and safety of Andexanet alfa compared to 4F-PCC in the management of apixaban- or rivaroxaban-associated intracranial hemorrhage were evaluated. The results showed that Andexanet alfa achieved better hemostatic effectiveness and improved survival compared to 4F-PCC.
Meeting Abstract
Cardiac & Cardiovascular Systems
Reinhold Hugo Kreutz, Gilbert Deray, Juergen Floege, Marianne Gwechenberger, Kai Hahn, Andreas Luft, Pontus Persson, Jan Beyer-Westendorf
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2022)
Meeting Abstract
Cardiac & Cardiovascular Systems
Thijs F. van Haaps, Alexander P. Benz, Lizhen Xu, Michiel Coppens, John W. Eikelboom, Truman J. Milling, Mark Crowther, Jan Beyer-Westendorf, Alexander T. Cohen, Patrick Yue, Pamela B. Conley, Genmin Lu, Stuart J. Connolly, Saskia Middeldorp
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)