Anticoagulation: Difference between revisions

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Patients aged 80 years or more may be especially susceptible to bleeding complications with a rate of 13 bleeds per 100 person-years.<ref name="pmid17515465">{{cite journal |author=Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S |title=Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation |journal=Circulation |volume=115 |issue=21 |pages=2689-96 |year=2007 |pmid=17515465 |doi=10.1161/CIRCULATIONAHA.106.653048}}PMID 17515465</ref>
Patients aged 80 years or more may be especially susceptible to bleeding complications with a rate of 13 bleeds per 100 person-years.<ref name="pmid17515465">{{cite journal |author=Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S |title=Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation |journal=Circulation |volume=115 |issue=21 |pages=2689-96 |year=2007 |pmid=17515465 |doi=10.1161/CIRCULATIONAHA.106.653048}}PMID 17515465</ref>


Patients with cancer are more likely to have bleeding complications, especially if they have metastatic cancer.<ref name="pmid12393647">{{cite journal |author=Prandoni P, Lensing AW, Piccioli A, ''et al'' |title=Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis |journal=Blood |volume=100 |issue=10 |pages=3484–8 |year=2002 |pmid=12393647 |doi=10.1182/blood-2002-01-0108}}</ref>
Patients with cancer are more likely to have bleeding complications, especially if they have Stage 3 or 4 cancer.<ref name="pmid12393647">{{cite journal |author=Prandoni P, Lensing AW, Piccioli A, ''et al'' |title=Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis |journal=Blood |volume=100 |issue=10 |pages=3484–8 |year=2002 |pmid=12393647 |doi=10.1182/blood-2002-01-0108}}</ref> Regardless of the extent of cancer, the risk of bleeding was less than the risk of recurrent [[embolism and thromboembolism]]:
 
 
 
{| class="wikitable"
|+ Rates of major bleeding and recurrent [[embolism and thromboembolism]] (VTE)
! colspan="2" |  !! No cancer !! Stage I or II cancer !! Stage III cancer !! Stage IV cancer
|-
| rowspan="2"| '''Major<br>bleeding''' || Events per<br>100 patient-years || 8.6 || 3.4 || 19.1 || 42.8
|-
|      Hazard ratio || 1 || 0.5 || 2.15 || 4.8
|-
| rowspan="2"|  '''Recurrent<br>VTE''' || Events per<br>100 patient-years  || 12.8 || 14.5 || 44.1 || 54.1
|-
|    Hazard ratio || 1 || 1.9 || 5.3 || 4.6
|-
|  colspan="6" align="right"| Adapted from Table 3 of Prandoni et al.<ref name="pmid12393647"/>
|}


==References==
==References==

Revision as of 20:51, 2 January 2008

[edit intro]

Adverse effects

Patients aged 80 years or more may be especially susceptible to bleeding complications with a rate of 13 bleeds per 100 person-years.[1]

Patients with cancer are more likely to have bleeding complications, especially if they have Stage 3 or 4 cancer.[2] Regardless of the extent of cancer, the risk of bleeding was less than the risk of recurrent embolism and thromboembolism:


Rates of major bleeding and recurrent embolism and thromboembolism (VTE)
No cancer Stage I or II cancer Stage III cancer Stage IV cancer
Major
bleeding		 Events per
100 patient-years		 8.6 3.4 19.1 42.8
Hazard ratio 1 0.5 2.15 4.8
Recurrent
VTE		 Events per
100 patient-years		 12.8 14.5 44.1 54.1
Hazard ratio 1 1.9 5.3 4.6
Adapted from Table 3 of Prandoni et al.[2]

References

  1. ↑ Hylek EM, Evans-Molina C, Shea C, Henault LE, Regan S (2007). "Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation". Circulation 115 (21): 2689-96. DOI:10.1161/CIRCULATIONAHA.106.653048. PMID 17515465. Research Blogging. PMID 17515465
  2. ↑ 2.0 2.1 Prandoni P, Lensing AW, Piccioli A, et al (2002). "Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis". Blood 100 (10): 3484–8. DOI:10.1182/blood-2002-01-0108. PMID 12393647. Research Blogging.

See also

External links

The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines

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