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 Stage | Patients with cancer are more likely to have bleeding complications, especially if they have Stage III (regionally extensive) or IV (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> Regardless of the extent of cancer, the risk of bleeding was less than the risk of recurrent [[embolism and thromboembolism]]: | ||
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{| class="wikitable" | {| class="wikitable" | ||
|+ Rates of major bleeding and recurrent [[embolism and thromboembolism]] (VTE) | |+ Rates of major bleeding and recurrent [[embolism and thromboembolism]] (VTE) | ||
! colspan="2" | | ! colspan="2" rowspan="2" | !! rowspan="2"| No cancer !! colspan="3" | Cancer | ||
|- | |||
! Stage I or II !! Stage III !! Stage IV | |||
|- | |- | ||
| rowspan="2"| '''Major<br>bleeding''' || Events per<br>100 patient-years || 8.6 || 3.4 || 19.1 || 42.8 | | rowspan="2"| '''Major<br>bleeding''' || Events per<br>100 patient-years || 8.6 || 3.4 || 19.1 || 42.8 |
Revision as of 19:59, 2 January 2008
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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 III (regionally extensive) or IV (metastatic) cancer.[2] Regardless of the extent of cancer, the risk of bleeding was less than the risk of recurrent embolism and thromboembolism:
No cancer | Cancer | ||||
---|---|---|---|---|---|
Stage I or II | Stage III | Stage IV | |||
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
- ↑ 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
- ↑ 2.0 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