Anticoagulants are widely used for the prevention and treatment of venous and arterial thrombosis. The main indications for long-term anticoagulation therapy include treatment of venous thromboembolism (VTE), stroke prevention in atrial fibrillation (AF) and the prevention of valve thrombosis in patients with mechanical heart valves. For the past 65 years, vitamin K antagonists (VKA), such as w...

BACKGROUND Significant uncertainty surrounds the treatment of patients who must discontinue warfarin sodium therapy before an invasive procedure. In part, the uncertainty results from the lack of published information about the risk of thromboembolism associated with short-term warfarin therapy interruption. We aimed to assess the frequency of thromboembolism and bleeding within a large cohort ...

Inflammatory bowel disease (IBD) is known to increase the risk of venous thromboembolism. Cerebral venous sinus thrombosis (CVST) is a rare but important complication of IBD. Timely diagnosis, particularly in younger patients, requires a high level of suspicion in order to prevent potentially devastating complications such as hemorrhage or venous infarction. The paper presents a 44-year-old Cau...

The newer oral anticoagulants including dabigatran, rivaraxoban, apixaban and edoxaban are replacing warfarin in the management of atrial fibrillation and venous thromboembolism. Accidental and surreptitious overdose of warfarin has been reported, but so far there is no reported case of overdose involving NOACs. Overdose of warfarin prolongs coagulation tests including PT and APTT. This gives a...

Patients with antiphospholipid antibody syndrome (APA) are at elevated risk of venous and arterial thromboembolic complications. Oral anticoagulation with warfarin is recommended for secondary prevention of thromboembolism, but warfarin-related outcomes have not been systematically investigated when warfarin therapy is managed by a dedicated anticoagulation clinic. The objectives of the study w...

BACKGROUND Whether to continue oral anticoagulant therapy beyond 6 months after an "unprovoked" venous thromboembolism is controversial. We sought to determine clinical predictors to identify patients who are at low risk of recurrent venous thromboembolism who could safely discontinue oral anticoagulants. METHODS In a multicentre prospective cohort study, 646 participants with a first, unprov...

BACKGROUND Rivaroxaban is established for the treatment and secondary prevention of venous thromboembolism, but whether it is useful in patients with antiphospholipid syndrome is uncertain. METHODS This randomised, controlled, open-label, phase 2/3, non-inferiority trial, done in two UK hospitals, included patients with antiphospholipid syndrome who were taking warfarin for previous venous th...

In recent years, a growing body of evidence has provided the convincing demonstration of a strong association between cancer and venous thromboembolism. This relationship is further supported by the risk of developing overt malignancy in patients with idiopathic venous thromboembolism. However, the cost-to-benefit ratio of an extensive diagnostic work-up aimed at identifying an occult cancer in...

BACKGROUND AND OBJECTIVE Venous thromboembolism includes two closely related clinical manifestations: deep vein thrombosis (DVT), more commonly of the lower limbs, and pulmonary embolism. Pulmonary embolism is the most common cause of preventable death in hospitalized patients. The definition of the risk factors for venous thromboembolism should allow to adopt the most suitable prophylactic reg...

The limitations of traditional anticoagulants, heparin and warfarin, have prompted the development of new anticoagulant drugs for prevention and treatment of both venous and arterial thromboembolism. After a brief review of thrombogenesis and its regulation, this study focuses on new anticoagulant agents in more advanced stages of clinical testing.