G Agnelli

..Clinical trials have begun to investigate many of these issues, and the resulting data have already contributed to improving the management of patients with a high risk of VTE...

..Due to the limitations of the currently available oral anticoagulant agents, search for the optimal agent to be used in the long-term treatment of pulmonary embolism is still open...

..Apixaban, an oral factor Xa inhibitor that can be administered in a simple, fixed-dose regimen, may be an option for the extended treatment of venous thromboembolism...

..Patients receiving chemotherapy for cancer are at increased risk for venous thromboembolism. Limited data support the clinical benefit of antithrombotic prophylaxis...

..The aims of this retrospective analysis were to evaluate the thromboembolic risk and the benefit of thromboprophylaxis according to type of chemotherapy...

..The aim of this study was to correlate ABI value (normal or low) with 1-year clinical outcome in patients hospitalized for acute coronary syndromes or cerebrovascular diseases (CVD)...

..Some of them have been approved for clinical use, others are in advanced phase of clinical development, and some are still in the initial phase of investigation...

..Recent data suggest that Factor Xa inhibitors are safe and effective for VTE prevention in patients with cancer undergoing abdominal surgery. Further study in this patient population is warranted...

..Rivaroxaban (BAY 59-7939) is an oral direct factor Xa inhibitor currently under clinical development...

..LY517717 is an oral direct inhibitor of activated factor X that is currently under clinical development...

....

....

....

..The recommended treatment for CVC-related thrombosis is based on long-term anticoagulant therapy, with or without catheter removal...

..However, the clinical relevance of asymptomatic venography-detected DVT is unclear, and the population of these clinical trials is not necessarily representative of the overall cancer surgery population...

....

..The optimal duration of oral anticoagulant treatment after a first episode of pulmonary embolism remains uncertain...

..The aim of this multicenter registry (MASTER) was to prospectively collect data on the epidemiology and long-term clinical outcome of VTE in an unselected cohort of patients...

..Oral direct thrombin inhibitors have a promising role in the management of venous thromboembolism and other associated medical conditions...

..Due to the high costs of treating thromboembolic complications and post-thrombotic syndrome, appropriately targeted prolonged thromboprophylaxis may be cost-effective...

..Prophylactic methods include pharmacological agents, such as heparin, low molecular weight heparins, warfarin, and hirudin, as well as mechanical methods such as compression stockings and intermittent pneumatic compression...

..Additionally, LMWHs can be used as a 'bridge' to revascularization in patients for whom early invasive treatment is not readily available...

..The long-term treatment of cancer-related VTE is based on therapeutic doses of LMWH in preference to warfarin. The optimal duration of antithrombotic treatment in cancer patients remains to be fully defined...

..Whether this benefit persists after anticoagulant therapy is discontinued is controversial...

..In future studies the clinical benefit of antithrombotic prophylaxis should be evaluated in cancer patients at particularly high risk for thromboembolism...

....

..We did a trial to assess the clinical benefit of the low-molecular-weight heparin nadroparin for the prophylaxis of thromboembolic events in ambulatory patients receiving chemotherapy for metastatic or locally advanced solid cancer...

..Although recognized for more than 100 years, its incidence has been underestimated in the past due to the lack of accurate diagnostic techniques...

..At the end of this treatment period physicians should decide for definitive withdrawal or indefinite anticoagulation with scheduled periodic re-assessment of the benefit from extending anticoagulation...

..Whether this advantage results in an improved clinical outcome is unclear. We sought to perform a clinical outcome-based meta-analysis of studies comparing thrombolytic and heparin treatment in patients with pulmonary embolism...

..However, UFH has some limitations such as the need for parenteral administration and close monitoring of its anticoagulant effect. UFH is also associated with bleeding, heparin-induced thrombocytopenia and osteoporosis...

..The aim of this study was to analyze the effect of prior use of antithrombotic agents (antiplatelets or anticoagulants) on neurological functional outcome in patients with acute ischemic stroke...

..36-1.41). CONCLUSIONS: The incidence of newly diagnosed clinically overt cancer is not reduced in patients with idiopathic venous thromboembolism treated with 1-year anticoagulant treatment compared with patients treated for 3 months...

..We performed an updated meta-analysis of studies to obtain the best estimates of the efficacy and safety of anticoagulants for the prevention of venous thromboembolism in patients with acute hemorrhagic stroke...

..Patients with distant metastases have an increased risk for thrombosis in absence of antithrombotic prophylaxis...

..We performed a meta-analysis of controlled randomized trials on the efficacy and safety of heparin in the prophylaxis of venous thromboembolism in neurosurgery...

..Some investigators have stated that monoparesis is almost never the result of a lacunar infarct or cerebral haemorrhage...

..8%). Old age, history of TIA, cardioembolic etiology, severity of neurological deficit and hemorrhagic stroke type all led to earlier arrival time. Admission within 3 hours 'per se' improves outcome and reduced disability at three months...

..The aim of this study was to assess the influence of antiplatelet treatment on clinical outcome at hospital discharge...

..Ximelagatran, the first oral direct thrombin inhibitor, was shown to be an effective antithrombotic agent but was associated with potential liver toxicity after prolonged administration...

..We evaluated the benefit/risk ratio of different anticoagulant regimens in the prevention of VTE in patients with AIS...

..This review focuses on the epidemiology, pathogenesis, diagnosis, prevention, and treatment of VTE in cancer patients with long-term CVC...

....

..Both aspirin and mechanical prophylaxis are suboptimal to prevent VTE. Graduated compression stockings should be reserved to patients with a clear contraindication to antithrombotic agents...

..0%) in Group B suffered major or other important bleeding. Our results indicate that the administration of weight-adjusted reduced-dose rt-PA bolus produces less impairment of blood coagulation than the FDA approved regimen...

..The purposes of this study were (1) to assess the predictive factors of adverse outcome in patients with stroke associated with an occlusion of the ICA and (2) to evaluate the rate of spontaneous recanalization of an occluded ICA...

..Whether patients with unprovoked venous thromboembolism (VTE) have a higher risk of arterial cardiovascular events than the general population and patients with provoked VTE is a matter of debate...

..In this review, we discuss new evidence on the aetiology of cryptogenic stroke, specifically focusing on patients with patent foramen ovale and atheroma of the aortic arch...

....

..An oral anticoagulant agent to be used without laboratory monitoring for both acute and long-term treatment of VTE remains an unsolved clinical need in the treatment of VTE...

..0 to 3.6]). The diagnosis was made 14 and 22 months, respectively, after the acute PE. CONCLUSIONS: The incidence of CTPH observed in this study was about 1%. CTPH was observed in two patients with idiopathic PE...

..The aims of this study were to evaluate: 1) alternative causes of lacunar stroke other than small-vessel disease; 2) functional outcome of lacunar strokes due to small vessel disease compared to lacunar strokes due to alternative causes...

..A multicentre study aimed at investigating this fascinating hypothesis is now being carried out...

..These patients could afford the trade-off of an increased risk of side effects related to a more aggressive treatment, such as thrombolysis or surgical or interventional procedures...

..Several achievements are anticipated from the development of new antithrombotics, including a further reduction of cardiovascular mortality and unwanted bleeding, and easier patient management...

..Future studies will evaluate the clinical benefit of thrombolytic treatment in hemodynamically stable patients with acute pulmonary embolism at high risk for adverse outcome...

..Elevated serum levels of troponins are associated with right ventricular overload and adverse in-hospital outcomes in patients with pulmonary embolism and normal blood pressure...

..The aims of this study were to assess: (1) the rate of early HT in patients admitted for ischemic stroke, (2) the correlation between early HT and functional outcome at 3 months, and (3) the risk factors for early HT...

..87, 95% CI = 0.75-1.01, p = 0.07) and a significant difference in the occurrence of major vascular events (OR = 0.78, 95% CI = 0.68-0.88, p = 0.0001) at final follow-up...

..Whether elevated serum troponin levels identify patients with acute pulmonary embolism at high risk of short-term mortality or adverse outcome is undefined...

..A common clinical dilemma in patients with acute stroke is whether the detection of one of the major cardiac sources of emboli requires an early anticoagulation to reduce early stroke recurrence and mortality...

....

..The aim of this study was to assess whether the admission blood glucose level is related to HT in a prospective study in consecutive patients with acute ischemic stroke...

..We performed a systematic review and meta-analysis aimed at assessing the effects of bosentan therapy in patients with CTEPH...

..Age did not influence prognosis in patients treated with rt-PA. The oldest stroke patients should not be excluded from rt-PA treatment on the basis of age per se...

..The purpose of this review was to describe neuroimaging modalities capable of identifying penumbra tissue so as to provide surrogate markers for new trials in acute ischemic stroke patients...

..The aim of this study was to evaluate the risk factors for cerebral ischemic events in warfarin-treated AF patients with an International Normalized Ratios (INR) above 1.8 on admission...

..Cardiovascular events are the major cause of death in patients with idiopathic pulmonary embolism...

..Differences in pharmacokinetics and pharmacodynamics could offer the potential for individualized anticoagulant therapies in the near future...

..In addition, both genders demonstrated different stroke pathophysiologies. These findings should be taken into account when diagnostic workup and treatment are being planned...

..In these patients bolus tenecteplase has the potential to provide an effective and safe thrombolysis...

..The role of thrombophilia in the long-term management of venous thromboembolism should be addressed in prospective management studies...

..The dose of enoxaparin used in this study proved to be safe. Clinical trials evaluating higher enoxaparin doses could optimize the efficacy of this agent for this indication...

....

..Here, the data from the most important studies are examined, concluding that HRT has no beneficial effect on dementia or stroke risk reduction in postmenopausal women...

..Clarification of the optimal strategy requires an adequately powered, multicentre, randomised clinical trial...

..No difference in the surgical bleeding was observed between the two groups. We conclude that a short-term prophylaxis with cefamandole is a safe regimen in patients undergoing hip replacement with heparin prophylaxis...

..We performed an updated meta-analysis of all randomized trials to obtain the best estimates of the efficacy and safety of anticoagulants for the initial treatment of acute cardioembolic stroke...

..Endothelial dysfunction is an early marker of atherosclerosis and has predictive value for ischemic events. We have evaluated endothelial function in patients with a history of spontaneous venous thromboembolism...

..Thus, a combined regimen of anticoagulant and antiplatelet therapy should be reserved for selected patients at high risk of thromboembolic events who have a low risk of bleeding...

..This study showed an 8.7% decrease in the relative risk reduction for further atherothrombotic events with clopidogrel over aspirin (p = 0.043) for the overall population, in terms of the combined endpoint of IS, Ml or vascular death...

..When a new pharmacologic agent is compared with the "gold standard" agent, the use of symptomatic end points should be preferable...

..Then, the available guidelines for the management of thrombophilic patients will be given...

..However, such treatments are invariably associated with bleeding and other procedural complications...

..The aim of this study was to assess the rate of and the predictive factors for ES as well the effects of ES on the clinical outcome at hospital discharge in patients with first-ever stroke...

..The clinical relevance of this activation has to be tested in prospective studies with adequate sample size...

..Vessel wall has a remarkable role in protecting against and in promoting thrombosis. The role of inflammation on venous thrombosis is under investigation...

..However, not all eligible patients benefit from this treatment. This study aimed to assess the determinants for clinical outcome in consecutive, eligible patients with ischemic stroke treated with thrombolysis in a single-center study...

....

..59 (0.41-0.86), P<0.0001]. CONCLUSION: Our data suggest that the combination of clopidogrel with a statin has synergistic effects on the clinical outcomes of patients with non-ST-segment elevation ACS...