Hereditary hemorrhagic telangiectasia patients can tolerate anticoagulation
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVMs) and hemorrhage. HHT patients can also suffer from unrelated medical conditions requiring anticoagulant or antiplatelet treatment (collectively “AT”), though clinicians ge...
Gespeichert in:
| Veröffentlicht in: | Annals of hematology 2012-12, Vol.91 (12), p.1959-1968 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1968 |
|---|---|
| container_issue | 12 |
| container_start_page | 1959 |
| container_title | Annals of hematology |
| container_volume | 91 |
| creator | Edwards, Christine Priscilla Shehata, Nadine Faughnan, Marie E. |
| description | Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVMs) and hemorrhage. HHT patients can also suffer from unrelated medical conditions requiring anticoagulant or antiplatelet treatment (collectively “AT”), though clinicians generally consider HHT a contraindication to AT. We hypothesized that HHT patients can tolerate AT with minimal hemorrhage. Through a chart review of 469 definite HHT patients (1997–2009), we found that 64 (14 %) had received AT. Forty-three out of 64 (67 %) underwent a telephone survey to retrospectively inquire about prescription, early cessation, and HHT-related bleeding. At the time of the study, nine patients were deceased, nine declined, and three were unreachable. During AT treatment, ten (23 %) reported severe complications (blood transfusion, emergency room visit, or hospital admission), while 25 (58 %) reported minor complications (increase or development of epistaxis, gastrointestinal bleeding, and anemia). No patients reported pulmonary/cerebral hemorrhage. The 43 patients received a total of 69 courses of AT. Fourteen out of 69 (20 %) AT courses in 13 patients required early cessation, mostly due to epistaxis. Two out of nine (22 %) deceased patients required early cessation. We conclude that HHT patients can be treated with AT but should be monitored closely given their risk for worsening chronic bleeding and should be screened/treated for pulmonary or cerebral AVMs prior to AT treatment. |
| doi_str_mv | 10.1007/s00277-012-1553-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1758238854</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1758238854</sourcerecordid><originalsourceid>FETCH-LOGICAL-c471t-34d34305b931c2acd965a14a946bbc83c5f350d645b8a975fd2f3bb52b0a49dd3</originalsourceid><addsrcrecordid>eNqFkTtPwzAUhS0EoqXwA1hQJBYWg5-JMyIEFFGJBWbLr6Sp8ii2M_DvcZWCEBLCyx3ud4_PvQeAc4yuMULFTUCIFAVEmEDMOYXiAMwxowQiLtghmKOSlpCnNwMnIWxQAgUjx2BGKOIUF3wOnpfOO9tE5T-ytesG79eqbkwWXav6unEmqtCobKti4_oYMqP6LA6t8yq6TPWxMYOqxza1h_4UHFWqDe5sXxfg7eH-9W4JVy-PT3e3K2hYgSOkzFKWDOiSYkOUsWXOFWaqZLnWRlDDK8qRzRnXQpUFryypqNacaKRYaS1dgKtJd-uH99GFKLsmGNcmx24Yg0yLCUKF4Ox_FHNcoJzmO_TyF7oZRt-nRRLFkg8scJkoPFHGDyF4V8mtb7p0PYmR3IUip1BkurXchSJFmrnYK4-6c_Z74iuFBJAJCKnV187_-PpP1U_rPJa1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1149751819</pqid></control><display><type>article</type><title>Hereditary hemorrhagic telangiectasia patients can tolerate anticoagulation</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Edwards, Christine Priscilla ; Shehata, Nadine ; Faughnan, Marie E.</creator><creatorcontrib>Edwards, Christine Priscilla ; Shehata, Nadine ; Faughnan, Marie E.</creatorcontrib><description>Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVMs) and hemorrhage. HHT patients can also suffer from unrelated medical conditions requiring anticoagulant or antiplatelet treatment (collectively “AT”), though clinicians generally consider HHT a contraindication to AT. We hypothesized that HHT patients can tolerate AT with minimal hemorrhage. Through a chart review of 469 definite HHT patients (1997–2009), we found that 64 (14 %) had received AT. Forty-three out of 64 (67 %) underwent a telephone survey to retrospectively inquire about prescription, early cessation, and HHT-related bleeding. At the time of the study, nine patients were deceased, nine declined, and three were unreachable. During AT treatment, ten (23 %) reported severe complications (blood transfusion, emergency room visit, or hospital admission), while 25 (58 %) reported minor complications (increase or development of epistaxis, gastrointestinal bleeding, and anemia). No patients reported pulmonary/cerebral hemorrhage. The 43 patients received a total of 69 courses of AT. Fourteen out of 69 (20 %) AT courses in 13 patients required early cessation, mostly due to epistaxis. Two out of nine (22 %) deceased patients required early cessation. We conclude that HHT patients can be treated with AT but should be monitored closely given their risk for worsening chronic bleeding and should be screened/treated for pulmonary or cerebral AVMs prior to AT treatment.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-012-1553-8</identifier><identifier>PMID: 23053175</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anticoagulants - adverse effects ; Anticoagulants - therapeutic use ; Arteriovenous Malformations - epidemiology ; Arteriovenous Malformations - etiology ; Contraindications ; Drug Monitoring ; Epistaxis - chemically induced ; Epistaxis - epidemiology ; Epistaxis - etiology ; Epistaxis - physiopathology ; Female ; Gastrointestinal Hemorrhage - chemically induced ; Gastrointestinal Hemorrhage - epidemiology ; Gastrointestinal Hemorrhage - etiology ; Gastrointestinal Hemorrhage - physiopathology ; Hematology ; Hospitals, University ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Ontario - epidemiology ; Original Article ; Platelet Aggregation Inhibitors - adverse effects ; Platelet Aggregation Inhibitors - therapeutic use ; Precision Medicine ; Prevalence ; Retrospective Studies ; Severity of Illness Index ; Telangiectasia, Hereditary Hemorrhagic - complications ; Telangiectasia, Hereditary Hemorrhagic - physiopathology ; Tertiary Care Centers ; Thromboembolism - complications ; Thromboembolism - drug therapy ; Thromboembolism - etiology ; Thromboembolism - prevention & control</subject><ispartof>Annals of hematology, 2012-12, Vol.91 (12), p.1959-1968</ispartof><rights>Springer-Verlag 2012</rights><rights>Springer-Verlag Berlin Heidelberg 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-34d34305b931c2acd965a14a946bbc83c5f350d645b8a975fd2f3bb52b0a49dd3</citedby><cites>FETCH-LOGICAL-c471t-34d34305b931c2acd965a14a946bbc83c5f350d645b8a975fd2f3bb52b0a49dd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-012-1553-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-012-1553-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23053175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Edwards, Christine Priscilla</creatorcontrib><creatorcontrib>Shehata, Nadine</creatorcontrib><creatorcontrib>Faughnan, Marie E.</creatorcontrib><title>Hereditary hemorrhagic telangiectasia patients can tolerate anticoagulation</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVMs) and hemorrhage. HHT patients can also suffer from unrelated medical conditions requiring anticoagulant or antiplatelet treatment (collectively “AT”), though clinicians generally consider HHT a contraindication to AT. We hypothesized that HHT patients can tolerate AT with minimal hemorrhage. Through a chart review of 469 definite HHT patients (1997–2009), we found that 64 (14 %) had received AT. Forty-three out of 64 (67 %) underwent a telephone survey to retrospectively inquire about prescription, early cessation, and HHT-related bleeding. At the time of the study, nine patients were deceased, nine declined, and three were unreachable. During AT treatment, ten (23 %) reported severe complications (blood transfusion, emergency room visit, or hospital admission), while 25 (58 %) reported minor complications (increase or development of epistaxis, gastrointestinal bleeding, and anemia). No patients reported pulmonary/cerebral hemorrhage. The 43 patients received a total of 69 courses of AT. Fourteen out of 69 (20 %) AT courses in 13 patients required early cessation, mostly due to epistaxis. Two out of nine (22 %) deceased patients required early cessation. We conclude that HHT patients can be treated with AT but should be monitored closely given their risk for worsening chronic bleeding and should be screened/treated for pulmonary or cerebral AVMs prior to AT treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulants - therapeutic use</subject><subject>Arteriovenous Malformations - epidemiology</subject><subject>Arteriovenous Malformations - etiology</subject><subject>Contraindications</subject><subject>Drug Monitoring</subject><subject>Epistaxis - chemically induced</subject><subject>Epistaxis - epidemiology</subject><subject>Epistaxis - etiology</subject><subject>Epistaxis - physiopathology</subject><subject>Female</subject><subject>Gastrointestinal Hemorrhage - chemically induced</subject><subject>Gastrointestinal Hemorrhage - epidemiology</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Gastrointestinal Hemorrhage - physiopathology</subject><subject>Hematology</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Ontario - epidemiology</subject><subject>Original Article</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Precision Medicine</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Severity of Illness Index</subject><subject>Telangiectasia, Hereditary Hemorrhagic - complications</subject><subject>Telangiectasia, Hereditary Hemorrhagic - physiopathology</subject><subject>Tertiary Care Centers</subject><subject>Thromboembolism - complications</subject><subject>Thromboembolism - drug therapy</subject><subject>Thromboembolism - etiology</subject><subject>Thromboembolism - prevention & control</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkTtPwzAUhS0EoqXwA1hQJBYWg5-JMyIEFFGJBWbLr6Sp8ii2M_DvcZWCEBLCyx3ud4_PvQeAc4yuMULFTUCIFAVEmEDMOYXiAMwxowQiLtghmKOSlpCnNwMnIWxQAgUjx2BGKOIUF3wOnpfOO9tE5T-ytesG79eqbkwWXav6unEmqtCobKti4_oYMqP6LA6t8yq6TPWxMYOqxza1h_4UHFWqDe5sXxfg7eH-9W4JVy-PT3e3K2hYgSOkzFKWDOiSYkOUsWXOFWaqZLnWRlDDK8qRzRnXQpUFryypqNacaKRYaS1dgKtJd-uH99GFKLsmGNcmx24Yg0yLCUKF4Ox_FHNcoJzmO_TyF7oZRt-nRRLFkg8scJkoPFHGDyF4V8mtb7p0PYmR3IUip1BkurXchSJFmrnYK4-6c_Z74iuFBJAJCKnV187_-PpP1U_rPJa1</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Edwards, Christine Priscilla</creator><creator>Shehata, Nadine</creator><creator>Faughnan, Marie E.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>8FD</scope><scope>FR3</scope><scope>P64</scope><scope>RC3</scope></search><sort><creationdate>20121201</creationdate><title>Hereditary hemorrhagic telangiectasia patients can tolerate anticoagulation</title><author>Edwards, Christine Priscilla ; Shehata, Nadine ; Faughnan, Marie E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-34d34305b931c2acd965a14a946bbc83c5f350d645b8a975fd2f3bb52b0a49dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - adverse effects</topic><topic>Anticoagulants - therapeutic use</topic><topic>Arteriovenous Malformations - epidemiology</topic><topic>Arteriovenous Malformations - etiology</topic><topic>Contraindications</topic><topic>Drug Monitoring</topic><topic>Epistaxis - chemically induced</topic><topic>Epistaxis - epidemiology</topic><topic>Epistaxis - etiology</topic><topic>Epistaxis - physiopathology</topic><topic>Female</topic><topic>Gastrointestinal Hemorrhage - chemically induced</topic><topic>Gastrointestinal Hemorrhage - epidemiology</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Gastrointestinal Hemorrhage - physiopathology</topic><topic>Hematology</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Ontario - epidemiology</topic><topic>Original Article</topic><topic>Platelet Aggregation Inhibitors - adverse effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Precision Medicine</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Severity of Illness Index</topic><topic>Telangiectasia, Hereditary Hemorrhagic - complications</topic><topic>Telangiectasia, Hereditary Hemorrhagic - physiopathology</topic><topic>Tertiary Care Centers</topic><topic>Thromboembolism - complications</topic><topic>Thromboembolism - drug therapy</topic><topic>Thromboembolism - etiology</topic><topic>Thromboembolism - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Edwards, Christine Priscilla</creatorcontrib><creatorcontrib>Shehata, Nadine</creatorcontrib><creatorcontrib>Faughnan, Marie E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><jtitle>Annals of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Edwards, Christine Priscilla</au><au>Shehata, Nadine</au><au>Faughnan, Marie E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hereditary hemorrhagic telangiectasia patients can tolerate anticoagulation</atitle><jtitle>Annals of hematology</jtitle><stitle>Ann Hematol</stitle><addtitle>Ann Hematol</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>91</volume><issue>12</issue><spage>1959</spage><epage>1968</epage><pages>1959-1968</pages><issn>0939-5555</issn><eissn>1432-0584</eissn><abstract>Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterized by arteriovenous malformations (AVMs) and hemorrhage. HHT patients can also suffer from unrelated medical conditions requiring anticoagulant or antiplatelet treatment (collectively “AT”), though clinicians generally consider HHT a contraindication to AT. We hypothesized that HHT patients can tolerate AT with minimal hemorrhage. Through a chart review of 469 definite HHT patients (1997–2009), we found that 64 (14 %) had received AT. Forty-three out of 64 (67 %) underwent a telephone survey to retrospectively inquire about prescription, early cessation, and HHT-related bleeding. At the time of the study, nine patients were deceased, nine declined, and three were unreachable. During AT treatment, ten (23 %) reported severe complications (blood transfusion, emergency room visit, or hospital admission), while 25 (58 %) reported minor complications (increase or development of epistaxis, gastrointestinal bleeding, and anemia). No patients reported pulmonary/cerebral hemorrhage. The 43 patients received a total of 69 courses of AT. Fourteen out of 69 (20 %) AT courses in 13 patients required early cessation, mostly due to epistaxis. Two out of nine (22 %) deceased patients required early cessation. We conclude that HHT patients can be treated with AT but should be monitored closely given their risk for worsening chronic bleeding and should be screened/treated for pulmonary or cerebral AVMs prior to AT treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>23053175</pmid><doi>10.1007/s00277-012-1553-8</doi><tpages>10</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0939-5555 |
| ispartof | Annals of hematology, 2012-12, Vol.91 (12), p.1959-1968 |
| issn | 0939-5555 1432-0584 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1758238854 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Aged, 80 and over Anticoagulants - adverse effects Anticoagulants - therapeutic use Arteriovenous Malformations - epidemiology Arteriovenous Malformations - etiology Contraindications Drug Monitoring Epistaxis - chemically induced Epistaxis - epidemiology Epistaxis - etiology Epistaxis - physiopathology Female Gastrointestinal Hemorrhage - chemically induced Gastrointestinal Hemorrhage - epidemiology Gastrointestinal Hemorrhage - etiology Gastrointestinal Hemorrhage - physiopathology Hematology Hospitals, University Humans Male Medicine Medicine & Public Health Middle Aged Oncology Ontario - epidemiology Original Article Platelet Aggregation Inhibitors - adverse effects Platelet Aggregation Inhibitors - therapeutic use Precision Medicine Prevalence Retrospective Studies Severity of Illness Index Telangiectasia, Hereditary Hemorrhagic - complications Telangiectasia, Hereditary Hemorrhagic - physiopathology Tertiary Care Centers Thromboembolism - complications Thromboembolism - drug therapy Thromboembolism - etiology Thromboembolism - prevention & control |
| title | Hereditary hemorrhagic telangiectasia patients can tolerate anticoagulation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-23T14%3A47%3A20IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Hereditary%20hemorrhagic%20telangiectasia%20patients%20can%20tolerate%20anticoagulation&rft.jtitle=Annals%20of%20hematology&rft.au=Edwards,%20Christine%20Priscilla&rft.date=2012-12-01&rft.volume=91&rft.issue=12&rft.spage=1959&rft.epage=1968&rft.pages=1959-1968&rft.issn=0939-5555&rft.eissn=1432-0584&rft_id=info:doi/10.1007/s00277-012-1553-8&rft_dat=%3Cproquest_cross%3E1758238854%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1149751819&rft_id=info:pmid/23053175&rfr_iscdi=true |