Thrombotic complications following the administration of high-dose prothrombin complex concentrate for acute warfarin reversal
Current recommendations for dosing of PCC in the United States may lead to overcorrection and increased risk of life-threatening thromboembolic complications. [...]an individualized approach to reversal balancing both the urgency of the situation and thromboembolic risk of the patient should be take...
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| Veröffentlicht in: | The American journal of emergency medicine 2016-08, Vol.34 (8), p.1736.e1-1736.e3 |
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| container_title | The American journal of emergency medicine |
| container_volume | 34 |
| creator | Zemrak, Wesley R., PharmD Kelley, Erin, PharmD Kovacic, Nicole L., PharmD Mooney, Deirdre M., MD Morris, Jane G., MD MacVane, Casey Z., MD Rosenblatt, Jeffrey A., MD |
| description | Current recommendations for dosing of PCC in the United States may lead to overcorrection and increased risk of life-threatening thromboembolic complications. [...]an individualized approach to reversal balancing both the urgency of the situation and thromboembolic risk of the patient should be taken into consideration before dose selection. [...]although the rate of thromboembolism with 4-factor PCC in clinical trials appeared similar to that of plasma, in the administration of PCC to more than 140 patients at our institution, thromboembolism within 72hours has occurred at a disproportionately higher rate in patients receiving higher doses of PCC (14.8% [4/27] for 35-50 U/kg vs. 0% [0/114] for 15-25 U/kg). |
| doi_str_mv | 10.1016/j.ajem.2015.12.069 |
| format | Article |
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[...]although the rate of thromboembolism with 4-factor PCC in clinical trials appeared similar to that of plasma, in the administration of PCC to more than 140 patients at our institution, thromboembolism within 72hours has occurred at a disproportionately higher rate in patients receiving higher doses of PCC (14.8% [4/27] for 35-50 U/kg vs. 0% [0/114] for 15-25 U/kg).</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2015.12.069</identifier><identifier>PMID: 26806175</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged, 80 and over ; Anticoagulants - adverse effects ; Blood Coagulation Factors - adverse effects ; Blood Coagulation Factors - therapeutic use ; Blood pressure ; Cardiac arrhythmia ; Cardiovascular disease ; Clinical trials ; Coronary Thrombosis - chemically induced ; Coronary Thrombosis - diagnosis ; Coronary vessels ; Embolisms ; Emergency ; Emergency medical care ; Family medical history ; Female ; Femoral Vein ; Gastrointestinal Hemorrhage - chemically induced ; Gastrointestinal Hemorrhage - drug therapy ; Health risk assessment ; Hemostatics - adverse effects ; Hemostatics - therapeutic use ; Humans ; Laboratories ; Male ; Middle Aged ; Stroke - chemically induced ; Stroke - diagnosis ; Studies ; Thromboembolism ; Thrombosis ; Thrombosis - chemically induced ; Thrombosis - diagnosis ; Venous Thrombosis - chemically induced ; Venous Thrombosis - diagnosis ; Warfarin - adverse effects</subject><ispartof>The American journal of emergency medicine, 2016-08, Vol.34 (8), p.1736.e1-1736.e3</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright Elsevier Limited 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-190761f54a3864e441978f773365c3fe66b0c06b52ad89b9256575e7af3189473</citedby><cites>FETCH-LOGICAL-c509t-190761f54a3864e441978f773365c3fe66b0c06b52ad89b9256575e7af3189473</cites><orcidid>0000-0002-5046-7966</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1807969813?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978,64366,64368,64370,72220</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26806175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zemrak, Wesley R., PharmD</creatorcontrib><creatorcontrib>Kelley, Erin, PharmD</creatorcontrib><creatorcontrib>Kovacic, Nicole L., PharmD</creatorcontrib><creatorcontrib>Mooney, Deirdre M., MD</creatorcontrib><creatorcontrib>Morris, Jane G., MD</creatorcontrib><creatorcontrib>MacVane, Casey Z., MD</creatorcontrib><creatorcontrib>Rosenblatt, Jeffrey A., MD</creatorcontrib><title>Thrombotic complications following the administration of high-dose prothrombin complex concentrate for acute warfarin reversal</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Current recommendations for dosing of PCC in the United States may lead to overcorrection and increased risk of life-threatening thromboembolic complications. [...]an individualized approach to reversal balancing both the urgency of the situation and thromboembolic risk of the patient should be taken into consideration before dose selection. [...]although the rate of thromboembolism with 4-factor PCC in clinical trials appeared similar to that of plasma, in the administration of PCC to more than 140 patients at our institution, thromboembolism within 72hours has occurred at a disproportionately higher rate in patients receiving higher doses of PCC (14.8% [4/27] for 35-50 U/kg vs. 0% [0/114] for 15-25 U/kg).</description><subject>Aged, 80 and over</subject><subject>Anticoagulants - adverse effects</subject><subject>Blood Coagulation Factors - adverse effects</subject><subject>Blood Coagulation Factors - therapeutic use</subject><subject>Blood pressure</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Clinical trials</subject><subject>Coronary Thrombosis - chemically induced</subject><subject>Coronary Thrombosis - diagnosis</subject><subject>Coronary vessels</subject><subject>Embolisms</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Family medical history</subject><subject>Female</subject><subject>Femoral Vein</subject><subject>Gastrointestinal Hemorrhage - 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[...]an individualized approach to reversal balancing both the urgency of the situation and thromboembolic risk of the patient should be taken into consideration before dose selection. [...]although the rate of thromboembolism with 4-factor PCC in clinical trials appeared similar to that of plasma, in the administration of PCC to more than 140 patients at our institution, thromboembolism within 72hours has occurred at a disproportionately higher rate in patients receiving higher doses of PCC (14.8% [4/27] for 35-50 U/kg vs. 0% [0/114] for 15-25 U/kg).</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26806175</pmid><doi>10.1016/j.ajem.2015.12.069</doi><orcidid>https://orcid.org/0000-0002-5046-7966</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0735-6757 |
| ispartof | The American journal of emergency medicine, 2016-08, Vol.34 (8), p.1736.e1-1736.e3 |
| issn | 0735-6757 1532-8171 |
| language | eng |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE; ProQuest Central UK/Ireland |
| subjects | Aged, 80 and over Anticoagulants - adverse effects Blood Coagulation Factors - adverse effects Blood Coagulation Factors - therapeutic use Blood pressure Cardiac arrhythmia Cardiovascular disease Clinical trials Coronary Thrombosis - chemically induced Coronary Thrombosis - diagnosis Coronary vessels Embolisms Emergency Emergency medical care Family medical history Female Femoral Vein Gastrointestinal Hemorrhage - chemically induced Gastrointestinal Hemorrhage - drug therapy Health risk assessment Hemostatics - adverse effects Hemostatics - therapeutic use Humans Laboratories Male Middle Aged Stroke - chemically induced Stroke - diagnosis Studies Thromboembolism Thrombosis Thrombosis - chemically induced Thrombosis - diagnosis Venous Thrombosis - chemically induced Venous Thrombosis - diagnosis Warfarin - adverse effects |
| title | Thrombotic complications following the administration of high-dose prothrombin complex concentrate for acute warfarin reversal |
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