جستجوی مقالات مرتبط با کلیدواژه « ضد انعقاد » در نشریات گروه « پزشکی »

Atrial Fibrillation (AF) is one of the most common arrhythmias that expose patients to thromboembolic events and hemodynamic instabilities. These events increase the risk of developing heart failure, myocardial infarction, sudden cardiac death, and dementia that eventually increase the rate of mortality in patients. The use of anticoagulants can prevent the mentioned severe adverse events. Two commonly used oral anticoagulant groups in AF patients are vitamin K antagonists (warfarin) and non-vitamin K oral antagonists (NOACs) that consist of direct factor Xa inhibitors and direct factor IIa inhibitors. Previous research proved the efficacy of both groups in reducing ischemic events in AF patients. In this review article, we were to evaluate and compare the safety and efficacy of these agents in reducing ischemic and thromboembolic events in AF patients with complicated risk factors such as chronic kidney disease, prosthetic heart valve, history of previous intracranial hemorrhage, etc. Finally, the reversal agents of these anticoagulants have been reviewed in case of severe bleeding, intoxication, and the urgent need for emergency surgery.

Contradicting statistics exist regarding the prevalence of deep vein thrombosis (DVT) following lower limb trauma despite administration of anti-thrombotic agents. The present study aimed to evaluate the prevalence of DVT in patients with lower limb trauma despite receiving anticoagulant prophylaxis.
The present crosssectional study was carried out to evaluate the prevalence of traumatic lower limbs DVT despite anti-thrombotic therapy, in patients presenting to emergency department. Patients over 18 years old with traumas in the areas lower than knees in need for fixation with cast or splint for > 2 weeks were enrolled. Data were analyzed using SPSS version 21 and descriptive statistics.
130 patients with the mean age of 40.05 ± 18.5 (15-92) were studied (61.5% male). 18 (13.8%) cases had history of drug abuse, 1 (0.8%) had diabetes mellitus, 8 (6.2%) had hypertension, 1 (0.8%) had asthma, and 1 (0.8%) had history of cranial vascular thrombosis. Mechanism of trauma was falling down in 44 (33.8%) cases, road traffic collisions in 50 (38.5%), and direct trauma in 36 (27.7%). 3 (2.3%) patients developed DVT despite receiving prophylactic anti-thrombotic agents. The mean time interval between discharge and development of DVT was 6 ± 3.6 days.
Based on the results of the present study, the prevalence of DVT, despite receiving anti-thrombotic agents, in patients with lower limb trauma in need for fixation for > 2 weeks was 2.3%. All three cases of DVT in this study were developed in the first 2 weeks of fixation.

Background and A post-cesarean wound complication occurs despite compliance with surgical techniques. The purpose of this study was to compare wound complications after cesarean sections in high-risk women with or without anticoagulant treatment. The mean age of participants was 28 years old. Among the subjects 71.6% underwent emergency cesarean section and post-cesarean wound was seen in 1.9%. There were 2.6% (n=18) who received anticoagulant treatment. Most of these patients aged 20 to 27 years old and the most common complications were superficial and deep wound dehiscence. There was a significant correlation between the symptoms and receiving anticoagulation (P<0.001). Significant differences were seen between the two groups in rate of wound complication following cesarean section (P <0.048). Use of anticoagulation in patients with cesarean section has complications such as wound dehiscence, bleeding, hematoma, and infection. Efforts should be made to increase the rate of normal deliveries, thereby reducing the number of caesarean section and its complications.