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COVID-19 and Coagulopathy – Two Management Guidance Documents For Health Care Professionals
Dr. Stephan Moll writes (last updated: March 27th, 2020)… Background and Questions: Infection with COVID-19 can lead to a coagulopathy. Are any of the coagulation markers helpful to predict good or bad outcome? Which coagulation tests should be obtained in hospitalized patients? Should the coagulopathy be treated and, if yes, how? Two separate documents were…
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Athletes and Blood Clots
Stephan Moll, MD writes: Athletes with DVT or PE and on anticoagulation face significant challenges returning to full athletic activities. A recent publication of the American College of Cardiology discusses individualized management regimens that may return athletes to return to their sport – http://www.bit.ly/2erRLc0. Last updated: Oct 30th, 2016
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NO FDA Approval Yet for Andexanet
Stephan Moll, MD writes… The FDA did NOT approve Andexanet (brand names: AndexXa™ in the US, IndexXa™ in Europe) in a decision on August 18th, 2016. Andexanet is the antidote in clinical development to reverse the anticoagulant effect of Eliquis® (rivaroxaban), Savaysa® (edoxaban), Xarelto® (rivaroxaban) and Lovenox® (enoxaparin). The FDA is said to have requested more information from…
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Heavier Menstrual Bleeding on Xarelto?
Stephan Moll, MD writes… Interesting and noteworthy observations published in the last 2 weeks: Heavy menstrual bleeding appears to occur more commonly with Xarelto® than with warfarin [ref 1] and may be also more common with Xarelto® than with Eliquis® [ref 2].
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Contraceptive Use While on Anticoagulants is Safe
Stephan Moll, MD writes… Interesting and clinically relevant publication this week [ref 1]. It is well known that estrogens and certain progestin preparations increase the risk for venous thromboembolism (VTE). A woman on an anticoagulant may have heavy menstrual bleeds and hormonal therapy – such as estrogen-progestin contraceptives – may be considered to decrease the bleeding.…
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Bleeding on Antithrombotics: Reversal Protocol 2016
Stephan Moll, MD writes… Our medical center (University of North Carolina Hospitals, Chapel Hill) has put together a comprehensive “Emergent Anticoagulation Reversal Guideline” for our local use, updated since its last edition in 2014 with information about Pradaxa® reversal (with Praxbind®). It is a practical, clinical how-to document (2016 PDF here ). Colleagues and hospitals are welcome to take the…
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IVC Filters, May-Thurner Syndrome, Pelvic Vein Stents
Stephan Moll, MD writes… An article for patients discussing (a) IVC filters, (b) narrowing of the main left pelvic vein (May-Thurner syndrome) and (c) pelvic venous stents has just been published (http://circ.ahajournals.org/content/133/6/e383.full.pdf). Color images of anatomy, filters and stents are included as visual aids. The article may be helpful as handout material for patients in…
