Category Archives: Hematology and Oncology

ASA for post-THA VTE prophylaxis

This trial randomized post-THA patients to dalteparin or ASA for 28 days (after 10 days of dalteparin) and found no significant difference in VTE or bleeding rates. After 10 days of dalteparin, 28 days of ASA is safe and effective … Continue reading

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Continue warfarin for pacer/ICD procedures

In this trial of patients on warfarin undergoing a pacer/ICD procedure, they were randomized to continue warfarin perioperatively, or receive heparin bridge therapy. The study was stopped early when the heparin group suffered 4 times more device pocket hematomas than … Continue reading

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FDA approves prothrombin concentrate

The FDA just approved a prothrombin complex concentrate (Kcentra) to reversal bleeding associated with vitamin K antagonists. It does not require thawing or blood type matching, unlike plasma, but it does carry a black box warning for risk of clotting … Continue reading

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Steroids may increase VTE risk

This large population based cohort found current use of steroids increased the risk of VTE by a factor of 2-3, depending on the timing and dosage. Steroids should be factored in when determining VTE risk (abstract).

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Lactate predicts mortality in PE

In this single center study, lactate levels >2 were significantly associated with risk of death at 30 days (mortality of 17% in those with levels >2 versus 2% in those with levels <2 mmol/L); overall the lactate level was significantly … Continue reading

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IVC filters rarely beneficial

This large single center retrospective cohort of ~700 patients who had retrievable IVC filters placed, found only 9% were successfully removed, 18% were attempted to be removed and failed, and 8% suffered a subsequent thrombotic event despite the IVC. Although … Continue reading

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Dabigatran vs warfarin for extended treatment of VTE

This large placebo controlled trial of patients with VTE, already treated with 3 months of anticoagulation, randomized them to dabigatran, warfarin, or placebo; dabigatran and warfarin had similar rates of recurrent VTE, but dabigatran had lower rates of major/minor bleeding … Continue reading

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No benefit for IVC filters with bariatric surgery

In this large statewide registry of bariatric patients, there was no benefit of prophylactic IVC filters, but there was significant harm, including higher rates of PE, DVT, complications, and death. There does not appear to be any benefit of IVC … Continue reading

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Preoperative transfusions for sickle cell

In this trial of preoperative sickle cell patients, they were randomized to preoperative RBC transfusions or none; those in the non-transfusion group had higher complication rates (39% vs 15%) and serious adverse events (10% vs 1%) compared to those in … Continue reading

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Rivaroxaban equivalent to LMWH for VTE prophylaxis, but higher bleeding

For standard duration VTE prophylaxis, rivaroxaban was equivalent to LMWH, but had a higher risk of bleeding. When VTE prophylaxis was extended (from 10 days to 35 days), the risk of VTE was further reduced, but the risk of bleeding … Continue reading

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