dicumarol and Thromboembolism

Topics: Administration, Oral; Anaphylaxis; Anticoagulants; Dicumarol; Disseminated Intravascular Coagulation; Drug Evaluation; Drug Hypersensitivity; Female; Fibrinolytic Agents; Heparin; Humans; Male; Pregnancy; Streptokinase; Thromboembolism; Time Factors

Topics: Adenine Nucleotides; Aminocaproates; Animals; Anticoagulants; Blood Platelets; Dicumarol; Fractures, Bone; Hemorrhage; Hemostasis; Heparin; Hip Injuries; Humans; Thromboembolism; Thrombosis

Topics: Anticoagulants; Chronic Disease; Dicumarol; Evaluation Studies as Topic; Humans; Myocardial Infarction; Thromboembolism; Thrombosis

Topics: Acenocoumarol; Angina Pectoris; Anticoagulants; Cerebrovascular Disorders; Dicumarol; Heparin; Humans; Myocardial Infarction; Phlebitis; Rheumatic Heart Disease; Thromboembolism; Thrombophlebitis; Warfarin

Topics: Dicumarol; Heart Failure; Heparin; Humans; Hydrocortisone; Muscle Relaxants, Central; Norepinephrine; Pulmonary Embolism; Thromboembolism

Topics: Adult; Aged; Anticoagulants; Blood Coagulation Tests; Cerebral Hemorrhage; Clinical Trials as Topic; Death, Sudden; Dicumarol; Female; Humans; Male; Middle Aged; Myocardial Infarction; Phenindione; Thromboembolism; Time Factors

Recent studies have demonstrated the efficacy and safety of new oral anticoagulant drugs for the prevention of thromboembolic events in patients with non-valvular atrial fibrillation. Our aim was to evaluate the factors that can influence physicians in their choice between a classic and a new anticoagulant in these patients.. Several variables of interest were discussed and analysed using a Workmat. Six regional meetings were held in Spain (East, Catalonia, Andalusia-Extremadura, Madrid, North-east, and North of Spain).. Meetings were attended by 39 specialists (cardiologists, neurologists, haematologists, internists, and emergency and Primary Care physicians).. Each participant graded their level of agreement, with a score from 1 to 10, on every analysed variable.. A new anticoagulant drug was preferred in patients with previous failure of dicoumarin therapy (9.7±0.5), high haemorrhagic risk (8.7±1), prior bleeding (7.8±1.5), and high thrombotic risk (7.7±1.2). Dicoumarins were preferred in cases of severe (1.2±0.4) or moderate (4.2±2.5) kidney failure, good control with dicoumarins (2.3±1.5), cognitive impairment (3.2±3), and low haemorrhagic risk (4.3±3). Age, sex, weight, cost of drug, polymedication, and low thrombotic risk achieved intermediate scores. There were no differences between the different specialists or Spanish regions.. The presence of a high thrombotic or haemorrhagic risk and the failure of previous dicoumarin therapy lead to choosing a new oral anticoagulant in patients with non-valvular atrial fibrillation, while kidney failure, cognitive impairment, good control with dicoumarins, and a low bleeding risk predispose to selecting a classic dicoumarin anticoagulant.

Topics: Anticoagulants; Atrial Fibrillation; Dicumarol; Humans; Practice Patterns, Physicians'; Spain; Stroke; Thromboembolism

The morbidity and mortality of pulmonary embolism (PE) have been found to be related to early diagnosis and appropriate treatment. The examinations used to diagnose PE are expensive and not always easily accessible. These options include noninvasive examinations, such as clinical pretests, ELISA D-dimer (DD) tests, and volumetric capnography (VCap). We report the case of a patient whose diagnosis of PE was made via pulmonary arteriography. The clinical pretest revealed a moderate probability of the patient having PE, and the DD result was negative; however, the VCap associated with arterial blood gases result was positive. The patient underwent all noninvasive exams following admission to hospital and again eight months after discharge. Results gained from invasive tests were similar to those produced by image exams, highlighting the importance of VCap as an important noninvasive tool.

Topics: Adult; Anticoagulants; Biomarkers; Capnography; Chronic Disease; Dicumarol; Enzyme-Linked Immunosorbent Assay; Fibrin Fibrinogen Degradation Products; Humans; Lung; Male; Perfusion Imaging; Predictive Value of Tests; Prognosis; Pulmonary Embolism; Respiratory Dead Space; Thromboembolism; Ventilation-Perfusion Ratio

A 19-year-old man with congenital cyanotic heart disease experienced subarachnoid bleeding from a ruptured cerebral aneurysm. Immediate rebleeding with disordered hemostasis caused by prophylactic anticoagulation treatment was the cause of death. Medical progress in repairing congenital heart disease or attenuating its effects has increased the life expectancy of such patients. Anesthesiologists who are not specialized in this area may find themselves assuming responsibility for these patients during non-cardiac surgery of greater or lesser extension.

Topics: Adult; Aneurysm, Ruptured; Anticoagulants; Cyanosis; Dicumarol; Encephalocele; Fatal Outcome; Heart Septal Defects, Ventricular; Humans; Intracranial Aneurysm; Intracranial Hypertension; Intraoperative Complications; Male; Postoperative Complications; Prothrombin; Pulmonary Atresia; Recurrence; Subarachnoid Hemorrhage; Thromboembolism

Topics: Aged; Anticoagulants; Atrial Fibrillation; Chronic Disease; Dicumarol; Female; Humans; Male; Platelet Aggregation Inhibitors; Risk Factors; Thromboembolism; Thrombolytic Therapy

Topics: Adolescent; Aortic Valve; Bioprosthesis; Child; Dicumarol; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Hemodynamics; Hemorrhage; Humans; Male; Mitral Valve; Postoperative Complications; Prosthesis Design; Prosthesis Failure; Thromboembolism

Topics: Adult; Atrial Fibrillation; Bioprosthesis; Calcinosis; Cardiac Output, Low; Dicumarol; Female; Follow-Up Studies; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Postoperative Complications; Prosthesis Design; Risk; Thromboembolism; Thrombosis

Veterinarians and physicians are frequently not fully aware of the interdependencies of veterinary and human medicine. This short outline of the history of anticoagulation by dicumarol(analogues) beginning with the observation in 1922 of a previously unknown illness in cattle is intended to point out this important interrelation.

Topics: Animals; Anticoagulants; Canada; Cattle; Cattle Diseases; Dicumarol; Disease Models, Animal; History, 20th Century; Humans; Hypoprothrombinemias; Thromboembolism; United States

Between November, 1970, and December, 1977, 932 consecutive patients received the standard Björk-Shiley prosthesis. Operative mortality was 4.6% for aortic valve replacement (AVR; N = 364), 5.1% for mitral valve replacement (MVR; N = 313); 11.3% for multiple valve replacement (N = 194), and 13.7% for valve replacement combined with coronary artery bypass grafting (CABG; N = 51). Factors influencing hospital mortality included type of valve replacement, age at operation, whether the valve replacement was done as an emergency, and year of implantation. Complete follow-up (mean, 3.7 years) was achieved in 95% of the survivors. Actuarial survival was 82% for AVR patients at 8 years, 83% for MVR patients at 7 years, 72% for multiple valve replacement patients at 7 years, and 76% for those who had valve replacement with CABG at 3 years. No significant difference in late survival was found between patients with mitral insufficiency alone (p greater than 0.2) or aortic insufficiency alone (p greater than 0.9) and those with stenotic lesions only. Thromboembolic complications occurred at an incidence of 1.17% per patient-year, and Dicumarol-induced hemorrhages occurred at an incidence of 2.11% per patient-year. Twelve out of 13 patients survived operation for prosthetic valve thrombosis, indicating that this complication is not as catastrophic as many believe. The incidence of reoperation in anticoagulated patients was 0.63% per patient-year. All of these results are compared with data from the recent literature.

Topics: Aged; Aortic Valve; Coronary Artery Bypass; Dicumarol; Follow-Up Studies; Heart Valve Prosthesis; Hemorrhage; Humans; Mitral Valve; Reoperation; Thromboembolism

Twenty-four children (ages 1 to 18 years, mean 12.2 years) underwent 27 operations for aortic, mitral, or combined aortic and mitral valve replacement. There was 1 operative death. Of the 23 operative survivors (12 aortic, 8 mitral, 3 combined valve replacement), only 5 were given warfarin for long-term anticoagulation. The remaining 18 (10 aortic, 8 mitral valve replacement) were given aspirin (plus dipyridamole in 5). Twelve of the 18 had at least one mechanical valve (11 Björk-Shiley and Beall valves; 1 Björk-Shiley valve was replaced with a Beall disc valve as the child grew). These 18 patients were followed for 1 to 59 months (mean, 20.4 months). There was no thrombotic, embolic, or bleeding complications. There were 2 late deaths (one cardiac). Review of the available literature indicates that in children with prosthetic cardiac valves, aspirin (with or without dipyridamole) provides adequate protection against thromboemboli and avoids the hemorrhagic complications associated with warfarin.

Topics: Adolescent; Anticoagulants; Aortic Valve; Aspirin; Bioprosthesis; Child; Child, Preschool; Dicumarol; Dipyridamole; Drug Therapy, Combination; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Infant; Mitral Valve; Postoperative Complications; Retrospective Studies; Thromboembolism; Warfarin

Replacement of the mitral valve with the Björk-Shiley tilting disc valve prosthesis was performed in 203 consecutive patients with isolated mitral valvular disease at Karolinska Sjukhuset, Stockholm, Sweden, during the 6-year period ending December 1975. Results with the Delrin and pyrolytic carbon disc prostheses were analysed with actuarial techniques and compared in terms of mortality rate, incidence of thrombo-embolism and frequency of re-operation. Early (4%) and late mortality rates (7.5 deaths per 100 patient years) were similar with both types of prostheses. No case of primary mechanical prosthetic failure was encountered. The pyrolytic carbon disc prostheses have obviously decreased the incidence of systemic emboli from 9.6 to 5.3 per 100 patient years and so far eliminated mortality due to embolization. This benefit is probably related to the increased opening angle from 50 degrees to 60 degrees in the pyrolytic carbon disc model, which causes less resistance to blood flow. Thrombotic obstruction of the prosthetic valve, however, has been a persistent problem in the order of 3.3 incidences per 100 patient years. Only one patient in twelve involved was referred to our clinic and could be saved by an emergency re-operation. The development of the ring-shaped radiopaque marker in the tilting disc occluder provides a valuable tool for instant diagnosis of partly or completely obstructed disc motion caused by thrombosis. Disc motion can be easily visualized by cineradiography or fluoroscopy. Early diagnosis of and emergency operation for thrombotic obstruction of the prosthesis will reduce the mortality due to this dangerous complication.

Topics: Adolescent; Adult; Arrhythmias, Cardiac; Child; Dicumarol; Evaluation Studies as Topic; Female; Follow-Up Studies; Heart Failure; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Myocardial Infarction; Thromboembolism; Time Factors; Warfarin

Dicumarol anticoagulation poved very effective in the prevention of thromboembolic complications after aortic valve replacement with the Björk-Shiley tilting disc valve. We have, however, encountered six late deaths because of massive cerebral hemorrhage, which represent 3% of the patients who were maintained on dicumarol medication at that time. This unacceptable mortality prompted us to introduce two programmes, one without anticoagulation and another one with dipyridamole-acetylsalicylic acid. Furthermore, dicumarol was terminated in patients with haemorrhagic episodes, instable anticoagulation, pregnancy, and in those reguiring surgery. The results were disappointing, however, and the majority of the patients involved were therefore put on dicumarol medication. Eleven of the 64 consecutive patients taking dipyridamole - acetylsalicylic acid had thrombo-embolic episodes during a mean follow-up period of 9 months...

Topics: Adult; Aortic Valve; Aspirin; Cerebral Hemorrhage; Dicumarol; Dipyridamole; Drug Therapy, Combination; Female; Follow-Up Studies; Heart Valve Prosthesis; Humans; Middle Aged; Postoperative Complications; Thromboembolism; Time Factors

Topics: Adult; Aged; Aortic Valve; Aortic Valve Insufficiency; Aortic Valve Stenosis; Aortography; Blood Flow Velocity; Blood Pressure; Dicumarol; Female; Follow-Up Studies; Haptoglobins; Heart Valve Prosthesis; Hemolysis; Humans; L-Lactate Dehydrogenase; Male; Middle Aged; Postoperative Complications; Prognosis; Recurrence; Thromboembolism

Topics: Blood Coagulation; Blood Coagulation Tests; Dicumarol; Humans; Methods; Thromboembolism

Topics: Adolescent; Adult; Blood Flow Velocity; Blood Pressure; Blood Volume; Cardiac Output; Cardiac Volume; Child; Child, Preschool; Dicumarol; Exercise Test; Female; Follow-Up Studies; Heart Valve Prosthesis; Hemodynamics; Hemoglobins; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Insufficiency; Mitral Valve Stenosis; Postoperative Complications; Pulmonary Circulation; Thromboembolism

Topics: Aged; Dextrans; Dicumarol; Female; Heparin; Humans; Iodohippuric Acid; Leg; Male; Middle Aged; Phlebography; Postoperative Complications; Radioisotopes; Regional Blood Flow; Rheology; Serum Albumin, Radio-Iodinated; Thromboembolism; Thrombophlebitis; Time Factors; Xenon

Topics: Anticoagulants; Cerebral Hemorrhage; Dicumarol; Drug Antagonism; Hematoma; Hematoma, Subdural; Humans; Middle Aged; Spinal Cord Diseases; Thromboembolism; Time Factors

Topics: Age Factors; Aged; Anticoagulants; Arrhythmias, Cardiac; Cerebrovascular Disorders; Coronary Disease; Death, Sudden; Dicumarol; Female; Humans; Long-Term Care; Male; Myocardial Infarction; Retrospective Studies; Sex Factors; Thromboembolism

Topics: Anaphylaxis; Antibodies; Blood Pressure; Cardiac Catheterization; Cardiac Output; Depression, Chemical; Dicumarol; Female; Hemodynamics; Heparin; Humans; Hypertension, Pulmonary; Male; Prednisone; Pulmonary Artery; Radionuclide Imaging; Stimulation, Chemical; Streptokinase; Thromboembolism; Vascular Resistance

Topics: Blood Coagulation Tests; Dicumarol; Fibrinolytic Agents; Heparin; Humans; Infusions, Parenteral; Myocardial Infarction; Streptokinase; Thromboembolism

Topics: Anticoagulants; Blood Coagulation Tests; Dicumarol; Fibrinolytic Agents; Heparin; Humans; Phenindione; Thromboembolism

Topics: Adult; Anticoagulants; Dicumarol; Female; Heart Valve Prosthesis; Humans; Pregnancy; Pregnancy Complications, Cardiovascular; Thromboembolism

Topics: Animals; Blood Coagulation Disorders; Dicumarol; Female; Fetal Diseases; Humans; Kidney; Liver; Lung; Pregnancy; Pregnancy Complications, Cardiovascular; Rabbits; Thromboembolism

Topics: Anticoagulants; Dicumarol; Fibrinolytic Agents; Heparin; Humans; Metformin; Myocardial Infarction; Thromboembolism

Topics: Abdomen; Coumarins; Dicumarol; Humans; Postoperative Complications; Thromboembolism; Warfarin

Topics: Arrhythmias, Cardiac; Dicumarol; Diet; Diet Therapy; Heart Failure; Heart Massage; Heparin; Humans; Meperidine; Morphine; Myocardial Infarction; Oxygen Inhalation Therapy; Rest; Therapeutics; Thromboembolism; Ventricular Fibrillation

Topics: Biomedical Research; Dicumarol; Drug Therapy; Thromboembolism

Topics: Anticoagulants; Coronary Disease; Dicumarol; Heart Defects, Congenital; Heart Valve Diseases; Intracranial Arteriosclerosis; Phlebitis; Pulmonary Emphysema; Thromboembolism; Toxicology; Vascular Diseases; Warfarin

Topics: Acenocoumarol; Anticoagulants; Ascorbic Acid; Dicumarol; Family Practice; General Practice; Occupations; Prothrombin Time; Statistics as Topic; Thromboembolism; Toxicology; Warfarin

Topics: Anaphylaxis; Dicumarol; Fibrinolysin; Hemorrhage; Heparin; Hepatitis; Hepatitis B virus; Humans; Myocardial Infarction; Pulmonary Embolism; Thromboembolism; Thrombophlebitis; Toxicology

Topics: Anticoagulants; Arrhythmias, Cardiac; Blood Cell Count; Cerebrovascular Disorders; Coronary Disease; Diabetes Mellitus; Dicumarol; Heart Failure; Heparin; Humans; Hypertension; Kidney Diseases; Liver Diseases; Myocardial Infarction; Peptic Ulcer; Pulmonary Embolism; Shock; Thromboembolism; Thrombophlebitis; Thrombosis; Varicose Veins; Warfarin

Topics: Anticoagulants; Blood Coagulation Tests; Dicumarol; Heparin; Humans; Thromboembolism

Topics: 4-Aminobenzoic Acid; Aminobenzoates; Bronchopneumonia; Cerebral Hemorrhage; Cerebrovascular Disorders; Dicumarol; Dihydroergotoxine; Ergot Alkaloids; Femoral Neck Fractures; Fracture Fixation; Heparin; Mortality; Myocardial Infarction; Neoplasms; Phenindione; Preventive Medicine; Pulmonary Embolism; Surgical Procedures, Operative; Sweden; Thromboembolism

Topics: Acenocoumarol; Aged; Anticoagulants; Cerebrovascular Disorders; Coronary Disease; Dicumarol; Drug Therapy; Ethyl Biscoumacetate; Geriatrics; Humans; Incidence; Middle Aged; Mortality; Neoplasm Metastasis; Neoplasms; Pathology; Phenindione; Thromboembolism; Warfarin

Topics: Animal Experimentation; Animals; Blood Circulation; Dicumarol; Humans; Necrosis; Niacin; Nicotinic Acids; Pharmacology; Postoperative Care; Rats; Research; Skin Transplantation; Surgical Flaps; Theophylline; Thromboembolism; Xanthinol Niacinate

Topics: Anticoagulants; Dicumarol; Heparin; Humans; Preventive Medicine; Surgical Procedures, Operative; Thromboembolism; Thrombophlebitis; Warfarin

Topics: Anticoagulants; Dicumarol; Ethane; Thromboembolism

Topics: Anticoagulants; Dicumarol; Thromboembolism

Topics: Anticoagulants; Dicumarol; Humans; Postoperative Complications; Pulmonary Embolism; Surgical Procedures, Operative; Thromboembolism

Topics: Anticoagulants; Coumarins; Dicumarol; Embolism; Humans; Phenprocoumon; Postoperative Complications; Surgical Procedures, Operative; Thromboembolism

Topics: Anticoagulants; Dicumarol; Embolism; Fibrinolysin; Thromboembolism

Topics: Coumarins; Dicumarol; Humans; Sodium; Sodium, Dietary; Thromboembolism; Warfarin

Topics: Anticoagulants; Dicumarol; Embolism; Heparin; Humans; Phenindione; Thromboembolism; Vascular Diseases

Topics: 4-Hydroxycoumarins; Coumarins; Dicumarol; Ethyl Biscoumacetate; Humans; Thromboembolism

Topics: Anticoagulants; Coumarins; Dicumarol; Sodium; Thromboembolism; Warfarin

Topics: Anticoagulants; Coumarins; Dicumarol; Humans; Phenprocoumon; Thromboembolism

Topics: Coumarins; Dicumarol; Ethyl Biscoumacetate; Humans; Thromboembolism

Topics: Anticoagulants; Coumarins; Dicumarol; Humans; Postoperative Care; Postoperative Complications; Private Practice; Thromboembolism

Topics: Coumarins; Dicumarol; Thromboembolism

Topics: Anticoagulants; Coumarins; Dicumarol; Humans; Patients; Postoperative Care; Postoperative Period; Thromboembolism

Topics: Coronary Thrombosis; Coumarins; Dicumarol; Thromboembolism

Topics: Coronary Disease; Coronary Thrombosis; Coumarins; Dicumarol; Embolism; Thromboembolism

Topics: American Heart Association; Anticoagulants; Coumarins; Dicumarol; Ethyl Biscoumacetate; Thromboembolism; United States

Topics: Anticoagulants; Dicumarol; Thromboembolism; Thrombophlebitis

Topics: Anticoagulants; Coumarins; Dicumarol; Humans; Suppositories; Thromboembolism

Topics: Anticoagulants; Dicumarol; Embolism; Heparin; Humans; Thromboembolism; Thrombosis

Topics: Dicumarol; Embolism; General Surgery; Humans; Incidence; Postoperative Period; Thromboembolism; Thrombosis; Walking

Topics: Dicumarol; Heart; Heart Failure; Humans; Thromboembolism

Topics: Dicumarol; General Surgery; Heparin; Manipulation, Osteopathic; Thromboembolism; Thrombosis