thromboplastin and Gastrointestinal-Hemorrhage

Anticoagulants are effective at preventing and treating thrombosis, but can cause bleeding. For decades, vitamin K antagonists (VKAs) have been the only available oral anticoagulants. The development of non-VKA oral anticoagulants (NOACs), which inhibit either factor Xa or thrombin stoichiometrically, has provided alternatives to VKAs for several indications. The results of recent large-scale randomised controlled trials comparing NOACs with VKAs for the prevention of stroke in patients with non-valvular atrial fibrillation (AF) have produced some unexpected results. As a group, NOACs showed similar efficacy as warfarin, but a reduced risk of major bleeding. The reduction in bleeding with NOACs was greatest with intracranial hemorrhage. In contrast, the relative risk of gastro-intestinal bleeding was increased with some NOACs. In this review, we explore the potential mechanisms as well as the implications of these organ-specific bleeding patterns.

Topics: Anticoagulants; Atrial Fibrillation; Blood Coagulation Factors; Endothelium, Vascular; Factor Xa Inhibitors; Gastrointestinal Hemorrhage; Hemorrhage; Humans; International Normalized Ratio; Intestinal Absorption; Intracranial Hemorrhages; Organ Specificity; Randomized Controlled Trials as Topic; Stroke; Thrombophilia; Thromboplastin; Vitamin K; Warfarin

Topics: Adult; Child; Ecchymosis; Epistaxis; Factor V; Factor V Deficiency; Female; Gastrointestinal Hemorrhage; Hemarthrosis; Hematuria; Hemorrhage; Humans; Hypoprothrombinemias; Male; Menstruation Disturbances; Prothrombin Time; Thromboplastin

Topics: Blood Coagulation Factors; Blood Coagulation Tests; Blood Transfusion; Cerebral Hemorrhage; Epistaxis; Factor VIII; Gastrointestinal Hemorrhage; Hemarthrosis; Hematuria; Hemophilia A; Hemorrhage; Humans; Oral Hemorrhage; Thromboplastin; Wounds and Injuries

Topics: Anticoagulants; Celiac Disease; Diagnosis, Differential; Esophageal and Gastric Varices; Female; Gastrointestinal Hemorrhage; Humans; Mesenteric Vascular Occlusion; Mesenteric Veins; Middle Aged; Thromboplastin; Thrombosis; Vitamin K

After observing that lavage of the stomach with alkaline solutions has a beneficial effect on the control of gastric hemorrhage, we examined the platelet and coagulation factor activities under conditions of lower and elevated pH. The results showed that change of the pH from acidosis to 7.0 and even to slight alkalosis induces platelet aggregation, platelet calcium and serotonin release, as well as platelet factor II availability. The prothrombin and partial thromboplastin times approached normal levels, whereas the fibrinogen level did not change significantly. The results obtained may serve as an explanation for the control of the intragastric bleeding in patients treated by maintenance of their gastric pH at 7.0.

Topics: Blood Coagulation Factors; Blood Coagulation Tests; Blood Platelets; Calcium; Epinephrine; Gastrointestinal Hemorrhage; Humans; Hydrogen-Ion Concentration; Platelet Aggregation; Serotonin; Thromboplastin

Topics: Animals; Blood Coagulation; Blood Platelets; Depression, Chemical; Disseminated Intravascular Coagulation; Ethanol; Factor V; Female; Fibrinogen; Gastrointestinal Hemorrhage; Hematocrit; Infusions, Parenteral; Male; Rabbits; Thromboplastin; Time Factors; Warfarin

Topics: Aged; Blood Coagulation Tests; Blood Platelet Disorders; Chronic Disease; Disseminated Intravascular Coagulation; Fibrin; Gastrointestinal Hemorrhage; Heparin; Humans; Male; Middle Aged; Neoplasm Metastasis; Prostatic Neoplasms; Prothrombin Time; Thromboplastin

Topics: Adult; Aged; Antifibrinolytic Agents; Blood Transfusion; Dextrans; Female; Gastrointestinal Hemorrhage; Humans; Infusions, Parenteral; Male; Middle Aged; Thromboplastin

Topics: Fibrinolysis; Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis; Prothrombin Time; Serum Globulins; Thromboplastin

Topics: Anti-Bacterial Agents; Blood Cell Count; Blood Coagulation; Blood Coagulation Disorders; Blood Coagulation Tests; Blood Platelets; Child; Cystic Fibrosis; Fibrinolysis; Gastrointestinal Hemorrhage; Hemoptysis; Hepatomegaly; Humans; Liver; Liver Function Tests; Lung; Prospective Studies; Prothrombin Time; Splenomegaly; Thrombocytopenia; Thromboplastin; Vitamin K

Topics: ABO Blood-Group System; Adolescent; Adult; Aged; Anemia, Aplastic; Blood Coagulation; Blood Coagulation Tests; Blood Transfusion; Capillary Fragility; Centrifugation; Female; Fibrinolysin; Fibrinolysis; Gastrointestinal Hemorrhage; Hematuria; Hemostasis; Hepatitis; Humans; Leukemia, Myeloid; Male; Middle Aged; Prothrombin Time; Stomach Neoplasms; Stomach Ulcer; Thrombin; Thromboangiitis Obliterans; Thromboplastin

Topics: Blood Coagulation Tests; Blood Platelet Disorders; Blood Transfusion; Factor VIII; Gastrointestinal Hemorrhage; Hemophilia A; Humans; Male; Thromboplastin; von Willebrand Diseases

Topics: Blood Coagulation Disorders; Factor XI Deficiency; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Thromboplastin

Topics: Duodenum; Gastrointestinal Hemorrhage; Gelatin Sponge, Absorbable; Hemorrhage; Humans; Stomach; Thrombin; Thromboplastin