PROTHROMBIN COMPLEX CONCENTRATE FOR RAPID REVERSAL OF WARFARIN-INDUCED ANTICOAGULATION AND INTRACEREBRAL HEMORRHAGE IN PATIENTS SUPPORTED BY A LEFT VENTRICULAR ASSIST DEVICE

被引:7
作者
Takahashi, Ayako [1 ]
Kato, Tomoko S. [1 ,2 ]
Oda, Noboru [1 ,2 ]
Komamura, Kazuo [1 ,2 ]
Kanzaki, Hideaki [1 ]
Asakura, Masaki [1 ]
Hashimura, Kazuhiko [1 ]
Niwaya, Kazuo [3 ]
Funatsu, Toshiaki [3 ]
Nakatani, Takeshi [2 ]
Kobayashi, Junjiro [3 ]
Kitamura, Soichiro [3 ]
Shishido, Toshiaki [4 ]
Miyata, Shigeki [5 ]
Takahashi, Jun C. [6 ]
Iihara, Koji [6 ]
Kitakaze, Masafumi [1 ]
机构
[1] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Osaka 5658565, Japan
[2] Natl Cerebral & Cardiovasc Ctr, Dept Organ Transplantat, Osaka 5658565, Japan
[3] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Surg, Osaka 5658565, Japan
[4] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Dynam, Osaka 5658565, Japan
[5] Natl Cerebral & Cardiovasc Ctr, Dept Blood Transfus, Osaka 5658565, Japan
[6] Natl Cerebral & Cardiovasc Ctr, Dept Neurosurg, Osaka 5658565, Japan
关键词
anticoagulants; cerebral hemorrhage; heart-assist devices; heart transplantation; prothrombin complex concentrate; INTRACRANIAL HEMORRHAGE; FACTOR VIIA; THERAPY; MANAGEMENT;
D O I
10.1016/S1873-9598(10)70038-7
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: Intracerebral hemorrhage (ICH) is one of the most serious complications in patients supported by a left ventricular assist device (LVAD). We evaluate the efficacy of prothrombin complex concentrate (PCC) for rapid reversal of warfarin-induced anticoagulation in this population. Methods: A total of 38 consecutive ICH events in patients supported by an LVAD between 1996 and 2007 were retrospectively reviewed. Fourteen ICH events were treated with fresh frozen plasma (FFP) (Group FFP) and 24 ICH events were treated with PCC (Group PCC). The efficacy and outcome of PCC administration versus FFP were evaluated. Results: The proportion of patients surviving after an ICH event was significantly smaller in Group FFP than Group PCC (35.7% vs. 75.0%, p<0.05). None of the patients in Group FFP were able to undergo heart transplantation, whereas 21.4% patients in Group PCC successfully underwent heart transplantation. Conclusion: Patients on LVAD are in need for intensified anticoagulation and are at high risk of ICH; therefore, adequate use of PCC in the event of ICH could be of importance for survival and allow subsequent heart transplantation. [International Journal of Gerontology 2010; 4(3): 143-147]
引用
收藏
页码:143 / 147
页数:5
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