Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ACENOCOUMAROL”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

Platelet function in patients with chronic coronary heart disease on long-term anticoagulant therapy: effect of anticoagulant stopping.

Plasma beta-thromboglobulin (beta TG), platelet procoagulant activity (PPA) and malondialdehyde were evaluated in a control group and in 59 patients with chronic coronary heart disease (CHD) undergoing long-term anticoagulant therapy (ACT) with acenocoumarol, and within 2 months after its termination. The patients were clinically stabilized after more than 1 year of an acute myocardial infarction. An increase in beta TG and PPA was found in the patients, both with or without ACT, when compared to the control group. In addition, PPA was found to be higher in older and hypercholesterolemic patients on ACT. After ACT suppression, PPA activity increased significantly, particularly in younger and normocholesterolemic patients. The results of the present study suggest that CHD patients on ACT have some platelet hyperactivity and that the termination of ACT induces an increase in platelet function, particularly in PPA.

Acenocoumarol↗
PubMed2006

Vitamin K antagonists and pregnancy outcome. A multi-centre prospective study.

Vitamin K antagonists (VKA) are known to act as teratogens; however, there is still uncertainty about the relative risk for birth defects and the most sensitive period. In a multi-centre (n = 12), observational, prospective study we compared 666 pregnant women exposed to phenprocoumon (n = 280), acenocoumarol (n = 226), fluindione (n = 99), warfarin (n = 63) and phenindione (n = 2) to a non-exposed control group (n = 1,094). Data were collected by institutes collaborating in the European Network of Teratology Information Services (ENTIS) during individual risk counselling between 1988 and 2004. Main outcome measures were coumarin embryopathy and other birth defects, miscarriage rate, birth-weight, and prematurity. The rate of major birth defects after 1st trimester exposure was significantly increased (OR 3.86, 95% CI 1.86-8.00). However, there were only two coumarin embryopathies (0.6%; both phenprocoumon). Prematurity was more frequent (16.0% vs. 7.6%, OR 2.61, 95% CI 1.76-3.86), mean gestational age at delivery (37.9 vs.39.4, p<0.001), and mean birth weight of term infants (3,166 g vs. 3,411 g; p < 0.001) were lower compared to the controls. Using the methodology of survival analysis, miscarriage rate reached 42% vs. 14% (hazard ratio 3.36; 95% CI 2.28-4.93). In conclusion, use of VKA during pregnancy increases the risk of structural defects and other adverse pregnancy outcomes. The risk for coumarin embryopathy is, however, very small, in particular when therapy during the 1(st) trimester did not take place later than week 8 after the 1(st) day of the last menstrual period. Therefore, elective termination of a wanted pregnancy is not recommended if (inadvertent) exposure took place in early pregnancy. Close follow-up by the obstetrician including level II ultrasound should be recommended in any case of VKA exposure during pregnancy.

Abnormalities, Drug-Induced↗
PubMed2001

Spontaneous cervical epidural hematoma associated with oral anticoagulant therapy.

A 54-year-old woman who was on anticoagulant treatment with acenocoumarol for a mitral prothesis developed a cervical spinal epidural hematoma, probably triggered by coughing fits together with supratherapeutic anticoagulation. Because of the subacute evolution of the hematoma, it was not diagnosed until the patient was admitted to the hospital with profuse hemorrhages. Given the subacute nature of the hematoma, along with the favorable evolution, conservative treatment with dexamethasone was decided upon, and it was resolved with almost no sequelae. This unusual clinical entity definitely should be suspected in patients on anticoagulants who complain of severe localized neck pain, most often with radicular irradiation.

Acenocoumarol↗
PubMed2003

Capillary whole blood testing by a new portable monitor. Comparison with standard determination of the international normalized ratio.

We evaluated a new portable monitor (AvoSure PT PRO, Menarini Diagnostics, Firenze, Italy) developed to test the prothrombin time in capillary blood and plasma by comparing it with the standard laboratory determination. We studied 62 patients receiving acenocoumarol therapy. The international normalized ratio (INR) in capillary blood was analyzed by 2 methods: AvoSure PT PRO and Thrombotrack Nycomed Analyzer (Axis-Shield, Dundee, Scotland). Parallel studies were performed in plasma samples by a reference method using the Behring Coagulation Timer (Behring Diagnostics, Marburg, Germany). Plasma samples also were tested with the AvoSure PT PRO. Correlation was good for INR values for capillary blood and plasma samples by AvoSure PT PRO and our reference method (R2 = 0.8596) and for capillary blood samples tested by the AvoSure PT PRO and Thrombotrack Nycomed Analyzer (R2 = 0.8875). The correlation for INR in capillary blood and plasma samples by AvoSure PT PRO was 0.6939 (P < .0004). Capillary blood determinations are rapid and effective for monitoring oral anticoagulation therapy and have a high correlation to plasma determinations. AvoSure PT PRO is accurate for controlling INR in plasma and capillary blood samples, may be used in outpatient clinics, and has advantages over previous portable monitors.

Acenocoumarol↗
PubMed2004

Oral anticoagulant drug interactions with statins: case report of fluvastatin and review of the literature.

A 67-year-old man receiving a stable maintenance dosage of warfarin experienced an increased international normalized ratio (INR) without bleeding when his atorvastatin therapy was switched to fluvastatin. His warfarin dosage was reduced and his INR stabilized. The fluvastatin was switched back to atorvastatin, and the warfarin dosage was increased to maintain the patient's goal INR. The literature supports a drug interaction between warfarin and fluvastatin due to the strong affinity of fluvastatin for the cytochrome P450 enzyme 2D6. This interaction has not been seen with atorvastatin. Lovastatin also reportedly has caused increases in INR when coadministered with warfarin. It is unclear whether simvastatin interacts with warfarin, but it may increase INRs slightly or increase serum simvastatin levels. One case report describes an interaction between simvastatin and the anticoagulant acenocoumarol, which resulted in an elevated INR. Pravastatin does not appear to interact with warfarin but has caused an increased INR when combined with the anticoagulant fluindione. Thus, until more definitive data are available, clinicians should monitor the INR closely after starting statin therapy in any patient receiving anticoagulation therapy.

Acenocoumarol↗
PubMed1975

Effect of coumarin and some coumarin derivatives on active transport and passive diffusion of sugars by chicken and rat intestine, in vitro.

The effect of coumarin, 4-hydroxycoumarin, coumarin-3-carboxylic acid and acenocoumarol on the active transport of D-galactose and the passive diffusion of arabinose by intestinal sacs was studied. All these substances, when added to the mucosal medium of incubation at concentrations from 10(-4) to 10(-3) M, inhibit the active transport of D-galactose and increase the diffusion of arabinose. Oxygen uptake by the intestinal tissue is only inhibited by coumarin-3-carboxylic acid. The results suggest that the effects obtained are probably due to an alteration in intestinal permeability, to inhibition of cell metabolism and to molecular size.

Acenocoumarol↗
PubMed2000

Potentiation of vitamin K antagonists by high-dose intravenous methylprednisolone.

BACKGROUND: Oral anticoagulants and pulse high-dose intravenous methylprednisolone are often administered concomitantly, but no data on potential interactions are available. OBJECTIVE: To assess possible potentiation of oral anticoagulation by high-dose intravenous methylprednisolone. DESIGN: Prospective cohort study. SETTING: University hospital in Paris, France. PATIENTS: 10 consecutive patients concomitantly receiving methylprednisolone and oral anticoagulants (fluindione and acenocoumarol) and 5 consecutive controls receiving methylprednisolone alone. MEASUREMENTS: Serial determinations of the international normalized ratio (INR) and clotting factors during administration of pulse methylprednisolone. The total plasma fluindione concentration was determined in 3 patients. RESULTS: The mean INR was 2.75 (range, 2.02 to 3.81) at baseline and increased to 8.04 (range, 5.32 to 20.0) after methylprednisolone administration. Plasma fluindione concentrations and the INR increased after methylprednisolone administration. Methylprednisolone alone did not increase prothrombin time. CONCLUSIONS: The action of oral anticoagulants is potentiated by intravenous high-dose methylprednisolone. The INR should be monitored daily during concomitant administration of these medications.

Acenocoumarol↗
PubMed2000

Assessment of patient capability to self-adjust oral anticoagulant dose: a multicenter study on home use of portable prothrombin time monitor (COAGUCHECK).

BACKGROUND AND OBJECTIVES: Self-testing and self-monitoring with portable prothrombin time (PT) monitors has been shown to be feasible and safe. However the ability of patients on chronic oral anticoagulant therapy (OAT) to self-adjust their dose without specific training has never been properly evaluated. The aims of this study were to evaluate: 1) the ability of patients on chronic OAT to self-adjust their dose without specific training; 2) the integration of a portable PT monitor (Coagucheck, Roche Diagnostics, Germany) for home use into routine patient care in anticoagulation clinics. DESIGN AND METHODS: A nested case-control study was conducted in four centers of the Italian Federation of Anticoagulation Clinics (FCSA). Patients (n=78) on stable OAT for at least 6 months (cases: 47 men, 31 women, age range: 18-75 years) were enrolled on a volunteer basis after passing an Abbreviated Mental Test and providing informed consent. After three instruction sessions on the use of Coaguchek, subjects performed the PT test at home, communicated the INR results to the Center and suggested the dose adjustment and date for next control as they thought appropriate. However, they were requested to follow the prescription made by the Center. Controls (78 subjects) matched by age (+/- 5 years), sex and therapeutic range with the cases, were selected from among those who attended the anticoagulation clinics and managed by usual care. RESULTS: When compared with the dose prescribed by the Clinic, the dose suggested by warfarin and acenocoumarol users was equal to or within +/- 6% of the mean weekly dose in 80% and 82% of suggestions, respectively. Time spent in the therapeutic range during the study was the same (80%) for cases and controls. INTERPRETATION AND CONCLUSIONS: Selected patients on chronic anticoagulant therapy can acquire a satisfactory ability for self-adjustment of OAT dose without specific training.

Acenocoumarol↗
PubMed2000

[Small bowel obstruction secondary to ischemic stenosis due to cholesterol crystal embolism].

Cholesterol crystal embolization is a well-known disorder resulting from release of cholesterol crystals from ulcerous atherosclerotic plaques. Gastrointestinal involvement occurs in about a third of cases, but it is usually asymptomatic. We report a case of an old woman with small bowel obstruction secondary to atheromatous embolism. She was treated by acenocoumarol for atrial fibrillation and pulmonary embolism. Two weeks before admission for small bowel obstruction, she had a watery diarrhea. After 3 weeks of parenteral nutrition, she underwent resection of the involved ileum. Pathological examination showed a small bowel stricture secondary to atheromatous embolism. Cholesterol emboli should be considered as a potential cause of small bowel obstruction in old patient who has taken anticoagulant therapy or after vascular invasive procedure.

Acenocoumarol↗
PubMed2000

[Secondary anticoagulant prophylaxis with low molecular heparins or oral anticoagulants and bone mineral density].

A broad spectrum of indications for low molecular weight heparin (LMWH) requires an assessment of side effects especially during prolonged administration. There are common risk factors for venous thromboembolism (VTE) and osteoporosis; heparin is "the drug of choice" for VTE treatment. The aim of our study was to assess the effect of treatment and prophylaxis with LMWH (enoxaparine sodium) and oral anticoagulant (acenocoumarol) for bone structure. Material consists of in- and outpatients. 49 densitometries were performed in 31 patients (in 15 cases double examination). We observed a decrease of bone mineral density in comparison to the initial examination in most cases: mean change of bone mass for examined areas was 3.05%.

Acenocoumarol↗
PubMedDate not supplied

A comparative study between INR and the determination of prothrombin time with the Coaguchek(r) portable coagulometer in the dental treatment of anticoagulated patients.

OBJECTIVE: To assess the usefulness of the Coaguchek(r) portable coagulometer for determining the International Normalized Ratio (INR) in dental practice. STUDY DESIGN: A total of 139 INR determinations were made in 88 patients anticoagulated with acenocoumarol (Sintrom(r)) for thrombotic pathology, based on the habitual laboratory procedure (Sample 1). Posteriorly and prior to dental treatment, INR was again determined using the Coaguchek(r) portable device (Sample 2). Both determinations were subsequently compared to evaluate possible significant differences between them, applying the Student t-test for paired data and regression measures. RESULTS: The mean INR in Sample 1 was not significantly different to that recorded with the Coaguchek(r) portable device (Sample 2) (2,31 0,81 versus 2,28 0,82, respectively, t= 0,98; p= 0,32). A statistically significant relation was observed between the two samples (R= 0,92; p< 0,01). CONCLUSIONS: The Coaguchek(r) portable coagulometer is a valid instrument for determining INR in anticoagulated individuals, and constitutes an effective method in application to the outpatient dental treatment of such patients.

Acenocoumarol↗
PubMed2005

[Feasibility of home self-administration of low molecular weight heparin by patients with atrial fibrillation recurrence. A new approach to thromboembolic prophyllaxis].

We checked the feasibility of self-screening for atrial fibrillation (AF) by instructed patients pts and prompt home self-administration of an initial dose of low-molecular weight heparin (LMWH) prior to seeking medical attention. INVESTIGATED GROUP AND METHODS: Pts with persistent AF and low risk of systemic embolisation qualified to elective cardioversion (CV) were the subjects of our interest. All pts were trained to identify AF by palpation of the radial pulse and to self-inject LMWH in case of arrhythmia recurrence. 232 pts (mean age 59.8 +/- 8.6 years) who maintained sinus rhythm (SR) during 4 weeks following successful cardioversion (CV) and correctly recognized AF recurrence and those without episodes of AF were equipped with nadroparine after acenocoumarol discontinuation. Thromboembolic prophylaxis was continued with antiplatelets agents or those no additional risk factors of systemic embolisation were left without medical therapy. RESULTS: 191 pts had AF recurrence during the mean 2.6 +/- 1.7 years observation period, 172 of them correctly identified AF episode, including 162 who performed LMWH injections at home. 7 pts, who had performed LMWH injections, presented with SR on arrival to hospital, 6 pts had AF1.2 out of 21 pts who failed to identify their AF episodes and 1 pt of those who correctly detected the AF recurrence but failed to perform LMWH self-injection suffered from ischemic stroke (sensitivity 96.1%, specificity 60.4%). No side effects of domiciliary LMWH self-injection were found. CONCLUSION: When properly trained, the majority of pts can accurately diagnose AF recurrence and self-inject initial dose of LMWH, what is feasible and may represent an attractive anti-thromboembolic strategy.

Acenocoumarol↗
PubMed2006

[Patient with haemoptysis, dyspnoea, fever and lung infiltration].

In this study we presented the case of 55 years old man who was admitted to the Dept. of Lung Diseases and Tuberculosis in Zabrze with haemoptysis, dyspnoea, fever and lung infiltration. Initially the neoplastic disease was diagnosed. From the information gathered from the patient's family it was stated that the patient has been taking acenocoumarol for a considerably long time without any professional supervision. In this study we emphasize the importance of motivating and informing patients about the purposefulness of control examinations while using this kind of drugs.

Acenocoumarol↗
PubMed1991

Influence of anticoagulants on growth and vitamin K production of intestinal bacteria.

The influence of anticoagulants on growth and vitamin K production of intestinal bacteria was studied. Bacteroides vulgatus and Escherichia coli were grown in vitro in the presence of increasing amounts of warfarin, phenprocoumon and acenocoumarol. It was found that growth of B. vulgatus was inhibited under anaerobic conditions whereas growth of E. coli under aerobic conditions was not inhibited. A specific inhibition of vitamin K biosynthesis was not observed in either case. It is concluded that therapeutic doses of anticoagulants are unlikely to affect growth or vitamin K production of intestinal bacteria.

Acenocoumarol↗
PubMed1991

Comparison of two levels of anticoagulant therapy in patients with substitute heart valves.

After cardiac valve replacement patients were blindly randomized into two groups, both receiving aspirin (330 mg) and dipyridamole (75 mg) twice daily and the oral anticoagulant acenocoumarol (Sintrom). An international normalized ratio of 2.0 to 2.99 was assigned to group A and 3.0 to 4.5 to group B; both groups were subsequently analyzed for thromboembolic and hemorrhagic complications. Final evaluation included 51 and 48 patients, respectively. The follow-up was 626 months for group A (12.3 months/patient) and 486 months for group B (10.1 months/patient). The frequency of thromboembolism was equal in both groups: one transient ischemic attack in group A (a rate of 1.92/100 patient-years) and two transient ischemic attacks in group B (a rate of 4.94/100 patient-years). There was, however, a statistical difference in bleeding complications between the two groups (p less than 0.02). Two patients bled in group A, a rate of 3.9% (3.8/100 patient-years), which represents an incidence of one episode each 25.6 years of treatment; 10 patients bled in group B, a rate of 20.8% (24.7/100 patient-years) representing an incidence of one episode each 4 years of treatment. We conclude that an international normalized ratio of 2 to 3 is safer than a ratio of 3 to 4.5 and confers good protection from thromboembolism when oral anticoagulant therapy is used conjointly with platelet function-inhibiting drugs in patients with mechanical substitute heart valves.

Acenocoumarol↗
PubMed1987

[A combination of dihydroergotamine and acetylsalicylic acid--prevention of postoperative thromboembolic complications. Clinical study in orthopedics].

202 patients undergoing surgery involving the lower limbs were given antithrombotic treatment for at least 21 days, or until they had regained full mobility. Following subcutaneous prophylaxis with a combination of heparin and dihydroergotamine, two oral regimens were compared in a controlled and randomized prospective study. The first treatment consisted of a combination of acetylsalicylic acid (ASA) and dihydroergotamine (DHE), and the second of acenocoumarol. The radiofibrinogen uptake test was carried out in high-risk patients (i.e. those undergoing hip surgery) to detect deep-vein thrombosis. No statistically significant difference was found between the two groups. However, the ASA/DHE combination enjoyed better patient acceptance and was much easier to use.

Acenocoumarol↗
PubMed1985

Anticoagulant-induced intracerebral bleeding in brain ischemia. Evaluation in 200 patients with TIAs, emboli from the heart, and progressing stroke.

During a 5-year period, 85 patients with TIAs, 65 patients with embolic brain ischemia of cardiac source and 50 patients with progressing stroke received intravenous heparin within 96 h. Twelve (6%) developed an early bleeding in the area involved by ischemia. In the 2 cases with transient ischemic attacks (TIAs) (2.3%), major functional sequelae persisted and the 2 cases with emboli from heart (3.2%) died, whereas among the 8 cases with progressing stroke (16%), only 3 worsened from anticoagulant-induced bleeding. Intracerebral bleeding was not associated with excessive anticoagulation or high blood pressure and was related to a large infarction only in the cases with emboli from the heart. Among the 108 patients who were placed on acenocoumarol during 3-12 months after heparin therapy, only one (0.9%) suffered a hemorrhagic infarct from a probable recurrent embolization. The risk of anticoagulant-induced intracerebral bleeding is quite different between the varieties of preceding ischemic events, with different subsequent impact on prognosis.

Acenocoumarol↗
PubMed1985

[Possibilities for treating patients with the idiopathic nephrotic syndrome].

The results from the treatment of 29 patients with idiopathic nephrotic syndrome are reported: 6--with glomerulonephritis with minimum alterations, 12--with diffuse mesangioproliferative glomerulonephritis and II--with focal and segmental glomerular sclerosis and hyalinosis. Corticosteroids, alone and in case they fail to help, in combination with cyclophosphamide were administered to patients with glomerulonephritis with minimum alterations. The rest of the patients were treated with a combination of anticoagulants (heparin and acenocoumarol), immune-suppressors (azathioprin) and corticosteroids. "Pulse" treatment with 300 mg methylprednisolon intravenously was carried out in single patients. Complete clinical-laboratory remission was attained in 5 out of 6 patients with glomerulonephritis with minimum alterations and in 7 out of 12 patients with diffuse mesangioproliferative glomerulonephritis. No effect was attained in any of the patients with focal and segmental glomerular sclerosis and hyalinosis. With repeated renal biopsy, a transition from glomerulonephritis with minimum alterations and from diffuse mesangioproliferative glomerulonephritis to focal and segmental glomerular sclerosis and hyalinosis was observed.

Acenocoumarol↗