#afxa - Twitter Hashtag

14a) Finally, there may be new options emerging on the pharmacological front--perhaps #aFXa #DOACs aren't the final 🏹in our anticoagulation quiver? Several #FXI/#FXIa inhibitors will be tested in phase 3 trials.

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cardio-met

@cardiomet_CE

over 3 years ago

13b) Our index article highlights a recent survey by @HRSonline (https://t.co/f6byjXlc86) ➡️prior bleeding & 🩸risk are most imp't barriers to #OAC initiation. 🛟 Yes, #DOACs are safer than #warfarin, but major bleeds on therapy with #aFXa DOACs still hover ~ 4%/yr.

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@cardiomet_CE

over 3 years ago

18a) So what can we conclude about the #aFXa #DOAC-treated trauma victim? 1⃣ If 🩸🩸can be controlled without #reversal, don't reverse. 2⃣ Reversal is an adjunct to multimodal medical and surgical management, not itself a hemostatic treatment.

cardiomet_CE's tweet photo. 18a) So what can we conclude about the #aFXa #DOAC-treated trauma victim?
1⃣ If 🩸🩸can be controlled without #reversal, don't reverse.
2⃣ Reversal is an adjunct to multimodal medical and surgical management, not itself a hemostatic treatment. https://t.co/nhdWQN37NR

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@cardiomet_CE

over 3 years ago

26a) While assessing anti-FXa activity calibrated for rivaroxaban or apixaban may help, the time of last dose taken is sufficient to guide dosing, as #ANNEXA_4 did not mandate #aFXa activity for #Andexanet administration.

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@cardiomet_CE

almost 4 years ago

21) It's c. #Andexanet_alfa is an altered, biologically inactive #FXa decoy that reversibly binds #aFXa #anticoagulants. #4F_PCC is a repletion approach that includes all of the vitamin K-dependent coag factors (II, VII, IX, X).

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@cardiomet_CE

almost 4 years ago

9a) Let’s discuss a representative case of major (serious) #GI bleeding in a patient receiving #aFXa therapy. This pt presented to the #ED with 2 episodes of large volume hematemesis, hypotension, severe #anemia, and acute kidney injury #AKI.

cardiomet_CE's tweet photo. 9a) Let’s discuss a representative case of major (serious) #GI bleeding in a patient receiving #aFXa therapy. This pt presented to the #ED with 2 episodes of large volume hematemesis, hypotension, severe #anemia, and acute kidney injury #AKI. https://t.co/nyZGdV2a8Q

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@cardiomet_CE

almost 4 years ago

1) Welcome to an #accredited #tweetorial on reversal of factor Xa inhibitor (#aFXa) #anticoagulants for patients with #gastrointestinal #bleeding. FOLLOW @cardiomet_ce for the latest and greatest accredited education in the #cardiometabolic space, wholly on Twitter!

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@cardiomet_CE

almost 4 years ago

15) Finally, a question about Professor Coppens' case study in the symposium at https://t.co/3CZrIqLG2u. "In his case, a patient going to surgery for #aFXa-#DOAC-associated #ICH was given #andexanet for reversal. Andexanet isn't approved for use in surgery, is it?"

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@cardiomet_CE

almost 4 years ago

12c) This suggests that post-reversal thromboembolic events more likely represent "de-protection" of high-risk patients. It's also noteworthy that thrombotic events occurred in the original #aFXa trials when patients d/c'd tx (🔓 https://t.co/EUpJbqijzI & https://t.co/jHojpAr8WM)

cardiomet_CE's tweet photo. 12c) This suggests that post-reversal thromboembolic events more likely represent "de-protection" of high-risk patients. It's also noteworthy that thrombotic events occurred in the original #aFXa trials when patients d/c'd tx (🔓 https://t.co/EUpJbqijzI & https://t.co/jHojpAr8WM) https://t.co/wyvJWhHay4

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@cardiomet_CE

almost 4 years ago

7) The bottom line re #aFXa-#DOAC-related #ICH is therefore as follows . . . an important and, despite the overall safety of #DOACs, a growing problem:

cardiomet_CE's tweet photo. 7) The bottom line re #aFXa-#DOAC-related #ICH is therefore as follows . . . an important and, despite the overall safety of #DOACs, a growing problem: https://t.co/vJzGq2NMRK

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@cardiomet_CE

almost 4 years ago

20) Point 1⃣: 🩸Elevated #PT can detect presence of some #aFXa agents but not degree of anticoagulation 🩸PT sensitivity rivaroxaban>apixaban>edoxaban 2⃣: 🩸anti-FXa levels more specific if calibrated for agent; not widely available 3⃣: 🩸#aPTT has low sensitivity for aFXa 💊

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