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News and updates at today's Improving Anticoagulation Therapy Services conference

Today's conference focuses on the important issue of improving anticoagulation therapy services: patient safety and quality.

Following the chair's introductions, Dr Deepa Arachchillage Consultant Haematologist and Honorary senior lecturer Royal Brompton Hospital/Hammersmith Hospital and Imperial College London who will look at: ‘Complex anticoagulation issues’: Anticoagulation in the frail, restarting anticoagulation after a bleed, oral anticoagulants combined with anti-platelet drugs, focusing on:

• managing complex anticoagulation issues
• anticoagulation in the frail elderly
• restarting anticoagulation after a bleed, oral anticoagulants combined with anti-platelet drugs

In her presentation Dr Arachchillage stated:

"there are different indications for anticoagulations"

"there are several anticoagulants you can give to patients"

Dr Arachchillage discussed

'Managing complex anticoagulation issues'  
•Management of patients with bleeding or at increased risk of bleeding on anticoagulants
•Renal failure
•Heparin Induced Thrombocytopenia (HIT)
•Extremes of body weight
•Patients on Drugs interacting with anticoagulants
•Antiphospholipid Syndrome
•Recurrent thrombosis associated with malignancy
•Recurrent Thrombosis whilst therapeutically anticoagulated
•Poor compliance

'Why special attention is require anticoagulation elderly patients'
•Risk of recurrent falls
•Renal impairment
•Compliance or monitoring issues
•Multiple interacting medications
•Dementia / cognitive impairment
•Anaemia, thrombocytopenia
• risk of gastrointestinal bleeding
• frailty

Recommendations on the Management of Patients on Oral Anticoagulation with ACS and/or Undergoing PCI
•Management of patients who require antiplatelet therapy on top of OAC cannot be reduced to a series of rules that fit in all cases, but it necessarily requires careful decision-making focused on individual characteristics
•Current North American and European expert consensus documents on the management of antithrombotic therapy in patients with AF undergoing PCI with stenting suggest that when coronary stent is necessary in patients undergoing elective PCI who need chronic OAC, BMS should be preferred whenever possible over a DES attributable to the shorter need for DAPT


29 November 2016

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