Our patient presented several risk factors (ESRD, female gender, history of obesity, diabetes mellitus, hyperparathyroidism, hyperphosphatemia and treatment with acenocoumarol
and vitamin D receptor activator), so that we acted on those that could be modified pharmacologically.
After 3 months, only 2 of the surviving patients (9.1%) continued to receive antiplatelet agents, further 2 (9.1%) received acenocoumarol
because both had a mechanical heart valve, 13 (59.1%) received DOAC, and 3 (13.6%) underwent left atrial appendage closure.
The patient is now on long-term anticoagulant therapy with acenocoumarol
. The imaging of splenic veins is unchanged.
He was prescribed a long-life medication with oral salicylic acid 100 mg daily and acenocoumarol
to target INR 2.0-3.0.
Pharmacogenetic relevance of CYP4F2 V433M polymorphism on acenocoumarol
He had been taking a vitamin K antagonist (acenocoumarol
) since 1989, when he suffered from 2 episodes of lower limb deep vein thrombosis.
Surgical management of severe spontaneous hemorrhage of the abdominal wall complicating acenocoumarol
Indeed, the standard for both prevention and treatment for over 60 years has been vitamin k antagonists like warfarin (Coumadin[R], Jantoven[R], and Marevan[R]), phenprocoumon, and acenocoumarol
; however, VKA therapy is inconvenient due in part to its increased risk of adverse events such as bleeding, dietary restrictions, and the need for regular blood monitoring, thereby making it a less desirable option .
We present two cases of shock induced by spontaneous mural intestinal hematoma related to excessive anticoagulation with acenocoumarol
. Oral anticoagulant therapy has been reported as the most common predisposing factor .
We report the case of a patient with CLL and moderate thrombocytopenia refractory to corticosteroids and intravenous immunoglobulins, in which continuous oral treatment with Eltrombopag has allowed us to initiate and maintain an oral anticoagulant treatment with Acenocoumarol
that was indicated due to a severe arrhythmogenic cardiomyopathy.
Eight patients had suffered repeated episodes of superficial phlebitis; six had more than one deep vein thrombotic episode and were therefore on long-term oral anticoagulant therapy with acenocoumarol
([C.sub.19][H.sub.15]N[O.sub.6], coumarin similar to warfarin) after monitoring hematocrit, hemoglobin, international normalized ratio, and liver panel.
His INR was within the therapeutic range one week before admission, while using normal dosages of acenocoumarol
. He had stopped the anticoagulation in preparation for a liver biopsy.