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http://dx.doi.org/10.1097/MAT.0000000000000937 | DOI Listing |
Br J Anaesth
September 2025
Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA. Electronic address:
Am J Emerg Med
August 2025
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare Edward Hines, Jr. VA Hospital, 5000 South 5th Ave, Hines, IL, USA. Electronic address:
Background: The two hemostatic agents utilized for reversal of life-threatening hemorrhage associated with Factor Xa (fXa) inhibition are andexanet alfa (AA) and four-factor prothrombin complex concentrate (4F-PCC). In May 2018, AA was approved with possible superior short-term hemostatic efficacy but has been linked with higher rates of thrombotic events. Considering these concerns, the absence of high-quality comparative studies, and the higher cost compared to other agents, four-factor prothrombin complex concentrate remained the more utilized agent.
View Article and Find Full Text PDFJ Hematol
August 2025
Versiti Blood Center of Wisconsin, Greenfield, WI 53220, USA.
Background: Four-factor prothrombin complex concentrate (4F-PCC) is used for warfarin reversal and off-label management of bleeding in patients taking direct oral anticoagulants (DOACs). Dosing strategies that optimize hemostatic efficacy and cost, such as fixed dosing of 4F-PCC, are still under evaluation. The objective of this study was to retrospectively evaluate the efficacy, safety, and cost savings of fixed-dosing of 4F-PCC (1,500 IU for warfarin, 2,000 IU for DOACs).
View Article and Find Full Text PDFToxins (Basel)
August 2025
Adaptive Biotoxicology Lab, School of the Environment, University of Queensland, St Lucia, QLD 4072, Australia.
Australian elapid snakes possess potent procoagulant venoms, capable of inducing severe venom-induced consumption coagulopathy (VICC) in snakebite victims through rapid activation of the coagulation cascade by converting the FVII and prothrombin zymogens into their active forms. These venoms fall into two mechanistic categories: FXa-only venoms, which hijack host factor Va, and FXa:FVa venoms, containing a complete venom-derived prothrombinase complex. While previous studies have largely focused on human plasma, the ecological and evolutionary drivers behind prey-selective venom efficacy remain understudied.
View Article and Find Full Text PDFJ Chest Surg
August 2025
Faculty of Medicine, Kafr-Elsheikh University, Kafr-Elsheikh, Egypt.