Related Experiment Video
Updated: May 7, 2026
08:13
Tail Vein Transection Bleeding Model in Fully Anesthetized Hemophilia A Mice
Published on: September 30, 2021
7.1K
Anticoagulation duration in heterozygous factor V Leiden: a decision analysis
Anna K Donovan1, Kenneth J Smith, Margaret V Ragni
1Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Thrombosis Research
|October 12, 2013
Summary
Lifelong anticoagulation may benefit young adults with factor V Leiden mutation and unprovoked venous thromboembolism. Further studies are needed to confirm optimal anticoagulation duration for this patient group.
Area of Science:
- Cardiology
- Hematology
- Pharmacology
Background:
- Current guidelines recommend individualized anticoagulation duration for unprovoked venous thromboembolism (VTE) based on bleeding vs. recurrence risk.
- Individuals with factor V Leiden mutation have higher VTE recurrence risk but lower bleeding risk, suggesting longer anticoagulation may be beneficial.
Purpose of the Study:
- To compare standard versus lifelong anticoagulation strategies in 20-year-old factor V Leiden heterozygotes with unprovoked VTE.
Main Methods:
- A Markov state-transition model was employed to assess outcomes.
- Model incorporated risks of major, minor, and fatal bleeding, VTE morbidity/mortality, and quality of life utilities.
- Sensitivity analyses determined parameter values favoring lifelong anticoagulation.
Main Results:
- In general populations, short-term anticoagulation yielded higher quality-adjusted life years (QALYs).
- Factor V Leiden heterozygotes favored lifelong anticoagulation if VTE recurrence risk exceeded 1.07 or bleeding risk was below 0.91.
- Results were largely insensitive to other parameter variations.
Conclusions:
- Lifelong anticoagulation may offer benefits for factor V Leiden heterozygotes with prior idiopathic VTE.
- Further research on bleeding risk and costs of indefinite anticoagulation is necessary to establish optimal strategies.
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
482
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
482
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.8K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.8K
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.6K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.6K
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
470
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
470
01:30Venous Thrombosis IV: Nursing Management
418
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
418
01:23Pharmacokinetic–Pharmacodynamic Relationship: Influence of Elimination Half-Life on Effect Duration
145
Drug elimination from the body primarily occurs through metabolic and excretion pathways. Hepatic metabolism transforms lipophilic drugs into hydrophilic forms for excretion, typically via enzymatic processes classified as phase I (modification) and phase II (conjugation). Renal excretion eliminates drugs and metabolites through filtration and secretion in the kidneys. Impairment in liver or kidney function can hinder these processes, delaying drug clearance and extending the drug’s...
145