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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
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Thromboembolic Complications After Receipt of Prothrombin Complex Concentrate
Emily J Owen1, Gabrielle A Gibson1, Theresa Human1
1Barnes-Jewish Hospital, Saint Louis, MO, USA.
Hospital Pharmacy
|November 4, 2021
Summary
Prothrombin complex concentrate (PCC) for oral anticoagulant reversal in bleeding patients carries a significant risk of thromboembolic complications (TEC). Factors like rivaroxaban use, repeat PCC doses, and prior TEC history increase this risk.
Area of Science:
- Cardiology
- Hematology
- Pharmacology
Background:
- Life-threatening bleeding from oral anticoagulants (OACs) presents a clinical challenge with limited treatment options.
- Prothrombin complex concentrate (PCC) is used for OAC reversal, but its safety regarding thromboembolic complications (TEC) in previously anticoagulated patients requires further investigation.
Purpose of the Study:
- To determine the incidence of TEC in patients receiving 4-Factor PCC for life-threatening bleeding.
- To identify risk factors associated with TEC development after PCC administration.
Main Methods:
- Retrospective evaluation of adult patients who received 4-Factor PCC for life-threatening bleeding over two years.
- Data collection included anticoagulant type, bleeding source, PCC dose, INR, and occurrence of TEC (VTE, myocardial infarction, ischemic stroke) within 14 days.
Main Results:
- Of 333 patients, 55 (16.5%) developed TEC.
- Higher TEC rates were observed with rivaroxaban use (25.4% vs 12.2%), prior TEC indication for anticoagulation (38.2% vs 23.4%), and receipt of multiple PCC doses (21.8% vs 7.9%).
Conclusions:
- PCC administration for OAC-related bleeding is associated with a notable risk of TEC.
- Rivaroxaban reversal, repeat PCC dosing, and a history of TEC are significant risk factors for post-PCC TEC.
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