Journal of Thrombosis and Thrombolysis

, Volume 44, Issue 4, pp 544–555 | Cite as

Highlights from the Ninth International Symposium of Thrombosis and Anticoagulation (ISTA IX), October 15, 2016, Salvador, Bahia, Brazil

  • Renato D. Lopes
  • Patricia O. Guimarães
  • Elaine Hylek
  • Gilson S. Feitosa-Filho
  • Luiz Ritt
  • Nivaldo Filgueiras
  • Eduardo Darzé
  • Mario S. Rocha
  • Luis P. Magalhães
  • Antonio Carlos Sobral Sousa
  • Luis Claudio Correia
  • Lucas Hollanda Oliveira
  • David A. Garcia
Article
  • 102 Downloads

Abstract

To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Ninth International Symposium of Thrombosis and Anticoagulation was held in Salvador, Bahia, Brazil, on October 15, 2016. This scientific program was developed by clinicians for clinicians and was promoted by two major clinical research institutes—the Brazilian Clinical Research Institute and the Duke Clinical Research Institute of the Duke University School of Medicine. Comprising academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists. This paper summarizes the symposium proceedings.

Keywords

Thrombosis Antithrombotic therapy Guidelines Clinical research 

Notes

Acknowledgements

The Ninth International Symposium of Thrombosis and Anticoagulation (ISTA IX) was sponsored by Pfizer and Unifenas. The symposium was organized and led by the Brazilian Clinical Research Institute (BCRI).

References

  1. 1.
    Shahjouei S, Tsivgoulis G, Bavarsad Shahripour R, Jones GM, Alexandrov AV, Zand R (2015) Safety of intravenous thrombolysis among stroke patients taking new oral anticoagulants—case series and systematic review of reported cases. J Stroke Cerebrovasc Dis 24:2685–2693CrossRefPubMedGoogle Scholar
  2. 2.
    Seiffge DJ, Hooff RJ, Nolte CH et al (2015) Recanalization therapies in acute ischemic stroke patients: impact of prior treatment with novel oral anticoagulants on bleeding complications and outcome. Circulation 132:1261–1269CrossRefPubMedGoogle Scholar
  3. 3.
    Kermer P, Eschenfelder CC, Diener H-C et al (2017) Antagonizing dabigatran by idarucizumab in cases of ischemic stroke or intracranial hemorrhage in Germany—a national case collection. Int J Stroke 12:383–391CrossRefPubMedGoogle Scholar
  4. 4.
    Rasmussen MS, Jørgensen LN, Wille-Jørgensen P (2009) Prolonged thromboprophylaxis with low molecular weight heparin for abdominal or pelvic surgery. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD004318.pub2 PubMedGoogle Scholar
  5. 5.
    Kahn SR, Lim W, Dunn AS et al (2012) Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e195S–e226SCrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Cohen AT, Harrington RA, Goldhaber SZ et al (2016) Extended thromboprophylaxis with betrixaban in acutely ill medical patients. N Engl J Med 375:534–544CrossRefPubMedGoogle Scholar
  7. 7.
    Lip GY, Larsen TB, Skjøth F, Rasmussen LH (2012) Indirect comparisons of new oral anticoagulant drugs for efficacy and safety when used for stroke prevention in atrial fibrillation. J Am Coll Cardiol 60:738–746CrossRefPubMedGoogle Scholar
  8. 8.
    Baker WL, Cios DA, Sander SD, Coleman CI (2009) Meta-analysis to assess the quality of warfarin control in atrial fibrillation patients in the United States. J Manag Care Pharm 15:244–252PubMedGoogle Scholar
  9. 9.
    Wallentin L, Lopes RD, Hanna M et al (2013) Efficacy and safety of apixaban compared with warfarin at different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation. Circulation 127:2166–2176CrossRefPubMedGoogle Scholar
  10. 10.
    Piccini JP, Hellkamp AS, Lokhnygina Y et al (2014) Relationship between time in therapeutic range and comparative treatment effect of rivaroxaban and warfarin: results from the ROCKET AF trial. J Am Heart Assoc 3:e000521CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Wallentin L, Yusuf S, Ezekowitz MD et al (2010) Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet 376:975–983CrossRefPubMedGoogle Scholar
  12. 12.
    Douketis JD, Spyropoulos AC, Spencer FA et al (2012) Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 141(2 Suppl):e326S–e350SCrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Di Biase L, Burkhardt JD, Santangeli P et al (2014) Periprocedural stroke and bleeding complications in patients undergoing catheter ablation of atrial fibrillation with different anticoagulation management: results from the Role of Coumadin in Preventing Thromboembolism in Atrial Fibrillation (AF) Patients Undergoing Catheter Ablation (COMPARE) randomized trial. Circulation 129:2638–2644CrossRefPubMedGoogle Scholar
  14. 14.
    Douketis JD, Spyropoulos AC, Kaatz S et al (2015) Perioperative bridging anticoagulation in patients with atrial fibrillation. N Engl J Med 373:823–833CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Lakkireddy D, Reddy YM, Di Biase L et al (2014) Feasibility and safety of uninterrupted rivaroxaban for periprocedural anticoagulation in patients undergoing radiofrequency ablation for atrial fibrillation: results from a multicenter prospective registry. J Am Coll Cardiol 2014 63:982–988CrossRefPubMedGoogle Scholar
  16. 16.
    Di Biase L, Lakkireddy D, Trivedi C et al (2015) Feasibility and safety of uninterrupted periprocedural apixaban administration in patients undergoing radiofrequency catheter ablation for atrial fibrillation: results from a multicenter study. Heart Rhythm 12:1162–1168CrossRefPubMedGoogle Scholar
  17. 17.
    Vedovati MC, Germini F, Agnelli G, Becattini C (2015) Direct oral anticoagulants in patients with VTE and cancer: a systematic review and meta-analysis. Chest 147:475–483CrossRefPubMedGoogle Scholar
  18. 18.
    van Es N, Di Nisio M, Bleker SM et al (2015) Edoxaban for treatment of venous thromboembolism in patients with cancer. Rationale and design of the Hokusai VTE-cancer study. Thromb Haemost 114:1268–1276CrossRefPubMedGoogle Scholar
  19. 19.
    Granger CB, Alexander JH, McMurray JJ et al (2011) Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 365:981–992CrossRefPubMedGoogle Scholar
  20. 20.
    Giugliano RP, Ruff CT, Braunwald E et al (2013) Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 369:2093–2104CrossRefPubMedGoogle Scholar
  21. 21.
    Carnicelli AP, De Caterina R, Halperin JL et al (2017) Edoxaban for the prevention of thromboembolism in patients with atrial fibrillation and bioprosthetic valves. Circulation 135:1273–1275CrossRefPubMedGoogle Scholar
  22. 22.
    Kong B, Liu Y, Huang H, Jiang H, Huang C (2015) Left atrial appendage closure for thromboembolism prevention in patients with atrial fibrillation: advances and perspectives. J Thorac Dis 7:199–203PubMedPubMedCentralGoogle Scholar
  23. 23.
    Patel MR, Mahaffey KW, Garg J et al (2011) Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 365:883–891CrossRefPubMedGoogle Scholar
  24. 24.
    Connolly SJ, Ezekowitz MD, Yusuf S et al (2009) Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 361:1139–1151CrossRefPubMedGoogle Scholar
  25. 25.
    Cohen AT, Imfeld S, Rider T (2014) Phase III trials of new oral anticoagulants in the acute treatment and secondary prevention of VTE: comparison and critique of study methodology and results. Adv Ther 31:473–493CrossRefPubMedPubMedCentralGoogle Scholar

Recommended reading

  1. Avezum A, Lopes RD, Schulte PJ et al (2015) Apixaban in comparison with warfarin in patients with atrial fibrillation and valvular heart disease: findings from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Circulation 132:624–632CrossRefPubMedGoogle Scholar
  2. Ben-Aharon I, Stemmer SM, Leibovici L, Shpilberg O, Sulkes A, Gafter-Gvili A (2014) Low molecular weight heparin (LMWH) for primary thrombo-prophylaxis in patients with solid malignancies—systematic review and meta-analysis. Acta Oncol 53:1230–1237CrossRefPubMedGoogle Scholar
  3. Brambatti M, Connolly SJ, Gold MR et al (2014) Temporal relationship between subclinical atrial fibrillation and embolic events. Circulation 129:2094–2099CrossRefPubMedGoogle Scholar
  4. Cohen AT, Spiro TE, Spyropoulos AC et al (2014) D-dimer as a predictor of venous thromboembolism in acutely ill, hospitalized patients: a subanalysis of the randomized controlled MAGELLAN trial. J Thromb Haemost 12:479–487CrossRefPubMedGoogle Scholar
  5. Connolly SJ, Eikelboom J, Joyner C et al (2011) Apixaban in patients with atrial fibrillation. N Engl J Med 364:806–817CrossRefPubMedGoogle Scholar
  6. De Caterina R, Renda G, Carnicelli AP et al (2017) Valvular heart disease patients on edoxaban or warfarin in the ENGAGE AF-TIMI 48 trial. J Am Coll Cardiol 69:1372–1382CrossRefPubMedGoogle Scholar
  7. Eikelboom JW, Connolly SJ, Brueckmann M et al (2013) Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med 369:1206–1214CrossRefPubMedGoogle Scholar
  8. Guimaraes PO, Kaatz S, Lopes RD (2015) Practical and clinical considerations in assessing patients with atrial fibrillation for switching to non-vitamin K antagonist oral anticoagulants in primary care. Int J Gen Med 8:283–291PubMedPubMedCentralGoogle Scholar
  9. Hacke W, Kaste M, Bluhmki E et al (2008) Thrombolysis with alteplase 3 to 4.5 h after acute ischemic stroke. N Engl J Med 359:1317–1329CrossRefPubMedGoogle Scholar
  10. Healey JS, Connolly SJ, Gold MR et al (2012) Subclinical atrial fibrillation and the risk of stroke. N Engl J Med 366:120–129CrossRefPubMedGoogle Scholar
  11. Healey JS, Lopes RD, Connolly SJ (2015) The detection and treatment of subclinical atrial fibrillation: evaluating the IMPACT of a comprehensive strategy based on remote arrhythmia monitoring. Eur Heart J 36:1640–1642CrossRefPubMedGoogle Scholar
  12. Heidbuchel H, Verhamme P, Alings M et al (2013) European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 15:625–651CrossRefPubMedGoogle Scholar
  13. Hess PL, Healey JS, Granger CB et al (2017) The role of cardiovascular implantable electronic devices in the detection and treatment of subclinical atrial fibrillation: a review. JAMA Cardiol 2:324–331CrossRefPubMedGoogle Scholar
  14. Holmes DR, Reddy VY, Turi ZG et al (2009) Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: a randomised non-inferiority trial. Lancet 374:534–542CrossRefGoogle Scholar
  15. Jauch EC, Saver JL, Adams HP Jr et al (2013) Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44:870–947CrossRefPubMedGoogle Scholar
  16. Khorana AA, Carrier M, Garcia DA, Lee AY (2016) Guidance for the prevention and treatment of cancer-associated venous thromboembolism. J Thromb Thrombolysis 41:81–91CrossRefPubMedPubMedCentralGoogle Scholar
  17. Kirchhof P, Benussi S, Kotecha D et al (2016) 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 37:2893–2962CrossRefPubMedGoogle Scholar
  18. Lee VH, Conners JJ, Prabhakaran S (2012) Intravenous thrombolysis in a stroke patient taking dabigatran. J Stroke Cerebrovasc Dis 21:916.e911–916.e912Google Scholar
  19. Lopes RD, Guimaraes PO, Kolls BJ et al (2017) Intracranial hemorrhage in patients with atrial fibrillation receiving anticoagulation therapy. Blood 129:2980–2987CrossRefPubMedGoogle Scholar
  20. Mantha S, Laube E, Miao Y et al (2017) Safe and effective use of rivaroxaban for treatment of cancer-associated venous thromboembolic disease: a prospective cohort study. J Thromb Thrombolysis 43:166–171CrossRefPubMedGoogle Scholar
  21. Nishimura RA, Otto CM, Bonow RO et al (2017) 2017 AHA/ACC Focused Update of the 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. doi:  10.1016/j.jacc.2017.03.011 Google Scholar
  22. Ohman EM, Roe MT, Steg PG et al (2017) Clinically significant bleeding with low-dose rivaroxaban versus aspirin, in addition to P2Y12 inhibition, in acute coronary syndromes (GEMINI-ACS-1): a double-blind, multicentre, randomised trial. The Lancet 389:1799­­–1808CrossRefGoogle Scholar
  23. Patti G, Pengo V, Marcucci R et al (2017) The left atrial appendage: from embryology to prevention of thromboembolism. Eur Heart J 38:877–887PubMedGoogle Scholar
  24. Pokorney SD, Rao MP, Wojdyla DM et al (2015) Abstract 17277: Apixaban use in patients with atrial fibrillation with bioprosthetic valves: insights from ARISTOTLE. Circulation 132(Suppl 3):A17277Google Scholar
  25. Reddy VY, Holmes D, Doshi SK, Neuzil P, Kar S (2011) Safety of percutaneous left atrial appendage closure: results from the Watchman Left Atrial Appendage System for Embolic Protection in Patients with AF (PROTECT AF) clinical trial and the Continued Access Registry. Circulation 123:417–424CrossRefPubMedGoogle Scholar
  26. Ruff CT, Giugliano RP, Braunwald E et al (2014) Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 383:955–962CrossRefGoogle Scholar
  27. Samuelson BT, Cuker A, Siegal DM, Crowther M, Garcia DA (2017) Laboratory assessment of the anticoagulant activity of direct oral anticoagulants: a systematic review. Chest 151:127–138CrossRefPubMedGoogle Scholar
  28. Siegal DM, Crowther MA (2013) Acute management of bleeding in patients on novel oral anticoagulants. Eur Heart J 34:489–498bCrossRefPubMedGoogle Scholar
  29. Spencer FA, Lessard D, Emery C, Reed G, Goldberg RJ (2007) Venous thromboembolism in the outpatient setting. Arch Intern Med 167:1471–1475CrossRefPubMedPubMedCentralGoogle Scholar
  30. Sun JC, Davidson MJ, Lamy A, Eikelboom JW (2009) Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends. Lancet 374:565–576CrossRefGoogle Scholar
  31. Testai FD (2013) Intravenous thrombolysis in a stroke patient taking dabigatran. J Stroke Cerebrovasc Dis 22:894CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Renato D. Lopes
    • 1
  • Patricia O. Guimarães
    • 1
  • Elaine Hylek
    • 2
  • Gilson S. Feitosa-Filho
    • 3
    • 4
    • 5
  • Luiz Ritt
    • 3
    • 6
  • Nivaldo Filgueiras
    • 7
    • 8
  • Eduardo Darzé
    • 6
  • Mario S. Rocha
    • 3
    • 9
  • Luis P. Magalhães
    • 10
  • Antonio Carlos Sobral Sousa
    • 11
    • 12
  • Luis Claudio Correia
    • 3
    • 13
  • Lucas Hollanda Oliveira
    • 13
    • 14
  • David A. Garcia
    • 15
  1. 1.Duke Clinical Research InstituteDuke University School of MedicineDurhamUSA
  2. 2.Boston University Medical CenterBostonUSA
  3. 3.Escola Bahiana de Medicina e Saúde Pública (EBMSP)SalvadorBrazil
  4. 4.Hospital Santa Izabel - Santa Casa da BahiaSalvadorBrazil
  5. 5.Hospital Ana NerySalvadorBrazil
  6. 6.Hospital Cárdio PulmonarSalvadorBrazil
  7. 7.Universidade Salvador (UNIFACS) - rede LaureateSalvadorBrazil
  8. 8.Universidade do Estado da Bahia (UNEB)SalvadorBrazil
  9. 9.Hospital PortuguêsSalvadorBrazil
  10. 10.Universidade Federal da Bahia (UFBA)SalvadorBrazil
  11. 11.Universidade Federal de Sergipe (UFS)AracajuBrazil
  12. 12.Hospital São LucasAracajuBrazil
  13. 13.Hospital São RafaelSalvadorBrazil
  14. 14.Hospital da BahiaSalvadorBrazil
  15. 15.Department of Medicine, University of Washington Medical CenterUniversity of Washington School of MedicineSeattleUSA

Personalised recommendations