Anticoagulation Therapy Considerations in Factor VII Deficiency

Paulus, Eric J.; Komperda, Kathy E.; Park, Gabriel; Fusco, Julie

doi:10.1007/s40800-016-0031-y

Cited by 12 publications

(6 citation statements)

References 38 publications

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“…Conventional trigger factors for thrombotic event in the setting of inherited FVII deficiency should not be underestimated and therapeutic options should be pursued. Although our patient was further treated with low‐dose aspirin (50 mg QD), as already suggested by others, direct oral anticoagulation (DOAC) could theoretically be treatment of choice since they do not directly affect FVII activity and could carry less bleeding risk than vitamin K antagonists …”

Section: Imagementioning

confidence: 72%

“…Unfortunately, there exists neither consensus nor guidelines for anticoagulation therapy or antithrombotic prophylaxis for patients harboring FVII deficiency. Some researchers found warfarin treatment plausible in the setting of mild FVII deficiency and atrial fibrillation and heparin therapy for venous thrombosis without excessive bleeding has been described …”

Section: Imagementioning

confidence: 99%

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Factor VII deficiency in major artery occlusion stroke

et al. 2018

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Section: Imagementioning

confidence: 72%

Section: Imagementioning

confidence: 99%

Factor VII deficiency in major artery occlusion stroke

et al. 2018

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“…While the inherited FVII deficiency is an autosomal recessive bleeding disorder, the acquired forms are sporadic and frequently associated with autoimmune disorders and neoplastic conditions [30]. The diagnosis hallmark of FVII deficiency is an elevated INR in the absence of liver disease and a normal activated partial thromboplastin time (aPTT) [31]. Thus, baseline INR is elevated precluding monitoring with usual INR goals, and there is limited data regarding anticoagulation therapy in such rare cases.…”

Section: General Consideration On Vkamentioning

confidence: 99%

Oral Anticoagulant Therapy—When Art Meets Science

Cîmpan¹,

Chira

Mocan

et al. 2019

JCM

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Anticoagulant treatment is extremely important and frequently encountered in the therapy of various cardiovascular diseases. Vitamin K antagonists (VKA) are in use for the prevention and treatment of arterial and venous thromboembolism, despite the introduction of new direct-acting oral anticoagulants (NOAC). The VKA still have the clear recommendation in patients with a mechanical prosthetic heart valve replacement or moderate to severe mitral stenosis of the rheumatic origin, in deep vein thrombosis associated with congenital thrombophilia, and in cases where NOAC are prohibited by social condition (financial reason) or by comorbidities (extreme weight, severe renal or liver disease). VKA dosing required to reach the targeted therapeutic range varies largely between patients (inter-individual variability). This inter-individual variability depends on multiple environmental factors such as age, mass, diet, etc. but it is also influenced by genetic determinism. About 30 genes implicated in the metabolism coumarins derivatives were identified, the most important being CYP2C9 and VKORC, each with several polymorphisms. Herein, we review the data regarding genetic alterations in general and specific populations, highlight the diagnosis options in particular cases presenting with genetic alteration causing higher sensitivity and/or resistance to VKA therapy and underline the utility of NOAC in solving such rare and difficult problems.

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“…To obtain more information about anticoagulant therapy in FVII deficiency, we searched the PubMed database on February 14, 2019, using the terms “factor VII deficiency,” “atrial fibrillation,” and “anticoagulant therapy.” We found nine published cases of patients with FVII deficiency requiring oral anticoagulant treatment (OAT) . (Table ).…”

Section: Introductionmentioning

confidence: 99%

Direct oral anticoagulants for atrial fibrillation in patients with congenital factor VII deficiency

Arletti

Coluccio

Romagnoli

et al. 2019

European J of Haematology

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The management of anticoagulant therapy (OAT) in patients with factor VII (FVII) deficiency is a very challenging clinical issue, as warfarin further reduces FVII levels, thus potentially increasing bleeding risk. On the other hand, the International Normalized Ratio test is misleading in such patients, as they do not reflect the actual level of global inhibition of the coagulation system. We report here three cases of patients with a moderate FVII deficiency and receiving direct oral anticoagulants (DOAC) for prevention of cardioembolism in atrial fibrillation. Of note, two of them experienced a treatment failure while on warfarin, while DOAC treatment was not associated with thrombotic or hemorrhagic adverse events. DOAC are very attractive for the management of OAT in FVII deficient patients, because they do not require monitoring by tests affected by the inherited defect, and their mechanism of action is FVII‐independent.

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Anticoagulation Therapy Considerations in Factor VII Deficiency

Cited by 12 publications

References 38 publications

Factor VII deficiency in major artery occlusion stroke

Factor VII deficiency in major artery occlusion stroke

Oral Anticoagulant Therapy—When Art Meets Science

Direct oral anticoagulants for atrial fibrillation in patients with congenital factor VII deficiency

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