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ASH: Researchers Target Bleeding, Clotting Disorders

New strategies and findings may benefit hip replacement patients and women considering hormone replacement

MONDAY, Dec. 10 (HealthDay News) -- New management approaches may help the millions of patients affected by a wide range of bleeding and clotting disorders, according to several research studies presented this week at the 49th Annual Meeting of the American Society of Hematology in Atlanta.

In one study, Bengt I. Eriksson, M.D., Ph.D., of Sahlgrenska University Hospital/Ostra in Goteborg, Sweden, and colleagues randomly assigned 4,541 hip replacement patients to receive either oral rivaroxaban or standard subcutaneous enoxaparin. After five weeks, the researchers found that rivaroxaban was associated with a significantly reduced incidence of deep vein thrombosis, non-fatal pulmonary embolism, all-cause mortality and major venous thromboembolism compared to enoxaparin, with a similar safety profile.

In a second study, Mary Cushman, M.D., of the University of Vermont in Burlington, and colleagues evaluated the role of coagulation markers in postmenopausal hormone-related venous thrombosis (VTE) in two trials from the Women's Health Initiative. In a nested case control study, baseline levels of coagulation markers were measured in 215 women who developed VTE and 867 age-matched controls. According to the researchers, risks for postmenopausal hormone-related VTE included low levels of protein C and free protein S, and high levels of D-dimer, plasmin antiplasmin complex and prothrombin fragment 1-2, with adjusted odds ratios of 2.0, 2.9, 2.8, 2.5, and 1.9.

"If our findings are confirmed in management studies, measurement of these factors might assist women with decision-making on safety of conjugated equine estrogens or conjugated equine estrogens plus medroxyprogesterone acetate," the authors conclude.

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