Essential Guide to Blood Coagulation

Professor Margareta Blomback, MD, PhD, Emeritus Professor, Coagulation Research Laboratory, Karolinska Institute and Hospital, Sweden. Professor Blomback served as Chair of the Scientific & Standardization Committee of the ISTH and is co-chair of the working party on women's issues in haemostasis and thrombosis. Professor Blomback has published almost 500 papers and is world renowned as an expert in blood coagulation. Dr Jovan Antovic, Coagulation Research Laboratory, Karolinska Institute and Hospital, Sweden. Dr Antovic is author or coauthor of about 30 articles published in peer-review scientific journals and serves as a reviewer for journals in the field of haematology and haemostasis (e.g. Journal of Thrombosis & Haemostasis, Atherosclerosis, Thrombosis & Vascular Biology, Circulation). He is also a member of the Editorial Board of Haemostasis Forum, and teaches on under- and postgraduate level courses.

List of contributors. Preface. Abbreviations. PART 1 General hemostasis. 1 Schematic presentation of the hemostatic system (Nils Egberg). 2 Proposals for sampling instructions (Margareta Blomback, Nils Egberg). Points to note prior to sampling. Sampling time and patient preparation. Referrals for coagulation analyses. Sampling. 3 Laboratory investigations (Jovan P. Antovic, Nils Egberg). Nomenclature. Reference intervals for laboratory investigations. Screening analyses. Special analyses. Markers of coagulation activation (hypercoagulation markers). DNA analyses. Global hemostatic assays and bedside methods. Useful components in research studies. Other nonhemostatic variables of importance. PART 2 Bleeding disorders. 4 Hereditary bleeding disorders (Margareta Holmstrom, Margareta Blomback). General remarks about hemophilia A and B. General remarks about von Willebrand s disease. Factor concentrates used for treatment of hemophilia A and B and VWD in Sweden in 2009. Treatment strategy in severe forms of hemophilia and VWD. Surgery in patients with bleeding disorders. Tooth extraction in a hemophilia patient. Caution in patients with bleeding disorders. Treatment principles for different types of bleeding disorders (severe, moderate and milder forms of hemostatic defects). Severe platelet function defect, e.g. Glanzmann s thrombasthenia. Mild hemostatic defects. Blood sampling in bleeding disorders. Bleeding risk charts. 5 Critical bleedings (Hans Johnsson). Introduction. Massive bleeding. Transfusion coagulopathy. Treatment. Complicating factors. Ongoing treatment with platelet-inhibiting and antithrombotic drugs. 6 Investigations of increased bleeding tendency (Nils Egberg, Margareta Holmstrom). Introduction. Diagnosis. Reasons for pathologic screening analyses and further actions. Causes of thrombocytopenia. Causes of prolonged activated partial thromboplastin time. Causes of elevated PT(INR). Investigation of bleeding tendency practical aspects. PART 3 Thromboembolic disorders. 7 Venous thrombosis and pulmonary embolism (Anders Carlsson). Introduction. Incidence of thrombosis in different clinical materials. Venous thrombosis. Pulmonary embolism. 8 Drug treatment in deep vein thrombosis and pulmonary embolism (Anders Carlsson). Treatment of acute deep vein thrombosis and pulmonary embolism. Drug treatment in deep vein thrombosis and pulmonary embolism. Action to take to avoid the risk of thrombosis. Primary prophylaxis against deep vein thrombosis and pulmonary embolism. 9 New anticoagulants: focus on currently approved oral factor Xa and factor IIa inhibitors (Rickard E. Malmstrom). Introduction. Rivaroxaban. Dabigatran. Ongoing clinical studies and other therapeutic indications. Possibility of and need for therapeutic monitoring of new anticoagulants. 10 Arterial thromboembolism (Kenneth Pehrsson, Hakan Wallen, Jesper Swedenborg, Nils Wahlgren). Ischemic heart disease. Thrombolysis. Percutaneous coronary intervention. Cardiac arrhythmias (atrial fibrillation). Stroke and transient ischemic attack (TIA). 11 Investigation of thromboembolic tendency (Margareta Holmstrom). Introduction. Venous thromboembolism. Arterial thromboembolism. Disseminated intravascular coagulation. PART 4 Special hemostasis. 12 Hemostasis in obstetrics and gynecology (Katarina Bremme). Thrombosis during pregnancy. Heart disease: treatment of women with mechanical heart valve prostheses. Thromboprophylaxis in obstetrics and gynecology. Blood sampling in children of women with severe forms of thrombophilia. Obstetric epidural/spinal analgesia (anethesia). Complications during pregnancy. Postpartum bleeding. Thromboprophylaxis in legal and spontaneous abortions. Thromboprophylaxis in gynecologic surgery. Oral contraceptives, hormone substitution. Investigation prior to artificial insemination. Investigation in repeated miscarriages. Investigation in menorrhagia. 13 Hemostasis defects in children (Pia Petrini). Bleeding disorders in children. Thromboembolic disorders in children. 14 Emergency conditions associated with coagulation activation (Jovan P. Antovic, Margareta Holmstrom). Disseminated intravascular coagulation. Heparin-induced thrombocytopenia. Thrombotic microangiopathies (TTP and HUS). Index.