warfarin / Generic mfg. - LARVOL DELTA

A Study of Thoracoscopic Left Atrial Appendage Occlusion to Discontinue Oral Anticoagulation After Atrial Fibrillation Ablation (clinicaltrials.gov) - P=N/A | N=200 | Not yet recruiting | Sponsor: Medical Corporation Tokushukai Chibanishi General Hospital

New trial • Atrial Fibrillation • Cardiovascular

Evaluating interaction of pharmacologically potent organoselenides with transport protein human serum albumin: Spectroscopic and molecular dynamic simulations based mechanistic insights. (PubMed, Spectrochim Acta A Mol Biomol Spectrosc) - "Displacement studies using warfarin and ibuprofen in addition to docking studies indicated that none of the ligands bind to either Sudlow site I or site II. Circular dichroism and thermal melting measurements showed minimal perturbation of the structure of HSA upon ligand binding. These findings highlight distinct binding modes of organoselenides with HSA and provide important insights that may aid in the rational design of selenium-based therapeutics with improved pharmacokinetic properties."

Journal

Assessment of Patients' Awareness of Anticoagulant Use in Atrial Fibrillation: A Cross-Sectional Survey. (PubMed, Turk Kardiyol Dern Ars) - "Despite high self-reported adherence, substantial knowledge gaps persist among patients receiving anticoagulation for AF, particularly regarding side effects and drug or food interactions. Targeted, health-literacy-sensitive educational strategies may improve medication safety and clinical outcomes in patients receiving anticoagulation for AF."

Journal • Atrial Fibrillation • Cardiovascular • Diabetes • Hypertension • Metabolic Disorders

Haemorrhagic event reporting with concomitant gemcitabine and warfarin: a VigiBase disproportionality analysis. (PubMed, Front Pharmacol) - "This VigiBase analysis identified disproportionate haemorrhagic-event reporting with concomitant gemcitabine and warfarin. These findings should be interpreted in light of the limitations inherent to spontaneous reporting, including under-reporting, reporting biases, missingness, and residual confounding."

Journal

Doxycycline postexposure prophylaxis (doxyPEP) in a patient with antiphospholipid syndrome receiving warfarin: balancing STI prevention and anticoagulation safety. (PubMed, Sex Transm Infect) - No abstract available

Journal • Genetic Disorders • Hematological Disorders

When Abdominal Pain Persists: An Atypical Presentation of IgA Vasculitis (ACG 2026) - "Case Description/ A 56-year-old male with PE on warfarin, positive anticardiolipin antibodies, COPD, hypothyroidism, OSA, and sporadic NSAID use presented with two weeks of progressive abdominal pain, early satiety, nausea, vomiting, and food aversion following presumed food poisoning...Prednisone 60 mg daily produced prompt improvement; the patient was discharged on a taper, with PPI and Bactrim prophylaxis, and achieved near-complete resolution at four-week follow-up...Endoscopic stellate ulcerations with diffuse erythema and early skin biopsy demonstrating LCV are critical diagnostic tools. This case underscores the importance of integrating GI, dermatologic, and rheumatologic findings and initiating systemic corticosteroids promptly in adults with GI-predominant IgAV to prevent ischemic and hemorrhagic complications."

Chronic Obstructive Pulmonary Disease • Crohn's disease • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammatory Bowel Disease • Pain • Respiratory Diseases • Thrombocytosis • Vasculitis

A Rare Case of Pseudomelanosis Duodeni (ACG 2026) - "Case Description/ A 71-year-old female with ESRD on hemodialysis, type 2 diabetes mellitus, hypertension, and atrial fibrillation on Warfarin who presented with one week of fatigue and confusion, difficulty finding words, and 3-4 days of melena...Despite its benign nature, the pathogenesis and clinical significance of PD has yet to be defined. Figure: Endoscopic image of the third portion of the duodenum with findings consistent with Pseudomelanosis duodeni."

Clinical • Atrial Fibrillation • Cardiovascular • Celiac Disease • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Gastroenterology • Heart Failure • Hypertension • Immunology • Inflammation • Metabolic Disorders • Nephrology • Peptic Ulcer • Renal Disease • Type 2 Diabetes Mellitus

Extensive Portomesenteric Venous Thrombosis Associated With Testosterone-Induced Erythrocytosis (ACG 2026) - "The patient was discharged on fondaparinux (warfarin contraindicated due to antiretroviral interactions) with symptomatic improvement and later transitioned to apixaban. Superior mesenteric venography (A) before and (B) after catheter-directed intervention Legend: (A) Complete occlusion of the superior mesenteric vein with absence of flow (red arrow). (B) Restored hepatopedal flow through the superior mesenteric vein following intervention."

Cardiovascular • Endocrine Disorders • Hematological Disorders • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammatory Arthritis • Thrombosis

An Unusual Case of Portal Hypertension Caused by Hepatic Sarcoidosis (ACG 2026) - "His T. Bili was 3.2 mg/dL, D. Bili was 0.9 mg/dL, and INR was 2.9, likely due to warfarin...He was started on prednisone taper and azathioprine, but due to intolerance, was later switched to mycophenolate mofetil...Corticosteroids and ursodeoxycholic acid are commonly used. Refractory cases may require immunosuppressive agents such as azathioprine. Liver transplant should be considered in HS once complications of PH develop as survival rates at 1-year are 78%-84.6% and 5-year are 61%."

Clinical • Cardiovascular • CNS Disorders • Fibrosis • Hematological Disorders • Hematological Malignancies • Hepatic Encephalopathy • Hepatology • Immunology • Infectious Disease • Lymphoma • Metabolic Dysfunction-Associated Steatotic Liver Disease • Portal Hypertension • Respiratory Diseases • Sarcoidosis • Thrombosis • Tuberculosis

Isolated Gastric Variceal Hemorrhage From Sinistral Portal Hypertension in JAK2 V617F-Positive Myeloproliferative Neoplasm (ACG 2026) - "Case Description/ A 48-year-old male with JAK2 V617F-positive MPN and chronic portal and splenic vein thrombosis, noncompliant with hydroxyurea and warfarin therapy, presented with 1 episode of hematemesis...He was resuscitated with vasopressors, octreotide, and pantoprazole infusion, and treated with rasburicase for TLS...He was ultimately transitioned to ruxolitinib as outpatient therapy, with normalization of counts and resolution of bleeding at follow-up...Figure: Figure 2. Esophagogastroduodenoscopy showing extensive isolated gastric varices (IGV1 and IGV2) and an actively bleeding, ulcerated varix (image 14), which was clipped endoscopically."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Hypertension • Myeloproliferative Neoplasm • Portal Hypertension • Thrombocytosis • Thrombosis • Varicose Veins • JAK2

EBV-Negative Polymorphic Post-Transplant Lymphoproliferative Disorder Presenting as a Hemorrhagic Duodenal Lesion Following Liver Transplantation (ACG 2026) - "Case Description/ A 64-year-old male with a history of hepatitis C virus (HCV)-related cirrhosis and well-differentiated hepatocellular carcinoma (HCC) status post deceased donor liver transplant 8 years ago, complicated by hepatic artery thrombosis (on Warfarin) and maintained on Tacrolimus, presented with one week of worsening melena, dyspnea on exertion, fatigue, and weakness...Figure: Figure 1. Sessile polyploid lesion in the duodenal bulb"

Post-transplantation • Bone Marrow Transplantation • Cardiovascular • CNS Disorders • Cytomegalovirus Infection • Fibrosis • Hematological Disorders • Hematological Malignancies • Hepatitis C • Hepatocellular Cancer • Hepatology • Immunology • Infectious Disease • Pulmonary Disease • Solid Tumor • Thrombosis • Transplantation • CD20 • SDC1

Not Just Gastric: An Elusive Esophageal Dieulafoy Revealed (ACG 2026) - "Recent medications included prednisone 20 mg twice daily for leg pain and intermittent ibuprofen use in addition to chronic warfarin therapy. Figure: Figure 2. Post-treatment appearance of an esophageal Dieulafoy lesion following successful hemoclip deployment."

Atrial Fibrillation • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Myelodysplastic Syndrome • Thrombocytopenia

Concurrent Aspirin Use in Anticoagulated Patients and Risk of Gastrointestinal Bleeding: A Propensity-Score-Matched Cohort Analysis (ACG 2026) - "Cohort 1 comprised adults on chronic anticoagulation (apixaban, rivaroxaban, dabigatran, edoxaban, or warfarin) with concurrent aspirin use; Cohort 2 comprised anticoagulated adults without aspirin. Post-PSM cohorts were well-balanced (all SMDs < 0.003). Aspirin use was associated with significantly higher rates of upper GI bleed (1.51% vs. 1.26%; HR 1.34, 95% CI 1.20â1.48; p< 0.001), unspecified GI hemorrhage (1.39% vs."

Clinical • Cardiovascular • Chronic Kidney Disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Renal Disease • Thrombocytopenia

Antithrombotic Agents and Post-Polypectomy Bleeding Risk in Patients With Polyps â¤20mm: Systematic Review and Meta-Analysis (ACG 2026) - "Fifty studies including 25,205 patients were included in the proportion meta-analysis. The pooled incidence of delayed PPB was 2.14% (95% CI 1.43â3.20), myocardial infarction was 0.18% (95% CI 0.05â0.72), stroke was 0.27% (95% CI 0.20â0.37), and composite TE events was 0.15% (95% CI 0.05â0.48). Delayed bleeding rates varied by antithrombotic class: aspirin 1.21%, P2Y12 inhibitors 1.43%, DOACs 2.01%, and warfarin 2.40%."

Retrospective data • Review • Cardiovascular • Myocardial Infarction

Perforated Low-Grade Appendiceal Mucinous Neoplasm Incidentally Discovered During Evaluation of Pneumonia-Associated Encephalopathy (ACG 2026) - "Case Description/ A 75-year-old man with atrial fibrillation on warfarin, chronic kidney disease, diabetes, and recent prosthetic joint septic arthritis on daptomycin/ceftriaxone presented with encephalopathy, cough, dysuria, and hypoxia to 88%. Figure: Figure 1: Intraoperative findings of large volume of thick, gelatinous, mucinous material in the right lower quadrant/pelvis highly concerning for mucinous malignancy. The appendix appeared to be completely obliterated"

Appendix Cancer • Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Cough • Diabetes • Diabetic Nephropathy • Immunology • Infectious Disease • Metabolic Disorders • Nephrology • Pneumonia • Pulmonary Embolism • Renal Disease • Respiratory Diseases

Bleeding Duodenal Adenocarcinoma as a New Primary Malignancy in a Patient With Lynch Syndrome (ACG 2026) - "Case Description/ A 67-year-old female with PMS2-related Lynch syndrome, stage III right-sided colon adenocarcinoma status post hemicolectomy, multiple sclerosis, and atrial flutter on warfarin presented with melena, dyspnea, and lightheadedness. She previously received pembrolizumab in 2024...Hematoxylin and Eosin (H&E) stain demonstrating an intermediate-power view of the duodenal mass showing high-grade morphology (arrowhead) and hemorrhage (arrow). Image captured with a 10x objective."

Clinical • CNS Disorders • Colon Adenocarcinoma • Colon Cancer • Colorectal Adenocarcinoma • Colorectal Cancer • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Infectious Disease • Multiple Sclerosis • Oncology • Pulmonary Disease • Small Intestinal Carcinoma • Solid Tumor • MSH6 • PMS2

Transfusion-Associated Hemolysis in Zieve's Syndrome: A Case for Ultra-Restrictive Transfusion Thresholds in Decompensated Cirrhosis (ACG 2026) - "Case Description/ An 82-year-old man with decompensated cirrhosis (alcohol use disorder, a-1AT), atrial fibrillation on warfarin, heart failure, and aortic stenosis presented with 2-3 days of melena and hematemesis...Greater awareness of Zieve's syndrome is essential to avoid iatrogenic exacerbation and guide individualized management. Figure: Figure 1 Demonstrates cirrhotic liver with splenomegaly"

Clinical • Addiction (Opioid and Alcohol) • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Dyslipidemia • Fibrosis • Gastroenterology • Heart Failure • Hematological Disorders • Hepatology • Immunology • Metabolic Disorders • HP

Unseen Bleeding, Unfavorable Outcomes: Spontaneous Retroperitoneal Hematoma in Cirrhosis (ACG 2026) - "Anticoagulants, including apixaban, enoxaparin, heparin, and warfarin, were associated with increased risk of SRPH, while antiplatelets were not. Among 725,979 patients with cirrhosis, 749 developed SRPH, corresponding to a prevalence of 0.1%, nearly 10-fold higher than in patients without cirrhosis (0.01%). SRPH risk was higher with chronic kidney disease (CKD) (HR 2.49, P< .0001) and alcohol-associated cirrhosis (HR 1.58, P< .0001), while chronic hepatitis B (HR 0.58, P=.03) and chronic hepatitis C (HR 0.66, P< .0001) were associated with lower risk. Markers of decompensated cirrhosis were also associated with SRPH, including ascites, variceal bleeding, hepatic encephalopathy, and hepatorenal syndrome."

Chronic Kidney Disease • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatitis B • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Cirrhosis • Nephrology • Renal Disease

EUS Guided Coil Embolization for Obliterating Massive Ectopic Gastric Antral Varices (ACG 2026) - "The patient had a history of a hypercoagulable disorder on warfarin, chronic portal vein thrombosis complicated by recurrent GV bleeding with splenic artery embolization, splenectomy, and an exploratory laparotomy with a bleeding gastric varix which was tied off 20 years prior...Figure: Figure 2. Endoscopic ultrasound-guided coiling and gelfoam slurry injection (A,B,C) with absence of doppler flow on follow-up exam (D)."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Thrombosis • Varicose Veins

Bleeding Severity and Clinical Outcomes With Direct Oral Anticoagulants Versus Warfarin in Hospitalized Patients With Inflammatory Bowel Disease and Pulmonary Embolism: A Propensity-Matched Analysis (ACG 2026) - "After matching, rates of GI hemorrhage were similar between warfarin and DOAC cohorts (2.0% vs 2.1%; RR 0.98, 95% CI 0.64â1.49; p=0.922). Upper GI bleeding was also comparable (1.7% vs 2.0%; RR 0.84, 95% CI 0.53â1.33; p=0.460). However, warfarin was associated with a significantly higher risk of transfusion compared to DOACs (2.40% vs 1.50%; RR 1.60, 95% CI 1.03â2.45; p=0.035), suggesting increased bleeding severity."

Clinical • Clinical data • Cardiovascular • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammation • Inflammatory Bowel Disease • Pulmonary Embolism • Respiratory Diseases • Ulcerative Colitis

Not Just the Gut: Reconsidering Bleeding Risk in Inflammatory Bowel Disease Patients on Anticoagulation: A Propensity-Matched Comparative Analysis (ACG 2026) - "Adults with ulcerative colitis or Crohn's disease were stratified by exposure to anticoagulant therapy (DOACs, warfarin, and Heparin)... After matching, 166,768 patients remained in each cohort. GI bleeding was modestly more frequent with anticoagulant exposure (8.7% vs. 7.9%; OR 1.12, 95% CI 1.09â1.15; HR 1.10, 95% CI 1.07â1.13; log-rank p< 0.001)."

Clinical • Cardiovascular • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Ulcerative Colitis • Venous Thromboembolism

Catastrophic Lower Gastrointestinal Bleeding Complicated by Disseminated Intravascular Coagulation in an Elderly Patient on Dual Antithrombotic Therapy (ACG 2026) - "Case Description/ An 88-year-old woman with atrial fibrillation on apixaban and aspirin presented with acute hematochezia and hemorrhagic shock...Her hospital course was further complicated by septic shock, acute hypoxic respiratory failure requiring mechanical ventilation, acute kidney injury, and digoxin toxicity...Although direct oral anticoagulants are widely used because of their favorable safety profile compared with warfarin, gastrointestinal bleeding remains a significant complication, particularly when combined with antiplatelet therapy...Figure: Laboratory findings demonstrated progressive consumptive coagulopathy consistent with overt disseminated intravascular coagulation (DIC), including worsening thrombocytopenia, prolonged PT/INR and aPTT, severe hypofibrinogenemia, and markedly elevated D-dimer levels. The patient also developed profound lactic acidosis with rising lactate levels, severe metabolic acidosis, worsening anemia, and acute kidney injury,..."

Clinical • Acute Kidney Injury • Atherosclerosis • Atrial Fibrillation • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Geriatric Disorders • Hematological Disorders • Metabolic Disorders • Nephrology • Renal Disease • Respiratory Diseases • Septic Shock • Thrombocytopenia

Ectopic Hepatic Tissue Within Recurrent Pancreatic Ductal Adenocarcinoma (ACG 2026) - "He was discharged on warfarin and with oncology follow-up but was readmitted shortly after for weakness and hyperbilirubinemia...Numerous single polygonal hepatocytes with central nuclei and abundant cytoplasm with sharp borders (upper right corner). Figure: Figure 2: Pancreatic desmoplastic stroma with an angulated malignant duct adjacent to benign ectopic hepatic parenchyma."

Hepatocellular Cancer • Hepatology • Oncology • Pancreatic Cancer • Pancreatic Ductal Adenocarcinoma • Solid Tumor • Thrombosis

Acute Esophageal Obstruction From Hemorrhage into an Esophageal Duplication Cyst in a Jehovah's Witness on Warfarin (ACG 2026) - "Figure: Figure 2. Coronal CT image demonstrating the duplication cyst with internal hemorrhage."

Gastrointestinal Disorder • Genetic Disorders

Big Heart Leads to Small Bites: A Case of Dysphagia Megalatriensis From Severe Left Atrial Enlargement (ACG 2026) - "Patient continued amiodarone and warfarin for atrial fibrillation and was placed on a proton pump inhibitor for GERD, and was discharged to short-term rehabilitation. Early recognition and management of underlying cardiac disease may lead to prevention or delay of dysphagia symptoms. Figure: Left atrial dilation on CT scan Figure: Barium Swallow study showing dilated esophagus"

Clinical • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Heart Failure • Hypotension • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases