Blood Vessels, Thrombosis & Hemostasis最新文献

{"title":"ECMO-induced coagulopathy: strategic initiatives for research and clinical practice (a workshop report of the NHLBI)","authors":"Jerrold H. Levy ,&nbsp;Peta M. A. Alexander ,&nbsp;Alisa S. Wolberg ,&nbsp;Owen J. T. McCarty ,&nbsp;Anthony E. Pusateri ,&nbsp;Raquel R. Bartz ,&nbsp;Wolfgang Bergmeier ,&nbsp;Mitchell J. Cohen ,&nbsp;Jean M. Connors ,&nbsp;James H. Morrissey ,&nbsp;Matthew D. Neal ,&nbsp;Elisabeth T. Tracy ,&nbsp;Keith McCrae ,&nbsp;Bruce A. Sullenger","doi":"10.1016/j.bvth.2025.100064","DOIUrl":"10.1016/j.bvth.2025.100064","url":null,"abstract":"<div><h3>Abstract</h3><div>In May 2024, the Division of Blood Diseases and Resources of the National Heart, Lung, and Blood Institute (NHLBI) hosted a hybrid workshop on “Extracorporeal membrane oxygenation (ECMO)-induced coagulopathy: strategic initiatives for research and clinical practice.” The event brought together clinicians, scientists, bioengineers, and policymakers to address the challenges of ECMO-associated coagulopathy and explore novel therapeutic approaches. Through expert presentations and collaborative discussions, the workshop focused on innovative anticoagulation strategies, precision medicine, and advanced diagnostics to enhance patient care. The discussions also identified critical research gaps and opportunities for future interdisciplinary collaboration. This summary reviews the current state of knowledge and outlines future research directions for improving ECMO-induced coagulopathy management.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 2","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bender MT, Aggarwal A, Godwin M, et al. Cellular and enzymatic features of thrombi in humans are vascular bed dependent. Blood Vessels Thromb Hemost. 2025;2(1):100029.","authors":"","doi":"10.1016/j.bvth.2025.100057","DOIUrl":"10.1016/j.bvth.2025.100057","url":null,"abstract":"","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 2","pages":"Article 100057"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated tissue factor pathway inhibitor delays thrombin generation in COVID-19 but is not associated with clinical outcomes","authors":"Alicia S. Eustes ,&nbsp;Meena Kumari Palani Kumar ,&nbsp;Julie A. Peterson ,&nbsp;Alan E. Mast ,&nbsp;Steven R. Lentz ,&nbsp;Sanjana Dayal","doi":"10.1016/j.bvth.2025.100071","DOIUrl":"10.1016/j.bvth.2025.100071","url":null,"abstract":"<div><h3>Abstract</h3><div>Plasma levels of tissue factor pathway inhibitor (TFPI) are elevated in many patients with COVID-19 but the role of TFPI in COVID-19 coagulopathy remains elusive. We sought to determine the contribution of TFPI to thrombin generation in patients with COVID-19 and assess its association with thrombosis and other clinical outcomes. We used blood samples from an early COVID-19 clinical trial of adult patients hospitalized with acute COVID-19 from April 2020 to January 2021 (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier: NCT04360824). Plasma TFPI was measured by enzyme-linked immunosorbent assay, and thrombin generation potential was measured in the presence or absence of TFPI neutralizing antibodies. Thromboelastography was performed with whole-blood samples. We found that plasma TFPI was elevated in patients with COVID-19 compared with healthy individuals. Thrombin generation triggered by exogenous TF and phospholipids was increased in COVID-19, reflected by greater peak thrombin, velocity index, and endogenous thrombin potential; however, the time to initiation of thrombin generation (lag time) was delayed. Addition of a neutralizing anti-TFPI antibody significantly shortened the lag time in COVID-19 and normalized the difference in lag time between those with COVID-19 and healthy individuals. Plasma TFPI was positively associated with lag time, time to peak thrombin, and time to initial clot formation in thromboelastography. Multivariate analysis demonstrated that TFPI correlated with lag time and time to reach peak thrombin but not with 30-day mortality, thrombosis, or other adverse clinical outcomes. We conclude that elevated plasma TFPI delays the initiation of thrombin generation and clot formation but is not associated with thrombosis in patients hospitalized with COVID-19.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100071"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of genotypes and phenotypes for von Willebrand factor gene variants using Japanese genome database","authors":"Takafumi Akimoto ,&nbsp;Hiroshi Inaba ,&nbsp;Soichi Ogishima ,&nbsp;Kazuki Kumada ,&nbsp;Ayano Mitsuhashi ,&nbsp;Ryui Miyashita ,&nbsp;Tomoko Yamaguchi ,&nbsp;Masato Bingo ,&nbsp;Yushi Chikasawa ,&nbsp;Keiko Shinozawa ,&nbsp;Takeshi Hagiwara ,&nbsp;Kagehiro Amano ,&nbsp;Eiichi N. Kodama ,&nbsp;Ei Kinai","doi":"10.1016/j.bvth.2025.100070","DOIUrl":"10.1016/j.bvth.2025.100070","url":null,"abstract":"<div><h3>Abstract</h3><div>von Willebrand disease (VWD) is a common inherited bleeding disorder. The aim of this study was to determine the predicted disease states associated with various pathogenic von Willebrand factor (VWF) variants and their phenotypes using the largest Japanese whole-genome database. Of the 5857 <em>VWF</em> gene variants registered in the Japanese Multi-Omics Reference Panel (jMorp), variants with the following criteria were extracted: (1) caused protein abnormalities due to genetic alterations; (2) have already been detected and included in a database, including known association with VWD; and (3) highly likely pathogenic by in silico analysis. We measured VWF activity, antigen, propeptide, and collagen binding activity in stored plasma samples obtained from heterozygous carriers of the selected variants. A total of 29 <em>VWF</em> variants (26 single nucleotide and 3 small insertions/deletions) were detected, and 6 of these were found in Leiden Open Mutation Database. We obtained 43 plasma samples from individuals carrying these 29 variants as heterozygous. For the 43 variant carriers, their mean age was 43.0 years, and blood group was type O in 17 (39.5%). Analysis of these plasma samples showed low VWF levels (&lt;50%) in 6 (14.0%). Low VWF levels were found in 2 of 8 of the nonsense (25%) and 4 of 31 of the missense variants (12.9%). Taking into consideration the limitation of using stored plasma samples, analysis of the jMorp indicated that most <em>VWF</em> gene variants with predicted pathogenic potential did not correlate with phenotypic expression. Our results supported incomplete penetrance and variable expressivity of the <em>VWF</em> gene variants.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100070"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-reactive protein and the menstrual cycle in females with sickle cell disease","authors":"Jessica Wu ,&nbsp;Veronica Bochenek ,&nbsp;Kandace Gollomp ,&nbsp;Andrea H. Roe","doi":"10.1016/j.bvth.2025.100067","DOIUrl":"10.1016/j.bvth.2025.100067","url":null,"abstract":"<div><h3>Abstract</h3><div>Females with sickle cell disease (SCD) experience more frequent and severe vaso-occlusive episodes (VOEs) than males. Many also report perimenstrual timing of VOEs, suggesting cyclic variation in pain risk. C-reactive protein (CRP) is a robust inflammatory marker that is elevated at baseline in patients with SCD and rises during VOEs. Cyclic patterns of inflammatory markers in female patients with SCD have not been previously examined. This study examined the relationship between CRP and menstrual cycle phase in female patients with SCD. Frozen plasma samples from reproductive-aged adult patients with SCD were analyzed. Estradiol, progesterone, and luteinizing hormone levels were measured in female patient samples to estimate menstrual cycle phase at time of collection. CRP levels were compared by SCD genotype, hydroxyurea treatment, female vs male sex, and menstrual cycle phase in the female subgroup. CRP levels did not differ significantly by SCD genotype (SS vs SC), hydroxyurea use, or sex. However, in females with SCD, median CRP levels were significantly higher during the follicular phase than the luteal phase (8.80 mg/L [2.7-10.5] vs 0.82 mg/L [0.6-2.1]; <em>P</em> = .03). Although there were no differences in CRP levels in patients with SCD by sex, genotype, or hydroxyurea use, our results suggest that female patients have cyclicity in inflammation across the menstrual cycle that may predispose them to VOEs during the follicular phase. Further study is needed to validate these findings prospectively and to correlate biomarker patterns with clinical symptoms.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144261372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human and mouse platelet transcriptomes and proteomes for phenotyping 3474 genes with hemostatic and platelet traits","authors":"Jingnan Huang ,&nbsp;Federico Marini ,&nbsp;Fiorella A. Solari ,&nbsp;Frauke Swieringa ,&nbsp;Bas de Laat ,&nbsp;Ilaria De Simone ,&nbsp;Luigi Grassi ,&nbsp;Xiang Gui ,&nbsp;Kunpeng Li ,&nbsp;Elizabeth A. Middleton ,&nbsp;Neil V. Morgan ,&nbsp;Isabella Provenzale ,&nbsp;Carina Santos ,&nbsp;Saskia Schols ,&nbsp;Sarah Westbury ,&nbsp;Albert Sickmann ,&nbsp;Matthew T. Rondina ,&nbsp;Wolfram Ruf ∗ ,&nbsp;Mattia Frontini ∗ ,&nbsp;Johan W. M. Heemskerk ∗","doi":"10.1016/j.bvth.2025.100068","DOIUrl":"10.1016/j.bvth.2025.100068","url":null,"abstract":"<div><h3>Abstract</h3><div>The hemostatic process relies on platelet and coagulation activation, with additional roles of red blood cells and the vessel wall. By systematic screening of databases for gene-linked information on hemostasis, we collected phenotypic profiles of 3474 orthologous human and mouse genes regarding bleeding, arterial thrombosis, thrombophilia, platelet traits, coagulation, and erythrocytes. Comparisons showed that defects in 252 mouse genes led to increased bleeding combined with platelet dysfunction or thrombocytopenia, in addition to 150 human orthologs that are registered for familial bleeding disorders, based on panel sequencing. Additionally, 139 mouse genes contributed to arterial thrombosis without bleeding phenotype. To further investigate the role of platelets in hemostasis, we integrated multiple genome-wide RNA-sequencing transcriptomes and proteomes from healthy subjects and C57BL/6 mice. This provided reference levels for 54 790 (54 247) transcripts and 6379 (4563) proteins in human (mouse) platelets. Orthologous transcripts in human and mouse platelets correlated with <em>R=</em>0.75, whereas orthologous platelet proteins correlated with <em>R=</em>0.87. Comparison with the phenotypic analysis revealed the following: (i) overall high qualitative similarity of human and mouse platelets regarding composition and function; (ii) presence of transcripts in platelets for most of the 3474 phenotyped genes; (iii) preponderance of syndromic platelet-expressed genes; and (iv) 20-40% overlap with genes from genome-wide association studies. For 42 mouse genes, among which receptors, signaling proteins, and transcription regulators (ASXL1, ERG, GATA2, MEIS1, NFE2, and TAL1), we confirmed novel links with human platelet function or count. This interspecies comparison can serve as a valuable resource for researchers and clinicians studying the genetics of blood-borne hemostasis and thrombosis.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100068"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of severe bleeds with eptacog beta in hemophilia A or B with inhibitors: a post hoc analysis of the PERSEPT 1 and 2 trials","authors":"Guy Young ,&nbsp;Johnny Mahlangu ,&nbsp;Lisa N. Boggio ,&nbsp;Manuel Carcao ,&nbsp;Yesim Dargaud ,&nbsp;Miguel Escobar ,&nbsp;Adam Giermasz ,&nbsp;Cédric Hermans ,&nbsp;Philip Kuriakose ,&nbsp;Wolfgang Miesbach ,&nbsp;Danielle Nance ,&nbsp;Amina Rafique ,&nbsp;Robert F. Sidonio Jr. ,&nbsp;Kateryna V. Vilchevska ,&nbsp;Michael Wang ,&nbsp;Steven W. Pipe","doi":"10.1016/j.bvth.2025.100069","DOIUrl":"10.1016/j.bvth.2025.100069","url":null,"abstract":"<div><h3>Abstract</h3><div>Severe bleeding episodes (BEs) in persons with hemophilia A or B and inhibitors (PwHABIs) represent challenging clinical situations and can require treatment regimens lasting days or weeks before hemostatic control is achieved. Eptacog beta is a recombinant activated human factor VII bypassing agent approved for treating and controlling bleeding in PwHABIs aged ≥12 years. The aim of this study is to assess the efficacy and safety of eptacog beta for severe bleed treatment in PwHABIs during 2 phase 3 trials (PERSEPT 1 and PERSEPT 2). Patients could treat severe BEs with initial doses of 75 or 225 μg/kg eptacog beta at home, followed by subsequent 75 μg/kg eptacog beta infusions administered at predefined intervals in a hospital or hemophilia treatment center. Satisfactory treatment responses to eptacog beta were typically defined in this post hoc analysis by physician- and patient-reported hemostasis evaluations of “excellent” or “good.” Hemostatic control of an intracranial hemorrhage (ICH) in 1 patient was assessed by computed tomography. Seven PwHABIs (aged 1-50 years) treated 8 BEs considered severe or otherwise life threatening with eptacog beta during PERSEPT 1 and PERSEPT 2. Hemostatic control of 7 of these BEs (including 3 ICH events) was achieved. Eptacog beta treatment durations ranged from 25 minutes to 96 hours. No thrombotic events were reported, and eptacog beta was well tolerated. Most severe BEs resolved with eptacog beta treatment during PERSEPT 1 and PERSEPT 2. The PERSEPT 1 and PERSEPT 2 trials were registered at <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> as #NCT02020369 and #NCT02448680, respectively.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144221425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japanese database analysis: effectiveness of early initiation of TPO-RA treatment in tapering corticosteroid dose in ITP","authors":"Kodai Suzuki ,&nbsp;Satoru Ito ,&nbsp;Stefano Carini ,&nbsp;Mami Shimizu ,&nbsp;Shigeki Hatanaka ,&nbsp;Yoshitaka Miyakawa","doi":"10.1016/j.bvth.2025.100066","DOIUrl":"10.1016/j.bvth.2025.100066","url":null,"abstract":"<div><h3>Abstract</h3><div>This longitudinal, descriptive study investigated the effect of the timing of thrombopoietin receptor agonist (TPO-RA) initiation on corticosteroid administration and related adverse events (AEs) in patients with immune thrombocytopenia (ITP) in Japan using real-world data from a health claim database. In total, 7696 patients were divided into 3 groups (early TPO-RA initiation, late TPO-RA initiation, and non–TPO-RA administration) by the presence and timing of TPO-RA administration. The early TPO-RA initiation group included patients first administered TPO-RA &lt;60, &lt;120, and &lt;180 days after the index date. The late TPO-RA initiation group included patients first administered TPO-RA ≥60, ≥120, and ≥180 days after the index date. The early TPO-RA initiation group received the highest daily average prednisolone dose, followed by a rapid decrease in dose, similar to that in the non–TPO-RA administration group. In the early TPO-RA initiation group, there was a long-term trend toward daily average prednisolone doses of ≤5 mg, and by approximately 10 to 11 months, the median dose was 0 mg. Diabetes (insulin-dependent) and hypertension tended to occur more frequently in the late TPO-RA (8.4% and 19.9%, respectively) than in the early TPO-RA initiation group (6.9% and 14.4%, respectively). Incidence rates of infections in the late TPO-RA and early TPO-RA initiation groups were similar (7.2% vs 7.6%). The incidence of AEs was similar between male and female patients; a trend toward a higher incidence was observed in those aged ≥60 years. Early initiation of TPO-RA administration can contribute to reducing total prednisolone dosage, treatment duration, and AEs (eg, hypertension and insulin-dependent diabetes).</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 2","pages":"Article 100066"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143858976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world analysis of strategies to prevent thrombosis and bleeding in adults with ALL treated with asparaginase","authors":"Joseph F. Mort ,&nbsp;David Brighton ,&nbsp;Benjamin Mautner ,&nbsp;Eric Pierce ,&nbsp;Farid Ghamsari ,&nbsp;Cecily Allen ,&nbsp;Darren D’Souza ,&nbsp;Imari Patel ,&nbsp;Justin Lawson ,&nbsp;Clayton Jackson ,&nbsp;Karin Abernathy ,&nbsp;Bradley Yelvington ,&nbsp;Ryan Miller ,&nbsp;Bhagirathbhai Dholaria ,&nbsp;Heather Wolfe ,&nbsp;Jordan Infield ,&nbsp;Susan C. Locke ,&nbsp;Rory M. Shallis ,&nbsp;Vu H. Duong ,&nbsp;Daniel R. Reed ,&nbsp;Firas El Chaer","doi":"10.1016/j.bvth.2025.100065","DOIUrl":"10.1016/j.bvth.2025.100065","url":null,"abstract":"<div><h3>Abstract</h3><div>The prognosis of adult patients with acute lymphoblastic leukemia (ALL) has improved with the incorporation of pediatric-inspired regimens that contain PEGylated asparaginase (PEG-Asp). However, PEG-Asp administration is associated with an increased rate of thrombosis. Data regarding the benefits of antithrombin (AT) repletion and prophylactic anticoagulation in adults receiving PEG-Asp–based regimens are limited. We performed a retrospective study to evaluate the rates of induction thrombosis and bleeding among adults receiving ALL therapy containing Asp at 6 academic centers in the United States. Of 233 patients who met the inclusion criteria, 98.3% received PEG-Asp. Ninety-six patients (41.2%) had their AT levels monitored, 58 patients (24.9%) received AT repletion, and 41 patients (17.6%) received prophylactic anticoagulation. Thirty-two patients (13.7%) experienced thrombotic events, with half (53.1%) being line-associated thromboses. In multivariate analysis, the odds of thrombosis did not differ between patients who received AT monitoring, AT repletion, or prophylactic anticoagulation. The odds of thrombosis were 4 times higher for patients with peripherally inserted central catheters than for those with other types of central lines (odds ratio, 4.112; 95% confidence interval, 1.622-10.427; <em>P</em> = .01). Thrombotic risk did not differ based on age, cumulative Asp dose, type of steroid administered, or whether transfusions were performed. Bleeding occurred in 12 patients (5.2%), and major bleeding occurred in 8 patients (3.4%). The odds of bleeding did not increase in the patients who received prophylactic anticoagulation. Our study brings into question whether prophylactic AT repletion and anticoagulation are beneficial strategies for reducing PEG-Asp–associated thrombosis, and large randomized prospective studies are needed.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 3","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"D-dimer after 3 months of anticoagulation therapy and outcomes in cancer-associated isolated distal deep vein thrombosis","authors":"Tatsuya Nishikawa ,&nbsp;Yugo Yamashita ,&nbsp;Masashi Fujita ,&nbsp;Takeshi Morimoto ,&nbsp;Nao Muraoka ,&nbsp;Michihisa Umetsu ,&nbsp;Yuji Nishimoto ,&nbsp;Takuma Takada ,&nbsp;Yoshito Ogihara ,&nbsp;Nobutaka Ikeda ,&nbsp;Kazunori Otsui ,&nbsp;Daisuke Sueta ,&nbsp;Yukari Tsubata ,&nbsp;Masaaki Shoji ,&nbsp;Ayumi Shikama ,&nbsp;Yutaka Hosoi ,&nbsp;Yasuhiro Tanabe ,&nbsp;Ryuki Chatani ,&nbsp;Kengo Tsukahara ,&nbsp;Naohiko Nakanishi ,&nbsp;Takeshi Kimura","doi":"10.1016/j.bvth.2025.100063","DOIUrl":"10.1016/j.bvth.2025.100063","url":null,"abstract":"<div><h3>Abstract</h3><div>Cancer-associated isolated distal deep vein thrombosis (IDDVT) is a common complication in patients with cancer. The Optimal Duration of Anticoagulation Therapy for Isolated Distal Deep Vein Thrombosis in Patients with Cancer study revealed the superiority of 12- over 3-month edoxaban treatment with respect to thrombotic risk. However, it remains unclear whether D-dimer levels during anticoagulation influence the efficacy of extended anticoagulation. In this post hoc subgroup analysis, we stratified 519 patients into the low D-dimer (&lt;1.0 μg/mL) (n = 308) and high D-dimer (≥1.0 μg/mL) (n = 211) subgroups based on D-dimer levels at 3 months. The cumulative incidence of a composite of symptomatic recurrent venous thromboembolism (VTE) or VTE-related death was lower in the 12-month edoxaban group than in the 3-month edoxaban group in both the low D-dimer (0.8% vs 5.6%; <em>P</em> = .02; odds ratio [OR], 0.12; 95% confidence interval [CI], 0.01-0.66) and high D-dimer (0.9% vs 10.2%; <em>P</em> = .01; OR, 0.11; 95% CI, 0.01-0.62) subgroups without interaction. Furthermore, there was no significant difference in the cumulative incidence of major bleeding between the 12- and 3-month groups in both the low D-dimer (3.6% vs 1.8%; <em>P</em> = .64; OR, 1.96; 95% CI, 0.47-9.67) and high D-dimer (18.3% vs 14.6%; <em>P</em> = .29; OR, 1.27; 95% CI, 0.60-2.75) subgroups without interaction. In conclusion, a 12-month edoxaban treatment for cancer-associated IDDVT was superior to a 3-month treatment in reducing thrombotic events, irrespective of D-dimer levels after 3 months of anticoagulation therapy. There was no significant increased risk of major bleeding in the 12-month edoxaban group relative to the 3-month edoxaban group regardless of the D-dimer levels at 3 months. This trial was registered at <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> as #NCT03895502.</div></div>","PeriodicalId":100190,"journal":{"name":"Blood Vessels, Thrombosis & Hemostasis","volume":"2 2","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}