Clinical and Applied Thrombosis/Hemostasis最新文献

{"title":"Treatment with Sulodexide Downregulates Biomarkers for Endothelial Dysfunction in Convalescent COVID-19 Patients.","authors":"Alejandro J Gonzalez-Ochoa, Gyozo Szolnoky, Ana G Hernandez-Ibarra, Jawed Fareed","doi":"10.1177/10760296241297647","DOIUrl":"https://doi.org/10.1177/10760296241297647","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent elevation of biomarkers associated with endothelial dysfunction in convalescent COVID-19 patients has been linked to an increased risk of long-term cardiovascular complications, including long COVID syndrome. Sulodexide, known for its vascular endothelial affinity, has demonstrated pleiotropic protective properties. This study aims to evaluate the impact of sulodexide on serum levels of endothelial dysfunction biomarkers in patients during the convalescent phase of COVID-19.</p><p><strong>Methods: </strong>We conducted a double-blind, single-center, randomized, placebo-controlled trial in Mexico, comparing sulodexide (250 LRU orally, twice daily) with placebo over 8 weeks in adult patients during early COVID-19 convalescence. Differences in serum biomarkers between the groups were analyzed using repeated measures and post hoc tests, with Thrombomodulin (TM) as the primary endpoint.</p><p><strong>Results: </strong>Among 206 analyzed patients (103 in each group), at week 8, the sulodexide group exhibited significantly lower mean levels of Thrombomodulin (TM) (25.2 ± 7.9 ng/mL vs 29.9 ± 14.7 ng/mL, <i>P</i> = .03), von Willebrand Factor (vWF) (232 ± 131 U/dL vs 266 ± 122 U/dL, <i>P</i> = .02) and Interleukin-6 (IL-6) (12.5 ± 13.2 pg/mL vs 16.2 ± 16.5 pg/mL, <i>P</i> = .03) compared to the placebo group. D-dimer and C reactive protein (CRP) in the sulodexide group were also lowered. No significant differences were observed for P-selectin, fibrinogen, VCAM-1, or ICAM-1 levels.</p><p><strong>Conclusions: </strong>Patients in the convalescent phase of COVID-19 who received sulodexide for eight weeks showed a reduction in TM, vWF, D-dimer, CRP, and IL-6 serum levels compared to placebo. These findings suggest a potential protective effect of sulodexide against thromboinflammation and endothelial damage.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296241297647"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LINC01088 Targets miR-195-5p to Promote Proliferation and Migration and Reduce Apoptosis in the Inhibition of Carotid Artery Stenosis.","authors":"Huoquan Tang, Shuo Sun, Yali Zhang, Ying Jin, Caijiao Wang, Chunchun Xu, Yanfeng Zhang, Li Chen, Defeng Wu","doi":"10.1177/10760296251319281","DOIUrl":"10.1177/10760296251319281","url":null,"abstract":"<p><p>Carotid artery stenosis (CAS) often goes undetected until it reaches an advanced stage, which can result in serious complications. The present study evaluated the potential of long noncoding RNA (lncRNA) LINC01088 as a biomarker for CAS. 92 CAS patients and 92 healthy controls (Control group) were included. RT-qPCR was performed to assess the relative levels of LINC01088 and miR-195-5p. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic potential of LINC01088. The relationship between LINC01088 and miR-195-5p was identified by luciferase reporter assay. Proliferation, migration, and apoptosis in human aortic endothelial cells (HAECs) were assessed using CCK8, transwell, and flow cytometry assay. DAVID was employed for Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses. CAS patients showed decreased LINC01088 expression and increased miR-195-5p expression compared to Control, with a negative correlation between their expression levels in CAS. LINC01088 demonstrated high sensitivity and specificity in distinguishing CAS patients from healthy individuals. LINC01088 directly targets miR-195-5p. Upregulation of LINC01088 reversed the effects of ox-LDL treatment, restoring proliferation and migration while reducing apoptosis in HAECs. However, miR-195-5p mimic reduced the protection of LINC01088 on HAECs proliferation, migration, and apoptosis. For miR-195-5p target genes, GO revealed protein metabolism pathways and KEGG highlighted the p53 and MAPK signaling pathways. The present study revealed the diagnosis value of LINC01088. LINC01088 reversed ox-LDL-induced proliferation, apoptosis, and migration by acting as sponges of miR-195-5p in HAECs. LINC01088 may serve as a protective biomarker in CAS progression.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251319281"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11946290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperferritinemia is Associated with Thrombocytopenia and Increased Mortality Risk in Adult Sepsis Patients: A Retrospective Study of Two Observational Cohorts.","authors":"Dengzhe Li, Xinqiang Li, Bo Wen, Boling Li, Yan Wang, Yuan Zong, Jun Lyu","doi":"10.1177/10760296251321314","DOIUrl":"10.1177/10760296251321314","url":null,"abstract":"<p><strong>Objective: </strong>Markedly elevated serum ferritin serves as a laboratory marker of macrophage activation syndrome and is associated with increased mortality in sepsis, where hyperinflammation, coagulopathy, and immune dysregulation interplay. Although laboratory studies suggest a relationship between hyperferritinemia and coagulopathy in sepsis, clinical evidence remains limited. This study aims to assess mortality risk and the interplay between hyperferritinemia (ferritin ≥ 500 ng/mL) and thrombocytopenia in two sequential cohorts of adult patients with sepsis.</p><p><strong>Patients: </strong>Patients with sepsis (≥18 years old) admitted to adult ICUs at Beth Israel Deaconess Medical Center between 2001 and 2008, and 2008 to 2019, with at least one ferritin value recorded within a 48-h window preceding or following the initial ICU admission.</p><p><strong>Results: </strong>Among 2339 eligible patients with hyperferritinemic sepsis, 921(39.4%) were categorized into the high ferritin (HF) group (ferritin ≥ 500 ng/mL). Multivariate logistic regression analysis revealed a significant association between the HF group and increased in-hospital mortality (p < .01). Survival analysis revealed significantly lower survival probabilities at 28 and 90 days in the HF group compared to the low ferritin group. The interaction between the HF group and thrombocytopenia revealed a statistically significant association with in-hospital mortality. Furthermore, causal mediation analysis showed that platelet count mediated 12.6% (95% CI: 0.063-0.27; p < .001) of the effect of elevated ferritin levels on in-hospital mortality.</p><p><strong>Conclusions: </strong>Hyperferritinemia is associated with an increased mortality risk in adult septic patients. Thrombocytopenia not only interacts with hyperferritinemia but also serves as a mediating factor in its impact on mortality.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251321314"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Assessment of All-Cause Hospital Readmissions among Pulmonary Embolism Patients Treated With Rivaroxaban Versus Apixaban.","authors":"Veronica Ashton, Guillaume Germain, Julien Boudreau, Manasvi Sundar, Sean D MacKnight, Shawn Murphy, Yichuan G Hsieh, François Laliberté","doi":"10.1177/10760296251327592","DOIUrl":"10.1177/10760296251327592","url":null,"abstract":"<p><p>BackgroundAlthough hospital readmission after pulmonary embolism (PE) is common, there is limited evidence on the comparative risk of readmission between rivaroxaban and apixaban. This study compared the real-world risk of all-cause hospital readmission among patients with PE treated with rivaroxaban or apixaban.MethodsThis retrospective study used data from Mass General Brigham's Research Patient Data Registry (01/2013-05/2023) to identify adult patients newly initiated on rivaroxaban or apixaban during a PE-related hospitalization (discharge = index). Patients with venous thromboembolism in the 3 months prior to the index PE hospitalization were excluded. All-cause hospital readmissions at 30, 60, and 90 days post-index were assessed using Kaplan-Meier analysis and were compared between cohorts using hazard ratios (HRs), 95% confidence intervals (CIs), and p-values from Cox proportional hazards regression models. Inverse probability of treatment weighting was used to adjust for baseline confounding.ResultsIn total, 686 rivaroxaban (mean age: 59.5; female: 50.1; Quan-Charlson comorbidity index: 1.51) and 2207 apixaban (mean age: 60.6; female: 50.8; Quan-CCI: 1.58) initiators were included. Rivaroxaban was associated with a 26% lower risk of all-cause hospital readmission at 30 days post-index (12.3% vs 16.5%; HR [95% CI]: 0.74 [0.58, 0.94]; <i>P </i>= .012). Risk of hospital readmission was also significantly lower at 60 days (17.0% vs 22.3%; HR [95% CI]: 0.74 [0.61, 0.91]; <i>P </i>= .004) and 90 days post-index (21.6% vs 25.6%; HR [95% CI]: 0.81 [0.68, 0.98]; <i>P </i>= .029).ConclusionsRivaroxaban was associated with significantly lower risk of all-cause hospital readmission within 90 days post-discharge from PE-related hospitalization than apixaban.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251327592"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating D-Dimer Thresholds into the Revised Caprini Risk Stratification to Predict Deep Vein Thrombosis Risk in Preoperative Knee Osteoarthritis Patients.","authors":"Yi-Feng Guo, Dingding Zhang, Yaping Chen, Weinan Liu, Na Gao, Xisheng Weng, Jin Lin, Jin Jin, Wenwei Qian, Xu Yang, Yin-Ping Zhang, Xiaopeng Huo","doi":"10.1177/10760296241311265","DOIUrl":"10.1177/10760296241311265","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative patients with knee osteoarthritis have a significantly increased risk of venous thromboembolism (VTE). While the Caprini risk assessment model offers some clinical guidance in predicting deep vein thrombosis (DVT), it has a relatively low predictive accuracy. Enhancing the model by integrating biomarkers, such as D-dimers, can potentially improve its accuracy. In this study, we explored the effectiveness of combining the Caprini risk model with D-dimer levels for individualized DVT risk assessment in patients with knee osteoarthritis.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 1605 knee osteoarthritis patients scheduled for total knee arthroplasty from Peking Union Medical College Hospital, screened between January 2015 and December 2018. A revised Caprini risk stratification model was developed, and a predictive DVT model was developed based on this revised system. The sensitivity, specificity, and the area under the curve (AUC) were used to determine predictive effectiveness of the model.</p><p><strong>Results: </strong>In the revised Caprini risk stratification, the incidence of DVT increased with higher risk levels: 2.52% in the low-risk group (scores 0-2), 2.88% in the moderate-risk group (score 3), 6.47% in the high-risk group (score 4), and 9.09% in the highest-risk group (score ≥ 5). The incidence of DVT was 3.869-fold higher in the highest-risk group and 2.676-fold higher in the high-risk group compared to the low-risk group (p = 0.013 and p = 0.014, respectively). Combining the revised Caprini risk stratification with D-dimer level demonstrated an improved AUC of 0.792, compared to D-dimer level alone (AUC 0.774) and the revised Caprini model alone (AUC 0.598). Furthermore, applying specific D-dimer thresholds across the four Caprini risk stratifications outperformed the combination of the revised Caprini model and D-dimer level in terms of AUC, specificity, and reduction in unnecessary ultrasonography. Using the Youden index, the AUC for the threshold-based method was slightly higher (0.775 vs 0.754, p = 0.310), with significantly better specificity (76.8% vs 63.6%, p < 0.001) and a greater reduction in ultrasound use (74.1% vs 61.4%). At a sensitivity of 85.5%, the differences were modest but still favored the threshold-based approach. At a sensitivity of 100%, the specificity (36.0% vs 24.7%, p < 0.001) and ultrasound reduction (34.8% vs 23.9%) were significantly better.</p><p><strong>Conclusion: </strong>The revised Caprini risk stratification improves preoperative DVT prediction in patients with knee osteoarthritis. Incorporating specific D-dimer thresholds into the four-level Caprini risk model enhances specificity and reduces unnecessary ultrasonography, outperforming both the use of individual indicators and the combination of the revised Caprini model with D-dimer level.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296241311265"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Risk Factors of Patients with Lung Cancer Complicated with Pulmonary Embolism: A Case Control Study.","authors":"Pengfei Wang, Lei Liang, Kejing Ma, Wei Duan","doi":"10.1177/10760296241311902","DOIUrl":"https://doi.org/10.1177/10760296241311902","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the clinical characteristics and risk factors for patients with lung cancer complicated by pulmonary embolism and to provide a reference for the early clinical identification of these patients.</p><p><strong>Methods: </strong>Eighty patients with lung cancer complicated with pulmonary embolism who were treated at Bethune Hospital of Shanxi from October 2018 to October 2025 were compared with 80 patients with lung cancer without pulmonary embolism. The clinical data of the two groups of patients were collected and analysed.</p><p><strong>Results: </strong>Compared with that in patients in the LC group, the proportion of patients with pulmonary interstitial fibrosis in the LP group was significantly greater (p < 0.05). The incidence of dyspnoea in the LP group was significantly greater than that in the LC group (p < 0.05). Compared with that in the LC group, the proportion of pulmonary artery compression in the LP group was significantly greater, and the difference was statistically significant (p < 0.05). In terms of pathological type, the proportion of adenocarcinoma patients in the LP group was significantly greater than that in the LC group (p < 0.05). In terms of tumor stage, the proportion of patients with stage III/IV disease in the LP group was significantly greater than that in the LC group, while the proportion of patients with stage I/II disease was significantly lower than that in the LC group, and the difference was statistically significant (p < 0.05). The neutrophil [NEUT (%)], prothrombin time (PT), white blood cell (WBC), carcinoma embryonic antigen (CEA) and D-dimer (DD) levels were significantly greater in the LP group than in the LC group (p < 0.05). In terms of treatment, the proportion of patients receiving systemic chemotherapy in the LP group was significantly greater than that in the LC group (p < 0.05). Logistic regression analysis revealed that adenocarcinoma, systemic chemotherapy and tumor stage III-IV were independent risk factors for lung cancer complicated with pulmonary embolism.</p><p><strong>Conclusion: </strong>(1) Tumor stage (III/IV), systemic chemotherapy, and adenocarcinoma were independent risk factors for pulmonary thromboembolism in patients with lung cancer. (2) In addition, patients with LP were more likely to have pulmonary interstitial fibrosis, dyspnoea, compression of the pulmonary artery by the tumor location, biological targeted therapy, and abnormal increases in D-dimer, WBC, NEUT (%), CEA and PT levels as laboratory indicators. (3) Pulmonary thromboembolism should be considered in lung cancer patients with a combination of the factors described above.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296241311902"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Application of Clot Waveform Analysis.","authors":"Hideo Wada, Katsuya Shiraki, Yuhko Ichikawa, Takeshi Matsumoto, Hideto Shimpo, Motomu Shimaoka","doi":"10.1177/10760296251331606","DOIUrl":"10.1177/10760296251331606","url":null,"abstract":"<p><p>Clot waveform analysis (CWA) involves an analysis of the activated partial thromboplastin time (CWA-APTT), diluted prothrombin time (CWA-dPT), and small amount of thrombin time (CWA-sTT), and clot fibrinolysis waveform analysis (CFWA). CWA was evaluated in order to propose its clinical application. CWA exhibits an abnormal waveform, as well as peak times and heights in its derivative curves. Although the CWA-APTT is frequently examined and <u>is</u> useful for diagnosing clotting deficiency, it has several limitations. Therefore, modified CWAs have been proposed for clinical application. <u>C</u>WA-dPT (small amount of tissue factor-induced FIX activation; sTF/FIXa) can detect hypercoagulability. <u>C</u>WA-sTT reflects thrombin burst and evaluates hemostatic abnormalities in patients treated with emicizumab. <u>C</u>FWA is a variant of <u>C</u>WA-APTT that includes a small amount of tissue-type plasminogen activator, indicating both clotting and fibrinolysis. The CWA-APTT and modified CWA should be further investigated in various diseases for many applications in the clinical setting, including the monitoring of hemophilia patients and patients receiving anticoagulant therapy<u>,</u> and the differential diagnosis of diseases.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251331606"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Undergoing Oesophageal Cancer Surgery Do Not Have Impaired Haemostasis.","authors":"Tua Gyldenholm, Nina Madsen, Niels Katballe, Daniel Willy Kjær, Thomas Decker Christensen, Anne-Mette Hvas","doi":"10.1177/10760296251327587","DOIUrl":"10.1177/10760296251327587","url":null,"abstract":"<p><p>BackgroundOesophagectomy is a major oncological surgical procedure. Previous studies have shown a wide range of bleeding during and after surgery, and it is unknown if perioperative bleeding associated with oesophagectomy is purely surgical in nature, or if it is exacerbated by impaired haemostasis. We aimed to perform a detailed investigation of the perioperative coagulation in patients undergoing oesophagectomy due to cancer.MethodsThe study was a prospective study including adult patients with adeno- or squamous cell carcinoma referred for intended curative oesophagectomy. Operative bleeding volume and blood transfusions were recorded. Blood samples were collected at three timepoints: before, at the end of surgery, and on postoperative day one. Dynamic global haemostasis was investigated employing thromboelastometry (ROTEM^®). Platelet aggregation was analysed with a Multiplate Analyzer^®, and routine coagulation parameters were analysed.ResultsWe included 87 patients. Patients bled a median of 300 mL during surgery. One patient bled 1830 mL, while the remaining patients bled ≤1000 mL. Blood transfusions were administered to 14 (16%) patients. Median platelet aggregation was within the reference ranges at all time points. Platelet aggregation increased during surgery and normalised within 24 h. ROTEM^® analyses showed no perioperative significantly decrease of clot formation or clot strength. Routine coagulation parameters were overall normal.ConclusionsSevere perioperative bleeding was rare, and transfusions of blood products were used sparingly. Patients undergoing oesophagectomy due to cancer had an intact haemostasis with no sign of impaired haemostasis.Clinical trial registrationThe trial was registered prior to initiation at www.clinicaltrials.gov (identification number NCT05067153).</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251327587"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure and the Non-Resolution of Atrial Thrombus Detected in Anticoagulated Patients with Non-Valvular Atrial Fibrillation.","authors":"Shu Yang, Jie Yang, Ning Chen, Chang Cui, Jincheng Jiao, Li Zhu, Mingfang Li, Minglong Chen","doi":"10.1177/10760296251324922","DOIUrl":"10.1177/10760296251324922","url":null,"abstract":"<p><p>BackgroundTo investigate the relationship between heart failure (HF) and the non-resolution of atrial thrombus detected in anticoagulated patients with non-valvular atrial fibrillation (NVAF).MethodsThis was a single-center, observational, retrospective, and prospective study. Anticoagulated patients with NVAF and atrial thrombus identified by transesophageal echocardiography or cardiac computed tomography angiography were consecutively enrolled. All patients received follow-up imaging within 6 months to assess the resolution of atrial thrombus. The primary endpoint was the resolution of atrial thrombus and the secondary endpoint was the occurrence of ischemic stroke, major bleeding, and all-cause death during the follow-up period.ResultsAmong 8987 patients with NVAF scheduled for catheter ablation or cardioversion, 70 anticoagulated patients with atrial thrombus were final analyzed. The average age was 61.8±10.6 years, 62.9% of them were men, and 32 (45.7%) patients presented with HF. Within the 6-month follow-up period, atrial thrombus resolution was observed in 47 (67.1%) patients. The rate of atrial thrombus resolution was lower in patients with baseline HF (50.0% vs 81.6%). In the adjusted logistic regression analysis model, HF was independently associated with the non-resolution of atrial thrombus (adjusted OR: 5.38, 95% CI: 1.19-24.27). During the median follow-up period of 4.5 years, four ischemic stroke events occurred in four patients. None of the patients in this study experienced major bleeding events or death during follow-up.ConclusionsHF was associated with the non-resolution of atrial thrombus detected in anticoagulated patients with NVAF. Further research is needed to identify optimal therapeutic approaches for this high-risk population.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251324922"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendelian Randomization Study on the Associations Between Genetically Predicted Cardiovascular Disease Subtypes and the Risk of Developing Cardiomyopathies.","authors":"Qiaolin Tang, Xiangzhu Meng, Xiaowen Tu, Jian Zhang","doi":"10.1177/10760296251328011","DOIUrl":"10.1177/10760296251328011","url":null,"abstract":"<p><p>Cardiomyopathies are commonly believed to have genetic origins; however, the connection between cardiomyopathies and cardiovascular diseases remains uncertain. Thus, we employed a Mendelian randomization (MR) approach to investigate the potential causal effects of specific cardiovascular disease subtypes on dilated and hypertrophic cardiomyopathies, focusing primarily on a European population. Summary-level data for cardiomyopathies and other cardiovascular diseases were obtained from public genome-wide association studies. Random-effects inverse-variance weighting was used as the primary analysis, whereas sensitivity analyses, including weighted median, MR-Egger, and multivariable MR methods, were also conducted. A genetic predisposition to atrial fibrillation [odds ratio (OR): 1.33; 95% confidence interval (CI): 1.18-1.50; P < 0.001], heart failure (OR: 3.22; 95% CI: 1.92-5.41; P < 0.001), and hypertension (OR: 1.50; 95% CI: 1.25-1.81; P < 0.001) were causally linked to an increased risk of developing dilated cardiomyopathy. However, there was no direct causal connection between genetically predicted coronary heart disease, pulmonary embolism, or ischemic stroke and the risk of developing dilated cardiomyopathy. In contrast, no significant associations were found between genetically predicted CVD subtypes and the risk of developing hypertrophic cardiomyopathy. Genetically predicted heart failure is significantly associated with the risk of developing dilated cardiomyopathy, underscoring the importance of effective heart failure management for risk prevention. Moreover, individuals with hypertension and atrial fibrillation might have an increased predisposition to dilated cardiomyopathy, highlighting crucial implications for management.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251328011"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143729042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}