Clinical and Applied Thrombosis/Hemostasis最新文献

{"title":"Thrombosis in Critically Ill Influenza Patients: Incidence and Risk Factors.","authors":"Xianming Qiu, Mingjie Liu, Quanzhen Wang, Yuke Zhang, Li Kong, Lei Zhou","doi":"10.1177/10760296241278615","DOIUrl":"10.1177/10760296241278615","url":null,"abstract":"<p><p>Influenza infection is associated with a risk of thrombosis. Whether factors associated with reduced thrombosis might also be associated with reduced risk in patients with severe influenza is unknown. To investigate risk factors associated with thrombosis in patients with severe influenza. We used a cohort data set to identify adults diagnosed with severe influenza. Univariable and multivariable logistic regression models explored potential risk factors for thrombosis events in patients with severe influenza. Cox regression analysis was used to examine the risk factors for mortality in patients with severe influenza. A total of 854 patients with severe influenza were included in the analysis. The incidence of VTE was 9.37% (80/854). Multivariable regression analysis showed that previous aspirin medication (OR: 0.37; 95%CI: 0.14-0.84; <i>P</i> = .029) could reduce the risk factor of thrombosis in patients with severe influenza. Compared with patients in the non-thrombosis group, patients in the thrombosis group required more mechanical ventilation (<i>P</i> < .001), tracheostomy (<i>P</i> < .001), ECMO (<i>P</i> = .046), and high-frequency ventilation (<i>P</i> = .004). The incidence of co-infection was higher in the thrombosis group compared to the non-thrombosis group (<i>P</i> = .025). Univariable Cox regression analysis showed that previous aspirin medication (HR 0.52, 95%CI: 0.33-0.82, <i>P</i> = .005) and previous statin medication (HR 0.54, 95%CI: 0.34-0.87, <i>P</i> = .011) were risk factors for 60-day mortality in patients with severe influenza. Patients with severe influenza are at high risk for thrombosis. The effect of aspirin on thrombosis in patients with severe influenza needs further investigation.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241278615"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055118","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":"Comparison of Three Different Disseminated Intravascular Coagulation (DIC) Criteria and Diagnostic and Prognostic Value of Antithrombin Investigation in Patients with Confirmed Sepsis-Induced Coagulopathy (SIC).","authors":"Qing Wei, Mengyao Wang, Xiaying Peng, Jingrong Yang, Ting Niu","doi":"10.1177/10760296241271334","DOIUrl":"10.1177/10760296241271334","url":null,"abstract":"<p><p>A new scoring system termed sepsis-induced coagulopathy (SIC) has been proposed to diagnose early sepsis-induced disseminated intravascular coagulation (DIC). This study performed DIC-related analyses in patients with confirmed SIC. Data from the intensive care unit (ICU) departments of the three hospitals between 2020 and 2022 were retrospectively analyzed. Finally, 125 patients with confirmed SIC were enrolled in the study. The diagnostic value of three widely used DIC criteria was assessed in patients with newly diagnosed SIC. In addition, the diagnostic and prognostic value of antithrombin (AT) was analyzed in patients with SIC. The Japanese Association for Acute Medicine DIC criteria (JAAM) exhibited the highest DIC diagnostic rate, while the mortality risk of SIC patients demonstrated a proportional increase with higher International Society on Thrombosis and Haemostasis (ISTH) and Chinese DIC scoring system (CDSS) scores. Low AT activity (<70%) in septic patients upon SIC diagnosis predicted a very high 28-day mortality rate, almost twice as high as in the normal AT activity (≥70%) group. A decreasing tendency in AT activity after clinical interventions was correlated with increased mortality. The area under the ROC curve (AU-ROC) of AT in DIC diagnosis was statistically significant when CDSS and ISTH were used as diagnostic criteria, but not JAAM. Each of the three DIC diagnostic criteria showed diagnostic and prognostic advantages for SIC. AT could be an independent prognostic indicator for SIC but demonstrated a relatively limited DIC diagnostic value. Adding AT to the SIC scoring system may increase its prognostic power.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241271334"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079424","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":"Cardiac Arrest-Associated Coagulopathy Could Predict 30-day Mortality: A Retrospective Study from Medical Information Mart for Intensive Care IV Database.","authors":"Jingwei Duan, Hongxia Ge, Wenyang Fan, Lanfang Du, Hua Zhang, Ayijiang Jiamaliding, Baomin Duan, Qingbian Ma","doi":"10.1177/10760296231221986","DOIUrl":"10.1177/10760296231221986","url":null,"abstract":"<p><strong>Background: </strong>Cardiac arrest (CA) can activate the coagulation system. Some coagulation-related indicators are associated with clinical outcomes. Early evaluation of patients with cardiac arrest-associated coagulopathy (CAAC) not only predicts clinical outcomes, but also allows for timely clinical intervention to prevent disseminated intravascular coagulation.</p><p><strong>Objective: </strong>To assess whether CAAC predicts 30-day cumulative mortality.</p><p><strong>Methods: </strong>From the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, we conducted a retrospective cohort study from 2008 to 2019. Based on international normalized ratio (INR) value and platelet count, we diagnosed CAAC cases and made the following stratification of severity: mild CAAC was defined as 1.4 > INR≧1.2 and 100,000/µL < platelet count≦150,000/µL; moderate CAAC was defined with either 1.6 > INR≧1.4 or 80,000/µL < platelet count≦100,000/µL; severe CAAC was defined as an INR≧1.6 and platelet count≦80,000/µL.</p><p><strong>Results: </strong>A total of 1485 patients were included. Crude survival analysis showed that patients with CAAC had higher mortality risk than those without CAAC (33.0% vs 52.0%, <i>P</i> < 0.001). Unadjusted survival analysis showed an incremental increase in the risk of mortality as the severity of CAAC increased. After adjusting confounders (prehospital characteristics and hospitalization characteristics), CAAC was independently associated with 30-day mortality (hazard rate [HR] 1.77, 95% confidence interval [CI] 1.41-2.25; <i>P</i> < 0.001); moderate CAAC (HR 1.48, 95% CI 1.09-2.10; <i>P</i> = 0.027) and severe CAAC (HR 2.22, 95% CI 1.64-2.97; <i>P</i> < 0.001) were independently associated with 30-day mortality.</p><p><strong>Conclusion: </strong>The presence of CAAC identifies a group of CA at higher risk for mortality, and there is an incremental increase in risk of mortality as the severity of CAAC increases. However, the results of this study should be further verified by multicenter study.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296231221986"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10777779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139402130","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":"Determination of vWF, ADAMTS-13 and Thrombospondin-1 in Venous Thromboembolism and Relating Them to the Presence of Factor V Leiden Mutation.","authors":"Anwar Al-Awadhi, Rajaa Marouf, Mehrez M Jadaon, Mohammad M Al-Awadhy","doi":"10.1177/10760296231223195","DOIUrl":"10.1177/10760296231223195","url":null,"abstract":"<p><p>Thrombophilia in venous thromboembolism (VTE) is multifactorial. Von Willebrand factor (vWF) plays a major role in primary hemostasis. While elevated vWF levels are well documented in VTE, findings related to its cleaving protease (ADAMTS-13) are contradicting. The aim of this study was to determine vWF, ADAMTS-13, and the multifactorial Thrombospondin-1 (TSP-1) protein levels in patients after 3-6 months following an unprovoked VTE episode. We also explored a possible association with factor V Leiden (FVL) mutation. vWF, ADAMTS-13 and TSP-1 were analyzed using ELISA kits in 60 VTE patients and 60 controls. Patients had higher levels of vWF antigen (<i>P</i> = .021), vWF collagen-binding activity (<i>P</i> = .008), and TSP-1 protein (<i>P</i> < .001) compared to controls. ADAMTS-13 antigen was lower in patients (<i>P</i> = .046) compared to controls but ADAMTS-13 activity was comparable between the two groups (<i>P</i> = .172). TSP-1 showed positive correlation with vWF antigen (rho = 0.303, <i>P</i> = .021) and negative correlation with ADAMTS-13 activity (rho = -0.244, <i>P</i> = .033) and ADAMTS-13 activity/vWF antigen ratio (rho = -0.348, <i>P</i> = .007). A significant association was found between the presence of FVL mutation and VTE (odds ratio (OR): 9.672 (95% confidence interval (CI) 2.074-45.091- <i>P</i> = .004), but no association was found between the mutation and the studied proteins (<i>P</i> > .05). There appears to be an imbalance between vWF and ADAMTS-13 in VTE patients even after 3-6 months following the onset of VTE. We report that the odds of developing VTE in carriers of FVL mutation are 9.672 times those without the mutation, but the presence of this mutation is not associated with the studied proteins.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296231223195"},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10793187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139472062","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":"Anti-inflammatory Effect of Batroxobin Combined With Anticoagulation in Patients With Cerebral Venous Thrombosis.","authors":"Duo Lan, Xiaoming Zhang, Xiangqian Huang, Jingrun Li, Jiahao Song, Da Zhou, Ran Meng","doi":"10.1177/10760296241264516","DOIUrl":"10.1177/10760296241264516","url":null,"abstract":"<p><p>Inflammation is pivotal in the pathogenesis and development of cerebral venous thrombosis (CVT). Herein, we aimed to assess the anti-inflammatory effects of batroxobin combined with anticoagulation in CVT. Participants were categorized into the batroxobin group (batroxobin combined with anticoagulation) and the control group (anticoagulation only). Regression analysis was employed to explore the association between the number of episodes of batroxobin administration and the fluctuation of inflammatory indicators, as well as the proportion of patients with inflammatory indicators that were reduced after batroxobin use. Twenty-three cases (age: 39.9 ± 13.8 years, female: 39.1%) in the batroxobin group and 36 cases (40.3 ± 9.6 years, 52.8%) in the control group were analyzed. Compared to the control group, batroxobin combined with anticoagulation significantly decreased fibrinogen (<i>P</i> < .001), platelet-lymphocyte ratio (PLR) (<i>P</i> = .016) and systemic immune-inflammation index (SII) (<i>P</i> = .008), and increased the proportion of the patients with lower fibrinogen (<i>P</i> < .001), neutrophil-lymphocyte ratio (NLR) (<i>P</i> = .005), PLR (<i>P</i> = .026), and SII (<i>P</i> = .006). Linear analysis showed that as the number of episodes of batroxobin administration increased, the fibrinogen (<i>P</i> < .001), the PLR (<i>P</i> = .001), and the SII (<i>P</i> = .020) significantly decreased. Logistic regression analysis showed as the number of episodes of batroxobin administration increased, the ratio of the patients with decreased NLR (<i>P</i> = .008) and PLR (<i>P</i> = .015), as well as SII (<i>P</i> = .013), significantly increased. Batroxobin could decrease NLR, PLR, and SII in CVT. The effect was related to the number of episodes of batroxobin administration. Besides reducing fibrinogen and indirect thrombolysis effects, this may be another critical benefit of batroxobin for CVT.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":" ","pages":"10760296241264516"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733695","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":"Peripheral Blood Lymphocyte Subsets in Factor VIII Inhibitor-Positive Patients with Severe Hemophilia A: A Case-Control Study.","authors":"Lu Zhao, Yiqun Zhang, Xinlei Guo, Zhi Li, Wenliang Lu, Zhijuan Pan, Yanru Guo, Jiajia Sun, Ying Zhang, Jinyu Hao, Zhiping Guo","doi":"10.1177/10760296241268421","DOIUrl":"10.1177/10760296241268421","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The present study aimed to investigate different peripheral lymphocyte subsets in patients with severe hemophilia A (HA) and factor VIII (FVIII) inhibitor production. For this, age-matched cases of 19 FVIII inhibitor-positive (IP), 21 FVIII inhibitor-negative (IN) and 45 healthy controls were selected for study.</p><p><strong>Methods: </strong>Flow cytometry was used to analyze the peripheral lymphocyte subsets, including T, B, natural killer (NK) and NKT cells. The T cell subsets included CD3 + CD4-CD8- [double negative T (DNT)], CD3 + CD4 + CD8+ [double-positive T (DPT)], CD3 + CD4 + CD8- and CD3 + CD4-CD8+ T cells. Pairwise comparisons of absolute lymphocyte subset values were conducted among the three groups. The cut-off value for absolute lymphocyte counts was determined using receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>The results demonstrated that the absolute values of DPT cells in the IN and IP groups were significantly lower than those in the healthy control group (<i>P = </i>0.007). The DNT values were also lower in severe HA patients with or without inhibitor than those in healthy subjects, but these differences were not statistically significant (<i>P = </i>0.053). In addition, the absolute value of CD4+ Th cells in the IP group was lower than that in the healthy controls (<i>P </i>= 0.013). Although not statistically significant (<i>P </i>= 0.064), the absolute values of NKT cells were higher in the IN group compared with the IP group, and higher in the IP group compared with the healthy control group. There were no statistically significant differences in total T, B, CD8 ⁺and NK cells among the IN, IP and healthy control groups. The cut-off value for absolute CD4+ Th cells in the IN group was < 598/µl.</p><p><strong>Conclusion: </strong>The decrease in absolute values of CD4+ Th cells in severe HA patients may contribute to the establishment of infused FVIII immune tolerance. If the CD4+ Th value remains > 598/µl, clinicians should be vigilant for possible FVIII inhibitor production, especially on days prior to FVIII exposure.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241268421"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987569","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":"Development and Validation of a Nomogram Model for Predicting in-Hospital Mortality in non-Diabetic Patients with non-ST-Segment Elevation Acute Myocardial Infarction.","authors":"Panpan Li, Wensen Yao, Jingjing Wu, Yating Gao, Xueyuan Zhang, Wei Hu","doi":"10.1177/10760296241276524","DOIUrl":"10.1177/10760296241276524","url":null,"abstract":"<p><p>Non-ST-segment elevation acute myocardial infarction (NSTEMI) is a life-threatening clinical emergency with a poor prognosis. However, there are no individualized nomogram models to identify patients at high risk of NSTEMI who may undergo death. The aim of this study was to develop a nomogram for in-hospital mortality in patients with NSTEMI to facilitate rapid risk stratification of patients. A total of 774 non-diabetic patients with NSTEMI were included in this study. Least Absolute Shrinkage and Selection Operator regression was used to initially screen potential predictors. Univariate and multivariate logistic regression (backward stepwise selection) analyses were performed to identify the optimal predictors for the prediction model. The corresponding nomogram was constructed based on those predictors. The receiver operating characteristic curve, GiViTI calibration plot, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram. The nomogram model consisting of six predictors: age (OR = 1.10; 95% CI: 1.05-1.15), blood urea nitrogen (OR = 1.06; 95% CI: 1.00-1.12), albumin (OR = 0.93; 95% CI: 0.87-1.00), triglyceride (OR = 1.41; 95% CI: 1.09-2.00), D-dimer (OR = 1.39; 95% CI: 1.06-1.80), and aspirin (OR = 0.16; 95% CI: 0.06-0.42). The nomogram had good discrimination (area under the curve (AUC) = 0.89, 95% CI: 0.84-0.94), calibration, and clinical usefulness. In this study, we developed a nomogram model to predict in-hospital mortality in patients with NSTEMI based on common clinical indicators. The proposed nomogram has good performance, allowing rapid risk stratification of patients with NSTEMI.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241276524"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11334244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003759","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":"Incidence of Recurrent Venous Thromboembolism in a Population-Based Cohort.","authors":"Tomas Ruthström, Lovisa Hägg, Lars Johansson, Marcus M Lind, Magdalena Johansson","doi":"10.1177/10760296241293337","DOIUrl":"10.1177/10760296241293337","url":null,"abstract":"<p><p>The incidence of recurrent venous thromboembolism (VTE) changes over time from the first VTE event and depends on the presence of risk factors. In this study, we aimed to determine the yearly incidence of VTE recurrence during five years of follow-up after a first-ever VTE event. For this cohort study, we identified persons who experienced a validated first-ever VTE between 2006-2014 in northern Sweden. These patients' medical records were reviewed to identify recurrent VTE events during five years of follow-up. The yearly incidence rates (IRs) of recurrent VTE per 100 person-years were calculated and stratified into three groups defined by characteristics at the first-ever VTE event: no risk factors, cancer, or other risk factors. A total of 1413 persons experienced a first-ever VTE during the study period, of whom 213 experienced a recurrent VTE. Among persons without risk factors, the IR was 4.2 during the first year of follow-up, and 4.1 during the fifth year. Among persons with cancer, the IR was 9.5 during the first year, and 5.4 during the fifth year. Among persons with other risk factors, the corresponding IRs were 6.1 and 2.3. In conclusion, after a first-ever VTE event, persons with cancer had the highest recurrence rate during the first years of follow-up. Among persons with cancer who were alive after five years, the incidence of recurrent VTE during the fifth year was similar to that in participants without risk factors.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241293337"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496246","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":"Angiopoietin-2 and Mortality Outcomes in End-Stage Renal Disease with Heart Failure as a Comorbidity.","authors":"Vanessa Robbin, Vinod Bansal, Kavitha Vellanki, Fakiha Siddiqui, Debra Hoppensteadt-Moorman, Jawed Fareed, Mushabbar Syed","doi":"10.1177/10760296241305101","DOIUrl":"10.1177/10760296241305101","url":null,"abstract":"<p><p>Angiopoeitin-2 (Ang2) is a vascular growth factor involved in regulating angiogenesis and endothelial remodeling. Higher Ang2 levels have been associated with mortality in the general population and among male hemodialysis patients, but its effects on concomitant heart failure with reduced ejection fraction (HFrEF) and end-stage renal disease (ESRD) are unknown. Plasma samples from 73 ESRD patients and 40 healthy patients were analyzed for Ang2 concentrations using ELISA. Patient groups were stratified into those with or without HFrEF (EF < 50%). At two years following sample collection, the medical record was reviewed for mortality. The optimal cut-off value for Ang2 to predict all-cause mortality was 1671 pg/mL (AUC 0.73, sensitivity 0.714, specificity 0.750) based on the regression analysis. Statistical analyses included Mann-Whitney U tests, Cox proportional hazards model, and Log-rank test. Multiple comorbidities were present; coronary artery disease 46%, diabetes 69%, hypertension 97%, and smoking 49%. Patients with one- and two-year mortality had higher Ang2. Ang2 levels above the optimal cut-off are associated with mortality within the entire ESRD sample and within the group with both ESRD and HFrEF. In the Cox proportional hazards analysis, Ang2 levels were associated with mortality within the larger ESRD sample but not in the group with ESRD and HFrEF. Ang2 has potential as a non-specific biomarker for prognostication in patients with cardiorenal syndrome given its association with mortality, despite modest sex-based differences. Future research should be conducted with larger samples to evaluate if it has prognostic value in individuals with HFrEF and ESRD of varying severity and temporality.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241305101"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11672603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876362","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":"Outcomes of Emicizumab in Acquired Hemophilia Patients: A Systematic Review.","authors":"Ghachem Ikbel, Baccouche Hela, Kaabar Mohamed Yassine, Khemiri Hamida, Ben Salem Kamel","doi":"10.1177/10760296241298661","DOIUrl":"10.1177/10760296241298661","url":null,"abstract":"<p><strong>Background: </strong>Emicizumab, a bispecific factor VIII mimetic antibody, was approved in 2018 for bleeding prophylaxis in congenital hemophilia A with or without inhibitors. Since then, several case reports and case series have described the off-label use of emicizumab in acquired hemophilia A (AHA), and data from two clinical trials were recently published (AGEHA, GTH-AHA-EMI).</p><p><strong>Objectives: </strong>To describe the reported data on the outcomes of emicizumab, highlighting its benefit/risk profile in treatment.</p><p><strong>Methods: </strong>We conducted a literature search in PubMed, Scopus, Cochrane, and Google Scholar up to August 2024, including all scientific articles reporting clinical outcomes of emicizumab use in patients with AHA.</p><p><strong>Results: </strong>Thirty-two studies were included in the final review, covering a total of 171 AHA patients. The majority started emicizumab for active bleeding management and prophylaxis with various regimens. Follow-up duration and remission criteria varied. Two clinical trials supported the use of emicizumab for bleeding prophylaxis with a new dosing regimen and completion criteria. Bleeding was well managed in all cases, with no major recurrent bleeds. Some adverse events were reported : 3 cases of deep venous thrombosis, 2 cases of stroke, and 2 cases of anti-emicizumab drug antibodies developing in patients with thromboembolic risk factors.</p><p><strong>Conclusions: </strong>Based on published data, emicizumab appears to be effective in bleeding management and prophylaxis in AHA patients, with a favorable benefit/risk profile.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"30 ","pages":"10760296241298661"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616024","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}