Clinical and Applied Thrombosis/Hemostasis最新文献

{"title":"Activated Partial Thromboplastin Time and Anti-IIa Monitoring in Argatroban Anticoagulation in COVID-19 Patients on Venovenous Extracorporeal Membrane Oxygenation.","authors":"Filip Burša, Michal Frelich, Peter Sklienka, Simona Němcová, Zuzana Kučerová, Ondřej Jor, Tereza Romanová, Adéla Kondé, Jaroslav Janošek, Jiří Sagan, Jan Máca","doi":"10.1177/10760296251341315","DOIUrl":"10.1177/10760296251341315","url":null,"abstract":"<p><p>Unfractionated heparin has long been considered the standard anticoagulation in ECMO, despite some pitfalls such as heparin resistance, heparin induced thrombocytopenia (HIT), etc Recently, some centres started to increasingly use argatroban for this purpose, typically using activated partial thromboplastin time (aPTT) for its monitoring. Direct monitoring of the efficacy of argatroban using Anti-IIa is not yet an established method, although it might be more appropriate as it targets the same pathway.An observational study was performed in adult veno-venous ECMO patients hospitalized with SARS-CoV-2 infection anticoagulated with argatroban to an aPTT target of 40-60 s and Anti-IIa target of 0.4-0.6 µg/mL. Bleeding and thrombotic complications were monitored.Forty-four VV ECMO patients were included, with an overall hospital mortality of approx. 50%. No life-threatening thrombotic events were recorded. The risk of bleeding complications significantly increased with aPTT above 52.7 s and with Anti-IIa values over 0.78 µg/mL. Using the above cut-offs for both the aPTT and Anti-IIa and their combination, the negative predictive value for bleeding was approximately 90%.It seems that the generally recommended limits for Anti-IIa of 1.5 µg/mL may be high. However, further data are needed to confirm lower limits.Trial Registration:retrospectively registered in ClinicalTrials.gov, NCT06038682.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251341315"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109874","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":"Cardiovascular Symposium on Perspectives in Long COVID.","authors":"Robert S Dieter, Prakasha Kempaiah, Elizabeth G Dieter, Andrew Alcazar, Alfonso Tafur, Grigoris Gerotziafas, Alejandro Gonzalez Ochoa, Salem Abdesselem, Jose Biller, Nicholas Kipshidze, Patrick Vandreden, Marco Guerrini, Raymond A Dieter, Ravi Durvasula, Meharvan Singh, Jawed Fareed","doi":"10.1177/10760296251319963","DOIUrl":"10.1177/10760296251319963","url":null,"abstract":"<p><p>Significant progress has been made in treating Coronavirus disease (COVID) - an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). An ominous turn in the pandemic is the evolving public health crisis emanating from persistent SARS-CoV-2 infection and its associated long-term impact. Long COVID or post-COVID syndrome describes protean symptoms that persist at least 3 months after the onset of acute illness and last for at least 2 months in individuals with a history of confirmed SARS-CoV-2 infection. Long COVID has become a public health concern. Millions of infected individuals are now facing chronic multi-organ failures, including neuropsychiatric, cardiovascular, pulmonary, and kidney complications. In general, the cause of long COVID syndrome is unclear but factors such as prolonged activation of immune responses, and viral persistence triggering transcription dysregulation of genes associated with normal thrombotic disease may play a role in cardiovascular complications. Although inflammatory biomarkers are reported in other disorders, it remains unclear whether similar biomarkers are associated with cardiovascular manifestations following COVID. Medications such as sulodexide directed at glycocalyx and coagulation have demonstrated benefits for long COVID in smaller studies. Here, we describe the outcomes of the symposium on the underlying cardiovascular mechanisms of the long COVID.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251319963"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406127","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":"Immature Platelets and Platelet Reactivity in Patients with COVID-19.","authors":"Yulia Balmakov, Tomer Mark, Itzik Barnett, Michal Cipok, Eli I Lev, Amir Cohen, Eliad Aviram, Ami Mayo","doi":"10.1177/10760296251318320","DOIUrl":"10.1177/10760296251318320","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) is associated with a high incidence of thromboembolic events, both venous and arterial. There are currently no specific clinical or laboratory markers to guide antithrombotic therapy for COVID-19 patients. Immature platelets represent a population of hyper-reactive platelets associated with arterial thrombotic events. This prospective study compared consecutive severe COVID-19 patients (n = 53, median age = 73 years) versus patients with sepsis from another origin (n = 41, median age = 69 years). Total platelet counts, immature platelet fraction (IPF) and immature platelet count (IPC) were determined by the Sysmex XN-3000 auto-analyzer on admission and at subsequent time-points. IPC levels three days after admission were significantly higher in the COVID-19 group compared to the sepsis group (13.4 × 10⁹/ L [IQR 9.1-18.5] in the COVID-19 group vs 9 × 10⁹/ L [5.5-14.7] in the sepsis group, P = 0.007). COVID-19 patients with respiratory disease show increased platelet turnover and reactivity, as seen in higher levels of immature platelet indices, especially IPC, compared to the sepsis control group. While these platelet indices remained high, CRP levels decreased, particularly in patients treated with tocilizumab. This reduction in CRP was not accompanied by any apparent clinical improvement. These findings suggest that immature platelets may serve as a biomarker for disease severity in COVID-19 patients and their CRP may not be a reliable marker for disease severity.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251318320"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406145","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":"Platelet Volume Parameters as Predictors of Valvular Thrombosis Risk in Patients with Aortic and Mitral Valve Replacement.","authors":"Boshra Pourbashash, Seyed Parsa Eftekhar, Pooria Ahmadi, Arash Jalali, Ali Hosseinsabet, Reza Mohseni Badalabadi","doi":"10.1177/10760296241311268","DOIUrl":"10.1177/10760296241311268","url":null,"abstract":"<p><p>Percutaneous valve implantation or surgical replacement with mechanical or biological valves are standard therapies for severe valvular heart diseases. Prosthetic valve thrombosis, though rare, is a serious complication, particularly with mechanical prostheses. This study aimed to investigate the predictive value of platelet volume parameters, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), for valvular thrombosis risk in patients undergoing valve replacement therapy. A retrospective cross-sectional study was conducted from May 2002 to May 2020, involving 108 patients with a history of mitral or aortic valve replacement and valvular thrombosis, and 216 controls with a history of valve surgery without valvular malfunction. PDW was significantly associated with an increased risk of thrombosis after adjusting for confounders, while MPV showed a clinical difference but did not reach statistical significance. P-LCR did not exhibit a significant association. These findings suggest PDW as a potential predictor of valvular thrombosis in such patients. The ease of measuring platelet volume parameters suggests their utility in routine hematological analysis for identifying patients at higher risk of valvular thrombosis post-replacement surgery. Further studies are warranted to validate these findings and explore additional laboratory markers, such inflammatory markers, for thrombotic risk assessment in this population.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296241311268"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945626","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":"Association of Fibrinogen Aα Thr312Ala (rs6050) Polymorphism with Venous Thrombosis and Chronic Thromboembolic Pulmonary Hypertension: A Meta-Analysis.","authors":"Han Cheng, Haozhe Yang, Yantong Zhang, Zhanxu Wei, Lei Xia, Jing Yang","doi":"10.1177/10760296251314476","DOIUrl":"10.1177/10760296251314476","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) comprises deep vein thrombosis (DVT) and pulmonary embolism (PE). Chronic thromboembolic pulmonary hypertension (CTEPH) typically arises from acute pulmonary embolism. The pathogenesis of them involves multiple risk factors such as genetic predisposition. However, the findings from these studies are not entirely consistent. This study aims to investigate the association between FGA rs6050 polymorphism and susceptibility to thrombotic diseases.</p><p><strong>Methods: </strong>We searched PubMed, OVID, Web of Science, Academic Search Ultimate, CNKI, and Wan Fang database. To assess the strength of associations, we calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs) in different genetic models. Additionally, subgroup analyses, sensitivity analysis, and assessment of publication bias were also carried out.</p><p><strong>Results: </strong>A total of 11 studies, including 9 reported results on VTE (3856 individuals [1545 cases]) and 3 on CTEPH (761 participants [350 cases]), revealed a significant association between the rs6050 polymorphism and susceptibility to both VTE and CTEPH. The A allele was consistently linked to an elevated risk of VTE across all genetic models (allele, homozygote, heterozygote, recessive, and dominant model), while it was also associated with an increased risk of CTEPH under all genetic models excluding the recessive model. Furthermore, subgroup analysis among ethnic groups revealed a significant association between rs6050 polymorphisms and VTE in both Caucasians and Asians under all genetic models. In Africans, the association with VTE was only observed for rs6050 polymorphisms in dominant and heterozygous models.</p><p><strong>Conclusions: </strong>The FGA rs6050 polymorphism is positively associated with susceptibility to VTE and CTEPH.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251314476"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001133","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":"The D-Dimer/Albumin Ratio as a Novel Biomarker for Predicting the Efficacy of Oral Tirofiban in Patients with Cerebral Infarction.","authors":"Xiaohui Li, Huimin Guo, Caixia Guo, Mingyang Wei, Chen Wang, Jianbin Zhang","doi":"10.1177/10760296241310438","DOIUrl":"10.1177/10760296241310438","url":null,"abstract":"<p><p><b>Objective:</b> The efficacy of oral tirofiban in patients with cerebral infarction varies. This study aims to identify novel biomarkers that can predict the efficacy of oral tirofiban in these patients. <b>Materials and methods:</b> A total of 300 patients diagnosed with cerebral infarction via neurosurgery at our hospital from January 2021 to January 2023 were enrolled in this study. Detailed information on their medical history and clinical characteristics was collected, and all the patients were followed up for 90 days. The modified Rankin scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS) were used to evaluate the efficacy of tirofiban. The modified Heidelberg bleeding classification was applied to classify symptomatic intracranial hemorrhage within 48 h after treatment. <b>Results:</b> At 90-days of follow-up, patients with higher mRS scores (Group I) compared to those in lower mRS scores (Group II) exhibited significantly higher levels of platelet count (Group I: 118.55 ± 8.89 10*9/L, Group II: 253.11 ± 13.87 10*9/L, <i>P </i>< .001), neutrophil counts (Group I: 3.38 ± 1.21 10*9/L, Group II: 3.36 ± 1.55 10*9/L, <i>P </i>= .001), D-dimer (Group I: 0.26 ± 0.17 mg/L, Group II: 0.31 ± 0.15 mg/L, <i>P </i>= .007), systemic immune-inflammation index (SII) (Group I: 199.87 ± 103.73, Group II: 258.82 ± 116.67, <i>P</i> < .001), and D-dimer/albumin ratio (DAR) (Group I: 118.55 ± 8.89 10*9 /L, Group II: 253.11 ± 13.87 10*9/L, <i>P </i>< .001). The levels of DAR (OR: 1.047, 95% CIs: 1.032-1.061, <i>P </i>< .001), SII (OR: 1.004, 95% CIs: 1.002-1.007, <i>P < </i>.001), and D-dimer (OR: 8.827, 95% CIs: 1.695-45.984, <i>P </i>= .010) were identified as independent factors affecting the efficacy of tirofiban, showing predictive and diagnostic value in assessing treatment response. <b>Conclusion:</b> Laboratory markers, including DAR, SII and D-dimer, are effective diagnostic indicators for predicting the efficacy of tirofiban in patients with cerebral infarction. These markers provide valuable insight for clinicians in selecting treatment plans, thereby reducing the economic burden for patients with cerebral infarction.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296241310438"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514865","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":"D-dimer Levels in Acute, Medically Ill, Hospitalized Patients: A Large, Prospective, Multicenter Study in the United States.","authors":"Jordan S Richardson, Carol L Clark, Aveh Bastani, Ali H Shams, Gregory J Fermann, Brian C Hiestand, Bory Kea, Sharon E Mace, W Frank Peacock, Alex Yang, James A Welker","doi":"10.1177/10760296251320406","DOIUrl":"10.1177/10760296251320406","url":null,"abstract":"<p><strong>Background: </strong>The study's main aim was to determine the prevalence of elevated D-dimer levels in adult patients hospitalized for acute medical illnesses not suspected to have venous thromboembolism (VTE). The secondary aims were to determine VTE prophylaxis rates and VTE events.</p><p><strong>Methods: </strong>This multicenter, prospective, observational study included patients who were admitted across nine US hospitals. Patients who were ≥60 years of age, admitted for an acute medical illness (nonsurgical/nontraumatic), and not suspected to have VTE (deep vein thrombosis [DVT]/pulmonary embolism [PE]) were enrolled. Current use of anticoagulation and recent major surgery were exclusion criteria. D-dimers were measured at hospital admission, and the analysis was performed at a central laboratory using the STA-Liatest D-Di test kit (Diagnostica Stago, Asnières sur Seine, France). The upper limit of normal (ULN) for D-dimer was defined as ≥500 ng/mL. Age-adjusted thresholds were calculated as age × 10 ng/mL. VTE events included symptomatic DVT (distal or proximal) or PE occurring during admission.</p><p><strong>Results: </strong>Among 995 patients (50.7% female; mean age, 70 ± 8 years), 74.4% (n = 740) had a D-dimer ≥ ULN, 62.2% (n = 619) had elevated age-adjusted levels, and 48.8% (n = 486) had D-dimers at least two times the ULN. The rate of VTE prophylaxis was 66.5% (n = 662); in this cohort, 1.8% (n = 18) developed a VTE.</p><p><strong>Conclusion: </strong>Most hospitalized acute medically ill patients ≥60 years of age had elevated D-dimer levels on admission. Although an elevated D-dimer may be associated with VTE risk, its poor specificity indicates that it should not guide prophylaxis management without a multifactor risk assessment.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251320406"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406142","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":"A Novel Non-invasive Marker for Predicting Mechanical Prosthetic Heart Valve Thrombosis: Red Cell Distribution Width to Platelet Ratio.","authors":"Çağatay Tunca, Mehmet Taha Özkan, Hatice Feyza Dilek, Murat Akdoğan, Ahmet Kıvrak, Kamuran Kalkan, Veysel Ozan Tanık, Bülent Özlek","doi":"10.1177/10760296251333772","DOIUrl":"10.1177/10760296251333772","url":null,"abstract":"<p><p>BackgroundProsthetic heart valve thrombosis (PHVT) is a serious and potentially life-threatening complication that affects patients with mechanical heart valves. Timely and precise prediction of PHVT is essential for prompt intervention. This study aims to assess the association between the ratio of red blood cell distribution width (RDW) and platelet (PLT) count with PHVT.MethodsWe conducted a retrospective analysis of 297 transesophageal echocardiography examinations performed between January 2007 and October 2022 on patients with mechanical mitral prosthetic valves. This cohort included 161 patients diagnosed with PHVT and 136 patients with functional prosthetic valves.ResultsPatients with PHVT were, on average, older than those with normofunctional valves (56 vs 53 years, <i>p</i> = .046). Univariable analysis indicated that advanced age, heart failure (HF), chronic renal failure, COPD, reduced LVEF, ineffective anticoagulation, elevated D-dimer levels, and an elevated RDW-to-PLT ratio were associated with PHVT. The multivariable logistic regression analysis identified elevated RDW-to-PLT ratio (OR: 1.278, 95% CI: 1.142-1.327, <i>p</i> = .001), ineffective anticoagulation, HF, and D-dimer were independently associated with PHVT. The ROC curve analysis demonstrated that the RDW-to-PLT ratio exhibited moderate diagnostic performance, with a cut-off value of 0.065, sensitivity of 65%, and specificity of 66%.ConclusionThis is the first study demonstrating that the higher RDW-to-PLT ratio is associated with PHVT. Further studies are necessary to validate these findings in broader clinical settings.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251333772"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779270","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":"The Impact of Hematologic Disorders on the Severity of Cerebral Venous Sinus Thrombosis: A Comparative Study.","authors":"Mengqi Wang, Xiangqian Huang, Yuchuan Ding, Xunming Ji, Ran Meng","doi":"10.1177/10760296241309630","DOIUrl":"10.1177/10760296241309630","url":null,"abstract":"<p><p>Hematologic diseases are considered important contributors to cerebral venous sinus thrombosis (CVST) cases. This retrospective study aims to compare the difference of the clinical and radiological characters between CVST patients with and without hematologic diseases. Consecutive hospitalized CVST patients with hematologic disorders constituted the hematologic disorder group, while that without identifiable risk factors comprised the control group in this study. We systematically documented the various types of hematologic diseases associated with CVST, along with laboratory tests. Clinical manifestations, imaging findings, as well as treatment and prognosis, were recorded. A comparative analysis was conducted between the hematologic disorder group and the control group based on the aforementioned parameters. The final analysis included 97 CVST cases associated with hematologic diseases and 65 cases without any identified risk factors. The spectrum of hematologic diseases in our study ranged from iron-deficiency anemia to acute leukemia. Patients with hematologic disorder showed higher admission mRS, greater thrombotic burden, and higher incidence of stroke and cerebral hemorrhage (p < 0.05). The use of batroxobin significantly improved the prognosis of CVST caused by hematologic diseases, without causing major bleeding or death during the follow-up period. Patients with hematologic disorders who develop CVST tend to present with more severe conditions compared to those without identifiable risk factors. It is essential to conduct timely screening for CVST in patients with hematologic diseases who present with risk factors of thrombosis.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296241309630"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001146","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":"Prognostic Nutritional Index as a Potential Biomarker for the Risk of Lower Extremity Deep Venous Thrombosis: A Large Retrospective Study.","authors":"Hong Wang, Qing Zhou, Zhicong Wang, Xi Chen, Yuxuan Wu, Mozhen Liu","doi":"10.1177/10760296251317520","DOIUrl":"10.1177/10760296251317520","url":null,"abstract":"<p><strong>Background: </strong>Prognostic nutritional index (PNI) has recently been identified as a novel marker of nutritional status. However, existing evidences on the association between PNI and the risk of lower extremity deep venous thrombosis (LEDVT) are limited and conflicting.</p><p><strong>Objective: </strong>To determine the association between PNI and the risk of LEDVT, and further evaluate its diagnostic value.</p><p><strong>Methods: </strong>Over a 10-year period (2012-2022), a total of 12790 patients who underwent compression ultrasonography examinations were consecutively included, and 1519 (11.9%) LEDVT events occurred. Multivariate logistic regression analysis was used to investigate the association, and receiver operating characteristic (ROC) curve was constructed to evaluate its diagnostic performance.</p><p><strong>Results: </strong>After full adjustment, patients in third quartile (odds ratio [OR] = 1.486, 95% confidence interval [CI]: 1.205-1.832), second quartile (OR = 2.436, 95% CI: 1.993-2.978) and first quartile (OR = 3.422, 95% CI: 2.791-4.195) of PNI were at higher risk of LEDVT compared with those in fourth quartile, and the test for trend was significant. Consistently, each unit decrease in PNI was associated with a 6.0 % (95% CI: 1.052-1.069) increased risk of LEDVT. Moreover, adding PNI to a base model improved the area under the curve (AUC) from 0.721 (95% CI: 0.709-0.734) to 0.746 (95% CI: 0.734-0.758).</p><p><strong>Conclusion: </strong>PNI is inversely associated with the risk of LEDVT, and provides significant incremental diagnostic value for the identification of LEDVT events. These findings suggest that PNI may be a potential biomarker to help clinicians identify patients at risk of thrombosis and make clinical decisions timely.</p>","PeriodicalId":10335,"journal":{"name":"Clinical and Applied Thrombosis/Hemostasis","volume":"31 ","pages":"10760296251317520"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11822822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405314","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}