Journal of Thrombosis and Thrombolysis最新文献_第2页

Effect of half-dose thrombolysis on hypoxemia duration in intermediate risk pulmonary embolism. 半剂量溶栓对中危肺栓塞患者低氧血症持续时间的影响。

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-09-04 DOI: 10.1007/s11239-025-03174-3

Cyrus Moini, Mehran Monchi, Umamaheswari Ramamourthy, Romuald Awede, Bénédicte Cabot, Kmar Hraiech, Sébastien Jochmans

{"title":"Effect of half-dose thrombolysis on hypoxemia duration in intermediate risk pulmonary embolism.","authors":"Cyrus Moini, Mehran Monchi, Umamaheswari Ramamourthy, Romuald Awede, Bénédicte Cabot, Kmar Hraiech, Sébastien Jochmans","doi":"10.1007/s11239-025-03174-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03174-3","url":null,"abstract":"In intermediate high-risk pulmonary embolism (PE), the role of thrombolysis remains debated with a disagreement between European and American guidelines. Expected benefits are counterbalanced by increased hemorrhagic events with full-dose fibrinolysis. In these patients, half-dose thrombolysis may have similar effects with less complications. We have hypothesized that half-dose thrombolysis compared to anticoagulation alone may reduce hypoxemia duration and hospital length of stay. We have performed a 6 years' retrospective study in 2 Emergency Departments of French hospitals. One practiced fibrinolysis in intermediate risk PE (tPA 50 mg/2 h) and the other did not. We used logistic regression and propensity score matching to assess the effect of a thrombolysis strategy. 473 patients had a diagnosis of acute PE during the study period. 110 (23%) patients with intermediate risk PE met the inclusion criteria. After propensity score matching, 30 patients with thrombolysis therapy were compared to 30 control patients. The duration of oxygen therapy was shorter in the thrombolysis group (3 days, interquartile range 2 to 4) than in the control group (8 days, interquartile range 3 to 11; p = 0.0003). There was no significant difference between groups regarding pulmonary, cardiac, and hemorrhagic complications. The rates of treatment failure, defined by death or persistent hypotension requiring vasopressors, were not significantly different between the 2 groups (2% vs. 6%). Compared to anticoagulation alone, half-dose thrombolysis in intermediate risk PE is associated with a significantly shorter duration of hypoxemia.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood pressure in the first 6 hours for older adults with stroke after endovascular therapy: a pooled analysis of the DEVT and RESCUE BT randomized clinical trials. 血管内治疗后老年中风患者前6小时血压：DEVT和RESCUE BT随机临床试验的汇总分析

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-09-04 DOI: 10.1007/s11239-025-03178-z

Cheng Ma, Jingfan Li, Xinyue Zheng, Dahong Yang, Qiangqiang Zhang, Chong Zhang, Yunlong Wang, Xiang Li, Chen Hu, Guannan Tong, Ke Tao, Jinrong Hu, Jian Miao, Wenzhe Wang

{"title":"Blood pressure in the first 6 hours for older adults with stroke after endovascular therapy: a pooled analysis of the DEVT and RESCUE BT randomized clinical trials.","authors":"Cheng Ma, Jingfan Li, Xinyue Zheng, Dahong Yang, Qiangqiang Zhang, Chong Zhang, Yunlong Wang, Xiang Li, Chen Hu, Guannan Tong, Ke Tao, Jinrong Hu, Jian Miao, Wenzhe Wang","doi":"10.1007/s11239-025-03178-z","DOIUrl":"https://doi.org/10.1007/s11239-025-03178-z","url":null,"abstract":"Optimal systolic blood pressure (SBP) targets after endovascular therapy (EVT) for stroke in older adults (≥ 65 years) remain undefined. This study assessed age-stratified associations between early post-EVT SBP (first 6 h) and outcomes. Post hoc analysis of two trials. Patients were stratified by age (18-64 vs. ≥ 65 years) and SBP (≤ 120, 120-140, > 140 mmHg). Primary outcome was 90-day functional status (modified Rankin Scale, mRS). Inverse probability treatment weighting (IPTW) and multivariable regression adjusted for confounders. Post-EVT SBP data were available for 267 young and 395 old patients. IPTW analysis revealed that sustained SBP below 120 mmHg during the first 6 h post-EVT significantly enhanced functional independence in elderly patients (common OR: 2.00; 95% CI: 1.18-3.39). Among young cohorts, maintenance of SBP ≤ 120 mmHg (cOR, 2.89; 95% CI, 1.45-5.82) and 120-140 mmHg (cOR, 3.18; 95% CI, 1.58-6.47) were associated with a better outcome. sICH incidence demonstrated no statistically significant association with systolic blood pressure (SBP) levels (P = 0.21; 95% CI: 0.93-1.35). During the initial 6-h window post-EVT, younger patients with SBP ≤ 140 mmHg and elderly patients with SBP ≤ 120 mmHg were associated with favorable outcome. These results suggest that stricter blood pressure control may be particularly beneficial for older adults in the early post-EVT phase.Trial Registration: The DEVT registration: URL: http://www.chictr.org.cn ; Chinese Clinical Trial Registry: ChiCTR-IOR-17013568, and the RESCUE BT registration: URL: http://www.chictr.org.cn ; ChiCTR-INR-17014167.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atopic dermatitis, venous thromboembolism and cancer: a cohort analysis. 特应性皮炎、静脉血栓栓塞和癌症：一项队列分析。

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-09-04 DOI: 10.1007/s11239-025-03175-2

Sissel Brandt Toft Sørensen, Cecilia H Fuglsang, Erzsébet Horváth-Puhó

{"title":"Atopic dermatitis, venous thromboembolism and cancer: a cohort analysis.","authors":"Sissel Brandt Toft Sørensen, Cecilia H Fuglsang, Erzsébet Horváth-Puhó","doi":"10.1007/s11239-025-03175-2","DOIUrl":"https://doi.org/10.1007/s11239-025-03175-2","url":null,"abstract":"Atopic dermatitis is a risk factor for venous thromboembolism which may be the first manifestation of occult cancer. We examined whether a venous thromboembolism in patients with atopic dermatitis is a marker of occult cancer. We used Danish health registries to conduct this population-based cohort study. Patients with a first-time diagnosis of venous thromboembolism and a history of atopic dermatitis were identified from the Danish National Patients Registry from 1980 through 2022. We calculated the absolute risk of cancer treating death as a competing event. As a measure of relative risk, we calculated standardized incidence ratios (SIRs) for cancer among patients with venous thromboembolism and atopic dermatitis and compared the observed cancer incidence to that of the general Danish population. We identified 582 patients with a first venous thromboembolism diagnosis and a history of atopic dermatitis. During the first year of follow-up, the absolute risk of overall cancer was 1.7%, corresponding to an SIR of 2.90 (95% confidence interval [CI] 1.39-5.34). The overall SIR decreased to 1.12 (95% CI 0.74-1.62) during the subsequent years of follow-up. Although the risk estimates were imprecise, an elevated cancer risk following venous thromboembolism in patients with atopic dermatitis cannot be ruled out, particularly within the first year after venous thromboembolism, when compared to the cancer risk in the general population.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Physical activity before venous thromboembolism and risk of recurrence in a population-based inception cohort. 在一个以人群为基础的初始队列中，静脉血栓栓塞前的身体活动和复发风险。

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-09-04 DOI: 10.1007/s11239-025-03127-w

Anna C Frauenheim, Kerri L Wiggins, Rozenn N Lemaitre, Nicholas L Smith, Laura B Harrington

{"title":"Physical activity before venous thromboembolism and risk of recurrence in a population-based inception cohort.","authors":"Anna C Frauenheim, Kerri L Wiggins, Rozenn N Lemaitre, Nicholas L Smith, Laura B Harrington","doi":"10.1007/s11239-025-03127-w","DOIUrl":"https://doi.org/10.1007/s11239-025-03127-w","url":null,"abstract":"Introduction: The association between moderate-to-vigorous physical activity (MVPA) and recurrent venous thromboembolism (VTE) is unclear, but an improved understanding could inform behavioral health recommendations.Methods: The Heart and Vascular Health study, set in a large integrated healthcare system, identified adults with a validated incident VTE between January 2002 and December 2010. An inception cohort was formed from these cases and followed for a first recurrent VTE through December 2014. Usual MVPA pre-incident VTE was self-reported by 1381 adults via telephone interview, and MVPA amount was calculated in metabolic equivalent of task (MET) hours (h) per week. Multivariable-adjusted Cox proportional hazards models estimated adjusted hazard ratios (HRadj) for any MVPA versus none and MVPA amount, continuously and in quartiles, in MET-h/week among participants reporting any MVPA. Secondary analyses separately evaluated MET-h/week, by intensity.Results: During follow-up (median = 5.23 years), 288 (20.9%) individuals developed a recurrent VTE. There was no evidence of an association between any MVPA versus none and VTE recurrence (HRadj=1.24, [95% confidence interval [CI]: 0.80, 1.91]). Among participants with any MVPA, there was no evidence of an association between MVPA in MET-h/week (HRadj per 7.5 MET-h/week = 1.00, [95% CI: 0.98, 1.03]), nor quartiles of MVPA (p-trend = 0.62) with VTE recurrence risk. In secondary analyses there was no evidence of an association of MET-h/week of moderate or vigorous physical activity (PA) with VTE recurrence.Conclusions: In this cohort of adults who experienced incident VTE, there was no evidence of an association between self-reported MVPA pre-incident VTE and VTE recurrence risk.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The prevalence of FV Hong Kong in patients with thrombotic disorders in South China. 香港FV在华南地区血栓性疾病患者中的流行情况。

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-08-29 DOI: 10.1007/s11239-025-03168-1

Lixuan Chen, Rui Tuo, Qinglin Mo, Chaolin Chen, Ying Feng, Hao Su, Sheng Luo, Dongling Cai, Yang Xiao

{"title":"The prevalence of FV Hong Kong in patients with thrombotic disorders in South China.","authors":"Lixuan Chen, Rui Tuo, Qinglin Mo, Chaolin Chen, Ying Feng, Hao Su, Sheng Luo, Dongling Cai, Yang Xiao","doi":"10.1007/s11239-025-03168-1","DOIUrl":"https://doi.org/10.1007/s11239-025-03168-1","url":null,"abstract":"To investigate the prevalence of FV Hong Kong(p.Arg306Gly) variant in patients with thrombotic disorders in South China, and to explore the association between FV Hong Kong and thrombosis according to genotype and clinical manifestations of the patients. A total of 367 patients with thrombotic disorders and 555 healthy volunteers in South China were screened by exon sequencing to identify FV Hong Kong variant carriers. Acquired risk factors for thrombosis of all subjects were also recorded. Among 367 thrombosis patients, 10 (2.72%) carried heterozygous FV Hong Kong mutations. In contrast, 9 of 555 healthy controls (1.62%) harbored the heterozygous mutation. There is no significant differences in the prevalence rate between patients and healthy controls. Among patients with the FV Hong Kong mutation, 90% exhibited concurrent predisposing factors. The FV Hong Kong variant demonstrates a high prevalence in the South Chinese population, with a similar rate in thrombosis patients and healthy population. The variant, when co-occurring with genetic or acquired risk factors, may synergistically elevate thrombotic risk. Further investigations are warranted to elucidate the clinical implications in thrombotic disorders.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Practical considerations about management of pulmonary embolism in patients with cancer. 癌症患者肺栓塞处理的实际考虑。

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-08-29 DOI: 10.1007/s11239-025-03122-1

Lorenzo Bianchi, Giorgio Ghigliotti, Matteo Sarocchi, Claudia Canale, Matteo Toma, Italo Porto, Paolo Spallarossa

{"title":"Practical considerations about management of pulmonary embolism in patients with cancer.","authors":"Lorenzo Bianchi, Giorgio Ghigliotti, Matteo Sarocchi, Claudia Canale, Matteo Toma, Italo Porto, Paolo Spallarossa","doi":"10.1007/s11239-025-03122-1","DOIUrl":"https://doi.org/10.1007/s11239-025-03122-1","url":null,"abstract":"Venous thromboembolism in cancer patients constitutes a complex and clinically significant disease due to its pathophysiology, morbidity and mortality. Pulmonary embolism is a potentially life-threatening disease, and therefore it represents the second leading cause of death among cancer patients, surpassed only by cancer itself. In recent years, direct-acting oral anticoagulants have emerged as the preferred option for the treatment of cancer-related venous thromboembolism, although low-molecular weight heparins are still specifically recommended for patients with high bleeding risk. The management of anticoagulant therapy beyond the first 6 months following pulmonary embolism remains a challenging scenario, requiring careful evaluation of the balance between benefits and risks. Anti-thrombotic prophylaxis is not routinely recommended in the outpatient setting, although emerging data suggest validated risk tools could help identify high-risk populations who might benefit. This review summarizes available clinical trial data, meta-analyses, real-world studies, both national and international guidelines providing a practical approach to the management of pulmonary embolism in patients with cancer.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of reduced-dose versus full-dose DOACs in extended treatment of VTE: A systematic review and meta-analysis. 减少剂量与全剂量DOACs在静脉血栓栓塞延长治疗中的疗效和安全性：一项系统回顾和荟萃分析。

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-08-29 DOI: 10.1007/s11239-025-03172-5

Abdur Rafay Bilal, Shahood Ahmed Umar, S M Washaqul Arfin, Abdur Raheem Bilal, Maryam Sajid, Hateem Gaba, Shaheer Qureshi, Muhammad Haris Inam, Saad Ahmed Waqas

{"title":"Efficacy and safety of reduced-dose versus full-dose DOACs in extended treatment of VTE: A systematic review and meta-analysis.","authors":"Abdur Rafay Bilal, Shahood Ahmed Umar, S M Washaqul Arfin, Abdur Raheem Bilal, Maryam Sajid, Hateem Gaba, Shaheer Qureshi, Muhammad Haris Inam, Saad Ahmed Waqas","doi":"10.1007/s11239-025-03172-5","DOIUrl":"https://doi.org/10.1007/s11239-025-03172-5","url":null,"abstract":"Extended anticoagulation is recommended for venous thromboembolism (VTE) patients at high recurrence risk. However, the optimal long-term dosing strategy for direct oral anticoagulants (DOACs) remains uncertain. This meta-analysis compares the efficacy and safety of reduced-dose versus full-dose DOACs during extended-phase VTE treatment. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing reduced-dose (apixaban 2.5 mg BID or rivaroxaban 10 mg QD) and full-dose (apixaban 5 mg BID or rivaroxaban 20 mg QD) DOACs. Searches were performed in PubMed, Cochrane CENTRAL, Embase and Scopus till June 10, 2025. Outcomes included recurrent VTE, major bleeding, clinically relevant non-major bleeding (CRNMB), and all-cause mortality. Risk ratios (RRs) were pooled using random-effects models. Five RCTs comprising 8,781 patients were analyzed. Reduced-dose DOACs significantly lowered major bleeding risk (RR: 0.62; 95% CI: 0.42-0.92; p = 0.02; I² = 12%) and CRNMB (RR: 0.75; 95% CI: 0.63-0.88; p = 0.0006; I² = 0%) compared to full-dose DOACs. No significant differences were observed between the groups in recurrent VTE (RR: 0.94; 95% CI: 0.68-1.29; p = 0.70; I² = 0%) or all-cause mortality (RR: 0.86; 95% CI: 0.63-1.17; p = 0.35; I² = 42%). No significant differences across outcomes were observed between cancer-associated and general VTE populations. Reduced-dose DOACs significantly lower bleeding risk without compromising efficacy in preventing recurrent VTE. These findings support the preferential use of reduced-dose DOACs as a safer and effective option for extended anticoagulation, especially in patients at elevated bleeding risk.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic mutations associated with congenital fibrinogen disorders: global distribution and clinical outcomes. 与先天性纤维蛋白原疾病相关的基因突变：全球分布和临床结果

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-08-29 DOI: 10.1007/s11239-025-03134-x

Thaís Nóbrega, Paula Villaça, Erica Okazaki, Cynthia Rothschild, Bianca Stefanello, Tânia Rocha, Vanderson Rocha, Fernanda A Orsi

{"title":"Genetic mutations associated with congenital fibrinogen disorders: global distribution and clinical outcomes.","authors":"Thaís Nóbrega, Paula Villaça, Erica Okazaki, Cynthia Rothschild, Bianca Stefanello, Tânia Rocha, Vanderson Rocha, Fernanda A Orsi","doi":"10.1007/s11239-025-03134-x","DOIUrl":"https://doi.org/10.1007/s11239-025-03134-x","url":null,"abstract":"Congenital fibrinogen disorders (CFD) are characterized by heterogeneous manifestations, from asymptomatic to severe bleeding or thrombosis, associated with genetic mutations in FGA, FGB, or FGG genes. As a result, diagnosis is challenging, particularly in low- and middle-income countries, where evidence is scarce. The aim of this review is to describe the distribution of CFD-associated genetic mutations across different regions of the world and their corresponding phenotypes. Data from MEDLINE and the French Group for the Study of Hemostasis and Thrombosis databases were qualitatively organized based on the United Nations regional classification. A total of 132 studies on CFD were selected from MEDLINE and GFHT fibrinogen database, comprising over 1000 mutations descriptions and approximately 340 unique mutations. FGA mutations are most associated with dys- or afibrinogenemia, while FGB mutations are associated with hypo- or afibrinogenemia and FGG with dys- or hypofibrinogenemia Across countries, the most common mutations in afibrinogenemia and hypofibrinogenemia were intronic variant sequence in FGA, p. Arg47stop in FGB, and mutations in exon 8 of FGG. Dysfibrinogenemia was associated with mutations in exon 2 of FGA, typically resulting in asymptomatic individuals and with mutations in exon 8 of FGG, which are associated with thrombosis. The majority of mutations related to CFD and their associated phenotypes have been reported in Western Europe, North America and East Asia. Evidence from Latin America, Southeast Asia, and Africa remains limited, with Brazil having only one study that evaluated CFD mutations. Data on CFD phenotypes and associated genetic mutations from low and middle income countries are necessary to ensure equity in the management of these rare diseases.t.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of left atrial strain and fibrin clot properties in patients with heart failure and severe mitral regurgitation undergoing transcatheter edge-to-edge repair. 经导管边缘对边缘修复心力衰竭和严重二尖瓣返流患者左心房应变和纤维蛋白凝块特性的关系

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-08-29 DOI: 10.1007/s11239-025-03169-0

Aleksandra Woźniak, Andrzej Gackowski, Karolina Golińska-Grzybała, Barbara Szlósarczyk, Jarosław Trębacz, Jadwiga Nessler, Grzegorz Gajos, Aleksander Siniarski

{"title":"Association of left atrial strain and fibrin clot properties in patients with heart failure and severe mitral regurgitation undergoing transcatheter edge-to-edge repair.","authors":"Aleksandra Woźniak, Andrzej Gackowski, Karolina Golińska-Grzybała, Barbara Szlósarczyk, Jarosław Trębacz, Jadwiga Nessler, Grzegorz Gajos, Aleksander Siniarski","doi":"10.1007/s11239-025-03169-0","DOIUrl":"https://doi.org/10.1007/s11239-025-03169-0","url":null,"abstract":"The link between heart failure (HF) and increased prothrombotic risk has gathered attention, with several studies exploring this association. Patients with HF and severe mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER) may present enhanced left atrial (LA) function and improve thrombosis-related factors due to the procedure. This study investigates the role of left atrial strain (LAS), assessed via speckle-tracking echocardiography, in detecting subtle LA abnormalities and its potential link to thrombotic risk in severe MR patients. 31 consecutive patients with severe MR who underwent TEER were enrolled. Six patients were lost to follow-up, and 25 completed both visits (V1 and V2). Coagulation parameters (thrombin generation, clot permeation [Ks], clot lysis time [CLT]) and echocardiographic assessments were performed at each visit. Subgroup analysis was also done for patients with sinus rhythm and atrial fibrillation. A significant correlation was found between LAS-r and changes in CLT (p = 0.03; R = -0.43) before and after TEER. LAS-cd decreased, and LAS-ct increased. No significant differences were noted in coagulation parameters. Patients with sinus rhythm also showed a significant correlation with CLT changes. This study demonstrates significant changes in LAS after TEER, with reduced LAS-cd and increased LAS-ct, which highlights a potential link between cardiac mechanics and clotting properties, with distinct differences between patients with sinus rhythm and atrial fibrillation. These findings provide insights into cardiac and thrombotic changes post-TEER, requiring further investigation.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Long-term efficacy and safety of direct oral anticoagulants in venous thrombotic antiphospholipid syndrome patients not candidate to warfarin: A pilot prospective case series study. 不适合华法林治疗的静脉血栓性抗磷脂综合征患者直接口服抗凝剂的长期疗效和安全性：一项前瞻性病例系列研究

IF 2.2 3区医学

Journal of Thrombosis and Thrombolysis Pub Date : 2025-08-29 DOI: 10.1007/s11239-025-03158-3

Daniele Pastori, Danilo Menichelli, Gian Marco Podda, Bianca Clerici, Simone Birocchi, Tommaso Bucci, Paul Rj Ames, Pasquale Pignatelli

{"title":"Long-term efficacy and safety of direct oral anticoagulants in venous thrombotic antiphospholipid syndrome patients not candidate to warfarin: A pilot prospective case series study.","authors":"Daniele Pastori, Danilo Menichelli, Gian Marco Podda, Bianca Clerici, Simone Birocchi, Tommaso Bucci, Paul Rj Ames, Pasquale Pignatelli","doi":"10.1007/s11239-025-03158-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03158-3","url":null,"abstract":"Data on direct oral anticoagulants (DOACs) in venous thrombotic antiphospholipid antibody syndrome (APS) are controversial. This pilot study aimed to assess the safety and efficacy of DOACs in APS patients requiring oral anticoagulation for venous thromboembolism (VTE) but unsuitable for treatment with vitamin K antagonists (VKAs). We performed a prospective multi-centre case-series including APS patients with previous VTE who were receiving treatment with DOACs due to ineligibility for VKAs. Main outcomes were bleeding, arterial and recurrent venous thrombotic events and all-cause death. We included 18 patients (median age 59.6 years, 66.7% women). The antiphospholipid antibody pattern was single positivity for 33.3% patients, double positivity for 33.3%, and triple positivity for 27.8%. Only one patient had seronegative APS. Apixaban, dabigatran, rivaroxaban and edoxaban were prescribed in 44.4%, 27.8%, 16.7% and 11.1% of patients, respectively. The mean follow-up was 50.1 ± 24.1 months. During the observation period, no recurrent VTE episodes or arterial thrombotic events were recorded. Four bleedings, of which 2 major, were reported. The incidence rate of bleeding was 5.3 per 100 patient-years (95% confidence interval [95%CI] 1.4-13.6). No intracranial bleedings were recorded.In conclusion, our preliminary findings may suggest DOAC as possible option for patients with venous thrombotic APS unsuitable to VKAs. Although these findings are promising, larger cohort studies are needed to confirm this finding.","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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