Journal of Thrombosis and Thrombolysis最新文献

{"title":"Missense and nonsense mutations and inhibitor development in patients with hemophilia A and B.","authors":"Fatemeh Karimi, Najmaldin Saki, Reyhane Khademi, Gholam-Abbas Kaydani, Bijan Keikhaei","doi":"10.1007/s11239-025-03171-6","DOIUrl":"https://doi.org/10.1007/s11239-025-03171-6","url":null,"abstract":"<p><p>Hemophilia A and B are X-linked bleeding disorders caused by mutations in the F8 and F9 genes, resulting in deficiencies of coagulation factors VIII (FVIII) and IX (FIX), respectively. A major complication of replacement therapy is the development of neutralizing antibodies (inhibitors), which occur in approximately 30% of patients with severe hemophilia A and about 3% of those with hemophilia B. The role of missense and nonsense mutations in inhibitor formation has been increasingly recognized. In hemophilia A, missense mutations within immunogenic domains may alter FVIII structure, eliciting immune responses. Nonsense mutations especially those located in the light chain are associated with higher inhibitor risk due to the production of truncated, non-functional proteins. In hemophilia B, missense mutations rarely result in inhibitor development, whereas nonsense mutations and large deletions carry a significantly higher risk. Molecular genotyping contributes to predicting inhibitor formation and supports individualized treatment planning.</p>","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":"144959132","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}

{"title":"Measurement of plasma direct oral anticoagulants concentrations in real-world clinical and laboratory settings on a 24/7 basis: a 10-year experience.","authors":"Agnieszka Kotnis-Gąska, Agata Trawińska, Elżbieta Broniatowska, Małgorzata Konieczyńska, Anetta Undas, Ewa Wypasek","doi":"10.1007/s11239-025-03159-2","DOIUrl":"10.1007/s11239-025-03159-2","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883117","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}

{"title":"Impact of antithrombin III deficiency on clinical outcomes in trauma patients: a systematic review and meta-analysis.","authors":"Joao Victor Silva Correia, Pedro Lawall de Carvalho, Mariana Merighi Moreira Salles, Ricardo Ormanes Massoud, Rafael Hortêncio Melo","doi":"10.1007/s11239-025-03166-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03166-3","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855646","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}

{"title":"Timing, indications and transition patterns associated with cangrelor use in patients undergoing PCI.","authors":"Angelo Oliva, Davide Cao, Mark Shneyderman, Gregory Serrao, Mauro Gitto, Francesca Maria Di Muro, Samantha Sartori, Yihan Feng, Birgit Vogel, Johny Nicolas, Joseph Sweeny, Prakash Krishnan, Benjamin Bay, James Johnson, Parasuram Melarcode, Giulio Stefanini, Pedro Moreno, Annapoorna Kini, George Dangas, Samin Sharma, Roxana Mehran","doi":"10.1007/s11239-025-03136-9","DOIUrl":"https://doi.org/10.1007/s11239-025-03136-9","url":null,"abstract":"<p><p>Optimal antiplatelet therapy is crucial in percutaneous coronary intervention (PCI) to balance thrombotic and bleeding risk. Cangrelor, a rapid-acting intravenous P2Y12 inhibitor, is particularly effective in high-risk PCI scenarios, including acute coronary syndrome (ACS) or patients unable to take oral medications. The SMILE study evaluated real-world timing, indications, and outcomes of cangrelor use, along with transition to oral P2Y12 inhibitors, in high-risk patients undergoing PCI. A retrospective analysis of Mount Sinai PCI registry was conducted, examining consecutive patients receiving cangrelor from January 2018 to March 2024. Transition to oral P2Y12 inhibitors (ticagrelor, clopidogrel, or prasugrel) followed institutional protocols based on guidelines and expert consensus. The primary endpoint was in-hospital major adverse cardiac and cerebrovascular events (MACCE), including myocardial infarction, stroke, and all-cause death. Among 493 patients, 78.7% presented with ACS (29.6% STEMI; 14.8% cardiogenic shock) and 79.3% underwent complex PCI. Of these, 80.5% were subsequently transitioned to ticagrelor (N=397) and 19.5% to a thienopyridine (clopidogrel N=85, prasugrel N=11). MACCE incidence was 12.6%, while bleeding occurred in 4.3%. A lower risk of MACCE was associated with transition to ticagrelor (9.8% vs. 24.0%; adjusted OR 0.35, 95%CI 0.20-0.62, p < 0.001) and adherence to protocol for transition to oral P2Y12 inhibitors (10.9% vs. 19.4%; adjusted OR 0.51, 95%CI 0.28-0.94). Extended low-dose cangrelor infusion was well-tolerated in critically ill patients requiring prolonged parenteral antiplatelet therapy. Overall, the SMILE study demonstrated that adherence to standardized transition protocols enhances clinical outcomes in high-risk PCI patients receiving cangrelor, particularly when transitioned to ticagrelor. Further research is needed to validate these results across diverse populations and clinical settings.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855649","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}

{"title":"The von Willebrand factor/ADAMTS13 ratio as an indicator of venous thromboembolism risk: results from the RETROVE project.","authors":"D Llobet, S Mojal, C Vallvé, M Carrasco, N Vilalta, J Mateo, C Moret, J Millón, J M Soria, J C Souto","doi":"10.1007/s11239-025-03165-4","DOIUrl":"https://doi.org/10.1007/s11239-025-03165-4","url":null,"abstract":"<p><p>The von Willebrand factor/ADAMTS13 ratio and shortened PFA-100 values have been associated with the risk of venous thromboembolism (VT). Our objective was to confirm the association of the VWF/ADAMTS13 ratio with VT risk and to assess the correlation between this ratio and PFA-100 values. We determined ADAMTS13 and VWF plasma levels, as well as PFA-100 values in 800 individuals (400 with VT and 400 healthy controls) from the RETROVE project. Using binary logistic regression and multivariate analyses, we evaluated the relationship between the VWF/ADAMTS13 ratio and VT risk. Quartile cut-offs of this ratio were calculated in controls, after which we estimated odds ratios (ORs) with 95% CIs. The risk of VT increased progressively with increasing quartiles of the VWF/ADAMTS13 ratio, with an OR of 4.12 (95% CI, 2.47-6.88) for the highest vs lowest quartiles in an age-adjusted analysis. When we analyzed the ROC curve for the VWF/ADAMTS13 ratio, we found similar results: we obtained three ranges of this ratio, with an increasingly progressive risk (ORs from 2.59 to 6.54). Values of the VWF/ADAMTS13 ratio correlated negatively with PFA-100 (R = - 0.5 p < 0.001). These findings indicate that the VWF/ADAMTS13 ratio is an indicator of VT risk and that a high ratio correlates negatively with PFA-100 values.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855648","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}

{"title":"Impact of time in therapeutic range (TTR) within the first 72 h on prognosis in patients with pulmonary embolism treated with unfractionated heparin.","authors":"Amit Ifergan, Ranel Loutati, Ariella Tvito, Mony Shuvy, Shemy Carasso, Dana Deeb, Louay Taha, Mohammad Karmi, Mohammed Manassra, Akiva Brin, Ofir Rabi, Noam Fink, Pierre Sabouret, Amro Moatz, Abed Qadan, Nir Levi, Tali Bdolah-Abram, Michael Glikson, Elad Asher","doi":"10.1007/s11239-025-03167-2","DOIUrl":"https://doi.org/10.1007/s11239-025-03167-2","url":null,"abstract":"<p><p>Pulmonary embolism (PE) is a life-threatening condition often treated with unfractionated heparin (UFH) in intermediate high-risk patients. Activated Partial Thromboplastin Time (aPTT) is used to monitor UFH efficacy. We sought to evaluate the correlation between time in therapeutic range (TTR) and prognosis in patients with pulmonary embolism treated with unfractionated heparin. A prospective cohort study included 203 patients admitted to a tertiary care center between July 2019 and August 2024 with a confirmed diagnosis of intermediate risk PE treated with UFH. TTR was calculated based on aPTT values during the first 72 h of hospitalization. The correlation between TTR and mortality rates was assessed. Out of the 203 patients, 116 (57%) achieved therapeutic range at least once, with a mean TTR of 43.1% (± 22.4) and a median of 39%. Nevertheless, the overall mean TTR for all patients was 24.6% (± 27.3), with a median of 18.8%. During the study period 25 (12.3%) patients have died, of them 9 (4.4%) within 30 days and 16 (7.9%) within one year. Higher TTR was associated with reduced 30-day (p = 0.051) and one-year (p = 0.045) mortality rates. Receiver Operating Characteristic (ROC) analysis identified a TTR threshold of 21.5% for predicting one-year mortality, demonstrating a high negative predictive value (NPV) of 96.8% but a low positive predictive value (PPV) of 12%. Patients with acute PE who achieved higher TTR exhibited better outcomes at 30 days and one year. However, most patients did not reach adequate TTR levels, leaving its role as an independent prognostic indicator uncertain. Larger studies are necessary to optimize therapeutic strategies and improve outcomes in intermediate-risk PE patients.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855647","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}

{"title":"Postoperative venous thromboembolism risk following lung cancer surgery: a systematic review and meta-analysis.","authors":"Jing Chen, Yuanzheng Mao, Zhiyu Peng","doi":"10.1007/s11239-025-03164-5","DOIUrl":"https://doi.org/10.1007/s11239-025-03164-5","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) remains a major contributor to postoperative morbidity and mortality in patients undergoing lung cancer surgery. This study aims to identify perioperative risk factors associated with VTE development following such procedures. We performed an exhaustive search of PUBMED and EMBASE from inception to November 1, 2023, using terms related to VTE following lung cancer surgery. A random-effects meta-analysis was performed to calculate the pooled incidence and odds ratios (ORs) for risk factors. Of 3,576 screened studies, 13 met eligibility criteria for qualitative synthesis, and 11 studies (53,382 patients) were included in the meta-analysis. The pooled incidence of postoperative VTE was 1.82% (971 cases). Significant risk factors included advanced age (standardized mean difference [SMD] 0.43, 95% CI 0.22-0.63; I² = 59.9%), prolonged surgical duration (SMD 0.58, 95% CI 0.24-0.92; I² = 81.2%), open thoracotomy (OR 1.77, 95% CI 1.50-2.09; I² = 19.9%), TNM stage > 1 (OR = 1.81, 95% CI 1.53-2.13; I² = 39.8%), adenocarcinoma histology (OR = 1.29, 95% CI 1.08-1.53; I² = 1.2%), and major lung resection (OR = 1.51, 95% CI 1.24-1.83; I2 = 0.0%). This study highlights key modifiable and non-modifiable risk factors for postoperative VTE in lung cancer surgery patients. These findings support individualized risk stratification and targeted thromboprophylaxis strategies to improve clinical outcomes.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799507","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}

{"title":"Safety and efficacy of Cangrelor versus GPIIb/IIIa inhibitors as adjunctive therapy in endovascular treatment of acute ischemic stroke: a systematic review and meta-analysis.","authors":"Mohamed Ellebedy, Rashad G Mohamed, Mina Ihab Lamie, Omar F Abbas, Amir Hegazi, Muataz Kashbour","doi":"10.1007/s11239-025-03160-9","DOIUrl":"https://doi.org/10.1007/s11239-025-03160-9","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784607","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}

{"title":"The future of stroke care: how telestroke is bridging the gap in stroke care.","authors":"Lucio D'Anna, Marilena Mangiardi, Francesco Corea, Christoph Gumbinger, Rene Handschu, Olfa Kaaouana, Vasileios Tentolouris-Piperas, Laetitia Yperzeele, Vaso Zisimopoulou","doi":"10.1007/s11239-025-03150-x","DOIUrl":"10.1007/s11239-025-03150-x","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"743-746"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New approaches to preventing venous thromboembolism, prognostication in stroke and myocardial infarction, and antiplatelet therapy after spontaneous coronary artery dissection.","authors":"Diana A Gorog","doi":"10.1007/s11239-025-03138-7","DOIUrl":"10.1007/s11239-025-03138-7","url":null,"abstract":"<p><p>Immobility following orthopedic surgery is a risk factor for venous thromboembolism (VTE), but the optimal duration of anticoagulant thromboprophylaxis remains controversial. The protocol of the \"Enhanced Recovery and Abbreviated Length of Anticoagulation for Thromboprophylaxis After Primary Hip Arthroplasty\" (ENABLE-Hip) is presented, an investigator-initiated randomized double-blind trial, comparing shorter anticoagulant duration with standard-of-care. To improve outcomes after complex thrombotic events, a novel multidisciplinary approach is presented, based loosely on the tumor board model from oncology, with establishment of a \"Clot Cases Conference\". East Asians are more susceptible to bleeding than other ethnicities, with sub-standard dose direct oral anticoagulant (DOAC) frequently prescribed. A meta-analysis evaluating Japanese patients with AF shows that patients receiving underdosed DOACs have fewer bleeding events, similar thromboembolic events, but an increase in all-cause mortality, possibly due to increased frailty. In terms of biomarkers, transforming growth factor-β1, a cytokine that can promote VTE, was shown in patients with pulmonary embolism to be associated with residual pulmonary vascular obstruction. Although monocytes have traditionally been classified into three subsets, expression of recently described Mon4 is reported to be a marker of cardiovascular risk following acute myocardial infarction (AMI). The benefit of carotid endarterectomy for moderate carotid artery stenosis (CAS) is unclear. In patients with minor stroke and moderate ipsilateral CAS (50-69%), the severity of CAS was inversely associated with microRNA-22 levels, while decreased expression was associated with recurrent ipsilateral stroke. Although dual antiplatelet therapy for 1 year is the default recommendation for most AMI patients, the benefit of this for spontaneous coronary artery dissection (SCAD) is unclear, and a review of antiplatelet strategies for conservatively managed SCAD patients is presented herein.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"679-681"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497455","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}