Journal of Thrombosis and Thrombolysis最新文献

{"title":"Safety and efficacy of routine anticoagulation after primary PCI in STEMI: a systematic review and meta-analysis.","authors":"Anika Chowdhury, Dhruvkumar Arvindbhai Vasoya, Mahfuja Jahan Ima, Srija Reddy Koppula, Ashesh Das, Kiran Kumar Dhivakaran, Muhammad Muneeb Khawar, Aadya Mishra, Muhammad Safiullah, Saman Siddique, Deng Siang Lee, Muhammad Hamza, Hemeesh Tandel, Aniket Chatterjee","doi":"10.1007/s11239-025-03130-1","DOIUrl":"10.1007/s11239-025-03130-1","url":null,"abstract":"<p><p>Percutaneous Coronary Intervention (PCI) is a widely used minimally invasive procedure that restores blood flow to the coronary artery, improving survival in STEMI patients. Despite its widespread application in clinical settings, the necessity and efficacy of postprocedural anticoagulation (PPAC) remain contentious. Our study aims to assess the outcomes of PPAC in STEMI patients who have undergone PCI. A comprehensive search of Embase, PubMed, and Clinicaltrials was conducted to identify randomized controlled trials (RCTs) comparing the clinical outcomes between PPAC and control (placebo or no PPAC) for STEMI after primary PCI. Statistical analyses were performed using RevMan version 5.4.1, employing a random-effects model to calculate odds ratios (ORs) and their 95% confidence intervals (CIs). Risk of Bias Assessment of the articles was assessed using RoB 2.0 software by the Cochrane Collaboration. A total of 5 RCTs comprising 13,586 patients were included, of which 6,829 patients (50.26%) received PPAC. Compared to the non-PPAC group, PPAC did not significantly reduce all-cause mortality (OR 1.08; 95% CI 0.84-1.39; P = 0.54, I² = 0%), cardiovascular mortality (OR 1.08; 95% CI 0.83-1.39; P = 0.57, I² = 0%), and MACE (major adverse cardiovascular events) (OR 1.13; 95% CI 0.92-1.37; P = 0.25, I² = 22%). Additionally, the odds of stent thrombosis (OR 1.07; 95% CI 0.77-1.47; P = 0.69, I² = 0%) and stroke (OR 1.50; 95% CI 0.49-4.57; P = 0.48, I² = 58%) did not differ significantly between the groups. However, PPAC was associated with higher odds of bleeding (OR 1.78; 95% CI 1.07-2.97; P = 0.03, I² = 94%). This meta-analysis reveals no significant differences in the odds of all-cause mortality, cardiovascular mortality, stent thrombosis, and stroke between PPAC and control following PCI for the management of STEMI. However, PPAC was associated with higher odds of bleeding. Further randomized controlled trials are warranted to corroborate these findings.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368957","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":"Eptifibatide as an adjuvant therapy to thrombolysis versus thrombolysis alone in stroke management: a systematic review and meta-analysis of randomized controlled trials.","authors":"Lucca Tamara Alves Carretta, Ocílio Ribeiro Gonçalves, Luiz Guilherme Silva Almeida, Sandy Souza, Christian Fukunaga, Fernando Baía Bezerra, Luiz Felipe Simões Antunes Nery Dos Santos, Pedro Rodrigues Teixeira, Ítalo Barros Andrade, Fabrício Salazar Fiorio Marques, Yasmin Picanço Silva, Gustavo Noleto","doi":"10.1007/s11239-025-03131-0","DOIUrl":"10.1007/s11239-025-03131-0","url":null,"abstract":"<p><p>Stroke is a leading cause of death and disability. Thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the primary treatment for acute ischemic stroke (AIS), but outcomes remain suboptimal. Eptifibatide, a glycoprotein IIb/IIIa inhibitor, has been explored as an adjunct to enhance reperfusion. This systematic review and meta-analysis assesses its effectiveness and safety compared to rt-PA alone. We searched PubMed, Embase, and Cochrane Library for randomized controlled trials (RCTs). Primary outcomes included 90-day functional independence (modified Rankin Scale, mRS 0-1), mortality, and symptomatic intracranial hemorrhage (sICH). Meta-analyses used random-effects models to calculate Odds Ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed with I². We included 988 patients from four RCTs. Eptifibatide was administered to 566 patients (57.3%). Adjuvant therapy did not significantly improved mRS 0-1 rates at 90 days (OR 1.12, 95% CI 0.60-2.09, p = 0.72, I²=74%) and did not reduce mortality (OR 1.55, 95% CI 0.92-2.61, p = 0.099, I²=0%). sICH was not statistically significantly different between the groups (OR 0.38, 95% CI 0.09-1.65, p = 0.196, I²=56%). Eptifibatide as an adjunct to rt-PA does not significantly impact functional independence, mortality, or sICH risk in AIS. Larger studies are needed to clarify its potential benefits and risks.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368952","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":"Prediction of thrombotic events in patients with autoimmune hemolytic anemia: a multicenter retrospective observational study.","authors":"Lucie Carneiro Esteves, Lucile Grange, Jean-Baptiste Gaultier, Baptiste Gramont, Emilie Chalayer, Martin Killian","doi":"10.1007/s11239-025-03129-8","DOIUrl":"10.1007/s11239-025-03129-8","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune hemolytic anemia (AIHA) is recognized to increase the risk of thrombotic events (TE), including venous thromboembolism (VTE) and arterial thromboembolism (ATE), but little is known about specific risk factors and characteristics.</p><p><strong>Methods: </strong>This retrospective multicenter observational study, sought to assess TE incidence, identify associated thrombotic risk factors and assess the external validity of the Padua score in AIHA for predicting VTE.</p><p><strong>Results: </strong>TE incidence during the study period was 25% (CI95%: 17-36), consisting of 19 VTE in 16 patients (18% [CI95%: 9-28]) and 11 ATE in 7 (8% [CI95%: 4-16]). A high number (≥ 5) of hemolysis attacks was associated with overall TE (OR 6.9 [CI95%: 1-82], p = 0.03). Univariate analysis confirmed splenectomy and VTE history as the strongest VTE-related risk factors (OR 7.5 [CI95%: 1-44], p = 0.009 and OR 3.8 [CI95%: 1-14], p = 0.04), whereas having primary warm AIHA was identified as a novel risk factor (3.1 [1-11] p = 0.05) which needs to be confirmed in further studies. ATE risk factors were age≥ 80 years at diagnosis (OR 8.9 [CI95%: 1-68] p = 0.02), and having ≥ 3 cardiovascular risk factors (OR 8.9 [CI95%: 1-70] p = 0.01). The area under the Receiver Operating Characteristic curve of the Padua score was 0.66.</p><p><strong>Conclusions: </strong>TE incidence is high in AIHA, especially when there are repeated hemolysis attacks and associated VTE and/or ATE-related risk factors, thus warranting the conduct of prospective clinical trials to allow for an improved TE risk stratification and to design adapted management for both VTE and ATE.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368955","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":"Proteomics of arterial thrombi in acute limb ischemia.","authors":"Robert D Stegman, Lauren R Schmitt, Kirk C Hansen, Adrianna Kayden, Ahana Ghosh, Ara Metjian, Max V Wohlauer","doi":"10.1007/s11239-025-03123-0","DOIUrl":"10.1007/s11239-025-03123-0","url":null,"abstract":"<p><p>Acute limb ischemia (ALI) is characterized by a sudden decrease in limb perfusion due to arterial occlusion. Without urgent revascularization, patients are at risk of ischemic damage and amputation. This study uses novel proteomic techniques to investigate the molecular architecture of ALI thrombi, identifying key proteins that may influence coagulation dynamics and fibrinolysis resistance. Arterial thromboemboli (n = 12) collected after revascularization procedures were analyzed and compared to in vitro clots (n = 10) generated from healthy donor blood via tissue factor‒induced coagulation. Proteins were identified and quantified via liquid chromatography‒mass spectrometry (LC-MS/MS). A comprehensive literature review of the most abundant proteins allowed for categorization based on their functional roles in fibrinolysis, red blood cell (RBC) degradation, complement activation, and platelet activation. Compared to in vitro clots, ALI clots contained 141 proteins with significantly increased abundance (fold change) and 38 with decreased abundance (p < 0.05). These include 17 fibrinolysis regulators, 8 RBC-related proteins, 6 complement proteins, and 36 platelet regulators. The antifibrinolytic protein vitronectin (VTN) was strikingly enriched (1067-fold), suggesting a substantial role in fibrinolysis resistance and clot stability. Scavengers of heme/hemoglobin, thromboinflammatory complement proteins, and platelet activators were highly abundant. This proof-of-concept study introduces novel proteomic methods for arterial thrombus analysis and identifies key proteins involved in ALI pathology. Our findings reveal a delicate balance between antifibrinolytic and profibrinolytic proteins, offering potential therapeutic targets to enhance thrombolysis and improve ALI management.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368956","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":"From \"time is brain\" to \"time is collaterals\": updates on the role of cerebral collateral circulation in stroke.","authors":"Mangiardi Marilena, Pezzella Francesca Romana, Alfano Guido, De Rubeis Gianluca, Fabiano Sebastiano, Pampana Enrico, Anticoli Sabrina","doi":"10.1007/s11239-025-03135-w","DOIUrl":"10.1007/s11239-025-03135-w","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic stroke (AIS) remains the leading cause of mortality and disability worldwide. While revascularization therapies-such as intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT)-have significantly improved outcomes, their success is strongly influenced by the status of cerebral collateral circulation. Collateral vessels sustain cerebral perfusion during vascular occlusion, limiting infarct growth and extending therapeutic windows. Despite this recognized importance, standardized methods for assessing collateral status and integrating it into treatment strategies are still evolving. This narrative review synthesizes current evidence on the role of collateral circulation in AIS, focusing on its impact on infarct dynamics, treatment efficacy, and functional recovery. We highlight findings from major clinical trials-including MR CLEAN, DAWN, DEFUSE-3, and SWIFT PRIME which consistently demonstrate that robust collateral networks are associated with improved outcomes and expanded eligibility for reperfusion therapies. Advances in neuroimaging, such as multiphase CTA and perfusion MRI, alongside emerging AI-driven automated collateral grading, are reshaping patients' selection and clinical decision-making. We also discuss novel therapeutic strategies aimed at enhancing collateral flow, such as vasodilators, neuroprotective agents, statins, and stem cell therapies. Despite growing evidence supporting collateral-based treatment approaches, real-time clinical implementation remains limited by challenges in standardization and access.</p><p><strong>Conclusion: </strong>Cerebral collateral circulation is a critical determinant of stroke prognosis and treatment response. Incorporating collateral assessment into acute stroke workflows-supported by advanced imaging, artificial intelligence, and personalized medicine-offers a promising pathway to optimize outcomes. As the field moves beyond a strict \"time is brain\" model, the emerging paradigm of \"time is collaterals\" may better reflect the dynamic interplay between perfusion, tissue viability, and therapeutic opportunity in AIS management.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368953","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":"Venous thromboembolism diagnosis definition in claims data: implications for research.","authors":"Vanessa Vyas, Ashlynn Fuccello, Seana L Corbin, Bradley C Martin, Mario Schootman, Michail N Mavros","doi":"10.1007/s11239-025-03125-y","DOIUrl":"10.1007/s11239-025-03125-y","url":null,"abstract":"<p><p>To examine whether the variability in ICD codes used for venous thromboembolism (VTE) definition among published studies affects VTE rates and associations detected from claims data. We extracted the ICD codes used for VTE definition from three published studies and proposed a new VTE definition based on clinical review of all utilized ICD codes. We compared these four definitions to assess differences in VTE rates and associated variables using a standardized scenario. We used a random 25% sample of the IQVIA PharMetrics® Plus for Academics database and analyzed patients undergoing gastrointestinal cancer surgery. The primary outcome was 90-day post-discharge VTE. The association of preoperative and intraoperative variables with VTE was assessed using bivariate and multivariable main effects logistic regression models. There were substantial differences in the use of ICD codes among the 4 VTE definitions (range 116 to 304 ICD-9/10 codes). Our population included 2,122 eligible patients (median age 59 years, 47% female) and the rate of VTE ranged from 2.3% to 4.4% using the four definitions. Multivariable analysis showed that the associations between VTE and age and type of surgery (esophageal surgery, gastric surgery) varied depending on the VTE definition used while the Elixhauser comorbidity score and liver surgery type were consistently associated with VTE. In this pilot study, differences in the incidence of VTE and associated risk factors were influenced by the choice of ICD9/10 codes used to define VTE. A standardized definition of VTE may improve the reproducibility and rigor of findings based on administrative claims data.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368958","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 role of activated partial thromboplastin time-clot waveform analysis in distinguishing positive samples of lupus anticoagulant from hemophilia A.","authors":"Nithye Parvathy, Debadrita Ray, Narender Kumar, Priya Punj, Vasant Kumar, Chander Hans, Jasmina Ahluwalia, Surjit Singh, Varun Dhir","doi":"10.1007/s11239-025-03128-9","DOIUrl":"https://doi.org/10.1007/s11239-025-03128-9","url":null,"abstract":"<p><strong>Introduction: </strong>Clot waveform analysis (CWA) is a technique that continuously monitors changes in light transmittance or absorbance during fibrin clot formation in plasma, enhancing routine clotting test assessment. Patients with Lupus Anticoagulant (LA) and Hemophilia A (HA) both exhibit isolated prolongation of activated partial thromboplastin time (aPTT); however, their management differs significantly. CWA can aid in distinguishing between these conditions, particularly in cases where standard coagulation tests are inconclusive and specialized assays are unavailable.</p><p><strong>Methods: </strong>This prospective case-control study included patients with demonstrable LA (n = 69), healthy controls (n = 75) and diseased controls [HA with (n = 16) and without inhibitor (n = 36).</p><p><strong>Results: </strong>The quantitative data of aPTT-CWA including velocity peak time, acceleration peak time and height of acceleration [-] were significantly lower in LA-positive samples with prolonged aPTT in comparison with HA without inhibitors. The qualitative data comprising Shoulder in 1st derivative, Biphasic wave in 2nd derivative [-] and Serrated wave pattern in 2nd derivative were significantly common in HA samples without inhibitors. In comparison to healthy controls, LA-positive patients with normal aPTT had significantly lower velocity peak time and height of velocity along with higher width of velocity. In acceleration peak time and width of acceleration [-] peak were significantly higher along with lower height of acceleration [+] and height of acceleration [-]. AUROCs of height of acceleration [-], width of acceleration [-] and width of velocity were statistically and biologically significant. The shoulder in 2nd derivative was significantly common in LA-positive samples.</p><p><strong>Conclusion: </strong>The aPTT-CWA has limited utility for differentiating LA positive from HA samples with and without inhibitors. However, aPTT-CWA may help in selecting patients with normal aPTT who merit further confirmatory testing for LA with a compatible history.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293885","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":"Direct oral anticoagulants as secondary prophylaxis of venous thromboembolism in paroxysmal nocturnal hemoglobinuria: an Italian monocentric experience.","authors":"M Biglietto, A L Faccini, J Micozzi, M Salvatori, M Antonacci, U La Rocca, A P Iori, Antonio Chistolini","doi":"10.1007/s11239-025-03124-z","DOIUrl":"https://doi.org/10.1007/s11239-025-03124-z","url":null,"abstract":"<p><p>In 2011 Luzzatto et al. stated that \"Paroxysmal nocturnal hemoglobinuria (PNH) is the most vicious acquired thrombophilic state known in medicine\". Fourteen years later, although anti-complement therapy reduced the incidence of thrombotic events, their management remains an unmet clinical need. Historically Vitamin K Antagonists were the first-choice medications for anticoagulation in this setting. Nowadays, Direct Oral Anticoagulants (DOACs) are the standard anticoagulant therapy in most settings due to their predictable pharmacokinetics, fixed dosing, and no need for laboratory monitoring. Poor data is available on their use in paroxysmal nocturnal hemoglobinuria patients in the treatment of the acute-phase of venous thromboembolism (VTE), while no data is available on their use in secondary prophylaxis of VTE. We describe our monocentric experience on the management of thrombotic events in PNH patients and on the use of DOACs as secondary prophylaxis medication. Our retrospective monocentric analysis shows that DOACs could be an effective and safe choice in this setting.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248522","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":"Indications of platelet indices in coronary artery disease (CAD): more insights into their diagnostic and prognostic importance.","authors":"Ehteramolsadat Hosseini, Seyed Mohammad Sadegh Pezeshki, Alireza Ghasemzadeh, Mehran Ghasemzadeh","doi":"10.1007/s11239-025-03121-2","DOIUrl":"https://doi.org/10.1007/s11239-025-03121-2","url":null,"abstract":"<p><p>As a readily available analysis, the complete blood count (CBC) has interpretative value and provides useful information about diseases, their differential diagnosis, and prognosis. Considering the crucial role of platelets in the pathogenesis of cardiovascular diseases (CVDs), examining their morphological changes can also be of particular interest. Therefore, this review aims to highlight the importance of interpreting platelet indices in coronary artery disease (CAD) and to provide appropriate explanations of the mechanisms behind changes in these parameters. To this end, the study presented here first introduces platelet indices obtained from automated blood cell counters, including mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and immature platelet fraction (IPF), while highlighting their interpretative significance in different disease states. This review then continues by discussing and interpreting the parameters mentioned in CAD using previously published data. Since the pathogenesis of CAD is related to various conditions, including inflammatory status, biomechanical forces (caused by non-physiological shear stress), and extracorporeal interventions (particularly during on pump Coronary-artery bypass grafting), despite controversies, changes in platelet indices caused by each of these factors have been proposed as useful markers for monitoring the disease status and its prognosis. Taken together, this review first presents scientific hypotheses to justify the diagnostic value of conventional platelet parameters in CAD patients, while highlighting their prognostic importance under different conditions of disease. The present study also extends its discussion to some neglected analytical parameters, including platelet histogram and its interpretations to further validate the other well-known platelet parameters.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248523","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":"Advancements in research on the thrombo-inflammation mechanisms mediated by factor XII in ischemic stroke.","authors":"Han Liu, Kailin Yang, Shanshan Wang, Jinwen Ge","doi":"10.1007/s11239-025-03101-6","DOIUrl":"10.1007/s11239-025-03101-6","url":null,"abstract":"<p><p>Ischemic stroke (IS) is a major cause of mortality and disability, with thrombo-inflammation constituting a core pathophysiological mechanism. This process is closely linked to coagulation cascade activation, endothelial injury, immune cell infiltration, and neuronal damage. Coagulation factor XII (FXII), a key mediator of the contact activation pathway, has emerged as a promising therapeutic target due to its dual role in pathological thrombosis and immune regulation, without compromising physiological hemostasis. However, the clinical translation of FXII-targeted therapies is hindered by paradoxical observations. Recent studies highlight that FXII's functional complexity stems from its structural and spatial heterogeneity: full-length FXII derived from the liver and short FXII mRNA isoforms expressed in neurons mediate distinct biological effects. While FXII contributes to neuroinflammation and vascular injury via endothelial-platelet-neutrophil interactions, neuron-derived FXII exhibits neuroprotective effects through HGF-mediated signaling pathways. Additionally, circulating FXIIa promotes vascular remodeling by enhancing endothelial growth factor (VEGF) release. This review summarizes the multifaceted regulatory mechanisms of FXII in IS, focusing on its structure, distribution, preclinical-clinical paradox, and current therapeutic strategies. Special emphasis is placed on its domain-specific functions and the neuroprotective effects of FXII.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"608-622"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016904","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}