Journal of Thrombosis and Thrombolysis最新文献

{"title":"Hydrogen sulphide alleviates platelet dysfunction in patients with type 2 diabetes.","authors":"Minqi Zhou, Difei Lu, Anna Jiang, Chenxu Zhao, Yao Lu, Bo Zheng, Linzi Miao, Youyuan Huang, Chenxue Qu, Ying Gao","doi":"10.1007/s11239-025-03071-9","DOIUrl":"10.1007/s11239-025-03071-9","url":null,"abstract":"<p><p>Hyperglycaemia stimulate platelet activation by reducing platelet H₂S concentrations, potentially leading to cardiovascular events. Exogenous supplementation with H₂S reversed this abnormal platelet activation under hyperglycaemia.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"433-442"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370801","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":"Incidence of arterial and venous thromboembolism in cancer patients- insights from more than 5,000,000 patients.","authors":"Hai-Wei Deng, Jie Li, Yuan-Sheng Zhai, Wei-Yi Mei, Xiao-Xiong Lin, Qing Xu, Qian Zheng, Jin-Sheng Chen, Zhi-Bin Huang, Xing Wu, Yun-Jiu Cheng","doi":"10.1007/s11239-025-03083-5","DOIUrl":"10.1007/s11239-025-03083-5","url":null,"abstract":"<p><p>The reported incidence of arterial thromboembolism (ATE) and venous thromboembolism (VTE) after cancer varies. A meta-analysis was performed to define the incidence of thromboembolism (TE) in cancer patients. Articles were searched in PubMed and Embase from inception to November 1, 2023. Studies reporting the incidence data or data from which incidence could be estimated among patients with cancer and the explicit follow-up duration were included. Seventy-four studies involving 5,059,134 cancer patients were identified. The incidence rate per 1000 person-years was 11.60 (95% CI 7.62-15.58) for ATE, 6.11 (95% CI 3.70-8.53) for myocardial infarction, 9.07 (95% CI 7.48-10.66) for ischemic stroke, 2.11 (95% CI 0.89-3.31) for another ATE, 26.32 (95% CI 24.46-28.18) for VTE, 12.69 (95% CI 11.51-13.87) for deep vein thrombosis, 5.94 (95% CI 5.29-6.59) for pulmonary embolism, and 13.18 (95% CI 9.93-16.42) for another VTE. In addition, the highest incidence of ATE was observed in patients with gastrointestinal cancer, while patients with pancreatic cancer had the highest incidence of VTE. The risk of ATE and VTE increased at the initial stage of cancer, and then declined and became non-significant. This meta-analysis provided overall estimates of ATE and VTE incidence in cancer patients, adding an important insight into the trajectory of the development of TE in cancer patients, which could help the early detection of TE in cancer patients in the future.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"370-379"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597313","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":"Evaluation of unfractionated heparin therapy for venous thromboembolism using adjusted body weight in elderly or higher weight patients.","authors":"Arielle J Hopkins, Terence Chau, Benjamin Pullinger, Sungwook Kim, Justin J Delic, Lauren A Igneri, Soyoung Kim","doi":"10.1007/s11239-024-03060-4","DOIUrl":"10.1007/s11239-024-03060-4","url":null,"abstract":"<p><p>The use of weight-based unfractionated heparin (UFH) infusions is the standard of care in hospital management of venous thromboembolism (VTE). Initial dosing strategies for UFH in older adults and higher body weight patients remain uncertain given differences in pharmacokinetics and concerns for over-anticoagulation. Methods: This was a single-center, retrospective, pre-post study involving older adults aged ≥ 65 years and patients weighing ≥ 100 kg with suspected or confirmed VTE to determine if the use of adjusted body weight (AdjBW)-based UFH regimens improves time to therapeutic anti-Xa levels compared to total body weight (TBW)-based regimens Patients received weight-based UFH infusions, dosed according to either TBW or AdjBW, to target a therapeutic anti-Xa level. Each cohort consisted of 40 patients, stratified by whether they met age or weight criteria to ensure equal representation of elderly and higher body weight patients between cohorts. The median time to therapeutic anti-Xa levels was shorter in the AdjBW group compared to the TBW group (13.6 h versus 20.9 h; point estimate 5.3 h (95% CI 0.2 to 9.9)). This finding was driven by those aged ≥ 65 years and those who received a bolus dose at the start of the infusion. Among older adults and higher weight adults with suspected or confirmed VTE, the use of AdjBW to guide heparin infusion initiation was associated with shorter time to therapeutic anti-Xa levels. This finding driven by the older adult sample and the subgroup analyses did not find a statistically significant difference in time to therapeutic anti-Xa levels in higher body weight patients aged less than 65 years.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"420-426"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780476","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":"Apixaban versus warfarin for treatment of venous thromboembolism in patients with severe renal impairment: a multicenter study.","authors":"Paige Hanke, Ma Emmanuelle Domingo, Ghenella Salanio, Kulsoom Ahmed, Jingyu Hu, Kristin Hendricks, Jacob Howard, Tori Hashimura, Chris Guiliano, Bradley J Haan, Tsz Hin Ng, Denise Kelley, Tamara Knight, Kathleen Koopman, Monika Obstoj, Thomas Breeden, Dumitru Sirbu, Meredith Romano, Andrew Harpenau, Rebecca Konneker, Jason Acevedo, Neil Pan, Stephanie B Edwin","doi":"10.1007/s11239-025-03075-5","DOIUrl":"10.1007/s11239-025-03075-5","url":null,"abstract":"<p><p>Limited evidence exists regarding the use of factor Xa inhibitors for the treatment of venous thromboembolism (VTE) in patients with severe renal impairment. Notably, these patients were excluded from clinical trials.The goal of this study was to examine the safety and effectiveness of apixaban versus warfarin for the treatment of acute VTE in patients with severe renal impairment.This retrospective cohort study was conducted across 36 Ascension Health sites between 2014 and 2024. Adult patients receiving apixaban or warfarin for VTE treatment with severe renal impairment were included. The primary outcome was time to composite bleeding event within six months.This study included 1200 patients receiving apixaban and 600 patients receiving warfarin. Overall, 23.4% of the study population had ESRD requiring renal replacement therapy. Among patients not requiring renal replacement therapy, stage IV CKD was most common (43.8%). No difference in time to composite bleeding events (HR 1.01; 95% CI 0.74-1.38, p = 0.97) or recurrent VTE (HR 1.24; 95% CI 0.70-2.18, p = 0.46) were noted after controlling for confounders. Furthermore, major bleeding (4.7% vs. 7.5%, p = 0.43) and clinically-relevant non-major bleeding (4.3% vs. 6.2%, p = 0.08) were similar between groups. Apixaban was associated with a significantly reduced incidence of anticoagulation-related ED admission (6.8% vs. 9.8%, p = 0.02) compared to warfarin. Anticoagulation-related readmission (7.4% vs. 8%, p = 0.66) and time to all-cause mortality (5.2% vs. 6.2%, p = 0.38) were similar between groups.No differences in safety or effectiveness were noted between apixaban and warfarin, providing encouraging evidence to support the use of apixaban for treatment of acute VTE in patients with severe renal impairment.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"380-390"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476801","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":"Unveiling the complexities of catheter-related thrombosis: risk factors, preventive strategies, and management.","authors":"Hannah L King, Thalia Padilla-Lazos, Akshit Chitkara, Virginia Tan, Genevieve B Benedetti, Aya Agha, Kylee L Martens, Joseph J Shatzel","doi":"10.1007/s11239-025-03073-7","DOIUrl":"10.1007/s11239-025-03073-7","url":null,"abstract":"<p><p>Catheter-related deep venous thrombosis (CR-DVT) is a common complication of central venous catheters, however optimal prophylactic and treatment strategies have yet to be fully defined. While the use of anticoagulation for CR-DVT prophylaxis is not routinely recommended, current available data offer heterogeneous results due to small sample size, non-uniform study design, and varying comorbid conditions. Available guidelines for the treatment of CR-DVT generally recommend a limited duration of anticoagulation after catheter removal. If ongoing use is required and the device remains functional, guidelines support anticoagulation throughout the time the catheter remains in place. It is worth acknowledging that data guiding these recommendations is largely derived from observational studies of upper extremity CR-DVT, along with randomized trials of anticoagulation in patients with lower extremity DVT. Therefore, large, randomized controlled trials are desperately needed to define optimal management, especially in patients who are at high risk for bleeding. This review explores the epidemiology and risk factors of CR-DVT, diagnostic, prophylactic and treatment strategies, guideline recommendations, and future advances in the field, including the introduction of novel anticoagulants. With current available evidence, we also conclude with an individualized approach to preventing and managing CR-DVT to assist clinicians who are faced with this common clinical scenario.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"443-457"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557130","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":"Recanalization is more important than procedure time on outcome of thrombectomy in acute vertebrobasilar artery occlusion.","authors":"Wenya Lan, Danyu Feng, Kefan Qiu, Mingyang Du, Feng Qiu, Lulu Xiao, Wen Sun, Zhongming Qiu, Hongfei Sang, Lingfei Li, Kefeng Luan, Xinfeng Liu, Hui Cao","doi":"10.1007/s11239-025-03082-6","DOIUrl":"10.1007/s11239-025-03082-6","url":null,"abstract":"<p><p>Longer procedure time (PT) predicts worse prognosis after endovascular treatment (EVT) in acute vertebrobasilar artery occlusion (VBAO), but it remains unknown whether it is worth pursuing recanalization when the PT is obviously extended. Patients with acute VBAO who received EVT were retrospectively enrolled from 21 stroke centers in China from December 2015 to December 2018. Multivariable logistic analysis was performed to analyze the associations of PT with favorable outcome (defined as modified Rankin Scale score of 0 to 3) and mortality at 90 days. A total of 541 patients with median age of 64 years (IQR, 55-73) were included. The median baseline National institutes of Health stroke scale score was 23 (IQR, 14-28) and PT was 110 min (IQR, 74-156). The rate of favorable outcome was 36.5% in patients with PT 111-155 min (adjusted OR 0.51 [95% CI 0.28-0.92]) and 33.3% in patients with PT > 155 min (adjusted OR 0.52 [95% CI 0.29-0.93]) compared with 42.9% in patients with PT ≤ 75 min. Compared with the PT ≤ 75 min, PT of 111-155 min (adjusted OR 1.96 [95% CI 1.11-3.46]) and PT > 155 min (adjusted OR 2.10 [95% CI 1.21-3.66]) were associated with increased risks of mortality. Recanalization within four PT intervals were consistently associated with better outcomes compared with failure of recanalization (all P < 0.05). For acute VBAO patients treated with EVT, recanalization regardless of PT was associated with improved prognosis than failure of recanalization, supporting the continued pursuit of recanalization despite the PT being obviously extended. The findings need validation in randomized controlled trials.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"401-410"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624693","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":"Tissue factor pathway inhibitor levels and atherothrombotic events in patients with chronic kidney disease or diabetes.","authors":"Rowena Brook, Mani Suleiman, Joseph Rigano, Brandon Lui, Harshal Nandurkar, Prahlad Ho, Hui Yin Lim","doi":"10.1007/s11239-025-03077-3","DOIUrl":"10.1007/s11239-025-03077-3","url":null,"abstract":"<p><p>Increased tissue factor pathway inhibitor (TFPI) has been associated with cardiovascular disease (CVD). We aim to evaluate the predictive capability of TFPI for atherothrombotic events (ATE) in patients with chronic kidney disease (CKD) and diabetes. A prospective observational study was performed at Northern Health, Australia. Patients with CKD (estimated glomerular filtration ratio (eGFR) < 30 ml/min/1.73m²) and/or diabetes were recruited. Baseline total TFPI was measured and the median follow-up was 3.35 years. All patients with egfr < 30 ml/min/1.73m² were analysed as CKD cohort while the diabetes cohort analysis excluded those with egfr < 30 ml/min/1.73m². The primary outcome was ATE (myocardial infarction, stroke/transient ischaemic attack, critical limb ischaemia or sudden cardiac death). 220 patients were recruited, median age 63.5 years (IQR 51.0, 72.5) and 59.1% males (n = 130). No differences were seen in TFPI levels between the CKD (n = 77) and diabetes (n = 143) cohorts (35.4 vs. 36.4 ng/mL, p = 0.44). TFPI did not correlate with creatinine or HbA1c levels. 46 episodes of ATE were captured (6.69/100-person years (100PY)), with a higher rate in the CKD compared to the diabetes cohort (16.03/100PY vs. 2.53/100PY). In the CKD cohort, those who experienced ATE had higher TFPI with an optimal calculated cut-off (61.36ng/mL) associated with a subhazard ratio of 3.23 (95%CI 1.59-6.57). In the diabetes cohort however, TFPI was not significantly higher in those who experience ATE (40.1 vs. 34.4ng/mL, p = 0.35). We found elevated TFPI may predict prospective ATE, particularly in patients with CKD. While further validation studies are required, these findings highlight that coagulation changes may differ between high-risk CVD populations.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"391-400"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597338","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":"Comparison of the procoagulant activity between extracellular vesicles obtained from cellular monolayers and spheroids.","authors":"Araci M R Rondon, Sophie Featherby, Tainá Gomes, El Houari Laghmani, Camille Ettelaie, Henri H Versteeg","doi":"10.1007/s11239-025-03076-4","DOIUrl":"10.1007/s11239-025-03076-4","url":null,"abstract":"<p><p>Tissue factor (TF) is the main activator of blood coagulation and is associated with thrombosis and tumor progression. It can be released into the blood circulation incorporated within cancer cell-derived extracellular vesicles (EVs). In this study, we investigated the influence of two-dimensional (monolayer) and three-dimensional (spheroid) tumor cell culture methods, and co-culture with cancer-associated fibroblasts (CAF), on the level of EVs release and the associated TF release and activity. The density of EVs and TF released from spheroids and monolayers of Hs578t human breast cancer and CAF were measured by the concentration of the phosphatidylserine and TF-ELISA. For some experiments, cells were activated using a protease-activated receptor (PAR)-2-activating peptide (PAR2-AP). The concentration and EV's size were accessed by nanoparticle tracking analysis, and a clotting assay was used to evaluate TF pro-coagulant activity. Hs578t monolayers released sevenfold more EVs, and it was associated with an 11-fold higher TF antigen release than the spheroids cultures. Activation of the cells with a PAR2-AP resulted in a significant increase in the release of EVs and TF from the Hs578t monolayers, but no significant increase was observed in the spheroids, only from half Hs578t, half CAF spheroids. Taken together, our results demonstrate that monolayer cell cultures are capable of releasing more significant amounts of EVs and associated TF than spheroid cultures. Monolayers and spheroids have different behavior when we compare the release of EVs and TF. It is essential to consider it when choosing a cell model to study cancer-associated thrombosis.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"458-466"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556904","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":"In reply: letter to the editor about \"Direct oral anticoagulants in embolic stroke of undetermined source: an updated meta-analysis\".","authors":"Gabriel Marinheiro, Beatriz Araújo, André Rivera, Gabriel de Almeida Monteiro, Laís Silva Santana, Marianna Leite, Antonio Mutarelli, Agostinho C Pinheiro, Eberval Gadelha Figueiredo, João Paulo Mota Telles","doi":"10.1007/s11239-025-03080-8","DOIUrl":"10.1007/s11239-025-03080-8","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"481-483"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764484","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":"Thrombus composition in ischaemic stroke: histological and radiological evaluation, and implications for acute clinical management.","authors":"Esmee Dohle, Abhishekh H Ashok, Shiv Bhakta, Isuru Induruwa, Nicholas R Evans","doi":"10.1007/s11239-025-03074-6","DOIUrl":"10.1007/s11239-025-03074-6","url":null,"abstract":"<p><p>Ischaemic stroke is one of the key causes of morbidity and mortality worldwide. Although rapid reperfusion through thrombolysis or mechanical thrombectomy is the cornerstone of acute management, the efficacy of these interventions is influenced by the underlying composition of the occluding thrombus, which varies widely. Histological examination of retrieved thrombi allows the determination of thrombus composition and may inform aetiology and secondary prevention strategies. Additionally, radiological features may provide valuable pre-treatment insights into thrombus composition to help predict treatment success. This narrative review discusses histological and radiological indicators of thrombus composition, and how this may predict success of thrombolysis and thrombectomy. Furthermore, it discusses how these insights can be applied in the diagnostic work-up of embolic stroke of undetermined source (ESUS), and the potential utility of emerging biomarkers relating to thrombus formation, in order to optimise secondary prevention strategies.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"355-369"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673577","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}