Journal of Thrombosis and Thrombolysis最新文献

{"title":"Management of thrombocytopenia and anticoagulant therapy in patients with hematological malignancy on chemotherapy: a binational prospective study (TAT study).","authors":"Elie Jalaber, Corentin Orvain, Vasiliki Papadopoulou, Alexis Genthon, Valentin Daguerre, Sabrina Barrière, Alice Teste, Emmanuelle Tavernier, Elisabeth Daguenet, Emilie Chalayer","doi":"10.1007/s11239-025-03085-3","DOIUrl":"10.1007/s11239-025-03085-3","url":null,"abstract":"<p><p>Anticoagulant use in patients with hematological malignancies treated on intensive chemotherapy represents a management challenge because of concomitant thrombocytopenia. This prospective multi-center cohort included 100 patients with hematological malignancies on anticoagulation. The aims of the study were to assess the incidence of WHO grade ≥ 2 bleeding, describe physician management strategies during thrombocytopenia (platelet count < 50 × 10⁹//L), and examine short-term outcomes and risk factors for bleeding and thrombosis. Median patients age was 60 years and median duration of severe thrombocytopenia was 16 days. The 30-day cumulative incidence of WHO grade ≥ 2 bleeding was 29.3% (95% CI 19.4-39.8), grade 4 bleeding was 7.2% (95% CI 2.8-14.2) and incidence of thrombus recurrence/progression was 6.2% (95% CI 2.2-13.3). No deaths occurred. The majority of patients received full-dose anticoagulation with a high platelet transfusion threshold. Half of the bleeding episodes grade ≥ 2 occurred with platelets counts between 20 and 50 × 10⁹/L. Longer period of full-dose anticoagulation during thrombocytopenia was associated with increased bleeding risk (16 days [IQR: 6-29] for participants who presented ≥ grade 2 bleeding versus 7 days for those who did not [IQR: 2-14], p < 0.001). So was a HAS-BLED score ≥ 3 (HR = 9 [4.1-20], p < 0.001). Multiple myeloma diagnosis was associated with lower bleeding risk versus other hematological malignancies (HR = 0.2 [0.0-0.9], p = 0.05). Our study underscores the complex trade-off between preventing thrombotic events' progression or recurrence and avoidance of bleeding. We highlight specific clinical scenarios and consider different risk factors. Future randomized controlled trials are required for these complex situations to achieve a rationalization of their management.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"646-656"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649588","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":"Treatment of isolated distal deep vein thrombosis: an international survey of healthcare professionals.","authors":"Ilia Makedonov, Lior Kapitanski, Joris Giai, Céline Vermorel, Elisabeth Chevrier, Grégoire Le Gal, Susan R Kahn, Lina Khider, Marie-Antoinette Sevestre, Jameel Abdulrehman, Jean-Luc Bosson, Marc Righini, Jean-Philippe Galanaud","doi":"10.1007/s11239-025-03091-5","DOIUrl":"10.1007/s11239-025-03091-5","url":null,"abstract":"<p><p>Isolated distal deep venous thrombosis (iDDVT) is an infra-popliteal DVT without pulmonary embolism (PE). It is a common condition, but its management remains debated. We conducted a survey distributed by email to the members of the French Society of Vascular Medicine, Thrombosis Canada, the Swiss Society of Angiology and INVENT-VTE research networks; Our objectives were to determine how healthcare professionals specialized in thrombosis manage iDDVT and to obtain experts input on the design of a future clinical trial. Participants were asked how they diagnosed and managed iDDVT and what should be the treatment arms of a future clinical trial on iDDVT management. 472 thrombosis specialists answered the questionnaire, mainly from France (n = 337), Canada (n = 61) and Switzerland (n = 28). Overall, 87.9% (n = 405) of respondents stated that their center always performed whole leg ultrasound in case of suspected DVT and that they managed patients with iDDVT usually at least once a week in 50.3% (n = 229) of cases. In 91.0% (n = 415) of cases respondents treated patients with iDDVT with anticoagulation more than 75% of time, with therapeutic doses and for a duration of 3 months in 90.2% (n = 406) and 74.7% (n = 334) of cases respectively. Most respondent managed muscular and deep-calf vein DVT similarly. More than 60% of respondents favored future trials comparing prophylactic versus therapeutic anticoagulation. Our real-world, international, practice survey of healthcare professionals shows that almost all respondents always conduct whole leg ultrasonography in case of suspected DVT and that they treat iDDVT with therapeutic anticoagulation usually for 3 months.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"657-662"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975119","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":"Edoxaban treatment without initial heparin lead-in for acute venous thromboembolism: insight from the COMMAND VTE registry-2.","authors":"Yuta Tsujisaka, Yugo Yamashita, Takeshi Morimoto, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Norimichi Koitabashi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Koh Ono, Takeshi Kimura","doi":"10.1007/s11239-025-03105-2","DOIUrl":"10.1007/s11239-025-03105-2","url":null,"abstract":"<p><p>The package insert of edoxaban for acute venous thromboembolism (VTE) recommended administration following initial parenteral anticoagulation including heparin. We explored the effectiveness and safety of edoxaban for acute VTE without initial heparin lead-in treatment. The COMMAND VTE Registry-2 is a multicenter registry enrolling 5197 consecutive acute symptomatic VTE patients in Japan between January 2015 and August 2020. The current study population consisted of 1842 patients with acute VTE treated with edoxaban. The baseline characteristics and clinical outcomes were compared between the 2 groups with or without initial heparin lead-in treatment stratified by pulmonary embolism (PE) (848 patients) and deep vein thrombosis (DVT) only (994 patients). Propensity score (PS) matching analysis was performed to balance potential baseline differences. PE and DVT patients without heparin lead-in treatment accounted for 225 (27%) and 750 (75%), respectively. PS matching provided 195 pairs of PE patients and 224 pairs of DVT patients. There was no significant difference between the no heparin and heparin groups in the cumulative 30-day incidence of all-cause death (PE: 2.6% vs. 4.2%, P = 0.40; DVT: 2.7% vs. 3.2%, P = 0.78) and a composite of all-cause death, recurrent VTE, or major bleeding (PE: 5.8% vs. 8.4%, P = 0.32; DVT: 4.6% vs. 6.4%, P = 0.41). In the current real-world VTE registry, a substantial proportion of patients with acute VTE were treated with edoxaban without initial heparin lead-in treatment. There was no obvious signal suggesting worse short-term clinical outcomes with edoxaban treatment without versus with initial heparin lead-in treatment.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"591-600"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173905","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":"A Mendelian randomization and animal study on the causal relationship between gut microbiota and ischemic stroke.","authors":"Zhen Wei, Jinjian Li, Xue Wang, Xu Wang, Dexi Zhao","doi":"10.1007/s11239-025-03120-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03120-3","url":null,"abstract":"<p><p>A growing body of evidence points to a strong link between ischemic stroke and the gut microbiome. Given the wide diversity present in gut microbiota, this research intends to employ advanced and thorough data to investigate the causative relationship between gut microbiota and ischemic stroke. We performed a two-sample study using Mendelian randomization to clarify the causal connection between gut microbiota and ischemic stroke. The GISCOME network encompassed 6,021 individuals with ischemic stroke, primarily of European descent. A total of 473 gut microbial taxa were extracted from the genome-wide association study catalog. The research involved a forward Mendelian randomization approach(gut microbiota as exposure, ischemic stroke as outcome). A variety of analytical techniques were applied, including inverse variance weighting, Weighted Median, MR-Egger, Weighted Mode, and Simple Mode. Following this, a sensitivity analysis was performed to confirm the reliability of our findings. Rats underwent treatment using a middle cerebral artery occlusion model, and after 7 days, stool samples were collected for 16s sequencing to assess changes in gut microbiota and to compare these with the Mendelian randomization results. Our analysis suggests a potential causal association between gut microbiota and ischemic stroke. Through forward causal analysis, relationships of causality between 20 different gut microbial taxa and ischemic stroke were unveiled. Findings from 16s sequencing indicated that there was an overlap of 6 gut microbial taxa with the results of Mendelian randomization. The results of our research indicate a direct link between gut microbiota and ischemic stroke, offering possible direction for upcoming clinical trials.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199523","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":"Comparison of safety and efficacy of ultrasound-accelerated thrombolysis vs. standard catheter-directed thrombolysis for the management of acute pulmonary embolism - a systematic review and meta-analysis.","authors":"Siddhant Passey, Hritvik Jain, Jagriti Jha, Kelin Zhong, Chia-Ling Kuo, Marissa Iverson, Haris Patail, Saurabh Joshi, Joseph Ingrassia","doi":"10.1007/s11239-025-03100-7","DOIUrl":"10.1007/s11239-025-03100-7","url":null,"abstract":"<p><p>Standard catheter-directed thrombolysis (SCDT) and Ultrasound-assisted thrombolysis (USAT) are used in intermediate and high-risk pulmonary embolism (PE). SCDT uses low-dose thrombolytic agents, minimizing bleeding risk. USAT adds acoustic energy to improve fibrin breakdown and thrombolytic penetration. A systematic literature search spanning PubMed/Medline, Embase, CENTRAL, CINAHL, and ClinicalTrials.gov databases (from inception to 17 June 2024) was conducted to retrieve studies comparing USAT to SCDT for managing acute PE. Risk of bias was assessed using Cochrane tools for randomized and non-randomized trials. Odds ratio (OR) and mean difference (MD) were pooled using random effects models. Statistical analyses were performed in R version 4.2.2. 11 studies with 37,398 patients (8,762: USAT and 28,636: SCDT) were included. The mean reduction in right ventricular to left ventricular diameter ratio was lower for USAT (MD: -0.12; 95% CI: -0.19, -0.06) compared to SCDT. There was no statistically significant difference between USAT and SCDT for odds of in-hospital mortality, intracranial hemorrhage, bleeding requiring transfusion or for means of hospital or ICU length of stay, or reduction in pulmonary artery pressures. Safety or efficacy of USAT is not superior to SCDT in patients with acute PE. Results were limited due to variable infusion protocol across studies and heterogeneity of results among studies. Large-scale randomized controlled trials (RCTs) are needed to corroborate these findings.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"623-635"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975114","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":"Genetic markers of thrombophilia as predictors of outcome in colorectal cancer.","authors":"Valéria Tavares, Catarina Lopes, Catarina Macedo-Silva, Mónica Farinha, João Costa, Maria Isabel Vilas-Boas, Sofia Pinelas, Joana Assis, Mário Dinis-Ribeiro, Deolinda Pereira, Carina Pereira, Rui Medeiros","doi":"10.1007/s11239-025-03106-1","DOIUrl":"10.1007/s11239-025-03106-1","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is the second leading cause of malignancy-related death worldwide, representing a significant health concern. Understanding the disease pathogenesis and identifying potential prognostic biomarkers is critical for improving patients' clinical outcomes. Haemostatic components implicated in cancer-associated thrombosis (CAT) seem to favour CRC progression. As such, genetic markers of thrombophilia might be potential prognostic biomarkers among patients with this malignant disease. To offer perspectives, a retrospective cohort study with 204 CRC patients was conducted to investigate the impact of seven germline haemostatic gene determinants on patient prognosis. A sex-stratified analysis was performed as the variants seem to have a distinct influence depending on the patient's sex. Genomic DNA was extracted from FFPE samples enriched in tumour cells. While the polymorphisms CNTN6 rs6764623 (CC/CA vs. AA; adjusted hazard ratio (aHR) = 0.44; 95% confidence interval (CI), 0.20-0.96; P = 0.040), PTGS2 rs20417 (GG vs. CC/CG; aHR = 2.88; 95%CI, 1.10-7.51; P = 0.031) and RGS7 rs2502448 (TT vs. CT/CC; aHR = 2.35; 95%CI, 1.20-4.61; P = 0.013) were associated with the five-year risk of cancer recurrence, ITGB3 rs5918 was a predictor of the risk of death due to all causes, particularly among male patients (TT vs. CT/CC; aHR = 2.05; 95% confidence interval (CI), 1.13-3.72; P = 0.019). While a sex-specific impact of the SNPs was observed, further investigation in larger cohorts, particularly with an increased representation of female patients, is required to confirm these associations. Collectively, these markers could help improve the prognosis assessment of CRC patients towards a more personalised intervention.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"663-678"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159582","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":"Direct oral anticoagulants do not affect miR-27a-3p expression, a regulator of coagulation cascade, in atrial fibrillation patients.","authors":"Georgia Ragia, Myria Pallikarou, Chrysoula Michou, Thomas Thomopoulos, Georgios Chalikias, Athanasios Trikas, Dimitrios N Tziakas, Vangelis G Manolopoulos","doi":"10.1007/s11239-025-03102-5","DOIUrl":"10.1007/s11239-025-03102-5","url":null,"abstract":"<p><p>miR-27a-3p targets several proteins on the coagulation cascade. The potential effect of direct oral anticoagulants (DOACs) treatment on miR-27a-3p expression and their broader regulative effect on anticoagulation is unknown. Fifty-nine atrial fibrillation patients treated with rivaroxaban (n = 19), apixaban (n = 27) or dabigatran (n = 13), were included in the study. miR-27a-3p expression was analyzed at baseline and after 7 days of DOAC therapy by using a predesigned TaqMan assay. Relative quantitation of miR-27a-3p expression was calculated and compared in pooled population and in different sample groups. DOAC therapy did not alter miR-27a-3p expression (0.80 fold-change, p = 0.486, pooled population; 0.839 fold-change, p = 0.706, rivaroxaban; 0.921 fold-change, p = 0.800, apixaban; 0.733 fold-change, p = 0.540, dabigatran). miR-27a-3p expression did not differ between controls and bleeding cases (0.833 fold-change, p = 0.588, baseline). Female patients had a trend towards increased baseline expression (1.564 fold-change, p = 0.177) and reduced expression after DOAC treatment (0.683 fold-change, p = 0.243) compared to male patients. Despite the regulatory role of miR-27a-3p on coagulation cascade, treatment with DOACs did not alter its expression. However, additional studies in different ethnic groups are necessary to fully elucidate the effect, if any, of DOACs on miR-27a-3p expression.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"636-645"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12148961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979273","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":"The current status and future perspective of extended anticoagulation therapy for cancer-associated venous thromboembolism.","authors":"Wei Xiong, Yugo Yamashita, Takahiro Horie, Koh Ono","doi":"10.1007/s11239-025-03103-4","DOIUrl":"10.1007/s11239-025-03103-4","url":null,"abstract":"<p><p>Cancer-associated venous thromboembolism (VTE) is one of important complications in cancer patients, with implications for morbidity, mortality, recurrent VTE, bleeding events, and quality of life. Extended anticoagulation therapy beyond 3-6 months of mandatory duration of anticoagulation therapy following an episode of VTE has been an unsolved issue in the management of patients with VTE. The current guidelines recommend extended anticoagulation therapy for patients with cancer-associated VTE because these patients could be at a high risk of recurrent VTE. However, patients with cancer-associated VTE are also at a high risk of bleeding events with anticoagulation therapy, which provoking dilemma taking a good balance between thrombotic and bleeding risk with extended anticoagulation therapy in the daily clinical practice. Thus, whether to extend anticoagulation therapy, which anticoagulants to use, what dosages of anticoagulants to take, and how long to extend the duration of anticoagulation therapy have been still a matter of active debate in these patients. So far, several studies including randomized clinical trials (RCT) have provided several insights into the optimal duration and dosage of extended anticoagulation therapy. Although recent RCTs significantly progress the understanding of extended anticoagulation therapy for cancer-associated VTE, there has been still a number of unmet needs in these patients. In the future perspective, a personalized approach that takes into account multiple factors could be needed for the optimal implementation of extended anticoagulation therapy in an individual patient with cancer-associated VTE. The current review overviews the current status and future perspective of extended anticoagulation therapy for cancer-associated VTE.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"601-607"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017299","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":"Prognostic implications of factor VIII levels in African Americans: insights from a propensity-matched US-based multicenter retrospective analysis.","authors":"Kerollos Abdelsayed, Qasi Najah, Ahmed Almahdy Mohamed, Basma Ehab Amer, Ahmed Eltanbedawi, Basel Abdelazeem, Arvind Kunadi, Daniel Brito","doi":"10.1007/s11239-025-03119-w","DOIUrl":"https://doi.org/10.1007/s11239-025-03119-w","url":null,"abstract":"<p><p>Elevated levels of coagulation factor VIII (FVIII) are more commonly observed in African Americans (AAs) and have been linked to higher risks of thromboembolism and other cardiovascular comorbidities. However, the prognostic implications of elevated FVIII levels in AAs have not been well-studied. We queried the TriNetX (August 2005 to August 2019) to compare AAs with FVIII > 200% to those with 50-200%. A propensity score match (PSM) was used to adjust for potential confounders. Primary outcomes were assessed within five years after the index FVIII and included major adverse cardiovascular events (MACE), while exploratory outcomes included venous thromboembolism (VTE), cerebrovascular events, new-onset heart failure (HF), HF exacerbations, and all-cause mortality. A survival analysis using log-rank tests, Kaplan-Meier curves, and a univariate Cox regression was performed to investigate the association of FVIII with the time to development of each outcome after PSM through the hazard ratio (HR). A multivariate-adjusted analysis was performed before PSM for select outcomes. An E-sensitivity analysis was implemented to assess the association of unmeasured confounders post-PSM. Initially, 11,199 patients were identified from the TriNetX database. After PSM, 3,833 patients with balanced baseline characteristics were included in each cohort. Patients with elevated FVIII had a higher 5-year risk of MACE (HR: 1.14, 95% CI: 1.02-1.27, P = 0.017), VTE (HR: 1.23, 95% CI: 1.11-1.35, P < 0.001), new-onset HF (HR: 1.41, 95% CI: 1.14-1.74, P = 0.001), and mortality (HR: 1.37, 95% CI: 1.20-1.57, P < 0.001). In adjusted models, the association between FVIII and new-onset HF attenuated after accounting for vWF and comorbidities, while the mortality risk remained significant (HR: 1.53, 95% CI: 1.34-1.73, P < 0.001). No significant association was found between FVIII and HF exacerbation. Elevated FVIII levels in AAs are linked to a higher risk of adverse cardiovascular outcomes, including new-onset HF. Future research should explore the dynamic interaction of FVIII with these outcomes, including its potential causal role and its use as a marker for the development of these conditions.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180073","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":"Outcomes of patients with in-hospital stroke with and without active cancer.","authors":"Hiroyuki Kawano, Ayumi Sakurai, Yuuki Takizawa, Risa Toyota, Reona Miwa, Hayate Onuki, Ayane Kawatake, Atsushi Yamamichi, Mikito Saito, Kaoru Nakanishi, Eisaku Tsuji, Shinya Tomari, Yuko Honda, Yoshiko Unno, Mayumi Uchida, Teruyuki Hirano","doi":"10.1007/s11239-025-03117-y","DOIUrl":"https://doi.org/10.1007/s11239-025-03117-y","url":null,"abstract":"<p><strong>Background: </strong>Cancer is common in patients with ischemic stroke. The aim was to reveal the differences in acute management and outcomes of patients with in-hospital acute ischemic stroke (IHS) with and without active cancer.</p><p><strong>Methods: </strong>Two hundred IHS patients (58% male, median age 78 years, median NIHSS score 9) from August 2016 to July 2023 at our institution were divided into two groups: 70 with active cancer (IHS-AC 35%) and 130 without AC (IHS-nonAC 65%). Patients' characteristics, time intervals, and clinical outcomes were compared between the groups. A good clinical outcome was defined as modified Rankin Scale score 0-3.</p><p><strong>Results: </strong>IHS was identified most frequently by a nurse (IHS-AC group 67%, IHS-nonAC group 71%). Time from recognition to stroke physician assessment (37 vs. 90 min, p = 0.008) was shorter in the IHS-AC group. Good clinical outcomes at discharge (31% in each group, p = 1.000) and in-hospital mortality (IHS-AC group 29%, IHS-nonAC group 21%, p = 0.225) were similar in the groups. The rates of reperfusion therapy (intravenous rt-PA and/or mechanical thrombectomy) were 16% in the IHS-AC group and 15% in the IHS-nonAC group (p = 1.000). The rates of good clinical outcomes and mortality at discharge in patients with reperfusion therapy were each 36%.</p><p><strong>Discussion and conclusion: </strong>One-third of IHS patients had comorbid active cancer. The rates of reperfusion therapy and good clinical outcomes were similar in groups with and without active cancer. Acute stroke management should not be withheld solely based on cancer.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144159586","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}