Journal of Thrombosis and Thrombolysis最新文献

{"title":"Association of lipid-lowering drugs with venous thromboembolism outcomes: a phenome-wide association study and a drug-target Mendelian randomization study.","authors":"Zhang Lingyu, Zhong Wanting, Guo Ying, Jin Qianqian, Wang Chunfang","doi":"10.1007/s11239-025-03108-z","DOIUrl":"https://doi.org/10.1007/s11239-025-03108-z","url":null,"abstract":"<p><p>Common anticoagulants can lead to potentially fatal internal bleeding, which restricts their extensive use in the prevention of Venous thromboembolism (VTE). We aimed to use a PheWAS and MR analysis to find novel therapeutic targets for VTE events(containing pulmonary embolism (PE) and deep vein thrombosis (DVT)) and offer new opportunities to develop safer and more effective preventative medications. The present study utilized a PheWAS analysis to examine 2005 health-related phenotypes from the MRC-IEU consortium on VTE risk genetic variants to pinpoint possible treatment targets. Subsequently, through Summary-data-based MR (SMR) and inverse-variance-weighted MR (IVW-MR) analysis, we assessed the associations between lipid-lowering drug targets (including HMGCR inhibitor, PCSK9 inhibitor, and NPC1L1 inhibitor) and VTE events. We utilized two types of genetic instruments to represent the exposure to lipid-lowering drugs: eQTLs of drug target genes and genetic variants within or near drug target genes associated with LDL cholesterol from genome-wide association studies. PheWAS analysis identified 13 cholesterol-related traits significantly associated with VTE risk, indicating lipid-lowering drugs might be targets of VTE outcomes. SMR analysis showed that higher NPC1L1 gene expression in the blood was a risk factor for PE (OR = 1.107, 95%CI = 1.026-1.195; p = 0.009). Additionally, an IVW-MR association was found between LDL mediated by NPC1L1 and blood clot in the lung (OR = 4.091, 95% CI = 1.375-12.173; p = 0.011). This study suggested a potential causal relationship between NPC1L1 inhibition and the reduced risk of PE.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142819","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":"Association between stable angina pectoris and gastric cancer: two-sample bidirectional mendelian randomization study.","authors":"Haoyu Zhao, Xintong Ye, Chuying Yu, Jie Huang, Tianxiang Xu, Canyang Song, Qingsheng Liu","doi":"10.1007/s11239-025-03089-z","DOIUrl":"https://doi.org/10.1007/s11239-025-03089-z","url":null,"abstract":"<p><p>To explore the possible causal link between stable angina pectoris (SAP) and gastric cancer (GC) through Mendelian randomization analysis. We used data from genome-wide association studies (GWAS) statistical datasets, with SAP and GC screened as relevant instrumental variables for exposure factors, respectively. To evaluate the causal link between SAP and GC, a two-sample bidirectional Mendelian randomization analysis was conducted, leveraging genetic variants as instrumental variables. In addition, effects of horizontal pleiotropy were evaluated using MR-PRESSO and MR-Egger intercept analysis. Sensitivity analysis was performed using Cochran Q test and \"leave one out\" method. The study showed a significant causal relationship between SAP and GC in the analysis with SAP as the exposure variable (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.69-0.87, p = 0.000027 using inverse variance weighting [IVW]). Sensitivity analysis confirmed the robustness of Mendelian randomization results. In the analysis of GC as an exposure variable, gastric cancer and SAP also showed a significant causal association (OR = 0.87, 95%CI = 0.77-0.98, p = 0.024 using IVW), but sensitivity analysis suggested a significant pleiotropy between instrumental variables (p = 0.0093 using MR-Egger intercept analysis), which cast doubt on the reliability of the study and requires careful interpretation of the results. Existing studies suggest that individuals with SAP may have a lower risk of developing GC. However, the precise causal relationship, particularly regarding whether GC contributes to an increased risk of SAP, remains unclear and warrants further investigation. GC and ischemic heart disease which represented by SAP are both associated with oxidative stress in their pathogenesis. Local tissue-induced mitochondrial autophagy or cellular ferroptosis triggers a systemic response, potentially underlying the negative correlation between GC and SAP. Thus, therapeutic strategies that target the interplay between local tissue and systemic responses in oxidative stress may hold promise for the benefits to patients.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021154","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":"Atrial fibrillation and ischemic stroke in cancer: the latest scientific evidence, current management, and future directions.","authors":"Lakshya Seth, Nickolas Stabellini, Shawn Doss, Vraj Patel, Viraj Shah, Gregory Lip, Susan Dent, Michael G Fradley, Lars Køber, Avirup Guha","doi":"10.1007/s11239-025-03104-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03104-3","url":null,"abstract":"<p><p>Atrial fibrillation is the most common cardiac arrhythmia and is a major risk factor for ischemic stroke. Atrial fibrillation and ischemic stroke are major cardiovascular complications in cancer patients, who have a higher burden and worse outcomes than the general population. Clinical risk stratification scores for stroke and bleeding, commonly used in the general population to estimate thromboembolic and bleeding risk, respectively, are less well validated in cancer patients, who have historically been excluded in clinical trials. There is a lack of consensus opinion on how to effectively risk-stratify cancer patients based on the currently available tools and a need for cancer-specific scores that offer a tailored approach to each patient in order to more effectively stratify ischemic stroke and bleeding risk in this cohort of patients. Cancer-mediated physiologic changes and adverse effects of antineoplastic therapy have been implicated as etiologies of the increased risk for both atrial fibrillation and ischemic stroke. Risk stratifying scores such as CHA₂DS₂-VASc and HAS-BLED, commonly used in the general population, are less well validated in cancer patients. There is a need for cancer-specific scores that can more effectively stratify ischemic stroke and bleeding risk in cancer patients, although given the heterogeneity of cancers, whether a \"one score fits all\" is uncertain.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000228","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":"Left atrial appendage occlusion in patients with cancer.","authors":"Nathaniel E Davis, Samuel A Shabtaie, Nicholas Y Tan","doi":"10.1007/s11239-025-03098-y","DOIUrl":"https://doi.org/10.1007/s11239-025-03098-y","url":null,"abstract":"<p><p>Atrial fibrillation (AF) and malignancy share a complex relationship, significantly complicating patient management. Patients with cancer, particularly those with lung, gastrointestinal, genitourinary, and hematologic malignancies, are at increased risk of AF due to cancer-related hypercoagulability, proinflammatory cytokines, and treatment-related factors. This population faces unique thrombotic and bleeding risks, challenging standard management approaches. Anticoagulation is often complicated by drug-drug interactions with cancer therapies and heightened bleeding risks, including thrombocytopenia and coagulopathy. Left atrial appendage occlusion (LAAO) offers an alternative stroke prevention strategy for patients unable to tolerate long-term anticoagulation. By isolating the left atrial appendage, LAAO reduces thromboembolic risk while minimizing bleeding complications. Indications include patients with elevated stroke risk with contraindications to anticoagulation due to nonreversible causes, such as recurrent bleeding or significant drug interactions. Surgical LAAO may also be considered during cardiac surgery in patients with AF and high thromboembolic risk, with previous studies showing reduced risk of thromboembolic complications. Outcomes of LAAO in cancer patients are generally favorable, with studies showing comparable stroke rates, bleeding risks, and mortality to non-cancer populations. However, malignancy-specific complications, such as device-related thrombus, require further investigation. LAAO provides a promising option for stroke prevention in this complex population, but further research is needed to refine patient selection and optimize outcomes.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788673","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":"Exploring the relationship of platelet aggregation function with efficacy and safety outcomes following the administration of prasugrel and clopidogrel in patients with thrombotic stroke: a post hoc analysis of PRASTRO pooled studies.","authors":"Kazumi Kimura, Masahiro Kamouchi, Yuji Matsumaru, Tetsuya Kimura, Rina Katsuro, Jun Hosokawa, Takanari Kitazono","doi":"10.1007/s11239-025-03093-3","DOIUrl":"https://doi.org/10.1007/s11239-025-03093-3","url":null,"abstract":"<p><p>The P2Y12 receptor inhibitor prasugrel was approved for thrombotic stroke in Japan following the phase 3 clinical trials PRASTRO-I, -II, and -III. However, correlations between elevated platelet reaction unit (PRU) and ischemic event risk remain unclear. This post hoc integrated analysis of PRASTRO-I, -II, and -III assessed the relationships of PRU with efficacy and safety outcomes, and risk factors for high PRU (HPR). Patients from PRASTRO-I, -II, and -III receiving prasugrel or clopidogrel and with PRU values at 4 and 24 weeks after treatment initiation were included. The primary endpoint was PRU at 4 weeks; secondary endpoints included cumulative incidence of ischemic and bleeding events from study drug initiation to 48 weeks. Exploratory univariate and multivariate analyses were conducted to identify HPR risk factors. Of 2688 patients analyzed, 2595 and 2434 had PRU values available at 4 and 24 weeks, respectively. Mean PRU was numerically lower with prasugrel than clopidogrel at 4 weeks (151.3 vs. 195.4) and 24 weeks (143.8 vs. 188.0). CYP2C19 polymorphisms affected PRU at 4 and 24 weeks with clopidogrel but not with prasugrel. PRU at 4 weeks did not predict ischemic and bleeding event incidence up to 48 weeks. The CYP2C19 poor metabolizer phenotype was the strongest HPR risk factor. PRU values at 4 and 24 weeks were numerically lower with prasugrel and unaffected by CYP2C19 genetic polymorphisms. Further research is needed to clarify the relationship of PRU with ischemic and bleeding events.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":"58 4","pages":"547-555"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033319","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":"Thrombin generation and clot lysis time to predict outcomes in patients undergoing transcatheter aortic valve implantation.","authors":"Aleksander Siniarski, Jakub Michal Zimodro, Aleksandra Gąsecka, Michał Łomiak, Marta Frydrych, Jadwiga Nessler, Grzegorz Gajos","doi":"10.1007/s11239-025-03090-6","DOIUrl":"10.1007/s11239-025-03090-6","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) is an established treatment method in patients with severe aortic stenosis at high surgical risk. TAVI might reduce thrombin generation and fibrin clot resistance to lysis. We aimed to evaluate the predictive value of thrombin generation and clot lysis time on TAVI outcomes. We screened 135 patients referred for TAVI. Thrombin generation (lag time, time to peak, peak thrombin concentration, and endogenous thrombin potential) and clot lysis time were assessed before TAVI and at hospital discharge. Major adverse cardiac and cerebrovascular events (MACCE) including all-cause death, cardiovascular death, myocardial infarction, stroke, transient ischemic attack, heart failure decompensation, and clinical valve thrombosis were assessed during 1-year follow-up. Among 70 patients who underwent TAVI, 14 (20%) experienced MACCE during the median follow-up of 361 days. Before TAVI, thrombin generation and clot lysis time were similar in patients with vs. without MACCE. Post-TAVI peak thrombin concentration was significantly lower in patients with MACCE (157.5 vs. 240.38 nM, p = 0.016), discriminated between those with and without MACCE (AUC: 0.773, p = 0.016), and was predictive for MACCE in both univariable (OR: 10.733, 95% CI: 1.197-96.283, p = 0.034) and multivariable (OR: 11.551, 95% CI: 1.104-120.828, p = 0.041) regression analyses. Pre-TAVI lag time was a predictor of MACCE in univariable regression analysis (OR: 5.304, 95% CI: 1.074-26.182, p = 0.041). Post-TAVI peak thrombin concentration and pre-TAVI lag time might potentially serve as novel predictors of MACCE in patients undergoing TAVI.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"503-513"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788081","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 thromboembolic complications in patients newly diagnosed with cholangiocarcinoma.","authors":"Piangrawee Niprapan, Phichayut Phinyo, Worakitti Lapisatepun, Chaiyut Charoentum, Adisak Tantiworawit, Ekarat Rattarittamrong, Lalita Norasetthada, Pokpong Piriyakhuntorn, Thanawat Rattanathammethee, Sasinee Hantrakool, Nonthakorn Hantrakun, Teerachat Punnachet, Chatree Chai-Adisaksopha","doi":"10.1007/s11239-025-03099-x","DOIUrl":"https://doi.org/10.1007/s11239-025-03099-x","url":null,"abstract":"<p><p>Cholangiocarcinoma (CCA) is an uncommon cancer, with limited data available on the incidence of cancer-associated thrombosis in CCA patients. This was a single-center, retrospective study conducted in a university-based hospital in Thailand. We included consecutive patients newly diagnosed with CCA between January 2019 and December 2022. The study outcomes focused on the incidence of venous thromboembolism (VTE) and all-cause mortality within 12 months of diagnosis. A total of 450 patients were included in the study, with a median follow-up time of 212 days, and 61.8% of participants were male. The one-year incidence of VTE was 15.3%, with a median time to VTE occurrence of 6 days (Q1-Q3: 1-86 days). Multivariable analysis indicated that age ≤ 55 years (hazard ratio 2.34, 95% confidence interval [CI] 1.40-3.88, p = 0.001), ECOG performance status ≥ 2 (HR 2.53, 95% CI 1.41-4.53, p = 0.002), stage IV cancer (HR 1.84, 95% CI 1.14-3.00, p = 0.013), and total bilirubin ≤ 13 mg/dL (HR 4.11, 95% CI 1.67-10.15, p = 0.002) were associated with VTE occurrence. During follow-up, all-cause mortality was 57.3%, and VTE presence increased the risk of all-cause mortality, with an HR of 1.41 (95% CI 1.02-1.94, p = 0.035). The incidence of VTE following a diagnosis of CCA was notably high. CCA patients who developed VTE were observed to be at a heightened risk of all-cause mortality. Therefore, VTE should be recognized as one of the significant complications among CCA patients.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":"58 4","pages":"566-575"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975077","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 severity of ischemic stroke and risk of all-cause mortality in patients with atrial fibrillation on different oral anticoagulant treatments admitted to the emergency department.","authors":"Tommasa Vicario, Danilo Menichelli, Alfredo Paolo Mascolo, Marina Diomedi, Sara Cerretti, Francesco Marconi, Pasquale Pignatelli, Carla Paganelli, Daniele Pastori","doi":"10.1007/s11239-025-03095-1","DOIUrl":"10.1007/s11239-025-03095-1","url":null,"abstract":"<p><p>Although direct oral anticoagulants (DOACs) are non-inferior to Vitamin K antagonists (VKA) in preventing ischemic stroke (IS) in atrial fibrillation (AF) patients, there are limited data regarding stroke severity and prognosis of patients admitted with IS during DOAC treatment. We performed a single center retrospective study including patients with AF on oral anticoagulants admitted to the Emergency Department for IS were included. The primary endpoint was to analyse the severity of stroke evaluated through NIHSS scale according to anticoagulant therapy. The secondary endpoint was 3-month all-cause mortality. A total of 106 AF patients were included, with a mean age of 81.3 ± 7.5 years. Overall, 54.7% were women and 61.3% on DOAC. The AF patients on DOAC were older, with no other clinical differences. Median NIHSS was 12 (Interquartile Range [IQR] 5-19). At multivariable logistic regression analysis DOAC use (compared to warfarin) was associated with lower risk of moderate-severe/severe stroke (NIHSS ≥ 16) (Odds Ratio [OR] 0.355, 95% confidence interval [95% CI] 0.127-0.995). Mechanical thrombectomy was strongly associated with higher severity of stroke (OR 6.113, 95%CI 2.186-17.099). During follow-up, 42 patients died. DOAC use inversely correlated with mortality risk (OR 0.323, 95%CI 0.127-0.822) after adjusting for CHA₂DS₂-VASc, time to hospital admission from symptom onset and type of acute treatment. In conclusion, in our contemporary real-world population, patients on DOACs treatment admitted for IS had better outcomes in terms of stroke severity and all-cause mortality compared with patients on VKAs.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"576-584"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788653","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":"Evaluation of unfractionated heparin dosing using an antifactor-Xa-based protocol in non-obese vs. obese patients for acute venous thromboembolism.","authors":"Trenton Flanagan, Monica Sharma, Uyen-Thi Cao, Xuan Wang, Vivek Kataria","doi":"10.1007/s11239-025-03097-z","DOIUrl":"10.1007/s11239-025-03097-z","url":null,"abstract":"<p><p>The pharmacokinetic profile of heparin may result in supratherapeutic antifactor-Xa levels using total weight-based protocols for the treatment of venous thromboembolism (VTE) in obese patients. Previous literature has been limited by choice of monitoring assay and inconsistent dosing strategies. The goal of this study was to evaluate safety and efficacy outcomes of an antifactor-Xa based UFH VTE protocol in obese vs. non-obese patients. This was a single center, retrospective study of adult patients with an acute VTE treated with our institution specific UFH VTE protocol. Patients were screened from the preceding 3 years for inclusion into the obese (BMI ≥ 30 kg/m²) or non-obese (BMI < 30 kg/m²) groups. The primary outcome was the weight-based rate of UFH (units/kg/hr) required to attain a therapeutic anti-Xa level. Secondary outcomes included rate required to attain steady state, time to first therapeutic anti-Xa level and steady state, proportion of patients to attain at least one therapeutic anti-Xa level and steady state, number of rate changes required to attain steady state, and proportion of anti-Xa levels being therapeutic, subtherapeutic, or supratherapeutic at the first anti-Xa level drawn, within the first 24 h of treatment, and for the duration of treatment with UFH. Safety outcomes evaluated the incidence of any major or non-major bleeding event, requiring reversal agents, or having additional thrombotic events. The primary outcome of weight-based rate at first therapeutic anti-Xa level was significantly lower in the obese group, and this was consistent for attainment of steady state, as well (14 units/kg/hour vs. 16 units/kg/hour, p < 0.001). Patients in the obese group had significantly more supratherapeutic anti-Xa levels within 24 h (50% vs. 33%, p < 0.0001) and for the total duration of UFH therapy (40% vs. 25%, p < 0.0001) No significant differences in clinically overt bleeding rates were found. Obese patients required a lower weight-based rate of UFH to attain therapeutic anti-Xa levels for the treatment of VTE. Additionally, there appears to be an inverse relationship between weight-based UFH rate and total UFH rate at the first therapeutic anti-Xa and steady state as BMI increases. Future studies should focus on dosing strategies that improve attainment of therapeutic anti-Xa levels in obese patients.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"556-565"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788670","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":"Associations between fibrinogen levels and the risk of all-cause mortality: a long-term cohort study.","authors":"Xinru Hu, Junwen Wang, Yuyang Ye, Xuefeng Chen, Simayi Abulikemu, Jiang Yu, Yifei Zhao, Teng Hu, Yong Peng","doi":"10.1007/s11239-025-03087-1","DOIUrl":"https://doi.org/10.1007/s11239-025-03087-1","url":null,"abstract":"<p><p>Although prior research has investigated the link between fibrinogen and mortality risk, there is a notable lack of long-term cohort studies. This study seeks to examine the relationship between plasma fibrinogen levels and all-cause mortality. Fibrinogen levels were divided into low and high groups based on the median and further categorized into quartiles. Kaplan-Meier analysis was employed for survival analysis, and hazard ratios (HRs) were calculated using the Cox proportional hazards model. Our study included 5,690 participants, divided into a lower fibrinogen group (fibrinogen ≤ 370 mg/dL, N = 2,851) and a higher fibrinogen group (fibrinogen > 370 mg/dL, N = 2,839). The survival probability of the lower fibrinogen group was higher than that of the higher group (70.98% vs. 47.98%, P < 0.0001). All-cause mortality was higher in the higher fibrinogen group compared to the low fibrinogen group (HR 1.26, 95% CI 1.09-1.45, P = 0.002). Compared to Q1, mortality risk increased in Q2 (HR 1.26, 95% CI 1.00-1.59, P = 0.05), Q3 (HR 1.39, 95% CI 1.15-1.69, P < 0.001), and Q4 (HR 1.51, 95% CI 1.23-1.87, P < 0.001). Higher fibrinogen levels correlate with an elevated risk of all-cause mortality, suggesting fibrinogen is a potential biomarker for mortality risk.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":"58 4","pages":"514-525"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016907","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}