Journal of Thrombosis and Thrombolysis最新文献

{"title":"Edoxaban for treatment of cancer-related isolated distal deep vein thrombosis: harnessing evidence, seeking equipoise.","authors":"Andrea Minghini, Sebastian Szmit, Pietro Ameri","doi":"10.1007/s11239-026-03319-y","DOIUrl":"10.1007/s11239-026-03319-y","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1375-1378"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964111","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 venous thromboembolism after spontaneous intracerebral hemorrhage based on machine learning.","authors":"Lei Yang, Fengyuan Zhou, Yiling Xia, Haijun Yao, Yanjie Chen, Yan Shangguan, Gang Wu, Jin Hu, Mei-Hua Wang","doi":"10.1007/s11239-026-03312-5","DOIUrl":"10.1007/s11239-026-03312-5","url":null,"abstract":"<p><p>Patients with intracerebral hemorrhage (ICH) are at high risk of venous thromboembolism (VTE). Current risk assessment tools are limited and not tailored for neurocritical care populations. This study aimed to develop and validate machine learning-based models to predict VTE in ICH patients. Clinical data of 872 ICH patients admitted to the Neurosurgical ICU of Huashan Hospital from June 2018 to July 2023 were analysed. After univariate analysis, feature selection was performed using Random Forest Importance Ranking and LASSO regression. Three machine learning models (random forest, logistic regression, and LASSO logistic regression) were trained using 10-fold cross-validation. The dataset was randomly split into training (80%) and validation (20%) sets. Model performance was evaluated using accuracy, sensitivity, specificity, F1 score, AUC, calibration curves, and decision curve analysis. Among 421 patients included in the final analysis, 215 (51.1%) developed VTE. Five independent predictors (BMI, D-dimer, homocysteine, triglycerides, albumin) were identified. All three models showed strong discriminatory performance, with the random forest model achieving the highest AUC (0.98) and PR-AUC (0.98), followed by logistic regression (AUC 0.94, PR-AUC 0.91) and LASSO-LR (AUC 0.93, PR-AUC 0.91). Machine learning-based models incorporating metabolic and clinical predictors can accurately stratify VTE risk in ICH patients. The random forest model demonstrated superior performance and clinical applicability, highlighting potential for guiding early prophylactic interventions.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1549-1562"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964081","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 association of angiostatin and plasminogen plasma levels with Charlson comorbidity burden and mortality in COVID-19.","authors":"Aleksandra Franczak, Paul Calistrate-Petre, Irina Dinu, Paul Jurasz","doi":"10.1007/s11239-026-03289-1","DOIUrl":"10.1007/s11239-026-03289-1","url":null,"abstract":"<p><p>Severe COVID-19 is associated with thrombotic complications. Dysregulated fibrinolysis, marked by increased plasminogen activator inhibitor-1 (PAI-1) and reduced plasmin generation, has been linked to adverse outcomes including death. Plasmin(ogen) is also the precursor of angiostatin, an angiogenesis inhibitor with dual roles both preventing SARS-CoV-2 infection and promoting cell death. While alterations in fibrinolytic markers are associated with disease severity, the relationship between plasminogen and angiostatin with survival outcomes remains unclear. Therefore we compared plasma angiostatin and plasminogen levels between COVID-19 survivors and non-survivors and assessed their association with mortality. The observational cohort study included age- and sex-matched hospitalized COVID-19 survivors and non-survivors. Plasma samples were collected during hospitalization, and angiostatin and plasminogen levels were quantified by immunoblotting. Cox regression, adjusted for Charlson comorbidity score and time from symptom onset to sample collection, assessed their association with mortality. Non-survivors had a higher Charlson score and significantly lower plasma angiostatin and plasminogen levels compared to survivors. Angiostatin was not associated with mortality after multivariate analysis. However, exploratory Kaplan-Meier survival curve analysis suggested that individuals with lowest Charlson score and angiostatin within the lower tertile exhibit lowest survival probability, while individuals with high Charlson score and with angiostatin in the middle tertile exhibit longest survival probability. By contrast, lower plasminogen was independently associated with mortality after adjustments, supporting a role for impaired fibrinolysis in poor outcomes, while a more complex potential association between angiostatin and COVID-19 mortality is emerging consistent with its dual roles in SARS-CoV-2 infection.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1591-1599"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964147","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":"Revisiting bleeding risk in cancer-associated thrombosis: Beyond the asian paradox.","authors":"Geraldine Poenou, Natacha Fevre, Christophe Marie-Sainte","doi":"10.1007/s11239-026-03294-4","DOIUrl":"10.1007/s11239-026-03294-4","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1389-1392"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930799","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":"Evaluating the indirect interaction between glucagon-like peptide-1 receptor agonists and warfarin using real-world data.","authors":"Spencer J Gilbert, Sara R Vazquez, Ramkiran Gouripeddi, Alexander Millar, Julio C Facelli, Daniel M Witt","doi":"10.1007/s11239-026-03310-7","DOIUrl":"10.1007/s11239-026-03310-7","url":null,"abstract":"<p><p>Increasing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) raises concern for interactions with warfarin. Although GLP-1 RAs do not affect warfarin pharmacokinetics, their appetite-reducing effects may decrease vitamin K intake and increase International Normalized Ratio (INR) variability. Large-scale real-world data (RWD) are needed to evaluate these effects. To evaluate changes in time-in-therapeutic INR range (TTR) among warfarin patients initiated on GLP-1 RA therapy. This retrospective cohort study evaluated TTR 6 months before and after GLP-1 RA initiation using RWD from the TriNetX Research Network. Included patients were required to have evidence of warfarin use before and after GLP-1 RA initiation. Primary outcomes included changes in TTR, INR, and INR recheck frequency. Secondary outcomes included time below and above the therapeutic range and INR variability. Of 53,943 patients screened, 1,021 met inclusion criteria. Mean TTR decreased by 2.1% (95% CI, -3.7% to -0.6%; p = 0.01), decreasing from 64.2% to 62.1%. Mean INR did not change (0.00; 95% CI, -0.02 to 0.03; p = 0.79). INR recheck frequency increased slightly, with a mean interval decrease of 0.7 days (95% CI -1.4 to 0.0; p = 0.049). Time below therapeutic range increased by 0.8% (p = 0.25), time above therapeutic range increased by 1.3% (p = 0.04), and INR standard deviation increased by 0.03 (p = 0.051). GLP-1 RA initiation was associated with a modest decrease in TTR and increased INR variability among warfarin-treated patients. Clinicians may consider closer INR monitoring following GLP-1 RA initiation.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1519-1527"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874537","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":"A qualitative study of warfarin self-management in the United States healthcare system: insights from patient experiences.","authors":"Spencer J Gilbert, Heeseung Hong, Aubrey E Jones, Sara R Vazquez, Geoffrey D Barnes, Katelyn W Sylvester, Daniel M Witt","doi":"10.1007/s11239-026-03320-5","DOIUrl":"10.1007/s11239-026-03320-5","url":null,"abstract":"<p><p>Evidence-based guidelines recommend patient self-management (PSM) over other warfarin dosing management methods. Despite this, PSM remains virtually nonexistent in the United States (US) healthcare system. We gathered perspectives and opinions about PSM from patients who participated in a PSM implementation study in three US healthcare systems. Interviews were conducted with patients from three different US healthcare systems. Thematic qualitative analysis informed by the Consolidated Framework for Implementation Research (CFIR) was performed on interview transcripts to explore patient-perceived benefits and challenges of PSM in the US. Fifteen patients participated in individual interviews. Six major themes were identified: (1) Patients found PSM easy and empowering, enhancing their autonomy, responsibility, knowledge, and control over warfarin management; (2) Patients emphasized that trust and support from clinicians was crucial to their confidence and success with PSM; (3) Patients felt PSM should be made widely available; (4) Patients felt they needed more support and training for complex or non-routine situations during PSM; (5) Inflexibility from the healthcare system, clinicians, and PSM processes were common challenges to PSM; (6) Most patients found PSM straightforward and relied on their own judgment, rarely using the provided dosing tools. Patients who participated in a PSM implementation study reported many benefits of PSM. Patients viewed PSM as an empowering approach to warfarin management that enhanced their autonomy and confidence - especially when supported by clinicians. Given the reported advantages of PSM, select patients with sufficient experience and training may benefit from being offered PSM in the US.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1667-1676"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005705","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":"Optical coherence tomography versus angiography guided percutaneous coronary intervention: a systematic review and meta-analysis.","authors":"Zeeshan Sattar, Mohammad Hamza, Junaid Mir, Asad Ur Rab, Safia Shaikh, Syed Murtaza Ishaq, Prakash Upreti, Astha Upadhyaya, Ali Awad, Muhammad Burhan, Farhan Sattar, Karthik Gonuguntla, Ramesh Daggubati, Yasar Sattar, M Chadi Alraies, M Akram Kawsara","doi":"10.1007/s11239-026-03263-x","DOIUrl":"10.1007/s11239-026-03263-x","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1445-1458"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717177","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 anticoagulation management in patients with suspected heparin-induced thrombocytopenia awaiting diagnosis confirmation.","authors":"Alyssa R George, Katelyn W Sylvester, Dareen M Kanaan, Delaney M Brooks, Kenneth E Lupi, Brian R Schuler, Jean M Connors","doi":"10.1007/s11239-026-03305-4","DOIUrl":"10.1007/s11239-026-03305-4","url":null,"abstract":"<p><p>The 2018 American Society of Hematology (ASH) guidelines recommend discontinuation of heparin products upon suspicion of heparin-induced thrombocytopenia (HIT) and initiation of therapeutic non-heparin anticoagulation. This practice may be influenced by various factors, including diagnostic method. Our institution recently switched from an enzyme-linked immunosorbent assay (ELISA) that was run once daily to a chemiluminescence immunoassay (CLIA) that is run on-demand to detect anti-platelet factor 4 (PF4)/heparin antibodies. The objective was to evaluate if implementation of an on-demand anti-PF4/heparin antibody CLIA assay changed the timing of initiating a non-heparin anticoagulant compared with the traditional ELISA assay. A retrospective analysis was performed at our single academic medical center. Eligible subjects included patients ordered for an ELISA or CLIA anti-PF4/heparin assay upon suspicion of HIT. The major endpoint was the percentage of patients transitioned to a therapeutic non-heparin anticoagulant at the time of testing. Minor endpoints included the development of new or worsening thrombosis and/or bleeding within 72 h of testing. Overall, 227 patients were included in the analysis (n = 123 (ELISA), n = 104 (CLIA)). Significantly fewer patients in the CLIA group were switched to non-heparin anticoagulation at the time of testing as compared to the ELISA group (10.4% vs. 23.6%, p = 0.006). There were no differences between groups for the development of the minor endpoints. Significantly fewer patients were switched to therapeutic non-heparin anticoagulation at the time of testing after converting to an on-demand anti-PF4/heparin antibody CLIA assay. These findings may aid in optimizing institutional guidelines.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1540-1548"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930782","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 of thrombogenicity indices with perioperative cardiovascular events after non-cardiac surgery: a prespecified analysis of the PANDA study.","authors":"Hendrianus Hendrianus, Jong-Hwa Ahn, Min-Gyu Kang, Kye-Hwan Kim, Jin-Sin Koh, Sang-Wook Kim, Jin-Yong Hwang, Udaya S Tantry, Paul A Gurbel, Jeong-Rang Park, Young-Hoon Jeong","doi":"10.1007/s11239-026-03299-z","DOIUrl":"10.1007/s11239-026-03299-z","url":null,"abstract":"<p><p>Traditional clinical risk models, such as Revised Cardiac Risk Index (RCRI), have limited predictive value for estimating postoperative cardiovascular complications following non-cardiac surgery. This analysis aimed to evaluate prognostic value of thrombogenicity profiles and coronary anatomy for cardiovascular events in patients undergoing non-cardiac surgery. In a prospective cohort of 120 patients who underwent intermediate-to-high risk surgery, thrombogenicity profiles were assessed using thromboelastography (TEG®) and conventional hemostatic measurements before surgery. Coronary artery disease (CAD) was preoperatively defined as presence of significant stenosis (≥ 50% luminal narrowing) on coronary computed tomography angiography (CCTA). Postoperative cardiovascular events were defined as cardiovascular death, non-fatal myocardial infarction, myocardial injury, pulmonary edema, non-fatal stroke, and systemic embolism within 30 days after surgery. Sixteen patients (13.3%) experienced cardiovascular events. In multivariable analysis, presence of CAD (odds ratio [OR]: 5.11; 95% confidence interval [CI]: 1.49-17.53; P = 0.009), D-dimer (per 1-μg/mL increase: OR: 1.22; 95% CI: 1.02-1.47; P = 0.030), and platelet-fibrin clot strength (PFCS) measured by TEG® (per 1-mm increase: OR: 1.10; 95% CI: 1.01-1.20; P = 0.027) were independently associated with cardiovascular events. Discrimination of cardiovascular event risk improved progressively with the sequential addition of the following risk stratification models: RCRI alone, RCRI + CCTA, and RCRI + CCTA + thrombogenicity profiles (C-index: 0.660 vs. 0.731 vs. 0.803). Cardiovascular event rates increased with greater risk burden, ranging from 4.2% in patients with no risk components to 77.8% in those with all components present. Integrating thrombogenicity assessment and CCTA with traditional clinical risk models may improve perioperative risk stratification and help guide tailored preventive strategies for patients undergoing non-cardiac surgery.Clinical trial registration. URL: http://www.clinicaltrials.gov . Unique identifier: NCT02250963.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1349-1361"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963966","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":"Leveraging technology to improve care: a real-time electronic dashboard within an anticoagulation stewardship service to optimise anticoagulant safety.","authors":"Emma Jane Leitinger, Nadishani Ratnayake, Simone Taylor, Hiu Lam Agnes Yuen, Jasmine Singh, Charithani Keragala, Kay Htun, Nicholas Ling, Katherine Wilson, Tania Duncan, Zane Kaplan, Mark Sheppard, Susan Brown, Sanjeev Chunilal, Anastasios Nalpantidis","doi":"10.1007/s11239-026-03277-5","DOIUrl":"10.1007/s11239-026-03277-5","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"1618-1627"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717135","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}