Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Thrombopoietin receptor agonists in inherited thrombocytopenias: an evolving mosaic of evidence","authors":"Carlo Zaninetti","doi":"10.1016/j.rpth.2026.106907","DOIUrl":"10.1016/j.rpth.2026.106907","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106907"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856099","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":"Integrating pharmacovigilance and machine learning: bleeding signal detection and risk prediction for oral anticoagulants in cancer patients","authors":"Meina Lv,&nbsp;Xiaochun Zheng,&nbsp;Hang Xie,&nbsp;Bijuan Lin","doi":"10.1016/j.rpth.2026.106868","DOIUrl":"10.1016/j.rpth.2026.106868","url":null,"abstract":"<div><h3>Background</h3><div>Oral anticoagulants (OACs) have been widely used for the prevention and treatment of thrombosis in cancer patients, but the bleeding signals associated with different OACs in this population have not been fully studied.</div></div><div><h3>Objectives</h3><div>This study aimed to compare bleeding signals, identify risk factors, and establish a prediction model for OACs in cancer patients.</div></div><div><h3>Methods</h3><div>This study was based on the Food and Drug Administration Adverse Event Reporting System database and used the reporting odds ratio to evaluate the bleeding event signals associated with OACs in cancer patients from Q1 2014 to Q1 2024. Additionally, this study used a retrospective cohort design to assess the impact of OACs on bleeding risk in cancer patients.</div></div><div><h3>Results</h3><div>This study analyzed 29,897 adverse event reports of OACs in cancer patients, which included 4084 bleeding events. We found that bleeding events were mainly concentrated within the first 2 months of medication use. Compared with apixaban, the other 4 OACs (warfarin, edoxaban, rivaroxaban, and dabigatran) showed increased risks of bleeding, especially in the gastrointestinal system. Male, cardiovascular diseases, cerebral infarction, renal insufficiency, gastrointestinal cancer, and elevated international normalized ratio are linked to an increased risk of bleeding from OACs in cancer patients. The XGBoost model was the top-performing model among the 4 bleeding prediction models (training set area under the curve = 0.788; test set area under the curve = 0.783).</div></div><div><h3>Conclusion</h3><div>Bleeding adverse events related to OACs primarily occur early in the treatment. Apixaban shows weaker bleeding signals. Male sex, cardiovascular diseases, cerebral infarction, renal insufficiency, gastrointestinal cancer, and an elevated international normalized ratio may be potential risk factors for bleeding events. The prediction model for OACs-related bleeding developed in this study demonstrated acceptable performance in internal validation.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106868"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856100","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":"Factors associated with postextraction bleeding in patients with hemophilia: a multicenter retrospective cohort study","authors":"Kazumi Atarashi,&nbsp;Hiroshi Nakamura,&nbsp;Kotaro Kaneko,&nbsp;Mirai Higaki,&nbsp;Kuniko Mizuta,&nbsp;Kotaro Sato,&nbsp;Takahiro Yagyuu","doi":"10.1016/j.rpth.2026.106903","DOIUrl":"10.1016/j.rpth.2026.106903","url":null,"abstract":"<div><h3>Background</h3><div>Postextraction bleeding, a form of postoperative hemorrhage, remains challenging in hemophilia, yet multicenter evidence linking bleeding to extraction technique and local hemostatic measures is limited.</div></div><div><h3>Objectives</h3><div>This study aimed to determine postextraction bleeding incidence and identify associated factors at procedure and tooth levels.</div></div><div><h3>Methods</h3><div>This retrospective multicenter cohort included patients with hemophilia A or B undergoing tooth extraction at 4 hemophilia care centers in Japan (January 2013 to March 2023). Postextraction bleeding was defined as bleeding not controlled by gauze compression requiring additional intervention within 14 days. Multivariable logistic regression analysis was performed.</div></div><div><h3>Results</h3><div>The cohort included 198 patients (hemophilia A, 161; hemophilia B, 37), 271 procedures, and 512 extracted teeth. Bleeding occurred in 33 procedures (12.2%) and 38 teeth (7.4%); first bleeding occurred at a mean of postoperative day 5.3 (median 6). At the procedure level, extraction of ≥4 teeth were associated with higher bleeding incidence (adjusted odds ratio [OR] 2.60, 95% CI 1.02-6.65). Tranexamic acid use was associated with a lower incidence at both the procedure level (adjusted OR 0.43, 95% CI 0.20-0.93) and tooth level (adjusted OR 0.38, 95% CI 0.18-0.78), and primary wound closure was associated with bleeding (adjusted OR 11.2, 95% CI 1.42-89.3). No thrombotic events were documented.</div></div><div><h3>Conclusion</h3><div>Delayed postextraction bleeding remains relatively common in hemophilia despite specialist care. Multiple extractions and nonuse of tranexamic acid was associated with postextraction bleeding. Findings require cautious interpretation because of retrospective design, confounding by indication, and limited bleeding events.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106903"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807063","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":"Pediatric venous thromboembolism: an illustrated review","authors":"Maria G. Espanol,&nbsp;Maissaa Janbain","doi":"10.1016/j.rpth.2026.106892","DOIUrl":"10.1016/j.rpth.2026.106892","url":null,"abstract":"<div><div>Venous thromboembolism (VTE) in children has historically been considered uncommon; however, it is increasingly recognized in hospitalized pediatric populations, and its incidence has risen over the past few decades. This can be attributed to several factors, including greater awareness of the condition, improved survival rates for children with chronic and complex medical conditions, increased use of supportive care (such as central venous catheters), and advancements in diagnostic imaging. Acquired conditions, such as infections, malignancies, cardiovascular diseases, and inflammatory bowel disease, are recognized as risk factors for VTE. Among these, the presence of a central venous catheter remains the most significant and common risk factor for pediatric VTE. In this review, we present and illustrate the pathophysiology and current treatment options for VTE in the pediatric population.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106892"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856097","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":"Von Willebrand factor A2 domain inhibits A1-DNA binding while preserving A1-platelet interaction under flow: evidence from recombinant domain constructs","authors":"Zhitong Peng,&nbsp;Xiaoxi Sun,&nbsp;Guangzhou Qu,&nbsp;Jinhua Fang,&nbsp;Aiying Liu,&nbsp;Yuming Huang,&nbsp;Zhiwei Wu,&nbsp;Junxian Yang,&nbsp;Jie Ma,&nbsp;Jiangguo Lin","doi":"10.1016/j.rpth.2026.106902","DOIUrl":"10.1016/j.rpth.2026.106902","url":null,"abstract":"<div><h3>Background</h3><div>Circulating cell-free DNA levels increase in the circulation during inflammation and thrombosis. During immunothrombosis, neutrophil extracellular traps provide long DNA fibers with prothrombotic properties. Von Willebrand factor (VWF) has been reported to interact with DNA via its A1 domain; however, the consequences of this interaction and its regulation by the adjacent A2 domain remain poorly understood.</div></div><div><h3>Objectives</h3><div>Using recombinant VWF domain constructs, we aimed to characterize VWF-A1–DNA interactions and to determine whether the VWF-A2 domain modulates A1–DNA binding and its impact on platelet adhesion under flow.</div></div><div><h3>Methods</h3><div>VWF-A1–DNA interactions were examined using atomic force microscopy, magnetic tweezers, ELISAs, and microfluidic flow assays. Both recombinant A1 and mammalian-expressed A1A2 constructs were employed to assess physiological relevance.</div></div><div><h3>Results</h3><div>VWF-A1 bound to DNA and induced concentration–dependent DNA compaction. DNA binding to VWF-A1 significantly impaired platelet adhesion under flow conditions. In contrast, the A2 domain inhibited VWF-A1–DNA binding, as shown using both isolated A2 and A1A2 constructs, and mitigated DNA’s inhibitory effect on A1-mediated platelet adhesion.</div></div><div><h3>Conclusion</h3><div>These findings suggest that, within recombinant VWF domain constructs, VWF-A1 compacts DNA and that the A2 domain negatively regulates A1–DNA interactions while preserving A1-mediated platelet binding under flow. Although further validation in native multimeric VWF and physiologically relevant models is required, these results provide new insights into how the A2 domain differentially regulates VWF-A1 interactions with DNA and platelets.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106902"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856096","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":"Efficacy and safety of anticoagulation for pediatric cerebral sinovenous thrombosis: systematic review and meta-analysis","authors":"Muayad Azzam,&nbsp;Hassan Kawtharany,&nbsp;Marisol Betensky,&nbsp;Aseel Alkhader,&nbsp;Qais Hamarsha,&nbsp;Hadi Khaled Abou Zeid,&nbsp;Razan Mansour,&nbsp;Carine Tabak,&nbsp;Payal Patel,&nbsp;Sarah Lamat Baghdadi,&nbsp;Rachel S. Bercovitz,&nbsp;Rukhmi Bhat,&nbsp;Tina Biss,&nbsp;Brian R. Branchford,&nbsp;Leonardo R. Brandão,&nbsp;Anthony K.C. Chan,&nbsp;E. Vincent S. Faustino,&nbsp;Julie Jaffray,&nbsp;Sophie Jones,&nbsp;Bryce A. Kerlin,&nbsp;Reem A. Mustafa","doi":"10.1016/j.rpth.2026.106905","DOIUrl":"10.1016/j.rpth.2026.106905","url":null,"abstract":"<div><div>We performed this systematic review and meta-analysis to assess the efficacy and safety of anticoagulation therapy versus no anticoagulation in pediatric patients with cerebral sinovenous thrombosis (CSVT). Eligible studies included pediatric patients with CSVT that compared anticoagulation to no anticoagulation and reported on at least one relevant outcome (mortality, neurological deficit, thrombus resolution, recurrence, and bleeding). Meta-analysis reported risk ratios (RR) or differences (RD) (95% CIs) and absolute effects per 1000 patients. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated with GRADE. After removing duplicates, we screened 8925 records independently and in duplicate, from which 12 nonrandomized studies of intervention were included. Compared with no anticoagulation, anticoagulation may be associated with lower risk of overall mortality RR 0.14 (0.05-0.39) (4 studies, <em>n</em> = 448), lower risk of neurological deficits RD −0.13 (−0.39 to 0.13) (6 studies, <em>n</em> = 462), and higher rates of complete and partial resolution RR 1.25 (0.94-1.66) (7 studies, <em>n</em> = 150). Recurrence RD 0 (−0.11 to 0.11) (2 studies, <em>n</em> = 56) and bleeding RD 0.03 (−0.09 to 0.15) (5 studies, <em>n</em> = 95) may be comparable between anticoagulation versus no anticoagulation. We judged outcomes to be very low to low certainty of evidence due to risk of bias, concerns from confounding, and imprecision from small sample sizes. To conclude, we show in this systematic review that anticoagulation therapy in pediatric patients with CSVT may be associated with better outcomes (reduced mortality, neurological deficits, and higher rate of thrombus resolution) with little to no effect on bleeding and recurrence.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106905"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856098","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":"Assessing genetic risk factors for early-onset coronary artery disease in Iranians","authors":"Ilaria Mancini,&nbsp;Maria Teresa Pagliari,&nbsp;Saeed Sadeghian,&nbsp;Seyed Hesameddin Abbasi,&nbsp;Hamidreza Poorhosseini,&nbsp;Mohammad Ali Boroumand,&nbsp;Masoumeh Lotfi-Tokaldany,&nbsp;Emanuela Pappalardo,&nbsp;Pasquale Agosti,&nbsp;Frits R. Rosendaal,&nbsp;Flora Peyvandi","doi":"10.1016/j.rpth.2026.106893","DOIUrl":"10.1016/j.rpth.2026.106893","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery disease (CAD) is a leading cause of death worldwide. Evidence of genetic predisposition is derived mostly from studies of Europeans and East Asians.</div></div><div><h3>Objectives</h3><div>To test selected variants for association with early-onset CAD.</div></div><div><h3>Methods</h3><div>We performed a case-control study of 697 young angiography-defined CAD cases (women aged &lt;55 years, men &lt;45) and 911 age- and sex-matched controls in Iran. We tested 24 variants (12 established CAD loci, 12 candidates in hemostasis genes) using age- and sex-adjusted logistic regression, stratified by ethnicity. A 6-variant unweighted genetic risk score (GRS) was built from the top loci. Additive interaction with cardiovascular risk factors was assessed by relative excess risk due to interaction.</div></div><div><h3>Results</h3><div>Of 12 established loci, <em>HCG27</em>–<em>HLA-C</em>, <em>CDKN2A</em>/<em>CDKN2B</em>, and <em>SORT1</em> showed nominal or near-nominal replication and 4 were directionally aligned with prior literature, whereas 5 showed no association. Among hemostasis candidates, <em>F5</em> rs4524 was nominally associated with increased risk, and <em>TSPAN15</em> rs78707713 and <em>F11</em> rs2289252 suggested reduced risk. Ethnicity-stratified analyses indicated nominal or suggestive ancestry-specific effects at <em>SORT1</em>, <em>HCG27</em>–<em>HLA-C</em>, <em>CDKN2A</em>/<em>CDKN2B</em>, <em>LPA</em>, <em>VWF</em>, <em>MIA3</em>, and <em>CXCL12</em>. The GRS (range, 2-11 alleles/person) yielded a per-allele odds ratio of 1.20 (95% CI, 1.12-1.29), ie, a 5.2-fold higher risk across the observed range. Combining GRS with metabolic comorbidities showed super-additive effects (relative excess risk due to interaction, 6.66; 95% CI, 2.04-11.28).</div></div><div><h3>Conclusion</h3><div>Ten variants, including 3 previously linked to venous thrombosis, showed nominal or suggestive association with early-onset CAD in Iranians or specific ethnic groups. Genetic burden substantially amplified risk in the presence of metabolic comorbidities. Our findings underscore the need for ancestry-aware studies in multiethnic populations.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106893"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148807062","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":"Extracellular vesicle tissue factor activity in sepsis-associated coagulopathy: advances and remaining challenges","authors":"Ecaterina Scarlatescu","doi":"10.1016/j.rpth.2026.106904","DOIUrl":"10.1016/j.rpth.2026.106904","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106904"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148847943","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":"Clinical decision support tool evaluation: Correction of direct oral anticoagulant dosing errors by clinical pharmacists and physicians","authors":"Anish Saraswat,&nbsp;Shawna N. Smith,&nbsp;Michael P. Dorsch,&nbsp;Morris Fabbri,&nbsp;Jacob Seagull,&nbsp;Seo Youn Choi,&nbsp;Michael Lanham,&nbsp;Geoffrey D. Barnes","doi":"10.1016/j.rpth.2026.106900","DOIUrl":"10.1016/j.rpth.2026.106900","url":null,"abstract":"<div><h3>Background</h3><div>Inappropriate dosing occurs in up to 20% of direct oral anticoagulant (DOAC) prescriptions and is associated with bleeding, hospitalization, and death. Understanding why DOAC dosing errors arise after the initial prescribing period and how clinicians decide to adjust doses may help improve future antithrombotic stewardship efforts.</div></div><div><h3>Objectives</h3><div>This study aimed to describe responses by clinicians to asynchronous electronic health record notifications regarding inappropriate DOAC prescriptions that develop after the initial prescribing period.</div></div><div><h3>Methods</h3><div>As part of a larger randomized trial to improve evidence-based DOAC prescribing, we conducted a manual chart review to assess reasons for inappropriate DOAC prescriptions, clinician response, and reasons for not changing DOAC prescriptions.</div></div><div><h3>Results</h3><div>Most apixaban prescribing errors occurred in patients aged 80 years or older (87.8%). Overall, dose changes occurred after 32.7% of notifications. Notifications to increase the dose of apixaban resulted in fewer dose changes (16.8%) than those to reduce the dose of apixaban (52%), increase the dose of rivaroxaban (43.2%), or decrease the dose of rivaroxaban (43.6%). The original DOAC prescribers were less likely than pharmacists to document a reason for not making a dose change (46.1% vs 90.5%). Renal function, weight, and bleeding-related reasons were commonly cited as reasons not to make a dose change.</div></div><div><h3>Conclusion</h3><div>Various patient factors differentially influenced the likelihood that a clinician would change an inappropriate DOAC prescription. These factors can be used to tailor electronic health record-based notifications to reduce the burden on prescribers while maximizing the impact on patient safety by increasing evidence-based prescribing.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 6","pages":"Article 106900"},"PeriodicalIF":3.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856095","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":"EP3T2_5 Controlling the crisis :Massive Transfusion Requirements in Abnormal Placentation A Retrospective Analysis of Blood Component Utilization and Anesthetic Management at a Tertiary Care Centre","authors":"R. Narala,&nbsp;S. Reddy,&nbsp;G. Nath","doi":"10.1016/j.rpth.2026.106693","DOIUrl":"10.1016/j.rpth.2026.106693","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 ","pages":"Article 106693"},"PeriodicalIF":3.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634164","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}