Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Association between coffee consumption and risk of recurrent venous thromboembolism – Results from the Trøndelag Health Study and Tromsø Study","authors":"Melliane M. Olsen,&nbsp;Sigrid K. Brækkan,&nbsp;Kristian Hveem,&nbsp;Kjersti Grønning,&nbsp;John-Bjarne Hansen","doi":"10.1016/j.rpth.2026.106966","DOIUrl":"10.1016/j.rpth.2026.106966","url":null,"abstract":"<div><h3>Background</h3><div>Epidemiological studies have shown that coffee consumption is associated with a lowered risk of incident venous thromboembolism (VTE). No previous study has explored whether coffee consumption influences the risk of VTE recurrence.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate whether the amount of coffee consumption (cups/d) is associated with the risk of VTE recurrence in a population-based cohort of incident VTEs.</div></div><div><h3>Methods</h3><div>The cohort consisted of 2071 patients with incident VTE recruited from 4 surveys of the Tromsø Study (enrolment, 1994-2008) and the third survey of the Trøndelag Health Study (enrolment, 2006-2008), followed from the date of the index VTE until 2020. Information on coffee consumption (cups/d) and potential confounders was extracted. Cox regression models were used to estimate hazard ratios (HRs) with 95% CIs for VTE recurrence.</div></div><div><h3>Results</h3><div>During a median follow-up of 2.8 years, 310 recurrent VTEs occurred. There was no linear relationship between increasing coffee intake and VTE recurrence. The HR for recurrence was 0.49 (95% CI, 0.30-0.81) for those consuming 1 to 2 cups of coffee per day and 0.71 (95% CI, 0.44-1.12) for those consuming &gt;6 cups compared with noncoffee consumers. The association between coffee consumption (yes/no) and lowered recurrence risk was more pronounced for provoked index VTE event (HR, 0.50; 95% CI, 0.30-0.82) than for unprovoked index VTE (HR, 1.01; 95% CI, 0.53-1.94).</div></div><div><h3>Conclusion</h3><div>Coffee consumption was associated with a nonlinear, lowered risk of VTE recurrence, particularly after provoked VTE. Our findings suggest that coffee can be safely consumed after VTE, potentially with a beneficial effect on recurrence risk.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106966"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162542","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 screening assay for type 2B von Willebrand factor variants using an enzyme-linked immunosorbent assay based on recombinant wild-type glycoprotein Ib and ristocetin","authors":"Maria Teresa Pagliari,&nbsp;Luciano Baronciani,&nbsp;Paola Colpani,&nbsp;Giovanna Cozzi,&nbsp;Omid Seidizadeh,&nbsp;Alessandro Ciavarella,&nbsp;Simona Maria Siboni,&nbsp;Flora Peyvandi","doi":"10.1016/j.rpth.2026.106971","DOIUrl":"10.1016/j.rpth.2026.106971","url":null,"abstract":"<div><h3>Background</h3><div>Type 2B von Willebrand disease (VWD) is caused by gain-of-function variants in the A1 domain of von Willebrand factor (VWF), leading to increased platelet binding, loss of high-molecular-weight multimers, and sometimes thrombocytopenia. Conventional diagnosis relies on ristocetin-induced platelet agglutination or molecular testing.</div></div><div><h3>Aim</h3><div>To evaluate an in-house enzyme-linked immunosorbent assay (ELISA) based on a recombinant glycoprotein Ib wild-type (rGPIb-WT) fragment and ristocetin, as a screening tool to identify first-time referral patients requiring further evaluation for possible type 2B VWD.</div></div><div><h3>Materials and Methods</h3><div>Plasma from 131 healthy controls and 31 type 2B patients was analyzed using rGPIb-WT ELISA at ristocetin concentrations of 0.06, 0.09, and 0.12 mg/mL. Optical density ratios of plasma sample to normal pooled plasma were used to generate receiver operating characteristic curves and define screening cut−offs. Plasma from 254 first-time referrals was tested. Positive samples were evaluated for platelet-dependent VWF activity over VWF antigen ratio (VWF:GPIbR/VWF:Ag) and VWF multimers. Candidate patients underwent <em>VWF</em> exon 28 Sanger sequencing.</div></div><div><h3>Results</h3><div>Twenty-six of 254 patients tested positive at least at 1 ristocetin concentration. Sixteen were considered candidates for type 2B VWD evaluation based on a VWF:GPIbR/VWF:Ag ratio &lt;0.7 and/or an abnormal multimeric pattern. Type 2B variants were found in 12 of 16 sequenced patients. The remaining 10 patients showed ultra−large multimers or an increased proportion of high-molecular-weight multimers; 8 of these had a normal VWF:GPIbR/VWF:Ag ratio (&gt;0.7).</div></div><div><h3>Discussion</h3><div>The rGPIb-WT ELISA positivity may reflect type 2B variants or the presence of larger multimers. Integrated with conventional assays, positivity may guide type 2B–directed evaluation.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106971"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149213346","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 significance of symptomatic and incidental venous thromboembolism in patients with cancer treated with apixaban","authors":"Parwana Hussaini,&nbsp;Trine-Lise Larsen,&nbsp;Waleed Ghanima,&nbsp;Anders Erik Astrup Dahm","doi":"10.1016/j.rpth.2026.106968","DOIUrl":"10.1016/j.rpth.2026.106968","url":null,"abstract":"<div><h3>Background</h3><div>Clinical characteristics and outcomes of patients with cancer with symptomatic vs incidental venous thromboembolism (VTE) remain poorly described.</div></div><div><h3>Methods</h3><div>In this <em>post hoc</em> analysis of the apixaban as treatment of venous thrombosis in patients with cancer (CAP) study, we explored patients with cancer with VTE who received apixaban 5 mg twice daily for 6 months and then 2.5 mg twice daily for 30 months. Patients were classified as having symptomatic or incidental VTE at inclusion. The main outcomes were recurrent VTE and clinically relevant bleeding. Baseline characteristics and outcomes were compared between the 2 groups during a 36-month follow-up.</div></div><div><h3>Results</h3><div>Of 284 patients, 163 (57%) had incidentally detected VTE. Compared with symptomatic patients, incidental patients had lower body mass index, more metastatic disease (79% vs 57%), and more pulmonary embolism or abdominal vein thrombosis. Deep vein thrombosis of the leg was more frequent in the symptomatic group (45.4% vs 7.4%, <em>P</em> &lt; .001). There were more colorectal cancers in the incidental group (31.9% vs 19.0%, <em>P =</em> .01) and more hematological (14.1% vs 5.5%, <em>P =</em> .01) or breast cancers (14.9% vs 5.5%, <em>P =</em> .01) in the symptomatic group. Recurrent VTE occurred in 9.8% of incidental and 6.6% of symptomatic patients (subdistribution hazard ratio, 1.5; 95% CI, 0.6-3.5). Clinically relevant bleeding was more frequent in the incidental group (24.5% vs 13.2%; subdistribution hazard ratio, 1.9; 95% CI, 1.1-3.4). In the multivariable analysis, low hemoglobin and incidental VTE were independently associated with bleeding.</div></div><div><h3>Conclusion</h3><div>The characteristics and outcomes in patients with incidental VTE differed from those with symptomatic VTE. While VTE recurrence was similar between the two groups, incidental VTE was associated with a higher risk of bleeding.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106968"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162562","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":"Microplastics, nanoplastics, and thrombogenesis","authors":"Rhesha Balwan,&nbsp;Yu Yue Hew,&nbsp;Gerard Gurumurthy,&nbsp;Xiao Wei Ang,&nbsp;Ryan Ruiyang Ling,&nbsp;Chuanhui Xu,&nbsp;Ying Jie Chee,&nbsp;Rinkoo Dalan,&nbsp;Prahlad Ho,&nbsp;Hui Yin Lim,&nbsp;Barbara D. Lam,&nbsp;Jecko Thachil,&nbsp;Emmanuel J. Favaloro,&nbsp;Bingwen Eugene Fan","doi":"10.1016/j.rpth.2026.106931","DOIUrl":"10.1016/j.rpth.2026.106931","url":null,"abstract":"<div><div>Micro- and nanoplastics (MNPs) are produced through mechanical, chemical, and ultraviolet-mediated degradation of plastics and may enter the human bloodstream via ingestion, inhalation, dermal exposure, and iatrogenic sources. Their detection in human blood, atheromas, and thrombi has raised concerns that they may contribute to thrombogenesis. We conducted a structured narrative review of English-language studies indexed in PubMed, Embase, and Scopus over the preceding 15 years, up to March 31, 2026. The search identified 981 database records and 39 additional manually identified articles; after removing duplicates and screening, 72 articles were included. Evidence was synthesized according to Virchow’s triad, focusing on endothelial injury, altered blood flow, hypercoagulability, cellular uptake, polymer type, surface charge, weathering, and protein corona formation. MNPs may contribute to all 3 components of Virchow’s triad. Proposed mechanisms include oxidative endothelial injury, glycocalyx disruption, monocyte adhesion, foam-cell formation, plaque instability, immune cell-mediated microvascular obstruction, platelet activation, NETosis, von Willebrand factor interactions, factor XII activation, thrombin generation, and fibrin-rich clot stabilization. These effects appear to vary with particle size, polymer composition, surface charge, and environmental weathering. However, mechanistic evidence largely comes from polystyrene nanoparticle models, whereas human thrombus and atheroma studies more commonly detect polyethylene and polyvinyl chloride. MNPs are biologically plausible contributors to thrombogenesis, but their clinical relevance remains uncertain. Prospective human studies, standardized contamination-controlled detection methods, and dose-response experiments using clinically relevant particles and concentrations are required.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106931"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162528","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":"Abnormal lipid profiles are associated with markers of impaired fibrinolysis in patients with cirrhosis","authors":"Fynn L. Elvers,&nbsp;Jelle Adelmeijer,&nbsp;Marilena Stamouli,&nbsp;William Bernal,&nbsp;Vishal C. Patel,&nbsp;Ton Lisman","doi":"10.1016/j.rpth.2026.106975","DOIUrl":"10.1016/j.rpth.2026.106975","url":null,"abstract":"<div><h3>Background</h3><div>Patients with liver cirrhosis exhibit abnormalities in lipid metabolism and in circulating proteins of clot breakdown. Recent studies have shown relationships between dyslipidemia and fibrinolytic abnormalities in noncirrhotic populations.</div></div><div><h3>Objectives</h3><div>We investigated associations between lipid profiles and fibrinolytic markers in patients with cirrhosis.</div></div><div><h3>Methods</h3><div>This observational study analyzed samples from 147 patients with stable cirrhosis, decompensated cirrhosis, acute-on-chronic liver failure, and sepsis without pre-existing chronic liver disease, and from 38 healthy controls. We studied fibrinolysis by clot lysis time (CLT), plasminogen, plasminogen activator inhibitor-1 (PAI-1), and tissue-type plasminogen activator (tPA), and lipid profiles by apolipoproteins A1 and B, common lipoproteins, triglycerides, and total cholesterol.</div></div><div><h3>Results</h3><div>CLT was slightly enhanced in stable and decompensated cirrhosis, but prolonged in acute-on-chronic liver failure and sepsis. Plasminogen levels decreased, whereas PAI-1 and tPA increased with cirrhosis severity. All lipid parameters decreased with cirrhosis severity, besides triglyceride levels, which were preserved. In an analysis of all patients with cirrhosis combined, apolipoprotein A1 correlated inversely with CLT, levels of PAI-1 and tPA, and positively with plasminogen. Apolipoprotein B, low-density lipoprotein, and lipoprotein(a) correlated positively with plasminogen. Triglycerides correlated positively with CLT.</div></div><div><h3>Conclusion</h3><div>Cirrhosis is characterized by decreased (apo)lipoprotein levels, preserved triglyceride levels, and a shift from enhanced to impaired fibrinolysis with increasing disease severity. Lower apolipoprotein A1 levels and higher triglyceride levels are associated with impaired fibrinolysis, which may reflect biological interactions between lipid metabolism and fibrinolysis or parallel alterations secondary to hepatic dysfunction.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106975"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162566","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":"Rapid plasma-based screening of fibrinolytic activation in trauma: a single-center observational cohort study","authors":"Anton Ilich,&nbsp;Izabela Pawlinski,&nbsp;Matthew J. Eckert,&nbsp;Linda E. Sousse,&nbsp;Jared R. Gallaher,&nbsp;Myung S. Park,&nbsp;Alyssa Caldwell-McGee,&nbsp;Mitchell J. Cohen,&nbsp;Jessica C. Cardenas,&nbsp;Nigel S. Key","doi":"10.1016/j.rpth.2026.106999","DOIUrl":"10.1016/j.rpth.2026.106999","url":null,"abstract":"<div><h3>Background</h3><div>Viscoelastic testing is commonly used to assess fibrinolytic phenotypes in trauma, with values of thromboelastogram (TEG) clot lysis at 30 minutes after maximum amplitude (LY30) &gt;3% considered indicative of hyperfibrinolysis. The \"Fibrinolytic Activation Screening Test\" (FAST) is a rapid assay that detects endogenous tissue plasminogen activator–dependent and plasmin-dependent fibrinolytic activation.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate FAST activity in trauma and determine its correlation with other indices of fibrinolytic activation, including plasmin-antiplasmin (PAP) complexes and TEG LY30.</div></div><div><h3>Methods</h3><div>FAST activity and PAP complexes were assayed in archived plasma samples from 99 patients with trauma on presentation. We evaluated the association of FAST activity with 4 different PAP thresholds (&gt;2000 ng/mL, &gt;5000 ng/mL, &gt;10,000 ng/mL, or &gt;20,000 ng/mL) representing increasing degrees of fibrinolytic activation.</div></div><div><h3>Results</h3><div>FAST activity was elevated in 65% of patients with trauma on admission. By Spearman’s rank correlation, FAST activity was strongly correlated with PAP complexes (<em>r</em>_<em>s</em> = 0.74). The strong association of FAST activity with all 4 PAP thresholds was more pronounced with increasing cutoffs, indicating enhanced specificity of FAST activity with greater fibrinolytic activation. TEG LY30 showed no correlation with FAST activity (<em>r</em>_<em>s</em> = –0.07) and no correlation with PAP complexes (<em>r</em>_<em>s</em> = –0.18). In an exploratory analysis, the FAST assay demonstrated good discriminatory performance for in-hospital mortality by receiver operating characteristic analysis (area under the curve, 0.8023; 95% CI, 0.6417-0.9630).</div></div><div><h3>Conclusion</h3><div>The FAST assay is a rapid and specific measure of fibrinolytic activation in trauma.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106999"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149253982","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":"Early outcomes after venous thromboembolism in Hispanic and non-Hispanic patients: insights from the Registro Informatizado de Enfermedad TromboEmbólica Registry","authors":"Lizbeth Cabrera,&nbsp;Alfonso Tafur,&nbsp;Leticia Guirado-Torrecillas,&nbsp;Jose Maria Pedrajas,&nbsp;Fares Moustafa,&nbsp;Concepción Falgá,&nbsp;Aída Gil-Díaz,&nbsp;Andris Skride,&nbsp;Javier Pagán Escribano,&nbsp;Manuel Monreal","doi":"10.1016/j.rpth.2026.106969","DOIUrl":"10.1016/j.rpth.2026.106969","url":null,"abstract":"<div><h3>Background</h3><div>Racial and ethnic differences in venous thromboembolism (VTE) incidence have been reported, but Hispanic patients remain underrepresented in VTE cohorts, and their 90-day postdiagnosis outcomes remain incompletely characterized.</div></div><div><h3>Objectives</h3><div>To compare 90-day risks of recurrent VTE, major bleeding, and mortality between Hispanic and non-Hispanic patients with acute VTE.</div></div><div><h3>Methods</h3><div>Exposure-matched analysis of the Registro Informatizado de Enfermedad TromboEmbólica Investigators registry, a prospective, international cohort of adults with acute VTE. Hispanic patients were matched 1:3 to non-Hispanic patients by age, sex, index VTE phenotype, active cancer, and calendar period. The matched cohort included 1792 Hispanic and 5376 non-Hispanic patients. Exposure was self-identified Hispanic ethnicity. Main outcomes and measures were 90-day recurrent VTE, major bleeding, and all-cause mortality. Odds ratios (ORs) with 95% CIs were estimated using hierarchical logistic regression.</div></div><div><h3>Results</h3><div>The matched cohort had a mean age of 57 ± 18 years, and 59% were women. At 90 days, recurrent VTE occurred in 1.6% of Hispanic patients and 1.2% of non-Hispanic patients (absolute difference, 0.4 percentage points); major bleeding occurred in 2.1% and 1.7%, respectively (absolute difference, 0.4 percentage points); the composite outcome occurred in 3.4% and 2.9%, respectively (absolute difference, 0.5 percentage points); and mortality occurred in 4.1% and 3.9%, respectively (absolute difference, 0.2 percentage points). In fully adjusted models, Hispanic ethnicity was associated with increased odds of recurrent VTE (OR, 1.90; 95% CI, 1.10-3.28), major bleeding (OR, 1.73; 95% CI, 1.09-2.75), and the composite outcome (OR, 1.77; 95% CI, 1.23-2.54), but not mortality (OR, 1.05; 95% CI, 0.68-1.64).</div></div><div><h3>Conclusion</h3><div>In this matched registry analysis, self-identified Hispanic ethnicity was associated with modestly higher adjusted odds of recurrent VTE and major bleeding, but not mortality. Although adjusted relative estimates differed, absolute differences were small. These observational associations should not be interpreted as causal because residual confounding cannot be excluded.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106969"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149162531","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":"Concizumab for the management of heavy menstrual bleeding in a woman with mild hemophilia A","authors":"Yoko Mizoguchi,&nbsp;Maiko Shimomura,&nbsp;Yuko Teraoka,&nbsp;Teruhisa Fujii,&nbsp;Satoshi Okada","doi":"10.1016/j.rpth.2026.106979","DOIUrl":"10.1016/j.rpth.2026.106979","url":null,"abstract":"<div><h3>Background</h3><div>Heavy menstrual bleeding (HMB) is a common bleeding manifestation in women with hemophilia A and may impair quality of life.</div></div><div><h3>Key Clinical Question</h3><div>Can concizumab control refractory HMB in a woman with mild hemophilia A who cannot tolerate conventional therapies?</div></div><div><h3>Clinical Approach</h3><div>An 18-year-old woman with mild hemophilia A had prolonged menstruation. Combined oral contraceptives improved bleeding but were discontinued because of mood-related adverse effects. Extended half-life factor (F)VIII concentrates shortened menstruation but caused significant burden due to repeated venipuncture. Following shared decision making, subcutaneous concizumab was initiated. During concizumab treatment, menstrual duration was generally maintained at 7 to 11 days per cycle. Menstrual control deteriorated after temporary concizumab dose reduction and remained inadequate despite the addition of tranexamic acid, prompting restoration of the previous concizumab dose. Subsequent concizumab concentration and D-dimer levels were within their respective target or reference ranges.</div></div><div><h3>Conclusions</h3><div>Concizumab provided menstrual bleeding control broadly comparable with intravenous FVIII replacement while reducing treatment burden. This single case does not establish concizumab as a treatment for HMB in women with mild hemophilia A, but its potential role in carefully selected patients warrants further investigation.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 106979"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149213395","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":"Signal of venous thromboembolism with ethinyl estradiol vs natural estrogens in oral contraceptives: analysis of the EudraVigilance and Food and Drug Administration Adverse Events Reporting System databases","authors":"Lucie Raskin,&nbsp;Marie Didembourg,&nbsp;Médéa Locquet,&nbsp;Laure Morimont,&nbsp;Charlotte Beaudart,&nbsp;Jean-Michel Dogné,&nbsp;Jonathan Douxfils","doi":"10.1016/j.rpth.2026.107005","DOIUrl":"10.1016/j.rpth.2026.107005","url":null,"abstract":"<div><h3>Background</h3><div>Disproportionality analyses in the Food and Drug Administration Adverse Events Reporting System (FAERS) and EudraVigilance reported lower reporting of venous thromboembolism (VTE) with natural estrogen–based combined oral contraceptives (COCs) than with ethinylestradiol/levonorgestrel. However, using ethinylestradiol/levonorgestrel as the reference showed reduced reporting only for natural estrogen–based products. We therefore reanalyzed both databases separately, using natural estrogen–based COCs as the reference.</div></div><div><h3>Methods</h3><div>Previously extracted individual case safety report datasets and published disproportionality analyses were re-examined, using natural estrogen–based contraceptives as the comparator. Proportional reporting ratios (PRRs) were recalculated separately for each database. COCs were categorized as ethinylestradiol-based or natural estrogen–based formulations. Drospirenone-only pills were included for comparison. Analyses used pooled natural estrogen contraceptives, estetrol/drospirenone, or estradiol/dienogest as reference groups. Disproportionality was defined as PRR &gt;2, at least 3 cases, and χ² ≥ 4.</div></div><div><h3>Discussion</h3><div>Consistent patterns were observed in EudraVigilance and FAERS. Compared with natural estrogen–based COCs, ethinylestradiol-based COCs showed a disproportionate reporting of VTE (EudraVigilance: PRR, 5.10 [95% CI, 4.68-5.56]; FAERS: PRR, 4.21 [95% CI, 3.49-5.08]). In EudraVigilance, when using estetrol/drospirenone as the reference, all ethinylestradiol-based formulations showed disproportionality according to the conventional PRR threshold. A similar trend was noted in FAERS, though not statistically significant, with the drospirenone-only formulation comparable to estetrol/drospirenone.</div></div><div><h3>Conclusion</h3><div>This analysis revealed a consistent and disproportionate reporting of VTE associated with ethinylestradiol-based COCs compared with natural estrogen–based alternatives across 2 pharmacovigilance databases. These results, together with prior biological and observational research, support further reevaluation of COC options given the estrogenic component’s potential influence on VTE risk.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 107005"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149283030","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":"AngioJet rheolytic thrombectomy under superior vena cava filter protection for acute upper extremity deep vein thrombosis in patients with cancer: a single-center, retrospective analysis","authors":"Shaobo Zhai,&nbsp;Jia Yu,&nbsp;Jifeng Sun,&nbsp;Yangyang Yu,&nbsp;Cheng Gao","doi":"10.1016/j.rpth.2026.107002","DOIUrl":"10.1016/j.rpth.2026.107002","url":null,"abstract":"<div><h3>Objective</h3><div>The incidence of upper extremity deep vein thrombosis (UEDVT) is increasing, and percutaneous mechanical thrombectomy (PMT) is receiving more attention as a treatment option. This study aims to evaluate the efficacy and clinical outcomes of PMT combined with superior vena cava (SVC) filter protection in cancer patients with acute UEDVT.</div></div><div><h3>Methods</h3><div>This study included all patients with acute UEDVT who underwent treatment with an 8-Fr AngioJet thrombectomy system (Boston Scientific) under the protection of a retrievable SVC filter between January 1, 2020, and October 1, 2025. The evaluation indicators included technical success rate (defined as a thrombus clearance rate &gt;80%), intraoperative adverse events, degree of limb swelling relief, incidence of pulmonary embolism, and thrombus recurrence during follow-up.</div></div><div><h3>Results</h3><div>A total of 19 patients (10 female; mean age 60.84 ± 11.30 years) were included. All patients had secondary UEDVT and a history of malignant tumors, with 14 cases (73.7%) having a history of central venous catheterization. All procedures achieved technical success, with no severe adverse events such as major bleeding occurring intraoperatively, nor were there any new symptomatic pulmonary embolisms. The average circumference of the affected limb 10 cm above the elbow before surgery was 29.83 ± 2.20 cm, which decreased to 26.98 ± 2.0 cm on the second postoperative day. During the 6-month follow-up, one patient with advanced lung cancer developed swelling of the upper limb on postoperative day 136, confirmed by ultrasound to be a recurrence of deep vein thrombosis; another patient was found to have an asymptomatic mural thrombus on ultrasound examination on postoperative day 28.</div></div><div><h3>Conclusion</h3><div>PMT with the 8-Fr AngioJet system and SVC filter protection appears to be a safe and effective treatment option for cancer patients with acute UEDVT.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 7","pages":"Article 107002"},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149253981","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}