Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Efficacy and safety of direct oral anticoagulants compared with warfarin in antiphospholipid syndrome. Results of a multicenter retrospective cohort study","authors":"Maha A.T. Elsebaie ,&nbsp;Zoe Wickham ,&nbsp;Stephanie DeBragga ,&nbsp;Stacey Fedewa ,&nbsp;Mohamed Amgad ,&nbsp;Jane Jungyoon Park ,&nbsp;Allen Li ,&nbsp;Ali Eshaghpour ,&nbsp;Juan Li ,&nbsp;Mark Crowther ,&nbsp;Manila Gaddh","doi":"10.1016/j.rpth.2025.102856","DOIUrl":"10.1016/j.rpth.2025.102856","url":null,"abstract":"<div><h3>Background</h3><div>Direct oral anticoagulants (DOACs) have become firstline treatment for many thrombotic conditions, but their use in antiphospholipid syndrome (APS) patients remains controversial.</div></div><div><h3>Objectives</h3><div>This multicenter, retrospective cohort study conducted at Emory and McMaster University Medical Centers aimed to explore pattern of DOAC use among APS patients and compare the efficacy and safety of DOACs vs warfarin.</div></div><div><h3>Methods</h3><div>We included APS patients aged ≥18 years who experienced acute thrombosis between 2012 and 2018 and initiated DOACs or warfarin. Clinical endpoints were recurrent thrombosis, clinically relevant bleeding, and a composite of thrombosis and bleeding (net clinical benefit). Cox proportional hazards models estimated hazard ratios (HRs) for the clinical endpoints and defined DOAC or warfarin exposure as time-varying to account for anticoagulant switching.</div></div><div><h3>Results</h3><div>A total of 152 patients were identified: 77 initiated treatment with warfarin and 75 with DOACs. Sixty patients switched anticoagulation therapy at least once. Twenty-four patients had triple-positive antiphospholipid antibodies anticoagulation class (DOAC vs warfarin) did not influence risk of recurrent thrombosis (HR, 0.91; 95% CI, 0.46-1.79) or net clinical benefit (HR, 0.81; 95% CI, 0.46-1.43). Conversely, DOACs were associated with 57% reduction in risk of clinically relevant bleeding (HR, 0.43; 95% CI, 0.20-0.95). The risk of recurrent venous or arterial thrombosis was comparable between DOAC and warfarin cohorts.</div></div><div><h3>Conclusion</h3><div>This study demonstrated comparable efficacy and improved safety of DOACs over warfarin in a predominantly lower-risk APS population. Caution is advised, particularly in APS patients with triple-positive antiphospholipid antibodies or history of arterial thrombosis.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102856"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070412","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":"Clonal hematopoiesis in patients with cancer and its association with risk of thrombosis and prognosis of disease","authors":"Cornelia Englisch ,&nbsp;Roland Jäger ,&nbsp;Jasmina Gassner ,&nbsp;Alice Assinger ,&nbsp;Matthias Preusser ,&nbsp;Peter Valent ,&nbsp;Ingrid Pabinger ,&nbsp;Cihan Ay","doi":"10.1016/j.rpth.2025.102882","DOIUrl":"10.1016/j.rpth.2025.102882","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cancer are at high risk for cardiovascular events, especially venous and arterial thromboembolism (VTE/ATE). Clonal hematopoiesis (CH) has been identified as risk factor for cardiovascular diseases. However, there is limited insight into the impact of CH on thrombosis risk in patients with cancer.</div></div><div><h3>Objectives</h3><div>The aim of this study was to elucidate the association between CH and cancer-associated VTE and ATE within the framework of the Vienna Cancer and Thrombosis Study (CATS), a prospective observational cohort study.</div></div><div><h3>Methods</h3><div>Peripheral blood DNA samples collected at study inclusion were screened for CH-associated mutations.</div></div><div><h3>Results</h3><div>In this study, 967 patients (median age: 61 [interquartile range, IQR: 50-68] years, 49.9% female) were included and followed-up for a median of 24 (IQR: 24-24) months. Of those, 787 (78.3%) had newly diagnosed cancer and 434 (44.9%) had stage IV disease. We identified 52 CH-associated variants in 46 patients (4.8%). Mutations in the genes <em>DNMT3A</em> (48.1%) and <em>TP53</em> (17.3%) were most commonly found. The presence of CH was not associated with VTE (adjusted subdistribution hazard ratio: 0.68, 95% CI: 0.21-2.19) or ATE risk (adjusted subdistribution hazard ratio: 1.08, 95% CI: 0.15-8.06). Available laboratory parameters and inflammatory and hemostatic biomarkers did not differ according to CH carrier status. Compared with patients without CH, those with CH showed decreased overall survival; however, this was not independent of age.</div></div><div><h3>Conclusion</h3><div>In our cohort of patients with cancer, the presence of CH was not associated with an increased risk of VTE or ATE. CH had no independent impact on overall survival.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102882"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196038","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":"In vivo activation of coagulation during human liver transplantation is associated with activation of the intrinsic pathway: an observational cohort study","authors":"Fynn L. Elvers ,&nbsp;Jelle Adelmeijer ,&nbsp;Sarah Bos ,&nbsp;Coen Maas ,&nbsp;William Bernal ,&nbsp;Ton Lisman","doi":"10.1016/j.rpth.2025.102872","DOIUrl":"10.1016/j.rpth.2025.102872","url":null,"abstract":"<div><h3>Background</h3><div>Patients undergoing hepato-pancreato-biliary surgery experience substantial changes in their hemostatic system. The postoperative risk of venous thromboembolism is high, even in the presence of adequate thromboprophylaxis.</div></div><div><h3>Objectives</h3><div>As the hemostatic mechanisms underlying the thrombotic risk in these patients are incompletely studied, we aimed to identify the extent of <em>in vivo</em> activation of coagulation in relation to the activation of the intrinsic and extrinsic pathways.</div></div><div><h3>Methods</h3><div>We studied plasma samples before, during, and after surgery from patients undergoing orthotopic liver transplantation (OLT; <em>n</em> = 20), partial hepatectomy (<em>n</em> = 20), and pylorus-preserving pancreaticoduodenectomy (PPPD; <em>n</em> = 20). Activation of coagulation was assessed by levels of thrombin-antithrombin (TAT) complexes and D-dimer. Intrinsic activation was assessed with ELISA detecting free factor (F)XIIa and C1-esterase inhibitor bound to coagulation FXIIa, FXIa, and plasma kallikrein. Extrinsic activation was assessed by quantification of FVIIa-antithrombin complexes.</div></div><div><h3>Results</h3><div>TAT and D-dimer were significantly elevated peri- and postoperatively in patients undergoing hepato-pancreato-biliary surgery. Markers of intrinsic pathway activation increased during OLT but not in patients undergoing partial hepatectomy or PPPD. Markers of extrinsic activation were low in all surgeries, even after adjustment for FVII zymogen levels. TAT and D-dimer were positively associated with intrinsic activation during OLT.</div></div><div><h3>Conclusion</h3><div>This study provides evidence that enhanced activation of coagulation during liver transplantation is mediated by the intrinsic pathway of coagulation, whereas the route of coagulation activation in patients undergoing partial hepatectomy and PPPD remains unclear.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102872"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105626","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":"75 Comparative Effectiveness and Safety of Direct Oral Anticoagulants Compared with Warfarin in Patients with Low Bodyweight who have Atrial Fibrillation: A Systematic Review and Meta-analysis","authors":"Mohamed Elshafei ,&nbsp;Ahmed El-Bardissy ,&nbsp;Muhammad Salem ,&nbsp;Mohamed Abdelmoneim ,&nbsp;Mohammed Danjuma","doi":"10.1016/j.rpth.2025.102769","DOIUrl":"10.1016/j.rpth.2025.102769","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102769"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203206","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":"172 Antithrombosis Stewardship as a Key Driver Within a VTE Center Of Excellence: The AMBITION Study","authors":"Angela Martoccia Grabazs ,&nbsp;Preeyaporn Sarangarm ,&nbsp;Allison E. Burnett","doi":"10.1016/j.rpth.2025.102760","DOIUrl":"10.1016/j.rpth.2025.102760","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102760"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203240","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":"187 Anticoagulation Stewardship Program Impact on Deprescribing Inappropriate Antiplatelet Therapy for Patients on Oral Anticoagulation Therapy in the Outpatient Setting","authors":"Josey Poppens ,&nbsp;Thaddaus Hellwig ,&nbsp;Shannon Wegleitner ,&nbsp;Sara Zochert ,&nbsp;Amanda Owen ,&nbsp;Michael Gulseth","doi":"10.1016/j.rpth.2025.102763","DOIUrl":"10.1016/j.rpth.2025.102763","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102763"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203323","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":"155 Evaluating the Clinical Utility and Appropriateness of Four-Factor Prothrombin Complex Concentrates for Anticoagulation Reversal at an Urban, Community Academic Hospital","authors":"Nicole Thurnherr ,&nbsp;Youssef Bessada","doi":"10.1016/j.rpth.2025.102809","DOIUrl":"10.1016/j.rpth.2025.102809","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102809"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203333","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":"96 The Effect of Individualized Intravenous Heparin Dosing on Activated Partial Thromboplastin Time Values in Neurocritical Care Patients","authors":"Keri S. Kim ,&nbsp;Mya Fitzpatrick ,&nbsp;Ruchi Patel ,&nbsp;Nishita Gandhi ,&nbsp;John Garofalo ,&nbsp;Jeffrey J. Mucksavage","doi":"10.1016/j.rpth.2025.102777","DOIUrl":"10.1016/j.rpth.2025.102777","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102777"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203341","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":"133 Argatroban Use in Therapeutic Plasma Exchange (TPE): A Case of Dynamic Anticoagulation Response","authors":"Jennifer E. Stanton ,&nbsp;Alexander R. Nixon","doi":"10.1016/j.rpth.2025.102779","DOIUrl":"10.1016/j.rpth.2025.102779","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102779"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203409","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":"180 Elevation of D-Dimer Without Any Evidence of Venous Thromboembolism: What Is Your Interpretation?","authors":"Om Joshi ,&nbsp;Riddhi Surve ,&nbsp;Deepa Nagarajan ,&nbsp;Atul Laddu ,&nbsp;Jawed Fareed","doi":"10.1016/j.rpth.2025.102830","DOIUrl":"10.1016/j.rpth.2025.102830","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102830"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203457","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}