Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Reduced-dose direct oral anticoagulants for the secondary prevention of venous thromboembolism: finding the sweet spot","authors":"Benjamin Crichi , Maxime Delrue , Corinne Frere","doi":"10.1016/j.rpth.2025.103170","DOIUrl":"10.1016/j.rpth.2025.103170","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103170"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118410","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":"How should abnormal uterine bleeding be managed in people with bleeding disorders: a systematic review of the literature and thematic synthesis","authors":"Rameen Masood ,&nbsp;Vidiya Dev ,&nbsp;Millie Gee ,&nbsp;Katie Finch ,&nbsp;Daniel M. Fletcher ,&nbsp;Olufikayo Bamidele ,&nbsp;Jo Traunter ,&nbsp;David Allsup ,&nbsp;Barbara-ann Guinn","doi":"10.1016/j.rpth.2025.103167","DOIUrl":"10.1016/j.rpth.2025.103167","url":null,"abstract":"<div><div>Abnormal uterine bleeding (AUB) describes any bleeding from the uterus that deviates from the norm in terms of regularity, duration, or volume. AUB is a common condition that can significantly affect quality of life. Although inherited bleeding disorders (IBDs) can cause heavy menstrual bleeding, there is no clear consensus on how AUB is best managed in those patients. This study aimed to address this knowledge gap using evidence based on clinical findings to define the best management of AUB in patients with IBD by conducting a systematic review of the literature. Searches were conducted for articles published from January 1, 2000, until May 6, 2024 in the Embase (PubMed), Medline, Scopus, Cochrane library, Google Scholar, and Cumulative Index to Nursing and Allied Health Literature complete via the Elton B. Stephens Company databases. In total, 244 studies were assessed for eligibility based on inclusion and exclusion criteria. Included studies were appraised for risk of bias and quality assurance using the Newcastle Ottawa Scale, after which data was systematically coded to generate descriptive and analytical themes. Thirteen studies were included in the thematic synthesis, encompassing over 893 participants. Thematic synthesis identified hormonal treatments, such as the levonorgestrel-releasing intrauterine system (LNG-IUS), to be largely effective in the symptom management of AUB in IBDs. Treatment of AUB patients with LNG-IUS, followed by tranexamic acid or 1-deamino-8-d-arginine vasopressin (DDAVP) commonly led to amenorrhea. The use of LNG-IUS as first-line therapy is recommended for those with AUB, followed by the use of combination therapy such as tranexamic acid and desmopressin. We identified the need to strengthen communication between specialists involved in the care of those with AUB and IBDs.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103167"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118409","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":"Characterization of the clinical and laboratory phenotype of hemophilia carriers and trends of utilization of hemostatic therapies: analysis of the American Thrombosis and Hemostasis Network dataset","authors":"Neeraja Swaminathan ,&nbsp;Alison Currie ,&nbsp;Jianzhong Hu ,&nbsp;Roshni Kulkarni ,&nbsp;Steven Pipe ,&nbsp;Peter Kouides ,&nbsp;Anjali Sharathkumar","doi":"10.1016/j.rpth.2025.102994","DOIUrl":"10.1016/j.rpth.2025.102994","url":null,"abstract":"<div><h3>Background</h3><div>Hemophilia carriers (HCs) experience varied bleeding tendencies affecting their quality of life, yet their bleeding phenotype and management remain poorly understood. Since majority of the studies in carriers have focused on women of reproductive age, an unmet need exists to characterize their clinical, laboratory phenotype and treatment patterns across the lifespan.</div></div><div><h3>Objectives</h3><div>The objective of our study was to investigate the age-dependent clinical and laboratory phenotype of hemophilia carriers across the lifespan. We also aimed to study the longitudinal treatment trends in HCs through analysis of the American Thrombosis and Hemostasis Network dataset.</div></div><div><h3>Methods</h3><div>We investigated the age-dependent variation of bleeding phenotype, coagulation factor levels, and trends of utilization of factor concentrates and nonfactor hemostatic therapies (antifibrinolytics, 1-desamino-8-D-arginine vasopressin) in HCs using the American Thrombosis and Hemostasis Network dataset from 2010 to 2020. The study included 3663 HCs (2728 hemophilia A, 935 hemophilia B) divided into 3 age groups: 0 to 12, 13 to 49, and &gt;50 years.</div></div><div><h3>Results</h3><div>Joint bleeding was prevalent across all ages of HCs. While bleeding events were more frequent among HCs within the reproductive-age group, hemophilia B carriers received factor therapy more frequently than hemophilia A carriers (<em>P</em> = .03). Factor (F)VIII activity levels in hemophilia A carriers increased significantly with age (<em>P</em> &lt; .001). Analysis of treatment trends from 2010 to 2020 showed increased utilization of factor concentrates and nonfactor hemostatic therapies among HCs (<em>P</em> &lt; .001 and <em>P</em> = .02, respectively).</div></div><div><h3>Conclusion</h3><div>Our study confirms prior reports of increased bleeding in reproductive-age HCs and identifies lifelong joint bleeding risk. While the rising trend in hemostatic therapy use suggests growing awareness of bleeding tendencies, age-dependent increase in FVIII levels in hemophilia A carriers emphasizes the need for developing tailored management strategies across the lifespan for this population.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 102994"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019504","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":"Incidence of and risk factors for hospital-acquired bleeding in people with cancer: a systematic review","authors":"Mansour Gergi ,&nbsp;Jinah Kim ,&nbsp;Amalia Dolan ,&nbsp;Laura Haines ,&nbsp;Ang Li ,&nbsp;Neil A. Zakai","doi":"10.1016/j.rpth.2025.102998","DOIUrl":"10.1016/j.rpth.2025.102998","url":null,"abstract":"<div><h3>Background</h3><div>Hospital-acquired (HA) bleeding (bleeding occurring during hospitalization) in cancer patients is poorly characterized, potentially increasing morbidity and mortality due to under- or overprescription of low-dose anticoagulation for venous thromboembolism prevention.</div></div><div><h3>Objectives</h3><div>To perform a systematic review and meta-analysis (as appropriate) to identify the incidence of and risk factors for HA bleeding in people with cancer.</div></div><div><h3>Methods</h3><div>A systematic English-language search was conducted using Ovid MEDLINE, Ovid EMBASE, Google Scholar, and Cochrane Library. Keywords and controlled vocabulary related to bleeding risk in hospitalized cancer patients were iteratively refined. Studies assessing HA bleeding as a primary or coprimary endpoint were included, excluding those focused solely on bleeding associated with venous thromboembolism prophylaxis or full-dose anticoagulation. Results were reviewed independently by 3 team members.</div></div><div><h3>Results</h3><div>Six studies met the inclusion criteria. Three studies were conference abstracts, and 3 were peer-reviewed articles. The incidence of HA major bleeding ranged from 1% in all cancer patients admitted to the general medical floor to 14% in hematologic malignancy patients in the intensive care unit.</div></div><div><h3>Conclusion</h3><div>Limited data suggest unique cancer- and patient-related characteristics are associated with risk of HA bleeding. The paucity of objective data on the incidence of and risk factors for HA bleeding in people with cancer underscores the need for further research to define the epidemiology of, improve risk stratification for, and assess clinical outcomes for HA bleeding in people with cancer.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 102998"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019507","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":"Repeated measures of coffee consumption and risk of future incident venous thromboembolism—the Trøndelag Health Study and the Tromsø study","authors":"Melliane Muteba Olsen ,&nbsp;Sigrid K. Brækkan ,&nbsp;Kristian Hveem ,&nbsp;Kjersti Grønning ,&nbsp;John-Bjarne Hansen","doi":"10.1016/j.rpth.2025.103019","DOIUrl":"10.1016/j.rpth.2025.103019","url":null,"abstract":"<div><h3>Background</h3><div>A limited number of epidemiological studies have reported mixed results on the association between coffee consumption and risk of venous thromboembolism (VTE).</div></div><div><h3>Objectives</h3><div>We aimed to investigate the association between repeated measures of coffee consumption over time and risk of incident VTE in a large population-based cohort.</div></div><div><h3>Methods</h3><div>Participants (<em>N</em> = 112,784) were recruited from 4 surveys of the Tromsø Study (enrolment: 1994-2008) and 2 surveys of the Trøndelag Health Study (enrolment: 1995-2008) and followed through 2020. Information on coffee consumption and major confounders (age, sex, body mass index, physical activity, arterial cardiovascular diseases, and cancer) was updated at each survey. Time-varying Cox regression models were used to calculate hazard ratios (HRs) for VTE across categories of coffee consumption.</div></div><div><h3>Results</h3><div>There were 178,696 observation periods and 3419 VTEs during follow-up. A threshold effect was observed, and those who drank 1 to 2 cups of coffee per day had 21% lower risk of overall VTE (HR, 0.79; 95% CI, 0.68-0.93) than nonconsumers. The inverse association of coffee consumption (1-2 cups/d) with VTE was more pronounced for pulmonary embolism (HR, 0.72; 95% CI, 0.58-0.89) than for deep vein thrombosis (HR, 0.87; 95% CI, 0.70-1.09). The HRs for VTE remained similar across categories of higher coffee consumption after adjustments for major potential confounders. The association of coffee consumption with VTE risk was similar in women and men.</div></div><div><h3>Conclusion</h3><div>Coffee consumption was associated with a nonlinear lower risk of overall VTE and, in particular, pulmonary embolism.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103019"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045821","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":"Standard cardiovascular risk prediction scores underestimate risk in immune-mediated thrombotic thrombocytopenic purpura survivors","authors":"Binish Javed ,&nbsp;Jenna Brown ,&nbsp;Jay Meade ,&nbsp;Vijay Nambi ,&nbsp;Ang Li ,&nbsp;Shruti Chaturvedi ,&nbsp;Senthil Sukumar","doi":"10.1016/j.rpth.2025.103005","DOIUrl":"10.1016/j.rpth.2025.103005","url":null,"abstract":"<div><h3>Background</h3><div>Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare hematologic disorder with improved survival due to advancements in treatment. However, long-term cardiovascular morbidity and mortality remain significant. Established cardiovascular risk calculators, such as the 2008 Framingham Heart Study (FHS) global cardiovascular disease (CVD) and the American College of Cardiology/American Heart Association (ACC/AHA) atherosclerotic CVD (ASCVD) risk estimators, may not adequately account for the elevated and unique cardiovascular risks in iTTP survivors.</div></div><div><h3>Objectives</h3><div>To evaluate the discrimination and calibration of the ACC/AHA ASCVD and FHS global CVD models in predicting major adverse cardiovascular events (MACEs) among iTTP survivors.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 135 iTTP survivors from Johns Hopkins University (1994-2024). Presence of MACEs, including myocardial infarction, stroke, and cardiac revascularization, was the primary outcome and was assessed during clinical remission. Discriminatory ability of the model was assessed using c-statistics, while calibration was evaluated with Hosmer-Lemeshow tests and calibration plots. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were also calculated.</div></div><div><h3>Results</h3><div>MACEs occurred in 37.8% of the cohort over a median follow-up of 3.8 years. The ASCVD and FHS models demonstrated poor discrimination (c-statistics, 0.54 and 0.52, respectively) and poor calibration, with observed MACE rates exceeding predicted probabilities (Hosmer–Lemeshow <em>P</em> &lt; .05). The ASCVD model showed sensitivity of 56.5%, specificity of 49.4%, PPV of 36.6%, and NPV of 64.9%, while the FHS model showed sensitivity of 69.6%, specificity of 39.3%, PPV of 37.2%, and NPV of 67.9%.</div></div><div><h3>Conclusion</h3><div>Standard cardiovascular risk models inadequately predict MACE risk in iTTP survivors, underscoring the need for tailored tools that incorporate iTTP-specific factors to improve cardiovascular risk stratification and management.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103005"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019488","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":"STARTing to bridge the evidence gap: management of cancer-associated thrombosis with concomitant thrombocytopenia","authors":"Vasiliki Xirou ,&nbsp;Rushad Patell","doi":"10.1016/j.rpth.2025.103165","DOIUrl":"10.1016/j.rpth.2025.103165","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 6","pages":"Article 103165"},"PeriodicalIF":3.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157995","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":"Is genetic testing for heritable thrombocytopenia coming of age?","authors":"Keith Gomez","doi":"10.1016/j.rpth.2025.102975","DOIUrl":"10.1016/j.rpth.2025.102975","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"102975"},"PeriodicalIF":3.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874947","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":"Prognostic relevance of early clinical and laboratory findings in immune-mediated thrombotic thrombocytopenic purpura.","authors":"Atsushi Hamamura, Kazuya Sakai, Toshiki Mushino, Yasunori Ueda, Yoshiyuki Ogawa, Hiroyuki Noguchi, Akinao Okamoto, Hideo Yagi, Takehiko Mori, Masanori Matsumoto","doi":"10.1016/j.rpth.2025.102974","DOIUrl":"10.1016/j.rpth.2025.102974","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a life-threatening condition caused by a severe deficiency of a disintegrin and metalloproteinase with thrombospondin type 1 motif 13 due to autoantibodies. Despite modern treatments, including therapeutic plasma exchange, immunosuppression, and rituximab, early mortality-often due to cardiac and neurologic events-remains a concern.</p><p><strong>Methods: </strong>We analyzed data from 125 patients between 2010 and 2023 in the Japanese thrombotic thrombocytopenic purpura (TTP) registry, examining demographics, electrocardiogram and transthoracic echocardiography findings, and neurologic symptoms. Troponin I was measured. Outcomes were categorized as survivors, TTP-related deaths, and non-TTP-related deaths.</p><p><strong>Results: </strong>Of the 125 patients, 15 died, with 5 deaths directly related to iTTP. Early cardiac findings and neurologic symptoms were not significant predictors of mortality. However, elevated lactate dehydrogenase levels and reduced von Willebrand factor multimer indices correlated with poorer prognosis. Patients with myocardial hypokinesis finally recovered their condition during the course of treatment. No patient treated with caplacizumab died during the observation period.</p><p><strong>Conclusions: </strong>These findings suggest that early cardiac and neurologic symptoms may not be definitive predictors of iTTP-related death. Instead, extremely high lactate dehydrogenase levels indicated a worse prognosis, highlighting the need for targeted monitoring and interventions in high-risk cases.</p>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"102974"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874948","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":"R<b>ole of polygenic risk scores in venous thromboembolism: current state and future direc</b> <b>tions</b>.","authors":"Aman Goyal, Sonia Hurjkaliani, Kevin Michael Alexander, Jianfeng Xu, Manan Pareek, Arman Qamar","doi":"10.1016/j.rpth.2025.102973","DOIUrl":"10.1016/j.rpth.2025.102973","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is a significant global health concern, with >1 million cases annually in the United States, making it a leading cause of preventable hospital-related deaths. Advances in genetic research, particularly genome-wide association studies, have demonstrated the polygenic nature of VTE by identifying numerous single-nucleotide polymorphisms associated with susceptibility. The polygenic risk score (PRS), which aggregates the effects of multiple single-nucleotide polymorphisms, has emerged as a valuable tool for improving VTE risk assessment. Recent studies have demonstrated that PRS significantly improves VTE risk prediction beyond traditional clinical factors. Integrating genetic and clinical data enhances predictive accuracy, with individuals at high risk identified by PRS showing nearly 8 times the VTE risk of those at low risk. Additionally, PRS models have been developed to predict VTE risk in various predisposing conditions, including malignancies, cardiometabolic disorders, and pulmonary hypertension. These findings indicate that PRS could inform thromboprophylaxis decisions for high-risk patients. Further evidence indicates that PRS improves VTE risk prediction, even in individuals without conventional risk factors, such as family history or lifestyle contributors. The future of PRS in VTE risk stratification is promising, offering refined risk assessment, optimized anticoagulation management, and tailored thromboprophylaxis. However, challenges persist, including the development of multiancestry PRS models to enhance predictive accuracy across diverse populations. Continued research and validation will be essential to unlocking the full clinical potential of PRS in VTE management.</p>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"102973"},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874949","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}