Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Radiotherapy—the not-so-insignificant contributor to cancer-associated venous thrombosis","authors":"Gerard Gurumurthy ,&nbsp;Jacob Miller ,&nbsp;Marc Carrier ,&nbsp;Alok Khorana ,&nbsp;Jecko Thachil","doi":"10.1016/j.rpth.2025.102985","DOIUrl":"10.1016/j.rpth.2025.102985","url":null,"abstract":"<div><div>Venous thromboembolism is a well-established complication in patients with cancer and a leading cause of morbidity and mortality in these subjects. However, the role of radiotherapy in cancer-associated venous thromboembolism (CAT) remains less clearly defined. The incidence of CAT in this population varies widely, with several large-scale studies suggesting an association. Although management of CAT in this population follows standard guidelines, less is known about the appropriateness of thromboprophylaxis in patients with different types of cancer. Patients with cancer undergoing radiotherapy may also be at increased risk of bleeding, which may be further worsened by anticoagulation. A multidisciplinary approach integrating hematology and oncology expertise is essential in this setting. Further research is needed to establish standardized protocols and predictive models to identify those at risk of thrombosis and bleeding while on anticoagulation.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102985"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829571","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":"Protein C concentrate pharmacokinetics—no need to fear the curve","authors":"Tiago Nava MD, PhD","doi":"10.1016/j.rpth.2025.102962","DOIUrl":"10.1016/j.rpth.2025.102962","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102962"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144711224","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":"Time to move beyond risk assessment models for ambulatory cancer-associated thrombosis","authors":"Karlyn A. Martin,&nbsp;Chris Holmes","doi":"10.1016/j.rpth.2025.102991","DOIUrl":"10.1016/j.rpth.2025.102991","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102991"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885482","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":"Artificial intelligence in clinical thrombosis and hemostasis: A review","authors":"Yi Kiat Isaac Kuan ,&nbsp;Yixin Jamie Kok ,&nbsp;Nigel Sheng Hui Liu ,&nbsp;Brandon Jin An Ong ,&nbsp;Ying Jie Chee ,&nbsp;Chuanhui Xu ,&nbsp;Minyang Chow ,&nbsp;Kollengode Ramanathan ,&nbsp;Rinkoo Dalan ,&nbsp;Prahlad Ho ,&nbsp;Bingwen Eugene Fan","doi":"10.1016/j.rpth.2025.102984","DOIUrl":"10.1016/j.rpth.2025.102984","url":null,"abstract":"<div><h3>Background</h3><div>Artificial Intelligence (AI) and machine learning (ML) are transforming hemostasis and thrombosis care, with applications spanning disease detection, risk assessment, laboratory testing, patient education, personalized medicine, and drug development. This narrative review explores AI’s clinical utility and limitations across these 6 domains.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Embase, and Scopus (up to February 2025) was conducted using terms related to AI, thrombosis, and hemostasis. Peer-reviewed, English-language studies were included, supplemented by manual and reference screening. Of 84 studies included, 38 focused on risk assessment, 16 on diagnostics, and others on personalized medicine, drug development, and patient engagement.</div></div><div><h3>Results</h3><div>AI demonstrated high accuracy in diagnosing thrombotic events via imaging and electronic health record analysis, although sensitivity gaps persisted for complex cases. In laboratory settings, AI outperformed manual review in detecting errors (eg, sample mislabeling and clotted specimens). Risk stratification models surpassed traditional scores (eg, CHA₂DS₂-VASc) in predicting thromboembolism, yet inconsistently performed in cancer-associated thrombosis. Personalized anticoagulation dosing and genetic severity prediction in hemophilia highlighted AI’s precision. Chatbots and adherence tools have enhanced patient education while AI-driven drug discovery identified novel anticoagulants and repurposed existing therapies. Limitations included variable external validation, “black box” interpretability issues, and dataset biases.</div></div><div><h3>Conclusion</h3><div>AI offers significant promise for improving diagnostics, risk prediction, and individualized therapy in thrombosis and haemostasis. Future integration depends on transparent, validated, and equitable AI systems embedded within clinical workflows.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102984"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144829651","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":"Antithrombotic therapy after cardiac valve surgery: prospective real-world data of Class II guidelines application and outcomes from the EURObservational Research Programme Valvular Heart Disease II survey","authors":"Bram Roosens ,&nbsp;Bernard Iung ,&nbsp;Julia Mascherbauer ,&nbsp;Susanna Price ,&nbsp;Cécile Laroche ,&nbsp;Jean-Luc Monin ,&nbsp;Hüseyin Ince ,&nbsp;Steven Droogmans ,&nbsp;Bernard Cosyns","doi":"10.1016/j.rpth.2025.102988","DOIUrl":"10.1016/j.rpth.2025.102988","url":null,"abstract":"<div><h3>Background</h3><div>Antithrombotic therapy (AT) after cardiac valve surgery is complex, with guidelines often relying on limited evidence.</div></div><div><h3>Objectives</h3><div>This study examines real-world adherence to the European Society of Cardiology Class II, level C recommendations for AT in valve surgery, as well as the 6-month impact of AT on patient outcomes.</div></div><div><h3>Methods</h3><div>This prospective, observational subanalysis of the European Society of Cardiology EURObservational Research Programme Valvular Heart Disease II survey included 6 substudies examining different valve interventions and AT regimens. Patient demographics, clinical characteristics, and 6-month outcomes were compared between groups receiving the recommended AT and those who did not.</div></div><div><h3>Results</h3><div>Guideline adherence varied widely (39.5%-81.1%) across substudies. Factors influencing AT decisions included cardiovascular risk factors, atrial fibrillation, and prior percutaneous coronary intervention. In unadjusted analyses of 3 substudies, 6-month all-cause mortality was significantly higher in patients not receiving the recommended AT. However, no significant differences were observed in thromboembolic events, bleeding, or other complications between AT and non-AT groups across all substudies at 6 months.</div></div><div><h3>Conclusion</h3><div>This analysis reveals potential mortality benefits associated with guideline-recommended AT in some patient groups. However, the observational nature of the study limits causal inferences, emphasizing the importance of further prospective research to optimize AT strategies and improve patient outcomes in this complex clinical setting, particularly as new AT and valve types emerge.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102988"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917479","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":"Long-term impact of central venous catheters in pediatric cancer survivors","authors":"Tasha Cusson ,&nbsp;Jessica Giguère ,&nbsp;Émilie Martineau ,&nbsp;Chantal Éthier ,&nbsp;André Lamarre ,&nbsp;Marie-Claude Pelland-Marcotte","doi":"10.1016/j.rpth.2025.102986","DOIUrl":"10.1016/j.rpth.2025.102986","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102986"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of statins on pulmonary embolism severity—a retrospective data analysis","authors":"Paul Gressenberger ,&nbsp;Bettina Wachmann ,&nbsp;Andrea Borenich ,&nbsp;Gudrun Pregartner ,&nbsp;Lisa Moser ,&nbsp;Nikolaus Schreiber ,&nbsp;Johannes Schmid ,&nbsp;Ewald Kolesnik ,&nbsp;Günther Silbernagel ,&nbsp;Reinhard B. Raggam ,&nbsp;Marianne Brodmann ,&nbsp;Thomas Gary","doi":"10.1016/j.rpth.2025.102982","DOIUrl":"10.1016/j.rpth.2025.102982","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have demonstrated decreased rates of venous thrombotic events, including pulmonary embolism (PE), in patients taking statins. It, however, remains elusive whether statins could also impact PE severity.</div></div><div><h3>Objectives</h3><div>To investigate a potential association between statin use and the severity of PE in a retrospective cohort.</div></div><div><h3>Methods</h3><div>We performed a retrospective data analysis of patients with PE confirmed by computed tomography pulmonary angiography between January 1, 2010, and December 31, 2019, at the University Hospital Graz, Austria. PE severity was assessed based on the 2019 European Society of Cardiology guidelines.</div></div><div><h3>Results</h3><div>Of 1590 patients analyzed, 235 (14.7%) were statin users. Statin users were significantly older than nonusers (median, 74 years [IQR, 66-80] vs 67 years [IQR, 52-78]; <em>P</em> &lt; .001) and had a higher body mass index (BMI kg/m²; median, 27.4 [IQR, 24.7-30.7] vs 26.2 [IQR, 23.6-29.7]; <em>P</em> = .001). Statin users had a significantly higher prevalence of comorbidities, including kidney insufficiency, arterial hypertension, diabetes, hyperlipidemia, atherosclerotic cardiovascular disease (all <em>P</em> &lt; .001), and heart failure (<em>P</em> = .006), while the nonstatin group had a higher prevalence of cancer (29.6% vs 14.0%; <em>P</em> = .04). Our study revealed a significantly smaller proportion of low-risk PE in statin users compared with nonstatin users (12.3% vs 19.9%; <em>P</em> = .006). After matching the groups based on sex (male and female), age, and BMI (kg/m²), no significant differences in PE severity were found.</div></div><div><h3>Conclusion</h3><div>Statin use was not associated with PE severity. The smaller proportion of low-risk PE in statin users is likely attributable to their older age, higher BMI, and comorbidities.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102982"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144827483","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":"Effectiveness and safety of rivaroxaban vs warfarin in patients with pulmonary embolism and right ventricular dysfunction: a retrospective cohort study","authors":"François Laliberté ,&nbsp;Behnood Bikdeli ,&nbsp;Veronica Ashton ,&nbsp;Guillaume Germain ,&nbsp;Julien Boudreau ,&nbsp;Manasvi Sundar ,&nbsp;Sean D. MacKnight ,&nbsp;Brahim Bookhart ,&nbsp;Dereck Wentworth ,&nbsp;Shawn Murphy ,&nbsp;Yichuan G. Hsieh ,&nbsp;Gregory Piazza","doi":"10.1016/j.rpth.2025.102951","DOIUrl":"10.1016/j.rpth.2025.102951","url":null,"abstract":"<div><h3>Background</h3><div>Limited data exist comparing the effectiveness and safety of rivaroxaban and warfarin in patients with right ventricular dysfunction (RVD), a common acute pulmonary embolism (PE) complication.</div></div><div><h3>Objectives</h3><div>To assess the effectiveness and safety of rivaroxaban compared with warfarin among patients with PE and RVD.</div></div><div><h3>Methods</h3><div>Adult patients newly prescribed rivaroxaban or warfarin during PE-related hospitalization with evidence of RVD were identified from Mass General Brigham’s Research Patient Data Registry database (January 2013-May 2023). Outcomes included time-to-first recurrent venous thromboembolism (VTE) and time-to-first major bleeding event. The proportion of international normalized ratio (INR) measurements within therapeutic range (INR: 2-3) while on warfarin was described. Kaplan–Meier analysis described event rates at 6-month intervals up to 36 months, which were compared using hazard ratios, 95% CIs, and <em>P</em> values from Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Overall, 246 rivaroxaban and 315 warfarin users were included (mean age, 63 years; female: 53%). Median time of treatment was 270 and 235 days for rivaroxaban and warfarin users, respectively; 50.9% of INR measurements among warfarin users were within therapeutic range. Rivaroxaban was associated with significantly lower risk of VTE recurrence than warfarin at all-time points, including 41% lower risk at 36 months (20.4% vs 30.3%; hazard ratio [95% CI], 0.59 [0.38, 0.92]). There was no significant difference in risk of major bleeding between cohorts up to 36 months of treatment (8.2% vs 13.6%).</div></div><div><h3>Conclusion</h3><div>Rivaroxaban was associated with lower risk of recurrent VTE compared with warfarin, without a significant difference in risk of major bleeding.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102951"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671059","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":"Increased platelet activation and thrombo-inflammation in early and late-onset preeclampsia","authors":"Kunal Singh ,&nbsp;Massimiliano Lia ,&nbsp;Akshay Prakasan Sheeja ,&nbsp;Martin Federbusch ,&nbsp;Anubhuti Gupta ,&nbsp;Ahmed Elwakiel ,&nbsp;Moritz Köhler ,&nbsp;Berend Isermann ,&nbsp;Holger Stepan ,&nbsp;Shrey Kohli","doi":"10.1016/j.rpth.2025.102956","DOIUrl":"10.1016/j.rpth.2025.102956","url":null,"abstract":"<div><h3>Background</h3><div>Preeclampsia is a vascular complication of pregnancy with limited therapeutic options. It is associated with hypertension and an increase in angiogenic factor soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor. Based on its onset, preclampsia can be categorized into early-onset (E-PE) or late-onset (L-PE) preeclampsia. Thrombo-inflammation, hallmarked by maternal platelet activation and sterile inflammation, is associated with pathophysiology of preeclampsia. However, whether these mechanisms are differentially regulated in E-PE vs L-PE remains unknown.</div></div><div><h3>Objectives</h3><div>We aim to study the role of maternal platelet activation, inflammation and endothelial dysfunction in E-PE vs L-PE.</div></div><div><h3>Methods</h3><div>Flow-cytometry analysis of platelet activation (P-selectin and active αIIbβ3) was conducted in whole blood from pregnant women with E-PE, L-PE and gestational age-matched patients. Plasma was evaluated for interleukin (IL)-1β and soluble vascular cell adhesion molecule 1 (sVCAM-1).</div></div><div><h3>Results</h3><div>An increase in P-selectin and active αIIbβ3 expressing platelets in both forms of preeclampsia (<em>n</em> = 22) was observed compared with their gestational age-matched controls (<em>n</em> = 18). Similarly, an increase in plasma IL-1β and sVCAM-1 was observed in both forms of preeclampsia, suggesting inflammation and endothelial dysfunction, respectively. Maternal platelet activation (P-selectin positive platelets) was linked with disease severity (sFlt-1/placental growth factor) and maternal plasma IL-1β and sVCAM-1 only in late-onset preeclampsia. A statistically significant correlation with αIIbβ3 expressing platelets and sFlt-1, IL-1β, and sVCAM-1 was not observed.</div></div><div><h3>Conclusions</h3><div>These findings identify that thrombo-inflammation is regulated in L-PE and E-PE through likely disjunct mechanisms supporting a role of maternal factors (eg, maternal platelet activation) involved in L-PE. Further studies with a larger cohort of patients are required to fully elucidate the mechanistic relevance of these findings.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 5","pages":"Article 102956"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696889","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":"Aims & Scope","authors":"","doi":"10.1016/S2475-0379(25)00261-4","DOIUrl":"10.1016/S2475-0379(25)00261-4","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102937"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144364499","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}