Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Diagnostic accuracy of the international classification of disease “I26” code to detect acute pulmonary embolism in a surveillance network","authors":"Jeffrey A. Kline ,&nbsp;Jesse O. Wrenn ,&nbsp;Mazin F. Alam ,&nbsp;Alexis N. Drinkhorn ,&nbsp;Conner D. Slotnick ,&nbsp;Fawas Shaman ,&nbsp;Christopher E. Conn ,&nbsp;Steven J. Korzeniewski ,&nbsp;Christopher Kabrhel","doi":"10.1016/j.rpth.2025.102900","DOIUrl":"10.1016/j.rpth.2025.102900","url":null,"abstract":"<div><h3>Background</h3><div>Emergency departments (EDs) offer a unique platform for a surveillance network for acute pulmonary embolism (PE) using International Classification of Disease (ICD-10) codes extracted from electronic medical records.</div></div><div><h3>Objectives</h3><div>Test the diagnostic accuracy of the I26 \"leader\" ICD-10 code for the detection of PE in near real-time in a large, ED-based surveillance network.</div></div><div><h3>Methods</h3><div>Standardized structured language queries were deployed at 91 hospitals to extract data, including ICD-10 codes, on a weekly basis from electronic medical records on ED patients with acute respiratory complaints. We used 2 methods for coding computed tomography pulmonary angiogram (CTPA) reports to derive a criterion or gold standard for PE diagnosis: (1) research associates were trained to interpret the CTPA reports, and (2) a validated Regular Expression computer program was used to interpret PE on CTPA reports. These 2 methods were independently adjudicated (PE⁺ or PE⁻). The primary outcome was diagnostic accuracy of the I26 leader compared with the final adjudication.</div></div><div><h3>Results</h3><div>From 6448 valid CTPA scan reports, 442 (6.8%) were adjudicated as PE⁺. On a weekly basis, the I26 leader had a sensitivity of 50.9% (95% CI, 46.1%-55.6%) and a specificity of 99.7% (95% CI, 99.5%-99.8%), likelihood ratio (LR) negative of 0.49 (95% CI, 0.44-0.54) and LR positive of 191 (95% CI, 116-12). At 1 month, the I26 sensitivity was 57.5% (95% CI, 52.7%-62.1%), and specificity was 99.5% (95% CI, 99.2%-99.6%); LRnegative of 0.43 (95% CI, 0.38-0.47) and LRpositive of 111 (95% CI, 77-159).</div></div><div><h3>Conclusion</h3><div>For low-latency surveillance of PE diagnosed in EDs, the ICD leader code I26 affords high specificity and high LR(+) for detection of acute PE in the United States but has modest sensitivity.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102900"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271368","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":"Strategies for anticoagulation in patients with thrombocytopenia and cancer-associated thrombosis (START): design and rationale of the START pilot randomized controlled trial","authors":"Tzu–Fei Wang ,&nbsp;Mari Thomas ,&nbsp;Andrea Cervi ,&nbsp;Yishi Tan ,&nbsp;Cynthia Wu ,&nbsp;Avi Leader ,&nbsp;Luis Jara–Palomares ,&nbsp;Simon J. Stanworth ,&nbsp;Marc Carrier","doi":"10.1016/j.rpth.2025.102898","DOIUrl":"10.1016/j.rpth.2025.102898","url":null,"abstract":"<div><div>Patients with cancer have high risks of venous thromboembolism (VTE) as well as thrombocytopenia. Thrombocytopenia is associated with an increased risk of bleeding. Hence, treatment of acute VTE with anticoagulation is challenging in patients with cancer and thrombocytopenia. Data are limited in the management of this condition, and there are no randomized controlled trials (RCTs) available. The strategies for anticoagulation in patients with thrombocytopenia and cancer-associated thrombosis pilot trial (NCT05255003) is an open-label pilot RCT to evaluate the feasibility of a full-scale trial in this population. Adult patients with acute cancer-associated thrombosis within 14 days and thrombocytopenia (platelet count &lt; 50,000/μL) are randomly assigned to 2 treatment arms as follows: (1) modified-dose low-molecular-weight heparin based on a predefined regimen to adjust dose by platelet count; or (2) platelet transfusion with a higher dose low-molecular-weight heparin regimen. The primary feasibility outcome is the overall average number of patients recruited per month. The main clinical outcomes include clinically relevant bleeding events (composite of major bleeding and clinically relevant nonmajor bleeding) and objectively confirmed recurrent VTE. This trial has the potential to define care in patients with acute cancer-associated thrombosis and thrombocytopenia. In this article, we present the rationale and design of the pilot trial and highlight several unique aspects of the study.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102898"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313451","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":"Development and validation of a genetic probability for venous thromboembolism","authors":"Zhuqing Shi ,&nbsp;Ashley J. Mulford ,&nbsp;Huy Tran ,&nbsp;Michal Filipczak ,&nbsp;Song Gao ,&nbsp;Stevie Xie ,&nbsp;Jason Lobel ,&nbsp;Jun Wei ,&nbsp;Andrew S. Rifkin ,&nbsp;Annabelle Ashworth ,&nbsp;Siqun Lilly Zheng ,&nbsp;Clay Wiske ,&nbsp;David Duggan ,&nbsp;Brian T. Helfand ,&nbsp;Arman Qamar ,&nbsp;Alan R. Sanders ,&nbsp;Alfonso J. Tafur ,&nbsp;Jianfeng Xu","doi":"10.1016/j.rpth.2025.102876","DOIUrl":"10.1016/j.rpth.2025.102876","url":null,"abstract":"<div><h3>Background</h3><div>Factor V Leiden (FVL) and prothrombin gene mutations (PGMs), as well as recently developed polygenic scores (PGSs), have been consistently associated with venous thromboembolism (VTE) risk in European ancestry populations.</div></div><div><h3>Objectives</h3><div>This study aimed to develop an optimized risk-assessment tool combining mutations and PGS for diverse ancestry populations.</div></div><div><h3>Methods</h3><div>The association of VTE risk with FVL/PGM and PGS was tested using multivariable analyses in the UK Biobank. A genetic probability for VTE (GenProb-VTE) combining PGS and FVL/PGM was developed. Its discriminative and reclassification performances over FVL/PGM alone were assessed using observed VTE rate and the continuous net reclassification index, respectively. Results were validated in the Genomic Health Initiative of Endeavor Health, an ancestry-diverse health care system–based biobank.</div></div><div><h3>Results</h3><div>Among 432,831 participants in the UK Biobank, FVL, PGM, and PGS were significantly and independently associated with VTE risk (<em>P</em> &lt; .001). Compared with FVL/PGM alone, GenProb-VTE identified 1.5 times more high-risk subjects whose observed VTE rates exceeded those of FVL/PGM carriers. GenProb-VTE also significantly reclassified VTE risk from the model with FVL/PGM alone, with continuous net reclassification index of 0.10 (<em>P</em> &lt; .001). VTE risk was reclassified in FVL/PGM heterozygous carriers (51%) and homozygous/compound heterozygous carriers (46%) as well as noncarriers (14%). These results were validated among 16,341 participants in the Genomic Health Initiative, in participants of both European and non-European ancestry.</div></div><div><h3>Conclusion</h3><div>GenProb-VTE, an optimized tool combining PGS with FVL/PGM, significantly improves VTE risk assessment compared with FVL/PGM alone in diverse ancestry populations. It provides a novel tool for genetic risk assessment of VTE.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102876"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105625","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":"104 To Prescribe or Deprescribe: Antiplatelet Discontinuation versus Proton Pump Inhibitor (PPI) Addition in Veterans with Combined Antithrombotic Therapy","authors":"Laura Calderon-Lugo ,&nbsp;Litzalee Camacho-Vega ,&nbsp;Jennifer Crowley ,&nbsp;Marina Babilonia-Leon","doi":"10.1016/j.rpth.2025.102805","DOIUrl":"10.1016/j.rpth.2025.102805","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102805"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144202998","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":"128 Evaluation of Heparin-Induced Thrombocytopenia Testing to Improve Anticoagulation Stewardship in an Acute Care Setting","authors":"Yelena Samofalova PharmD ,&nbsp;Nicole Thurnherr PharmD ,&nbsp;Micaela Powner PharmD, BCPS ,&nbsp;Jillian Searle PharmD, BCPS, BCACP ,&nbsp;Michelle Byram BS, Pharm, CACP","doi":"10.1016/j.rpth.2025.102783","DOIUrl":"10.1016/j.rpth.2025.102783","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102783"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203007","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":"185 The Youth is our Future, and the Future is Here","authors":"Omkar Garud ,&nbsp;Naga Sahithi Rajuladevi ,&nbsp;Sonika Tatipalli ,&nbsp;Atul Laddu ,&nbsp;Jawed Fareed","doi":"10.1016/j.rpth.2025.102834","DOIUrl":"10.1016/j.rpth.2025.102834","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102834"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203533","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":"161 Evaluation of a Pharmacist-led Perioperative Antithrombotic Management Service","authors":"Nghi Ha ,&nbsp;Liza Renner ,&nbsp;Erin Mouland ,&nbsp;Denise Sutter-Long ,&nbsp;Anisa Bici","doi":"10.1016/j.rpth.2025.102794","DOIUrl":"10.1016/j.rpth.2025.102794","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102794"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203746","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":"132 Antithrombotic Prescribing Practices in Patients with Atrial Fibrillation Presenting with Acute Ischemic Stroke while on Oral Anticoagulation","authors":"Corinne M. Bertolaccini ,&nbsp;Collin J. Culbertson ,&nbsp;Yixin Kong ,&nbsp;Zhibang Lin ,&nbsp;Tara K. Lech","doi":"10.1016/j.rpth.2025.102771","DOIUrl":"10.1016/j.rpth.2025.102771","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102771"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203807","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":"140 Impact of Amiodarone Exposure on Apixaban Pharmacokinetics in Hospitalized Patients","authors":"Samantha Kolowrat BS ,&nbsp;Chazmyn Riley PharmD ,&nbsp;Kevin Lam PharmD ,&nbsp;Lynda Thomson PharmD ,&nbsp;Douglas Stickle PhD ,&nbsp;Thomas Hyson PharmD ,&nbsp;Gil Berreby BS ,&nbsp;Walter Kraft MD","doi":"10.1016/j.rpth.2025.102772","DOIUrl":"10.1016/j.rpth.2025.102772","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 ","pages":"Article 102772"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203808","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":"Gene-based therapies for hemophilia","authors":"Melissa F. Glasner ,&nbsp;Steven Pipe ,&nbsp;Wolfgang Miesbach","doi":"10.1016/j.rpth.2025.102870","DOIUrl":"10.1016/j.rpth.2025.102870","url":null,"abstract":"<div><div>Gene therapy is a transformative approach to treating genetic disorders in order to improve disease outcomes for patients. Hemophilia A and B are inherited genetic disorders caused by mutations in the <em>FVIII</em> and <em>FIX</em> genes, respectively. Traditional treatments for hemophilia have included intravenous plasma, factor concentrates, and nonfactor therapies that require lifelong prophylaxis and carry risks of factor inhibitor development. Gene therapy offers a novel solution by delivering functional <em>FVIII</em> or <em>FIX</em> genes via adeno-associated virus vectors, which enable the production of the missing factors. Clinical outcomes have shown promise through gene therapies like valoctocogene roxaparvovec for hemophilia A and etranacogene dezaparvovec and fidanacogene elaparvovec for hemophilia B. Each therapy has demonstrated efficacy in reducing bleeding rates and maintaining factor activity. However, challenges such as hepatotoxicity, immune response, and durability of gene expression persist. Future advancements aim to expand eligibility, achieve sustained expression, and minimize adverse effects. Current trials are exploring new vectors, transgenes, and methods to overcome existing limitations. Gene therapy holds the potential to revolutionize hemophilia treatment, offering a path toward long-term management and improved quality of life for patients.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 4","pages":"Article 102870"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070411","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}