Seminars in thrombosis and hemostasis最新文献

Postpartum Disseminated Intravascular Coagulation: A Comprehensive Review of Pathophysiology, Diagnosis, Management, and Prevention. 产后弥散性血管内凝血：病理生理学、诊断、管理和预防的综合综述。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-18 DOI: 10.1055/a-2645-2845

Amir Wolfovitz, Benjamin Brenner, Ido Solt

{"title":"Postpartum Disseminated Intravascular Coagulation: A Comprehensive Review of Pathophysiology, Diagnosis, Management, and Prevention.","authors":"Amir Wolfovitz, Benjamin Brenner, Ido Solt","doi":"10.1055/a-2645-2845","DOIUrl":"https://doi.org/10.1055/a-2645-2845","url":null,"abstract":"Disseminated intravascular coagulation (DIC) in the postpartum period is a rare but potentially life-threatening complication arising from various obstetric conditions, including postpartum hemorrhage (PPH), placental abruption, intrauterine fetal demise (IUFD), and amniotic fluid embolism. This review explores pathophysiology, risk factors, diagnostic challenges, and management strategies of postpartum DIC. The delicate balance of hemostasis during pregnancy predisposes women to thromboembolic events, which, when disrupted, may lead to rapid consumption of coagulation factors and subsequent coagulopathy. The incidence of obstetric-related DIC varies globally, with higher rates reported in low-resource settings due to delayed diagnosis and management. Diagnostic criteria, including the International Society on Thrombosis and Haemostasis (ISTH), Japanese obstetric DIC, and pregnancy-specific DIC scores, are evaluated, emphasizing their applicability and limitations in obstetric practice. Preventive strategies, primarily targeting the early identification and treatment of PPH, are discussed, with particular focus on active management of the third stage of labor, the administration of uterotonic agents, and the use of antifibrinolytic medications like tranexamic acid. Timely recognition, standardized diagnostic protocols, and multidisciplinary management are essential for improving maternal outcomes and reducing the burden of postpartum DIC.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Current Understandings on Biological Characteristics of Thrombolytics in Acute Ischemic Stroke. 急性缺血性脑卒中溶栓生物学特性的新认识。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-15 DOI: 10.1055/a-2655-4120

Surasak Wichaiyo, Chuthamanee Suthisisang

{"title":"Current Understandings on Biological Characteristics of Thrombolytics in Acute Ischemic Stroke.","authors":"Surasak Wichaiyo, Chuthamanee Suthisisang","doi":"10.1055/a-2655-4120","DOIUrl":"https://doi.org/10.1055/a-2655-4120","url":null,"abstract":"Acute ischemic stroke leads to rapid and progressive neuronal losses. Early revascularization with thrombolytics and/or endovascular thrombectomy plays an important role in salvaging brain infarction. Currently, alteplase and tenecteplase are approved thrombolytics for the treatment of acute ischemic stroke, whereas favorable outcomes of reteplase have recently been reported in a phase 3 clinical trial. These thrombolytics share common and distinct pharmacological characteristics, which contribute to their efficacy and safety in patients. In this review, biological profiles of alteplase, tenecteplase, and reteplase, including their advantages versus disadvantages in acute ischemic stroke, are discussed. Tenecteplase has high fibrin specificity, increased resistance to plasminogen activator inhibitor-1 (PAI-1), wider concentration-response curve, and less off-target activities, which support its efficacy with low incidence of symptomatic intracranial hemorrhage (sICH). Reteplase greatly penetrates into the clot with prolonged retention, generating durable clot lysis. This activity might be associated with its excellent clinical outcomes in patients, although reteplase is sensitive to PAI-1. Notably, reteplase and alteplase produce off-target activities by inducing hypofibrinogenemia and hypoplasminogenemia, which may increase risk of hemorrhagic transformation. Moreover, orolingual angioedema is a life-threatening complication of all thrombolytics. Mechanistically, an increase in plasmin by thrombolytics leads to bradykinin generation. In addition, plasmin activates mast cell degranulation (e.g., histamine release). Together, these biopharmacological data of thrombolytics promote insights into their clinical outcomes, and might provide comprehensive bases for future research.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparative Study of Venous Thromboembolic Prophylaxis Strategies for Patients with Ischemic Stroke: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. 缺血性脑卒中患者静脉血栓栓塞预防策略的比较研究：随机对照试验的系统评价和网络荟萃分析。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-10 DOI: 10.1055/a-2635-2266

Changyi Wang, Maonan Han, Ling Ren, Yihan Wang, Qingchuan Wei, Ping Mou, Jing He

{"title":"Comparative Study of Venous Thromboembolic Prophylaxis Strategies for Patients with Ischemic Stroke: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials.","authors":"Changyi Wang, Maonan Han, Ling Ren, Yihan Wang, Qingchuan Wei, Ping Mou, Jing He","doi":"10.1055/a-2635-2266","DOIUrl":"https://doi.org/10.1055/a-2635-2266","url":null,"abstract":"Venous thromboembolism (VTE), including deep vein thrombosis (DVT), and pulmonary embolism (PE), is a common complication in patients with ischemic stroke. Several prophylactic strategies are used to reduce the risk of VTE. However, there is still a lack of consensus on the optimal strategy due to the lack of randomized controlled trials (RCTs) directly comparing different interventions. The objective of this study was to explore the efficacy and safety of different thromboembolic prophylaxis strategies in patients with ischemic stroke. We conducted a systematic literature review to identify all eligible RCTs, searching MEDLINE and Embase up to December 31, 2024. We considered DVT and PE as efficacy outcomes and intracranial and extracranial hemorrhage as safety outcome measures. Relevant data were extracted for network meta-analyses. A random-effects model was used for the analysis. A total of 33 RCTs were included in the analysis. Network meta-analysis revealed that low-molecular-weight heparin (LMWH) and heparinoid were associated with significantly decreased risk of DVT and PE compared with no prophylaxis, with risk ratios of 0.18 (95% confidence interval: 0.10-0.32) and 0.36 (0.20-0.63), respectively. However, LMWH and heparinoid were associated with an increased risk of extracranial hemorrhage compared with no prophylaxis, with a risk ratio of 2.03 (1.24-3.34). Our study supports the use of LMWH and heparinoid as the primary thromboembolic prophylaxis measure in patients with acute ischemic stroke. Further, high-quality RCTs are needed to strengthen the evidence base and determine the optimal prophylactic strategy in these patients.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Puerperal Fever to Ovarian Vein Thrombosis: An Historical Journey and Contemporary Challenges in Diagnosis and Management. 从产褥热到卵巢静脉血栓：诊断和治疗的历史历程和当代挑战。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-09 DOI: 10.1055/a-2651-7717

Elvira Grandone, Francesco Marongiu, Doris Barcellona

{"title":"From Puerperal Fever to Ovarian Vein Thrombosis: An Historical Journey and Contemporary Challenges in Diagnosis and Management.","authors":"Elvira Grandone, Francesco Marongiu, Doris Barcellona","doi":"10.1055/a-2651-7717","DOIUrl":"https://doi.org/10.1055/a-2651-7717","url":null,"abstract":"Puerperal sepsis (PPS) is a severe postpartum infection that remains a significant maternal health concern. Recent evidence suggests a potential link between PPS and ovarian vein thrombosis (OVT), a rare but life-threatening complication occurring in 0.01% to 0.18% of pregnancies. Despite the historical significance of PPS and its well-documented consequences, its association with thrombosis remains underrecognized in obstetric practice. This narrative review explores the historical context, clinical presentation, diagnosis, and management of PPS and OVT while emphasizing the need for increased awareness and preventive strategies. Sepsis triggers a hypercoagulable state through inflammatory cytokine release, endothelial injury, and coagulation activation, contributing to thrombotic complications such as OVT. The right ovarian vein is more commonly affected due to anatomical factors, including uterine dextrorotation during pregnancy. OVT typically presents with abdominal pain and fever, requiring imaging modalities such as Doppler ultrasound and MRI for diagnosis. Although anticoagulation therapy is widely used for deep vein thrombosis, its application in OVT remains inconsistent, despite comparable recurrence rates between the two conditions. The review also highlights the lack of consensus on thromboprophylaxis in septic postpartum patients. Although guidelines from major obstetric organizations are inconsistent, emerging evidence suggests that low-molecular-weight heparins may reduce thrombotic risk in PPS. In the absence of large-scale randomized trials, observational studies remain essential for guiding clinical decision.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Seminars in Thrombosis and Hemostasis: 2024 Impact Factor, Most Highly Cited Papers, and Other Journal Metrics. 血栓和止血研讨会：2024年影响因子、高被引论文和其他期刊指标。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-09 DOI: 10.1055/s-0045-1810021

Emmanuel J Favaloro

引用次数: 0

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-09 DOI: 10.1055/a-2633-0027

Akitada Ichinose

{"title":"Immune-Related and Non-Immune-Related Acquired Factor XIII Deficiency.","authors":"Akitada Ichinose","doi":"10.1055/a-2633-0027","DOIUrl":"10.1055/a-2633-0027","url":null,"abstract":"Coagulation factor XIII (FXIII) is an essential protein that stabilizes the hemostatic plug formed in the final stage of the coagulation reaction and controls its dissolution. In the blood, it exists as a heterotetramer consisting of A subunit dimers and B subunit dimers. Genetic defects in each subunit result in a congenital deficiency, which causes fatal or mild bleeding symptoms. Acquired FXIII deficiency can develop owing to reduced production or increased consumption of FXIII, and its severe form can cause various bleeding symptoms. In particular, autoimmune FXIII deficiency (AiF13D) causes fatal bleeding symptoms due to the suppression of FXIII activity by anti-FXIII autoantibodies and/or accelerated clearance of FXIII. AiF13D is characterized by extremely severe FXIII deficiency and severe bleeding symptoms. It is associated with the highest hemorrhagic mortality rate among autoimmune coagulation factor deficiencies, making it essential to differentiate it from other non-immune FXIII deficiencies (NiF13D), such as those arising from liver cirrhosis or leukemia. The probable and definitive diagnosis of AiF13D require the presence of FXIII inhibitors and anti-FXIII autoantibodies, respectively. FXIII inhibitors can be detected by a general FXIII activity assay in the mixed plasma of patients and healthy controls, and can be measured in a regular laboratory. In contrast, immunological assays are conducted in limited research facilities because they are not commercially available. NiF13D is usually treated by hemostatic therapy with FXIII concentrates, but AiF13D requires hemostatic therapy plus autoantibody eradication therapy with immunosuppressants. Since the disease often becomes resistant to treatment, long-term follow-up is strongly recommended.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Red Blood Cells are Critical for Hemostasis and Thrombosis. 红细胞是止血和血栓形成的关键。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-07-03 DOI: 10.1055/a-2640-3081

Hyunjung Kim, Katie Houck, Sam Neuffer, Jing-Fei Dong

{"title":"Red Blood Cells are Critical for Hemostasis and Thrombosis.","authors":"Hyunjung Kim, Katie Houck, Sam Neuffer, Jing-Fei Dong","doi":"10.1055/a-2640-3081","DOIUrl":"10.1055/a-2640-3081","url":null,"abstract":"Hemostasis in humans has traditionally been considered to be a function of platelets, coagulation, and the subendothelial matrix, but the role of red blood cells (RBCs) has been increasingly recognized. RBCs regulate hemostasis through biophysical and biochemical means. For the former, faster-moving RBCs in the center of vessels marginalize platelets and plasma to the vessel walls, where the platelets constantly probe the endothelial surface for injury. RBC counts also determine blood viscosity, which regulates the shear stress of laminar blood flow. For the latter, RBCs are the largest pool of adenosine triphosphate (ATP), which, upon release, is rapidly hydrolyzed to adenosine diphosphate (ADP). Both ATP and ADP activate platelets. Quantitative and qualitative abnormalities in RBCs have also been consistently identified as significant risk factors for arterial and venous thrombosis. Thrombosis is a major complication associated with diseases such as polycythemia vera, secondary erythrocytosis, and sickle cell anemia, all of which present with changes in numbers and physical properties of RBCs. Thrombosis is also common in conditions with significant hemolysis, such as paroxysmal nocturnal hemoglobinuria, severe infections, and when patients are on mechanical support. In this review, we discuss findings from clinical observations and mechanistic studies of how RBCs regulate hemostasis and contribute to thrombosis.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

JAK2 V617F Mutation Screening for Peripheral Arterial Thrombosis. JAK2 V617F突变在外周动脉血栓形成筛查

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-06-24 DOI: 10.1055/a-2633-7948

Antoine Villa, Clotilde Bravetti, Nicolas Gauthier, Adrien Mirouse, Thibault Couture, Laurent Chiche, Sylvain Choquet, Frédéric Davi, Patrice Cacoub, David Saadoun, Alexandre Le Joncour

引用次数: 0

Use of Present-on-Admission Indicators to Improve Accuracy of Pulmonary Embolism Identification from Electronic Health Record Data. 利用当前入院指标提高电子健康记录数据中肺栓塞识别的准确性。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-06-24 DOI: 10.1055/a-2554-0043

Sina Rashedi, Hannah Leyva, Mariana B Pfeferman, Darsiya Krishnathasan, Antoine Bejjani, Candrika D Khairani, Mehrdad Zarghami, David Jimenez, Alfonso Muriel, Samuel Z Goldhaber, Liqin Wang, Eric A Secemsky, Gregory Piazza, Harlan M Krumholz, Zhenqiu Lin, Behnood Bikdeli

引用次数: 0

Bleeding Events and Correlation with Anti-Xa Levels and Therapeutic Nadroparin Dose in Patients with Impaired Renal Function. 肾功能受损患者出血事件与抗xa水平和治疗性纳德帕林剂量的相关性。

IF 3.6 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2025-06-23 DOI: 10.1055/a-2628-2304

Arlette R Cox, Monique M de Maat, Sabine J G M Ahlers, Lian Roovers, Marcel M C Hovens

{"title":"Bleeding Events and Correlation with Anti-Xa Levels and Therapeutic Nadroparin Dose in Patients with Impaired Renal Function.","authors":"Arlette R Cox, Monique M de Maat, Sabine J G M Ahlers, Lian Roovers, Marcel M C Hovens","doi":"10.1055/a-2628-2304","DOIUrl":"https://doi.org/10.1055/a-2628-2304","url":null,"abstract":"Dutch national guidelines for therapeutic treatment with low-molecular-weight heparins (LWMHs) in patients with renal insufficiency recommend dose adjustment based on observed anti-Xa levels. The literature on the relationship between anti-Xa levels and clinical outcome in terms of bleeding events is inconsistent. The primary aim of this study was to investigate the incidence and correlation of bleeding events in relation to anti-Xa levels in patients with impaired renal function, using therapeutic nadroparin according to the national guidelines. The secondary objective was to investigate the correlation between the LMWH dose and bleeding events. This was a retrospective study of patients with impaired renal function treated with therapeutic nadroparin for which anti-Xa levels were monitored. Bleeding and thrombotic events were assessed for each patient. This study included 243 patients, of whom 61 (25%) had a bleeding event. There was no correlation between anti-Xa levels and the occurrence of bleeding. Although there was no difference in renal function, weight, or body mass index (BMI) between patients with or without a bleeding event, the median dose of nadroparin was significantly higher (p < 0.005) in patients with a bleeding event. In conclusion, for this study population, there was a high incidence of bleeding. No correlation was found between anti-Xa levels and the occurrence of a bleeding event, with the majority of anti-Xa levels being subtherapeutic. However, a correlation was found between the dose and the occurrence of a bleeding event. Therefore, it is questionable whether the focus on monitoring anti-Xa levels is a justified method to reduce the risk of a bleeding event.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0