Seminars in thrombosis and hemostasis最新文献

Global Hemostasis Testing in Chronic Kidney Disease-Are They Better Predictors of Bleeding and Thrombosis Risk? 慢性肾脏疾病的全球止血试验是否能更好地预测出血和血栓形成风险？

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2025-05-15 DOI: 10.1055/s-0045-1809162

Hui Yin Lim, Eng Soo Yap, Prahlad Ho

引用次数: 0

Impact of Hematocrit on Coagulation Measured by Rotational Thromboelastometry in Healthy Subjects and Patients with Polycythemia. 健康人及红细胞增多症患者血液压积对凝血的影响

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2025-04-01 DOI: 10.1055/a-2570-4455

Marie Martin, Elie Nader, Hamdi Rezigue, Yesim Dargaud, Céline Renoux, Philippe Joly, Mael Heiblig, Christophe Nougier, Philippe Connes

{"title":"Impact of Hematocrit on Coagulation Measured by Rotational Thromboelastometry in Healthy Subjects and Patients with Polycythemia.","authors":"Marie Martin, Elie Nader, Hamdi Rezigue, Yesim Dargaud, Céline Renoux, Philippe Joly, Mael Heiblig, Christophe Nougier, Philippe Connes","doi":"10.1055/a-2570-4455","DOIUrl":"10.1055/a-2570-4455","url":null,"abstract":"Abstract: Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia, more specifically for those with primary origin. It has been suggested that the high hematocrit (Hct) would favor hypercoagulability. However, the impact of Hct on coagulation in patients with polycythemia has not been investigated so far. The aim of our study was to compare the coagulation profiles of healthy subjects and patients with polycythemia and to evaluate the in vitro impact of Hct on coagulation. Blood from healthy individuals (n = 100 for blood viscosity; n = 19 for coagulation) and patients with primary/secondary polycythemia (n = 29 for blood viscosity; n = 20 for coagulation) was used to perform measurements at native Hct. The impact of Hct modulation (20% vs. 50%) on coagulation was tested in vitro in 9 healthy subjects and 19 patients with polycythemia. Blood viscosity was measured by viscosimetry and coagulation and fibrinolysis by rotational thromboelastometry. In patients with polycythemia, Hct, and blood viscosity were higher, clotting time was prolonged and clot lysis was faster compared to healthy individuals. Our in vitro results showed that the clotting time was faster and the clot firmness higher at 20% versus 50% Hct for both populations, without any difference between the two populations at a given Hct. Our findings suggest that the interpretation of thromboelastometry results should be approached with caution in patients with high Hct. The in vivo hypercoagulable state of patients with polycythemia is probably the consequence of changes in hemodynamic conditions attributed to blood hyper-viscosity, that may promote venous stasis and platelet margination.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":"487-494"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764951","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

Thrombin Generation Assays in Clinical Hemostasis: From Mechanistic Insights to Clinical Applications. 凝血酶生成测定在临床止血：从机理的见解到临床应用。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2026-02-13 DOI: 10.1055/a-2811-3096

Joris Godelaine, Christine Van Laer

{"title":"Thrombin Generation Assays in Clinical Hemostasis: From Mechanistic Insights to Clinical Applications.","authors":"Joris Godelaine, Christine Van Laer","doi":"10.1055/a-2811-3096","DOIUrl":"10.1055/a-2811-3096","url":null,"abstract":"Abstract: Thrombin plays a central role in hemostasis, serving as both the primary enzyme driving fibrin formation and the central regulator of anticoagulant pathways. Routine coagulation assays, such as prothrombin time and activated partial thromboplastin time, capture only a limited fraction of thrombin's role, overlooking inhibitory pathways and downstream regulation. Thrombin generation assays (TGAs) provide a global view of coagulation, measuring both formation and inhibition of thrombin over time. TGAs generate thrombin activity curves, from which parameters such as lag time, peak thrombin, time to peak, velocity index, and endogenous thrombin potential are derived. These parameters reflect hyper- or hypocoagulability and have been linked to clinical outcomes. Applications include monitoring anticoagulant therapy and reversal strategies, predicting venous thromboembolism recurrence, assessing thrombotic risk in cardiovascular disease and antiphospholipid syndrome, and stratifying bleeding risk in bleeding disorders. TGAs can also evaluate the efficacy of bypassing agents and novel hemostatic drugs in ex vivo settings. Barriers include technical complexity, preanalytical variability, and lack of standardization across laboratories. TGAs provide a global assessment of coagulation, demonstrating added value in both hyper- and hypocoagulable states. While most data remain research-based, growing evidence supports their utility in thrombotic risk prediction and bleeding risk assessment. Wider adoption in clinical practice will depend on assay standardization, validation in multicenter studies, and integration into clinical decision-making pathways.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":"448-459"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195482","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

2026 Eberhard F. Mammen Award Announcements: Part I-Most Popular Articles. 2026 Eberhard F. Mammen奖公告：第一部分-最受欢迎的文章。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2026-02-26 DOI: 10.1055/a-2811-4911

Emmanuel J Favaloro

引用次数: 0

Viscoelastic Hemostatic Assays in Sepsis: From Pathophysiology to Potential Clinical Implications. 脓毒症的粘弹性止血试验：从病理生理学到潜在的临床意义。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2025-05-24 DOI: 10.1055/s-0045-1809373

Claudia Bonetti, Ivan Silvestri, Alessio Caccioppola, Andrea Meli, Giacomo Grasselli, Mauro Panigada

{"title":"Viscoelastic Hemostatic Assays in Sepsis: From Pathophysiology to Potential Clinical Implications.","authors":"Claudia Bonetti, Ivan Silvestri, Alessio Caccioppola, Andrea Meli, Giacomo Grasselli, Mauro Panigada","doi":"10.1055/s-0045-1809373","DOIUrl":"10.1055/s-0045-1809373","url":null,"abstract":"Abstract: Sepsis is a complex syndrome characterized by physiological, pathological, and biochemical abnormalities induced by infection, with up to 70% of patients experiencing coagulation alterations, ranging from subclinical coagulopathy to disseminated intravascular coagulation (DIC). The multifactorial nature of sepsis-related coagulopathy and the limitations of standard diagnostic parameters, such as platelet count and traditional coagulation tests, complicate its definition and management. Assessing coagulopathy related to sepsis presents significant challenges due to current definitions primarily focusing on diagnosing advanced stages of coagulation dysfunction, thereby overlooking the dynamic and evolving nature of the condition. Viscoelastic hemostatic assays (VHAs) have emerged as valuable tools in this context, offering real-time insights into clot formation, stabilization, and lysis by integrating both plasma and cellular contributions to coagulation. Data from clinical studies suggest that early stages of sepsis coagulopathy are characterized by hypercoagulability, while advanced stages may lead to hypocoagulability and DIC. Moreover, specific point-of-care assays can evaluate platelet performance in the clotting mechanism and potentially help the diagnosis of platelet dysfunction in sepsis. Additionally, the phenomenon of fibrinolysis inhibition contributes to the persistence of fibrin clots, promoting tissue ischemia and multiorgan dysfunction. Modified VHAs appear promising for detecting fibrinolysis impairment, which is associated with poorer outcomes, but the standardization of results is still a work in progress. Incorporating VHAs data into treatment strategies could lead to more targeted therapies, potentially improving outcomes in septic patients by addressing both hypercoagulable and hypocoagulable states, as well as fibrinolysis abnormalities.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":"405-416"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143460","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

Decoding Clot Waveform Analysis: Toward Better Understanding and Harmonization. 解码血凝块波形分析：走向更好的理解和协调。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2026-01-08 DOI: 10.1055/a-2778-9810

Jing Yuan Tan, Marvin Raden Torres De Guzman, Wan Hui Wong, Chi Kiat Yeo, Guan Hao Goh, Heng Joo Ng, Chuen Wen Tan

{"title":"Decoding Clot Waveform Analysis: Toward Better Understanding and Harmonization.","authors":"Jing Yuan Tan, Marvin Raden Torres De Guzman, Wan Hui Wong, Chi Kiat Yeo, Guan Hao Goh, Heng Joo Ng, Chuen Wen Tan","doi":"10.1055/a-2778-9810","DOIUrl":"10.1055/a-2778-9810","url":null,"abstract":"Abstract: Clot waveform analysis (CWA) extends routine coagulation assays (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) by incorporating continuous optical monitoring to generate kinetic profiles of clot formation. This method provides both qualitative and quantitative information on hemostasis, with increasing evidence for its clinical utility in detecting factor deficiencies and characterizing thrombotic and bleeding disorders. Despite the growing body of evidence, translation of CWA into routine clinical practice remains limited.Abstract: This review identifies three principal barriers: (1) variability arising from differences in optical detection methods (absorbance vs. transmittance), (2) interreagent variation even within the same analyzer platform, and (3) lack of a clear distinction between standard CWA, performed with commercially available reagents, and modified CWA, incorporating in-house adjustments. To address these challenges, we encourage adopting distinct nomenclature for detection modalities (CWA-A; A for absorbance and CWA-T; T for transmittance), establishing standardized reporting requirements including reagent and platform details, and establishing quality assurance frameworks for CWA.Abstract: Standardization of terminology and reporting will enhance reproducibility, enable cross-study comparisons, and accelerate the clinical translation of CWA from the laboratory bench to the bedside.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":"460-475"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thrombin Generation Assays: What are the Current Clinical Applications? 凝血酶生成测定：目前的临床应用是什么？

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2025-04-07 DOI: 10.1055/s-0045-1807261

Armando Tripodi, Marigrazia Clerici, Erica Scalambrino, Flora Peyvandi

引用次数: 0

Advancing Point-of-Care Analysis: The Future of Thromboelastographic DOAC-Detection: A Systematic Review. 推进护理点分析：血栓弹性成像doac检测的未来：系统回顾。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2026-03-18 DOI: 10.1055/a-2822-7599

Gerrit U Herpertz, Johannes Altmann, Sven Poli, Simon T Schäfer

{"title":"Advancing Point-of-Care Analysis: The Future of Thromboelastographic DOAC-Detection: A Systematic Review.","authors":"Gerrit U Herpertz, Johannes Altmann, Sven Poli, Simon T Schäfer","doi":"10.1055/a-2822-7599","DOIUrl":"10.1055/a-2822-7599","url":null,"abstract":"Abstract: Direct oral anticoagulants (DOACs) have largely replaced vitamin K antagonists owing to their predictable pharmacokinetics and improved safety. In emergency situations such as urgent surgery, major bleeding, or thrombolysis for acute ischemic stroke, rapid assessment of clinically relevant DOAC activity is essential. Conventional viscoelastic testing (VET) using devices such as ROTEM, TEG 5000, TEG6s, or ClotPro is insufficiently sensitive to detect DOACs, prompting the development of modified assays with specific activators. This systematic review summarizes recent advances in VET-based DOAC detection and evaluates the diagnostic performance of novel assay strategies and their correlation with plasma drug concentrations. A systematic search of PubMed and Google Scholar (January 2019-June 2025) was conducted in accordance with PRISMA 2020 recommendations. Twelve of 113 identified studies met the inclusion criteria. Ecarin-based assays demonstrated 100% sensitivity and specificity for detecting the direct thrombin inhibitor dabigatran. For direct factor Xa inhibitors-rivaroxaban, apixaban, and edoxaban-modified assays using Russell's Viper Venom, factor Xa-based reagents, and low-tissue-factor activation showed variable but generally good correlations with drug levels (r = 0.571-0.969). Sensitivity was lower for apixaban (83-97%) than for rivaroxaban (90-100%) and edoxaban (100%). Factor Xa-based and low-tissue-factor assays achieved sensitivities of 85 to 100% and specificities of 62 to 100%. In summary, modified VET assays show promise as rapid point-of-care tools for DOAC detection in emergency settings. Ecarin-based tests appear reliable for dabigatran, while Russell's Viper Venom and low-tissue-factor approaches may enable detection of direct factor Xa inhibitors. However, further clinical validation and standardization are required before routine implementation.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":"430-440"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481083","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

Tests of Global Hemostasis in Thrombosis and Hemostasis-Part I. 血栓和止血的全止血试验——第一部分。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2026-05-05 DOI: 10.1055/a-2840-5763

Bingwen E Fan, Mauro Panigada, Chuen W Tan

引用次数: 0

Risk Factors of Catheter-Related Thrombosis in Elderly Patients with Lung Cancer Based on Thromboelastography: A Retrospective, Case-Control Study. 基于血栓弹性成像的老年肺癌患者导管相关血栓形成的危险因素：回顾性病例对照研究。

IF 4.1 2区医学

Seminars in thrombosis and hemostasis Pub Date : 2026-06-01 Epub Date: 2025-05-02 DOI: 10.1055/a-2576-4895

Jiaji Hu, Binbin Xu, Nian Yao, Sha Peng, Jiaxin Lv, Haixia Yu, Jianmei Hou, Zhengkun Shi, Jianan Wang, Xin Huang, Guiyuan Ma, Jinghui Zhang

{"title":"Risk Factors of Catheter-Related Thrombosis in Elderly Patients with Lung Cancer Based on Thromboelastography: A Retrospective, Case-Control Study.","authors":"Jiaji Hu, Binbin Xu, Nian Yao, Sha Peng, Jiaxin Lv, Haixia Yu, Jianmei Hou, Zhengkun Shi, Jianan Wang, Xin Huang, Guiyuan Ma, Jinghui Zhang","doi":"10.1055/a-2576-4895","DOIUrl":"10.1055/a-2576-4895","url":null,"abstract":"Abstract: Catheter-related thrombosis (CRT) poses serious risks for cancer patients. Identifying risk factors and implementing targeted interventions can prevent CRT. To explore thromboelastogram parameters and clinical risk factors for CRT in elderly lung cancer patients. A total of 663 elderly lung cancer patients were selected from three hospitals in Hunan, Hainan, and Qinghai provinces in China from January 1, 2022, to June 30, 2024. The patients were divided into two groups: a CRT group (221 patients) and a non-CRT group (442 patients), with a ratio of 1:2. A between-group comparison and binary logistic regression were used to analyze risk factors for CRT in elderly lung cancer patients. Binary logistic regression analysis showed that decreased R (odds ratio [OR]: 0.849, 95% confidence interval [CI]: 0.763-0.945, p = 0.003), decreased K (0.571, 95% CI: 0.404-0.807, p = 0.001), advanced age (OR: 1.073, 95% CI: 1.033-1.113, p < 0.001), elevated platelet count (OR: 1.006, 95% CI: 1.004-1.009, p < 0.001), increased hemoglobin level (OR: 1.020, 95% CI: 1.009-1.031, p < 0.001), shortened PT (OR: 0.904, 95% CI: 0.830-0.985, p = 0.022), surgery ≤ 1 month (OR: 2.258, 95% CI: 1.420-3.590, p = 0.001), male sex (OR: 4.534, 95% CI: 2.815-7.304, p < 0.001), diabetes (OR: 2.478, 95% CI: 1.373-4.472, p = 0.003), hypertension (OR: 2.386, 95% CI: 1.505-3.784, p < 0.001), physical activity disorders (OR: 9.038, 95% CI: 4.462-18.309, p < 0.001) were independent risk factors for CRT in elderly lung cancer patients. Independent risk factors for CRT in elderly lung cancer patients include decreased K-values and decreased R-values, shortened PT, advanced age, elevated platelet count, increased hemoglobin level, surgery ≤ 1 month, male sex, diabetes, hypertension, and physical activity disorders.","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":"476-486"},"PeriodicalIF":4.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043884","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