{"title":"Global Hemostasis Testing in Chronic Kidney Disease-Are They Better Predictors of Bleeding and Thrombosis Risk?","authors":"Hui Yin Lim, Eng Soo Yap, Prahlad Ho","doi":"10.1055/s-0045-1809162","DOIUrl":"https://doi.org/10.1055/s-0045-1809162","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) affects over 10% of the global population and significantly increases the risk of cardiovascular disease as well as arising bleeding. There are alterations in hemostasis, which are multifactorial, involving complex interactions between coagulation, platelets, and the vessel wall. Hemostasis evaluation in CKD is critical for the optimal management of patients. However, conventional coagulation testing and renal function do not fully reflect the hemostatic alterations and do not adequately represent the risk of bleeding and/or thrombosis in patients with CKD. Global hemostatic assays, including thrombin and fibrin generation assays, provide a more wholesome assessment of the process, including the interaction between procoagulants, anticoagulants, platelets, and fibrinolysis. This review critically appraises published studies reporting the use of global coagulation assays to evaluate hemostasis in patients with CKD, as well as associated clinical outcomes.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080113","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}
{"title":"Pulmonary Embolism-Related Mortality in Femur Fracture Patients: A Recent Retrospective Epidemiological Analysis.","authors":"Camilla Mattiuzzi, Giuseppe Lippi","doi":"10.1055/a-2597-5208","DOIUrl":"https://doi.org/10.1055/a-2597-5208","url":null,"abstract":"","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080131","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}
{"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":"https://doi.org/10.1055/a-2576-4895","url":null,"abstract":"<p><p>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 <i>R</i> (odds ratio [OR]: 0.849, 95% confidence interval [CI]: 0.763-0.945, <i>p</i> = 0.003), decreased <i>K</i> (0.571, 95% CI: 0.404-0.807, <i>p</i> = 0.001), advanced age (OR: 1.073, 95% CI: 1.033-1.113, <i>p</i> < 0.001), elevated platelet count (OR: 1.006, 95% CI: 1.004-1.009, <i>p</i> < 0.001), increased hemoglobin level (OR: 1.020, 95% CI: 1.009-1.031, <i>p</i> < 0.001), shortened PT (OR: 0.904, 95% CI: 0.830-0.985, <i>p</i> = 0.022), surgery ≤ 1 month (OR: 2.258, 95% CI: 1.420-3.590, <i>p</i> = 0.001), male sex (OR: 4.534, 95% CI: 2.815-7.304, <i>p</i> < 0.001), diabetes (OR: 2.478, 95% CI: 1.373-4.472, <i>p</i> = 0.003), hypertension (OR: 2.386, 95% CI: 1.505-3.784, <i>p</i> < 0.001), physical activity disorders (OR: 9.038, 95% CI: 4.462-18.309, <i>p</i> < 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 <i>K</i>-values and decreased <i>R</i>-values, shortened PT, advanced age, elevated platelet count, increased hemoglobin level, surgery ≤ 1 month, male sex, diabetes, hypertension, and physical activity disorders.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-02","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}
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":"<p><p>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 (<i>n</i> = 100 for blood viscosity; <i>n</i> = 19 for coagulation) and patients with primary/secondary polycythemia (<i>n</i> = 29 for blood viscosity; <i>n</i> = 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.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-25","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}
Marc H M Thelen, Marith van Schrojenstein Lantman, Anne Stavelin, Tze Ping Loh
{"title":"Comments to the International Council for Standardization in Hematology Guidance for New Lot Verification of Coagulation Reagents, Calibrators, and Controls.","authors":"Marc H M Thelen, Marith van Schrojenstein Lantman, Anne Stavelin, Tze Ping Loh","doi":"10.1055/a-2572-1299","DOIUrl":"10.1055/a-2572-1299","url":null,"abstract":"","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773308","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}
Mingyao Zhou, Pan Hou, Ying Liang, Wenqi Tao, Zhifu Guo, Bili Zhang, Yang Lu, Guojun Chu, Pan Li
{"title":"Comparison of Platelet Function Tests for Long-Term Cardiovascular Events after Percutaneous Coronary Interventions.","authors":"Mingyao Zhou, Pan Hou, Ying Liang, Wenqi Tao, Zhifu Guo, Bili Zhang, Yang Lu, Guojun Chu, Pan Li","doi":"10.1055/a-2570-4538","DOIUrl":"https://doi.org/10.1055/a-2570-4538","url":null,"abstract":"<p><p>Patients with high on-treatment platelet reactivity (HTPR) undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) face increased risks of major adverse cardiovascular events (MACEs). Although platelet function tests like thrombelastography (TEG), vasodilator-stimulated phosphoprotein (VASP), PL-11, and VerifyNow have been described, the correlation between them and their prognostic implications remains uncertain. This prospective study aims to evaluate the consistency and effectiveness of four platelet function detection methods in predicting long-term MACEs in patients with ACS. All 98 ACS patients undergoing PCI with clopidogrel were assessed for HTPR using four platelet function detection methods. The endpoint was the occurrence of MACEs, including cardiac death, nonfatal myocardial infarction (MI), and target vessel revascularization (TVR). Among 98 patients enrolled from April 1, 2014 to June 30, 2014, 27 (27.6%) patients with VerifyNow-detected HTPR (P2Y12 reaction units [PRUs] >240). The incidence of HTPR was 58.2% for TEG, 52% for VASP, and 13.3% for PL-11. VerifyNow and TEG showed the highest consistency in detecting HTPR (kappa = 0.201, <i>p</i> = 0.015). During a median follow-up of 6.1 years, 29 MACEs occurred, including 24 TVRs, 3 cardiovascular deaths, and 2 nonfatal MIs. VerifyNow-detected HTPR independently predicted long-term MACEs (hazard ratio: 5.73, 95% confidence interval: 2.04-16.09, <i>p</i> = 0.001), even after adjusting for traditional risk factors (TRFs). Receiver operating characteristic (ROC) analysis indicated that the model incorporating TRFs and VerifyNow-detected HTPR had superior predictive discrimination for MACEs (area under ROC curve = 0.889). VerifyNow-detected HTPR independently emerges as a robust predictor for long-term MACEs, demonstrating superior predictive discrimination compared with other platelet function tests.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022516","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}
Eleni Petrou, Anna Maria Donta, Sophia Mellou, Stavros Tsalas, Andreas G Tsantes, Dimitrios Andreas Bethanis, Anastasios Kriebardis, Elias Kyriakou, Rozeta Sokou, Argirios E Tsantes
{"title":"The ABO Blood System and Associated Implications for Hemostasis and Thrombosis.","authors":"Eleni Petrou, Anna Maria Donta, Sophia Mellou, Stavros Tsalas, Andreas G Tsantes, Dimitrios Andreas Bethanis, Anastasios Kriebardis, Elias Kyriakou, Rozeta Sokou, Argirios E Tsantes","doi":"10.1055/a-2565-3382","DOIUrl":"https://doi.org/10.1055/a-2565-3382","url":null,"abstract":"<p><p>The relationship between non-O blood groups and thromboembolic events has been suggested by several studies, although the exact underlying mechanisms are not fully elucidated. However, the correlation between ABO blood groups with the opposite pole of hemostasis, hemorrhage, has been investigated less thoroughly. Non-O blood groups confer an overall increased risk of single, recurrent, and provoked thromboembolic episodes. On the other hand, blood group O has been associated with more severe bleeding events and less favorable manifestations in individuals with hemorrhagic disorders. Therefore, ABO blood group screening may have a role in both thrombotic and hemorrhagic risk assessment and could potentially be added to available clinical prediction systems. This strong belief is supported by the ongoing research. Nevertheless, up to date, the majority of studies represent important heterogeneity, and given the frequency of non-O blood groups, a natural reluctance to incorporate blood groups in risk assessment models arises. Therefore, a more targeted approach should be considered to provide safe outcomes. The in vitro estimation of the thrombotic and hemorrhagic profile of each blood group separately, the quantitative estimation of VWF, FVIII, and platelet function in several disease settings and in well-organized studies, could be useful to establish a clear relationship of ABO blood types with hemostatic and thrombotic disorders. This may ensure a safe approach to categorizing a patient's risk, managing treatment, and influencing prognosis.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995860","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}
{"title":"2024 Eberhard F. Mammen Award Announcements: Part II-Young Investigator Awards.","authors":"Emmanuel J Favaloro","doi":"10.1055/s-0045-1807739","DOIUrl":"https://doi.org/10.1055/s-0045-1807739","url":null,"abstract":"","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006465","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}
{"title":"Thrombin Generation Assays: What are the Current Clinical Applications?","authors":"Armando Tripodi, Marigrazia Clerici, Erica Scalambrino, Flora Peyvandi","doi":"10.1055/s-0045-1807261","DOIUrl":"10.1055/s-0045-1807261","url":null,"abstract":"<p><p>The thrombin generation assay (TGA), originally developed by McFarlane and Biggs in 1956, was modified in the 2000s by Hemker and coworkers. TGA aims to monitor the continuous generation of thrombin upon activation of coagulation in plasma by the addition of such triggers as small amounts of tissue factor, synthetic phospholipids, and calcium chloride. TGA is sensitive to hypo- and hypercoagulability and is affected by prohemostatic as well as antithrombotic drugs. The review of the current literature shows that TGA is mainly used to investigate conditions characterized by hypo- as well as hypercoagulability and as a laboratory tool to elucidate coagulation mechanisms that are not yet completely understood. This article aims to overview the value and limits of current procedures for TGA for the investigation of hemostasis.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804207","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}