TH Open: Companion Journal to Thrombosis and Haemostasis最新文献

{"title":"Can a Single Measurement of Apixaban Levels Identify Patients at Risk of Overexposure? A Prospective Cohort Study.","authors":"Tim A C de Vries,&nbsp;Jack Hirsh,&nbsp;Vinai C Bhagirath,&nbsp;Jeffrey S Ginsberg,&nbsp;Ron Pisters,&nbsp;Martin E W Hemels,&nbsp;Joris R de Groot,&nbsp;John W Eikelboom,&nbsp;Noel C Chan","doi":"10.1055/s-0041-1740492","DOIUrl":"https://doi.org/10.1055/s-0041-1740492","url":null,"abstract":"<p><p><b>Background</b>  Patients with atrial fibrillation (AF) are frequently treated with apixaban 2.5-mg twice daily (BID) off-label, presumably to reduce the bleeding risk. However, this approach has the potential to increase the risk of ischemic stroke. If a single measurement could reliably identify patients with high drug levels, the increased stroke risk may be mitigated by confining off-label dose reduction to such patients. <b>Objectives</b>  This study aimed to determine whether a single high apixaban level is predictive of a similarly high level when the test is repeated in 2 months. <b>Methods</b>  In this prospective cohort study of clinic patients receiving apixaban 5-mg BID for AF or venous thromboembolism, peak and trough apixaban levels were measured using the STA-Liquid anti-Xa assay at baseline and 2 months. We calculated the proportions of patients with levels that remained in the upper quintile. <b>Results</b>  Of 100 enrolled patients, 82 came for a second visit, 55 of whom were treated with apixaban 5-mg BID. Seven (63.6%, 95% confidence interval [CI]: 35.4-84.8%) and nine (81.8%, 95% CI: 52.3-94.9%) of 11 patients with a baseline trough and peak level in the upper quintile, respectively, had a subsequent level that remained within this range. Only one (9.1%, 95% CI: 1.6-37.7%) patient had a subsequent level that fell just lower than the median. <b>Conclusion</b>  The trough and peak levels of apixaban in patients who have a high level on a single occasion, usually remain high when the assay is repeated in 2 months. Accordingly, the finding of a high apixaban level in patients deemed to be at high risk of bleeding, allows physicians contemplating off-label use of the 2.5-mg BID dose to limit its use to selected patients who are less likely to be exposed to an increased risk of thrombosis.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":" ","pages":"e10-e17"},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39728259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrinogen Longmont: A Clinically Heterogeneous Dysfibrinogenemia with Discrepant Fibrinogen Results Influenced by Clot Detection Method and Reagent.","authors":"Becky Leung,&nbsp;Joanne Beggs,&nbsp;Jane Mason","doi":"10.1055/s-0041-1740644","DOIUrl":"https://doi.org/10.1055/s-0041-1740644","url":null,"abstract":"Fibrinogen is a 340kDa glycoprotein composed of three pairs of polypeptide chains. Thrombin cleaves the N-terminal A α and B β chains, exposing binding sites that enable polymerization and cross-linking to form a fi brin clot. Fibrinogen disorders can be quantitative or qualitative, inherited or acquired. Current International Society on Thrombosis and Haemostasis guidelines recommend a stepwise approach to diagnosis of congenital fi brinogen disorders, involving clot-based activated partial thromboplastin time (APTT) and prothrombin time (PT), and fi brinogen measurement by functional and antigenic assays. 1 Congenital dys fi brinoge-nemias encompass over 400 abnormal variants, typi fi ed by abnormal functional assays with discordant normal antigenic levels. They are clinically diverse and can be asymptomatic or associated with bleeding and thrombotic sequelae. 1 – 3 We report two adult siblings ( ► Table 1 ) diagnosed with the fi brinogen Longmont variant after an unmeasurable Clauss fi brinogen (FibC) was found. Informed consent for publication of this case report was obtained. The 49-year-old female proband human STA-Thrombin. Subsequently, our laboratory validated the use of STA-Thrombin on the ACL TOP and repeated the female patient ’ s FibC, obtaining a normal result. Examination of ammonium sulfate puri fi ed fi brinogen by online reverse-phase electrospray time-of- fl ight mass spectrometry for both patients, suggested heterozygosity for an Arg- > Cys (-53Da) polymorphism in the B β chain. DNA sequencing of exon 4 of FGB con fi rmed that both were heterozygous for fi brinogen Longmont with a point mutation resulting in B β 166Arg- > Cys ( FGB NM_0005141.4:c.586C > T, p.Arg196Cys).","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":" ","pages":"e18-e20"},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39728260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of a Prospective Study on Pharmacokinetic-Guided Dosing of Prophylactic Factor Replacement in Hemophilia A and B (OPTI-CLOT TARGET Study).","authors":"Tine M H J Goedhart,&nbsp;Laura H Bukkems,&nbsp;Michiel Coppens,&nbsp;Karin J Fijnvandraat,&nbsp;Saskia E M Schols,&nbsp;Roger E G Schutgens,&nbsp;Jeroen Eikenboom,&nbsp;Floor C J I Heubel-Moenen,&nbsp;Paula F Ypma,&nbsp;L Nieuwenhuizen,&nbsp;K Meijer,&nbsp;Frank W G Leebeek,&nbsp;Ron A A Mathôt,&nbsp;Marjon H Cnossen","doi":"10.1055/a-1760-0105","DOIUrl":"https://doi.org/10.1055/a-1760-0105","url":null,"abstract":"<p><p>In resource-rich countries, almost all severe hemophilia patients receive prophylactic replacement therapy with factor concentrates to prevent spontaneous bleeding in joints and muscles to decrease the development of arthropathy and risk of long-term disability. Pharmacokinetic (PK)-guided dosing can be applied to individualize factor replacement therapy, as interindividual differences in PK parameters influence factor VIII (FVIII) and FIX activity levels. PK-guided dosing may therefore lead to more optimal safeguarding of FVIII/FIX levels during prophylaxis and on demand treatment. The OPTI-CLOT TARGET study is a multicenter, nonrandomized, prospective cohort study that aims to investigate the reliability and feasibility of PK-guided prophylactic dosing of factor concentrates in hemophilia-A and -B patients in daily clinical practice. At least 50 patients of all ages on prophylactic treatment using standard half-life (SHL) and extended half-life (EHL) factor concentrates will be included during 9 months and will receive PK-guided treatment. As primary endpoint, a minimum of four FVIII/FIX levels will be compared with FVIII/FIX levels as predicted by Bayesian forecasting. Secondary endpoints are the association of FVIII and FIX levels with bleeding episodes and physical activity, expectations and experiences, economic analyses, and optimization of population PK models. This study will lead to more insight in the reliability and feasibility of PK-guided dosing in hemophilia patients. Moreover, it will contribute to personalization of treatment by greater knowledge of dosing regimens needed to prevent and treat bleeding in the individual patient and provide evidence to more clearly associate factor activity levels with bleeding risk.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e60-e69"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10771434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coagulation Studies Are Not Predictive of Hematological Complications of COVID-19 Infection.","authors":"Sarah Hadique,&nbsp;Varun Badami,&nbsp;Rahul Sangani,&nbsp;Michael Forte,&nbsp;Talia Alexander,&nbsp;Aarti Goswami,&nbsp;Adriana Garrison,&nbsp;Sijin Wen","doi":"10.1055/s-0041-1742225","DOIUrl":"https://doi.org/10.1055/s-0041-1742225","url":null,"abstract":"<p><p><b>Objectives</b>  Thrombotic and bleeding complications are common in COVID-19 disease. In a prospective study, we performed a comprehensive panel of tests to predict the risk of bleeding and thrombosis in patients admitted with hypoxic respiratory failure due to severe COVID-19 infection. <b>Methods</b>  We performed a single center (step down and intensive care unit [ICU] at a quaternary care academic hospital) prospective study. Sequentially enrolled adult (≥18 years) patients were admitted with acute hypoxic respiratory failure due to COVID-19 between June 2020 and November 2020. Several laboratory markers of coagulopathy were tested after informed and written consent. <b>Results</b>  Thirty-three patients were enrolled. In addition to platelet counts, prothrombin time, and activated partial thromboplastin time, a series of protocol laboratories were collected within 24 hours of admission. These included Protein C, Protein S, Antithrombin III, ADAMTS13, fibrinogen, ferritin, haptoglobin, and peripheral Giemsa smear. Patients were then monitored for the development of hematological (thrombotic and bleeding) events and followed for 30 days after discharge. Twenty-four patients (73%) required ICU admissions. At least one laboratory abnormality was detected in 100% of study patients. Nine patients (27%) suffered from significant hematological events, and four patients had a clinically significant bleeding event requiring transfusion. No significant association was observed between abnormalities of coagulation parameters and the incidence of hematologic events. However, a higher SOFA score (10.89 ± 3.48 vs. 6.92 ± 4.10, <i>p</i>  = 0.016) and CKD (5/9 [22.2%] vs. 2/24 [12.5%] <i>p</i>  = 0.009) at baseline were associated with the development of hematologic events. 33.3% of patients died at 30 days. Mortality was similar in those with and without hematological events. Reduced ADAMTS13 level was significantly associated with mortality. <b>Conclusion</b>  Routine extensive testing of coagulation parameters did not predict the risk of bleeding and thrombosis in COVID-19 patients. Thrombotic and bleeding events in COVID-19 patients are not associated with a higher risk of mortality. Interestingly, renal dysfunction and a high SOFA score were found to be associated with increased risk of hematological events.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e1-e9"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians' Views on Utilization of an Electronic Health Record-Embedded Calculator to Assess Risk for Venous Thromboembolism among Medical Inpatients: A Qualitative Study.","authors":"Stephanie R Moss,&nbsp;Kathryn A Martinez,&nbsp;Cassandra Nathan,&nbsp;Elizabeth R Pfoh,&nbsp;Michael B Rothberg","doi":"10.1055/s-0041-1742227","DOIUrl":"https://doi.org/10.1055/s-0041-1742227","url":null,"abstract":"<p><p><b>Background</b>  Venous thromboembolism (VTE) causes preventable in-hospital morbidity. Pharmacologic prophylaxis reduces VTE in at-risk patients but also increases bleeding. To increase appropriate prescribing, a risk calculator to guide prophylaxis decisions was developed. Despite efforts to promote its use, providers accessed it infrequently. <b>Objective</b>  This study aimed to understand provider perspectives on VTE prophylaxis and facilitators and barriers to using the risk calculator. <b>Design</b>  This is a qualitative study exploring provider perspectives on VTE prophylaxis and the VTE risk calculator. <b>Participants</b>  We interviewed attending physicians and advanced practice providers who used the calculator, and site champions who promoted calculator use. Providers were categorized by real-world usage over a 3-month period: low (<20% of the time), moderate (20-50%), or high (>50%). <b>Approach</b>  During semistructured interviews, we asked about experiences with VTE, calculator use, perspectives on its implementation, and experiences with other risk assessment tools. Once thematic saturation was reached, transcripts were analyzed using content analysis to identify themes. <b>Results</b>  Fourteen providers participated. Five were high utilizers, three were moderate utilizers, and six were low utilizers. Three site champions participated. Eight major themes were identified as follows: (1) ease of use, (2) perception of VTE risk, (3) harms of thromboprophylaxis, (4) overestimation of calculator use, (5) confidence in own ability, (6) underestimation of risk by calculator, (7) variability of trust in calculator, and (8) validation to withhold prophylaxis from low-risk patients. <b>Conclusions</b>  While providers found the calculator is easy to use, routine use may be hindered by distrust of its recommendations. Inaccurate perception of VTE and bleeding risk may prevent calculator use.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e33-e39"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid Artery Stenosis and Ischemic Strokes in Patients with Giant Cell Arteritis: A Characteristic Pattern-Literature Review and Case Report.","authors":"Clemens Oerding,&nbsp;Frank Uhlmann,&nbsp;Johannes Wollmann,&nbsp;Ingmar Kaden,&nbsp;Kai Wohlfarth","doi":"10.1055/a-1704-0741","DOIUrl":"https://doi.org/10.1055/a-1704-0741","url":null,"abstract":"<p><p><b>Purpose</b>  Ischemic stroke is a relatively rare complication of giant cell arteritis often accompanied by vessel stenosis. Our purpose was to compare the location of internal carotid artery stenosis in GCA patients by performing a literature review suggesting a specific and characteristic pattern. <b>Methods</b>  We performed a PubMed research including all articles and cited articles reporting cases and case series about giant cell arteritis patients with internal carotid artery stenosis and ischemic strokes. <b>Results</b>  In this case series 39 cases were included. We found a clear tendency of giant cell arteritis-related stenosis to be in the intracranial segments (35/39 (89.7%)). Only in 8/39 (20.5%) patients there was further involvement of extracranial segments. Many cases (27/39 [69.2%]) showed a bilateral involvement. <b>Discussion</b>  This literature review reveals a specific pattern of internal carotid artery involvement in patients with giant cell arteritis and ischemic strokes. To our knowledge this pattern has not been reported as a sign strongly pointing toward giant cell arteritis before. We have not found case reports mentioning other common types of vasculitis reporting this involvement pattern. <b>Conclusion</b>  Internal carotid artery stenosis and ischemic stroke is a rare complication in patients with giant cell arteritis. Considering the characteristic features of bilateral distal internal carotid artery stenosis giant cell arteritis should be suspected which potentially leads to an early diagnosis and immunotherapy.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e40-e49"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8801894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Monitoring of D-Dimer Allows Outcomes Prediction in COVID-19.","authors":"David M Smadja,&nbsp;Olivier M Bory,&nbsp;Jean-Luc Diehl,&nbsp;Alexis Mareau,&nbsp;Nicolas Gendron,&nbsp;Anne-Sophie Jannot,&nbsp;Richard Chocron","doi":"10.1055/a-1709-5441","DOIUrl":"https://doi.org/10.1055/a-1709-5441","url":null,"abstract":"No Abstract","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e21-e25"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Induced Coagulopathy (CIC): Thrombotic Manifestations of Viral Infection.","authors":"Swati Sharma,&nbsp;Aastha Mishra,&nbsp;Zahid Ashraf","doi":"10.1055/s-0042-1744185","DOIUrl":"https://doi.org/10.1055/s-0042-1744185","url":null,"abstract":"<p><p>Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and may result in an overactive coagulative system, thereby resulting in serious cardiovascular consequences in critically affected patients. The respiratory tract is a primary target for COVID-19 infection, which is manifested as acute lung injury in the most severe form of the viral infection, leading to respiratory failure. A proportion of infected patients may progress to serious systemic disease including dysfunction of multiple organs, acute respiratory distress syndrome (ARDS), and coagulation abnormalities, all of which are associated with increased mortality, additionally depending on age and compromised immunity. Coagulation abnormalities associated with COVID-19 mimic other systemic coagulopathies otherwise involved in other severe infections, such as disseminated intravascular coagulation (DIC) and may be termed COVID-19 induced coagulopathy (CIC). There is substantial evidence that patients with severe COVID-19 exhibiting CIC can develop venous and arterial thromboembolic complications. In the initial stages of CIC, significant elevation of D-dimer and fibrin/fibrinogen degradation products is observed. Alteration in prothrombin time, activated partial thromboplastin time, and platelet counts are less common in the early phase of the disease. In patients admitted to intensive care units (ICUs), coagulation test screening involving the measurement of D-dimer and fibrinogen levels, has been recommended. Prior established protocols for thromboembolic prophylaxis are also followed for CIC, including the use of heparin and other standard supportive care measures. In the present review, we summarize the characteristics of CIC and its implications for thrombosis, clinical findings of coagulation parameters in SARS-CoV-2 infected patients with incidences of thromboembolic events and plausible therapeutic measures.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e70-e79"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8913175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10699102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypercoagulation Detected by Rotational Thromboelastometry Predicts Mortality in COVID-19: A Risk Model Based on a Prospective Observational Study.","authors":"Lou M Almskog,&nbsp;Agneta Wikman,&nbsp;Jonas Svensson,&nbsp;Matteo Bottai,&nbsp;Mariann Kotormán,&nbsp;Carl-Magnus Wahlgren,&nbsp;Michael Wanecek,&nbsp;Jan van der Linden,&nbsp;Anna Ågren","doi":"10.1055/a-1725-9221","DOIUrl":"https://doi.org/10.1055/a-1725-9221","url":null,"abstract":"<p><p><b>Background</b>  Severe disease due to the novel coronavirus disease 2019 (COVID-19) has been shown to be associated with hypercoagulation. The aim of this study was to assess the Rotational Thromboelastometry (ROTEM) as a marker of coagulopathy in hospitalized COVID-19 patients. <b>Methods</b>  This was a prospective, observational study where patients hospitalized due to a COVID-19 infection were eligible for inclusion. Conventional coagulation tests and ROTEM were taken after hospital admission, and patients were followed for 30 days. A prediction model, including variables ROTEM EXTEM-MCF (Maximum Clot Firmness) which in previous data has been suggested a suitable marker of hypercoagulation, age, and respiratory frequency, was developed using logistic regression to evaluate the probability of death. <b>Results</b>  Out of the 141 patients included, 18 (13%) died within 30 days. In the final prediction model, the risk of death within 30 days for a patient hospitalized due to COVID-19 was increased with increased EXTEM-MCF, age, and respiratory frequency. Longitudinal ROTEM data in the severely ill subpopulation showed enhanced hypercoagulation. In an in vitro analysis, no heparin effect on EXTEM-coagulation time (CT) was observed, supporting a severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) effect on prolonged initiation of coagulation. <b>Conclusion</b>  Here, we show that hypercoagulation measured with ROTEM predicts 30-day mortality in COVID-19. Longitudinal ROTEM data strengthen the hypothesis of hypercoagulation as a driver of severe disease in COVID-19. Thus, ROTEM may be a useful tool to assess disease severity in COVID-19 and could potentially guide anticoagulation therapy.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e50-e59"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10694799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporary Rise in Blood Thrombogenicity in Patients with Acute Myocardial Infarction.","authors":"Shumpei Kosugi,&nbsp;Yasunori Ueda,&nbsp;Haruhiko Abe,&nbsp;Kuniyasu Ikeoka,&nbsp;Tsuyoshi Mishima,&nbsp;Tatsuhisa Ozaki,&nbsp;Kohtaro Takayasu,&nbsp;Takuya Ohashi,&nbsp;Haruya Yamane,&nbsp;Masayuki Nakamura,&nbsp;Takashi Fukushima,&nbsp;Kohei Horiuchi,&nbsp;Takashi Iehara,&nbsp;Satoshi Osaki,&nbsp;Kazuki Ozato,&nbsp;Koichi Inoue,&nbsp;Yukihiro Koretsune,&nbsp;Yasushi Matsumura","doi":"10.1055/a-1719-6178","DOIUrl":"https://doi.org/10.1055/a-1719-6178","url":null,"abstract":"<p><p><b>Objective</b>  Although blood thrombogenicity seems to be one of the determinant factors for the development of acute myocardial infarction (MI), it has not been dealt with in-depth. This study aimed to investigate blood thrombogenicity and its change in acute MI patients. <b>Methods and Results</b>  We designed a prospective, observational study that included 51 acute MI patients and 83 stable coronary artery disease (CAD) patients who underwent cardiac catheterization, comparing thrombogenicity of the whole blood between: (1) acute MI patients and stable CAD patients; and (2) acute and chronic phase in MI patients. Blood thrombogenicity was evaluated by the Total Thrombus-Formation Analysis System (T-TAS) using the area under the flow pressure curve (AUC ₃₀ ) for the AR-chip. Acute MI patients had significantly higher AUC ₃₀ than stable CAD patients (median [interquartile range], 1,771 [1,585-1,884] vs. 1,677 [1,527-1,756], <i>p</i>  = 0.010). Multivariate regression analysis identified acute MI with initial TIMI flow grade 0/1 as an independent determinant of high AUC ₃₀ ( <i>β</i>  = 0.211, <i>p</i>  = 0.013). In acute MI patients, AUC ₃₀ decreased significantly from acute to chronic phase (1,859 [1,550-2,008] to 1,521 [1,328-1,745], <i>p</i>  = 0.001). <b>Conclusion</b>  Blood thrombogenicity was significantly higher in acute MI patients than in stable CAD patients. Acute MI with initial TIMI flow grade 0/1 was significantly associated with high blood thrombogenicity by multivariate analysis. In acute MI patients, blood thrombogenicity was temporarily higher in acute phase than in chronic phase.</p>","PeriodicalId":22238,"journal":{"name":"TH Open: Companion Journal to Thrombosis and Haemostasis","volume":"6 1","pages":"e26-e32"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10756453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}