Thrombosis Journal最新文献

{"title":"Association of initial national early warning score with clinical deterioration in pulmonary embolism.","authors":"Anthony J Weekes, Fernanda Calienescerpa, Kelly L Goonan, Alexa L Polzella, Melanie M Hogg, Dalton Cox, Sean Flannigan, Emma Cruz, Halie A O'Neill, Nathaniel S O'Connell, Daniel R Troha","doi":"10.1186/s12959-025-00735-7","DOIUrl":"https://doi.org/10.1186/s12959-025-00735-7","url":null,"abstract":"<p><strong>Background: </strong>The National Early Warning Score (NEWS2) predicts clinical deterioration in hospitalized patients. Its role in pulmonary embolism (PE) risk stratification remains underexplored. This study assessed the association of initial NEWS2 with clinical deterioration and advanced interventions during hospitalization.</p><p><strong>Methods: </strong>We retrospectively analyzed a PE response team (PERT) registry of adults with submassive and massive PE from 11 emergency departments (2016-2024). Initial NEWS2 was calculated for each registry patient. The primary outcome was in-hospital PE-related clinical deterioration (death, cardiac arrest, vasoactive medications for hypotension, or emergent respiratory interventions). The secondary outcome was advanced intervention use. We calculated odds ratios (OR) for different NEWS2 cut-offs. We used multivariable analysis to assess the association of NEWS2 and study outcomes, and decision curve analysis to determine net benefit of clinical deterioration.</p><p><strong>Results: </strong>Among 2119 patients (mean age 62.2 [16.8], 51.2% female, 168 [7.9%] with massive PE, and 1951 [92.1%] with submassive PE), 309 patients (14.6%) experienced clinical deterioration and 488 (23.0%) required advanced interventions. Mean NEWS2 was higher in patients with vs. without clinical deterioration (6.0 ± 3.3 vs. 3.0 ± 2.4; p < 0.001) and in those with vs. without advanced interventions (4.8 ± 3.1 vs. 3.0 ± 2.5; p < 0.001). NEWS2 cut-off of ≥ 3 identified patients at risk of clinical deterioration: sensitivity 87% (82-90%), OR 6.1 (95% CI: 4.3-8.5), and negative predictive value (NPV) 96% (94-97%). NEWS2 cut-off ≥ 4 had specificity of 62% (60-65%), OR of 5.1 (95% CI: 3.9-6.7), and NPV of 94% (92-95%). As a continuous variable, NEWS2 had an OR of 1.2 (95% CI: 1.1-1.3). NEWS2 cut-offs from 3 to 5 showed an improved net benefit (0.08, 0.16, and 0.34) compared with treating all patients as high risk for clinical deterioration.</p><p><strong>Conclusion: </strong>Patients with PE and initial NEWS2 scores ≥ 3 had a four-fold to eight-fold higher odds of clinical deterioration than those with NEWS2 < 3. NEWS2 is useful for predicting clinical deterioration and guiding intervention strategies in PE.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"49"},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective cohort analysis of plasma TAT level trends and adverse pregnancy outcomes in early pregnancy patients with newly diagnosed VTE.","authors":"Rong Zhang, Xiao Mei Wang, Chao Yun Jiang, Tian Hong Cai, Jian Feng He, Kai Chen, Dian Xi Chen, Teng Hui Zhan","doi":"10.1186/s12959-025-00732-w","DOIUrl":"10.1186/s12959-025-00732-w","url":null,"abstract":"<p><strong>Objective: </strong>Venous thromboembolism (VTE) is a leading cause of maternal mortality, yet effective biomarkers for early prediction of adverse pregnancy outcomes remain limited. We aimed to investigate the association between changes in thrombin-antithrombin complex (TAT) levels and adverse pregnancy outcomes in early-pregnancy patients with VTE.</p><p><strong>Methods: </strong>In this retrospective cohort study, we enrolled 89 pregnant women diagnosed with VTE during early pregnancy (< 14 weeks) who received care at Fujian Maternity and Child Health Hospital between June 2021 and May 2024. Plasma TAT levels measured in early and mid-pregnancy were collected as exposure variables, while adverse pregnancy outcomes (including miscarriage, preterm birth, and fetal growth restriction) served as outcome variables. Multivariate regression analysis was performed to evaluate the association between TAT level changes and adverse pregnancy outcomes, adjusting for potential confounding factors including age, BMI, and obstetric history. Additionally, threshold effect analysis was conducted.</p><p><strong>Results: </strong>After adjusting for potential confounding factors including age, BMI, and underlying conditions, changes in TAT levels were significantly associated with a reduced risk of adverse pregnancy outcomes (adjusted OR = 0.62, 95% CI: 0.47-0.80). Threshold effect analysis identified a critical turning point of -2.87 in TAT level changes (TATp2-1), below which the risk of adverse outcomes increased significantly (adjusted OR = 0.37, 95% CI: 0.22-0.63).</p><p><strong>Conclusion: </strong>The association between TATp2-1 and adverse pregnancy outcomes in early pregnancy VTE patients was non-linear. A threshold effect was observed with an inflection point of -2.87. When the TATp2-1 were below - 2.87, there was a significantly increased risk of adverse pregnancy outcomes.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"48"},"PeriodicalIF":2.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144080546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of stress hyperglycemia ratio in patients with type 2 diabetes mellitus and acute coronary syndromes.","authors":"Xiaoteng Ma, Huijun Chu, Yan Sun, Yujing Cheng, Dai Zhang, Lixia Yang, Zhijian Wang, Xiaoli Liu, Yujie Zhou","doi":"10.1186/s12959-025-00729-5","DOIUrl":"10.1186/s12959-025-00729-5","url":null,"abstract":"<p><strong>Background: </strong>Prognostic significance of stress hyperglycemia ratio (SHR) has not been well studied in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndromes (ACS).</p><p><strong>Methods: </strong>We prospectively measured admission fasting blood glucose (AFBG) and glycated hemoglobin A1c (HbA1c), and retrospectively calculated the stress hyperglycemia ratio (SHR, = AFBG/[1.59 × HbA1c (%) - 2.59]) in 791 patients with T2DM and ACS undergoing percutaneous coronary intervention (PCI). The primary endpoint was defined as major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause mortality, non-fatal stroke, non-fatal myocardial infarction, and unplanned repeat coronary revascularization.</p><p><strong>Results: </strong>The mean age of the study population was 61 ± 10 years, and 72.8% were male. Over a median follow-up of 927 days, 194 patients developed at least one primary endpoint event. The follow-up incidence of MACCE increased in parallel with SHR tertiles (15.6%, 21.9%, and 36.1%, respectively; P for trend < 0.001). The Cox proportional hazards regression analysis adjusted for multiple confounding factors showed hazard ratios for MACCE of 1.525 (95% CI: 1.009-2.305; P = 0.045) for the middle tertile and 2.525 (95% CI: 1.729-3.687; P < 0.001) for the highest tertile of SHR, with the lowest tertile as the reference. The addition of SHR to the baseline reference prediction model improved model predictive performance markedly (C-statistic: increased from 0.704 to 0.721; cNRI: 0.176 [95% CI: 0.063-0.282], P = 0.002; IDI: 0.030 [95% CI: 0.009-0.063], P = 0.002).</p><p><strong>Conclusion: </strong>SHR was independently and significantly associated with adverse cardiovascular outcomes in T2DM and ACS patients who underwent PCI, and had an incremental effect on the predictive ability of the baseline reference prediction model.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"47"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"D-dimer to fibrinogen ratio as a marker for acute cerebral venous thrombosis.","authors":"Minh-Hoang Tran, Kim-Huong Truong-Nguyen","doi":"10.1186/s12959-025-00730-y","DOIUrl":"https://doi.org/10.1186/s12959-025-00730-y","url":null,"abstract":"<p><p>Despite D-dimer to fibrinogen ratio (DFR) being reported as a prognostic factor for cerebral venous thrombosis (CVT), we note some concerns about the misused terminology (prognostic versus predictive), potential variability in D-dimer and fibrinogen assays that may impact the reliability and utility of DFR. From the statistical aspect, its validity was not adequately ensured due to inappropriate methods (inability to address multicollinearity, confounding, and multiple comparisons) and lack of validation for unvalidated discrimination cut-offs. The prognostic value of DFR was not clinically or statistically justified, given its poor-to-acceptable discrimination. Finally, an unexpectedly positive association between venous cerebral infarction and non-severe CVT suggests possible issues in data labelling, reference value, uncontrolled confounders/biases, or overadjustment. Addressing these issues would strengthen the reliability, validity, and utility of DFR in CVT prognosis.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"46"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoplasmic reticulum protein 29 negatively regulates platelet functions and thrombosis in mice.","authors":"Xiaofeng Yan, Yishan Lu, Keyu Lv, Miao Jiang, Chao Fang, Yi Wu, Aizhen Yang","doi":"10.1186/s12959-025-00726-8","DOIUrl":"https://doi.org/10.1186/s12959-025-00726-8","url":null,"abstract":"<p><strong>Background: </strong>Several members of protein disulfide isomerase (PDI) family with the CXYC active motif such as PDI, ERp57, ERp72, ERp46, ERp5 and TMX1 have important roles in platelet functions and thrombosis. These members contribute to the network of redox regulation of platelet activities. However, whether other PDI family members without the CXYC motif such as ERp29, have a role in these processes remains unknown.</p><p><strong>Aims: </strong>To determine the role of ERp29 in platelet functions and thrombosis.</p><p><strong>Methods: </strong>The phenotypes of platelet-specific ERp29-deficient (Pf4-Cre/ERp29^fl/fl) mice were evaluated using tail bleeding assay and laser-induced and FeCl₃-induced arterial injury models, as well as venous thrombosis model. In vitro, the functions of ERp29-deficient platelets were assessed in respect to aggregation, adhesion, spreading, clot retraction, granule secretion and integrin αIIbβ3 activation measured by flow cytometry. Redox state of integrin αIIbβ3 thiols was detected using 3-(N-maleimido-propionyl) biotin (MPB) labeling.</p><p><strong>Results: </strong>Compared with WT mice, Pf4-Cre/ERp29^fl/fl mice exhibited shortened tail-bleeding times, increased platelet accumulation in the two arterial thrombosis models, and enhanced thrombogenesis in the venous thrombosis model. ERp29-deficient platelets had enhanced response in aggregation, ATP release, spreading, clot retraction, αIIbβ3 activation, fibrinogen binding and P-selectin expression. As detected by MPB labeling, the free thiol content of integrin αIIbβ3 in ERp29-deficient platelets were increased compared with WT platelets, suggesting that the role of ERp29 is associated with oxidation of the functional disulfides of integrin αIIb and/or β3 subunits.</p><p><strong>Conclusion(s): </strong>ERp29 is the first disulfide isomerase without the CXYC motif that negatively regulates platelet function. This study provides new insight into the redox network controlling thrombosis.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"44"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enoxaparin dosing for venous thromboembolism prophylaxis in hospitalized underweight adult patients: a retrospective cohort study.","authors":"Salam Ibrahim Abou Safrah, Mohamed Omar Saad, May Alasmar, Fatima Ashfaq Butt, Somaya Khaled Koraysh","doi":"10.1186/s12959-025-00716-w","DOIUrl":"https://doi.org/10.1186/s12959-025-00716-w","url":null,"abstract":"<p><strong>Background: </strong>Enoxaparin is commonly used for venous thromboembolism (VTE) prophylaxis in adult hospitalized patients. Although anti-Xa levels are inversely related to body weight, limited studies evaluated clinical outcomes of dose reduction in the underweight population.</p><p><strong>Objective: </strong>To compare the incidence of bleeding and VTE in underweight patients receiving reduced doses of enoxaparin (< 40 mg daily) versus the standard dose (40 mg daily) for VTE prophylaxis.</p><p><strong>Methods: </strong>This was a multicentre retrospective cohort study at Hamad Medical Corporation in Qatar. We included hospitalized patients with a total body weight ≤ 57 kg or body mass index (BMI) ≤ 18.5 kg/m² who received prophylactic enoxaparin for at least 48 h. The outcomes were bleeding, VTE, and composite unfavourable outcome (bleeding or VTE). Inverse-probability-of-treatment weighting (IPTW) was used to adjust for confounding.</p><p><strong>Results: </strong>We identified 1,130 eligible patients, of whom 124 patients (11%) received the reduced dose, and 1,006 patients (89%) received the standard dose. Bleeding occurred in one patient (0.8%) of the reduced dose group compared to 15 patients (1.5%) in the standard dose group (p > 0.99), VTE occurred in two patients (1.6%) in the reduced dose group compared to four patients (0.4%) in the standard dose group (p = 0.13). In the IPTW analysis, there was no significant difference in overall bleeding (odds ratio (OR) 1.4, 95% CI 0.18-10.75, p = 0.74), VTE (OR 0.3, 95% CI 0.05-1.81, p = 0.19), or the composite unfavourable outcome (OR 0.74, 95% CI 0.2-2.75, p = 0.66).</p><p><strong>Conclusion: </strong>There is no significant difference in the incidence of bleeding or VTE between the reduced dose and the standard dose of enoxaparin for VTE prophylaxis in underweight adult patients. Due to the low event rates in both groups, larger studies are required to delineate any differences between the two dosing strategies.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"45"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk factors of liver cirrhosis complicated with portal vein thrombosis and the efficacy and safety of anticoagulant therapy: a meta analysis.","authors":"Le Zhang, Xia Wang, Pu Ming, Li-Na Ma, Wanlong Ma, Xiang-Chun Ding","doi":"10.1186/s12959-025-00725-9","DOIUrl":"https://doi.org/10.1186/s12959-025-00725-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk factors of liver cirrhosis complicated with portal vein thrombosis and the efficacy and safety of anticoagulant therapy.</p><p><strong>Methods: </strong>Relevant literature was searched through PubMed, Cochrane library, Embase, Web of Science, Wanfang Medical Network and CNKI databases, and eligible literature was included. QUADS scale was used to evaluate the quality of the included literatures, and Stata15.1 software was used for meta-analysis and statistical processing.</p><p><strong>Results: </strong>For risk factors analysis for cirrhosis with Portal vein thrombosis, 19 literatures were included, including 1563 patients with cirrhosis with portal vein thrombosis and 2579 patients with cirrhosis without portal vein thrombosis, all of which were not treated with anticoagulation. The results of meta-analysis showed that compared with the PVT group, there was no significant difference in creatinine(Scr,MD = 0.09,95%CI: -0.03-0.22,P = 0.132)and total bilirubin(TBIL,MD = -0.00, 95%CI: -0.10 ~ 0.09,P = 0.948).There was significant difference in albumin(ALB,MD = -0.32, 95%CI:-0.43-0.21,P = 0.000)and PLT(PLT, MD = 0.15, 95%CI: 0.05-0.26, P = 0.004).And there was also no difference in hypertension history (OR = 0.78,95%CI:0.59 ~ 1.03,P = 0.079). In the study on the anticoagulant effect and safety of liver cirrhosis complicated with portal vein thrombosis, a total of 9 literatures were included. Among them,497 patients with liver cirrhosis complicated by portal vein thrombosis are treated with Anticoagulation treatment, and 633 patients with cirrhosis complicated by portal vein thrombosis without anticoagulation treatment. The analysis results showed that the thrombus recanalization situation of liver cirrhosis complicated with portal vein thrombosis after anticoagulation treatment was better than that of patients without anticoagulation (OR = 4.052,95%CI: 2.737-6.000,P = 0.000),and there was no significant difference in the occurrence of bleeding events between patients with anticoagulation and those without anticoagulation (OR = 1.017, 95%CI:0.735-1.407,P = 0.920). The Stata15.1Egger test showed no significant publication bias for all the results(P > 0.05).</p><p><strong>Conclusions: </strong>Patients with liver cirrhosis complicated with low platelet and low albumin are more likely to develop PVT. Anticoagulation is helpful and safe for thrombolysis in patients with liver cirrhosis complicated with PVT.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"43"},"PeriodicalIF":2.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence and risk factors of pulmonary embolism in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.","authors":"Mingzhu Li, Yeqian Jiang, Ying Xu, Qianbing Li","doi":"10.1186/s12959-025-00728-6","DOIUrl":"https://doi.org/10.1186/s12959-025-00728-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;An increased prevalence of PE has been found in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Early identification of risk factors for the development of PE in patients with AECOPD and intervention is important. Therefore, we comprehensively pool and analyze the prevalence and risk factors of PE among patients experiencing AECOPD, aiming to provide valuable insights for clinical-based diagnostic determination and prevention of PE in the AECOPD patient population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search was conducted for studies reporting the incidence and risk factors for PE in patients with AECOPD. Study quality was assessed using the modified Newcastle-Ottawa Quality Assessment Scale. The degree of heterogeneity was assessed by the I&lt;sup&gt;2&lt;/sup&gt; statistic. The publication bias (studies ≥ 10) was evaluated using Egger's test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 1421 studies initially retrieved, 22 articles were ultimately selected and incorporated into the analysis. Based on the meta-analysis and the review's updated findings, the prevalence of PE in AECOPD is 17.82% (95% CI 12.72%-23.57%, P&lt;0.001). The following factors were identified as risk factors for PE among patients with AECOPD: age(weighted mean difference [WMD] 2.0119, 95% CI 0.7126-3.3133, I&lt;sup&gt;2&lt;/sup&gt; = 51.8%, P = 0.02), males(odds ratio [OR] 0.9528, 95% CI 0.6869-1.3216, I&lt;sup&gt;2&lt;/sup&gt; = 65.0%, P&lt;0.001), obesity(OR 1.3086, 95% CI 0.1895-9.0385, I&lt;sup&gt;2&lt;/sup&gt; = 74.5%, P = 0.02), malignant disease(OR 1.5902, 95%CI 0.9689-2.6097, I&lt;sup&gt;2&lt;/sup&gt; = 54.7%, P = 0.03), hypertension(OR 1.0663, 95%CI 0.7920-1.4355, I&lt;sup&gt;2&lt;/sup&gt; = 57.7%, P = 0.009), immobilization ≥ 3d(OR 3.9158, 95% CI 1.0925-14.0354, I&lt;sup&gt;2&lt;/sup&gt; = 91.6%, P&lt;0.001), edema of lower limb(OR 2.1558, 95% CI 1.3365-3.4773, I&lt;sup&gt;2&lt;/sup&gt; = 75.4%, P&lt;0.001), pulmonary hypertension(OR 1.3146, 95%CI 0.7481-2.3100, I&lt;sup&gt;2&lt;/sup&gt; = 70.1%, P = 0.04), cough(OR 0.7084, 95%CI 0.1304-3.8497, I&lt;sup&gt;2&lt;/sup&gt; = 88.8%, P&lt;0.001), purulent sputum(OR 0.7570, 95%CI 0.4005-1.4309, I&lt;sup&gt;2&lt;/sup&gt; = 61.9%, P = 0.049), and D-dimer(WMD 0.8619, 95%CI 0.0449-1.6789, I&lt;sup&gt;2&lt;/sup&gt; = 91.4%, P&lt;0.001), C-reactive protein(CRP)(WMD 0.8852, 95%CI -4.0639-5.8344, I&lt;sup&gt;2&lt;/sup&gt; = 76.4%, P = 0.005) or fibrinogen(WMD 0.8663, 95%CI -0.2572-1.9898, I&lt;sup&gt;2&lt;/sup&gt; = 92.2%, P&lt;0.001) levels. Clinical risk factors(including S1Q3 pattern on electrocardiograph(ECG), hospital stay and home oxygen therapy) showed no significant association with the occurrence of PE (P&gt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This updated meta-analysis and systematic review revealed that the prevalence of pulmonary embolism in the AECOPD was 17.82%. This figure may vary depending on how the diagnostic procedure is carried out. Age, males, obesity, malignant disease, hypertension, immobilization ≥ 3d, edema of lower limb, pulmonary hypertension, cough, purulent sputum, and D-dimer, CRP or fibrinogen ","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"42"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Von Willebrand disease (VWD) and pregnancy: a comprehensive overview.","authors":"Hamed Soleimani Samarkhazan, Mohammad Navid Khaksari, Ali Rahmati, Mahsa Loran Esfahani, Amin Solouki, Mojtaba Aghaei","doi":"10.1186/s12959-025-00727-7","DOIUrl":"https://doi.org/10.1186/s12959-025-00727-7","url":null,"abstract":"<p><p>Von Willebrand disease (VWD) is a hereditary bleeding disorder characterized by a quantitative or qualitative deficiency of von Willebrand factor (VWF). Pregnancy significantly impacts hemostasis, leading to a hypercoagulable state. However, women with VWD experience unique challenges due to the interplay between pregnancy-related hormonal changes and VWF deficiencies. This review delves into the intricate relationship between VWD and pregnancy. We explored the physiological changes that occur during pregnancy, including hormonal fluctuations, hemodilution, and alterations in platelet-VWF interactions. We discuss how these changes can exacerbate bleeding tendencies in women with VWD, particularly during childbirth and the postpartum period. This review highlights the increased risk of postpartum hemorrhage (PPH) in women with VWD and the potential for severe maternal morbidity and mortality. We examine the various types of VWD and their specific implications for pregnancy outcomes. Additionally, we discuss the challenges associated with diagnosing and managing VWD during pregnancy, as well as the importance of prenatal counseling and careful monitoring. The management of VWD during pregnancy involves a multidisciplinary approach, including the use of prophylactic treatments, such as desmopressin and tranexamic acid, as well as factor replacement therapy when necessary. Careful planning of delivery, including the choice of delivery mode and the timing of interventions, is essential to minimize bleeding complications. By understanding the complexities of VWD during pregnancy and implementing appropriate management strategies, healthcare providers can significantly improve the outcomes for women with VWD and their offspring.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"41"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of magnetic resonance angiography combined with serum ischemia-modified albumin for secondary cerebral infarction after transient ischemic attack.","authors":"Lige Liu, Qiuyue Yan, Jingyi Ai, Rudong Jiao, Meng Li","doi":"10.1186/s12959-025-00717-9","DOIUrl":"https://doi.org/10.1186/s12959-025-00717-9","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the diagnostic value of magnetic resonance angiography (MRA) combined with serum ischaemia-modifier albumin (IMA) testing in predicting secondary cerebral infarction (CI) following transient ischemic attack (TIA).</p><p><strong>Methods: </strong>All TIA patients underwent MRA and IMA level assessments, along with ABCD² scoring (a TIA risk stratification tool). Patients were categorized into secondary CI and non-CI groups based on the occurrence of CI within a 90-day follow-up period. Vessel stenosis, serum IMA levels, the predictive value of MRA and IMA levels for secondary CI after TIA, and the independent factors associated with secondary CI in TIA patients were analyzed.</p><p><strong>Results: </strong>The high-risk and intermediate-risk groups showed a higher proportion of moderate-severe vessel stenosis and elevated IMA levels compared to the low-risk group, with IMA levels significantly higher in the high-risk group than in the intermediate-risk group (P < 0.05). The secondary CI group exhibited a greater proportion of moderate-severe vessel stenosis and higher IMA levels compared to non-CI group (P < 0.05). The combined predictive model using MRA and IMA demonstrated a significantly higher area under the curve (AUC = 0.908) compared to MRA alone (AUC = 0.798; z = 3.083, P = 0.002), but only slightly higher than IMA alone (AUC = 0.875; z = 1.226, P = 0.220). Independent factors associated with secondary CI included advanced age, moderate-severe vessel stenosis, ABCD² scores, and elevated IMA levels (OR > 1, P < 0.05).</p><p><strong>Conclusion: </strong>Changes in MRA and IMA levels were correlated with disease severity in TIA patients. MAR combined with serum IMA demonstrated high predictive efficacy for secondary CI after TIA, making it a valuable tool for CI risk assessment. Independent factors associated with secondary CI included advanced age, moderate-severe vessel stenosis, intermediate-high-risk ABCD² scores, and elevated IMA levels.</p>","PeriodicalId":22982,"journal":{"name":"Thrombosis Journal","volume":"23 1","pages":"40"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}