Thrombosis and haemostasis最新文献

{"title":"Left Atrial Appendage Closure Lacks Sufficient Evidence for Routine Use.","authors":"Mohammed Ruzieh, Andrew J Foy, John Mandrola","doi":"10.1055/a-2862-6722","DOIUrl":"https://doi.org/10.1055/a-2862-6722","url":null,"abstract":"<p><p>Percutaneous left atrial appendage occlusion (pLAAO) is increasingly being adopted as an alternative to non-vitamin K antagonist oral anticoagulants (NOACs) for patients with atrial fibrillation. However, the current evidence does not justify this enthusiasm. Key limitations include wide non-inferiority margins in some of the trials, inclusion of components in the primary efficacy endpoint that are not directly influenced by pLAAO, making non-inferiority easier to achieve, limited statistical power to detect differences in ischemic stroke or systemic embolism, and an overstated bleeding advantage.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843161","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":"Assessment of Commutability in Factor VIII Activity Testing Using Fresh Human Plasma Samples.","authors":"Laura Vierbaum, Michael Weigand, Mira Ganslmeier, Dorothea Fichtl, Daniel Teupser, Michael Spannagl, Patrick Moehnle, Mathias Bruegel","doi":"10.1055/a-2852-9387","DOIUrl":"https://doi.org/10.1055/a-2852-9387","url":null,"abstract":"<p><p>For the diagnosis and therapeutic monitoring of bleeding disorders as well as for thrombotic risk assessment, reliable measurement of factor VIII (FVIII) coagulant activity is required. The complex FVIII structure and limited stability pose major challenges in hemostaseological diagnostics concerning the preanalytical handling and the availability of commutable control and calibrator materials. The aim of this study was to assess the commutability of frozen and lyophilized patient plasma and routinely used external quality assessment materials (EQAMs) for FVIII activity measurement.FVIII activity was measured in 97 native plasma samples covering a broad activity range using clotting tests and chromogenic assays from two manufacturers. Corresponding frozen and lyophilized aliquots as well as four commercially available lyophilized control materials from three manufacturers were analyzed the same way. Commutability was assessed by comparing the mean natural logarithmic differences of candidate materials from those of native plasma using Bland-Altman plots. A commutability criterion was defined with respect to the intended use of the materials as EQAMs, based on the mean ± 2 standard deviations derived from the distribution of natural logarithmic differences in native plasma samples.Native plasma measurements showed good agreement across the four methods. Method-specific effects on FVIII activity measurement were minor after freezing, but more pronounced after lyophilization. Nevertheless, mean differences observed for frozen and lyophilized plasma remained within the predefined commutability criterion. All investigated EQAMs were deemed commutable for their intended use in external quality assessment. All in all, commutability studies for FVIII activity measurement are feasible but resource-intensive.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147820845","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":"Venous Thromboembolism Outcomes Among Cancer and Non-cancer Patients Managed with Patient-centric Guideline-driven Protocol.","authors":"Claire E Cassianni, Robert D McBane, Danielle T Vlazny, David O Hodge, Ana I Casanegra, Damon E Houghton, Waldemar E Wysokinski","doi":"10.1055/a-2653-6161","DOIUrl":"10.1055/a-2653-6161","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer and venous thromboembolism (VTE) have higher complication rates of anticoagulation. However, studies supporting this data are relatively old reflecting the era of vitamin K inhibitors.</p><p><strong>Methods: </strong>To assess VTE recurrence, major bleeding, and clinically relevant non-major bleeding (CRNMB) in patients (March 1, 2013 to April 30, 2023) with cancer-associated VTE and patients without cancer, the prospective Mayo Clinic Thrombophilia Clinic Registry was analyzed.</p><p><strong>Results: </strong>Over the study period, 4,711 patients with acute VTE were enrolled including 2,064 patients with cancer (mean age 62.5 ± 12.4, 46% female) and 2,647 patients without cancer (mean age 59.4 ± 16.0, 45% female). The most common cancers were gastrointestinal (<i>n</i> = 423, 21%), pancreatic (<i>n</i> = 287, 14%), and genitourinary (<i>n</i> = 198, 10%). Direct oral anticoagulants were used in 1,339 (65%) cancer and in 1,952 (74%) non-cancer patients. Among cancer patients, 12-month Kaplan-Meier probability of VTE recurrence was 2.4-fold greater (7.1% vs. 2.9%, <i>p</i> < 0.001) compared with the non-cancer group, including higher recurrent leg deep vein thrombosis (3.0% vs. 1.4%; <i>p</i> = 0.002) and pulmonary embolism (3.5% vs. 1.0%, <i>p</i> < 0.001). Patients with cancer also had 2.1-fold greater risk of major bleeding (6.3% vs. 3.0%; <i>p</i> < 0.001) including bleeding from the gastrointestinal tract (3.0 vs. 1.4, <i>p</i> = 0.01) compared with patients without cancer. Clinically relevant non-major bleeding events were similar between the groups.</p><p><strong>Conclusion: </strong>In this large prospective registry of VTE management, patients with cancer had significantly higher rates of VTE recurrence and major bleeding compared with patients without cancer, yet the rate of complications are substantially smaller relative to historic values of a prior vitamin K antagonist era.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"518-525"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733356","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":"Performance of Bleeding Risk Scores for Major Bleeding in Anticoagulated Patients with Pulmonary Embolism: Insights from the CURES Registry-2.","authors":"Yuzhi Tao, Hong Chen, Chunling Dong, Jie Zhang, Yiwei Shi, Xiaomao Xu, Maoyun Wang, Ling Zhu, Juhong Shi, Yingqun Ji, Hong Chen, Zhe Cheng, Yongjun Tang, Yanxia Li, Chaosheng Deng, Qin Luo, Pinyao Lu, Yuanhua Yang, Linfeng Xi, Yu Zhang, Rui Liang, Dingyi Wang, Guohui Fan, Wanmu Xie, Jun Wan, Zhu Zhang, Shuai Zhang, Yunxia Zhang, Qiang Huang, Qian Gao, Min Liu, Peiran Yang, Shengfeng Wang, Chen Wang, Zhenguo Zhai","doi":"10.1055/a-2642-0241","DOIUrl":"10.1055/a-2642-0241","url":null,"abstract":"<p><strong>Background: </strong>Most bleeding risk scores for pulmonary embolism (PE) were developed in patients receiving traditional anticoagulants. Evidence in East Asian populations and its applicability to direct oral anticoagulants (DOACs) remain limited.</p><p><strong>Methods: </strong>This post-hoc analysis was based on a multicentre, prospective study (NCT02943343) conducted from 2016 to 2021. The predictive performance of bleeding risk scores was assessed using a time-dependent area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and decision curve analysis (DCA). Propensity score matching (PSM) was adjusted for baseline characteristics. We analyzed the impact of initial DOAC versus low-molecular-weight heparin (LMWH) on outcomes. The endpoint was major bleeding (MB) within 90 days and composite outcomes (all-cause mortality, recurrent VTE, and MB).</p><p><strong>Results: </strong>Of 7,619 patients with PE, 1.4% (107 patients) experienced MB within 90 days. The RIETE score showed a modest predictive ability (AUC: 0.70; 95% CI, 0.65-0.75) for predicting 90-day MB and demonstrated a predictive advantage in the DCA results. NRI also revealed significantly better reclassification capability than the other scores, except for HAS-BLED. Among low-risk patients classified by the RIETE score, initial DOAC treatment significantly reduced 14-day composite outcomes compared with LMWH (HR = 0.13; 95% CI, 0.02-0.93). Furthermore, DOACs at discharge did not increase the risk of MB or composite outcomes.</p><p><strong>Conclusion: </strong>RIETE score shows modest performance in predicting MB and identifying low bleeding risk in PE patients, which could potentially guide early DOAC use. Further studies are needed to test its clinical utility, especially in East Asian populations.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"496-508"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485849","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":"Factor XI Inhibitors or Direct Oral Anticoagulants in Atrial Fibrillation: A Focused Meta-analysis.","authors":"Claudio Laudani, Davide Capodanno, Felice Gragnano, Paolo Calabrò, Sebastiano Sciarretta, Domenico D'Amario, Raffaele De Caterina, Dominick J Angiolillo, Mattia Galli","doi":"10.1055/a-2675-0663","DOIUrl":"10.1055/a-2675-0663","url":null,"abstract":"","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"550-552"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785375","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":"How to Manage Venous Thromboembolism Risk during Pregnancy in Patients with Inherited Antithrombin Deficiency?","authors":"Laetitia Mauge, Hugo Madar, Julie Carré, Mathieu Fiore, Nicolas Gendron, Christine Mouton, Valérie Proulle, Pierre Suchon, Nathalie Trillot, Thomas Lechat, Loïc Sentilhes, Laurent Macchi","doi":"10.1055/a-2650-7959","DOIUrl":"10.1055/a-2650-7959","url":null,"abstract":"<p><p>Inherited antithrombin deficiency (ATD) is associated with a high risk of venous thromboembolic complications. Association of ATD with other conditions such as pregnancy obviously increases thromboembolic risk and may require anticoagulant therapy for prevention. Although there are several/heterogenous international guidelines regarding thromboprophylaxis in pregnant patients with ATD, data on anticoagulant prophylaxis in this context are scarce in the literature. Thus, this situation remains a challenge both in the antepartum period and during delivery. Physicians from the French Society of Thrombosis and Haemostasis (SFTH) performed a review of the literature to suggest propositions regarding the management of thrombosis prevention based on anticoagulation and antithrombin substitution in ATD pregnant women. In this review, after reporting the thrombotic risk associated with ATD, the indication of anticoagulant therapy, its dosing regimen and monitoring, and the indication of antithrombin concentrates during pregnancy and the postpartum period are discussed as well as peripartum management. Finally, this work confirms the complex management of thrombotic prevention in pregnant patients with ATD. Indeed, it requires to take into account a multiplicity of features cited in our propositions that will hopefully provide some help in this field. This work also highlights the importance of multidisciplinary discussions for pregnant women with ATD who should be counseled in an expert center including hematologist, obstetrician, and anesthetist to optimize their management.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"455-472"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592431","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}

{"title":"Gut Microbiota-Platelet Axis and Thrombosis in Advanced Chronic Liver Disease.","authors":"Francesco Violi, Vittoria Cammisotto, Pasquale Pignatelli, Emanuele Valeriani","doi":"10.1055/a-2628-4143","DOIUrl":"10.1055/a-2628-4143","url":null,"abstract":"<p><p>Advanced chronic liver disease is characterized by metabolic-associated liver disease, metabolic-associated steatohepatitis, and cirrhosis. This clinical setting is associated with platelet activation, which has been suggested to play a role in the progression of liver disease; thus, platelet activation has been detected in portal circulation as well within liver sinusoids. Experimental studies with antiplatelet drugs and observational studies in human suggested a role for platelet activation in the mechanism of the disease. Furthermore, advanced chronic liver disease may be complicated by atherosclerotic complications, where the role of platelet activation is well consolidated. Platelet activation may represent a unique mechanism leading to liver disease on one hand and to atherosclerotic complications on the other hand. Several studies pointed to the role of gut dysbiosis as key step for eliciting platelet activation via the production of pro-aggregating metabolites such as trimethylamine N-oxide or translocation of bacterial products such as lipopolysaccharide into the systemic circulation. The aims of this narrative review are to show the experimental and clinical evidence relating platelets with advanced chronic liver disease, to explore the role of gut microbiota as mechanism for platelet activation, and to suggest novel therapeutic strategies to inhibit gut microbiota-platelet axis.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"445-454"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235264","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":"Derivation and Validation of a COPD-specific Pulmonary Embolism Diagnostic Strategy.","authors":"Vicky Mai, David Jimenez, Dean Fergusson, Olivier Sanchez, Raquel Morillo, Pierre-Marie Roy, Carmen Rodriguez, Frédéric Gagnadoux, Pedro Ruiz-Artacho, Jeannot Schmidt, Eva Tabernero, Laurent Bertoletti, Cécile Tromeur, Philippe Girard, Ranjeeta Mallick, Grégoire Le Gal, Francis Couturaud","doi":"10.1055/a-2645-3594","DOIUrl":"10.1055/a-2645-3594","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosing pulmonary embolism (PE) in patients with chronic obstructive pulmonary disease (COPD) exacerbation is challenging due to similarities in clinical symptoms. The aim of this study was to evaluate predictors of PE and to derive and validate a COPD-specific PE diagnostic strategy.</p><p><strong>Methods: </strong>A post-hoc analysis of the PEP trial, a prospective multicenter study of patients with COPD hospitalized with acutely worsening respiratory symptoms, was conducted. The outcome predicted was PE at admission. Univariable and multivariable analyses were conducted to evaluate predictors of PE. Receiver operating characteristic curves were computed to determine the most discriminant D-dimer cut-offs. The COPD-specific PE diagnostic strategy was externally validated in the independent SLICE trial cohort.</p><p><strong>Results: </strong>A total of 734 patients were included. At admission, the prevalence of PE and/or proximal deep venous thrombosis (DVT) was 6.5% (95%CI 5.0-8.6%). A COPD-specific PE diagnostic strategy consisting of a 3-item score (type of COPD exacerbation, alternative diagnosis less likely than PE, and clinical signs of DVT) combined with D-dimer at specific cut-offs (1,000 μg/L if 0 score item and 500 μg/L if 1 or 2 score items) was derived. The overall diagnostic failure rate was 0.9% (95%CI 0.4-1.9%) and 392 patients (53.4%) would need imaging to rule out PE. The external validation showed comparable results.</p><p><strong>Conclusion: </strong>A COPD-specific PE diagnostic strategy was derived specifically for patients with COPD and acutely worsening respiratory symptoms. Further prospective validation of this diagnostic algorithm is needed prior to integrating it in clinical practice.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"509-517"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609626","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":"Predictors, Incidence, and Proximal Extension Rate of Distal Deep Vein Thrombosis in Internal Medicine Wards: Insights from the AURELIO Study.","authors":"Lorenzo Loffredo, Enrico Maggio, Arianna Magna, Gianpaolo Vidili, Angela Sciacqua, Chiara Cogliati, Sciaila Bernardini, Alessia Fallarino, Ilaria Maria Palumbo, Arianna Pannunzio, Chiara Bagnato, Nausica Polisena, Carla Serra, Lorenzo Falsetti, Vincenzo Zaccone, Evaristo Ettorre, Giovambattista Desideri, Luca Santoro, Vito Cantisani, Pasquale Pignatelli, Angelo Santoliquido, Francesco Violi","doi":"10.1055/a-2595-5458","DOIUrl":"10.1055/a-2595-5458","url":null,"abstract":"<p><strong>Background: </strong>Distal deep venous thrombosis (DDVT) is a clinical condition that can affect patients hospitalized in internal medicine wards and may result in pulmonary embolism. However, many aspects of distal thrombosis in hospitalized medical patients remain poorly understood.</p><p><strong>Objective: </strong>This study aimed to evaluate the rate of asymptomatic DDVT at admission, the occurrence of DDVT during hospitalization, and to analyze the factors associated with thrombotic events.</p><p><strong>Methods: </strong>A multicenter, prospective observational study (AURELIO) was conducted across eight centers affiliated with the Ultrasound Study Group of the Italian Society of Internal Medicine. Venous ultrasound of the lower limb veins was performed within 48 hours of admission and at discharge to diagnose distal deep vein thrombosis.</p><p><strong>Results: </strong>Among 1,458 patients (721 males and 737 females; mean age 71 ± 16 years), asymptomatic distal thrombosis was detected in 59 patients (4%) upon admission. Of these, 47% (<i>n</i> = 28) were classified as isolated DDVT, while 31 cases involved DDVT that extended to the proximal tract. At discharge, 9 additional cases of distal thrombosis were identified, bringing the total to 68 cases. Of these, 46% were DDVT, while 54% DDVT extended to the proximal venous system. Multivariate analysis identified reduced mobility (<i>p</i> = 0.036) and active malignancy (<i>p</i> = 0.02) as independent risk factors for DDVT extending to the proximal tract. Additionally, pneumonia (<i>p</i> = 0.043) and active malignancy (<i>p</i> = 0.008) were associated with DDVT.</p><p><strong>Conclusion: </strong>The study emphasizes the high prevalence of DDVT in hospitalized patients and the risk of proximal extension. Ultrasound screening should be considered for oncology patients and those with pneumonia to ensure early diagnosis and timely anticoagulant therapy.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"488-495"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027551","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":"Circulating and Regional Matrix Gla Protein Indicating Plaque Calcification and Prognosis of Patients with ST-Segment Elevation Myocardial Infarction.","authors":"Jiannan Li, Runzhen Chen, Xiaoxiao Zhao, Chen Liu, Peng Zhou, Yi Chen, Li Song, Yu Tan, Hongbing Yan, Hanjun Zhao","doi":"10.1055/a-2599-9386","DOIUrl":"10.1055/a-2599-9386","url":null,"abstract":"<p><strong>Background and aims: </strong>The association between matrix Gla protein (MGP) and vascular calcification has been investigated in recent years; however, studies focusing on MGP with plaque calcification are lacking. In the present study, we aimed to explore the association of circulating and regional levels, as well as polymorphism of MGP with plaque calcification detected by optical coherence tomography (OCT) and adverse clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI).</p><p><strong>Methods and results: </strong>A prospective cohort of 1,648 consecutive patients with STEMI were established. Circulating level of dephosphorylated-uncarboxylated MGP (dp-ucMGP) was determined using enzyme-linked immunosorbent assay. The primary outcome was major adverse cardiovascular event (MACE), composite of all-cause death, recurrent myocardial infarction, and ischemic stroke. Plaque calcification of 326 patients in the cohort was analyzed via OCT and MGP single nucleotide polymorphism (SNP) was detected in 1,313 patients. A total of 54 patients with aspirated coronary material undertook immunohistochemical (IHC) staining for quantifying regional MGP expression surrounding culprit lesions. During a median follow-up of 4 years, patients with high dp-ucMGP (≥1128 ng/mL) were associated with higher risk of death (hazard ratio [HR]: 1.41, 95% confidence interval [CI]: 1.02-1.97, <i>p</i> = 0.040), which was sustained in propensity score matching (HR: 1.488, 95% CI: 1.049-2.109, <i>p</i> = 0.026). In OCT observation, patients with annular calcification had higher level of dp-ucMGP than those without calcification (1,273 ng/mL [972.2-2168] vs. 1,079 ng/mL [729.2-1888], <i>p</i> = 0.0136). On IHC examination, patients with culprit plaque calcifications had significantly higher regional MGP expression than those without in their aspirated coronary material (AOD: 0.225 ± 0.021 vs. 0.183 ± 0.021, <i>p</i> < 0.0001). However, MGP variants showed no correlation with plaque calcification or the prognosis of patients in the cohort.</p><p><strong>Conclusion: </strong>High levels of circulating dp-ucMGP were significantly associated with increased mortality and annular plaque calcification in patients with STEMI. Moreover, higher expression of regional MGP in aspirated coronary material showed more indicative value for patients with culprit lesion calcification. However, MGP variants including rs4236, rs1800801, and rs1800802 in the current study were not significantly correlated with plaque calcification or poorer prognosis.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"537-549"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133166","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}