Thrombosis and haemostasis最新文献

{"title":"Risk Factors and Outcomes of Subsegmental versus More Central Pulmonary Embolism in Patients with Lung Cancer.","authors":"Delun Yang, Jiajun Deng, Shenghao Huang, Hua He, Chenyang Dai, Deping Zhao, Chang Chen","doi":"10.1055/a-2661-2326","DOIUrl":"10.1055/a-2661-2326","url":null,"abstract":"<p><strong>Background: </strong>The clinical significance of lung cancer-associated subsegmental pulmonary embolism (PE) remains unclear.</p><p><strong>Methods: </strong>This study retrospectively included 902 patients with lung cancer-associated PE (160 subsegmental PE, 742 more central PE). Cox proportional hazards regression was used to assess the risk of all-cause death. Fine-Gray tests and competing risk models were applied to evaluate the risks (hazard ratio [HR] [95% confidence interval]) of venous thromboembolism (VTE) recurrence and major bleeding. All-cause death was treated as a competing event for both VTE recurrence and major bleeding.</p><p><strong>Results: </strong>Compared with the more central PE group, the subsegmental PE group showed no significant differences in the adjusted risks of VTE recurrence (HR 0.99 [0.62-1.57], <i>p</i> = 0.95) and all-cause death (HR 0.83 [0.52-1.34], <i>p</i> = 0.45), and this finding was consistent across subgroups. Compared with patients with subsegmental PE without anticoagulation, those with anticoagulation had a lower adjusted risk of VTE recurrence (HR 0.16 [0.05-0.53], <i>p</i> = 0.003). The adjusted risks of major bleeding (HR 0.30 [0.05-1.70], <i>p</i> = 0.18) and all-cause death (HR 0.43 [0.13-1.42], <i>p</i> = 0.17) did not reach statistical significance. Independent predictors of VTE recurrence included symptomatic deep vein thrombosis (HR 2.71 [1.63-4.52], <i>p</i> < 0.001), tumor-node-metastasis stage (HR 2.07 [1.19-3.60], <i>p</i> = 0.010), <i>EGFR</i> mutations (HR 0.62 [0.39-0.98], <i>p</i> = 0.041), and anticoagulation (HR 0.32 [0.20-0.52], <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The risk of recurrent VTE is not miniscule in patients with lung cancer-associated subsegmental PE.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"526-536"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683230","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":"Integrin β3E726 Regulates the Switch Between Platelet Spreading and Clot Retraction by Interfering Gα13/RhoA Pathway.","authors":"Jie Peng, Yichen Liu, Yilin Zhu, Honglei Xin, Yun Wang, Bing Xiao, Tiantian Li, Rong Huang, Jing'an Liu, Ruonan Shao, Zijian Li, Jiao Wu, Han Yan, Yongqiu Di, Zijie Gan, Yifei Ma, Jianhua Mao, Shuai Chen, Jiansong Huang, Chao Fang, Xiaodong Xi, Xiaofeng Shi","doi":"10.1055/a-2664-7955","DOIUrl":"10.1055/a-2664-7955","url":null,"abstract":"<p><p>Platelet spreading and clot retraction, albeit both mediated by integrin outside-in signaling, lead to platelet shape changes in two opposite directions. The mechanisms by which these processes are regulated are not fully understood. Our previous study found that E726Q mutation in β3 integrin caused impaired spreading in Chinese hamster ovary (CHO) cells on immobilized fibrinogen.The current study further utilized knock-in mice bearing the β3^E726Q mutation to explore the underlying mechanisms whereby the E⁷²⁶ residue differentially influences platelet spreading and clot retraction.Compared to wild type (WT) platelets, β3^E726Q platelets displayed similar level of β3 expression but partially impaired fibrinogen binding associated with attenuated responses in platelet aggregation and P-selectin exposure. Notably, β3^E726Q mutation resulted in defective platelet spreading but accelerated clot retraction concomitant with increased clot density. Functionally, β3^E726Q mice displayed prolonged bleeding time and defective thrombogenesis in vitro and in vivo. Further mechanistic study showed that in β3^E726Q platelets the activities of RhoA and Rac1 were significantly enhanced following thrombin stimulation, possibly due to reduced binding of Gα13 to the β3 cytoplasmic tail.Taken together, the β3E⁷²⁶ is a potential novel regulatory site that influences the direct interaction of β3 cytoplasmic tail with Gα13 and therefore the activity of downstream RhoA, a molecular switch that shifts platelet spreading into clot retraction.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"473-487"},"PeriodicalIF":4.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733419","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":"Altered Fibrin Clot Properties and Long-term Mortality are Associated with Biventricular Decompensation in Heart Failure with Reduced Contractility.","authors":"Karol Witold Nowak, Paweł Zmudzki, Aleksandra Karcinska, Alicia Del Carmen Yika, Anna Matrejek, Konrad Stepien, Anna Furman-Niedziejko, Jadwiga Nessler, Jaroslaw Zalewski","doi":"10.1055/a-2858-4628","DOIUrl":"https://doi.org/10.1055/a-2858-4628","url":null,"abstract":"<p><strong>Background: </strong>Prothrombotic risk in heart failure (HF) decompensation remains incompletely understood; therefore, we sought to investigate fibrin clot properties, their determinants, and their impact on long-term mortality in HF patients with reduced ejection fraction (HFrEF) and symptoms of biventricular (BVHF) versus isolated left ventricular (LVHF) decompensation.</p><p><strong>Methods: </strong>In this prospective study, 85 consecutive patients with sinus rhythm and HFrEF decompensation were enrolled. Clot permeability (Ks), reflecting fibrin pore size, and lysis time (CLT) along with thrombin generation and liver-dependent metabolites including succinic, amino, and bile acids were assessed during index hospitalization and after 3-month pharmacotherapy. Long-term mortality and HF rehospitalizations were recorded within a median follow-up time of 27 (17-38) months.</p><p><strong>Results: </strong>LVHF decompensation was identified in 46 (54.1%) patients, while BVHF in 39 (45.9%) patients. At baseline, subjects with BVHF had lower Ks by 31.9% (<i>p</i> = 0.002). Following 3-month pharmacotherapy, Ks increased in BVHF patients (<i>p</i> < 0.001) reaching values similar to those in LVHF group. Baseline Ks was independently associated with BVHF (R² = 0.346, <i>p</i> < 0.001). Ks improvement was five times (<i>p</i> < 0.001) higher in BVHF than in LVHF group and was associated with baseline INR (<i>p</i> = 0.04), creatinine (<i>p</i> = 0.011), and a non-ischemic etiology of HF (<i>p</i> = 0.033). Regardless of baseline Ks, the long-term mortality was higher in BVHF versus LVHF patients (12.5 versus 5.8%/year, <i>p</i> = 0.049, respectively).</p><p><strong>Conclusion: </strong>BVHF decompensation was associated with formation of more compact fibrin clots in the acute phase and with a higher long-term mortality. Fibrin clot permeability improvement following 3-month pharmacotherapy was driven by the favorable changes in BVHF patients.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780861","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":"Reply to the Comment: Revisiting Platelet-Associated Tissue Factor: Methodological Concerns in Flow Cytometry Detection: A Letter to the Editor.","authors":"Marina Camera","doi":"10.1055/a-2862-6769","DOIUrl":"https://doi.org/10.1055/a-2862-6769","url":null,"abstract":"<p><p>na.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781918","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":"Title: Association of Anisocytosis with Platelet-Rich Thrombi and Stroke Recurrence in Patients Undergoing Thrombectomy.","authors":"Hyungwoo Lee, Hyo Suk Nam, Young Dae Kim, Tae-Jin Song, Gyu Sik Kim, Tae Donk Ok, Kwon-Duk Seo, Jang-Hyun Baek, Il Kwon, Ji Hoe Heo","doi":"10.1055/a-2862-6619","DOIUrl":"https://doi.org/10.1055/a-2862-6619","url":null,"abstract":"<p><strong>Background: </strong>Anisocytosis, indicated by an elevated red blood cell distribution width (RDW), has been associated with poor cardiovascular outcomes. However, its relevance to thrombus composition and long-term outcomes in stroke patients undergoing thrombectomy remains unclear. We investigated whether anisocytosis is associated with histologic thrombus characteristics and long-term prognosis in this population.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study included 401 patients with acute ischemic stroke who underwent intra-arterial thrombectomy between September 2014 and December 2020. Thrombus composition was assessed using immunohistochemistry to quantify the proportions of fibrin, red blood cells, platelets, and thrombin. Patients were followed for major adverse cardiovascular events, including all-cause mortality, ischemic heart disease, and recurrent ischemic stroke.</p><p><strong>Results: </strong>Among the 401 patients (mean age, 73.1 years; 50.1% male), anisocytosis (RDW>15.7%) was present in 67 (16.7%). Thrombi from patients with anisocytosis had higher platelet content (12.2% vs. 9.1%; P = 0.008) and lower erythrocyte content (30.0% vs. 37.3%; P = 0.007) than those without anisocytosis. During a median follow-up of 38.5 months, anisocytosis was independently associated with increased risk of recurrent ischemic stroke (hazard ratio, 2.61; 95% confidence interval, 1.12-6.10; P = 0.027), but not with overall major adverse cardiovascular events, mortality, or ischemic heart disease.</p><p><strong>Conclusion: </strong>Anisocytosis was associated with platelet-rich thrombi and an increased risk of stroke recurrence after thrombectomy. These findings suggest a possible role of red blood cells in platelet-mediated thrombosis and indicate that RDW may have potential prognostic value for identifying patients at higher risk for recurrent events.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781879","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":"Plasminogen Activator Inhibitor-1 Controls Mitochondrial Oxidative Stress in Vascular Smooth Muscle Cells and Coronary Arteries.","authors":"Alex Schoenherr, Yan Ji, Hekmat Khoukaz, Zhen Lyu, Owen Walls, Mojgan Golzy, Trupti Joshi, Dunpeng Cai, Shiyou Chen, Michael A Hill, Luis A Martinez-Lemus, Scott Zawieja, Charles E Norton, William P Fay","doi":"10.1055/a-2852-0770","DOIUrl":"10.1055/a-2852-0770","url":null,"abstract":"<p><p>No Abstract.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781896","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":"De Ritis Ratio and Heparin Therapy in Sepsis-Associated Liver Injury: A Multicenter Cohort Study.","authors":"Bo Yu, Dazheng Li, Yingyi Luan, Rajaganesh Rajagopalan, Yuhong Guan, Yu Xiang, Lei Song, Zhiye Fang, Yongming Yao, Ming Wu","doi":"10.1055/a-2852-9288","DOIUrl":"https://doi.org/10.1055/a-2852-9288","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated liver injury (SALI) is a highly heterogeneous thromboinflammatory disorder with no specific treatment. The De Ritis ratio (DRR, aspartate aminotransferase/alanine aminotransferase) stratifies mortality risk, and unfractionated heparin (UFH) possesses pleiotropic effects that may attenuate thromboinflammation. We investigated whether DRR identifies a SALI subphenotype that derives differential benefit from UFH therapy.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study included 9,561 SALI patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV; <i>n</i> = 6,133) and eICU-CRD (<i>n</i> = 3,428) databases. The primary outcome was intensive care unit (ICU) mortality. We employed propensity score matching (PSM) and marginal structural Cox models (MSCM) to adjust for baseline and time-varying confounders. Subgroup analyses evaluated the association between UFH and mortality across DRR strata, with formal testing for UFH × DRR interaction.</p><p><strong>Results: </strong>UFH therapy was associated with significantly reduced ICU mortality after PSM in both cohorts MIMIC-IV (hazard ratio [HR]: 0.34, 95% confidence interval [CI]: 0.28-0.42) and eICU (HR: 0.43, 95% CI: 0.29-0.65), with consistent results in MSCM analyses (HR: 0.22, 95% CI: 0.17-0.30). Subgroup analysis suggested numerical benefit in patients with DRR > 1, but formal tests for interaction were not significant in either cohort (MIMIC-IV: <i>p</i> = 0.111; eICU: <i>p</i> = 0.775).</p><p><strong>Conclusion: </strong>UFH therapy is associated with reduced mortality in SALI patients. Although DRR identifies a high-risk subgroup, the lack of significant interaction precludes its use as a predictive biomarker for UFH response. A prospective randomized trial is warranted to validate these findings and DRR-stratified UFH benefits.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147781103","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":"Beyond the Average Effect: Identifying the Trauma Patients Who Benefit Most from Tranexamic Acid.","authors":"Eva Soler-Espejo, Vanessa Roldán","doi":"10.1055/a-2848-3364","DOIUrl":"https://doi.org/10.1055/a-2848-3364","url":null,"abstract":"","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147780914","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":"Ischemic Stroke Burden Attributable to Household Air Pollution in WHO Regions from 1990 to 2021.","authors":"Bin Feng, Ling Chao","doi":"10.1055/a-2849-6275","DOIUrl":"https://doi.org/10.1055/a-2849-6275","url":null,"abstract":"<p><p>Household air pollution (HAP) is a major environmental risk factor. It is strongly associated with increased disability-adjusted life years (DALY) and mortality from ischemic stroke (IS). This study aims to evaluate the burden of IS attributable to HAP across WHO regions.This study used Global Burden of Disease 2021 to analyze the IS burden attributed to HAP across WHO regions from 1990 to 2021. We used Joinpoint regression to analyze the temporal trend. The annual percent change (APC) and average annual percent change were calculated. We also assessed the age-specific burden of IS in the WHO regions for 2021.From 1990 to 2021, the burden of IS attributable to HAP in WHO regions showed a downward trend, with the highest burden in the African region and the lowest in the European region and the region of the Americas. The most substantial decline occurred in the European region between 2005 and 2010, with the age-standardized DALY rates for both sexes and the age-standardized mortality rates for males decreasing markedly (APC = - 15.17 and -15.19, respectively). The burden is heavier in the elderly, especially males, and the mortality and DALY rates increase significantly after the age of 60. The Western Pacific region, Southeast Asian region, and African region are the regions with the highest burden in 2021.HAP remains an important risk factor for IS burden. It is necessary to take targeted prevention strategies and measures to reduce regional differences.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676726","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":"Stent Thrombogenicity is Modulated by Design: Wire Crossings in Braided Stents are Focal Thrombogenic Niches.","authors":"Axelle Y Kern, Lise Charle, Yevgeniy Kreinin, Mark Epshtein, Christian J Spieker, Nabil Chakfé, Gábor Závodszky, Raoul Pop, Netanel Korin, Pierre H Mangin","doi":"10.1055/a-2841-9866","DOIUrl":"https://doi.org/10.1055/a-2841-9866","url":null,"abstract":"<p><p>Stent thrombosis remains a critical and fatal complication of angioplasty with stenting, particularly in tandem lesion patients, where the incidence can exceed 20%. A better understanding of the thrombogenicity of clinically used stents could reduce the occurrence of stent thrombosis.We have developed a macrofluidic model mimicking the geometry of the human carotid artery, which is perfectly suited to evaluate the intrinsic thrombogenicity of carotid stents. Real-time video microscopy and scanning electron microscopy were combined to assess the thrombogenicity of three clinically used carotid stents: the laser-cut Protégé RX stent, the braided Casper stent, and Wallstent.The Casper and the Wallstent led to higher rates of platelet adhesion and thrombus formation than the Protégé RX. The thrombi were essentially localized at the intersections of the metal wires in the braided stents, whereas in the laser-cut stent, only more evenly distributed platelet adhesion was observed. Hot spots of thrombosis were identified at the crossings of the stent struts, especially around the external wires of these crossings, which are in contact with the vessel wall. Thrombus formation was effectively prevented in the presence of aspirin or the αIIbβ3 blocker abciximab. Computational fluid dynamics indicated that the wire crossings of braided stents generate a prothrombotic shear environment, with flow recirculation and stagnation regions leading to thrombus formation, as demonstrated by a macroscale in silico simulation.Design plays a major role in thrombus formation on stent wires, with braided stents being more thrombogenic than laser-cut stents.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646425","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}