Thrombosis and haemostasis最新文献

{"title":"Lymphoblasts Express Hemostatic Factors: A Mechanism for Hypercoagulability in Pediatric Acute Lymphoblastic Leukemia.","authors":"Ghada A Aborkhees, Kevin Dietrich, Amy J Barr, Lesley G Mitchell","doi":"10.1055/a-2713-0764","DOIUrl":"10.1055/a-2713-0764","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a serious complication of pediatric acute lymphoblastic leukemia (ALL), primarily occurring during induction therapy and associated with acquired hemostatic abnormalities. However, the contribution of leukemic lymphoblasts to hypercoagulability remains unexplored. This study aimed to determine whether leukemic lymphoblasts express hemostatic factors that promote a hypercoagulable state and to assess the functional impact of lysed lymphoblasts on thrombin and fibrin generation.</p><p><strong>Methods: </strong>We examined the expression of 28 hemostatic factors at both mRNA and protein levels in four pediatric leukemic cell lines (T-ALL and B-ALL) and normal lymphocytes using RT-PCR and immunoblotting. To evaluate the overall functional effect, we conducted thrombin and fibrin generation assays by adding cell lysates to platelet-poor plasma in the absence of exogenous tissue factor or phospholipids.</p><p><strong>Results: </strong>Leukemic lymphoblasts constitutively expressed the procoagulants tissue factor, factor VIII and factor XIIIa; the coagulation inhibitors antithrombin, ADAMTS13 and TFPI; and the pro-fibrinolytic and antifibrinolytic proteins uPA, TAFI, and α2-AP. Lysed, but not intact, leukemic lymphoblasts enhanced thrombin and fibrin generation, indicating a procoagulant state. Additionally, leukemic lysates exhibited a hypo-fibrinolytic state, as evidenced by prolonged fibrin clot lysis times.</p><p><strong>Conclusion: </strong>These findings suggest that leukemic lymphoblasts actively contribute to a hypercoagulable state in pediatric ALL by simultaneously increasing procoagulant activity and impairing fibrinolysis. This study provides novel insights into the mechanisms underlying VTE risk in pediatric ALL, highlighting the role of leukemic lymphoblasts in disrupting the hemostatic balance.</p><p><strong>Key points: </strong>· Leukemic lymphoblasts express hemostatic system factors at gene and protein levels.. · Leukemic lymphoblasts lysis directly contributes to hypercoagulability and hypofibrinolysis in thrombin and fibrin generation assays..</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"1037-1048"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293745","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":"Val325Met Mutation Affects N-glycosylation and Impairs the Function of Protein C.","authors":"Shijie Zhou, Junwei Yuan, Xi Wu, Guanqun Xu, Yu Liu, Qiulan Ding, Wenman Wu, Jing Dai, Xiaobo Hu, Xuefeng Wang, Yeling Lu","doi":"10.1055/a-2963-4595","DOIUrl":"10.1055/a-2963-4595","url":null,"abstract":"<p><strong>Background: </strong>Protein C (PC) is a key anticoagulant protein that regulates hemostatic balance. Hereditary PC deficiency increases the risk of thrombosis. We identified the same mutation, c.1099G > A:p.V325 M (V325 M), in the <i>PROC</i> gene in four unrelated patients with thrombotic events and one patient with recurrent pregnancy loss, prompting further investigation.</p><p><strong>Objective: </strong>The objective of this study was to decipher the molecular basis of the clotting defect in patients carrying the V325 M mutation.</p><p><strong>Methods: </strong>We expressed and purified both wild-type and mutant PC/activated protein C (APC) in mammalian cells and characterized their properties in established coagulation and cytoprotective assay systems.</p><p><strong>Results: </strong>Functional characterization of the recombinant mutant APC revealed multiple defects, including reduced catalytic efficiency toward chromogenic substrates, decreased affinity for Na⁺, impaired anticoagulant activity in both purified and plasma systems, and diminished barrier-protective function. In parallel, electrophoretic analysis showed that the mutant APC exhibited an altered isoform distribution compared with wild-type; this difference was eliminated upon treatment with PNGase F for deglycosylation.</p><p><strong>Conclusion: </strong>Our studies demonstrate that the V325 M mutation directly impairs the anticoagulant and cytoprotective functions of PC, together with altered Nglycosylation patterns, providing a molecular mechanism for the prothrombotic phenotype observed in the carriers with this mutation.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025900","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":"VLDL Subfractions and Risk of Future Venous Thromboembolism- The HUNT Study.","authors":"Inga Aalberg Røstvold, Ben Michael Brumpton, Kristian Hveem, Bjørn Olav Åsvold, Guro Fanneløb Giskeødegård, George Davey Smith, Nicholas J Timpson, Kaitlin H Wade, John-Bjarne Hansen, Sigrid Kufaas Brækkan","doi":"10.1055/a-2963-4851","DOIUrl":"10.1055/a-2963-4851","url":null,"abstract":"<p><strong>Background: </strong>In vitro studies have suggested prothrombotic properties of very low-density lipoproteins (VLDL). Whether differences in VLDL particle size and lipid composition are related to venous thromboembolism (VTE) risk has been scarcely investigated. We aimed to investigate the association between chylomicron and VLDL subfractions and the risk of incident VTE in a population-based cohort.</p><p><strong>Methods: </strong>Participants (<i>n</i> = 17,032) from the third survey of the Trøndelag Health Study (HUNT3, 2006-08) were followed through December 31, 2019, and all incident VTE events during follow-up were validated and recorded. Nuclear magnetic resonance (NMR) spectroscopy was used to measure chylomicron and VLDL subfractions (including particle size, concentration, and lipid composition) in serum collected at cohort baseline. Associations between VLDL subfractions and risk of VTE were assessed using Cox regression models, adjusted for age, sex, and body mass index.</p><p><strong>Results: </strong>In total, 342 incident VTE cases occurred during a median follow-up of 12.0 years. No associations were found between VLDL particle size, VLDL concentration, VLDL lipid composition, and total triglycerides and VTE risk. All hazard ratios (HRs) per 1 standard deviation increase in VLDL metrics were within the range 0.87 to 1.16 and all 95% confidence intervals (CIs) included 1. Increasing quartiles of total VLDL particles (Q4 vs. Q1 HR: 1.12, 95% CI: 0.80-1.56) and the proportion of larger VLDL particles (Q4 vs. Q1: HR: 1.09, 95% CI: 0.81-1.45) were not associated with VTE risk.</p><p><strong>Conclusion: </strong>Total triglycerides and VLDL subfractions, including particle size, concentration, and lipid composition, were not associated with risk of incident VTE.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025889","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":"Primary Thromboprophylaxis in Patients with Malignancy and Central Venous Catheters: TRIM-Line Randomized Controlled Trial-Design and Rationale.","authors":"Tzu-Fei Wang, Rick Ikesaka, Isabelle Mahé, Danny Hill, Catherine Sperlich, Vicky Tagalakis, Sudeep Shivakumar, Blair Leonard, Andrea Cervi, Philip G Kuruvilla, Fréderic Larose, Davide Matino, Steffan Frosi Stella, Chantal Séguin, Abdulrahman Al Raizah, Grégoire Le Gal, Deborah M Siegal, Aurélien Delluc, Ranjeeta Mallick, Alejandro Lazo-Langner, Cynthia Wu, Dennis Christopher, Marcello Di Nisio, Walter Ageno, Bashour Yazji, Marc Carrier","doi":"10.1055/a-2963-4656","DOIUrl":"10.1055/a-2963-4656","url":null,"abstract":"<p><p>Patients with cancer have an increased risk of venous thromboembolism (VTE). This risk is further elevated in those with a central venous catheter (CVC). Previous studies have shown that prophylactic doses of direct oral anticoagulants (DOACs) reduce the risk of VTE in ambulatory cancer patients starting chemotherapy, which has led to recommendations from international clinical guidelines to use DOACs as primary thromboprophylaxis in this population. Primary thromboprophylaxis after CVC insertion is not recommended due to a lack of definitive evidence. As such, the TRIM-Line trial randomized 1,828 patients with active cancer and a newly inserted CVC to rivaroxaban 10 mg daily versus placebo. The primary efficacy outcome was the first objectively confirmed symptomatic or incidental major VTE (proximal upper or lower extremity deep vein thrombosis and/or pulmonary embolism) within 90 days of randomization. The primary safety outcome was major bleeding, as defined by the International Society on Thrombosis and Haemostasis criteria, within 90 days. The key secondary outcomes included clinically relevant non-major bleeding, arterial thrombosis, and overall mortality. The study provides high-quality evidence to address a key knowledge gap regarding the benefits and risks of thromboprophylaxis in patients with active cancer and an indwelling CVC (NCT05029063).</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017930","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":"Antithrombotic Therapy for Secondary Prevention After Noncardioembolic Ischemic Stroke: Current Status, Limitations, and Future Directions.","authors":"Mukul Sharma, Jeffrey I Weitz, Ashkan Shoamanesh, S Claiborne Johnston, Graeme J Hankey","doi":"10.1055/a-2952-7857","DOIUrl":"10.1055/a-2952-7857","url":null,"abstract":"<p><p>Ischemic stroke is increasing in frequency and results in significant morbidity and mortality. Disability due to ischemic stroke results from motor, language, and cognitive deficits, with depression and nonmotor symptoms increasingly recognized as common and associated with disability and a reduced quality of life. Stroke associated with major cardiac sources makes up about one-fifth of all strokes, with the remainder being noncardioembolic. Most noncardioembolic strokes fall into three subtypes: large artery atherosclerosis, small vessel disease, and cryptogenic. Thrombosis and thromboembolism underlie most stroke subtypes, and antithrombotic therapy remains an essential component of secondary stroke prevention. Survivors of ischemic stroke have a considerable risk of disabling recurrent stroke and other major ischemic events despite advances in prevention strategies. Dual antiplatelet therapy is the standard secondary prevention strategy for short-term treatment after minor stroke or transient ischemic attack, and aspirin monotherapy is used for more severe stroke and long-term thromboprophylaxis. Current antiplatelet strategies are limited by moderate efficacy and bleeding risk. Inhibition of activated factor XI (FXIa) in the intrinsic pathway of the coagulation cascade has the potential to prevent recurrent stroke by attenuating pathologic thrombosis with minimal effects on hemostasis. The first efficacy trial of FXIa inhibition for stroke prevention has been completed and shows a reduction in ischemic stroke without an increase in major hemorrhage.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148920352","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":"Ticagrelor vs. Clopidogrel in ACS Patients Underwent PCI: An Analysis Based on Systemic Immune-inflammation Risk Stratification.","authors":"Hengbo Zhai, Miaohan Qiu, Kun Na, Yang Li, Chenghui Yan, Yi Li, Yaling Han","doi":"10.1055/a-2954-8993","DOIUrl":"https://doi.org/10.1055/a-2954-8993","url":null,"abstract":"<p><strong>Objective: </strong>The systemic immune-inflammation index (SII) is an established prognostic marker in coronary artery disease. This study investigated the association between SII and 1-year prognosis in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), and explored its potential utility in informing P2Y₁₂ inhibitor selection.</p><p><strong>Methods: </strong>A total of 15,123 consecutive ACS patients undergoing PCI between January 2021 and December 2022 were enrolled. Patients were stratified into high- and low-inflammation groups based on the optimal SII cut-off derived from receiver operating characteristic analysis. The primary endpoint was 12-month ischemic events, defined as a composite of cardiac death, myocardial infarction, and stroke. Propensity-score matching was performed to compare ticagrelor-based versus clopidogrel-based dual antiplatelet therapy within each group.</p><p><strong>Results: </strong>The optimal SII cut-off was 651 × 10⁹/L. Elevated SII was associated with increased ischemic events (HR 1.86; 95% CI: 1.52-2.28; <i>p</i> < 0.0001) and all-cause mortality (HR 2.44; 95% CI: 1.90-3.13; <i>p</i> < 0.0001). In the low-SII group (1,422 matched pairs), ticagrelor was associated with increased bleeding risk (HR 2.15; 95% CI: 1.60-2.88; <i>p</i> < 0.0001) without association with ischemic benefit. In the high-SII group (1,299 matched pairs), ticagrelor was associated with reduced ischemic events (HR 0.52; 95% CI: 0.33-0.83; <i>p</i> = 0.006), cardiac death (HR 0.45; 95% CI: 0.23-0.86; <i>p</i> = 0.015), and all-cause mortality (HR 0.40; 95% CI: 0.23-0.70; <i>p</i> = 0.001) without association with increased major bleeding.</p><p><strong>Conclusion: </strong>The SII is associated with 12-month post-PCI ischemic and mortality risk and demonstrates potential as a candidate biomarker for risk stratification, with exploratory observations of ticagrelor benefit in high-SII and clopidogrel adequacy in low-SII patients.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031432","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":"Statin Intensification and LDL Cholesterol Reduction are Associated with Longitudinal Changes in Circulating Amyloid-β 1-40 in a Prospective Dyslipidemia Cohort.","authors":"Evmorfia Aivalioti, Georgios Georgiopoulos, Dimitris Delialis, Christina Konstantaki, Raphael Patras, Chrysoula Moustou, Panagiota Mpatziou, Georgios Mavraganis, Kateryna Sopova, Marco Sachse, Konstantinos Stellos, Kimon Stamatelopoulos","doi":"10.1055/a-2958-4419","DOIUrl":"10.1055/a-2958-4419","url":null,"abstract":"<p><strong>Background: </strong>Circulating amyloid β 1-40 (Aβ40), a pro-inflammatory and pro-atherogenic peptide, is an emerging biomarker in atherosclerotic cardiovascular disease (ASCVD), but evidence on its modulation by cardiovascular therapies is limited and conflicting. We explored associations between statin therapy and Aβ40 plasma levels.</p><p><strong>Methods: </strong>In this prospective study, patients with dyslipidemia (<i>n</i> = 146) were consecutively recruited. Αβ40 was measured in plasma by enzyme-linked immunosorbent assay at baseline, after a mean follow-up of 5.2 (visit 2 [V2]) and 15 months (visit 3 [V3]). Patients in whom statin treatment was initiated or intensified (<i>n</i> = 68, intensification group) were compared with patients who were untreated or on stable statin intensity (<i>n</i> = 78, control group).</p><p><strong>Results: </strong>After multivariable adjustment for biologically plausible confounders, increased Aβ40 at baseline associated with ASCVD, heart failure, decreased estimated glomerular filtration rate (eGFR), and diabetes mellitus (DM). Aβ40 increased from baseline to V2 in the intensification group (<i>p</i> = 0.05 and adjusted <i>p</i> for interaction = 0.031 vs. the control group) and then stabilized. In the control group, Aβ40 increased at V3 compared with V2 (<i>p</i> = 0.043). Excluding ezetimibe-treated patients did not alter these findings. In patients with low-density lipoprotein cholesterol (LDL-C) reduction ≥ 50% at V3, Aβ40 levels remained unchanged, whereas they increased in the rest of the population (adjusted <i>p</i> for group interaction = 0.030).</p><p><strong>Conclusion: </strong>In high-risk patients, statin initiation or intensification is associated with a short-term increase, followed by a long-term return to initial Aβ40 circulating levels, whereas patients achieving LDL-C reduction show long-term stabilization of Aβ40 levels. Further research is warranted to clarify the mechanistic insights of these observations.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971531","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":"Chronic Preoperative Corticosteroid Use and Postoperative Venous Thromboembolism Risk: A Systematic Review and Meta-analysis.","authors":"Narat Srivali, Federica De Giacomi","doi":"10.1055/a-2958-4309","DOIUrl":"10.1055/a-2958-4309","url":null,"abstract":"<p><strong>Background: </strong>Chronic corticosteroid use is prevalent among surgical patients, yet its association with postoperative venous thromboembolism (VTE) has not been systematically quantified. We conducted a systematic review and meta-analysis to assess this risk.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, and Cochrane Central through January 2026 (PROSPERO: CRD420261298063). Eligible studies were observational studies or RCTs examining chronic preoperative corticosteroid use and postoperative VTE in adult surgical patients. We used random-effects meta-analysis to calculate pooled risk ratios (RR) with 95% confidence intervals. Evidence certainty was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and methodological quality using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Nine retrospective cohort studies (2,678,513 patients; 97,201 corticosteroid users) were included. Chronic corticosteroid use was associated with increased composite VTE risk (RR 1.51, 95% CI: 1.31-1.73; <i>I</i> ² = 71%). Pulmonary embolism (PE) did not reach statistical significance (RR 1.31, 95% CI: 0.95-1.80), while deep vein thrombosis (DVT) risk was significantly increased (RR 1.48, 95% CI: 1.19-1.84; <i>I</i> ² = 64%). GRADE yielded low-quality evidence for composite VTE and DVT and very low-quality evidence for PE.</p><p><strong>Conclusions: </strong>Chronic preoperative corticosteroid use is associated with a 51% increased postoperative VTE risk across 2.6 million surgical patients, suggesting potential value in considering chronic corticosteroid use within perioperative VTE risk assessment, pending higher-quality prospective data. Current evidence is insufficient to support specific protocol changes; prospective studies are needed to define dose-response relationships.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971475","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":"Ambient Particulate Matter Exposure and Risk of Venous Thromboembolism: An Updated Systematic Review and Meta-Analysis.","authors":"Maximiliano Victor Manuel Correa Lara, Jaime García Chávez, Erika Martínez Hernández","doi":"10.1055/a-2945-4974","DOIUrl":"10.1055/a-2945-4974","url":null,"abstract":"<p><strong>Background: </strong>Ambient air pollution is associated with cardiovascular morbidity and mortality, but its relationship with venous thromboembolism (VTE) remains uncertain. We performed an updated systematic review and meta-analysis evaluating particulate matter exposure and VTE risk.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and the Cochrane Library were searched for observational studies evaluating PM2.5 or PM10 exposure and venous thrombotic outcomes. Studies were stratified by pollutant, exposure duration, and effect measure. Estimates were harmonized to 10 μg/m³, and random-effects models using restricted maximum-likelihood estimation and Hartung-Knapp adjustment were applied.</p><p><strong>Results: </strong>Nineteen studies representing > 4.5 million participants met the inclusion criteria. Overall long-term analyses showed no significant association for PM2.5 (HR 1.42, 95% CI: 0.88-2.28; <i>I</i> ² = 97.0%) or PM10 (HR 1.18, 95% CI: 0.85-1.64; <i>I</i> ² = 96.2%). However, sensitivity analyses restricted to studies natively reporting effects per 10 μg/m³ showed an association between PM2.5 and VTE (HR 1.070, 95% CI: 1.010-1.135; <i>I</i> ²  = 0%), while PM10 showed a borderline association (HR 1.023, 95% CI: 1.000-1.047; <i>I</i> ² = 0%). Short-term PM2.5 and PM10 exposures were not significantly associated with venous thrombotic risk.</p><p><strong>Conclusion: </strong>Evidence suggests a possible modest association between long-term PM2.5 exposure and VTE; however, considerable between-study variability and sensitivity to exposure harmonization limit definitive conclusions. Standardized exposure metrics and consistent VTE definitions are needed to clarify this association.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831887","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":"Treatment Approaches and Outcomes of Central Vascular Catheter-related Thrombosis in Neonates: A Canadian Retrospective Cohort Study.","authors":"Marie-Pier Desjardins, Mahukpe Narcisse Ulrich Singbo, Audrey Hébert, Janie Charlebois, Anie Lapointe, Christine A Sabapathy, Alexandra Zabeida, Kriti Kumar, Soumitra Tole, Mihir Bhatt, Mira Liebman, Juliette Dery, Ali Amid, Jonathan Wong, Marc Beltempo, Marie-Claude Pelland-Marcotte","doi":"10.1055/a-2945-5238","DOIUrl":"https://doi.org/10.1055/a-2945-5238","url":null,"abstract":"<p><strong>Background: </strong>Management of neonatal central vascular catheter (CVC)-related thromboembolism is complex, as the higher risk of bleeding must be balanced with the thrombotic risks.</p><p><strong>Objectives: </strong>To describe management of neonatal CVC-related thrombosis and to compare the effectiveness and safety between treatment modalities.</p><p><strong>Methods: </strong>A multicenter retrospective cohort study enrolled neonates ≤ 28 days requiring a CVC with a radiologically confirmed thrombosis. Data from the Canadian Neonatal Network database were linked to clinical outcomes in individual medical records, namely, thrombosis resolution and thrombosis progression, major bleeding and clinically relevant non-major bleeding defined using ISTH criteria. Multivariable logistic regression explored predictors of anticoagulation use and whether treatment modality predicted clinical outcomes.</p><p><strong>Results: </strong>A total of 497 neonates sustained a CVC-related thrombosis (83% venous, 16% arterial). Older gestational age, the absence of hypoxic-ischemic encephalopathy, occlusive, and non-portal thrombosis were associated with anticoagulation use for venous thrombosis; only older gestational age predicted anticoagulation use for arterial thrombosis. Complete thrombosis resolution and progression occurred in 38.3% (95%CI: 33.5-43.2%) and 2.0% (95%CI: 0.9-4.4%) of patients, respectively. Anticoagulation was not associated with complete resolution of thrombosis (adjusted OR: 0.83, adjusted 95%CI: 0.46-1.50, <i>p</i> = 0.531) or thrombosis progression (OR: 3.41, 95%CI: 0.65-17.86, <i>p</i> = 0.146) for venous events, but was associated with higher rates of resolution (aOR: 5.66, a95%CI: 1.96-16.31, <i>p</i> = 0.001) in arterial events. Anticoagulation was not associated with increased risk of clinically significant bleeding (aOR: 1.75, a95%CI: 0.92-3.31, <i>p</i> = 0.086).</p><p><strong>Conclusion: </strong>Thrombotic progression was rare and not associated with anticoagulation. Anticoagulation was often withheld in neonates with less thrombotic risk factors or in presence of bleeding risk factors.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956483","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}