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Potent Inhibition of Arterial Thrombosis and Venous Thrombogenesis Subject to Adequate Hemostasis via Disrupting β3/Src Interaction in Platelets. 通过破坏血小板中β3/Src相互作用有效抑制充分止血条件下的动脉血栓形成和静脉血栓形成
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-09-01 Epub Date: 2025-10-10 DOI: 10.1055/a-2706-9879
Jiayi Chen, Shuang Liu, Yan Shen, Huan Xiong, Chao Chen, Bing Xiao, Yun Wang, Lu Jin, Wanlin Yu, Dounan Xu, Zheng Ruan, Jingqiu Liu, Yaxi Yang, Lianghe Mei, Li Hua, Cheng Luo, Bing Zhou, Kankan Wang, Xiaodong Xi, Jianhua Mao
{"title":"Potent Inhibition of Arterial Thrombosis and Venous Thrombogenesis Subject to Adequate Hemostasis via Disrupting β3/Src Interaction in Platelets.","authors":"Jiayi Chen, Shuang Liu, Yan Shen, Huan Xiong, Chao Chen, Bing Xiao, Yun Wang, Lu Jin, Wanlin Yu, Dounan Xu, Zheng Ruan, Jingqiu Liu, Yaxi Yang, Lianghe Mei, Li Hua, Cheng Luo, Bing Zhou, Kankan Wang, Xiaodong Xi, Jianhua Mao","doi":"10.1055/a-2706-9879","DOIUrl":"10.1055/a-2706-9879","url":null,"abstract":"<p><strong>Background: </strong>Antiplatelet and anticoagulation are the cornerstones for arterial and venous thrombosis, respectively; however, hemorrhage remains a significant clinical challenge. Platelets are crucial for arterial thrombosis and contribute to venous thrombosis. Integrin β3 mediates outside-in signaling, which is critical for thrombosis, while inside-out signaling maintains hemostasis. Targeting the β3/Src interactions to selectively inhibit outside-in signaling offers a promising antithrombotic strategy without compromising hemostasis.</p><p><strong>Objectives: </strong>To develop more potent small molecules that selectively disrupt the β3/Src interaction, thereby inhibiting arterial and venous thrombogenesis without increasing bleeding risk.</p><p><strong>Methods: </strong>Building on the previously identified compound DCDBS84, we developed the structurally modified small molecules C109 and C116, with enhanced affinity for the Src SH3 domain. Their antithrombotic effects on both arterial and venous thrombosis were systematically evaluated through in vitro and in vivo studies. The impact on hemostatic function was assessed using a tail-bleeding model. Additionally, the drug developability of C109 was assessed via pharmacokinetic (PK) and metabolite analysis.</p><p><strong>Results: </strong>C109 and C116 exhibited superior efficacy in disrupting the β3/Src interaction. In vitro and in vivo studies demonstrated that C109 and C116 effectively suppress thrombosis at levels comparable to high doses of the αIIbβ3 antagonist integrilin, without elevating bleeding risk. In the Stenosis Model, C109 and C116 significantly reduced venous thrombogenesis by suppressing platelet activation and neutrophil extracellular trap formation. Additionally, C109 displayed favorable PK properties and robust metabolic stability.</p><p><strong>Conclusion: </strong>These findings identify promising small molecules that inhibit thrombosis while maintaining hemostasis, providing new avenues for safer and more effective clinical management.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"930-947"},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275956","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}
引用次数: 0
Inherited Thrombophilia as a Risk Factor for Persistent Left Ventricular Thrombus Following Acute Myocardial Infarction. 遗传性血栓病是急性心肌梗死后持续性左室血栓的危险因素。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-09-01 Epub Date: 2026-02-09 DOI: 10.1055/a-2794-5001
Krystian Mróz, Elżbieta Paszek, Ewa Wypasek, Anetta Undas
{"title":"Inherited Thrombophilia as a Risk Factor for Persistent Left Ventricular Thrombus Following Acute Myocardial Infarction.","authors":"Krystian Mróz, Elżbieta Paszek, Ewa Wypasek, Anetta Undas","doi":"10.1055/a-2794-5001","DOIUrl":"10.1055/a-2794-5001","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular thrombus (LVT) commonly complicates ST-segment elevation myocardial infarction (MI), and up to 30% of LVT may persist despite anticoagulation. Data linking post-MI LVT and inherited thrombophilias are sparse.</p><p><strong>Methods: </strong>A total of 148 consecutive MI patients with LVT at a mean age of 63.9 (6.9) years were referred for further workup. After 3 months of oral anticoagulation, screening for factor V Leiden (FVL) and prothrombin G20210A variant, protein S, protein C, and antithrombin deficiency was performed. Subjects with antiphospholipid syndrome were not eligible. Thrombus persistence was assessed after 3 and 6 months of anticoagulation.</p><p><strong>Results: </strong>Inherited thrombophilias were identified in 34 (23%) patients, including 18 (52.9%) with FVL, 9 (26.5%) with prothrombin G20210A variant, 3 (8.8%) with protein C deficiency, and 4 (11.8%) with protein S deficiency. Carriers of thrombophilias were similar to non-thrombophilic subjects, except for higher fibrinogen in the former group. Inherited thrombophilias were associated with LVT persistence after 3 and 6 months post MI (25 [73.5%] vs. 50 [43.9%], <i>p</i> = 0.002 and 20 [58.8%] vs. 24 [21.1%], <i>p</i> < 0.001, respectively). Inherited thrombophilias were independently associated with an increased risk of persistent LVT 3 and 6 months post MI (OR 2.75, 95% CI 1.13-6.74, <i>p</i> = 0.026 and OR 4.06, 95% CI 1.57-10.51, <i>p</i> = 0.004, respectively).</p><p><strong>Conclusion: </strong>Our findings suggest that inherited thrombophilias may predispose to LVT persistence despite anticoagulation in MI survivors. Thrombophilia screening may help identify a subgroup likely to benefit from prolonged anticoagulation.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"897-907"},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150643","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}
引用次数: 0
Stroke in Mechanical Circulatory Supported Cardiogenic Shock. 机械循环支持的心源性休克中的中风。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-09-01 Epub Date: 2025-09-18 DOI: 10.1055/a-2697-3309
Victor Galusko, Vasileios Panoulas, Diana A Gorog, Christophe Vandenbriele
{"title":"Stroke in Mechanical Circulatory Supported Cardiogenic Shock.","authors":"Victor Galusko, Vasileios Panoulas, Diana A Gorog, Christophe Vandenbriele","doi":"10.1055/a-2697-3309","DOIUrl":"10.1055/a-2697-3309","url":null,"abstract":"<p><p>Stroke is a devastating and underdiagnosed complication in patients with cardiogenic shock (CS) supported by temporary mechanical circulatory support (tMCS). Stroke occurs in approximately 1 to 4% of patients on microaxial flow pumps and 6 to 7% of those on veno-arterial extracorporeal membrane oxygenation, though the true incidence is likely higher due to diagnostic limitations in sedated and critically ill patients. The occurrence of stroke in this population significantly worsens clinical outcomes, increasing morbidity, mortality, and healthcare resource utilization. This review outlines the risk factors and mechanisms underlying both ischaemic and haemorrhagic stroke in patients receiving tMCS. It explores how the aetiology of CS, the choice of tMCS device, anticoagulation strategies, and cellular injury contribute to stroke risk. The pathophysiology in this setting is multifactorial and often dual-edged, driven by haemolysis, platelet dysfunction, endothelial disruption, and immune-mediated thrombogenesis. Concurrently, bleeding complications arise from acquired von Willebrand syndrome, thrombocytopenia, and dysregulated fibrinolysis. Currently, there are no evidence-based guidelines for managing bleeding and thrombotic complications in patients on tMCS, largely due to the lack of robust data. Consequently, clinical practices vary, and treatment decisions often require navigating a complex balance between thrombosis and bleeding without high-quality evidence to guide care. This review highlights the key physiological and pathological changes associated with tMCS to inform strategies for stroke prevention, early detection, and management. Developing standardised protocols through prospective studies is essential to improving outcomes in this high-risk population.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"883-896"},"PeriodicalIF":5.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087280","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}
引用次数: 0
Antiphospholipid Antibodies and Atrial Fibrillation: Clinical Implications and the TaPL-AF Study Design. 抗磷脂抗体和心房颤动:临床意义和TaPL心房颤动研究设计。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-24 DOI: 10.1055/a-2899-3848
Bassil Bacare, Syed Bukhari, Nathan W Watson, Julia Malejczyk, Christopher Amalan, Sina Rashedi, Mariana B Pfeferman, Brittany Weber, Siddharth Patel, Christian Ruff, Yogendra Kanthi, Mary Cushman, Jason Knight, Samuel Z Goldhaber, Karen Costenbader, Ryan Mize, Sacha Uljon, Christine M Albert, Gregory Y H Lip, Harlan M Krumholz, Gregory M Piazza, Behnood Bikdeli
{"title":"Antiphospholipid Antibodies and Atrial Fibrillation: Clinical Implications and the TaPL-AF Study Design.","authors":"Bassil Bacare, Syed Bukhari, Nathan W Watson, Julia Malejczyk, Christopher Amalan, Sina Rashedi, Mariana B Pfeferman, Brittany Weber, Siddharth Patel, Christian Ruff, Yogendra Kanthi, Mary Cushman, Jason Knight, Samuel Z Goldhaber, Karen Costenbader, Ryan Mize, Sacha Uljon, Christine M Albert, Gregory Y H Lip, Harlan M Krumholz, Gregory M Piazza, Behnood Bikdeli","doi":"10.1055/a-2899-3848","DOIUrl":"10.1055/a-2899-3848","url":null,"abstract":"<p><strong>Abstract: </strong>Antiphospholipid antibodies (aPL) are a heterogeneous group of autoantibodies that target phospholipids and phospholipid-binding proteins, and are identified clinically by anticardiolipin, anti-β2-glycoprotein I, or lupus anticoagulant assays. While aPL are a well-established mediator of thrombosis through both proinflammatory and prothrombotic pathways, the role of aPL in arrhythmogenesis including atrial fibrillation (AF) and their association with AF-related thromboembolic outcomes remains poorly defined. In small observational studies, testing positive for aPL has been reported in up to 20% of patients with AF and has been associated with a higher risk of ischemic stroke and other thromboembolic events. In this mini-review, in addition to sharing a succinct summary on prevalence and pathogenicity of aPL in various vascular and thrombotic conditions, we specifically summarize the existing body of literature investigating the association between aPL and AF prevalence and clinical outcomes. Furthermore, we describe the rationale and study design of the TaPL-AF (Thrombophilia with aPL in Atrial Fibrillation) study, an ongoing investigation leveraging Mass General Brigham (MGB) Biobank data to provide evidence on the incidence and prognostic relevance of aPL positivity in AF and explore the impact of aPL on the effectiveness of direct oral anticoagulants in preventing thromboembolic events. These efforts aim to define the clinical relevance of aPL in AF, including their potential role in refining thromboembolic risk stratification and guiding anticoagulation strategies.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333066","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}
引用次数: 0
Clinical Validation of a Point-of-Care Whole Blood Coagulometer in Patients on Factor Xa Inhibitors. 在Xa因子抑制剂患者中使用即时全血凝血仪的临床验证。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-14 DOI: 10.1055/a-2930-1041
Sasha Bakhru, Jean Connors, Robert Giugliano, Dardan Osmani, Brendan Keenan, Lirong Chen, Xuan Jiang, Jack Ansell
{"title":"Clinical Validation of a Point-of-Care Whole Blood Coagulometer in Patients on Factor Xa Inhibitors.","authors":"Sasha Bakhru, Jean Connors, Robert Giugliano, Dardan Osmani, Brendan Keenan, Lirong Chen, Xuan Jiang, Jack Ansell","doi":"10.1055/a-2930-1041","DOIUrl":"10.1055/a-2930-1041","url":null,"abstract":"<p><p>Currently, no sensitive, widely available, rapid turnaround assays to measure the effect on coagulation of direct oral anticoagulants exist.The point-of-care ClotChek (Perosphere Technologies Inc.) coagulometer was developed to address this unmet need with high sensitivity and precision. This proof-of-concept study aimed to determine normal clotting time in healthy, non-anticoagulated subjects; summarize clotting times at trough and peak drug concentrations in patients taking apixaban and rivaroxaban; and identify cut-points that maximize both sensitivity and specificity for predicting whether an individual is meaningfully anticoagulated.In 141 normal subjects, the mean clotting time was 244.2 ± 25.8 seconds (median 244.0 seconds; range 183-296 seconds). In 39 patients on apixaban, mean clotting times were 293.9 ± 32.5 seconds at trough and 323.1 ± 27.9 seconds at peak. In 42 patients on rivaroxaban, mean clotting times were 287.8 ± 44.9 seconds at trough and 380.4 ± 41.2 seconds at peak. Strong positive correlations are seen between the anticoagulant drug response determined by the assay and anticoagulant drug levels for apixaban (Spearman's rho = 0.74, <i>p</i> < 0.0001) and for rivaroxaban (Spearman's rho = 0.82, <i>p</i> < 0.0001). ClotChek clotting times showed good sensitivity and specificity to identify meaningful anticoagulation (>75 ng/mL) among patients taking apixaban (AUC = 0.91, 83% sensitivity, 86% specificity) or rivaroxaban (AUC = 0.96, 91% sensitivity, 90% specificity). Similar results were seen using the lower threshold of >30 ng/mL.These results require clinical validation in further studies but suggest that the ClotChek assay could aid physicians at the point of care in making therapeutic decisions in patients with adverse events associated with oral factor Xa inhibitors.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680105","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}
引用次数: 0
Association between Pulmonary Vascular Obstruction Phenotype and Pulmonary Embolism Recurrence: Results from the PADIS-PE Study. 肺血管阻塞表型与肺栓塞复发之间的关系:来自PADIS-PE研究的结果。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-11 DOI: 10.1055/a-2930-1129
Marion Ranty, Cecile Tromeur, Pauline Pronost, Mathilde Moreau, Philippe Robin, Pierre-Yves Le Roux, Brieg Dissaux, Jamal El Hasnaoui, Benjamin Espinasse, Emilie Presles, Emmanuelle Le Moigne, Marie Guegan, Olivier Sanchez, Laurent Bertoletti, Michel Nonent, Christophe Leroyer, Francis Couturaud
{"title":"Association between Pulmonary Vascular Obstruction Phenotype and Pulmonary Embolism Recurrence: Results from the PADIS-PE Study.","authors":"Marion Ranty, Cecile Tromeur, Pauline Pronost, Mathilde Moreau, Philippe Robin, Pierre-Yves Le Roux, Brieg Dissaux, Jamal El Hasnaoui, Benjamin Espinasse, Emilie Presles, Emmanuelle Le Moigne, Marie Guegan, Olivier Sanchez, Laurent Bertoletti, Michel Nonent, Christophe Leroyer, Francis Couturaud","doi":"10.1055/a-2930-1129","DOIUrl":"https://doi.org/10.1055/a-2930-1129","url":null,"abstract":"<p><p>Pulmonary vascular obstruction index (PVOI), assessed using the Qanadli index on computed tomography pulmonary angiography (CTPA) at pulmonary embolism (PE) diagnostic, has been associated with recurrence after unprovoked PE, but its complexity limits routine use. We aimed to evaluate simplified semiquantitative (Sq) measures of initial PVOI for predicting recurrent PE after anticoagulation discontinuation.This post hoc analysis, based on the double-blind, randomized PADIS-PE trial where patients with a first unprovoked PE initially treated during 6 months were allocated to receive either an additional 18-month warfarin or placebo, was restricted on the 180 patients who had PE diagnosed by CTPA. Initial PVOI was assessed using four methods: Qanadli score, modified Qanadli score, anatomical-based SqPVOI1, and lobe-based SqPVOI2. Accuracy and associations with recurrent PE were evaluated using area under the curve (AUC) analysis and Cox regression models.Among the 180 included patients (mean age 66.2 ± 16.5 years; 45.2% female), recurrent PE occurred in 42 patients (36-month median follow-up). Accuracy was comparable across the four PVOI scores, with AUCs ranging from 0.70 to 0.74. All scores showed comparable ability to predict recurrent PE. When using the anatomical-based SqPVOI1, recurrence risk increased progressively with more proximal thrombus location: compared with segmental artery involvement (36-month cumulative incidence, 10.5%; <i>n</i> = 76), risk was 2- to 3-fold with lobar artery involvement (HR 2.90, 95%CI, 1.20-7.05, <i>p</i> = 0.005; 36-month cumulative incidence, 25.6%; <i>n</i> = 63) and 4- to 5-fold increased risk (HR 4.59, 95%CI, 1.85-11.42, <i>p</i> = 0.001; 36-month cumulative incidence, 46.8%; <i>n</i> = 41) with main pulmonary artery involvement.Simplified anatomical assessment of PVOI showed prognostic information comparable to quantitative indices. Further prospective validation is needed.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713613","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}
引用次数: 0
Ticagrelor versus Clopidogrel in Acute Coronary Syndrome Patients with High Ischemic and Bleeding Risk after Drug-eluting Stent Implantation. 替格瑞洛与氯吡格雷在药物洗脱支架植入术后具有高缺血和出血风险的急性冠脉综合征患者中的作用。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-11 DOI: 10.1055/a-2922-8191
Kun Na, Miaohan Qiu, Tianai Zhang, Yuying Li, Yixuan Duan, Yang Li, Jing Li, Yi Li, Yaling Han
{"title":"Ticagrelor versus Clopidogrel in Acute Coronary Syndrome Patients with High Ischemic and Bleeding Risk after Drug-eluting Stent Implantation.","authors":"Kun Na, Miaohan Qiu, Tianai Zhang, Yuying Li, Yixuan Duan, Yang Li, Jing Li, Yi Li, Yaling Han","doi":"10.1055/a-2922-8191","DOIUrl":"https://doi.org/10.1055/a-2922-8191","url":null,"abstract":"<p><p>Patients with acute coronary syndrome (ACS) who have concurrent high ischemic and high bleeding risk are common after percutaneous coronary intervention (PCI), yet evidence guiding P2Y<sub>12</sub> inhibitor selection remains limited. We compared ticagrelor and clopidogrel in ACS patients meeting OPT-BIRISK dual high-risk criteria after drug-eluting stent (DES) implantation.We retrospectively analyzed a single-center PCI registry. ACS patients undergoing new-generation DES implantation (March 2019-March 2022) who met both high ischemic and high bleeding risk criteria were classified by discharge P2Y<sub>12</sub> inhibitor. Propensity score overlap weighting was adjusted for confounding. The primary endpoint was 12-month net adverse clinical events (NACE): all-cause death, myocardial infarction, stroke, or Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding.The final cohort comprised 20,213 dual high-risk patients (ticagrelor, 4,563 [22.6%]; clopidogrel, 15,650 [77.4%]). NACE was similar between groups (4.58% vs. 5.21%; adjusted hazard ratio [aHR], 1.05; 95% confidence interval [CI], 0.89-1.23; <i>p</i> = 0.568). Ticagrelor was not associated with reduced ischemic events (aHR, 0.90; 95% CI, 0.72-1.12; <i>p</i> = 0.333) but with higher BARC type 3 or 5 bleeding (2.17% vs. 1.57%; aHR, 1.39; 95% CI, 1.08-1.77; <i>p</i> = 0.009). In exploratory subgroup analysis, ticagrelor was associated with higher NACE in patients aged 75 years or older (<i>p</i>-Value for interaction = 0.04).In dual high-risk ACS patients undergoing DES implantation, discharge ticagrelor-based dual antiplatelet therapy was associated with higher bleeding risk without reducing NACE or ischemic events compared with clopidogrel. These observational findings support individualized P2Y<sub>12</sub> inhibitor selection and warrant prospective confirmation.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713595","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}
引用次数: 0
Beyond the Eureka Moment: Serendipity and the Discovery of Heparin. 超越尤里卡时刻:意外发现和肝素的发现。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-04 DOI: 10.1055/a-2923-5301
Donatella Lippi, Rossella Marcucci, Francesco Baldanzi
{"title":"Beyond the Eureka Moment: Serendipity and the Discovery of Heparin.","authors":"Donatella Lippi, Rossella Marcucci, Francesco Baldanzi","doi":"10.1055/a-2923-5301","DOIUrl":"https://doi.org/10.1055/a-2923-5301","url":null,"abstract":"","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702274","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}
引用次数: 0
Rotem Platelet Component (A5 Platelet) as a Rapid Marker of Thrombocytopenia after Severe Trauma. Rotem血小板成分(a5血小板)作为严重创伤后血小板减少的早期标志物。
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-04 DOI: 10.1055/a-2922-8113
Jean-Stephane David, Louise Sibille, Hamdi Rezigue, Jonathan Meltzer, Laurent Jallades, Marie-Odile Geay-Baillat, Christophe Nougier, Yesim Dargaud
{"title":"Rotem Platelet Component (A5 Platelet) as a Rapid Marker of Thrombocytopenia after Severe Trauma.","authors":"Jean-Stephane David, Louise Sibille, Hamdi Rezigue, Jonathan Meltzer, Laurent Jallades, Marie-Odile Geay-Baillat, Christophe Nougier, Yesim Dargaud","doi":"10.1055/a-2922-8113","DOIUrl":"10.1055/a-2922-8113","url":null,"abstract":"<p><p>Thrombocytopenia contributes to trauma-induced coagulopathy and may require platelet transfusion. Viscoelastic assays can provide rapid surrogates of platelet count, but thresholds may be influenced by physiological derangements. We compared ROTEM-derived parameters for diagnosing thrombocytopenia and tested their robustness across selected conditions.We performed a retrospective registry-based cohort study in a level 1 trauma center (2011-2021). Severely injured adults were included if they had at least one paired ROTEM and platelet count measurement within 24 hours of admission; patients receiving anticoagulants were excluded. Thrombocytopenia was defined as platelets <100 G/L. Associations between platelet count and ROTEM parameters were assessed with Spearman correlation. Diagnostic accuracy was evaluated using ROC and precision-recall (PR) analyses; optimal thresholds were chosen by maximal F1-score. For the best parameter, performance was explored across hemoglobin level, acidosis, and hypocalcemia.Of 4,395 admissions, 865 patients were included with 1,395 paired measurements; thrombocytopenia occurred in 213 samples (15.3%) and was present at admission in 35 (4%). Platelet count correlated with clot amplitude/elasticity (<i>p</i> < 0.001). The platelet component of clot amplitude at 5 minutes (A5 PLAT) had the best discrimination (AUC 0.929; AUPRC 0.627). The optimal PR-based threshold was A5 PLAT ≤21 mm. Performance was mainly affected by severe acidosis and severe hypocalcemia.In severe trauma, ROTEM-derived A5 PLAT accurately identifies platelet count <100 G/L and outperforms other ROTEM parameters, supporting its use for rapid platelet-related decision-making. Hypocalcemia and acidosis may reduce precision and should be considered when applying ROTEM-based thresholds during early trauma resuscitation.</p>","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585265","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}
引用次数: 0
DOACs for Superficial Vein Thrombosis: Risks of Pooling RCTs and Observational Studies in Comparative Effectiveness. DOACs治疗浅静脉血栓:对照试验的风险和比较疗效的观察性研究
IF 5.2 2区 医学
Thrombosis and haemostasis Pub Date : 2026-08-01 Epub Date: 2026-03-06 DOI: 10.1055/a-2825-8897
Behnood Bikdeli, Mariana Pfeferman, Sina Rashedi, Gregory Piazza
{"title":"DOACs for Superficial Vein Thrombosis: Risks of Pooling RCTs and Observational Studies in Comparative Effectiveness.","authors":"Behnood Bikdeli, Mariana Pfeferman, Sina Rashedi, Gregory Piazza","doi":"10.1055/a-2825-8897","DOIUrl":"10.1055/a-2825-8897","url":null,"abstract":"","PeriodicalId":23036,"journal":{"name":"Thrombosis and haemostasis","volume":" ","pages":"843-845"},"PeriodicalIF":5.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370230","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}
引用次数: 0
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