Thrombosis research最新文献

{"title":"Reduced ADP-induced platelet aggregation may predict poor clinical outcomes in patients with COVID-19","authors":"Hiroyuki Koami,&nbsp;Yuichiro Sakamoto,&nbsp;Yutaro Furukawa,&nbsp;Ayaka Matsuoka,&nbsp;Kota Shinada,&nbsp;Kento Nakayama,&nbsp;Ryota Sakurai,&nbsp;Sachiko Iwanaga,&nbsp;Takayuki Onohara,&nbsp;Mayuko Koba","doi":"10.1016/j.thromres.2025.109501","DOIUrl":"10.1016/j.thromres.2025.109501","url":null,"abstract":"<div><h3>Background</h3><div>COVID-19-associated coagulopathy remained a major contributor to mortality and morbidity even after mutation to the Omicron strain. Pathologic platelet hyperactivation caused by COVID-19 infection is generally recognized as an important mechanism of thrombotic complications; however, evaluating platelet aggregation in the emergency department remains challenging. This study explains the relationship between poor clinical outcomes and platelet aggregation capacity, based on viscoelastic testing.</div></div><div><h3>Methods</h3><div>This single-center retrospective study enrolled adult COVID-19 patients admitted to our hospital who underwent thromboelastography (TEG) with platelet mapping from August 2021 to April 2022. Patients were classified into two groups based on 28-day mortality. Using univariate analysis, multiple logistic regression modeling, and survival analysis, we statistically analyzed whether platelet aggregation abnormalities were related to poor clinical outcomes in COVID-19.</div></div><div><h3>Results</h3><div>Forty-seven cases were allocated to survival (<em>N</em> = 40) and mortality Groups (<em>N</em> = 7). Compared to the survival group, the mortality group had significantly higher ages and Charlson scores, and was associated with poor consciousness levels upon admission, high APACHE II scores, and high SOFA scores. Time from onset to admission, strain type, and clinical severity of COVID-19 were statistically equivalent in the two groups. TEG analysis revealed that the mortality group showed significantly decreased LY30 and impaired platelet aggregation via the ADP pathway. ADP aggregation impairment was an independent predictor for 28-day mortality and demonstrated significantly poorer outcomes. ADP aggregation inhibition was not associated with clinical severity, time since COVID-19 onset, or platelet count.</div></div><div><h3>Conclusion</h3><div>Impaired ADP-induced platelet aggregation is an independent predictor of poor clinical outcomes in COVID-19 patients.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109501"},"PeriodicalIF":3.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the safety outcomes of whole blood versus component transfusion in trauma: A meta-analysis of 59,213 patients","authors":"Muhammad Taha Khan ,&nbsp;Fatima Ali Raza ,&nbsp;Rafiya Altaf ,&nbsp;Syeda Hoorulain Ahmed ,&nbsp;Muhammad Saliha ,&nbsp;Fazila Zehria ,&nbsp;Hussain Haider Shah ,&nbsp;Wajeeh Anisa ,&nbsp;Sohaib Tousif ,&nbsp;Priya Goyal","doi":"10.1016/j.thromres.2025.109495","DOIUrl":"10.1016/j.thromres.2025.109495","url":null,"abstract":"<div><h3>Background</h3><div>Blood transfusion can play a critical role in saving lives by replenishing lost blood volume and helping to stabilize patients. This meta-analysis aims to compare the clinical effectiveness of whole blood (WB) transfusion against component therapy (CT) in the treatment of individuals suffering from traumatic injuries.</div></div><div><h3>Methods</h3><div>A comprehensive search of electronic databases was conducted up to March 2025 to identify randomized controlled trials and cohort studies. Data from continuous and categorical outcomes were synthesized using a random-effects model, producing mean differences (MD) and odds ratios (OR) along with corresponding 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A random-effects meta-analysis of 14 studies showed a significant reduction in 24-h all-cause mortality with whole blood transfusion compared to component therapy (OR: 0.67, 95 % CI [0.50, 0.88]; <em>p</em> = 0.005). No significant differences were found between the two groups for length of hospital stay, ICU stay, days on ventilator, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), or sepsis. Specifically, the length of hospital stay (WMD: −1.57, <em>p</em> = 0.06), ICU stay (WMD: −0.20, <em>p</em> = 0.75), days on ventilator (WMD: −0.57, <em>p</em> = 0.24), ARDS (OR: 1.34, <em>p</em> = 0.30), and AKI (OR: 0.91, <em>p</em> = 0.63) showed no statistically significant differences, while sepsis (WMD: 1.10, <em>p</em> = 0.74) also revealed no significant variation between the groups. Removal of certain studies reduced heterogeneity in several outcomes.</div></div><div><h3>Conclusion</h3><div>Although whole blood has been demonstrated to improve 24-h mortality, the current findings are limited by observational data to classify it as a completely safe approach, thus necessitating the need for more randomized controlled trials (RCTs).</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109495"},"PeriodicalIF":3.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged duration of pharmacological thromboprophylaxis following oncologic surgery: A systematic review and meta-analysis of RCTs","authors":"Zhongwang Wang ,&nbsp;Zhengyu Yu ,&nbsp;Ting Niu","doi":"10.1016/j.thromres.2025.109500","DOIUrl":"10.1016/j.thromres.2025.109500","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) is the leading cause of 30-day postoperative mortality, with current guidelines recommending extended-duration thromboprophylaxis despite limited evidence on its impact on clinically meaningful benefits.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of prolonged anticoagulant prophylaxis versus in-hospital only prophylaxis in cancer surgery patients using a meta-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of 10 RCTs. The primary outcomes included overall VTE, symptomatic VTE, pulmonary embolism (PE), major bleeding, and all-cause mortality. Results were summarized using relative ratios (RR) and 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>Prolonged prophylaxis significantly reduced the 30-day incidence of overall VTE (4.0 % vs. 10.0 %; RR 0.40, 95 %CI 0.22–0.76). No significant differences were observed in the 30-day incidence of symptomatic VTE (0.7 % vs. 1.1 %; RR 0.66, 95 %CI 0.29–1.48), PE (0.5 % vs. 0.5 %), or 90-day mortality (1.4 % vs. 1.6 %). A non-significant increase in major bleeding occurred (0.9 % vs. 0.2 %; RR 2.37, 95 %CI 0.79–7.11). Subgroup analyses indicated heterogeneity in primary outcomes based on surgical site (abdominopelvic vs. thoracic surgery).</div></div><div><h3>Conclusion</h3><div>While prolonged duration of pharmacological thromboprophylaxis reduces the incidence of overall VTE, it does not demonstrate clinically meaningful benefits for symptomatic events or survival. Current risk-stratification tools may overestimate thrombotic risk in cancer surgery patients receiving standard in-hospital prophylaxis. Our findings support a selective, rather than universal, approach to prolonged prophylaxis, emphasizing individualized risk assessment.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109500"},"PeriodicalIF":3.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding disorders of unknown cause: A conglomeration of disorders with heterogeneous etiology","authors":"Shrimati Shetty ,&nbsp;Fiza Jivani ,&nbsp;Aniket Kamble ,&nbsp;Shruti Kharat ,&nbsp;Kranti Patil ,&nbsp;Gurpreet Kaur Saini ,&nbsp;Anam Dhawlarker ,&nbsp;Shrinath Kshirsagar ,&nbsp;Savita Rangarajan","doi":"10.1016/j.thromres.2025.109496","DOIUrl":"10.1016/j.thromres.2025.109496","url":null,"abstract":"<div><div>Patients with clinically significant bleeding, but with normal hemostatic investigations are identified as a distinct group known as “bleeding disorders of unknown cause” (BDUC). Though the clinical symptoms often resemble that of mild bleeding disorders (MBDs) with confirmed laboratory diagnosis, these patients have to go through multiple laboratory investigations only to end up in a diagnosis of exclusion i.e. BDUC. There are no standard protocols or general consensus on treatment of these patients, either for a generalized bleeding or prophylaxis prior to surgical procedures; patients are treated as per the physician perceptions or practices and many patients go untreated. Patients with BDUC are at increased risk of uncontrolled bleeding during trauma, surgery, and during delivery. Present review discusses the standard tests required for diagnosis of BDUC, type of bleeding, treatment modalities and future perspectives. Research should focus both on hemostatic, non-hemostatic and acquired factors contributing to bleeding. Evidence based diagnostic and treatment guidelines for this clinically mild group of patients are warranted for specific hemostatic interventions.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109496"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linezolid impair proplatelet formation by reducing mitochondrial energy metabolism in MEG-01 cells","authors":"Ya Yang ,&nbsp;Ning Wang ,&nbsp;Lirong Xiong ,&nbsp;Peishu Fu ,&nbsp;Yanping Tian ,&nbsp;Shenglin Luo ,&nbsp;Fengjun Sun ,&nbsp;Peiyuan Xia","doi":"10.1016/j.thromres.2025.109498","DOIUrl":"10.1016/j.thromres.2025.109498","url":null,"abstract":"<div><h3>Background</h3><div>Thrombocytopenia is a common adverse side effects of Linezolid (LZD) but the underlying mechanism remains unclear. This study aimed to analyze the mechanism of LZD induced thrombocytopenia for LZD induced thrombocytopenia.</div></div><div><h3>Methods</h3><div>Cells proliferation, proplatelet formation assay and platelet production were evaluated in human megakaryoblastic leukemia cell line MEG-01 or C57BL/6 mice following LZD administration. The metabolic profiles and gene expression of MEG-01 cells was subsequently analyzed using molecular and bioinformatics techniques.</div></div><div><h3>Results</h3><div>LZD induced a dose- and time-dependent decrease in cells proliferation and inhibited proplatelet formation. It alters metabolic pathways including central carbon metabolism as indicated by a decrease in pyruvate, ATP and GTP levels (<em>P</em> &lt; 0.01). Expression of genes related to energy production and conversion and the cytoskeleton were altered, such as <em>SLC25A21</em>, <em>HBB</em>, <em>PRR5</em>, <em>MYL4</em> and <em>RHoE</em> (<em>P</em> &lt; 0.01). Pyruvate supplementation rescued reduced metabolites induced by LZD, increased proplatelet formation of MEG-01 cells and length of pseudopod (<em>P</em> &lt; 0.05). Furthermore, pyruvate rescued the counts of megakaryocytes in bone marrow and peripheral platelets in LZD treated mice (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>LZD inhibits mitochondrial energy metabolism, resulting in proplatelet formation reduction. Pyruvate reverses LZD induced thrombocytopenia, which provide a basis for mechanistic insights of LZD induced thrombocytopenia.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109498"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular histones promote retraction and impair lysability of platelet-rich clots","authors":"Concetta T. Ammollo ,&nbsp;Nicola Semeraro ,&nbsp;Mario Colucci ,&nbsp;Fabrizio Semeraro","doi":"10.1016/j.thromres.2025.109494","DOIUrl":"10.1016/j.thromres.2025.109494","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109494"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative analysis of perioperative management of antiplatelet agent guidelines across US institutions","authors":"Ming Y. Lim ,&nbsp;Jacob C. Cogan ,&nbsp;Caroline Cromwell ,&nbsp;Manila Gaddh ,&nbsp;Radhika Gangaraju ,&nbsp;Colleen Morton ,&nbsp;Andrew Peseski ,&nbsp;Rishabh Singh ,&nbsp;Ishan Tatake ,&nbsp;Kimberley Youkhana ,&nbsp;Lisa Baumann Kreuziger","doi":"10.1016/j.thromres.2025.109493","DOIUrl":"10.1016/j.thromres.2025.109493","url":null,"abstract":"<div><h3>Introduction</h3><div>Cardiovascular disease (CVD) is the leading cause of mortality worldwide, prompting increasing use of antiplatelet agents for primary and secondary prevention. Despite guidelines from multiple professional societies on the perioperative management of antiplatelet agents, we hypothesized that their implementation varies, leading to inconsistencies in perioperative practices across the United States (US).</div></div><div><h3>Methods</h3><div>We surveyed eleven members of the Systems-Based Hematology Committee of the Venous ThromboEmbolism Network US (VENUS) to gather their institutions' guidelines on the perioperative management of antiplatelet agents for non-cardiac surgery. Institutional guidelines were compared with five professional society guidelines.</div></div><div><h3>Results</h3><div>Of the 11 academic medical centers (AMCs), 8 (72.7 %) had institutional guidelines on perioperative management of antiplatelet agents (aspirin and three P2Y₁₂ inhibitors) prior to non-cardiac surgery. Of the remaining three, two had guidelines on the management of antiplatelet agents prior to interventional radiology procedures (<em>n</em> = 1) and for neuraxial anesthesia (<em>n</em> = 1).</div><div>Five AMCs gave differing recommendations on managing phosphodiesterase inhibitors perioperatively, while none of the five society guidelines addressed them.</div><div>Five AMCs provided variable recommendations on the timing of postoperative resumption of antiplatelet agents ranging from as soon as possible to 12–24 h postoperatively depending on bleeding risk.</div><div>Only two AMCs provided recommendations for those on antiplatelet agents who have life-threatening peri-operative bleeding or undergoing urgent high-bleeding risk surgery.</div></div><div><h3>Conclusion</h3><div>AMCs vary in their recommendations on the perioperative management of antiplatelet agents prior to non-cardiac surgery. Further research is needed to determine if this variability impacts patient outcomes and to identify ways to improve guideline implementation.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109493"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of coagulation profiles across different stages of chronic kidney disease: A cross-sectional study","authors":"Emelina Stambolliu ,&nbsp;Panagiota Giannou ,&nbsp;Aikaterini Damianaki ,&nbsp;Maria Panagiota Terzi ,&nbsp;Euthymia Pavlou ,&nbsp;Elpiniki Stathopoulou ,&nbsp;Efrossyni Nomikou ,&nbsp;Dimitrios Petras","doi":"10.1016/j.thromres.2025.109497","DOIUrl":"10.1016/j.thromres.2025.109497","url":null,"abstract":"<div><h3>Background and aims</h3><div>Patients with chronic kidney disease (CKD), especially those with end stage renal disease (ESRD) are prone to both bleeding and thrombosis. We aimed to evaluate several hemostasis parameters and identify any differences in the coagulation process among patients with CKD at different stages.</div></div><div><h3>Methods</h3><div>This cross-sectional study included patients with CKD stages 2 to5 (non-dialysis) and ESRD patients on hemodialysis (HD) or peritoneal dialysis (PD). Standard coagulation tests were performed, along with thromboelastography (TEG) and platelet function analyze (PFA).</div></div><div><h3>Results</h3><div>A total of 148 patients were included in the analysis, mean age 65.6 ± 14.3 years; 75 % males; 76 % hypertensive. Significant differences were identified across all groups, particularly between CKD stages 2 and 5, in D-Dimers, FVIII, homocysteine, fibrinogen, von Willebrand factor (vWF), aPTT and TEG parameters (maximal amplitude [MA], K time, A angle), with values progressively increasing as CKD advanced (all <em>p</em> &lt; 0.05). The PD and HD groups had major differences in FVIII, vWF, PFA and TEG parameters, with PD patients being more hypercoagulable. PFA values did not correlate with TEG parameters, while platelet count correlated with both PFA and MA values. eGFR independently predicted most of the coagulation and TEG parameters tested.</div></div><div><h3>Conclusion</h3><div>CKD progression affects TEG, PFA, and most coagulation examinations, indicating a prothrombotic profile even in the early stages of CKD. Moreover, significant differences in coagulation parameters are observed between HD and PD patients, with the latter exhibiting a more pronounced hypercoagulable state. These results should be interpreted cautiously, considering the limitations and the possible confounders of the study.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109497"},"PeriodicalIF":3.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic fibrosis and its impact on prognosis in pulmonary embolism","authors":"Karsten Keller ,&nbsp;Volker H. Schmitt ,&nbsp;Visvakanth Sivanathan ,&nbsp;Omar Hahad ,&nbsp;Thomas Münzel ,&nbsp;Philipp Lurz ,&nbsp;Christine Espinola-Klein ,&nbsp;Stefano Barco ,&nbsp;Stavros Konstantinides ,&nbsp;Lukas Hobohm","doi":"10.1016/j.thromres.2025.109499","DOIUrl":"10.1016/j.thromres.2025.109499","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) and cystic fibrosis (CF) are both diseases that impact the cardiovascular-pulmonary system. While CF is a rare heterogeneous monogenetic autosomal-recessive inherited multisystem-disease that reduces life-expectancy, PE is a common emergency event with also high morbidity and mortality. We aimed to investigate the impact of CF on prognosis of PE patients.</div></div><div><h3>Methods</h3><div>The German nationwide inpatient sample was used for this study. All patient-cases of patients with PE in Germany 2005–2020 were included and stratified for CF.</div></div><div><h3>Results</h3><div>Overall, 1,373,084 patient-cases of PE patients (median age 72.0 years, 53.0 % females) in Germany were included in our study 2005–2020. Among these, 126 patients (0.01 %) were coded with CF.</div><div>PE patients with CF were younger (33.0 [24.0–43.0] vs. 72.0 [60.0–80.0] years, <em>P</em> &lt; 0.001) displaying a lower prevalence of arterial hypertension, hyperlipidemia and lower comorbidity-burden (Charlson comorbidity index: 2.0 [1.0–4.0] vs. 4.0 [3.0–7.0], <em>P</em> &lt; 0.001) compared to those without CF. In contrast, diabetes mellitus was more frequent in PE patients with CF (49.2 % vs. 18.7 %, <em>P</em> &lt; 0.001).</div><div>After adjustment for age, sex and comorbidities, CF was associated with higher case-fatality (OR 2.451 [95 % CI 1.542–3.896], <em>P</em> &lt; 0.001), pneumonia (OR 1.518 [95 % CI 1.059–2.176], <em>P</em> = 0.023) and necessity regarding transfusion of blood constituents (OR 3.702 [95 % CI 2.540–5.396], P &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>PE patients with CF were younger at the time of PE event and accompanied by typical comorbidities such as diabetes mellitus and renal disease compared to PE patients without CF. CF was associated with higher complication rates comprising pneumonia, bleeding events and 2.5-fold increased case-fatality.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109499"},"PeriodicalIF":3.4,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials","authors":"Luis Ortega-Paz ,&nbsp;Azita H. Talasaz ,&nbsp;Parham Sadeghipour ,&nbsp;Sina Rashedi ,&nbsp;Jean M. Connors ,&nbsp;Dominick J. Angiolillo ,&nbsp;Larisa H. Cavallari ,&nbsp;David Jimenez ,&nbsp;Gabriela Bastidas ,&nbsp;Elizabeth Lorenzi ,&nbsp;Lindsay R. Berry ,&nbsp;Thomas Hills ,&nbsp;Daniel Francis McAuley ,&nbsp;Tayyab Shah ,&nbsp;Alexandra J. Lansky ,&nbsp;Siddharthan Deepti ,&nbsp;Hernando Guillermo Gaitán-Duarte ,&nbsp;Tatjana S. Potpara ,&nbsp;Mattia Galli ,&nbsp;Dave L. Dixon ,&nbsp;Behnood Bikdeli","doi":"10.1016/j.thromres.2025.109484","DOIUrl":"10.1016/j.thromres.2025.109484","url":null,"abstract":"<div><h3>Aims</h3><div>Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospitalized patients with COVID-19 remains unclear due to the limited power of existing randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Embase, and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> was conducted through July 17th, 2024. RCTs were included if they compared statin therapy to control (placebo or standard care) in hospitalized COVID-19 patients and enrolled at least 250 randomized participants. Studies with co-treatment were considered in sensitivity analyses. The primary effectiveness outcome was 30-day all-cause death. The main safety outcomes were myopathy and rise in liver enzymes.</div></div><div><h3>Results</h3><div>Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7 % female, average follow-up duration 37 days). Compared with control, statin therapy was associated with reduced all-cause death (20.9 % vs. 23.8 %; odds ratio [OR]: 0.82, 95 % confidence interval [CI] 0.70–0.96; <em>P</em> = 0.01), with a small but significant increase in myopathy (0.6 % vs. 0 %; risk difference: 0.00, 95 % CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0 % vs. 1.4 %; OR 1.00, 95 % CI: 0.25–3.99). A sensitivity analysis including two additional RCTs that included randomized co-treatments yielded similar findings. There were no significant interactions for effectiveness by disease severity (critically vs. non-critically ill, <em>P</em> = 0.38) or sex (males vs. females, <em>P</em> = 0.83).</div></div><div><h3>Conclusion</h3><div>Among hospitalized patients with COVID-19, statin therapy was associated with a significant reduction in 30-day all-cause death compared with control and exhibited an excellent safety profile.</div></div><div><h3>Study registration</h3><div>This study is registered in PROSPERO (CRD42023478764).</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"255 ","pages":"Article 109484"},"PeriodicalIF":3.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}