Sara R. Vazquez , Connor Jensen , Aaron S. Wilson , Daniel M. Witt
{"title":"Who are we bridging? Description of warfarin patients receiving injectable bridging therapy","authors":"Sara R. Vazquez , Connor Jensen , Aaron S. Wilson , Daniel M. Witt","doi":"10.1016/j.thromres.2025.109303","DOIUrl":"10.1016/j.thromres.2025.109303","url":null,"abstract":"<div><h3>Purpose</h3><div>The evidence guiding the decision to provide injectable anticoagulant bridging therapy during periods of subtherapeutic warfarin anticoagulation is sparse. This study aims to identify the types of patients currently bridged within an academic medical center's Thrombosis Service, to highlight patient populations for future study of bridging outcomes.</div></div><div><h3>Methods</h3><div>This descriptive cohort study included patients taking warfarin managed by University of Utah Health Thrombosis Service who received outpatient enoxaparin bridging between January 1 and December 31, 2022. Anticoagulation indication, reason for bridging, and type of procedure were validated via manual chart review.</div></div><div><h3>Results</h3><div>During the one-year study period, 181 unique patients (9.4 % of the service's total warfarin population) experienced 244 bridging episodes, mostlyin the periprocedural setting (67.6 %) for gastrointestinal-type procedures (39.4 %). The most common anticoagulation indications in all bridged patients were antiphospholipid syndrome (APS) (23.2 %), venous thromboembolism (VTE) (21.5 %), or a mechanical mitral valve plus another indication (13.3 %). Most bridging episodes for VTE occurred >3 months from the acute event, with the rationale for bridging including breakthrough VTE (31 %) or APS (23 %). Just over one-half of bridged patients fit the guideline-recommended criteria for high thrombotic risk, and just over one-third were low-moderate thrombotic risk.</div></div><div><h3>Conclusions</h3><div>In this one-year outpatient study, warfarin patients received enoxaparin bridging most commonly due to a gastrointestinal procedural interruption in the setting of APS, VTE with a prior breakthrough thrombotic event, or mechanical mitral valve. Just over one-third of bridged patients were guideline-classified as low-moderate thrombotic risk, indicating these populations may warrant further investigation or bridging de-escalation.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"249 ","pages":"Article 109303"},"PeriodicalIF":3.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620418","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":"Efficacy and safety of antithrombin or recombinant human thrombomodulin in the treatment of disseminated intravascular coagulation: A systematic review and meta-analysis","authors":"Wenchi Li , Shuyue Sheng , Feng Zhu","doi":"10.1016/j.thromres.2025.109302","DOIUrl":"10.1016/j.thromres.2025.109302","url":null,"abstract":"<div><h3>Objective</h3><div>Multiple organ damage is a hallmark of the highly lethal condition known as disseminated intravascular coagulation (DIC). The efficacy and safety of recombinant human soluble thrombomodulin (rhTM) and antithrombin (AT) in DIC is still debatable. Therefore, we used a fixed-effects model to conduct a comprehensive evaluation and meta-analysis to examine the safety and efficacy of AT or rhTM administration for treating DIC.</div></div><div><h3>Methods</h3><div>Up until September 2024, the databases of the Cochrane Library, Embase, Web of Science, PubMed, and CNKI were searched for pertinent papers that satisfied the inclusion requirements. Following the researchers' review of the literature, data extraction, and quality assessment, RevMan 5.4 software was used to conduct meta-analysis.</div></div><div><h3>Results</h3><div>The AT group included two randomized controlled trials with 95 patients, 47 in the test and 48 in the control groups. The test group's DIC resolution rate was higher than the control group's (OR = 5.21 [2.10, 12.90], P = 0.0004), while the 28-day mortality and bleeding-related adverse events did not differ significantly (OR = 0.45 [0.16, 1.31], P = 0.14; OR = 1.02 [0.22, 4.74], P = 0.98). Of the 1105 patients in the rhTM group, 554 were in the trial group and 551 were in the control group across four randomized controlled trials. The trial group showed a greater rate of DIC resolution than the control group (OR = 1.76 [1.34, 2.30], P < 0.0001), although there was no significant difference in the 28-day mortality rate or bleeding-related adverse events. (OR = 0.79 [0.59, 1.05], P = 0.11; OR = 1.08 [0.63, 1.86], P = 0.78).</div></div><div><h3>Conclusion</h3><div>Both AT and rhTM therapy improved the rate of symptomatic relief in patients with DIC without increasing the risk of bleeding, but there was no benefit in terms of their mortality.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"249 ","pages":"Article 109302"},"PeriodicalIF":3.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578036","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}
Sergio Moragón-Ledesma , Rubén Alonso-Beato , Francisco Galeano-Valle , Lucía Ordieres-Ortega , Marina López-Rubio , Marta-Olimpia Lago-Rodríguez , Luis Antonio Alvarez-Sala-Walther , Pablo Demelo-Rodríguez
{"title":"Clinical outcomes of direct oral anticoagulants in patients with thrombosis in unusual sites: Insights from a tertiary care center","authors":"Sergio Moragón-Ledesma , Rubén Alonso-Beato , Francisco Galeano-Valle , Lucía Ordieres-Ortega , Marina López-Rubio , Marta-Olimpia Lago-Rodríguez , Luis Antonio Alvarez-Sala-Walther , Pablo Demelo-Rodríguez","doi":"10.1016/j.thromres.2025.109301","DOIUrl":"10.1016/j.thromres.2025.109301","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"249 ","pages":"Article 109301"},"PeriodicalIF":3.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578037","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}
Kun Liu , Can Hu , Ling-yun Zhou , Zhi-yao Tang , Yi-feng Wu , Yu-jie Huang , Xiao-cong Zuo
{"title":"The efficacy and safety of low-molecular-weight heparins for venous thromboembolism prophylaxis in abdominal or pelvic cancer surgery: A systematic review and network meta-analysis of randomized controlled trials","authors":"Kun Liu , Can Hu , Ling-yun Zhou , Zhi-yao Tang , Yi-feng Wu , Yu-jie Huang , Xiao-cong Zuo","doi":"10.1016/j.thromres.2025.109294","DOIUrl":"10.1016/j.thromres.2025.109294","url":null,"abstract":"<div><h3>Background</h3><div>Low-molecular-weight heparins (LMWHs) have been widely used for thromboprophylaxis in postoperative patients with abdominal or pelvic cancer. However, evidence regarding the optimal type of LMWHs remains limited.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the efficacy and safety of different types of LMWHs in patients undergoing abdominal or pelvic cancer surgery through a network meta-analysis of randomized controlled trials (RCTs).</div></div><div><h3>Methods</h3><div>The network meta-analysis was guided by the PRISMA guidelines. The primary outcomes included venous thromboembolism (VTE), major bleeding, and all-cause death. Results were summarized with relative ratios (RR) and 95 % confidence intervals (CIs). The surface under the cumulative ranking curve (SUCRA) was calculated to assess the performance of various LMWHs.</div></div><div><h3>Results</h3><div>A total of 19 RCTs involving 6318 patients were identified. Compared to non-LMWH, LMWHs significantly reduced the risk of VTE [RR 0.57, (95 % CI 0.41–0.81)], DVT [RR 0.56, (95 % CI 0.39–0.81)], and PE [RR 0.26, (95 % CI 0.10–0.66)], without increasing the risk of all-cause death [RR 0.67, (95 % CI 0.39–1.14)], major bleeding [RR 1.51, (95 % CI 0.82–2.77)], minor bleeding [RR 1.23, (95 % CI 0.84–1.80)], all bleeding [RR 1.35, (95 % CI 0.98–1.84)], or thrombocytopenia [RR 0.41, (95 % CI 0.13–1.31)]. Notably, no significant differences in efficacy and safety were observed among different types of LMWHs, with parnaparin (SUCRA 86.3), dalteparin (SUCRA 74.5), and certoparin (SUCRA 88.5) ranking highest in the prevention of VTE, major bleeding, and all-cause death, respectively.</div></div><div><h3>Conclusion</h3><div>LMWHs are efficacious options for thromboprophylaxis in patients undergoing abdominal or pelvic cancer surgery, without increasing the risk of major bleeding or all-cause death. However, no significant differences were observed in efficacy and safety among different types of LMWHs used in this context.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"249 ","pages":"Article 109294"},"PeriodicalIF":3.7,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549092","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}
Mia Giertz , Henri Aarnivala , Sascha W. Michelsen , Caroline Björklund , Marika Grönroos , Lisa L. Hjalgrim , Pasi Huttunen , Riitta Niinimäki , Tuuli Pöyhönen , Päivi Raittinen , Susanna Ranta , Johan E. Svahn , Lisa Törnudd , Annika Englund , Arja Harila
{"title":"Venous thromboembolism in children with Hodgkin lymphoma – A population-based study in Sweden, Finland, and Denmark","authors":"Mia Giertz , Henri Aarnivala , Sascha W. Michelsen , Caroline Björklund , Marika Grönroos , Lisa L. Hjalgrim , Pasi Huttunen , Riitta Niinimäki , Tuuli Pöyhönen , Päivi Raittinen , Susanna Ranta , Johan E. Svahn , Lisa Törnudd , Annika Englund , Arja Harila","doi":"10.1016/j.thromres.2025.109287","DOIUrl":"10.1016/j.thromres.2025.109287","url":null,"abstract":"<div><h3>Background</h3><div>Children and adolescents with Hodgkin lymphoma (HL) are susceptible to developing venous thromboembolism (VTE) due to several predisposing factors such as cancer itself, central venous catheter use, mediastinal mass, and glucocorticoid therapy, yet reports on the topic are scarce.</div></div><div><h3>Aim</h3><div>To study incidence, risk factors, and treatment of VTE, and the use of thromboprophylaxis, in a retrospective clinical study on pediatric HL.</div></div><div><h3>Methods</h3><div>Children under 18, diagnosed with HL 2005–2019 in Sweden, Denmark, and Finland were included. Data on patient characteristics, treatment, thrombotic events and follow up were collected from patients' medical records.</div></div><div><h3>Results</h3><div>A total of 490 children were identified and data were assessed for 489. The cumulative 2-year incidence of VTE was 8.1 % (42/489). Older age at diagnosis (<em>p</em> = 0.004), mediastinal involvement (<em>p</em> = 0.024), and HL stage III + IV (<em>p</em> = 0.036) were significant risk factors for VTE. Children over 15 with mediastinal mass and HL stage III or IV had a 1-year cumulative incidence of VTE of 18 % and a nearly three-fold risk of developing VTE compared to all other patients (OR 2.94, 95 % CI 1.47–5.88, <em>p</em> = 0.002). The majority (39/42; 92.9 %) were treated with low-molecular-weight heparin. Four (9.5 %) patients developed post-thrombotic syndrome. Thromboprophylaxis was given to 18/489 (3.7 %) patients with HL, two of whom developed VTE.</div></div><div><h3>Conclusion</h3><div>VTE is a common complication in adolescents treated for HL with large tumor burden at diagnosis. Prospective studies should focus on identifying patients who would benefit from thromboprophylaxis.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"248 ","pages":"Article 109287"},"PeriodicalIF":3.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuko Mishima , Hisako Okada , Amir L. Butt , Kenneth E. Stewart , Michael A. Mazzeffi , Kenichi A. Tanaka
{"title":"In vitro procoagulant effects of Gla-domainless factor Xa in factor XI-deficient and factor IX-deficient plasma","authors":"Yuko Mishima , Hisako Okada , Amir L. Butt , Kenneth E. Stewart , Michael A. Mazzeffi , Kenichi A. Tanaka","doi":"10.1016/j.thromres.2025.109286","DOIUrl":"10.1016/j.thromres.2025.109286","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"247 ","pages":"Article 109286"},"PeriodicalIF":3.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428789","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}
Tzu-Fei Wang , Suhong Luo , Brian F. Gage , Martin W. Schoen , Amber Afzal , Kenneth Carson , Su-Hsin Chang , Amir Mahmoud , Kristen M. Sanfilippo
{"title":"Association between anticoagulant-related bleeding and mortality in patients with hematological malignancies and cancer-associated venous thromboembolism","authors":"Tzu-Fei Wang , Suhong Luo , Brian F. Gage , Martin W. Schoen , Amber Afzal , Kenneth Carson , Su-Hsin Chang , Amir Mahmoud , Kristen M. Sanfilippo","doi":"10.1016/j.thromres.2025.109284","DOIUrl":"10.1016/j.thromres.2025.109284","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with hematological malignancies are at an increased risk of severe bleeding. Anticoagulant (AC) therapy further increases this risk. Mortality after these bleeds is unclear and may differ by bleeding site.</div><div>Aim</div><div>To evaluate the association between bleeding and mortality in patients with hematological malignancies prescribed AC therapy for cancer-associated venous thromboembolism (VTE).</div></div><div><h3>Methods</h3><div>In a nationwide cohort of US Veterans (2012−2020), we identified patients with hematological malignancies and cancer-associated VTE prescribed AC therapy. Bleeding events were identified by a previously validated algorithm using hospitalization International Classification of Disease (ICD) codes. Within 12 months of AC therapy initiation, we evaluated the association between bleeding and mortality using multivariate Cox regression models, with AC-related bleeding analyzed as a time-varying covariate.</div></div><div><h3>Results</h3><div>The cohort included 1825 patients. Within 12 months of starting AC therapy, 123 (6.7 %) had bleeding events and 162 (8.9 %) patients died. Patients with bleeding events were more likely to have anemia, history of bleeding, aspirin use, chemotherapy use, and frailty. A multivariable Cox proportional-hazard model showed that AC-related bleeding was associated with tripled mortality rate (aHR 3.26, 95 % CI 1.96–5.45). When stratified by bleeding site, intracranial bleeding was associated with the highest risk of death (aHR 13.41, 95 % CI 4.13–43.48), followed by gastrointestinal bleeding (aHR 4.55, 95 % CI 2.48–8.35).</div></div><div><h3>Conclusion</h3><div>In this cohort of patients with hematological malignancies and newly diagnosed VTE initiated on AC therapy, bleeding was associated with an increased risk of mortality within 12 months. Association was highest with intracranial and gastrointestinal bleeding.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"248 ","pages":"Article 109284"},"PeriodicalIF":3.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437726","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}
Rafaela Vostatek , Marina Trappl , Cornelia Englisch , Philipp Hohensinner , Matthias Preusser , Ingrid Pabinger , Cihan Ay
{"title":"Mitochondrial DNA copy number and its association with venous thromboembolism in patients with cancer","authors":"Rafaela Vostatek , Marina Trappl , Cornelia Englisch , Philipp Hohensinner , Matthias Preusser , Ingrid Pabinger , Cihan Ay","doi":"10.1016/j.thromres.2025.109285","DOIUrl":"10.1016/j.thromres.2025.109285","url":null,"abstract":"<div><div>Venous thromboembolism (VTE) is a common and serious complication among cancer patients. Mitochondrial DNA (mtDNA) copy number is known to influence various cellular pathways involved in cancer development. While an association between reduced mtDNA and VTE risk in non-cancer patients was previously reported, its relationship with VTE in cancer patients remains unclear.</div><div>Therefore, we aimed to investigate the association between mtDNA copy number and VTE risk in a nested-case control study of 48 patients from the Vienna Cancer and Thrombosis Study (CATS), a prospective observational cohort study. The mtDNA copy number was measured in equally distributed age, sex, cancer type, and stage matched patients with and without VTE using a qPCR-based method.</div><div>Of the 48 patients, 24 were diagnosed with VTE (median age [IQR] 62 [57–60] years, 54.2 % female) and 24 had no VTE event (median age [IQR] 63 [58–71] years, 54.2 % female). We found that patients who developed VTE had lower mtDNA copy numbers compared to those without VTE (216.73 [167.99–401.39] vs 301.47 [210.66–526.84]). Multivariable analysis adjusting for chronological age, D-dimer, sex, cancer stage and BMI revealed that each 10-unit increase in mtDNA copy number decreased the odds of VTE occurrence by 5.9 % (<em>p</em> = 0.021). Patients with distant metastatic cancer (M1) had lower mtDNA copy numbers than those without distant metastasis at study inclusion (220.34 [172.67–323.70] vs 328.48 [213.89–556.68; <em>p</em> = 0.052).</div><div>Overall, our findings suggest a potential link between reduced mtDNA copy number and increased VTE risk in cancer patients.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"248 ","pages":"Article 109285"},"PeriodicalIF":3.7,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acquired factor XI deficiency in paediatrics patients: A French series and review of literature cases","authors":"Julie Avoine , Annie Harroche , Saba Azarnoush , Yoann Huguenin , Adeline Blandinieres , Emanuelle De Raucourt , Caroline Galeotti , Alexandre Theron","doi":"10.1016/j.thromres.2025.109282","DOIUrl":"10.1016/j.thromres.2025.109282","url":null,"abstract":"<div><div>Acquired factor XI (FXI) deficiency of autoimmune origin is a rare condition, with only a few cases in children having been documented in the literature. In this study, we present a series of four pediatric patients from France who have been diagnosed with FXI deficiency of autoimmune origin and review four cases from the literature. The majority of patients were adolescents, and many had associated autoimmune disorders. The bleeding symptoms manifested as mild or non-existent, and despite the anticipated hemorrhagic phenotype, two patients exhibited thrombotic episodes, one of which was associated with the administration of prophylactic treatment with activated factor VII.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"247 ","pages":"Article 109282"},"PeriodicalIF":3.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387348","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}
Robert J. Trager , Catherine P. Haering , Anthony N. Baumann , Debbie S. Wright
{"title":"Association between combined oral contraceptive prescription and cervical artery dissection: A retrospective cohort study","authors":"Robert J. Trager , Catherine P. Haering , Anthony N. Baumann , Debbie S. Wright","doi":"10.1016/j.thromres.2025.109279","DOIUrl":"10.1016/j.thromres.2025.109279","url":null,"abstract":"<div><h3>Background</h3><div>To date, research has identified positive associations between combined oral contraceptives (COCs) and adverse vascular events, however, evidence regarding the possible association with cervical artery dissection (CeAD) remains limited. We tested the hypothesis of a positive association between COCs and CeAD within one year following COC initiation compared to matched controls initiating intrauterine devices (IUDs), as measured by risk ratio (RR).</div></div><div><h3>Methods</h3><div>We queried de-identified United States health records data (TriNetX, Inc.) from 2014 to 2024 for females aged 15–50 years without previous cerebrovascular disease or CeAD, creating mutually exclusive cohorts initiating either COCs or IUDs. We used propensity matching to control for variables associated with CeAD. Our primary outcome included the RR for CeAD within one year follow-up. We secondarily explored cumulative CeAD incidence and RR of stroke, also examining outcomes for females with ≥2 COC prescriptions (COC2).</div></div><div><h3>Results</h3><div>After matching there were 214,020 patients per cohort (mean age 31 years). The incidence and risk of CeAD was greater among those prescribed COCs compared to matched controls with IUDs [95 % CI] (COCs: 0.016 %, IUDs: 0.008 %; RR 1.94 [1.10,3.43]; <em>P</em> = 0.0195). A similar association was observed for stroke (COCs: 0.106 %, IUDs: 0.057 %; RR = 1.86 [1.49,2.32]; <em>P</em> < 0.0001). The secondary COC2 analysis revealed similar findings.</div></div><div><h3>Conclusions</h3><div>The present findings suggest that females prescribed COCs have an increased risk of CeAD and stroke compared to matched controls using IUDs. These observations should be viewed as preliminary, require corroboration by other studies, and in isolation do not replace the broader clinical and shared decision-making regarding contraceptive use.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"247 ","pages":"Article 109279"},"PeriodicalIF":3.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}