Thrombosis research最新文献

{"title":"Effectiveness and safety of postoperative hemostatic drugs in colorectal cancer: A retrospective analysis of a prospectively collected multicenter database using inverse probability of treatment weighting","authors":"Qi Wei, Yang Li, Changqing Lin, Liting Sun, Hongwei Yao, Yongxiang Li, the CRC-VTE Investigators","doi":"10.1016/j.thromres.2026.109827","DOIUrl":"10.1016/j.thromres.2026.109827","url":null,"abstract":"<div><h3>Background</h3><div>Hemostatic drugs are frequently prescribed after colorectal cancer (CRC) surgery to prevent bleeding. However, in real–world practice, their net clinical benefit and thrombotic safety remain uncertain. This study aimed to evaluate the effectiveness and safety of prophylactic postoperative hemostatic drug use after CRC surgery.</div></div><div><h3>Methods</h3><div>This retrospective analysis was based on a prospectively collected multicenter CRC–venous thromboembolism (VTE) database involving 46 tertiary centers across 17 provinces in China between May 2021 and May 2022. Adults who underwent elective curative CRC surgery were included and followed up for 28 days. Exposure was defined as initiation of any prophylactic postoperative hemostatic drug (tranexamic acid, hemocoagulase, or carbazochrome sodium sulfonate) within 0–48 h after surgery in the absence of active bleeding at the first administration. Primary outcome was postoperative bleeding within 28 days; a surrogate outcome was hemoglobin decrease (dHb) ≥20 g/L. The secondary outcome was imaging-confirmed VTE, defined as postoperative DVT and/or PE; DVT was systematically screened within prespecified follow-up windows, whereas PE was assessed when clinically suspected. Inverse probability of treatment weighting (IPTW) based on propensity scores was used to balance baseline covariates, followed by weighted logistic regression.</div></div><div><h3>Results</h3><div>Among 1810 patients, 322 (17.8%) received prophylactic postoperative hemostatic drugs. After IPTW, all covariates achieved adequate balance, with standardized mean differences <0.10. Hemostatic drug use was not associated with reduced postoperative bleeding (2.9% vs. 1.7%; weighted odds ratio [OR]: 1.72, 95% confidence interval [CI]: 0.77–3.86) or dHb ≥20 g/L (21.4% vs. 26.1%; weighted OR: 0.77, 95% CI: 0.55–1.06). In contrast, hemostatic drug use was associated with a higher postoperative VTE rate (13.8% vs. 9.5%; weighted OR: 1.51, 95% CI: 1.02–2.24), mainly driven by DVT without PE, whereas PE events were rare and did not differ significantly between groups. Additional analyses showed that this association was also observed for symptomatic VTE (4.7% vs. 2.3%; weighted OR: 2.12, 95% CI: 1.03–4.37), whereas the association for asymptomatic/screening-detected VTE was not statistically significant after IPTW. Most VTE events with a DVT component involved distal DVT. Sensitivity analyses using winsorized weights yielded consistent estimates, and Propensity score trimming excluded no participants, supporting adequate overlap. In multivariable analysis, tumor–node–metastasis stage III–IV (OR: 3.20, 95% CI: 1.31–7.79) and intraoperative blood loss ≥50 mL (OR: 3.15, 95% CI: 1.20–8.22) were independent predictors of postoperative bleeding.</div></div><div><h3>Conclusions</h3><div>In this retrospective analysis of a prospectively collected multicenter database, routine prophylactic postoperative hemostatic dru","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"265 ","pages":"Article 109827"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913661","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":"Dysregulated autophagic flux is associated with intrinsic platelet dysfunction in heatstroke-induced coagulopathy","authors":"Mei-Fang Chou,&nbsp;Hung-Yen Ke,&nbsp;Shih-Yao Kao,&nbsp;Cheng-Ming Tsao,&nbsp;Chin-Chen Wu,&nbsp;Chih-Chin Shih","doi":"10.1016/j.thromres.2026.109831","DOIUrl":"10.1016/j.thromres.2026.109831","url":null,"abstract":"<div><h3>Introduction</h3><div>Heatstroke progresses from acute thermal injury to multiorgan dysfunction syndrome and heatstroke-induced coagulopathy (HIC). Although consumptive thrombocytopenia is a known hallmark of HIC, whether surviving platelets develop intrinsic qualitative impairments remains unclear. Autophagy maintains platelet mitochondrial quality and energy homeostasis, thereby ensuring appropriate platelet responsiveness to activating stimuli. However, its specific role in heatstroke-induced platelet dysfunction remains unexplored. This study examined the hemodynamic, hemostatic, and molecular consequences of heatstroke, focusing on platelet autophagic flux.</div></div><div><h3>Materials and methods</h3><div>Male Wistar rats were subjected to environmental heat stress (42 °C) until their core temperature reached 41.1 °C. Hemodynamic parameters and multiorgan injury markers were monitored during the experimental period. At 6 h after heat stress, coagulation profiles and platelet functional experiments were assessed using platelet-count-adjusted platelet-rich plasma to differentiate qualitative dysfunction from quantitative depletion. Various platelet autophagy markers were evaluated through Western blotting.</div></div><div><h3>Results</h3><div>Heatstroke induced acute hyperthermia and compensatory cardiovascular responses, followed by hypotension, tachycardia, multiorgan dysfunction, thrombocytopenia, and prolonged coagulation times. Platelet functions were impaired following heatstroke, as evidenced by reduced platelet aggregation, fibrinogen binding, CD62P (P-selectin) expression, adhesion, and spreading. Furthermore, heatstroke was associated with decreased levels of the autophagy-related proteins Atg7, Beclin1, and LC3B, as well as the mitophagy-associated protein PINK1, accompanied by increased levels of BCL2 and p62.</div></div><div><h3>Conclusions</h3><div>Multiorgan metabolic catastrophe coincides with substantial count-independent qualitative platelet dysfunction associated with arrested autophagic flux and impaired mitophagy in heatstroke. These findings challenge reliance on platelet count alone for managing HIC and highlight the autophagic machinery as a potential therapeutic target.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"265 ","pages":"Article 109831"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913700","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":"Peri-procedural management of direct oral anticoagulants for central VENOus catheters in CAncer patients with venous Thromboembolism or atrial fibrillation (VENO CAT): Health Care Practitioner Survey","authors":"Jameel Abdulrehman,&nbsp;Joseph R. Shaw,&nbsp;Steffan Frosi Stella,&nbsp;Sebastian Mafeld,&nbsp;Jim Douketis,&nbsp;Rita Selby,&nbsp;Peter L. Gross,&nbsp;Marc Carrier","doi":"10.1016/j.thromres.2026.109828","DOIUrl":"10.1016/j.thromres.2026.109828","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"265 ","pages":"Article 109828"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148937293","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":"OPtimal TIming for Reperfusion in Acute Pulmonary Embolism: Rationale and design of the OPTIRAPE registry","authors":"Marco Zuin,&nbsp;Cecilia Becattini,&nbsp;Alice Sacco,&nbsp;Guido Tavazzi,&nbsp;Claudia Colombo,&nbsp;Rosalinda Madonna,&nbsp;Maria Cristina Vedovati,&nbsp;Chiara Dalla Valle,&nbsp;Catia De Rosa,&nbsp;Stefano Ghio,&nbsp;Leonardo De Luca,&nbsp;Pier Luigi Temporelli,&nbsp;Giuseppe Musumeci,&nbsp;Rigatelli Gianluca,&nbsp;Fabrizio Oliva,&nbsp;Raffaele De Caterina,&nbsp;Claudio Bilato,&nbsp;OPTIRAPE Investigators","doi":"10.1016/j.thromres.2026.109824","DOIUrl":"10.1016/j.thromres.2026.109824","url":null,"abstract":"<div><h3>Background</h3><div>The optimal timing of reperfusion therapy in acute pulmonary embolism (PE) remains uncertain, despite guideline recommendations supporting urgent intervention in high-risk and selected intermediate-high-risk presentations.</div></div><div><h3>Objective</h3><div>The OPTIRAPE registry (Optimal Timing for Reperfusion in Acute Pulmonary Embolism) aims to evaluate the association between reperfusion timing and in-hospital outcomes and to characterize real-world treatment patterns and system-related delays in patients undergoing systemic thrombolysis (ST) or catheter-directed therapies (CDTs).</div></div><div><h3>Design and interventions</h3><div>OPTIRAPE (<span><span>NCT07436702</span><svg><path></path></svg></span>) is a prospective, multicentre, observational registry enrolling consecutive adults with acute high-risk or intermediate-high-risk PE undergoing ST or CDTs reperfusion therapy across seven Italian hospitals with 24/7 access to advanced imaging and reperfusion strategies. Treatment decisions are based on the 2019 European Society of Cardiology guidelines and local practice, without protocol-mandated interventions.</div></div><div><h3>Study outcomes</h3><div>The primary exposure is time-to-reperfusion, defined as the interval from diagnostic confirmation of high-risk PE, or, in intermediate-high-risk patients, from clinical deterioration to initiation of reperfusion therapy. The primary endpoint is in-hospital mortality. Secondary endpoints include major bleeding, early haemodynamic deterioration, need for mechanical circulatory or respiratory support, recurrent venous thromboembolism, intensive care unit admission, and length of hospital stay.</div></div><div><h3>Implication</h3><div>OPTIRAPE will provide granular real-world data on reperfusion timing, treatment modality, and inter-hospital variability in severe PE management. It will quantify the relationship between treatment delays and in-hospital outcomes and explore potential time thresholds associated with improved survival, informing future guideline recommendations and supporting the implementation of standardized, time-sensitive reperfusion pathways in acute PE.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"265 ","pages":"Article 109824"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892299","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":"Tranexamic acid and its use in early pregnancy; a scoping review","authors":"Chung Bethany,&nbsp;Santiapillai Georgina,&nbsp;Memtsa Maria,&nbsp;Abdul-Kadir Rezan","doi":"10.1016/j.thromres.2026.109811","DOIUrl":"10.1016/j.thromres.2026.109811","url":null,"abstract":"<div><h3>Background</h3><div>Bleeding in early pregnancy is reported in 1 in 4 of pregnancies and is linked to increased risks of miscarriage, preterm birth, low birth weight, placental abruption, and stillbirth. Current treatments are limited and none of the recommended treatments target cessation of bleeding. Tranexamic acid (TXA), an antifibrinolytic agent, presents a potential option for halting bleeding in early pregnancy, potentially reducing the risk of associated adverse outcomes.</div></div><div><h3>Aims</h3><div>To review the current literature on the use and efficacy of TXA in early pregnancy.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using JBI methodology. Searches were performed in Embase, Medline, CENTRAL, and grey literature. Three separate searches assessed TXA's efficacy in early pregnancy, safety profile during pregnancy, and potential teratogenicity.</div></div><div><h3>Results</h3><div>Four studies met inclusion criteria for efficacy: three non-randomised prospective trials and one observational study, totaling 319 patients. Studies had small sample sizes and varied methodologies. For safety, 30 studies involving 76,302 patients were included: 13 systematic reviews/meta-analyses, 13 RCTs, 2 retrospective cohorts, 1 prospective case-control study, and 1 open-label dose-ranging study. Most focused on postpartum haemorrhage. No significant increase in venous thromboembolism was observed with TXA versus control. No case-control studies evaluated teratogenicity directly. However, 22 studies from 14 countries reported TXA use in pregnancy (not related to postpartum haemorrhage). Among 234 pregnancies exposed to TXA, 230 (98%) resulted in live births.</div></div><div><h3>Conclusion</h3><div>Evidence for TXA use in early pregnancy is limited, with small, low-quality studies. Larger, high-quality trials are needed to determine safety and efficacy.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"265 ","pages":"Article 109811"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857788","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":"Direct oral anticoagulants versus vitamin K antagonists after venous thrombosis in antiphospholipid syndrome: Recurrence, safety, and exploratory phenotype analysis. A real-life cohort study","authors":"Ariela Hoxha,&nbsp;Giovanni Gobbo,&nbsp;Elena Campello,&nbsp;Luca Spiezia,&nbsp;Paolo Scarinzi,&nbsp;Ezio Zanon,&nbsp;Stéfan Zuily,&nbsp;Walter Ageno,&nbsp;Paolo Simioni","doi":"10.1016/j.thromres.2026.109805","DOIUrl":"10.1016/j.thromres.2026.109805","url":null,"abstract":"<div><h3>Background</h3><div>Evidence comparing direct oral anticoagulants (DOACs) with vitamin K antagonists (VKAs) remains uncertain, particularly in patients whose index event is venous thromboembolism (VTE).</div></div><div><h3>Objective</h3><div>To compare the effectiveness and safety of DOACs versus VKAs after an index VTE in APS and, as an exploratory objective, to identify APS features associated with recurrent thrombosis (rTEs).</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of 84 consecutive adults fulfilling 2023 ACR/EULAR APS classification criteria and followed between 2010 and 2025 after an index VTE. Patients received VKAs (n = 54) or DOACs (n = 30). The primary efficacy outcome was rTEs during treatment; bleeding was the primary safety outcome. Time-to-event and propensity-score methods were used to address differences between treatment groups. Phenotype analyses were considered exploratory.</div></div><div><h3>Results</h3><div>Over 686.2 patient-years, 25 rTEs occurred. Recurrence was more frequent with DOACs than with VKAs (46.7% vs. 20.4%; p = 0.012), with incidence rates of 12.2 and 1.9 events per 100 patient-years, respectively. In multivariable Cox analysis, DOACs exposure was associated with earlier recurrence (HR 4.1, 95% CI 1.7–10.3; p = 0.002), and the association remained in propensity-score analyses. Microvascular involvement was more frequent among patients with rTEs (40.0% vs. 13.6%; p = 0.007). Bleeding rates were low and did not differ significantly between groups.</div></div><div><h3>Conclusions</h3><div>In this single-centre cohort restricted to APS patients with an index VTE, DOACs exposure was associated with more frequent and earlier recurrent thrombosis than VKAs therapy, without an evident bleeding advantage. Microvascular involvement may mark a higher-risk phenotype, but this exploratory finding requires confirmation in larger prospective cohorts.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"265 ","pages":"Article 109805"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857732","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":"Diverse antiphospholipid syndromes and beyond: A multicenter comprehensive analysis from the Egyptian College of Rheumatology","authors":"Noha A. Azab,&nbsp;Eman I. ElGazzar,&nbsp;Samar Tharwat,&nbsp;Hanan El-Saadany,&nbsp;Rawhya El-Shereef,&nbsp;Nesrin A. AboEladl,&nbsp;Yousra H. Abdel-Fattah,&nbsp;Marwa ElKhalifa,&nbsp;Amira T. El-Shanawany,&nbsp;Rasha M. Fawzy,&nbsp;Soha Senara,&nbsp;Mohamed N. Salem,&nbsp;Faten Ismail,&nbsp;Abdelhfeez Moshrif,&nbsp;Ehab Saad,&nbsp;Ahmed M. Abdalla,&nbsp;Omnia ElBayumi,&nbsp;Osman Hammam,&nbsp;Nevin Hammam,&nbsp;Tamer Gheita","doi":"10.1016/j.thromres.2026.109791","DOIUrl":"10.1016/j.thromres.2026.109791","url":null,"abstract":"<div><h3>Background</h3><div>Antiphospholipid syndrome (APS) is a complex autoimmune thrombo-inflammatory disorder characterized by diverse clinical manifestations and heterogeneous antibody profiles. We aimed to characterize the demographic, clinical, laboratory features, and treatment patterns of primary (PAPS) and secondary antiphospholipid syndrome (SAPS) patients in Egypt.</div></div><div><h3>Methods</h3><div>A total of 510 APS patients were recruited from 14 rheumatology centers. Data on demographics, clinical manifestations, serologic findings, and medications were analyzed.</div></div><div><h3>Results</h3><div>The cohort included 406 females and 104 males (mean age: 32.0 ± 8.7 years); 42.4% had PAPS and 57.6% SAPS. SAPS patients had an earlier disease onset (<em>p</em> = 0.008). Thrombotic events and pregnancy morbidity were more common in PAPS (40.7% and 83.8%) than SAPS (19% and 47.3%) (<em>p</em> &lt; 0.0001). In contrast, mucocutaneous symptoms, arthritis, oral ulcers, gastrointestinal, pulmonary, renal, and cardiovascular involvement, as well as ANA, anti-dsDNA positivity, and complement consumption, were significantly more frequent in SAPS (<em>p</em> &lt; 0.0001). Antiphospholipid (APL) antibodies positivity was more common in PAPS (p &lt; 0.0001). Ocular and CNS manifestations, along with APL positivity, were notably higher in males (<em>p</em> = 0.002, <em>p</em> = 0.02, and p &lt; 0.0001, respectively). A lupus like presentation was seen in 10.6% of PAPS, All ANA and anti dsDNA positive. Seronegative PAPS constituted 7.9% of cases and had higher thrombotic rates (<em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>PAPS and SAPS share several key features but exhibit clinical and serological profiles. Male APS patients more frequently present with ocular, and CNS involvement, and are more likely to be APL positive. Subsets of PAPS, including lupus like and seronegative forms, require further investigation.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109791"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621536","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":"Descriptive analysis of the Nationwide START2 antiphospholipid registry: Clinical and laboratory characteristics of patients with persistently positive antiphospholipid antibodies","authors":"Vittorio Pengo,&nbsp;Daniela Poli,&nbsp;Luca Sarti,&nbsp;Piera Sivera,&nbsp;Doris Barcellona,&nbsp;Domenico Prisco,&nbsp;Attilia Maria Pizzini,&nbsp;Giuseppe Vercillo,&nbsp;Emilia Antonucci,&nbsp;Gualtiero Palareti","doi":"10.1016/j.thromres.2026.109786","DOIUrl":"10.1016/j.thromres.2026.109786","url":null,"abstract":"<div><h3>Background</h3><div>The clinical significance of persistently positive antiphospholipid antibodies (aPLs) remains incompletely defined.</div></div><div><h3>Objectives</h3><div>To describe the clinical and laboratory characteristics of patients with confirmed aPL positivity enrolled in the nationwide START2 Antiphospholipid Registry.</div></div><div><h3>Methods</h3><div>Adult patients were included if all three laboratory tests—Lupus Anticoagulant (LA), anticardiolipin antibodies (aCL), and anti-β2-glycoprotein I antibodies (aβ2GPI)—were performed and confirmed after ≥12 weeks. Patients were categorized as Antiphospholipis Syndrome (APS) or aPL carriers. Clinical manifestations, non-criteria features, laboratory profiles, associated risk factors, and antithrombotic treatments were analyzed descriptively.</div></div><div><h3>Results</h3><div>Among 500 enrolled patients, 341 were classified as APS and 159 as carriers. Women were overrepresented among carriers (76% vs 62%, <em>p</em> = 0.002). APS patients displayed a higher prevalence of non-criteria manifestations, largely driven by renal involvement in those with SLE. Laboratory profiles were similarly distributed across APS and carriers: triple positivity (43% vs 44%), double positivity (13% vs 12%), and isolated LA positivity (23% vs 30%). Venous thromboembolism (VTE) occurred more frequently in APS patients LA-positive only (67%, <em>p</em> = 0.004), while arterial thrombosis was more evenly distributed across profiles. After a first VTE, most APS patients received warfarin (62%), whereas arterial APS was treated with either warfarin (51%) or aspirin (37%). Among carriers, aspirin was the preferred prophylactic strategy (45%).</div></div><div><h3>Conclusions</h3><div>Triple, double, and LA positive only represent the most common laboratory patterns. LA positivity omly shows a disproportionately high rate of VTE. Non-criteria manifestations remain more common in APS. Substantial variability persists in antithrombotic management, underscoring the need for prospective treatment trials.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109786"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654412","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":"Predicting chronic immune thrombocytopenia in children using IFNA17 rs9298814 polymorphism and clinical features: a study from a low- and middle-income country","authors":"Hong Nguyen Thi Mong,&nbsp;Thi Mong Ngoc Nguyen,&nbsp;Quang Vinh Bui,&nbsp;Thi My Lam,&nbsp;Nguyen The Nguyen Phung,&nbsp;Mai Anh Thi Nguyen","doi":"10.1016/j.thromres.2026.109799","DOIUrl":"10.1016/j.thromres.2026.109799","url":null,"abstract":"<div><div>Immune thrombocytopenia (ITP) is a common acquired hematologic disorder in childhood, with approximately 20–25% of children progressing to chronic disease. Early identification of those at risk remains a major clinical challenge. In this prospective cohort study, 205 children with newly diagnosed ITP at a tertiary center in Vietnam were followed for 12 months. Clinical and laboratory variables, along with IFNA17 rs9298814 genotype, were assessed. Multivariable analysis identified independent predictors of chronic ITP, defined as platelet counts &lt;100 × 10⁹/L persisting beyond 12 months. Of the 205 children, 48 (23.4%) developed chronic ITP. Older age at onset, a longer bleeding-onset duration, and a lower platelet count at 4 weeks were associated with chronic ITP, as was the IFNA17 rs9298814 TT genotype (homozygosity for the reference allele; i.e. absence of the G variant); conversely, carriage of the minor G allele was protective (G-allele odds ratio [OR] 0.10, 95% confidence interval [CI] 0.05–0.20; TT versus G-carrier OR 26.4, 95% CI 11.1–63.1). Two prediction models were developed and expressed as a risk score: a clinical model (age at onset, bleeding-onset duration, platelet count at 4 weeks, and antinuclear antibody status) with an area under the receiver operating characteristic curve (AUC) of 0.92 (95% CI 0.88–0.96), and an IFNA17-integrated model with a significantly improved AUC of 0.95 (95% CI 0.92–0.98; DeLong test <em>p</em> = 0.005). The integrated model demonstrated good calibration. A nomogram and bedside score were constructed for clinical application. Both clinical factors and host genetic variation contribute to the risk of chronic ITP in children. Integrating IFNA17 rs9298814 genotype into clinical prediction models improves early risk stratification. External validation in independent cohorts is warranted.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109799"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148738883","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":"Letter to the editor — Re: Pereira Portela et al., Thromb. Res. 2026 (10.1016/j.thromres.2026.109683) comments on thrombin generation in compensated cirrhosis","authors":"Rawan Alhamami,&nbsp;Amir L. Butt,&nbsp;Kenichi A. Tanaka","doi":"10.1016/j.thromres.2026.109790","DOIUrl":"10.1016/j.thromres.2026.109790","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109790"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631496","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}