Thrombosis research最新文献

{"title":"Aspirin dose, urinary thromboxane and prostacyclin metabolites, and clinical outcome in acute coronary syndrome: A nested case-control study from CURRENT-OASIS 7","authors":"John W. Eikelboom,&nbsp;Shamir R. Mehta,&nbsp;Qilong Yi,&nbsp;Jeffrey I. Weitz","doi":"10.1016/j.thromres.2026.109788","DOIUrl":"10.1016/j.thromres.2026.109788","url":null,"abstract":"<div><h3>Background</h3><div>Aspirin reduces urinary thromboxane, which predicts major adverse cardiovascular events (MACE) during aspirin therapy. However, in CURRENT-OASIS 7, higher-dose aspirin did not improve outcomes compared with lower-dose aspirin.</div></div><div><h3>Objectives</h3><div>To assess relationships between aspirin dose, urinary thromboxane and prostacyclin metabolites, and ischemic and bleeding outcomes, and to determine whether greater prostacyclin suppression with higher-dose aspirin explains the absence of clinical benefit.</div></div><div><h3>Methods</h3><div>In a nested case-control study within CURRENT-OASIS 7, urinary 11-dehydro thromboxane B2 (11-dTXB2) and 2,3-dinor-6-keto-prostaglandin F1α, corrected for creatinine and expressed as ng/mmol creatinine, were measured in patients not taking nonsteroidal anti-inflammatory drugs. Cases had myocardial infarction, ischemic stroke, or non-hemorrhagic cardiovascular death (n = 275), or major bleeding (n = 137); controls had neither ischemic nor bleeding events (n = 1014). Associations were assessed with multivariable logistic regression by quartiles and restricted cubic splines.</div></div><div><h3>Results</h3><div>Compared with aspirin 75–100 mg/day, aspirin 300–325 mg/day modestly lowered 11-dTXB2 (153.0 vs 164.3 ng/mmol creatinine; p = 0.03) and the 11-dTXB2/prostacyclin metabolite ratio (0.09 vs 0.10; p = 0.02) but not the prostacyclin metabolite (1767.1 vs 1694.5 ng/mmol creatinine; p = 0.25). Higher 11-dTXB2 quartiles predicted MACE, with adjusted odds ratios of 1.01, 2.38, and 3.44 for quartiles 2–4 versus quartile 1, whereas prostacyclin-metabolite quartiles did not. In spline analyses, 11-dTXB2 remained associated with MACE (p &lt; 0.0001), whereas the prostacyclin metabolite did not (p = 0.67).</div></div><div><h3>Conclusions</h3><div>In acute coronary syndrome, higher-dose aspirin modestly reduced urinary thromboxane without lowering the urinary prostacyclin metabolite. These findings do not support the hypothesis that systemic prostacyclin suppression by higher dose aspirin offsets any benefits of greater thromboxane suppression. Trial registration: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT00335452</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109788"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607722","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":"Phenotypic and glycosylation profiles of the FGG c.902G > A (p.Arg301His) mutation in a Chinese pedigree with congenital dysfibrinogenemia","authors":"Xiaozhen Kang,&nbsp;Luoyuan Cao,&nbsp;Weitong Peng,&nbsp;Xianxiang Peng,&nbsp;Jiaojiao Lu,&nbsp;Tao Zhang,&nbsp;Shouzhong Wei","doi":"10.1016/j.thromres.2026.109793","DOIUrl":"10.1016/j.thromres.2026.109793","url":null,"abstract":"<div><h3>Objective</h3><div>Congenital dysfibrinogenemia (CD) is characterized by functionally impaired fibrinogen. This study aimed to characterize the phenotypic, molecular, and clinical features associated with the <em><em>FGG</em></em> p.Arg301His mutation in a Chinese pedigree.</div></div><div><h3>Methods</h3><div>A Chinese pedigree comprising 12 members was enrolled, including 6 individuals carrying the <em><em>FGG</em></em> p.Arg301His mutation. Phenotypic evaluation was performed using conventional coagulation tests, thromboelastography (TEG), and thrombosis biomarker panels. Fibrinogen was purified from plasma and subjected to structural analysis via SDS-PAGE and LC-MS/MS mass spectrometry. Glycosylation profiles of the fibrinogen γ-chain were compared between mutation carriers and healthy controls. Molecular modeling was conducted to predict the structural effects of the mutation.</div></div><div><h3>Results</h3><div>Conventional coagulation tests combined with TEG effectively identified a hypocoagulable state in mutation carriers, whereas thrombosis biomarker panels showed limited diagnostic value. Structural analysis revealed markedly increased O-glycosylation sites (17 vs. 3) and N-glycosylated peptides (5 vs. 3) in the fibrinogen γ-chain of mutation carriers compared with controls. A unique glycan HexNAc(6)Hex(4)Fuc(2) was detected exclusively in the mutation group. Bioinformatic modeling predicted that the p.Arg301His substitution reduces hydrogen bonding, leading to conformational destabilization (ΔΔG ranging from −0.08 to −1.211 kcal/mol.). Clinically, female carriers experienced miscarriage and postpartum hemorrhage, while male carriers remained asymptomatic.</div></div><div><h3>Conclusion</h3><div>The <em><em>FGG</em></em> p.Arg301His mutation induces aberrant glycosylation and structural alterations in fibrinogen, contributing to functional impairment and a hypocoagulable state. These molecular changes may underlie the obstetric complications observed in female carriers. Integration of genetic, functional, glycosylation, and conformational analyses is of great significance for accurate assessment of bleeding and obstetric complication risks in patients with CD.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109793"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702289","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":"Corrigendum to “Assessing the risk of venous thromboembolism in trans masculine persons on gender-affirming hormone therapy: A literature review” [Thromb. Res. 256 (2025) 109516]","authors":"Juliette Hugueny,&nbsp;Anna de Ricolfis,&nbsp;Nicolaï Johnson,&nbsp;Nathalie Chabbert-Buffet,&nbsp;Sarra Cristofari","doi":"10.1016/j.thromres.2026.109804","DOIUrl":"10.1016/j.thromres.2026.109804","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109804"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798054","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":"Who says “no” – Patient-specific risk factors for refusal of venous thromboembolism chemoprophylaxis in hospitalized patients","authors":"Anitha Ramadoss,&nbsp;Sydney Graboyes-Griffin,&nbsp;Jeremiah J. Duby,&nbsp;Tricia Parker","doi":"10.1016/j.thromres.2026.109787","DOIUrl":"10.1016/j.thromres.2026.109787","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) increases morbidity and mortality for hospitalized patients. VTE chemoprophylaxis mitigates the risk of VTEs; however, missed doses are common. The purpose of this study was to investigate patient-specific risk factors for refusal of VTE chemoprophylaxis.</div></div><div><h3>Methods</h3><div>This was a retrospective, case-control study conducted at a large academic medical center. Adult, hospitalized patients (7/1/2021–6/30/2023) with active orders for VTE chemoprophylaxis were screened for inclusion. Patients on therapeutic anticoagulation or anticoagulated with fondaparinux were excluded. Patients with 0–1 and greater than 2 refused doses were cohorted into “Non-Refusal” and “Refusal” groups, respectively. Regression analysis was used to assess potential risk factors associated with refusal of VTE chemoprophylaxis for the primary outcome. Rates of refusal were compared by hospital unit for the secondary outcome.</div></div><div><h3>Results</h3><div>18,711 patients were included in final analysis, 16,599 in the “Non-Refusal” group and 2,112 in the “Refusal” group. Characteristics associated with increased risk of VTE chemoprophylaxis refusal were Black race, English-preferred language, former/current smoker, and substance use disorder. Hispanic ethnicity and increasing age were associated with a decreased risk of refusal. There were no statistically significant associations between gender, place of residence, or psychiatric diagnoses and refusal. When compared across hospital units, rates of VTE chemoprophylaxis refusal varied.</div></div><div><h3>Conclusion</h3><div>This study identified several patient-specific characteristics associated with increased and decreased risk of VTE chemoprophylaxis refusal. Additionally, variance in rates of refusal was noted across hospital units. Identification of factors associated with VTE chemoprophylaxis refusal may help inform targeted interdisciplinary education and intervention strategies.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109787"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621534","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":"Substitution-induced allosteric activation of coagulation factor IX as a potential alternative hemophilia A treatment strategy","authors":"Viola J.F. Strijbis,&nbsp;Ka Lei Cheung,&nbsp;Dorothea Gobbo,&nbsp;Jeroen Eikenboom,&nbsp;Ying Poi Liu,&nbsp;Mettine H.A. Bos","doi":"10.1016/j.thromres.2026.109803","DOIUrl":"10.1016/j.thromres.2026.109803","url":null,"abstract":"<div><div>Cofactor-independent activity of FIX has previously been achieved in FIX-IDAV and FIX-FIAV variants containing L6F, V181I, E185D, K265A, and I383V substitutions. Cofactor-dependent FIX hyperactivity was attained through the V10K, R338L, and S377W (KLW) modifications. We evaluated whether combining IDAV/FIAV and KLW substitutions could enhance cofactor-independent activity and elucidated the biochemical mechanisms underlying FVIII-independent FIX-FIAV function. Recombinant FIX variants, expressed in HEK293 cells, were analyzed for FIX-specific and FVIII-equivalent clotting activities. Highly purified FIX-FIAV was characterized using purified component assays and FXIa-triggered thrombin generation in FVIII-deficient plasma. FIX-IDAV-KLW and FIX-FIAV-KLW exhibited 20–28-fold higher FIX-specific activity and a modest twofold increase in FVIII-equivalent clotting activity. Owing to thrombotic safety concerns, KLW combinations were not further pursued. FIX-FIAV displayed normal FIX-specific activity and fourfold enhanced FVIII-equivalent clotting activity. The FIAV substitutions did not alter activation by the extrinsic (TF–FVIIa) or intrinsic (FXIa) pathways, nor cofactor-dependent FX activation, but conferred FVIII-independent FX conversion. Kinetic analyses revealed a modified active site conformation with a trend toward reduced antithrombin inhibition. In FVIII-deficient plasma, FIX-FIAV dose-dependently increased FXIa-triggered thrombin generation by shortening the lag time and time to peak and shifted coagulation phenotype categories based on FVIII-equivalent thrombin generation (TG) activity from severe toward moderate/mild ranges in plasma-based models, without exceeding normal FVIII-equivalent TG activity. FIX-FIAV represents a FIX variant with FVIII-independent activity, normal FIX-specific activity, and reduced inactivation by antithrombin. Targeted modification of regions surrounding the FIXa active site enables allosteric activation, providing a potential foundation for novel bypassing strategies in hemophilia A therapy.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109803"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776995","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":"Prognostic indicators in VA-ECMO: Insights from thromboinflammatory markers","authors":"Shengqiang Pei,&nbsp;Jie Xu,&nbsp;Zixin Chen,&nbsp;Danyu Song,&nbsp;Dabuxilite Bayartaikishigtai,&nbsp;Jiayue Liu,&nbsp;Zhihan Zhang,&nbsp;Bingyang Ji,&nbsp;Shujie Yan,&nbsp;Zhou Zhou,&nbsp;Yang Zhang","doi":"10.1016/j.thromres.2026.109773","DOIUrl":"10.1016/j.thromres.2026.109773","url":null,"abstract":"<div><h3>Background</h3><div>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-saving intervention for refractory cardiogenic shock but is frequently complicated by thromboinflammation, leading to high morbidity and mortality. Neutrophil extracellular traps (NETs) and S100A8/A9 are involved in the thromboinflammatory process, yet their value as prognostic biomarkers for adverse outcomes in VA-ECMO patients remains to be further elucidated.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the dynamic changes of NETs and S100A8/A9 in VA-ECMO patients and evaluate their predictive value for adverse outcomes.</div></div><div><h3>Methods</h3><div>A prospective cohort of 24 critically ill patients undergoing VA-ECMO was consecutively enrolled. Plasma levels of CitH3, dsDNA, and S100A8/A9 were measured at three predefined time points: baseline, 48 h post-initiation, and pre-decannulation. Their associations with adverse clinical outcomes were analyzed. Additionally, DNaseI intervention was employed in rat VA-ECMO models to further validate the mechanistic role of NETs.</div></div><div><h3>Results</h3><div>During VA-ECMO support, the thromboinflammatory markers S100A8/A9 and CitH3 remained persistently elevated, with significantly higher concentrations observed in the withdrawal group (54.2%) compared to the successful weaning group. Spearman's correlation analysis indicated significant positive associations between S100A8/A9, CitH3, dsDNA, and the withdrawal of ECMO support. ROC curve analysis demonstrated that these markers were superior to traditional indicators, such as C-reactive protein, in predicting the withdrawal of ECMO support. Multivariate Cox regression analysis identified CitH3 serve as better prognostic indicators in patients undergoing VA-ECMO. In a rat VA-ECMO model, DNaseI treatment effectively reduced S100A8/A9 levels, while significantly extending the duration of ECMO support, thereby providing proof-of-concept for NETs-targeted therapy.</div></div><div><h3>Conclusion</h3><div>NETs-associated thromboinflammatory markers are closely associated with adverse outcomes in VA-ECMO patients and offer better prognostic value compared to traditional biomarkers. Targeting NETs may represent a promising therapeutic strategy to mitigate the thromboinflammatory burden and improve patient prognosis.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109773"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580216","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":"Cytochalasins modulate donor responsiveness in functional assays for heparin-induced thrombocytopenia","authors":"Minghai Li,&nbsp;Atsushi Yasumoto,&nbsp;Takayuki Usami,&nbsp;Masanao Hatase,&nbsp;Koji Hayasaka,&nbsp;Masahiro Ieko,&nbsp;Takanori Teshima","doi":"10.1016/j.thromres.2026.109754","DOIUrl":"10.1016/j.thromres.2026.109754","url":null,"abstract":"<div><h3>Background</h3><div>Functional assays are essential for confirming platelet-activating anti-PF4/heparin antibodies in heparin-induced thrombocytopenia (HIT), yet their performance is limited by procedural complexity and donor variability. The actin cytoskeleton regulates platelet activation, but its role in donor responsiveness during functional assays remains unclear.</div></div><div><h3>Objective</h3><div>To investigate donor responsiveness to anti-PF4/heparin antibodies and examine whether cytochalasin B (CB) influences platelet activation responses in HIT functional assays.</div></div><div><h3>Methods</h3><div>Functional assays using light transmission aggregometry and flow cytometry were performed using washed platelets from healthy donors. The effects of cytochalasins on platelet activation were evaluated, and FcγRIIA-, GPVI-, and CLEC-2-mediated activation pathways were compared.</div></div><div><h3>Results</h3><div>Low concentrations of cytochalasins (1–2 μg/mL) significantly shortened lag time to platelet aggregation without altering maximal aggregation. High concentrations (≥10 μg/mL) prolonged lag time or inhibited aggregation. CB increased platelet responsiveness among low-responder donors and increased the number of donors classified as high responders to weakly positive HIT serum. Among the platelet activation pathways examined, significant lag time shortening following CB treatment was observed in FcγRIIA-mediated activation, whereas GPVI- and CLEC-2–mediated activation did not.</div></div><div><h3>Conclusions</h3><div>Low-dose cytochalasins shortened lag time during FcγRIIA-mediated platelet activation and increased the number of responsive donors in functional assays. These findings provide insight into donor-dependent variability and may help improve the performance of functional assays for HIT.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109754"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585333","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 efficacy of fondaparinux in pediatric venous thromboembolism: A retrospective cohort study","authors":"Guy Young,&nbsp;Prasanna Ganapathi,&nbsp;Sandeep Jagtap,&nbsp;Jean-Philippe Verbist,&nbsp;Scott Haughie","doi":"10.1016/j.thromres.2026.109798","DOIUrl":"10.1016/j.thromres.2026.109798","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric venous thromboembolism (VTE) lacks robust, age-specific evidence to guide parenteral anticoagulation. Prior FondaKIDS studies suggested feasibility of fondaparinux but were limited by small samples, heterogeneous endpoints, and non-standardized assessments.</div></div><div><h3>Objective</h3><div>To assess long-term, real-world evidence on the safety, efficacy, and pharmacokinetics of fondaparinux in pediatric VTE using standardized dosing and harmonized outcome definitions.</div></div><div><h3>Methods</h3><div>This retrospective cohort study at Children's Hospital Los Angeles included patients &lt;18 years receiving at least one dose of fondaparinux (<em>n</em> = 366). A weight-based dosing algorithm targeting anti-Xa 0.5–1.0 mg/L was applied. Endpoints were aligned with International Society on Thrombosis and Hemostasis (ISTH) pediatric standards, with imaging at Month 1 and Month 3 (±15 days) and “any time” analyses. Efficacy outcomes included clot resolution and recurrence. Safety outcomes included major bleeding, post-thrombotic syndrome (PTS), mortality, and adverse events of special interest.</div></div><div><h3>Results</h3><div>Therapeutic anti-Xa levels were achieved in 92.6% within a median of 3 days, with ~55% requiring no dose adjustment. At 3 months, complete resolution occurred in 44.9% (primary VTE) and 44.0% (all VTEs); 66.2% achieved complete or partial resolution. Overall, 75.1% achieved resolution at any time, consistent across subgroups. One-year VTE recurrence was ~8%. Major bleeding occurred in 1.9% (no fatalities); PTS in 1.6%. Mortality of 8.7% was driven by comorbidities.</div></div><div><h3>Conclusions</h3><div>This largest pediatric fondaparinux cohort demonstrates rapid therapeutic anticoagulation, clinically meaningful clot resolution, and low bleeding risk using standardized dosing and ISTH-harmonized endpoints, supporting its role as a once-daily parenteral option when DOACs are unsuitable and informing pediatric labeling.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109798"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148738882","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":"Development and external validation of a text-matching algorithm to identify patients with lower extremity deep venous thrombosis from radiology reports at five medical centers","authors":"Drew A. Birrenkott,&nbsp;William B. Stubblefield,&nbsp;Alyssa Altheimer,&nbsp;Sarah J. Ouadah,&nbsp;Richard T. Griffey,&nbsp;Phillip Asaro,&nbsp;Joshua A. Beckman,&nbsp;Gregory J. Fermann,&nbsp;Jason L. Keller,&nbsp;Alan B. Storrow,&nbsp;Michael J. Ward,&nbsp;Christopher Kabrhel,&nbsp;Jesse O. Wrenn","doi":"10.1016/j.thromres.2026.109796","DOIUrl":"10.1016/j.thromres.2026.109796","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Venous ultrasound studies evaluating for deep venous thrombosis (DVT) are often only available as unstructured radiology reports. To identify the presence or absence of DVT in a cohort of patients often requires manual review. Existing automated methods (i.e., natural language processing) for identifying the presence of DVT from free text are computationally complex and difficult to integrate into the electronic health record (EHR) and electronic data warehouses as structured data. We sought to develop and validate a simple regular expression algorithm-based approach in structured query language (SQL) to extract the presence or absence of DVT from unstructured ultrasound (US) reports.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We extracted the radiology reports for venous US obtained from the ED at five academic medical centers to create the &lt;u&gt;R&lt;/u&gt;egular &lt;u&gt;E&lt;/u&gt;xpression &lt;u&gt;A&lt;/u&gt;ided &lt;u&gt;D&lt;/u&gt;etermination of &lt;u&gt;D&lt;/u&gt;eep &lt;u&gt;V&lt;/u&gt;enous &lt;u&gt;T&lt;/u&gt;hrombosis (READ-DVT) algorithm. All reports were reviewed for the presence or absence of DVT by trained adjudicators. We split data from one medical center into test and training sets and used the data from four remaining centers for external validation. We created the algorithm through an iterative process within the training set and applied these results to the test and validation sets. We then evaluated performance, and based on these results, re-iterated and conducted multiple rounds of testing and validation including validation on new, unseen data when indicated. For each data set we calculated the sensitivity, specificity, positive predictive value, negative predictive value, and F1 score.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We extracted 9249 radiology reports, of which 1398 (15.1%) were adjudicated positive for DVT. Our algorithm achieved a sensitivity of 93.4%, a specificity of 99.8%, and an F1 score of 0.958 on the test set. On three external validation sets our algorithm achieved sensitivities ranging from 93.7% to 100.0%, specificities ranging from 98.9% to 99.5%, and F1 scores ranging from 0.991 to 0.957. Notably, on our fourth external validation set, our algorithm underperformed with sensitivity of 83.8%, specificity of 99.4%, and F1 score of 0.901. By using these data to iteratively update READ-DVT we found a simple addition to our algorithm vastly improved the model function with no change in performance in the original test, training, and initial three validation sets. We created a new external validation set from the same medical center as our fourth external validation set and achieved sensitivity of 98.0%, specificity of 99.5%, and F1 score of 0.980.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;READ-DVT is a robust, multi-center validated method for identifying the presence or absence of DVT in radiology reports. The algorithm performed similarly to the published results of more complex natural language processing tools designed for the same task. In combination with","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109796"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776996","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":"Prevalence of iron deficiency in reproductive-age females on anticoagulation","authors":"Brianna R. Bakow,&nbsp;Rebecca L. Zon,&nbsp;Shreya Agarwal,&nbsp;Imo J. Akpan,&nbsp;Ming Y. Lim,&nbsp;Anna L. Parks,&nbsp;Michael A. Pfeffer,&nbsp;Madhvi Rajpurkar,&nbsp;Rachel P. Rosovsky,&nbsp;Bethany Samuelson Bannow,&nbsp;Xin Yang,&nbsp;Lisa Baumann Kreuziger","doi":"10.1016/j.thromres.2026.109792","DOIUrl":"10.1016/j.thromres.2026.109792","url":null,"abstract":"<div><div>The use of anticoagulation in reproductive-aged females increases the risk of heavy menstrual bleeding (HMB). Excessive blood loss from HMB can lead to iron deficiency (ID), without or with anemia (IDA). We investigated the frequency with which reproductive-aged female patients on anticoagulants undergo screening for and receive a diagnosis of ID/IDA.</div><div>We conducted a retrospective cohort study using the TriNetX global dataset of females aged 18–55 without a diagnosis of cancer who started anticoagulation therapy. The cohort was divided into sub-groups based upon ferritin testing within 90 days of starting anticoagulation and descriptive statistics were calculated.</div><div>The initial cohort included 1,463,349 unique female patients across 93 healthcare organizations. Exclusion of those with cancer and those without laboratory values resulted in a final cohort of 783,196. Out of the final cohort, 9.2% had a ferritin level checked within 90 days of starting anticoagulation. Of those, 36.6% had a ferritin level ≤ 50 ng/mL while 25.8% had ferritin levels ≤30 ng/mL. Among individuals with ferritin ≤30 ng/mL, 19.7% (<em>n</em> = 3655) had a hemoglobin ≥12 and 44.0% (<em>n</em> = 8170) had MCV &lt; 80 fL.</div><div>These findings highlight a significant gap in the evaluation of ID for reproductive-aged females taking anticoagulation and emphasize the importance of using ferritin for the diagnosis of ID with or without anemia. Future studies and interventions are indicated to increase screening and expedite treatment of ID/IDA in reproductive-aged female patients starting anticoagulation.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109792"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631580","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}