Thrombosis research最新文献

{"title":"Frailty and venous thromboembolism in older adults: Biological links and translational opportunities for risk stratification (narrative review)","authors":"Diego Arauna,&nbsp;Simón Navarrete,&nbsp;Francisco J. Garcia-Garcia,&nbsp;Roberto Tapia,&nbsp;Amelia Guadalupe-Grau,&nbsp;Magdalena Sepúlveda,&nbsp;Victoria Villalobos,&nbsp;Iván Palomo,&nbsp;Eduardo Fuentes","doi":"10.1016/j.thromres.2026.109774","DOIUrl":"10.1016/j.thromres.2026.109774","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty is a geriatric syndrome characterized by reduced physiological reserve and increased vulnerability to stressors. Frailty overlaps with risk factors for deep vein thrombosis (DVT) and venous thromboembolism (VTE), yet it remains underrecognized in thrombotic risk stratification.</div></div><div><h3>Objective</h3><div>To synthesize evidence linking frailty to DVT and VTE in older adults and to discuss translational approaches for incorporating frailty into risk stratification and diagnostic pathways.</div></div><div><h3>Methods</h3><div>This narrative review synthesized epidemiological, mechanistic, and translational evidence on the relationship between frailty and thrombotic disease. It critically appraised established frailty assessment tools alongside emerging approaches, including electronic frailty indices and artificial intelligence (AI).</div></div><div><h3>Results</h3><div>Available evidence supports links between frailty and all components of Virchow's triad. Studies indicate that frail older adults have a higher risk of incident VTE than robust peers, with the strongest estimates exceeding a twofold increase. Frailty is further associated with adverse outcomes after VTE or pulmonary embolism, including higher mortality. Electronic frailty indices offer potential for clinical implementation.</div></div><div><h3>Conclusion</h3><div>Frailty is a relevant marker of thrombotic vulnerability in older adults. Its incorporation into risk models and diagnostic frameworks may improve identification and support prevention and management strategies. However, prospective validation remains necessary before clinical use.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109774"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585318","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":"Risk of venous thromboembolism in first-degree relatives of affected patients compared with general population","authors":"Sara Robin,&nbsp;Alice Nau,&nbsp;Eloïse Laouenan,&nbsp;Benjamin Espinasse,&nbsp;Gaëlle Munsch,&nbsp;Emmanuelle Le Moigne,&nbsp;Cécile Tromeur,&nbsp;Claire de Moreuil,&nbsp;Marie Guegan,&nbsp;Solen Melac,&nbsp;Clive Kearon,&nbsp;James D. Douketis,&nbsp;Karine Lacut,&nbsp;Aurélien Delluc,&nbsp;Francis Couturaud","doi":"10.1016/j.thromres.2026.109789","DOIUrl":"10.1016/j.thromres.2026.109789","url":null,"abstract":"<div><h3>Background</h3><div>Determining venous thromboembolism (VTE) risk among first-degree relatives (FDRs) of VTE patients requires effective risk assessment. We aimed to evaluate VTE risk in FDRs of index cases (ICs) compared to the general population.</div></div><div><h3>Methods</h3><div>A cross-sectional family study (France, Canada) and a population-based study in the Brest district (France) were conducted. VTEs were adjudicated by an independent clinical event committee. The standardised incidence ratio (SIR), defined as observed-to-expected ratios of VTE in FDR, and 95% confidence interval (CI) were calculated using an indirect standardisation. Expected numbers of VTE were calculated from age-specific incidence rates in the reference population.</div></div><div><h3>Results</h3><div>Among the 2617 FDRs of 507 ICs with VTE, 123 had VTE (annual incidence: 1.2 per 1000 person-years). Of 367,911 Brest district inhabitants, 576 had VTE (annual incidence: 1.6 per 1000 person-years). Compared with the general population, FDRs had a higher VTE risk when the ICs had unprovoked VTE (SIR 1.31, 95%CI 1.11–1.53), had VTE before 47 years (SIR 3.28, 95%CI 2.69–3.85) or when ≥2 FDRs were affected (SIR 1.51, 95%CI 1.14–1.88). The highest VTE risk in FDRs was observed when ICs had unprovoked VTE and ≥2 affected FDRs (SIR 6.36, 95%CI 5.52–7.20) or when ICs had VTE before 47 and ≥2 affected FDRs (SIR 9.93, 95%CI 7.75–12.12). Factor V Leiden and G20210 prothrombin variant status of ICs had a modest influence.</div></div><div><h3>Conclusion</h3><div>FDR VTE risk is significantly higher when the IC had unprovoked VTE, before 47 years, and/or when multiple FDRs were affected, compared to the general population.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109789"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607762","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":"Long-term analytical performance of apixaban measurements based on external quality assessment data","authors":"Bob Smit,&nbsp;Piet Meijer,&nbsp;An Stroobants","doi":"10.1016/j.thromres.2026.109795","DOIUrl":"10.1016/j.thromres.2026.109795","url":null,"abstract":"<div><h3>Objectives</h3><div>Although direct oral anticoagulants (DOACs) do not usually require monitoring and clinical cut-off values are not well established yet, measurement of apixaban is often requested in emergency settings and may be requested for patients with suspected variable pharmacokinetics. For safe interpretation, results must be comparable between laboratories and platforms. Most external quality assessment (EQA) schemes, however, only provide short-term performance data. This study aimed to assess the long-term analytical performance of apixaban assays using multicenter EQA data and to identify sources of analytical variation.</div></div><div><h3>Methods</h3><div>Anonymized data from the ECAT program were analyzed. Twice yearly, two lyophilized citrate plasma samples (apixaban range 24–413 ng/mL) were distributed. Consensus values were established, and linear regression of individual laboratory results versus consensus values was performed to calculate slope, intercept, and standard error. Total error, random error, bias (constant and proportional), long-term coefficient of variation (LCVa), and analytical critical difference (ACD) were determined. The effect of platform uniformity was also evaluated.</div></div><div><h3>Results</h3><div>Data from 233 laboratories representing 238 method-reagent-calibrator combinations met inclusion criteria. Consensus coefficients of variation were &lt; 10% above 50 ng/mL but increased at lower concentrations, reaching 24.6%. Mean total error was 16.8% and was mainly driven by random error (10.7%). Mean total bias was 33.1 ng/mL, predominantly proportional. The median LCVa was 5% (range 1.7–19.9%), and the median ACD was 34.2 ng/mL. Uniform platforms (same-manufacturer equipment, method, and calibrator) showed significantly lower LCVa and ACD than partially or non-uniform platforms.</div></div><div><h3>Conclusions</h3><div>Apixaban assays demonstrate good long-term precision despite methodological heterogeneity. Proportional bias is the primary source of deviation. Platform harmonization improves reproducibility.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"264 ","pages":"Article 109795"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148738881","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":"Bleeding risk in patients receiving concurrent treatment with direct oral anticoagulants and corticosteroids: A systematic review","authors":"Rosa Talerico,&nbsp;Chiara Cavallaro,&nbsp;Michela Iorio,&nbsp;Maria Alessandra Capparella,&nbsp;Francesco Bossi,&nbsp;Angelo Porfidia,&nbsp;Koichiro Abe,&nbsp;Mario Biglietto,&nbsp;Antonio Chistolini,&nbsp;Anders Holt,&nbsp;Lies Lahousse,&nbsp;Roberto Pola,&nbsp;Cecilia Becattini,&nbsp;Maria Cristina Vedovati","doi":"10.1016/j.thromres.2026.109752","DOIUrl":"10.1016/j.thromres.2026.109752","url":null,"abstract":"<div><h3>Background</h3><div>Direct oral anticoagulants (DOACs) and corticosteroids are frequently co-prescribed in clinical practice. While both drug classes independently increase bleeding risk, the impact of their concurrent use remains unclear.</div></div><div><h3>Aim</h3><div>To systematically review the literature on bleeding outcomes associated with combined DOAC and corticosteroid use.</div></div><div><h3>Methods</h3><div>We conducted a systematic review following PRISMA guidelines. PubMed, Web of Science, and Scopus were searched for studies reporting bleeding in patients receiving both DOACs and corticosteroids. Cumulative incidences of any bleeding and major bleeding (MB) were estimated using a random-effects model, and study quality assessed using the Newcastle–Ottawa Scale and the Cochrane RoB2. Subgroup analyses were performed for patients treated for atrial fibrillation (AF) and venous thromboembolism (VTE).</div></div><div><h3>Results</h3><div>Nine studies including 87,209 patients were included. The weighted cumulative incidence of any bleeding was 7.0% (95% CI 3.96–12.01%), and of MB 6.6% (95% CI 6.21–6.97%). Heterogeneity was high for any bleeding in the overall and in the AF populations, likely reflecting differences in patient characteristics, corticosteroid exposure, follow-up duration, and study design, whereas heterogeneity was minimal in the VTE subgroup. Variability in bleeding definitions, limited reporting of corticosteroid dose and duration, and absence of stratification by DOAC type/dose or bleeding site further contributed to differences in observed incidences.</div></div><div><h3>Conclusions</h3><div>Available evidence suggests a clinically relevant incidence of bleeding among patients receiving concomitant DOAC and corticosteroid therapy. Clinicians should carefully evaluate the risk–benefit profile, monitor patients closely, and consider preventive strategies. Future studies are needed to improve risk characterization in this common clinical scenario.</div></div><div><h3>Prospero registration</h3><div>CRD420251045710.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109752"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284642","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":"The mechanisms of contractile dysfunction following chronic limited platelet activation in (pro)thrombotic conditions","authors":"Alina I. Khabirova,&nbsp;Rafael R. Khismatullin,&nbsp;Shakhnoza M. Saliakhutdinova,&nbsp;Rustem I. Litvinov,&nbsp;John W. Weisel","doi":"10.1016/j.thromres.2026.109765","DOIUrl":"10.1016/j.thromres.2026.109765","url":null,"abstract":"<div><h3>Background</h3><div>Patients with (pro)thrombotic conditions often exhibit a combination of platelet activation and dysfunction, including impaired contractility, which may contribute to thrombosis progression.</div></div><div><h3>Aims</h3><div>To study the mechanisms of secondary platelet dysfunction developed during prolonged limited activation <em>in vitro</em>.</div></div><div><h3>Methods</h3><div>Platelet-rich plasma from healthy subjects was incubated with 10 μM thrombin receptor-activating peptide (PAR1-receptor agonist) for 6 h at 37 °C to simulate continuous incomplete platelet activation. The dynamic functional and morphological state of platelets was assessed at specific time points by the rate and degree of thrombin-induced clot contraction, the mitochondrial membrane potential, intracellular ATP content, expression of phosphatidylserine, P-selectin and active integrin αIIbβ3 (before and after hyper-stimulation), platelet aggregation, as well as by scanning electron microscopy.</div></div><div><h3>Results</h3><div>In long-term activated platelets, a significant decrease in contractility was observed, while in control untreated plasma samples the contractility remained relatively stable throughout the 6-h observation period. Continuing platelet activation was accompanied by a decrease in the mitochondrial membrane potential and intracellular ATP level. An increase in expression of phosphatidylserine and P-selectin was steady, while the expression of active integrin αIIbβ3 was initially elevated, but dropped eventually, which disrupts platelet aggregation and mechanotransmission from contracting platelets to fibrin. Morphologically, the activated platelets initially formed aggregates followed by disaggregation along with progressive platelet inactivation and fragmentation.</div></div><div><h3>Conclusions</h3><div>The reduced platelet contractility in (pro)thrombotic conditions results from continuing limited activation of circulating platelets, leading to multiple functional and structural impairments, altogether underlying ‘activation-induced platelet dysfunction’, a particular and common type of acquired thrombocytopathy.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109765"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340306","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":"Molecular basis of the E69Q and R383W heterozygous F2 variants identified in the proband associated with severe hemostatic defects","authors":"Liya Lin,&nbsp;Yang Li,&nbsp;Changming Chen,&nbsp;Junwei Yuan,&nbsp;Xi Wu,&nbsp;Wenman Wu,&nbsp;Xuefeng Wang,&nbsp;Qiulan Ding,&nbsp;Jing Dai","doi":"10.1016/j.thromres.2026.109762","DOIUrl":"10.1016/j.thromres.2026.109762","url":null,"abstract":"<div><h3>Background</h3><div>Functional studies of <em>F2</em> variants causing congenital prothrombin deficiency are few.</div></div><div><h3>Objectives</h3><div>To investigate the molecular basis of dysprothrombinemia in a proband with severe bleeding manifestations and reduced prothrombin activity (5.7%) and antigen levels (28.5%).</div></div><div><h3>Methods</h3><div>Genetic analysis was performed using the targeted gene panel sequencing. Variant prothrombins were expressed and characterized in kinetic assays. The binding capacity of the variant prothrombin to phospholipid membranes was analyzed using surface plasmon resonance.</div></div><div><h3>Results</h3><div>Two heterozygous <em>F2</em> variants (E69Q and R383W) were identified in the proband. The secretion of R383W prothrombin was severely impaired (5% of WT). The activation of FVIII by the R383W thrombin was severely impaired, resulting from reduced catalytic rate toward FVIII (<em>k</em>_cat ∼ 10-fold). Interaction with soluble thrombomodulin (sTM) was significantly weakened (<em>K</em>_d ∼ 8-fold), resulting in impaired protein C activation in the presence of sTM. The E69Q prothrombin exhibited a markedly weaker phospholipid binding capacity (<em>K</em>_D ∼ 100-fold), and the activation of the variant by the prothrombinase complex was severely impaired (∼600-fold).</div></div><div><h3>Conclusions</h3><div>The impaired catalytic rate toward FVIII of the R383W variant indicated that the R383 residue, located in exosite I, played a role in regulation of the active-pocket function of thrombin. Thus the variant disrupted the timely amplification of thrombin generation. The E69Q prothrombin exhibited a profound defect of zymogen activation, the E69 residue was critical for calcium-dependent phospholipid binding and procoagulant activity. These findings highlight that comprehensive functional evaluations are essential for elucidating the mechanisms of <em>F2</em> variants underlying bleeding phenotypes.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109762"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340345","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 regarding “Anticoagulation therapy vs clinical surveillance in isolated subsegmental pulmonary embolism: A systematic review and meta-analysis.” by Nicoletto M et al.","authors":"Michele Dalla Vestra,&nbsp;Giuliana Autiero,&nbsp;Sara Angela Malerba,&nbsp;Elisabetta Grolla","doi":"10.1016/j.thromres.2026.109757","DOIUrl":"10.1016/j.thromres.2026.109757","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109757"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278847","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":"Catheter-related thrombosis in oncology: A retrospective analysis of 803 long-term central venous catheters","authors":"Margarida Pascoal,&nbsp;Margarida Bernardo,&nbsp;André Caiado,&nbsp;Francisco Cabral,&nbsp;Sara Carvalhal,&nbsp;Rita Barroca,&nbsp;Nuno Abecasis,&nbsp;Rodrigo Oom","doi":"10.1016/j.thromres.2026.109749","DOIUrl":"10.1016/j.thromres.2026.109749","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109749"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284617","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":"Postoperative thrombosis in patients with hemophilia and malignancy: Mechanisms and perioperative prevention and management — A scoping review","authors":"Lisha Zhao,&nbsp;Yanyan Xie,&nbsp;Zhenyu Yan","doi":"10.1016/j.thromres.2026.109750","DOIUrl":"10.1016/j.thromres.2026.109750","url":null,"abstract":"<div><div>Hemophilia is traditionally viewed as a hypocoagulable disorder, but the occurrence of postoperative venous thromboembolism (VTE) in these patients, particularly when malignancy is present, challenges this paradigm. Cancer-related and surgery-induced prothrombotic factors, when combined with perioperative factor replacement, bypassing agents, or non-factor therapies, may transiently shift the patient from a hypocoagulable state to a prothrombotic one, creating a narrow therapeutic window where both bleeding and thrombosis are clinically significant.</div><div>This review aims to synthesize the existing mechanistic and clinical evidence on postoperative thrombosis in hemophilia patients with malignancy and to identify where evidence is direct, indirect, or extrapolated. We outline a pragmatic, multidisciplinary team (MDT)-based framework for risk assessment, diagnosis, prophylaxis, and treatment, recognizing that the framework has not been validated in this rare population.</div><div>A comprehensive scoping review was conducted using MEDLINE (PubMed), Embase, Web of Science, and the Cochrane Library, covering publications from 2000 to 2025. We also hand-searched major society guidelines and consensus documents. Direct evidence addressing postoperative VTE in patients with both hemophilia and malignancy was scarce; therefore, we separated direct hemophilia perioperative evidence from indirect cancer-surgery and mechanistic evidence used for contextual interpretation.</div><div>Available hemophilia perioperative data are derived mainly from orthopedic cohorts and cannot define the incidence of postoperative VTE after cancer surgery in hemophilia. Reported thrombotic phenotypes include deep vein thrombosis (DVT), pulmonary embolism (PE), catheter-related thrombosis, and less commonly arterial events. Risk assessment should therefore integrate patient factors, cancer biology, surgical context, hemostatic treatment intensity, and FVIII/FIX peak and trough monitoring. Routine laboratory tests such as aPTT and D-dimer are frequently unreliable, supporting an imaging-first diagnostic strategy when VTE is clinically suspected.</div><div>We present a four-tier VTE risk framework as a practical organizing tool rather than a validated prediction model. Pharmacologic thromboprophylaxis or therapeutic anticoagulation may be considered only after individualized bleeding-thrombosis assessment, stable surgical hemostasis, adequate factor coverage, and continuous MDT communication from preoperative planning to post-discharge care.</div><div>Future research should focus on prospective registries, the development of standardized outcome definitions, and the validation of global coagulation assays to improve recommendations and management strategies in this evolving therapeutic landscape.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109750"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296432","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":"Outcome of catheter associated upper extremity deep vein thrombosis in cancer: A two year prospective study with enoxaparin","authors":"Michelangelo Sartori,&nbsp;Alice Trentini,&nbsp;Sofia Cavara,&nbsp;Elisabetta Favaretto,&nbsp;Laura Borgese,&nbsp;Mario Soldati,&nbsp;Benilde Cosmi","doi":"10.1016/j.thromres.2026.109755","DOIUrl":"10.1016/j.thromres.2026.109755","url":null,"abstract":"<div><h3>Background</h3><div>Current guidelines suggest three month anticoagulation for the treatment of catheter-related upper extremity deep vein thrombosis (CRT), but few data are available on outcome beyond three months in cancer patients.</div></div><div><h3>Methods</h3><div>This was a prospective, single center study to ascertain the long term venous thromboembolism (VTE) recurrences for CRT in cancer patients. We enrolled 233 participants (age: 56.8 ± 16.6y, female: 58.4%) who received enoxaparin for 3 months. The follow-up was 24 months and the primary outcome was the composite measure of recurrent VTE.</div></div><div><h3>Findings</h3><div>182 (78.1%) patients received therapeutic enoxaparin for 3 months whereas 51 (21.9%) patients continued therapeutic enoxaparin for 6 months. During the follow-up, the primary outcome occurred in 32 (13.7%) patients for a cumulative incidence rate of 9.2/100 patient years (95%CI: 6.6–12.7).There were: 28 (12.0%) CRT recurrences for a cumulative incident rate of 8.1/100 patient years, 3 (1.3%) pulmonary embolisms (0.9/100 patient years), and one (0.4%) cerebral venous sinus thrombosis (0.3/100 patient years). No patients in cancer remission had VTE recurrences. In multivariable modeling, insertion of a new vascular device (SHR 3.00, 95%CI: 1.14–7.88; <em>p</em> = 0.026) and the use prophylactic enoxaparin (SHR 0.05, 95%CI: 0.01–0.20; <em>p</em> &lt; 0.001) were associated with the primary outcome, whereas the duration of therapeutic enoxaparin was not.</div></div><div><h3>Interpretation</h3><div>Recurrent VTE was not infrequent in subgroups of patients with CRT; these data may lead to improved risk stratification and to tailored management strategies.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109755"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296470","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}