Thrombosis research最新文献

{"title":"Prevalence and clinical outcomes associated with proximal deep vein thrombosis at hospital admission detected by bedside ultrasound in patients hospitalized in a medical oncology ward: An exploratory prospective study","authors":"Francisco Javier Teigell Muñoz,&nbsp;María García-Ferrón,&nbsp;María Mateos-González,&nbsp;Elsa Bernal Hertfelder,&nbsp;Ana Sánchez de Torre,&nbsp;Diana Paredes Ruiz,&nbsp;Sara Sevo Spahiu,&nbsp;Coralia Bueno Muiño","doi":"10.1016/j.thromres.2026.109758","DOIUrl":"10.1016/j.thromres.2026.109758","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) is a frequent and serious complication in patients with cancer. Although lifetime VTE risk is well established, data on the prevalence of proximal deep vein thrombosis (pDVT) at hospital admission are lacking, particularly in medical oncology wards.</div></div><div><h3>Objectives</h3><div>To explore the prevalence of pDVT at hospital admission in patients with cancer using systematic bedside ultrasound screening, and to explore associated clinical factors and outcomes.</div></div><div><h3>Methods</h3><div>We conducted a prospective, single-center prevalence study including adult patients with solid tumors admitted to a medical oncology ward. Bilateral lower-extremity point-of-care ultrasound using a simplified compression technique was performed within 72 h of admission. Clinical, laboratory, and oncologic variables were recorded. Associations with pDVT were analyzed using univariable and multivariable logistic regression.</div></div><div><h3>Results</h3><div>A total of 203 patients were included. pDVT was detected in 16 patients (7.9%). The prevalence of pDVT increased with worsening functional status. In multivariable analysis, an ECOG performance status ≥2 and a Khorana score ≥2 were independently associated with pDVT at admission. Patients with pDVT had higher in-hospital mortality (31.3% vs 8.0%) and significantly shorter overall survival (median 36 vs 176 days; <em>p</em> &lt; 0.001). No in-hospital deaths were directly attributable to VTE.</div></div><div><h3>Conclusions</h3><div>Bedside ultrasound screening identified a clinically relevant prevalence of previously unrecognized pDVT at hospital admission among patients with cancer. pDVT was associated with poorer functional status, higher thrombotic risk, and worse prognosis. While the clinical benefit of routine screening remains uncertain, further studies are needed before screening strategies can be recommended in this setting.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109758"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318653","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":"Altered IGF-1R, p70S6K, and GSK-3β expression in PBMCs of immune thrombocytopenia patients and clinical associations","authors":"Xin Zhou,&nbsp;Yuqi Shi,&nbsp;Yulu Liu,&nbsp;Yang Jiang,&nbsp;Shuyan Liu,&nbsp;Ningning Shan","doi":"10.1016/j.thromres.2026.109766","DOIUrl":"10.1016/j.thromres.2026.109766","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the expression profiles of insulin-like growth factor-1 receptor (IGF-1R), p70S6 kinase (p70S6K), and glycogen synthase kinase-3β (GSK-3β) in peripheral blood mononuclear cells (PBMCs) of adults with newly diagnosed primary immune thrombocytopenia (ITP), and to evaluate their associations with clinical hematologic parameters.</div></div><div><h3>Methods</h3><div>A case-control study was conducted enrolling 30 adults with newly diagnosed primary ITP and 28 healthy volunteers. PBMCs were isolated from peripheral venous blood. The expression levels of Akt/mTOR pathway-related proteins were quantified using a high-throughput multiplex Luminex xMAP platform. Statistical analyses were performed to compare protein levels between the ITP and control groups and to assess the correlations between these signaling molecules and peripheral blood indices, specifically platelet counts. In addition, a small cohort of patients with chemotherapy-induced thrombocytopenia (CTIT) was included in the RT-qPCR validation analysis to further explore disease specificity.</div></div><div><h3>Results</h3><div>Compared with healthy controls, patients with ITP showed significantly elevated protein levels of IGF-1R and GSK-3β in PBMCs after FDR correction, whereas p70S6K showed only a nominal increase that did not remain significant after multiple-testing correction. RT-qPCR validation further showed significant upregulation of p70S6K and GSK-3β mRNA levels, with a concordant but non-significant increasing trend in IGF-1R mRNA. No significant differences were observed in other pathway components (e.g., Akt, mTOR, PTEN) or across different age and gender subgroups within the patient cohort. Notably, the expression levels of IGF-1R and p70S6K showed a significant negative correlation with peripheral platelet counts (<em>P</em> &lt; 0.05), whereas no significant associations were found with red blood cell counts, hemoglobin, or white blood cell counts. In the validation analysis, comparison with the chemotherapy-induced thrombocytopenia cohort suggested that these alterations were more pronounced in ITP rather than representing a nonspecific consequence of thrombocytopenia.</div></div><div><h3>Conclusion</h3><div>The altered expression of IGF-1R and GSK-3β, together with the potential involvement of p70S6K supported by transcriptional validation, may be associated with thrombocytopenia severity in newly diagnosed ITP, suggesting dysregulation of immunometabolic signaling in PBMCs.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109766"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333091","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":"Prospective comparison of viscoelastic coagulation monitor (VCM) and rotational thromboelastometry (ROTEM) in the assessment of cirrhosis coagulopathy","authors":"Elisa Pinto,&nbsp;Alberto Zanetto,&nbsp;Elena Campello,&nbsp;Cristiana Bulato,&nbsp;Francesca Gerli,&nbsp;Kymentie Ferdinande,&nbsp;Francesco Paolo Russo,&nbsp;Patrizia Burra,&nbsp;Marco Senzolo,&nbsp;Paolo Simioni","doi":"10.1016/j.thromres.2026.109763","DOIUrl":"10.1016/j.thromres.2026.109763","url":null,"abstract":"<div><h3>Background</h3><div>Rotational thromboelastometry (ROTEM) provides comprehensive hemostasis assessment in cirrhosis but relies on exogenous activators, potentially limiting its reflection of in vivo conditions. The Viscoelastic Coagulation Monitor (VCM) is a new, activator-free device to assess whole-blood coagulation dynamics.</div></div><div><h3>Objectives</h3><div>To investigate the concordance between VCM and ROTEM and to explore their association with clinical outcomes in cirrhosis.</div></div><div><h3>Methods</h3><div>We prospectively included 110 patients with cirrhosis admitted to our service. VCM and ROTEM were performed at hospitalization. All patients were followed up for bleeding, thrombosis, hepatic decompensation and liver-related mortality.</div></div><div><h3>Results</h3><div>Patients were mostly male (68.2%) with a median age of 61 years (53–68). Alcohol-related liver disease was the most common etiology (44.5%). 16.4% of patients were Child-Pugh A, 39.1% B, and 32.7% C. Inter-test analysis showed that parameters of VCM and ROTEM had moderate to strong correlation (ρ = 0.37–0.84, <em>p</em> &lt; 0.0001). We observed progressive, significant alterations of VCM in parallel with disease severity (Child-Pugh C &gt; B &gt; A). In contrast, ROTEM was comparable between Child-Pugh A and B patients, being altered only in Child-Pugh C cirrhosis. The median follow-up was 11 months (7–13). No patient experienced bleeding or thrombosis. Incidence of hepatic decompensation and liver-related death was 27.2% and 14.5%, respectively. No VCM parameter was associated with decompensation/death.</div></div><div><h3>Conclusions</h3><div>In a prospective cohort of hospitalized cirrhosis patients, VCM showed more gradual hemostatic changes across disease severity stages than ROTEM. However, neither test predicted decompensation or liver-related death, indicating that viscoelastic assessment alone is insufficient for prognosis. Further studies are needed to define VCM's role in cirrhosis management.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109763"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333114","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":"A study protocol for a randomised controlled trial evaluating the safety and efficiency of the YEARS algorithm versus computed tomography pulmonary angiography only for suspected acute pulmonary embolism in patients with cancer: the Hydra Study","authors":"E.S.L. Martens,&nbsp;B. Akerboom,&nbsp;C. Baumgartner,&nbsp;R.E. Brouwer,&nbsp;C. Cavallaro,&nbsp;M. Coppens,&nbsp;G. Costantino,&nbsp;F. Couturaud,&nbsp;A. D'Errico,&nbsp;Y.P.A. van Dooren,&nbsp;F. Gianni,&nbsp;R. van der Griend,&nbsp;M.J.J.H. Grootenboers,&nbsp;O. Hugli,&nbsp;T. van der Hulle,&nbsp;Z. Jaderi,&nbsp;D. Jiménez,&nbsp;P.W. Kamphuisen,&nbsp;V.R. Lanting,&nbsp;J. Leentjens,&nbsp;M.V. Huisman","doi":"10.1016/j.thromres.2026.109745","DOIUrl":"10.1016/j.thromres.2026.109745","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) is frequently suspected in patients with cancer due to non-specific symptoms suggestive of PE and their inherent risk of venous thromboembolism (VTE). Commonly used clinical decision rules (CDRs) and D-dimer testing may be less reliable in this specific population. Due to the lack of guideline recommendations on the optimal diagnostic approach and the perceived futility of D-dimer in patients with cancer, clinicians often use computed tomography pulmonary angiography (CTPA) as a sole diagnostic test. This practice exposes patients to potentially unnecessary radiation and harm, and contributes to a significant burden on healthcare systems through inefficient resource allocation. The YEARS algorithm is an easy-to-use CDR that has been shown to safely exclude PE without the need for CTPA in a diverse population of patients with suspected PE.</div></div><div><h3>Objective</h3><div>To compare the safety and efficiency of the YEARS algorithm to the safety and efficiency of CTPA only in the diagnostic management of acute PE in cancer patients.</div></div><div><h3>Design and interventions</h3><div>The Hydra study (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> <span><span>NCT04657120</span><svg><path></path></svg></span>) is an investigator-initiated, multicentre, multinational open-label, randomised, non-inferiority trial with blinded adjudication of outcome events, comparing the YEARS algorithm with CTPA only in the diagnostic work-up of cancer patients with clinically suspected acute PE. Participants are randomised in a 1:1 ratio to each diagnostic strategy via a web-based system. The trial anticipates to include 1566 patients.</div></div><div><h3>Participants</h3><div>Consecutive patients with active cancer who are hospitalised or present to the emergency department, outpatient clinic, or thrombosis clinic with clinically suspected PE and who are not receiving therapeutic anticoagulation or have an indication for anticoagulation therapy other than PE.</div></div><div><h3>Study outcomes</h3><div>The primary safety outcome is the proportion of symptomatic and objectively proven fatal or non-fatal VTE (i.e., PE or deep vein thrombosis in the upper or lower extremities) or death with undetermined cause where acute PE could not be ruled out as contributing factor during three months follow-up in patients in whom PE was ruled out at initial testing. The primary efficiency outcome is the proportion of negative CTPA scans for PE, relative to the total number of CTPA scans performed at initial testing.</div></div><div><h3>Implication</h3><div>This trial will provide pivotal data on the optimal diagnostic approach for suspected acute PE in patients with cancer.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109745"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346259","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":"LY96–CCNT1–IFI44L core molecular features characterize VTE-associated inflammatory prothrombotic risk in elderly cancer patients","authors":"Jie Wu,&nbsp;Baoji Hu,&nbsp;Lingyi Shao,&nbsp;Jinhuo Wang,&nbsp;Yujia Wang,&nbsp;Lukun Wang,&nbsp;Yue Ju,&nbsp;Jianrong Guo","doi":"10.1016/j.thromres.2026.109747","DOIUrl":"10.1016/j.thromres.2026.109747","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Venous thromboembolism (VTE) is an important complication in elderly patients with cancer, yet traditional clinical scoring systems insufficiently capture its molecular heterogeneity. This study aimed to construct a VTE-related molecular risk stratification framework for elderly cancer patients, identify molecular features that remain stable across datasets, and clarify the potential inflammation-coagulation interaction mechanisms underlying high-risk states.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The peripheral-blood discovery cohort GSE19151 and the validation cohort GSE48000 from the Gene Expression Omnibus (GEO) database were integrated to identify stably differentially expressed genes (SDEGs). In The Cancer Genome Atlas (TCGA) elderly pan-cancer cohort, SDEGs and related pathway features were then used to construct a VTE-related molecular risk stratification framework. LASSO and random forest recursive feature elimination were applied for feature selection, multiple machine-learning models were compared, and SHAP analysis was used to evaluate feature contributions. GO/KEGG enrichment analysis, GSVA and weighted gene co-expression network analysis (WGCNA) were performed to characterize the biological basis of the high molecular-risk state. Kaplan-Meier analysis, time-dependent ROC curves and Cox regression were used to assess associations between the molecular risk score and prognosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 427 VTE-related differentially expressed genes were identified in the GSE19151 discovery cohort, and 38 SDEGs were retained after cross-cohort validation in GSE48000. Machine-learning analysis further identified 11 robust core features. Among them, LY96, CCNT1 and IFI44L showed dominant contributions in feature importance ranking, SHAP analysis and interaction analysis. Model comparison indicated that XGBoost and random forest achieved favorable classification performance. Functional enrichment analysis showed that SDEGs were mainly enriched in innate immunity, inflammatory responses, cytokine signaling and complement-coagulation-related processes. GSVA and WGCNA further revealed significant activation of complement-coagulation cascades, IL-6/JAK/STAT signaling and immune-inflammatory networks in the high VTE molecular-risk group. Survival analysis showed that the high-risk group had significantly poorer overall survival and progression-free interval, and the VTE molecular risk score retained independent prognostic value in multivariable Cox models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study identified elderly cancer VTE-related core molecular features represented by LY96-CCNT1-IFI44L and established an interpretable molecular risk stratification framework. The framework highlights the coordinated activation of immune inflammation and coagulation pathways in high-risk states and provides a basis for evaluating VTE-related molecular heterogeneity and prognosis in elderly cancer p","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109747"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284598","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":"Associating the phenotypic expression of platelets with disease type through image-based single-cell profiling","authors":"Huidong Wang,&nbsp;Masako Nishikawa,&nbsp;Yuqi Zhou,&nbsp;Ruoxi Yang,&nbsp;Junyu Chen,&nbsp;Hongqian Zhang,&nbsp;Yuma Ibayashi,&nbsp;Hiroshi Kanno,&nbsp;Makoto Kurano,&nbsp;Eriko Morishita,&nbsp;Yutaka Yatomi,&nbsp;Keisuke Goda","doi":"10.1016/j.thromres.2026.109768","DOIUrl":"10.1016/j.thromres.2026.109768","url":null,"abstract":"<div><h3>Background</h3><div>Platelets are central to hemostasis and thrombosis and contribute to diverse diseases, including cardiovascular disorders, infections, and cancer. Although platelet activation and dysfunction in disease have been studied extensively, disease-associated platelet phenotypes remain poorly defined, largely because phenotypic changes are subtle, transient, and difficult to capture at single-cell resolution.</div></div><div><h3>Methods</h3><div>We acquired bright-field images of numerous circulating platelets in whole-blood samples anticoagulated with 3.2% sodium citrate that were collected from patients (<em>n</em> = 65) and healthy volunteers (<em>n</em> = 10) at the University of Tokyo Hospital, using optofluidic imaging with an optical frequency-division-multiplexed (FDM) microscope integrated with a microfluidic chip. Convolutional neural network (CNN) models were trained to classify platelet phenotypes across disease categories. Feature-importance analysis was performed to identify image-derived parameters driving the deep-learning-based characterization.</div></div><div><h3>Results</h3><div>We developed three CNN models to classify platelet images by disease category, achieving accuracies of up to 81.3%, indicating measurable associations between platelet phenotypic expression and disease type. Longitudinal analysis of platelet images further showed that the CNN models could predict thrombotic progression up to 7 days before clinical thrombus detection. Feature-importance analysis highlighted texture-related descriptors as the dominant contributors, accounting for 54.5% of overall importance.</div></div><div><h3>Conclusions</h3><div>Image-based analysis of circulating platelets can capture disease-associated phenotypic signatures and may complement existing clinical workflows for prediagnosis and early assessment of thrombotic risk.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109768"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346272","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":"Mapping thrombus habitat: Non-contrast MRI radiomics and pixel-tile histomics approach to track venous thrombosis evolution in mice","authors":"Sicheng Yao,&nbsp;Xinran Wu,&nbsp;Yingxin Liu,&nbsp;Xinyu Zhang,&nbsp;Qun Liu,&nbsp;Yaqi Xing,&nbsp;Xiao Di,&nbsp;Yuexin Chen","doi":"10.1016/j.thromres.2026.109770","DOIUrl":"10.1016/j.thromres.2026.109770","url":null,"abstract":"<div><h3>Background</h3><div>Determining the age and composition of deep vein thrombosis (DVT) is essential for optimizing thrombus removal strategies, yet clinical decision-making remains restrained by the subjectivity of symptom-based assessment. We applied non-contrast T1/T2 weighted MRI radiomics with habitat clustering to quantify thrombus evolution, validating MRI habitats against histopathology with translational clinical potential.</div></div><div><h3>Methods</h3><div>Venous thrombosis was induced in BALB/c mice using a refined inferior vena cava ligation model to ensure consistent thrombus development. Longitudinal and cross-sectional cohorts were imaged at 7 T MRI with T1- and T2-weighted sequences on post-ligation days 2, 7, and 14. Thrombus regions were delineated using a hybrid approach and voxel-level radiomic features were extracted. Unsupervised K-Means clustering defined MRI-based habitats. Imaging signatures were correlated with an artificial neural network pixel classifier and tile-based histomics clustering to quantify red blood cells (RBC), fibrin, and collagen.</div></div><div><h3>Results</h3><div>Radiomic analysis showed a decline in Energy and TotalEnergy and a similar trend in GrayLevelNonUniformity, reflecting a transition from acute to more uniform chronic thrombi. A two habitats strategy could differentiate acute RBC-rich regions from fibrotic components. Histology confirmed RBC-rich areas fell from 88.22% to 6.52% over 14 days, while collagen-rich areas rose from 0.16% to 79.67%. MRI habitat proportions correlated strongly with histological tile clusters (Spearman <em>r</em> = 0.74, <em>p</em> = 0.0005).</div></div><div><h3>Conclusion</h3><div>Multiparametric MRI radiomics combined with habitat analysis captures thrombus composition and temporal evolution, with unsupervised histomics providing biological validation. These findings support the translational potential of MRI habitat analysis as a non-invasive biomarker of thrombus heterogeneity.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109770"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353621","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":"Heatstroke-induced coagulopathy: A scoping review of therapeutic strategies and outcome reporting","authors":"Takuto Yasuda,&nbsp;Kasumi Satoh,&nbsp;Kei Imai,&nbsp;Kyohei Maeno,&nbsp;Manabu Okuyama,&nbsp;Hiroyuki Koami,&nbsp;Hajime Nakae","doi":"10.1016/j.thromres.2026.109760","DOIUrl":"10.1016/j.thromres.2026.109760","url":null,"abstract":"<div><div>Heatstroke-induced coagulopathy (HSIC) is a life-threatening complication of heatstroke that often progresses to disseminated intravascular coagulation. Despite its prognostic significance, standardized treatment strategies have not yet been established. This scoping review aimed to systematically map existing treatment approaches and outcome measures for HSIC in both clinical and experimental research.</div><div>We conducted a scoping review in accordance with PRISMA-ScR and the Joanna Briggs Institute methodology. Literature searches were conducted in MEDLINE, Web of Science, and Scopus on June 2, 2025. To enhance relevance to contemporary clinical practice, inclusion was limited to studies published from January 2010 onward. Eligible studies included clinical and basic research evaluating treatment interventions for HSIC.</div><div>A total of 61 studies were included, comprising clinical studies, case reports/series, reviews, editorials, and basic research. Only two clinical studies evaluated treatments using control groups. Anticoagulants such as antithrombin and recombinant thrombomodulin were evaluated, but clinical evidence remained limited. Case reports and case series frequently described transfusion therapies, particularly platelet and fresh frozen plasma administration. However, standardized treatment protocols were lacking, and outcome assessments were mostly descriptive. Basic research explored multiple therapeutic candidates targeting inflammation and coagulation pathways, but clinical application remained limited.</div><div>These findings suggest that progress in HSIC therapeutics is hampered not only by a lack of controlled trials, but also by the absence of standardized diagnostic criteria, assessment timepoints, and outcome measures across studies. A consensus framework for standardizing diagnostic and outcome reporting in HSIC, alongside multicenter registries and translational research, is an urgent priority for the field.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109760"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362544","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 prediction in elderly patients with acute PE: Progress and persistent challenges","authors":"Romain Chopard","doi":"10.1016/j.thromres.2026.109748","DOIUrl":"10.1016/j.thromres.2026.109748","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109748"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148273116","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":"Pre-analytical storage and reagent-dependent sensitivity as sources of variability in prothrombin time and activated partial thromboplastin time measurements","authors":"A.D. van Dam,&nbsp;M.M. Bioch,&nbsp;E.H. Jeninga,&nbsp;J.B. de Kok,&nbsp;S.R. Rijpma,&nbsp;M.H.M. Thelen,&nbsp;Y.M.C. Henskens,&nbsp;R.G.M. van Oerle,&nbsp;A.K. Stroobants,&nbsp;Coagulation Section of the Dutch Foundation for Quality Assessment in Medical Laboratory Diagnostics (SKML)","doi":"10.1016/j.thromres.2026.109771","DOIUrl":"10.1016/j.thromres.2026.109771","url":null,"abstract":"<div><h3>Background</h3><div>Prothrombin time (PT) and activated partial thromboplastin time (aPTT) are widely used coagulation assays whose results can vary due to pre-analytical and analytical factors. Understanding these sources of variability is essential for reliable laboratory practice and external quality assessment (EQA).</div></div><div><h3>Objectives</h3><div>This study evaluates the impact of pre-analytical storage and method-dependent sensitivity on PT and aPTT measurements and provides guidance for EQA programmes and clinical interpretation.</div></div><div><h3>Methods</h3><div>Plasma samples from 42 healthy volunteers were analysed within 4 h of collection or after storage at −20 °C, −80 °C, or snap-frozen in liquid nitrogen (LN₂) and subsequent storage at −80 °C. Additionally, pooled plasma was spiked with direct oral anticoagulants, heparins, and lupus anticoagulant antibodies to assess reagent-specific sensitivity. PT and aPTT were measured on multiple routine platforms using commonly used reagents from 4 different manufacturers.</div></div><div><h3>Results</h3><div>Storage at −80 °C or LN₂ preserved PT and aPTT values, whereas storage at −20 °C caused variable prolongation. In healthy volunteers, PT and aPTT showed marked inter-method variability. Sensitivity to anticoagulants and lupus anticoagulant also differed considerably between reagents, with the largest variation observed for edoxaban. This study provides an overview of inter-method variability, which may affect clinical decision-making and inter-laboratory comparability.</div></div><div><h3>Conclusions</h3><div>PT and aPTT are screening tests whose accurate interpretation depends on optimal sample handling and awareness of reagent- and method-specific sensitivities. These differences can affect clinical decision-making in anticoagulated patients. EQA programmes could increase their value by using frozen plasma, including clinically relevant anticoagulants, and implementing case-based scenarios rather than reporting only clotting times.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"263 ","pages":"Article 109771"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412964","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}