Thrombosis Update最新文献

{"title":"Efficacy of oral aspirin in prevention of embolic events in infective endocarditis: A systematic review and meta analysis","authors":"Jonathan Victor Salazar-Ore ,&nbsp;Angie Carolina Alonso-Ramírez ,&nbsp;Gabriela Vanessa Flores-Monar ,&nbsp;Emily Patricia Solarte-Zabaleta ,&nbsp;Miguel Ángel Castaneda-Diaz ,&nbsp;Ada Lizandra Motino-Villanueva ,&nbsp;Anuj Manish-Kakkad ,&nbsp;Camila Sanchez-Cruz ,&nbsp;Ernesto Calderón-Martínez","doi":"10.1016/j.tru.2025.100208","DOIUrl":"10.1016/j.tru.2025.100208","url":null,"abstract":"<div><h3>Introduction</h3><div>Infective endocarditis (IE) involves inflammation of the heart's inner lining and valves, leading to complications like embolic events. The role of aspirin in preventing these events is controversial, with concerns about bleeding risk, limiting its use. This meta-analysis evaluates the effectiveness of oral aspirin in preventing embolic events and its adverse outcomes in IE patients.</div></div><div><h3>Methods</h3><div>A systematic search was conducted on July 20, 2024, across PubMed/MEDLINE, Cochrane, Scopus, Web of Science, EMBASE, and CINAHL for studies comparing aspirin to placebo or no treatment. The protocol was registered in PROSPERO (CRD42024573274).</div></div><div><h3>Results</h3><div>Five studies involving 1174 participants were included, with three eligible for meta-analysis due to data limitations. Findings on embolic event incidence were inconsistent: one randomized clinical trial (RCT) excluding prior aspirin therapy (OR 1.62, [0.68–3.86], p = 0.29) and a reanalysis examining long-term use (OR 0.80, [0.36–1.78], p = 0.582) found no significant reduction, while another study reported a possible reduction (OR 0.65, [0.43–0.98], p = 0.04). Bleeding rates trended higher in aspirin groups across two studies, though not statistically significant. Mortality data also varied; one study found higher mortality in aspirin users, while another associated chronic antiplatelet therapy with lower mortality, particularly with early initiation after admission.</div></div><div><h3>Conclusion</h3><div>Aspirin may reduce embolic events in IE, but evidence remains inconclusive due to mixed findings. Aspirin showed a non-significant increase in bleeding risk and mortality, so routine use for embolic prevention in IE is not recommended, highlighting the need for further research to clarify its potential role.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"19 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound assisted, catheter-directed thrombolysis for acute intermediate-high risk pulmonary embolism: Focus on safety for oncological patients","authors":"Claudia Colombo ,&nbsp;Lorenzo Tua ,&nbsp;Nicolò Capsoni ,&nbsp;Francesco Musca ,&nbsp;Ilaria Emanuela Bossi ,&nbsp;Filippo Russo ,&nbsp;Mario Iannaccone ,&nbsp;Andrea Discalzi ,&nbsp;Luciana D'Angelo ,&nbsp;Fabrizio Oliva ,&nbsp;Marco Solcia ,&nbsp;Alice Sacco","doi":"10.1016/j.tru.2025.100206","DOIUrl":"10.1016/j.tru.2025.100206","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"19 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel method for pulmonary embolism prognosis: Right to left ventricular volume ratio (RLVR) on pulmonary angiography (CTPA)","authors":"Aykut Yucal,&nbsp;Mustafa Burak Sayhan","doi":"10.1016/j.tru.2025.100203","DOIUrl":"10.1016/j.tru.2025.100203","url":null,"abstract":"<div><h3>Introduction</h3><div>Right ventricular dysfunction is the main cause of mortality in patients with acute massive pulmonary embolism (PE) and early diagnosis is extremely important. This study aimed to investigate whether the right/left ventricular volume ratio (RLVR) calculated using pulmonary angiography (CTPA) is a valuable tool for PE prognosis.</div></div><div><h3>Method</h3><div>Clinical, echocardiographic and pulmonary angiography data of cases diagnosed with pulmonary embolism in the emergency department between January 2021 and December 2023 were retrospectively evaluated. Patients were stratified according to the presence of massive PE, one month mortality and pulmonary embolism severity index (PESI) score. Clinical, laboratory and radiographic parameters were compared to search for prognostic factors.</div></div><div><h3>Results</h3><div>Of the 210 patients, the mean age was 67 ± 15 years, 46 % were male, and 42 % had massive PE. The right/left ventricular volume ratio was significantly higher in patients with massive PE, in those who died within one month after admission; and in patients with PESI Class III. When the cut-off value of right/left ventricular volume ratio was accepted as &gt;1.7, its predictive value for acute PE mortality was higher than other CTPA and echocardioraphy measurements (AUC = 0.706).</div></div><div><h3>Conclusion</h3><div>An increased right/left ventricular volume ratio on CTPA, a valuable tool for diagnosing right ventricular dysfunction, is associated with a worse prognosis in subjects with pulmonary thromboembolism.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"19 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity and VTE","authors":"Lucy A. Norris (Editors in Chief),&nbsp;Emmanouil S. Papadakis (Editors in Chief)","doi":"10.1016/j.tru.2025.100204","DOIUrl":"10.1016/j.tru.2025.100204","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thank you reviewers","authors":"","doi":"10.1016/j.tru.2025.100205","DOIUrl":"10.1016/j.tru.2025.100205","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordance and bleeding in critically ill patients with COVID-19 receiving unfractionated heparin: A comparison between aPTT and anti-factor Xa activity level monitoring","authors":"Merijn C. Reuland ,&nbsp;Thijs F. van Haaps ,&nbsp;Pieter O.L.P. Broeren ,&nbsp;Nick van Es ,&nbsp;Claire E. Dijkslag-van der Laan ,&nbsp;Alexander P.J. Vlaar ,&nbsp;Michiel Coppens ,&nbsp;Marcella C.A. Müller","doi":"10.1016/j.tru.2025.100202","DOIUrl":"10.1016/j.tru.2025.100202","url":null,"abstract":"<div><h3>Introduction</h3><div>COVID-19 is associated with hypercoagulability and an increased risk of thrombotic complications. In critically ill COVID-19 patients with thrombosis receiving unfractionated heparin (UFH), heparin resistance is frequently observed when the activated Partial Thromboplastin Time (aPTT) is used for monitoring. It is unclear whether UFH monitoring with anti-factor Xa (anti-Xa) is beneficial.</div></div><div><h3>Methods</h3><div>Retrospective cohort of critically ill COVID-19 patients treated with UFH in a single center tertiary Intensive Care Unit (ICU) before and after changing treatment protocol from a nurse-driven aPTT guided to an anti-Xa guided UFH dosing protocol. Measurements of aPTT and anti-Xa were simultaneously collected to evaluate discordance. Next, bleeding events while treated using the different treatments protocols was assessed, using the validated HEME scoring system.</div></div><div><h3>Results</h3><div>We included 149 patients with a median age of 63 years (interquartile range: 59, 70). Among the 715 samples with simultaneous measurements of aPTT and anti-Xa, discordance was observed in 57 % of samples. This was based on a low aPTT and normal anti-Xa activity in 40 %, and a normal aPTT and high anti-Xa activity in 9 %. In the aPTT period 43 of 83 patients developed any bleeding (52 %) compared to 23 of 68 patients (34 %) in the anti-Xa-guided period. In the 83 patients in the aPTT guided group, there were 43 bleeding events in 19 patients, compared to 23 bleeding events in 16 patients in the group guided by anti-Xa activity.</div></div><div><h3>Conclusion</h3><div>In critically ill patients with COVID-19 receiving UFH, measurement of aPTT and anti-Xa activity are frequently discordant. Anti-Xa monitoring could potentially help in reducing the risk of bleeding.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"19 ","pages":"Article 100202"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct oral anticoagulants in patients with severe inherited thrombophilia: Real-world data from a tertiary care center","authors":"Omri Cohen ,&nbsp;Merav Arnon ,&nbsp;Irit Birger ,&nbsp;Ophira Salomon ,&nbsp;Shadan Lalezari ,&nbsp;Orly Efros ,&nbsp;Tami Barazani Brutman ,&nbsp;Gili Kenet ,&nbsp;Aaron Lubetsky ,&nbsp;Sarina Levy-Mendelovich","doi":"10.1016/j.tru.2025.100201","DOIUrl":"10.1016/j.tru.2025.100201","url":null,"abstract":"<div><h3>Background</h3><div>Inherited thrombophilia (IT) predisposes individuals to venous thromboembolism (VTE) and increases the risk for first event VTE as well as for recurrent VTE. Outcomes in patients with IT treated with direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs), remain mostly underexplored.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed VTE patients with severe IT treated with DOACs at a large tertiary center. The MDClone platform was used for data extraction. Main outcomes were rates of VTE recurrence and major bleeding while on treatment with either DOAC or VKAs.</div></div><div><h3>Results</h3><div>A total of 160 patients with IT were included. The median age was 44.3 and 56.9 % were female. Unprovoked VTE was the most common presentation, accounting for 45.0 % of cases, followed by events provoked by estrogen exposure (21.9 %) and other minor triggers (16.9 %). DOACs were exclusively administered in 82 patients (51.2 %), whereas 78 (48.7 %) received vitamin Kantagonists (VKAs), of whom 40 were later switched to DOACs.</div><div>Over a median of 5.2 years follow-up, VTE recurrence was observed in 12.5 %, and associated with higher Charlson comorbidity scores. Patients with unprovoked VTE exhibited the highest recurrence rates (20.8 %). In multivariate analysis recurrence rates were unaffected by gender, age at initial VTE event, comorbidity, thrombophilia subtype, or anticoagulant type. Incidence of major bleeding was low and was also similar across anticoagulant groups.</div></div><div><h3>Conclusion</h3><div>DOACs and VKAs provide comparable outcomes in patients with IT in terms of VTE recurrence and bleeding risk.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Rosuvastatin on a murine model of deep vein thrombosis","authors":"Megan E. Barney ,&nbsp;Shenghao Zhou ,&nbsp;Anh Le-Cook ,&nbsp;Naly Setthavongsack ,&nbsp;Gabriel Nager ,&nbsp;Jennifer M. Loftis ,&nbsp;Randy L. Woltjer ,&nbsp;Monica Hinds ,&nbsp;Khanh P. Nguyen","doi":"10.1016/j.tru.2025.100200","DOIUrl":"10.1016/j.tru.2025.100200","url":null,"abstract":"<div><h3>Introduction</h3><div>Rosuvastatin reduces C-reactive protein and cardiovascular mortality. After deep vein thrombosis (DVT), elevated inflammatory markers persist. We hypothesize that statins may reduce the inflammation that may be associated with the development of post thrombotic syndrome (PTS).</div></div><div><h3>Materials and methods</h3><div>Wildtype CD1 mice were fed either regular chow or 1 mg/kg rosuvastatin diets for 1 week prior to surgically induced DVT. Thrombus weights, plasma inflammatory markers, and histology were examined on postoperative days 3 and 7.</div></div><div><h3>Results</h3><div>Thrombus weights were equivalent in the rosuvastatin treated mice compared to control mice on day 3 (1.25 mg/g±0.61 vs 1.46 mg/g±0.61, <em>p</em> = 0.23) and day 7 (1.07 mg/g ± 0.39 vs 1.04 mg/g±0.32, <em>p</em> = 0.43). On day 3, rosuvastatin treated mice demonstrated decreased levels of monocyte chemoattractant protein-1(MCP-1) (8.20 pg/mL ± 4.07 vs 17.37 pg/mL ±3.26, <em>p</em> = 0.04) and tumor necrosis factor-α (TNF-α) (2.42 pg/mL ±0.42 vs 4.74 pg/mL ± 0.91, <em>p</em> = 0.02) in comparison to the control mice. On day 7, rosuvastatin treated mice demonstrated increased levels of interferon-γ (IFN-γ) (4.22 pg/mL ±5.02 vs 0.49 pg/mL ±0.01, <em>p</em> = 0.04) in comparison to the control mice. There was a significant increase in collagen deposition seen both in the thrombus (2.00 ± 0.63 vs 0.75 ± 0.46, <em>p</em> = 0.002) and vein wall (2.33 ± 0.82 vs 1.13 ± 0.35 <em>p</em> = 0.008) on day 7 in the rosuvastatin treated animals compared to the control animals.</div></div><div><h3>Conclusions</h3><div>After DVT, rosuvastatin did not accelerate thrombus resolution nor did it affect thrombus formation. However, rosuvastatin decreases MCP-1 and TNF-α during thrombus formation and increases IFN-γ in early thrombus resolution. Additionally, rosuvastatin may promote positive remodeling within the thrombus but increases vein wall fibrosis.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced versus full apixaban lead-in dosing following parenteral treatment of acute venous thromboembolism","authors":"Daniella Veloria ,&nbsp;Benjamin Wang ,&nbsp;Ran Ran ,&nbsp;David Ha ,&nbsp;Robert Diep ,&nbsp;Calvin Diep","doi":"10.1016/j.tru.2025.100199","DOIUrl":"10.1016/j.tru.2025.100199","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study","authors":"Jonatan Ahrén ,&nbsp;MirNabi Pirouzifard ,&nbsp;Björn Holmquist ,&nbsp;Jan Sundquist ,&nbsp;Kristina Sundquist ,&nbsp;Bengt Zöller","doi":"10.1016/j.tru.2025.100198","DOIUrl":"10.1016/j.tru.2025.100198","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity, i.e. two or more non-communicable diseases (NCDs), has been associated with venous thromboembolism (VTE), but whether multimorbidity is a predictor for incident VTE is unknown.</div></div><div><h3>Aims</h3><div>To examine the associations between multimorbidity and its severity with risk of incident VTE, and examine the association between nine different disease clusters and incident VTE.</div></div><div><h3>Methods</h3><div>A cohort study using landmark analysis of 2,694,442 individuals. Swedish national registers were linked and three landmarks (L1, L2, L3), i.e. baselines, were created with 14-, nine- and four-year follow-up times, respectively. Two or more NCDs defined multimorbidity and ≥5 marked multimorbidity severity. A hazard ratio (HR) with 95 % confidence interval (CI) for VTE was calculated and adjusted for sex, education and year of birth. Death and emigration were treated as competing events.</div></div><div><h3>Results</h3><div>A total of 2,694,442 individuals were included. Multimorbidity was associated with incident VTE in all three analyzed landmarks: adjusted HR for VTE was 2.47 (95%CI 2.24–2.72) for L1, HR was 2.23 (95%CI 2.11–2.36) for L2, and HR was 2.16 (95%CI 2.03–2.29) for L3. HR increased with multimorbidity severity. For instance, HRs for multimorbidity with five or more NCDs was 4.29 (95%CI 2.53–7.28) in L1 analysis, 4.45 (95%CI 3.64–5.45) in L2 analysis and 4.83 (95%CI 4.20–5.55) in L3 analysis. Moreover, seven of nine different multimorbidity disease clusters were predictors for VTE.</div></div><div><h3>Conclusion</h3><div>This study demonstrated proof-of-concept that multimorbidity is a novel dose-graded predictor for VTE. Further studies will determine the usefulness of multimorbidity for VTE prediction in different clinical settings.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}