Thrombosis Update最新文献

{"title":"Successful treatment of acquired von Willebrand syndrome in multiple myeloma","authors":"Sandra Marten ,&nbsp;Raphael Teipel ,&nbsp;Oliver Tiebel ,&nbsp;Karolin Trautmann-Grill","doi":"10.1016/j.tru.2022.100108","DOIUrl":"10.1016/j.tru.2022.100108","url":null,"abstract":"<div><p>Acquired von Willebrand syndrome (AVWS) is a rare bleeding disorder characterized by quantitative or qualitative defects of the von Willebrand factor (vWF) with laboratory findings and clinical presentations similar to those of inherited von Willebrand disease (vWD). In contrast to the inherited form, the bleeding disorder is not due to genetic defects of von Willebrand factor. The prevalence of AVWS is poorly defined. Data from reviews, international registry and reference laboratories in Germany suggest a rate of approximately one case of AVWS in every 30–40 samples from patients with confirmed bleeding disorders. An association with different disorders has been described.</p><p>Multiple myeloma (MM) is a malignant plasma cell disorder defined by the accumulation of monoclonal plasma cells in the bone marrow or extramedullary lesions and often accompanied with a monoclonal paraprotein in blood and/or urine.</p><p>Symptomatic myeloma disease requiring treatment is usually characterized by renal failure, anemia or destructive bone lesions. Bleeding due to AVWS as a leading symptom of the disease is uncommon.</p><p>Here we report the case of a patient with MM presenting with significant bleeding from AVWS as primary symptom. Bleeding lasted for several years before diagnostic work-up including a bone marrow puncture revealed MM. Myeloma-specific treatment resulted in an adequate hematological response characterized by decreasing monoclonal paraprotein-levels and AVWS was resolved.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"7 ","pages":"Article 100108"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572722000128/pdfft?md5=2cb9838d226967d7f7050e9ce56f96f7&pid=1-s2.0-S2666572722000128-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46448038","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":"New insights into neonatal hemostasis","authors":"Gili Kenet ,&nbsp;Assaf Arie Barg ,&nbsp;Ulrike Nowak-Göttl","doi":"10.1016/j.tru.2022.100103","DOIUrl":"10.1016/j.tru.2022.100103","url":null,"abstract":"<div><p>Hemostasis is a dynamic process that starts in utero. Neonates, especially those who are born preterm, are at high risk of bleeding. The perinatal period is also associated with increased thrombosis risk as compared to older children. The coagulation system evolves with age, and the decreased levels of coagulation factors along with hypo-reactive platelets are counterbalanced by the increased activity of von Willebrand factor, high hematocrit and MCV as well as low levels of coagulation inhibitors that promote hemostasis. This review will address the concept and manifestations of developmental hemostasis with respect to the pathogenesis of severe bleeding or thrombosis in neonates. A special focus will be shared regarding intracerebral hemorrhages and perinatal arterial ischemic stroke. Hemostatic challenges associated with pathogenesis, diagnosis and treatment will be discussed.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"7 ","pages":"Article 100103"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572722000074/pdfft?md5=8eb01a4711c9cf8da1073185eb160e6d&pid=1-s2.0-S2666572722000074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48918357","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":"Similarities of antiphospholipid antibodies in HIT and APS patients with heparin-platelet factor 4 antibodies","authors":"Imene Hocine","doi":"10.1016/j.tru.2022.100106","DOIUrl":"10.1016/j.tru.2022.100106","url":null,"abstract":"<div><p>Heparin-induced thrombocytopenia (HIT) is a prothrombotic autoimmune disorder confirmed by the existence of Heparin-Platelet Factor 4 (HPF4) antibodies. The aim of this work is to study the possible relationship between anti-HPF4 and antiphospholipid antibodies (aPLs) that may explain the discrepancies observed in patients with a suspected HIT (HIT group) with positive immunoassay (HPF4-Elisa) and negative functional assay (heparin-induced platelet aggregation test). So, we performed H-PF4 antibodies research in 31 APS confirmed patients (APL group). All tests performed have been compared to normal controls (n = 34). We found anti-H-PF4 in 7/31 patients of APL group. In parallel, we search for aPLs in 9/34 patients tested positive for anti-HPF4 in HIT group, all of them were positive. All specificities were observed in the two anti-HPF4 positive groups (aβ2GP1 IgM/IgG/IgA, aCL (IgM/IgG/IgA, aPS-PT IgM/IgG). The most associated antibodies with anti-HPF4 are the anti ß2Glycoprotein1 (Odds ratio = 50.1). We suggest that the presence of aPLs in HIT group with anti-HPF4 could be the cause of the discrepancies. In addition, we performed the Heparin Neutralization Assay (HNA) which is specific for anti-HPF4, neutralization was obtained for patients exposed to heparin. Furthermore, we suggest that we should performed a larger cohort to confirm the causal relationship of aPLs and also to expand the tests allowing the differentiation between these autoantibodies.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"7 ","pages":"Article 100106"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572722000104/pdfft?md5=f8055d993cde80746f4ddcf16e8975c3&pid=1-s2.0-S2666572722000104-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49325671","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":"Implementation of a care pathway for deep vein thrombosis: What's the benefit?","authors":"Jorn S. Heerink,&nbsp;Nathalie Péquériaux,&nbsp;Ruud Oudega,&nbsp;Mathijn de Jong,&nbsp;Hendrik Koffijberg,&nbsp;Ron Kusters","doi":"10.1016/j.tru.2022.100109","DOIUrl":"https://doi.org/10.1016/j.tru.2022.100109","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"7 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266657272200013X/pdfft?md5=2abfc043021da48fcacbf7bead9fdf0e&pid=1-s2.0-S266657272200013X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72217069","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":"Venous thromboembolism risk, prophylaxis and management in cancer patients with COVID-19: An unmet medical need","authors":"Benjamin Brenner ,&nbsp;Cihan Ay ,&nbsp;Grégoire Le Gal ,&nbsp;Marc Carrier ,&nbsp;Andrés J. Muñoz ,&nbsp;Giancarlo Agnelli ,&nbsp;Ana Thereza Cavalcanti Rocha ,&nbsp;Hikmat Abdel-Razeq ,&nbsp;Ismail Elalamy ,&nbsp;Anna Falanga","doi":"10.1016/j.tru.2022.100098","DOIUrl":"10.1016/j.tru.2022.100098","url":null,"abstract":"<div><p>Cancer patients exhibit an increased risk of venous thromboembolism (VTE), with VTE being the second leading cause of morbidity and mortality in these patients. The implementation of lockdowns following the COVID-19 pandemic has resulted in decreased mobility and delayed access to care, thus further increasing the susceptibility to VTE. Cancer patients may also be at a higher risk of SARS-CoV-2 infection and have been shown to be more likely to experience severe COVID-19 disease compared to patients without cancer. Given that both cancer and COVID-19 exhibit a hypercoagulable state, stasis of blood flow, and endothelial injury, cancer patients with COVID-19 constitute a vulnerable population with a high risk of thrombosis and bleeding. However, to date there are limited studies evaluating whether cancer patients infected with SARS-CoV-2 have a higher VTE incidence than COVID-19 patients without cancer, how to assess the risk of VTE, prophylaxis and treatment in this special population. Herein, we highlight the urgent need for studies in cancer patients with COVID-19 to ensure appropriate patient care and improve clinical outcomes.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"6 ","pages":"Article 100098"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572722000025/pdfft?md5=9651bd963d46f565db1cb86db60176d8&pid=1-s2.0-S2666572722000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47854854","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":"Disseminated intravascular coagulation in pregnancy: New insights","authors":"Offer Erez","doi":"10.1016/j.tru.2021.100083","DOIUrl":"10.1016/j.tru.2021.100083","url":null,"abstract":"<div><p>DIC is a leading cause of maternal mortality. It is secondary to obstetrical complications such as placental abruption, amniotic fluid embolism, HELLP syndrome, retained stillbirth and acute fatty liver of pregnancy. Abnormal activation of the hemostatic system can be compensated (non-overt) or decompensated (overt) DIC. Specific scores that were adjusted to the physiological changes during pregnancy can diagnose overt and non-overt DIC. The pregnancy specific DIC score has 88% sensitivity, 96% specificity, a LR+ of 22, and a LR-of 0.125 for the diagnosis of DIC. Management of DIC during pregnancy requires prompt attention to the underlying condition leading to this complication, including the delivery of the patient, and correction of the hemostatic problem that can be guided by point of care testing adjusted for pregnancy. Novel therapeutic modalities like fibrinogen concentrate may facilitate the management of DIC in pregnancy in low resources areas.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"6 ","pages":"Article 100083"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572721000523/pdfft?md5=f8d5d639e04ae0267ac256b61d85cd45&pid=1-s2.0-S2666572721000523-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48035968","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":"Congenital hypofibrinogenemia with recurrent thromboembolism: A clinical case report","authors":"Xiaowei Gong ,&nbsp;Boyun Yuan ,&nbsp;Yadong Yuan","doi":"10.1016/j.tru.2022.100099","DOIUrl":"https://doi.org/10.1016/j.tru.2022.100099","url":null,"abstract":"<div><p>A 33-year-old female with a history of pulmonary embolism was admitted for surgical treatment of an atrial myxoma. The patient developed right atrial thrombosis during the postoperative period, despite the introduction of anticoagulant therapy. Coagulation tests revealed low levels of circulating fibrinogen (FIB) and the genetic analysis showed mutations in the fibrinogen genes FGA, FGB and FGG, which led to a diagnosis of congenital hypofibrinogenemia. The patient was treated with low-molecular-weight heparin (LMWH) whose dose was tightly adjusted according to the anti-Xa factor activity. The clinical response was favorable with reduction of the size of the cardiac thrombus and pulmonary emboli.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"6 ","pages":"Article 100099"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572722000037/pdfft?md5=f834b514cdb5adcdaa4f8aad48429ca6&pid=1-s2.0-S2666572722000037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92029879","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":"Predictors of anticoagulation adherence in patients with acute pulmonary embolism","authors":"Karim Merchant ,&nbsp;Parth V. Desai ,&nbsp;Stephen Morris ,&nbsp;Sovik De Sirkar ,&nbsp;Dalila Masic ,&nbsp;Parth Shah ,&nbsp;Nicolas Krepostman ,&nbsp;Matthew Collins ,&nbsp;Kevin Walsh ,&nbsp;Nathalie Antonios ,&nbsp;Lucas Chan ,&nbsp;Sorcha Allen ,&nbsp;Ahmad Manshad ,&nbsp;Shannon Kuhrau ,&nbsp;Alexandru Marginean ,&nbsp;Ahmed Elkaryoni ,&nbsp;Jawed Fareed ,&nbsp;Yevgeniy Brailovsky ,&nbsp;Amir Darki","doi":"10.1016/j.tru.2022.100100","DOIUrl":"https://doi.org/10.1016/j.tru.2022.100100","url":null,"abstract":"<div><h3>Background</h3><p>Anticoagulation (AC) adherence after acute pulmonary embolism (PE) is vital to prevent mortality and future recurrence of venous thromboembolism (VTE). We aimed to analyze factors affecting AC adherence after acute PE.</p></div><div><h3>Methods</h3><p>Consecutive adult patients with CT angiography or V/Q scan confirmed acute PE were included in a single-center retrospective study from April 2016 to May 2020. Adherence data, including AC refill dates, were collected from pharmacies, and adherence measures including Continuous Measure of Medication Acquisition (CMA), Proportion of Days Covered (PDC), and Optimal Medication Adherence (OMA) were calculated per standardized formulas. Univariable and multivariable linear and logistic regression was used to analyze different variables affecting AC adherence.</p></div><div><h3>Results</h3><p>A total of 118 out of 144 patients had sufficient follow-up data to measure adherence and were included in the final analysis. Mean age was 60 ± 15 years, with 64 (54.2%) women; 70 (59.3%) White, 26 (22%) African American, 13 (11%) Hispanic; 58 (49.2%) patients had private insurance, 48 (40.7%) Medicare, 11 (9.3%) Medicaid. Type of AC comprised of 57 (48.3%) apixaban, 17 (14.4%) rivaroxaban, 8 (6.8%) warfarin, 6 (5.1%) enoxaparin, and 30 (25.4%) patients with changing AC. In univariable regression, African American and Medicaid-insured patients had significantly lower adherence, while advancing age, apixaban usage, and 30-day follow-up clinic visit showed a higher adherence. However, in multivariable regression, African American race (PDC -0.135, p = 0.006, CI (−0.231, −0.040) | OMA Adjusted OR 0.166, p = 0.030, CI (0.033, 0.837)) and other non-White, non-Hispanic races (PDC -0.314, p = 0.009, CI (−0.548, −0.080)) were associated with lower AC adherence.</p></div><div><h3>Conclusion</h3><p>In our study, African American and other minority race patients showed lower AC adherence after hospital admission for acute PE. Further studies are needed to address underlying contributors and improve adherence in this population.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"6 ","pages":"Article 100100"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572722000049/pdfft?md5=07161a56690c3bb43f6bcc0062f34910&pid=1-s2.0-S2666572722000049-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136517632","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":"Concordance of experienced-based maintenance warfarin dosing vs. algorithm-based dosing","authors":"Aaron S. Wilson ,&nbsp;Sara R. Vazquez ,&nbsp;John A. Saunders ,&nbsp;Daniel M. Witt","doi":"10.1016/j.tru.2021.100093","DOIUrl":"10.1016/j.tru.2021.100093","url":null,"abstract":"<div><h3>Introduction</h3><p>Warfarin maintenance dosing algorithms improve the time in therapeutic International Normalized Ratio (INR) range (TTR), a surrogate marker for clinical outcomes. Despite demonstrated benefit, many anticoagulation providers utilize experience-based dosing instead. This study assessed rates of concordance between experience-based and algorithm-based warfarin dosing at a single anticoagulation clinic.</p></div><div><h3>Methods</h3><p>Within University of Utah Health Thrombosis Service, patients on a maintenance dose of warfarin with an INR goal of 2.0–3.0 or 2.5–3.5 and who had INR results during November 2019 were included. Experienced-based approaches for out-of-range INRs were compared to a validated dosing algorithm to determine algorithm concordance rates as well as likelihood that algorithm concordance would return the INR into therapeutic range.</p></div><div><h3>Results</h3><p>During the one-month study period, there were 1120 out-of-range INRs in 770 patients included in this analysis. Providers’ decisions were 50.5% algorithm-concordant for dosing adjustments and 59.2% concordant for follow-up intervals. Algorithm-concordant dosing practices resulted in a significantly higher likelihood of returning the subsequent INR to the target range (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.05–1.68), whereas algorithm-concordant follow-up intervals did not significantly impact return of INR to therapeutic range (OR 0.79, 95% CI 0.62–1.00). Baseline deviation from INR goal was determined to be significantly different between concordant and discordant study groups. Controlling for the deviation magnitude attenuated the significance of dosing concordance rates on return to INR target range (adjusted OR 1.16, 95% CI 0.91–1.48), while impact of follow-up concordance remained not statistically significant (adjusted OR 0.84, 95% CI 0.66–1.07). No provider characteristics were associated with the likelihood of return to INR goal.</p></div><div><h3>Conclusion</h3><p>Experience-based dosing was concordant with a validated dosing algorithm only half the time. Algorithm-concordant dosing increased the likelihood of returning the next INR to therapeutic range, though controlling for deviation magnitude attenuated the statistical significance of dosing concordance with return to INR goal rates. These findings support further research regarding implementing strategies that promote the use of a validated dosing algorithm among experienced anticoagulation providers.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"6 ","pages":"Article 100093"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572721000626/pdfft?md5=ebf774855463e4f351faa10bbe935cb4&pid=1-s2.0-S2666572721000626-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42819973","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":"Predictors of thrombosis in patients treated with bevacizumab","authors":"Jessica Sparks ,&nbsp;Xiaoyong Wu ,&nbsp;Mika Kessans Knable ,&nbsp;Shesh N. Rai ,&nbsp;Vivek Sharma","doi":"10.1016/j.tru.2021.100095","DOIUrl":"10.1016/j.tru.2021.100095","url":null,"abstract":"<div><h3>Introduction</h3><p>Bevacizumab is an anti-VEGF monoclonal antibody used widely in oncology. It causes an increased risk of both thrombotic events and proteinuria. Thrombotic events are also a known association of nephrotic syndrome, however, drug-induced proteinuria contributing to thrombosis in this patient population has not been reported in the literature.</p></div><div><h3>Methods</h3><p>Patients treated with bevacizumab from April 2016 to April 2020 at our institution were identified. The primary objective was to investigate the risk of thrombosis in patients who had proteinuria compared to those without proteinuria. Secondary objectives included evaluating other predictors of thrombosis including hypertension, hyperlipidemia, Khorana score, diabetes, atrial fibrillation, tobacco use, and BMI.</p></div><div><h3>Results</h3><p>Of the 203 patients treated with bevacizumab, 160 had some degree of proteinuria. A thrombotic event occurred in 8/58 (13.8%) of the trace proteinuria cohort, 19/102 (18.6%) of the proteinuria greater than 30 mg/dL cohort and 5/43 (11.6%) of the no proteinuria cohort (p = 0.508). Additionally, thrombotic events occurred in 24/116 (20.7%) of the hypertension cohort compared to 8/87 (9.2%) of the normotensive patients (p = 0.026) and in 15/52 (28.8%) of hyperlipidemic patients vs 17/151 (11.3%) of those with normal lipids (p = 0.003). The Khorana score was not a significant predictor in this population. In further analyzing our data, we found increasing thrombotic events with each addition of the most telling predictors of thromboses in our population: hypertension, hyperlipidemia, and greater than trace proteinuria, such that patients with all three risk factors present vs none had an odds ratio of 6.786 (p = 0.004).</p></div><div><h3>Conclusion</h3><p>In patients on bevacizumab, hypertension and hyperlipidemia may better predict thrombotic risk than the Khorana score. While overall proteinuria did not reach statistical significance, there was a numerical trend toward higher rates of thrombosis as the degree of proteinuria increased. Finally, incorporating these three risk factors into a clinical risk score may help stratify patients into lower and higher risk categories which may assist clinicians in making decisions about the use of prophylactic anticoagulation in this population.</p></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"6 ","pages":"Article 100095"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266657272100064X/pdfft?md5=f8024189aec916fe2096e8d40e7c4ff7&pid=1-s2.0-S266657272100064X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48337933","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}