Thrombosis Update最新文献

{"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":"2025-06-01","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":"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":"2025-06-01","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":"Developing a decision support tool for the continuation or deprescribing of antithrombotic therapy in patients receiving end-of-life care: Protocol for a European Delphi study","authors":"Imene Deneche ,&nbsp;Camille Couffignal ,&nbsp;Nassima Si Mohammed ,&nbsp;Anette Arbjerg Højen ,&nbsp;Carme Font ,&nbsp;Stavros Konstantinides ,&nbsp;Marieke Kruip ,&nbsp;Luigi Maiorana ,&nbsp;Sebastian Szmit ,&nbsp;Denise Abbel ,&nbsp;Laurent Bertoletti ,&nbsp;Susanne Cannegieter ,&nbsp;Adrian Edwards ,&nbsp;Michelle Edwards ,&nbsp;Alessandra Gava ,&nbsp;Jacobijn Gussekloo ,&nbsp;Miriam J. Johnson ,&nbsp;Rashmi Kumar ,&nbsp;Johan Langendoen ,&nbsp;Kate Lifford ,&nbsp;Isabelle Mahé","doi":"10.1016/j.tru.2025.100209","DOIUrl":"10.1016/j.tru.2025.100209","url":null,"abstract":"<div><h3>Introduction</h3><div>To develop a European shared decision support tool (SDST), a Delphi process will be used to reach consensus about aspects relating to the continuation or deprescribing of antithrombotic therapy (ATT) in cancer patients at the end of life. As part of the SERENITY project, this study corresponds to work package (WP) 4.</div></div><div><h3>Methods</h3><div>Findings from SERENITY WPs 1–3 (realist review, flash mob research, epidemiological and qualitative studies) informed the Delphi study. The WP4 steering committee had two objectives. (1) to build a representative expert panel comprising physicians, pharmacists, nurses and psychologists from eight European countries; and (2) to advise on the content of the Delphi form, divided into four sections: context, content, SDST design and trial outcomes. The form was reviewed by the SERENITY patient and public involvement group to ensure that it met patients’ needs. The Delphi study will take place in three rounds held at 6-week intervals, involving experts from eight countries. Consensus will be reached on items with at least 70 % agreement. The steering committee will review and validate the results across the different rounds.</div></div><div><h3>Results</h3><div>Through this Delphi study, the following aspects will be defined: characterisation of candidate patients for discussion about ATT deprescribing; healthcare team roles in ATT decision-making; specific information and communication requirements for patients when making deprescribing decisions; SDST content priorities; and optimal outcomes for the planned clinical trial.</div></div><div><h3>Conclusion</h3><div>This study will feed directly into the development and evaluation of the SDST, aimed at reducing complications and improving quality-of-life in end-of-life cancer patients receiving ATT.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"19 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166908","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":"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":"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":"2025-03-01","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":"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":"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":"2025-03-01","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}

{"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":"2025-03-01","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":"2025-03-01","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":"Involving patients and the public in cancer associated thrombosis research: A strategy for success","authors":"Michelle Edwards ,&nbsp;Kathy Seddon ,&nbsp;Elin Baddeley ,&nbsp;Anne Gulbech Ording ,&nbsp;Mark Pearson ,&nbsp;Isabelle Mahe ,&nbsp;Simon Mooijaart ,&nbsp;Frederikus A. Klok ,&nbsp;Simon I.R. Noble ,&nbsp;SERENITY consortium","doi":"10.1016/j.tru.2024.100196","DOIUrl":"10.1016/j.tru.2024.100196","url":null,"abstract":"<div><div>The role of public involvement (PI) in biomedical research has never been greater, with accumulating evidence demonstrating its ability to improve the quality of research and the likelihood of translating findings into clinical practice. As the demand for meaningful PI in research continues to grow, research teams are required to provide more than a tokenistic acknowledgement of the role of public contributors to the success of a project.</div><div>This paper presents an overview of PI as a whole and specifically reflects on how it has added value, to an international cancer associated thrombosis research program. It introduces tools designed to guide teams unfamiliar with PI, introducing the Public Involvement in Research Impact Toolkit (PIRIT) which provides a structure for planning and reporting on PI activities from the study inception through conduct, to its impact.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162994","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}