Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis最新文献

{"title":"Factors Affecting the Time in Therapeutic Range of Warfarin Anticoagulation Therapy in Patients with Atrial Fibrillation.","authors":"Xiao Luo, Qibao Zhou","doi":"10.1177/10760296251414128","DOIUrl":"10.1177/10760296251414128","url":null,"abstract":"<p><p>ObjectiveTo explore the factors affecting the Time in Therapeutic Range (TTR) of warfarin anticoagulation therapy and propose a novel TTR prediction model.MethodsPatients with atrial fibrillation who received warfarin anticoagulation therapy and had complete follow-up data between January 2020 and September 2021 at The First Hospital of Jiujiang City were retrospectively included. All participants were divided into a high quality TTR group and a non high quality TTR group based on whether TTR ≥70%. The predictive value of clinical indicators for TTR was assessed utilizing the area under the receiver operating characteristic curve (AUC).ResultsA total of 136 patients were included in the final analysis. The results showed that PT, RDW, PDW, RAVD, and NXT were significantly associated with TTR. The combination model of PT, RDW, PDW, RAVD, and NXT resulted in the highest AUC of 0.900 (95% CI: 0.848-0.952) with the specificity (0.835) and sensitivity (0.843).ConclusionPT, RDW, PDW, RAVD, and NXT were important influencing factors for TTR in warfarin anticoagulation therapy. Combining these clinical indicators can effectively predict the TTR of warfarin anticoagulation therapy.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296251414128"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004986","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":"Outcomes of Thrombolysis for Left-Sided Mechanical Valve Thrombosis: A 10-Year Retrospective Study.","authors":"Abid M Sadiq, Nithin P R, Pradeep Kumar Karkal","doi":"10.1177/10760296261417224","DOIUrl":"10.1177/10760296261417224","url":null,"abstract":"<p><p>BackgroundThrombolysis remains a key treatment for mechanical left-sided valve thrombosis, but outcomes vary across agents and patient groups. We evaluated thrombolysis effectiveness and predictors of failure in a large single-center cohort.MethodsWe performed a retrospective cohort study of all patients with mechanical left heart valve thrombosis treated with thrombolysis at the Narayana Institute of Cardiac Sciences, Bangalore, from January 2013 to December 2023. Clinical, echocardiographic, and treatment data were obtained from the emergency registry and medical records. The primary outcome was successful thrombolysis, defined as complete restoration of valve function on echocardiography by hospital discharge without in-hospital complications. Logistic regression identified determinants of failure (p < 0.05 significant).ResultsWe analyzed 190 patients (median age 43 years, IQR 36-52; 50% female). Bi-leaflet valves were present in 81.1%, and streptokinase was most frequently used (57.9%). Overall, 145 patients (76.3%) achieved successful thrombolysis, while 45 (23.7%) failed treatment. Major ischemic events occurred in 7.4%, hemorrhage in 1.6%, and 13 patients (6.8%) died. On multivariable analysis, failure was independently associated with female sex (aOR 2.59, 95% CI 1.13-5.92), double valve replacement (aOR 6.40, 95% CI 2.48-16.56), anemia (aOR 5.02, 95% CI 1.55-16.28), streptokinase use (aOR 3.05, 95% CI 1.11-8.33), and absence of fluoroscopy prior to therapy (aOR 3.77, 95% CI 1.59-8.95).ConclusionThrombolysis achieved a 76.3% success rate, consistent with global reports. Tenecteplase showed greater success and fewer complications than streptokinase. Accounting for sex, valve type, anemia, and fluoroscopy may improve outcomes in mechanical valve thrombosis.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261417224"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021268","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":"Value of Multimodal Computed Tomography Quantitative Analysis for Predicting Early Neurological Deterioration in Acute Ischemic Stroke Patients Undergoing Intravenous Thrombolysis.","authors":"Mo Chen, Yujia Zhai, Liangqun Rong, Xiue Wei, Haiyan Liu","doi":"10.1177/10760296261416510","DOIUrl":"10.1177/10760296261416510","url":null,"abstract":"<p><p>ObjectiveWe aimed to explore the performance of multimodal computed tomography (CT) quantitative analysis for predicting early neurological deterioration in acute ischemic stroke (AIS) patients undergoing intravenous thrombolysis.MethodsData from 100 AIS patients who underwent multimodal CT and intravenous thrombolysis between January 2020 and December 2023 were collected. An END group and a non-END group were set based on the presence and absence of END after treatment.ResultsAmong the 100 AIS patients, 22 developed END after intravenous thrombolysis, accounting for 22.00%. Infarct core volume was positively associated with END (P < .05), whereas ischemic penumbra volume, ASPECTS, and rLMC score showed inverse associations with END (P < .05). In multivariable analysis, infarct core volume independently increased the odds of END, while higher ASPECTS, rLMC scores, and larger penumbra volumes were associated with lower odds of END. The areas under the receiver operating characteristic (ROC) curves of infarct core volume, ischemic penumbra volume, ASPECTS and rLMC score for predicting the occurrence of END in AIS patients receiving intravenous thrombolysis were 0.761, 0.710, 0.726, 0.715 and 0.846, respectively.ConclusionMultimodal CT quantitative indicators like infarct core volume, ischemic penumbra volume, ASPECTS, and rLMC score have independent predictive values for the occurrence of END in AIS patients receiving intravenous thrombolysis, and their combination exhibits the highest predictive value.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261416510"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021216","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":"Perioperative Deep Vein Thrombosis in Elderly Patients with Lower Extremity Fracture: A Comprehensive Review of Anesthetic Management Strategies.","authors":"Yanping Jian, Qing Liu, Fei Wang, Zhendong Huang","doi":"10.1177/10760296261417219","DOIUrl":"10.1177/10760296261417219","url":null,"abstract":"<p><p>Elderly patients with lower extremity fractures are at high risk for deep vein thrombosis (DVT) and its potentially fatal complication, pulmonary embolism. As perioperative physicians, anesthesiologists serve pivotal roles in mitigating thrombosis risk and optimizing patient outcomes, thus requiring a comprehensive understanding of the pathophysiology and management of DVT in this vulnerable population. Despite its significant clinical importance, comprehensive literature on perioperative DVT management for elderly patients with lower extremity fractures remains scarce. This review synthesizes evidence regarding epidemiology, pathophysiology, diagnostic challenges, multimodal prevention strategies for fracture-related thrombosis, and specific anesthetic considerations for this vulnerable population. It emphasizes the importance of routine preoperative Doppler ultrasonography and early DVT prevention. Besides pharmacological prevention, physical prevention and early mobilization constitute essential DVT prophylaxis components. Anesthesiologists must judiciously weigh thromboprophylaxis benefits against hemorrhage risks while addressing the inherent conflict between preoperative comorbidity optimization and timely surgical intervention, striving to perform surgery within 48 h after injury. Intraoperatively, neuraxial anesthesia should be preferred in the absence of contraindications, and anticoagulation and effective analgesia should be resumed early postoperatively to facilitate early mobilization. Through rigorous evaluation of contemporary literature and clinical practice, this review delivers evidence-based recommendations to enhance clinical decision-making and improve perioperative anesthesia management for this high-risk population.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261417219"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021234","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":"Causal Associations Between Human Blood Metabolites and Cardio-Cerebrovascular Diseases: A Mendelian Randomisation Study.","authors":"Honghong Zhang, Jiangzhen Xie, Chaojie He, Huilin Hu, Changlin Zhai, Gang Qian, Menghui Mao","doi":"10.1177/10760296261420227","DOIUrl":"10.1177/10760296261420227","url":null,"abstract":"<p><p>BackgroundBlood metabolites are crucial in various aspects of human health. However, current evidence regarding the role of circulating metabolites in various cardio-cerebrovascular diseases (CVDs) is limited. Mendelian randomisation (MR) can be used to provide information about these metabolites.ObjectivesOur primary aim was to investigate the causal relations between human blood metabolites and the risk of 10 CVDs.MethodsWe conducted a two-sample MR study. Data on 486 human blood metabolites were obtained from a genome-wide association study (GWAS) involving 7824 participants. Outcome data were sourced from the most recent large-scale GWAS meta-analysis by FinnGen (R9) on various CVDs. The inverse variance-weighted (IVW) model was used as the primary method for this analysis. Moreover, we performed sensitivity analyses, which included heterogeneity testing, horizontal pleiotropy testing and leave-one-out analysis, to evaluate the robustness and credibility of the findings.ResultsThis study identified 36 known metabolites potentially associated with 10 CVDs, and sensitivity analyses showed no significant heterogeneity or pleiotropy.ConclusionsOur study utilised systematic MR analyses and provides evidence for the causal relations between blood metabolites and CVDs. This sheds new light on the potential mechanisms underlying various CVDs and holds significant implications for screening, preventing and treating these conditions.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261420227"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146095285","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":"Stress Hyperglycemia Ratio as a Predictor of All-Cause Mortality in Patients With Non-Traumatic Intracerebral Hemorrhage: From the MIMIC-IV Database.","authors":"Qianmiao Zhu, Zhichao Chen, Weiqi Bian, Haifeng Liu, Qiang Li, Tao Xu, Zhongzhong Lvy, Handong Wang","doi":"10.1177/10760296261474718","DOIUrl":"10.1177/10760296261474718","url":null,"abstract":"<p><p>BackgroundStress hyperglycemia ratio (SHR) reflects the acute glycemic response to physiological stress. This study aimed to investigate the association between SHR and clinical outcomes in hospitalized patients with intracerebral hemorrhage (ICH).MethodData were extracted from the MIMIC-IV database. SHR was calculated using the following formula: admission blood glucose (mg/dL)/(28.7 × HbA1c (%) - 46.7). Restricted cubic spline (RCS) curves were utilized to explore potential nonlinear relationships between SHR and outcomes. Cox regression models were employed to assess the association between SHR and in-hospital mortality, and Kaplan-Meier curves were used to examine survival outcomes.ResultsA total of 1663 inpatients with ICH were included, with an in-hospital mortality rate of 7.5% (125/1663). RCS analysis revealed a significant non-linear association between SHR and the risk of all-cause mortality (all P < 0.05 for non-linearity). In the multi-variable Cox regression analysis, a higher SHR was significantly associated with an increased risk of all-cause mortality [adjusted HR =2.13 (95%CI 1.20-3.70), P = 0.009]. This positive association remained consistent across specific subgroups, including individuals aged > 65 years [HR 3.23 (95% CI 1.14-9.09)], females [HR 3.33 (95% CI 1.43-7.69)], and those with diabetes [HR 2.94 (95% CI 1.54-5.88)], COPD [HR 2.86 (95% CI 1.64-4.76)], or CKD [HR 3.03 (95% CI 1.61-5.56)].ConclusionA significant non-linear relationship was observed between SHR and all-cause mortality in hospitalized patients with ICH. Elevated SHR may serve as a potential predictor of poor prognosis in patients with ICH.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261474718"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687541","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":"Comparative Efficacy and Safety of Non-Clotting Factor Prophylaxis Versus. on-Demand Therapy in Hemophilia: A Meta-Analysis of Randomized Controlled Trials.","authors":"Rehan Ishaque, Abdul Subhan Talpur, Huda Memon, Laksh Ahuja, Fnu Reya, Amna Ikram, Muhammad Ahsan Siddiqui, Manahil Ali, Hamza Danish, M Raafe Ali Khan, Raghad El Joujou, Hamza Janjua, Hira Janjua, Aswanth Reddy, Supratik Rayamajhi","doi":"10.1177/10760296261425039","DOIUrl":"10.1177/10760296261425039","url":null,"abstract":"<p><p>IntroductionHemophilia A and B are among the most common inherited bleeding disorders in humans with lifelong risk of spontaneous and recurrent bleeding. While prophylaxis with clotting factors has improved outcomes, challenges like inhibitor development and treatment burden persist. We aim for a comparative effectiveness between these agents and traditional therapy with this study.MethodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Studies were identified through PubMed, Cochrane Central, and ClinicalTrials.gov up to May 30th, 2025. Eligible studies were double-arm RCTs comparing non-clotting factor prophylaxis (emicizumab, fitusiran, concizumab) and on-demand therapy in patients with hemophilia A or B.ResultsNon-clotting factor prophylaxis significantly reduced the annualized bleeding rate (ABR) for all treated bleeds [<i>n</i> = 399, (RR = 0.13; 95% CI: 0.09-0.19), <i>I</i>² = 63.8%, <i>p</i> = 0.0107], spontaneous bleeds [RR = 0.08; 95% CI: (0.06, 0.11), <i>I</i>² = 0.0%, <i>p</i> = 0.5933)] and joint bleeds [RR = 0.09; 95% CI: (0.06, 0.14), : <i>I</i>² = 26.2%, <i>p</i> = 0.2468 ]. Haem-A-QoL total score improved with prophylaxis [MD = -11.08 [-16.34, -5.83], <i>I</i>² = 57.5%, <i>p</i> = 0.0949]. Prophylaxis increased the likelihood of achieving zero treated bleeds [RR = 4.11; 95% CI: (1.48%, 11.45%), <i>I</i>² = 88.5%, <i>p</i> < 0.0001]. An exploratory network meta-analysis comparing fitusiran, emicizumab, and concizumab reported no statistically significant difference in the ABR for all treated bleeds.ConclusionCompared to on-demand therapy, non-factor prophylactic therapies significantly reduce bleeding episodes, improve quality of life, and increase the likelihood of zero bleeds in patients with hemophilia.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261425039"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345935","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":"Efficacy and Safety of Romiplostim Versus Placebo in Immune Thrombocytopenia: A Systematic Review and Meta-Analysis.","authors":"Humayou Ahmed, Muhammad Saad Khan, Daniyal Zulfiqar, Kainat Mehmood, Kanza Farhan, Syed Ali Hassan, Fiza Shaikh, Umarah Lutuf, Aqsa, Aminath Waafira","doi":"10.1177/10760296261476820","DOIUrl":"10.1177/10760296261476820","url":null,"abstract":"<p><p>BackgroundImmune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia and increased bleeding risk. Although first-line therapies such as corticosteroids and intravenous immunoglobulin provide initial benefit, many patients relapse or develop refractory disease. Romiplostim, a thrombopoietin receptor agonist, has emerged as an effective second-line therapy; however, evidence comparing its efficacy and safety with placebo across both pediatric and adult populations remains limited.MethodsA systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines (PROSPERO: CRD420261357179). PubMed, Scopus, Cochrane Library, and Google Scholar were searched up to March 2026. RCTs comparing romiplostim with placebo in ITP patients were included. A random-effects model was used to calculate mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI). Risk of bias was assessed using the Cochrane RoB 2 tool. Certainty of evidence was evaluated using the GRADE approach.ResultsNine RCTs (n=748) were included. Romiplostim significantly increased platelet counts at week 2 (MD 25.71; 95% CI 9.41-42.02), week 4 (MD 42.74; 95% CI 26.82-58.66), week 6 (MD 50.42; 95% CI 33.87-66.97), and week 8 (MD 49.14; 95% CI 20.45-77.83), with larger effects in adults. Platelet response rates were significantly higher with romiplostim (RR 6.10). The proportion achieving ≥20×10⁹/L increase improved (RR 3.23), and the need for rescue therapy decreased (RR 0.49). Adverse events were comparable between groups, with slight increases in myalgia and rash.ConclusionRomiplostim is an effective and well-tolerated therapy for ITP, significantly improving platelet outcomes and reducing rescue therapy requirements without major safety concerns.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261476820"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681944","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":"Diagnostic Management of Asymptomatic Pulmonary Embolism: A Predictive Model Integrating Inflammatory Markers and Clinical Characteristics in Patients With Deep Vein Thrombosis.","authors":"Xiaomin Mu, Qi An, Guangxu Wan, Ziqiang Sun","doi":"10.1177/10760296261472604","DOIUrl":"10.1177/10760296261472604","url":null,"abstract":"<p><p>BackgroundPulmonary embolism (PE) may be asymptomatic due to the compensatory function of the lungs themselves, which easily leads to missed diagnosis and increased risks. Although computed tomography pulmonary angiography (CTPA) can improve the detection rate, routine CTPA screening for patients with concurrent lower extremity deep vein thrombosis (DVT) still faces challenges. These include limited medical resources, restricted use of contrast agents (e.g., allergies, renal function issues), and low specificity of D-dimer. Therefore, there is a need to develop optimized diagnostic strategies based on inpatient DVT populations to accurately identify high-risk patients requiring CTPA, while acknowledging that these findings cannot be directly generalized to all DVT outpatients and reduce unnecessary contrast agent exposure.MethodsThis retrospective study analyzed patients admitted with lower extremity DVT (Jan 2022-Apr 2024). After excluding those with acute PE symptoms or other key confounders (e.g., recent anticoagulation), 401 patients were included. All underwent CTPA and were classified into asymptomatic PE (n=198) or isolated DVT (n=203) groups. Predictors of asymptomatic PE were identified using binary logistic regression.ResultsAfter screening based on inclusion and exclusion criteria, 401 patients were finally included in the analysis, with 198 cases in the asymptomatic PE group and 203 cases in the DVT group. Multivariate regression analysis showed that hypertension, neutrophil-to-lymphocyte ratio (NLR), smoking duration, right distal DVT, right proximal DVT, and lower extremity swelling and pain were independent risk factors for asymptomatic PE (OR = 3.461, 1.303, 1.103, 2.878, 4.495, 7.176,). The area under the curve (AUC) of the model was 0.874, with a sensitivity of 73.74% and a specificity of 82.27%.ConclusionThe combined detection of these independent risk factors-hypertension, NLR, smoking duration, right distal DVT, right proximal DVT, and lower extremity swelling and pain-is expected to facilitate early screening for asymptomatic PE in hospitalized DVT populations, with further external verification required to extend its applicability to broader DVT cohorts.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261472604"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595480","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":"Discrepant Outcomes of Direct Oral Anticoagulant Trials in Device-Detected Atrial Fibrillation after Stroke: Insights from NOAH-AFNET 6 and ARTESIA.","authors":"Heng Liu, Zhangbin Li, Xiaoqing Chen, Junjie Zhou","doi":"10.1177/10760296261438235","DOIUrl":"10.1177/10760296261438235","url":null,"abstract":"<p><p>The management of device-detected atrial fibrillation in patients with a history of stroke or transient ischemic attack remains a clinical dilemma, balancing the potential benefits of stroke prevention against the risks of anticoagulant-related bleeding. This review synthesizes evidence from the NOAH-AFNET 6 and ARTESIA trials, which evaluated the efficacy and safety of direct oral anticoagulants in this population. Collectively, randomized evidence regarding the use of direct oral anticoagulants in patients with device-detected atrial fibrillation and a history of stroke or transient ischemic attack remains limited and internally discordant. In ARTESIA, apixaban was associated with a reduction in ischemic stroke accompanied by an increase in major bleeding, yielding a relatively coherent benefit-risk signal in this high-risk subgroup. In contrast, NOAH-AFNET 6 demonstrated a modest and statistically non-significant reduction in ischemic stroke alongside a substantial increase in major bleeding. Further research is still needed to refine patient selection and optimize therapeutic strategies.</p>","PeriodicalId":520590,"journal":{"name":"Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis","volume":"32 ","pages":"10760296261438235"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518155","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}