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

{"title":"Health-Related Quality of Life and Associated Factors Among Patients with Deep Vein Thrombosis at a Tertiary University Teaching Hospital in Ethiopia.","authors":"Yeabsira Endale, Melaku Tileku, Amha Gebremedhin, Tamrat Assefa Tadesse","doi":"10.1177/10760296251408062","DOIUrl":"10.1177/10760296251408062","url":null,"abstract":"<p><p>Deep vein thrombosis (DVT) poses a significant global health challenge that affects patients' physical function and symptom burden. Evidence on the health-related quality of life (HRQoL) of patients with DVT remains scarce in Ethiopia. This study aimed to assess DVT-specific quality of life and associated factors among patients with DVT. A hospital-based cross-sectional study was conducted at Tikur Anbessa Specialized Hospital, Ethiopia, in which 123 adults with confirmed DVT were recruited. Data were collected using the Amharic version of the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QOL/Sym) questionnaire, supplemented with clinical and demographic data. VEINES-QOL/Sym scores were standardized to T-scores (mean = 50, SD = 10), with raw scores scaled 0-100 (higher values indicated better HRQoL). Data were analyzed using Statistical Package for the Social Sciences version 28. Binary logistic regression was used to identify factors associated with HRQoL, with statistical significance set at <i>P</i> < .05. Among 123 patients (73.2% provoked, 93.5% unilateral DVT), VEINES-QOL ranged 33.4-59.6 and VEINES-Sym 26.7-58.7, both with a mean value of 50. Longer time since diagnosis was significantly associated with improved QoL (AOR = 1.922; 95% CI 1.155-3.199; <i>P</i> = .012), while proximal DVT (AOR = 0.240; <i>P</i> = .008), combined proximal/distal DVT (AOR = 0.136; <i>P</i> = .014), and post-thrombotic syndrome (PTS) (AOR = 0.108; <i>P</i> = .017) predicted poorer outcomes. In conclusion, VEINES-QOL/Sym scores indicated average QoL with modest improvement over time. Routine HRQoL assessment, PTS prevention, and improved monitoring, adherence, and patient education are recommended to strengthen DVT care in Ethiopia.</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":"10760296251408062"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12775289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914571","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":"Comparing the Direct Oral Anticoagulants versus Vitamin K Antagonists in Bioprosthetic Valves: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Muhammad Hassan Waseem, Zain Ul Abideen, Ameer Haider Cheema, Kanza Farhan, Hafsa Arshad Azam Raja, Muhammad Zubair Tahir, Fahad Saleem, Amna Nadeem, Pawan Kumar Thada","doi":"10.1177/10760296251415375","DOIUrl":"10.1177/10760296251415375","url":null,"abstract":"<p><p>BackgroundReplacing bioprosthetic valves is common but can cause coagulation issues. This study assesses the safety and efficacy of Direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in bioprosthetic valve procedures.MethodsPubMed, Cochrane Central, and ScienceDirect were searched till May 2025. The risk ratios (RRs) were pooled with 95% confidence intervals (CIs) under the random effects model using Review Manager software. The quality assessment was conducted using the Cochrane risk of bias (RoB 2.0) tool.ResultsEight randomized controlled trials involving 3863 patients were included in the meta-analysis. DOACs were associated with a significant reduction in the risk of stroke or systemic embolism compared with VKAs (RR = 0.48; 95%CI: [0.26, 0.88]; p = .02). The rate of major bleeding was similar between the DOACs and VKAs (RR = 0.92; 95%CI: [0.49, 1.72]; p = .79). There was no significant difference in the incidence of any stroke between the two groups (RR = 0.65; 95%CI: [0.32, 1.31]; p = .23). The occurrence of clinically relevant non-major bleeding (RR = 1.17; 95%CI: [0.97, 1.40]; p = .10), all-cause mortality (RR = 0.94; 95%CI: [0.75, 1.17]; p = .57), and intracranial hemorrhage (ICH) (RR = 0.71; 95%CI: [0.40, 1.26]; p = .25) were comparable between the groups.ConclusionDOACs seem safe after bioprosthetic valve implantation, lowering the risk of stroke or systemic embolism. However, rates of major bleeding, clinically relevant non-major bleeding, any stroke, ICH, and all-cause mortality were comparable between DOACs and VKAs.</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":"10760296251415375"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12847668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055581","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":"Prognostic Value of Inflammatory Biomarkers for Mortality in Intensive Care Patients with Acute Pulmonary Embolism: A Retrospective Observational Study.","authors":"Mingqin Zhou, Lifeng Xiao, Hongzhuang Chen, Xiaoluan Lin, Shaona Lin, Ruiyun Lin","doi":"10.1177/10760296251415184","DOIUrl":"10.1177/10760296251415184","url":null,"abstract":"<p><p>ObjectiveTo develop a new inflammatory biomarker-based and simple-to-use nomogram for the early identification of acute pulmonary embolism (PE) patients at a high-risk mortality in intensive care unit (ICU).MethodsWe randomly allocated 1083 acute PE patients from the Medical Information Mart for Intensive Care IV database to derivation and internal validation cohort. We used logistic regression analysis to determine independent risk factors and to construct a predictive nomogram. We subsequently evaluated the calibration, discrimination and clinical usefulness of the nomogram.ResultsAge>66, neutrophil-to-lymphocyte ratio (NLR) > 10.1, lymphocyte-to-monocyte ratio (LMR) < 1.5, red cell distribution width (RDW) > 14.35, respiratory rate (RR) > 26bpm, oxygen saturation (SPO₂), vasopressor use and malignant cancer were detected as important determinants of 28-day mortality and included in our nomogram. The calibration plot revealed an adequate fit of the nomogram for predicting the risk of 28-day mortality. Regarding discriminative power, receiver operating characteristic curve analysis showed that the nomogram had an area under the curve of 0.772 (95% CI:0.732, 0.811, <i>P</i> < .001) in the primary cohort, outperforming other scores.ConclusionsThis proposed simple-to-use nomogram based on age, NLR, LMR, RDW, vasopressor use, RR, SPO₂ and malignant cancer provides accurate death prediction for acute PE patients in ICU.</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":"10760296251415184"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004932","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":"Inherited Thrombophilia and the Risk of Venous Thromboembolism in Patients with Non-Small Cell Lung Cancer, a Case-Control Study.","authors":"José Costa, Margarida Carvalho, Emanuel Cadavez, Jovita Gomes, Rosário Pinto Leite, António Araújo","doi":"10.1177/10760296251399654","DOIUrl":"10.1177/10760296251399654","url":null,"abstract":"<p><p>Background/ObjectivesVenous thromboembolism (VTE) is a frequent complication of cancer, namely lung cancer. Many studies have been done searching for risk factors for VTE, but most don't address the topic of inherited thrombophilia. The aim of this study is to evaluate the contribution of inherited thrombophilia to VTE in patients with Non-Small Cell Lung Cancer (NSCLC).MethodsThis is an observational, prospective, case-control study, involving 40 patients with NSCLC, stages IIIB or IV, 20 with a diagnosis of VTE, and 20 with no VTE. Blood samples were collected for factor V and prothrombin genotyping, functional assays of antithrombin, protein C and protein S, and activated protein C resistance. All patients gave a signed informed consent, and the study was approved by the Ethics Committees of the Institutions involved.ResultsThe case and control groups were similar in terms of gender, age, Body Mass Index (BMI), stage or type of cancer. No patients were found with deficiencies of antithrombin or protein C, or with the prothrombin mutation. Factor V Leiden (FVL) was found in 2 patients from the case group, both with activated protein C resistance, and in none of the control group. Low levels of protein S were found in 2 patients from the control group and 1 from the case group.ConclusionsWe conclude that FVL may be an important risk factor for VTE in patients with NSCLC. If these patients were screened for FVL, we could probably reduce the prevalence of VTE.</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":"10760296251399654"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12783558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145937413","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 Increase Overall but Not Major Bleeding in Critically Ill Chronic Kidney Disease Patients With Pulmonary Embolism.","authors":"Zi-Kang Zhou, Qin-Yi Xu, Jia-Lu Ping, Hao-Nan Chen, Song-Tao Shou, Yan-Cun Liu","doi":"10.1177/10760296261452851","DOIUrl":"10.1177/10760296261452851","url":null,"abstract":"<p><p>BackgroundPatients with pulmonary embolism (PE) and chronic kidney disease (CKD) have a fragile hemostatic balance, yet evidence comparing bleeding risk between direct oral anticoagulants (DOACs) and warfarin in critically ill patients remains limited. We compared overall and major bleeding risks associated with DOACs versus warfarin in ICU patients with PE and CKD.MethodsWe conducted a retrospective cohort study using the MIMIC-IV (v3.1) database. Adult ICU patients with PE and an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² treated with DOACs or warfarin were included. Propensity score matching (PSM) was used as the primary adjustment strategy, with stabilized inverse probability of treatment weighting (IPTW) as sensitivity analysis. Cox proportional hazards models were applied. The primary outcome was any bleeding, and the secondary outcome was major bleeding.ResultsAmong 1,363 patients, 832 received warfarin and 531 received DOACs. After PSM, 1,038 patients were well balanced. In IPTW-weighted analyses, DOAC use was associated with a higher risk of any bleeding compared with warfarin (HR 1.37, 95% CI 1.13-1.66; P = 0.001), while no significant difference was observed for major bleeding (HR 0.97, 95% CI 0.74-1.28; P = 0.84). Results were consistent in the PSM cohort. Renal function did not significantly modify the relative bleeding risk.ConclusionsIn critically ill patients with PE and CKD, DOACs were associated with increased overall bleeding but not major bleeding compared with warfarin. Differentiating non-major from major bleeding is essential when selecting anticoagulant therapy in this 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":"10760296261452851"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950226","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":"Extensive Inferior Vena Cava Thrombosis in Trauma when IVC Filter Placement Is Not Feasible Managed Using ClotTriever and FlowTriever.","authors":"Karthigesu Aimanan, Muhammad Aizat Tamlikha Ismail, Michael Arvind, Putera Mas Pian, Hanif Hussein","doi":"10.1177/10760296261463768","DOIUrl":"10.1177/10760296261463768","url":null,"abstract":"<p><p>BackgroundManagement of extensive inferior vena cava (IVC) thrombosis following trauma is challenging, particularly when IVC filter placement is unsuitable. The presence of concomitant injuries requiring surgical intervention further complicates decisions regarding anticoagulation and pulmonary embolism prevention.Case PresentationA 40-year-old man presented following a high-velocity motorcycle accident with multiple facial fractures and a left radial shaft fracture. Contrast-enhanced computed tomography demonstrated no solid organ or major vascular injury but revealed extensive thrombosis extending from the infrarenal IVC into the bilateral common iliac veins. Following hemodynamic stabilization and exclusion of intracranial and intra-abdominal hemorrhage, therapeutic unfractionated heparin infusion was initiated. Despite anticoagulation, progressive lower limb swelling developed. Given the extensive thrombus burden and the need for subsequent surgical procedures, further intervention was considered. The suprarenal IVC measured 32 mm in diameter, and concerns regarding filter stability, migration, and reduced efficacy rendered IVC filter placement suboptimal.Intervention and OutcomeFollowing multidisciplinary discussion, percutaneous mechanical thrombectomy was performed using a combined ClotTriever BOLD and FlowTriever system. A 25-mm FlowTriever disc was deployed in the retrohepatic IVC for temporary embolic protection during thrombectomy. Successful thrombus extraction restored caval patency without complications. Lower limb swelling resolved within three days, allowing staged orthopedic and maxillofacial reconstruction. Thrombophilia screening was negative, and the patient completed nine months of rivaroxaban therapy without recurrence.ConclusionCombined ClotTriever and FlowTriever mechanical thrombectomy may be an effective treatment option for extensive traumatic iliocaval thrombosis when IVC filter placement is not feasible or considered suboptimal.</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":"10760296261463768"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304378","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 Association Between Immune Cells and Venous Thromboembolism: A Causal Inference Based on Mendelian Randomization.","authors":"Jingyi Zhu, Jiamei Chen, Yanxiao Wang, Xiaodong Xu, Feiyang Wang, Yixin Zhu, Qi Zhang, Lin Zhu","doi":"10.1177/10760296261456850","DOIUrl":"10.1177/10760296261456850","url":null,"abstract":"<p><p>BackgroundEmerging evidence suggests that various types of immune cells are associated with venous thromboembolism (VTE). However, the roles of distinct immune cell phenotypes in VTE remain largely unclear.MethodsBy analyzing 731 distinct immune traits identified through genome-wide association studies (GWAS) and publicly available genetic data from patients with VTE in the FinnGen database, we applied rigorous quality control steps to identify instrumental variables (IVs) associated with exposure. We performed two-sample Mendelian randomization (MR) using inverse-variance weighting to assess causal associations between 731 immune traits and VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE). To assess the robustness of the findings, sensitivity analyses such as leave-one-out cross-validation and additional Mendelian randomization approaches were performed. Subsequently, Bayesian colocalization analysis (COLOC) was employed to identify potential colocalized genetic signals, thereby providing additional support for the MR findings.ResultsAt an FDR-adjusted significance threshold, three immune phenotypes, including CD4 on CD39+CD4+T cell, naive CD4+ T cell absolute cell counts (ACs), and CD4-CD8-natural killer (NK) T% T cell were negatively associated with the risk of VTE. CD45RA+ CD8+ T cell AC was negatively linked to the onset of DVT. Additionally, five immune phenotypes, including human leukocyte antigen (HLA) DR+ NK%CD3-lymphocyte, HLA DR+ NK%NK, side scatter area (SSC)-A on HLA DR+ NK, PDL-1 on CD14-CD16+ monocyte and CD16 on CD14+CD16+ monocyte were negatively associated with the risk of PE. CD86+ myeloid dendritic cell (DC) ACs and CD86+ myeloid DC% DC were positively correlated with PE. COLOC analysis revealed that naive CD4+ T cell AC variants (rs3104369) colocalized with VTE.ConclusionOur findings reveal that different immune phenotypes exhibit either protective or risk-increasing effects on VTE, improving our understanding of VTE risk factors and offering valuable insights for advancing future research and clinical implementation.</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":"10760296261456850"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140602","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":"A Prospective Analysis of Viscoelastic Assays, Platelet Aggregometry, and Standard Laboratory Tests in Predicting Perioperative Blood Loss in Cardiac Surgery.","authors":"Yerlan Orazymbetov, Serik Aitaliyev, Povilas Jakuška, Audronė Veikutienė, Tadas Lenkutis, Rassul Zhumagaliyev, Vilius Skipskis, Yerik Aitaliyev, Aušra Saudargienė, Rimantas Benetis","doi":"10.1177/10760296261432450","DOIUrl":"10.1177/10760296261432450","url":null,"abstract":"<p><p>BackgroundPostoperative bleeding following cardiopulmonary bypass (CPB) remains a significant challenge. Although viscoelastic testing is increasingly used, the relative contributions of fibrinogen, platelet count and clot firmness to blood loss remain debated. We evaluated the diagnostic accuracy of thromboelastometry (ROTEM) compared with platelet aggregometry (PA) and standard tests, using the Hb/kg index to quantify blood loss.MethodsIn this prospective observational study conducted at the University Hospital (Kaunas, Lithuania) we enrolled 79 patients undergoing elective cardiac surgery. Simultaneous assessments using ROTEM (EXTEM, INTEM, FIBTEM, PLTEM), PA, and standard coagulation tests were performed. The primary endpoint was the correlation between haemostatic parameters and the Hb/kg Index. Diagnostic accuracy for hypofibrinogenaemia (<2.5 g/L) and thrombocytopenia (<150 × 10⁹/L) was assessed using Receiver Operating Characteristic (ROC) analysis.ResultsPost-CPB platelet count and fibrinogen decreased significantly (p < 0.001). However, a notable dissociation was found: neither platelet count, PLTEM, PA parameters nor standard clotting times correlated with the Hb/kg Index (p > 0.05). In contrast, viscoelastic measures of clot firmness (FIBTEM A10) and fibrinogen levels significantly predicted blood loss. FIBTEM A10 (12 mm) demonstrated excellent accuracy for hypofibrinogenaemia (AUC = 0.888), providing a sensitivity of 96% and a negative predictive value of 97.4%.ConclusionPost-CPB bleeding is primarily driven by reduced clot firmness and fibrinogen deficiency rather than by platelet count or aggregation defects. FIBTEM A10 is a superior rapid detector of hypofibrinogenaemia. Transfusion algorithms should prioritize the maintenance of functional clot firmness over the correction of static platelet numbers.</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":"10760296261432450"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12966529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367837","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":"Quantifying Lupus Anticoagulant Interference in Intrinsic Coagulation Factor Activity Assays and Evaluating the Corrective Performance of the SCT-Based Method.","authors":"Yu Yang, Yuanyuan Li, Anna Jiang, Yao Lu, Ran You, Linzi Miao, Run Qin, Zijing Zhu, Ying Xing, Chenxue Qu","doi":"10.1177/10760296261427177","DOIUrl":"10.1177/10760296261427177","url":null,"abstract":"<p><p>BackgroundLupus anticoagulant (LA) prolongs phospholipid-dependent coagulation tests and can falsely reduce intrinsic coagulation factor activities in one-stage assays. The quantitative relationship between LA intensity and the degree of assay interference remains insufficiently defined.MethodsOne hundred patients with LA-positive antiphospholipid syndrome or systemic lupus erythematosus were studied. FVIII:C, FIX:C, and FXI:C were measured using one-stage assays, and a modified assay incorporating SCT-confirm reagent was applied to reduce LA interference. The pseudo-lowering degree (PLD) was calculated to quantify correction efficacy. Associations between LA characteristics and reduced factor activities were analyzed, and activity levels or PLD values across LA-intensity subgroups were compared.ResultsUsing one-stage assays, reduced FVIII:C, FIX:C, and FXI:C were noted in 27%, 23%, and 26% of patients, respectively. LA intensity was unrelated to reduced FVIII:C but significantly associated with decreased FIX:C (<i>P</i> = .006) and FXI:C (<i>P</i> < .001). Moderate LA positivity showed higher FIX:C levels than weak positivity, whereas markedly lower FXI:C was seen only in strongly LA-positive patients. The SCT correction assay restored FVIII:C, FIX:C, and FXI:C to normal levels in approximately 66.7%, 82.6%, and 92.3% of affected cases, respectively. In strongly LA-positive patients, PLD values of FVIII:C, FIX:C, and FXI:C were significantly higher than in weak or moderate subgroups.ConclusionsFVIII:C, FIX:C, and FXI:C exhibit differential susceptibility to LA interference. The SCT-based correction approach effectively mitigates this effect, especially for FXI and offers a practical improvement over conventional one-stage assays to avoid misclassification of intrinsic factor deficiencies in LA-positive patients.</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":"10760296261427177"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12932892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286852","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 Association of Monocytes/High-Density Lipoprotein Cholesterol Ratio With Cardiovascular-Kidney-Metabolic Syndrome and Its All-Cause Mortality - Evidence From NHANES 2003-2018.","authors":"Xuhou Ji, Guangzan Yu, Lulu Liu, Qian Ma, Hua He","doi":"10.1177/10760296261486135","DOIUrl":"10.1177/10760296261486135","url":null,"abstract":"<p><p>BackgroundCardiovascular-kidney-metabolic syndrome, defined by the American Heart Association (AHA), is characterized by heart and kidney dysfunction. This dysfunction results from systemic inflammation and oxidative stress, which are caused by insulin resistance (IR) and severe obesity. This study explores the association between the monocyte/high-density lipoprotein-cholesterol ratio (MHR) and cardiovascular-kidney-metabolic syndrome, and its association with all-cause mortality.MethodsThe data for this study come from the National Health and Nutrition Examination Survey (NHANES) conducted from 2003 to 2018 and the National Death Index (NDI) database. Statistical analysis methods such as multiple logistic regression and Cox regression were employed. Additionally, restrictive cubic spline models and subgroup analyses were applied.ResultsThis study included 13,323 participants, of whom 2,452 were identified as having Cardiovascular-Kidney-Metabolic (CKM) syndrome. MHR levels differed significantly between participants with and without CKM syndrome. Weighted logistic regression showed that higher MHR was significantly associated with increased prevalence of CKM syndrome (OR: 1.19; 95% CI: 1.07-1.32). When MHR was analyzed by quartiles, the prevalence of CKM syndrome increased progressively across quartiles (Q4 vs. Q1, OR: 1.63; 95% CI: 1.27-2.11). Restricted cubic spline analysis revealed a nonlinear positive association between MHR and CKM syndrome (P-nonlinear < 0.001). Among participants with CKM syndrome, weighted Cox regression showed that MHR was significantly associated with all-cause mortality (HR: 1.04; 95% CI: 1.01-1.06). After covariate adjustment, restricted cubic spline analysis demonstrated a significant overall association between MHR and mortality (global P = 0.02), with no evidence of nonlinearity (P for nonlinearity = 0.48), suggesting a linear dose-response relationship. Subgroup analyses indicated that the association between MHR and all-cause mortality in CKM syndrome was generally consistent across subgroups, with no significant interactions detected.ConclusionOur study demonstrates that MHR is independently associated with a higher prevalence of CKM syndrome. Among patients with CKM syndrome, MHR showed a modest association with all-cause mortality. These findings suggest that MHR may have potential utility as a biomarker for CKM syndrome, although its prognostic value for mortality appears limited and warrants further prospective validation.</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":"10760296261486135"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13558920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922550","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}