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

{"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}

{"title":"Safety and Efficacy of Asundexian in Cardiovascular Diseases, Updated Systemic Review and Meta Analysis.","authors":"Erum Siddiqui, Noor Ahmad, Simrn Majid, Maryam Ayesha, Marium Khan, Arshia Arif Janjua, Shamyl Zehra, Daniyal Rashid, Sajida Batool, Hajra Fatima, Roheen Raza, Ayesha Masood, Misheezable Ishaq, Muhammad Saad Khan, Syed Hassan Ali, Aminath Waafira","doi":"10.1177/10760296261496962","DOIUrl":"10.1177/10760296261496962","url":null,"abstract":"<p><p>BackgroundThromboembolic events remain a major cause of morbidity and mortality in cardiovascular diseases. Asundexian, an oral factor XIa inhibitor, has been proposed to reduce thrombosis while minimizing bleeding risk. The recent OCEANIC-STROKE trial provided substantial new evidence. We conducted an updated systematic review and meta-analysis incorporating this large trial.MethodsPubMed, Scopus, embase and CENTRAL were searched through April 2026. Five RCTs (n=31,301) comparing asundexian 50 mg daily with placebo or apixaban in patients with AF, acute myocardial infarction or stroke were included. Outcomes included all-cause mortality, ischemic stroke, stroke or systemic embolism, ISTH-defined major bleeding, other bleeding events, adverse events (AEs) and serious AEs. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model.ResultsFive RCTs involving 31,301 participants were included. Asundexian did not significantly affect all-cause mortality (RR 0.98, 95% CI 0.85-1.14), ischemic stroke (RR 1.33, 95% CI 0.66-2.66) or stroke/systemic embolism (RR 1.20, 95% CI 0.28-5.12). No significant differences were observed in major bleeding, clinically relevant non-major bleeding, minor bleeding, hemorrhagic stroke, adverse events or serious adverse events. Sensitivity analyses reduced heterogeneity and suggested a lower risk of stroke/systemic embolism (RR 0.74, 95% CI 0.65-0.84), while other findings remained unchanged.ConclusionsAsundexian demonstrated a favorable safety profile but did not significantly reduce mortality or ischemic stroke. Sensitivity analyses suggest a potential benefit in reducing stroke or systemic embolism without increasing bleeding risk. Further trials are needed to identify patient populations most likely to benefit.</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":"10760296261496962"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169747","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":"Global, Regional, and National Burden of Atherosclerotic Cardiovascular Disease in Pre- and Post-Menopausal Women: 1990-2021 Trends and 2041 Projections from the Global Burden of Disease Study.","authors":"Jie Tan, Zhiyu Zhang, Shouying Xiang, Fei Zhang, Heng Zhu, Li Xu, Jing Huang","doi":"10.1177/10760296251414114","DOIUrl":"10.1177/10760296251414114","url":null,"abstract":"<p><p>BackgroundThe global burden and temporal trends of atherosclerotic cardiovascular disease (ASCVD) stratified by menopausal status have not been comprehensively described.MethodsAge-standardized incidence rates (ASIR), prevalence rates (ASPR), disability-adjusted life year rates (ASDALYR), and death rates (ASDR) for ASCVD, including ischemic heart disease (IHD), ischemic stroke (IS), and lower extremity peripheral artery disease (LEPAD), were estimated among pre- and post-menopausal women from 1990 to 2021 using data from the Global Burden of Disease Study 2021. Temporal trends were quantified using average annual percent change, and the population attribution fractions were calculated for established ASCVD risk factors. Projections to 2041 were generated using the Nordpred model.ResultsIn 2021, the highest IHD burden was observed in low-middle socio-demographic index (SDI) regions, whereas the highest LEPAD burden occurred in high SDI regions among both pre- and post-menopausal women. Among premenopausal women, ASIR and ASPR for IS demonstrated a negative correlation with SDI level. Between 1990 and 2021, premenopausal women exhibited increases in IHD ASIR (12.86%) and ASPR (11.43%), accompanied by reductions in ASDALYR (23.97%) and ASDR (24.35%). In contrast, postmenopausal women experienced a modest increase in ASPR (4.14%) along with declines in ASIR (10.61%), ASDALYR (34.99%), and ASDR (37.09%). The contribution of specific risk factors varied by menopausal status: elevated low-density lipoprotein cholesterol, systolic blood pressure, and body mass index were predominant among premenopausal women, whereas elevated fasting glucose and kidney dysfunction contributed more substantially among postmenopausal women. Projections to 2041 indicate continued increases in ASCVD incidence and prevalence numbers, particularly among postmenopausal women.ConclusionsThe burden of ASCVD varies significantly by menopausal status and across socio-demographic regions. Age-specific and regionally targeted screening, prevention, and resource allocation strategies are warranted to address the projected rise in ASCVD among women.</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":"10760296251414114"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12816503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146000503","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":"Association of Protein C, but Not Protein S or Antithrombin With Ischemic Stroke: Bidirectional Two-Sample Mendelian Randomization and Meta-Analysis.","authors":"Liang Shu, Bin He, Cong Yu, Jie Li, Liguo Zhang, Ping Zheng","doi":"10.1177/10760296261465494","DOIUrl":"10.1177/10760296261465494","url":null,"abstract":"<p><p>AimTo explore the causal effects of protein C and protein S on ischemic stroke (IS) risk.MethodsEmploying a two-sample bidirectional Mendelian randomization (MR) framework, we investigated the causal association between protein C, protein S and anti-thrombin with ischemic stroke and further performed the mediating analysis based on several risk factors for IS. Then, systematic review and meta-analysis of relevant literature was conducted to validate the association between protein C and ischemic stroke.ResultsGenetic data from a genome-wide association study involving 440,328 individuals, including 34,217 IS patients and 406,111 controls, revealed odds ratios for IS per standard deviation (SD) increases of 0.918 (95% CI: 0.884-0.954; P=1.027e-05) for protein C, 0.997 (95% CI: 0.986-1.035; P=1.027e-05) for protein S, and 0.990 (95% CI: 0.895-1.094; P=8.383e-01) for anti-thrombin (three anticoagulation factor). Mediation analysis indicated that body mass index (BMI) partially mediated this effect, with a mediated proportion of 5.88% (95% CI, 2.236% to 7.232%). In the meta-analysis of 2107 IS patients and 12209 healthy controls, we found that patients with decreased protein C had a significantly higher risk of IS compared with controls (risk ratio: 5.47; 95% CI 3.33, 9.00).ConclusionThese findings suggest a potential relationship between protein C and ischemic stroke and BMI mediates this causal relationship, which might offer prevention strategies targeting protein C and ischemic stroke.</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":"10760296261465494"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371752","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 Serum Salusin-α and Salusin-β in COVID-19 Patients.","authors":"Safiye Bilge Guclu Kayta, Sevil Alkan Varoglu, Havva Yasemin Cinpolat, Taylan Onder, Isil Deniz Aliravci","doi":"10.1177/10760296261448753","DOIUrl":"10.1177/10760296261448753","url":null,"abstract":"<p><p>BackgroundVascular inflammation has an important role in the development and progression of coronavirus disease 2019 (COVID-19). Also, a high cytokine level predicts a poor prognosis for COVID-19. In this study, we aimed to investigate the effect of salusin-α and salusin-β peptides in determining the severity of the disease in the acute period of COVID-19.MethodThe investigation involved studying a group of 74 hospitalized individuals who had tested positive for SARS-CoV-2 through polymerase chain reaction (PCR) tests. The patients were divided into two groups: those who did not reach the primary endpoint and were discharged without complications and those who reached the primary endpoint (a composite of ICU admission and/or mortality). Salusin-α and salusin-β levels of serum samples taken at the time of application were statistically compared.OutcomeThere was no statistically significant difference in salusin-α levels between the groups (p=0.279). However, salusin-β levels were found to be significantly higher in patients who reached the primary endpoint compared to those who did not reach the primary endpoint and the healthy control group.ConclusionThe results of the analysis showed that a salusin-β level of 12.45 ng/mL predicts the risk of complications such as intensive care unit admission or mortality, with a sensitivity of 83.8% and a specificity of 40.5% for the estimation of the primary endpoint. The obtained data support our hypothesis, but observational studies with larger sample sizes are needed to evaluate salusins' determination of COVID-19 prognosis.</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":"10760296261448753"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849011","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":"Incidence and Timing of Venous Thromboembolism After Implantable Port Placement in Cancer Patients: A Single-Centre Cohort Study.","authors":"Jagoda Kania, Bartosz Kudliński, Jacek Zawadzki, Wiktoria Kulińska, Robert Kozłowski","doi":"10.1177/10760296261472617","DOIUrl":"10.1177/10760296261472617","url":null,"abstract":"<p><p>BackgroundImplantable venous access devices are widely used in oncology but introduce an additional risk of venous thromboembolism (VTE). Data on the incidence and temporal distribution of thrombotic events after port implantation remain limited and heterogeneous. This study aimed to evaluate the incidence and timing of VTE following implantable port placement in cancer patients.MethodsThis single-centre cohort study included consecutive adult oncology patients undergoing totally implantable venous access device placement between February 2024 and August 2024. Early catheter-related thrombosis (CRT) was assessed using ultrasound 10-12 days after implantation. Outcomes were obtained through chart review until February 2026. The primary endpoint was first objectively confirmed VTE event. Cumulative incidence functions accounting for death as a competing risk were used for time-to-event analyses.ResultsA total of 131 patients were included in survival analysis. Early CRT was detected in 2.29% of patients. During a median follow-up of 534 days, nine VTE events occurred (6.87%), corresponding to an incidence rate of 0.166 per 1,000 catheter-days. Six patients (4.58%) died during follow-up. The cumulative incidence of late VTE accounting for death as a competing risk was 3.26% at 90 days, 5.94% at 180 days and 8.05% at 365 days. No predictors of late VTE were identified in exploratory analyses.ConclusionsVTE following implantable port placement occurs with a modest cumulative incidence and was concentrated within the first six months after implantation. Early asymptomatic CRT was uncommon. These findings highlight a period of increased thrombotic vulnerability during early port use.</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":"10760296261472617"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148538035","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":"Interpretation of Prothrombin Time and Activated Partial Thromboplastin Time Mixing Studies Using Predefined Algorithms.","authors":"Fatima Farhan, Bushra Afaq Rizvi, Bushra Moiz","doi":"10.1177/10760296261464807","DOIUrl":"10.1177/10760296261464807","url":null,"abstract":"<p><p>BackgroundMixing test plasma with prolonged Prothrombin Time (PT) and activated partial thromboplastin time (aPTT) with normal plasma in a 1:1 ratio, helps distinguish between clotting factor deficiency and inhibitors. In our clinical laboratory, the upper reference interval (URI) is routinely used to determine correction (or no correction) in mixing studies.Aims and objectivesWe aimed to use the International Council for Standardization in Haematology. (ICSH) 2024 recommendations for interpreting PT/aPTT mixing studies following validation of the defined cutoffs.Materials and MethodsFrom December 2022 to December 2024, plasma samples with prolonged PT/aPTT were tested by mixing them with normal pooled plasma at a 1:1 ratio. A cut-off of ≥70% correction or ≤15% Rosner Index was used to identify clotting factor deficiency per ICSH, and this was compared with URI.ResultsAfter validating the cutoffs, the analysis of mixing results and factor assays was performed on 243 patients with prolonged PT (n=54), aPTT (n=56), and PT/aPTT (n=133). All patients exhibited either single or multiple clotting factor deficiencies. Inhibitor detection varied depending on the interpretive criteria: the upper reference interval method identified 12/243 cases (4.9%), the 70% correction criterion identified 20/243 cases (8.2%) overall, and the Rosner Index identified 7/189 cases (3.7%) among samples with prolonged aPTT, highlighting method-dependent discordance. Agreement between the various methods was 90.0% or higher.ConclusionThe ICSH recommendations accurately identified clotting factor deficiencies after local validation of the cut-offs. Clinical correlation and appropriate laboratory testing are essential for detecting concurrent inhibitors in clotting factor deficiency.</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":"10760296261464807"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335540","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":"Dual-Channel Inhibition With Rivaroxaban and Aspirin for Thromboprophylaxis in Patients With Long-Term Inferior Vena Cava Filter Implantation: A Two-Center Cohort Study.","authors":"Yihao Wang, Lei Qi, Hongzhi Sun, Lei Xiao, Xianchen Huang","doi":"10.1177/10760296261463769","DOIUrl":"10.1177/10760296261463769","url":null,"abstract":"<p><p>BackgroundInferior vena cava filter (IVCF) is used to prevent pulmonary embolism (PE) due to deep vein thrombosis (DVT), and some filters are indwelling for a long time, which increase the risk of thrombotic events. Single-channel anticoagulation is still inadequate in the prevention of thrombosis. This study aims to explore the efficacy and safety of rivaroxaban combined with aspirin versus rivaroxaban alone in the prevention of thrombotic events in patients with long-term IVCF implantation.MethodsA retrospective analysis was conducted on patients with long-term IVCF implantation in the two centers from August 2021 to October 2024. Among them, 58 cases were in the single-channel (SC) group, who only took rivaroxaban orally after surgery, and 61 cases were in the dual-channel (DC) group, who took rivaroxaban and aspirin orally after surgery. The follow-up period was 12 months. The primary endpoint was the incidence of combined venous thromboembolism (VTE). The secondary endpoints were the recurrence rate of lower extremity DVT, the incidence of IVCF thrombosis (IVCFT), PE, and adverse events, Venous Clinical Severity Score (VCSS) and Chronic Venous Insufficiency Questionnaire (CIVIQ-20).ResultsThe incidence of combined VTE in Group SC (14/58, 24.1%) was higher than that in Group DC (6/61, 9.8%) (HR: 0.38, 95% CI: 0.14-0.98, P=0.037). The incidence of IVCFT, VCSS and CIVIQ-20 at 12 months in Group SC were higher than those in Group DC. There were no significant differences in the incidence of DVT recurrence, PE, bleeding-related adverse events, and all-cause mortality between the two groups.ConclusionFor patients with long-term IVCF implantation, compared with rivaroxaban alone, the dual-channel inhibition of rivaroxaban combined with aspirin may reduce the occurrence of thrombotic events, alleviate clinical symptoms and improve the quality of life of patients, without increasing the risk of adverse events such as bleeding.</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":"10760296261463769"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319771/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348590","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":"Triple Antithrombotic Therapy versus Dual Antiplatelet Therapy Alone Following Anterior STEMI, a Systematic Review and Meta-Analysis With GRADE Assessment.","authors":"Muhammad Ahsan, Ammad Uddin, Muhammad Ibrahim Siddique, Abbeha Talib, Muhammad Ahmed, Muhammad Tahir, Abdur Rafay Bilal, Faisal Islam, Tawab Aziz Samandari, Shaheer Bin Shafiq","doi":"10.1177/10760296261486151","DOIUrl":"10.1177/10760296261486151","url":null,"abstract":"<p><p>BackgroundLeft ventricular thrombus (LVT) remains an important complication following anterior ST-elevation myocardial infarction (STEMI), despite widespread adoption of primary percutaneous coronary intervention (pPCl). Current guidelines supporting prophylactic oral anticoagulation in high-risk patients are based on limited evidence, and the balance between thromboembolic prevention and bleeding risk remains uncertain. PubMed, Embase and etc were searched for studies comparing triple antithrombotic therapy (TAPT; anticoagulation plus DAPT) versus DAPT alone in patients with anterior STEMI undergoing pPCI. Random-effects model was used to pool risk ratios with 95% confidence intervals (CI). Outcomes included mortality, bleeding, LVT, and etc.Main Text7 studies including 3,692 participants were included. TAPT was associated with a significantly increased risk of bleeding compared with DAPT alone (RR: 2.10; 95% CI: 1.60-2.76; P<0.0001; I²=0%). No significant differences were observed in all-cause mortality (RR: 1.05; 95% CI: 0.54-2.04; P=0.89; I²=39%), recurrent myocardial infarction (RR: 1.52; 95% CI: 0.94-2.45; P=0.09; I²=0%), stroke (RR: 0.86; 95% CI: 0.20-3.73; P=0.84; I²=55%), LVT formation (RR: 0.54; 95% Cl: 0.21-1.40; P=0.21; l²=61%), NACE (RR: 0.93; 95% CI: 0.49-1.75; P=0.82; I²=77%), or embolic events (RR: 0.53; 95% CI: 0.21-1.33; P=0.18; I²=0%).ConclusionsTAPT significantly increased bleeding risk compared with DAPT. No significant reductions were observed in ischemic outcomes; however, wide confidence intervals indicate limited precision and do not exclude a clinically meaningful benefit or harm. Current evidence therefore does not support routine prophylactic TAPT, and adequately powered contemporary randomised trials are needed.</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":"10760296261486151"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892732","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":"Transforming Hemophilia Treatment With Novel Rebalancing Agents: Clinical Studies and Practical Perspectives.","authors":"Sheng-Chieh Chou, Te-Fu Weng, Yeu-Chin Chen","doi":"10.1177/10760296261480921","DOIUrl":"10.1177/10760296261480921","url":null,"abstract":"<p><p>While conventional prophylaxis with clotting factor concentrates (CFC) is the standard of care for hemophilia A and B, its challenges include frequent intravenous administration, factor level fluctuations, and potential inhibitor development. Rebalancing agents, including fitusiran (antithrombin-lowering small interfering ribonucleic acid), concizumab and marstacimab (tissue factor pathway inhibitor antagonists), are novel nonfactor therapies that restore hemostatic balance by targeting natural anticoagulants rather than replacing missing clotting factors. Clinical trials demonstrate that these three rebalancing agents provide effective prophylaxis for people with hemophilia (PwH) with or without inhibitors through subcutaneous administration. Rebalancing agents thus provide subcutaneous alternatives to current treatment regimens and offer effective prophylaxis for people with hemophilia B with inhibitors who previously had limited therapeutic options. Their novel mechanism of action may necessitate individualized dose optimization and unique approaches for managing breakthrough bleeds and surgeries. Those conditions require reduced dosing of CFC or bypassing agents to mitigate potential thrombotic risk. In addition, the use of rebalancing agents in pediatric patients (<12 years old) remains under investigation. While promising, successful implementation depends on individualized treatment approaches, appropriate monitoring protocols, and thorough patient education to improve current care for PwH.</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":"10760296261480921"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882036","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}