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

{"title":"Pharmacist-Led Discharge Counseling and Adherence to Postpartum Venous Thromboembolism Prophylaxis: A Pre-Post Observational Study.","authors":"Manal A Behisi, Reem F Bamogaddam, Amani Z Alotaibi, Hajar A Almutairi, Eiman M Fallatah, Fuddah M Assiri, Ibrahim M Alalmai, Munirah H Alohaydib, Nada A Nawab, Ohoud M Alotaibi, Omamah S Aldosari, Waleed Tharwat Aletreby","doi":"10.1177/10760296261476825","DOIUrl":"10.1177/10760296261476825","url":null,"abstract":"<p><p>BackgroundVenous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality, during postpartum period. It may be mitigated through pharmacological and non-pharmacological interventions. However, adherence to prevention measures and patient education remain critical to optimizing outcomes.MethodsA pre-post observational study. The pre-intervention (PRE) phase was a retrospective review of postnatal women receiving pharmacological prophylaxis without counseling (January-December 2024), in the post-intervention (POST) phase eligible women received standardized pharmacist-led discharge counseling (January-December 2025). Medication adherence, complications, and VTE events were assessed via structured telephone interviews. The primary outcome was adherence to VTE prophylaxis; secondary outcomes included confirmed or suspected VTE, and patient satisfaction in the post-intervention group only.ResultsA total of 459 postnatal women were included. Adherence to VTE prophylaxis was higher in the POST group (91.2% vs. 77.8%; p < 0.001), while reported complications showed a trend of lower incidence (11.5% vs. 18.2%; p = 0.045). The incidence of confirmed or suspected VTE was lower but not statistically significance (1.1% vs. 3%; p = 0.2). No reported difficulties with medication administration in the POST group. Patient satisfaction was high (99.6%). In exploratory analysis, elective cesarean section was the only factor significantly associated with VTE occurrence (p = 0.026).ConclusionStructured pharmacist-led discharge counseling significantly improved adherence to postpartum VTE prophylaxis, reduced treatment-related complications, and was associated with high patient satisfaction. The observed trend in reduction of VTE suggests potential clinical benefit. Pharmacist-led education during postnatal care may be associated with higher self-reported adherence of VTE prevention 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":"10760296261476825"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681931","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":"Beyond Bleeding: Underrecognized Thrombotic Complications in Acute Promyelocytic Leukemia - A Single-Center Experience from the GCC Region.","authors":"Shehab F Mohamed, Rafal AlShebly, Hawraa Shawaylia, Anil Elahie, Rola Ghasoub, Dina Soliman, Deen Mudawi, Mohammed Abdulgayoom, Abdulrahman F Al-Mashdali, Maritta Rabadi, Hesham El-Sabah, Anas Hamad, Mohamed Yassin, Honar Cherif","doi":"10.1177/10760296261439468","DOIUrl":"10.1177/10760296261439468","url":null,"abstract":"<p><p>BackgroundThrombosis remains a clinically important complication of acute promyelocytic leukemia (APL), coexisting with the prototypical hemorrhagic diathesis. Data from Gulf Cooperation Council (GCC) populations are limited in addition to data specifically about thrombosis, which is heterogenous in general.ObjectivesTo describe the incidence, clinical characteristics, treatment, and outcomes of thrombotic events in patients with APL treated at a tertiary center in the GCC.MethodsWe conducted a retrospective cohort study of 75 consecutive patients with newly diagnosed APL managed at a single tertiary center. Baseline demographic variables (age, sex, regional background), hematologic parameters (hemoglobin, leukocyte, platelet counts), and coagulation indices (fibrinogen, activated partial thromboplastin time, prothrombin time, international normalized ratio, and D-dimer) were compared between patients with and without thrombosis. Thrombotic event type, timing, antithrombotic management, bleeding complications, and mortality (including early mortality within 30 days) were recorded.ResultsEleven of 75 patients (14.7%) developed thrombosis. Baseline demographic characteristics, hemoglobin level, leukocyte count, platelet count, fibrinogen, and activated partial thromboplastin time were comparable between patients with and without thrombosis, whereas prothrombin time, international normalized ratio, and D-dimer levels were numerically higher in patients who developed thrombosis. Most thrombotic events (73%) occurred during active therapy, and the majority were venous (55%). Pulmonary embolism accounted for 36% of all thrombotic episodes, and catheter-associated thromboses represented a clinically relevant subset. Anticoagulation was initiated in 45% of patients with thrombosis and antiplatelet therapy in 18%. Bleeding episodes occurred in 36% of patients who experienced thrombosis. Thrombosis was associated with a 27% all-cause mortality.ConclusionsIn this GCC APL cohort, thrombosis, though less frequent than bleeding, emerged as a serious and clinically significant manifestation associated with substantial morbidity and mortality. These findings underscore the need for vigilant thrombo-hemorrhagic assessment and individualized antithrombotic strategies, particularly during induction and early consolidation 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":"10760296261439468"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725436","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 Between TNF-Alpha Levels and Atrial Fibrillation Outcomes: A Systematic Review and Meta-Analysis.","authors":"Alireza Fatemi, Bahar Amirgholami, Yasmin Yazdooei, Aylin Taghipour, Amirali Zamani, Ali Ajdarkosh","doi":"10.1177/10760296261464805","DOIUrl":"10.1177/10760296261464805","url":null,"abstract":"<p><p>Background and objectivesPrevious studies suggest a link between tumor necrosis factor-alpha (TNF-alpha) levels and atrial fibrillation (AF). However, the nature of this relationship is disputed. To address this, we conducted a study to gather and assess evidence on the association between TNF-alpha and AF prediction.MethodologyStudies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After the screening, the selected articles' quality and risk of bias assessment were evaluated. Meta-analysis calculated std. mean difference on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed.ResultsTwenty-three studies were included in this systematic review and meta-analysis, comprising a total of 2,369 patients with atrial fibrillation (AF) and 6,091 control participants. Pooled analysis using a random-effects model demonstrated a significant positive association between serum TNF-alpha levels and AF (standardized mean difference [SMD] = 1.15; 95% CI: 0.57-1.74; P = 0.0001). However, substantial between-study heterogeneity was observed (τ²= 1.4060; Cochran's Q = 947.52; I²= 98.82%; P < 0.0001), indicating considerable variability in effect sizes across the included studies.ConclusionsElevated TNF-α levels are significantly associated with the presence of atrial fibrillation. Despite strong overall evidence, substantial heterogeneity and publication bias were observed among studies. These findings support a role for inflammation in AF and highlight the need for more standardized future research.</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":"10760296261464805"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341908","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":"Prevalence and Predictors of Left Atrial Appendage Thrombus by Sex.","authors":"Radosław Walczewski, Katarzyna Żelazowska-Chmielińska, Beata Uziębło-Życzkowska, Martyna Dąbrowska, Monika Gawałko, Monika Budnik, Konrad Pieszko, Katarzyna Starzyk, Beata Wożakowska-Kapłon, Damian Kaufmann, Ludmiła Daniłowicz-Szymanowicz, Maciej Wójcik, Robert Błaszczyk, Katarzyna Łojewska, Jarosław Hiczkiewicz, Maciej Wybraniec, Katarzyna Mizia-Stec, Katarzyna Kosmalska, Marcin Fijałkowski, Anna Szymańska, Joanna Syska-Sumińska, Maciej Haberka, Michał Kucio, Błażej Michalski, Karolina Kupczyńska, Anna Tomaszuk-Kazberuk, Katarzyna Wilk-Śledziewska, Renata Wachnicka-Truty, Marek Koziński, Paweł Burchardt, Paweł Krzesiński, Agnieszka Kapłon-Cieślicka","doi":"10.1177/10760296261447951","DOIUrl":"10.1177/10760296261447951","url":null,"abstract":"<p><p>BackgroundWomen with atrial fibrillation (AF) have historically been considered to have higher thromboembolic risk than men. The CHA₂DS₂-VASc score treated female sex as an independent risk factor. Recent guidelines recommend CHA₂DS₂-VA score, redefining female sex as a risk modifier.AimsThis study aimed to assess the prevalence of left atrial appendage thrombus (LAAT) by sex and identify independent predictive factors for LAAT.MethodsThis analysis used data from the multicenter, prospective Left Atrial Thrombus on Transesophageal Echocardiography (LATTEE) registry, including 3,109 patients with AF. All patients underwent preprocedural transesophageal echocardiography to assess LAAT.ResultsWomen constituted 36.5% of the study population. They were older, had more comorbidities, higher CHA₂DS₂-VA scores compared with men (median 3 vs. 2, <i>p</i> < 0.001). Among 3034 patients, LAAT was detected in 7.7% of cases, without significant difference between sexes (8% vs. 7.2%, <i>p</i> = 0.42). In multivariable logistic regression, paroxysmal AF was associated with lower odds of LAAT (OR 0.35), smoking (OR 1.71), reduced left ventricular ejection fraction (LVEF) <50% (OR 1.94), DOAC use (OR 0.42), and LAAV (per 1 cm/s increase; OR 0.92) were independent predictors of LAAT in men. In women only LAAV (per 1 cm/s increase; OR 0.91) remained significant (<i>p</i> < 0.001). No sex-related effect modification was observed (<i>p</i> > 0.05).ConclusionsAlthough women with AF present a more adverse clinical profile, sex itself was not an independent predictor of LAAT.</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":"10760296261447951"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937167","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":"Time-Anchored miR-424-5p Predicts Neurological Deterioration and 90-Day Disability After Acute Ischemic Stroke.","authors":"Zhao Li, Weixiang Wu, Yong Tang, Rujuan Zhou, Jikai Yin, Yifan Zhao, Qiaozhuan Li","doi":"10.1177/10760296261489115","DOIUrl":"10.1177/10760296261489115","url":null,"abstract":"<p><p>BackgroundCirculating microRNAs may predict stroke outcomes, but unaccounted sampling time can distort their prognostic value. We assessed whether plasma miR-424-5p interpreted with the elapsed time from stroke onset to blood draw predicted early neurological deterioration (END) and 90-day disability after acute ischemic stroke.MethodsThis prospective single-center observational cohort enrolled consecutive adults with imaging-confirmed acute ischemic stroke in China from June 2024 to June 2025. Time zero was the first research plasma draw with contemporaneous baseline NIHSS assessment. Primary analyses evaluated post-baseline END within 72 hours and 90-day disability in patients with valid repeat sampling 18-30 hours after time zero. Baseline miR-424-5p and 24-hour change normalized to the actual interval between the two blood draws were tested using multivariable models adjusted for pretreatment/time-zero covariates and onset-to-draw windows, with bootstrap internal validation.ResultsAmong 368 patients, 73 developed END (19.8%). The repeat-sample cohort included 337 patients, of whom 149 had 90-day disability (44.2%). Higher baseline miR-424-5p independently predicted END (adjusted OR per 1 SD, 1.57; 95% CI, 1.16-2.13; p=0.003). For 90-day disability, normalized 24-hour miR-424-5p change, but not baseline level, remained independently associated with outcome (adjusted OR per 1 SD, 1.69; 95% CI, 1.24-2.31; p=0.001). Within this development dataset, biomarker addition yielded apparent AUC changes from 0.79 to 0.83 for END and from 0.80 to 0.84 for disability.ConclusionsTime-anchored baseline miR-424-5p predicted post-baseline END, whereas its normalized 24-hour trajectory predicted 90-day disability. External validation, including comparison with 24-hour neurological reassessment, is 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":"10760296261489115"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932475","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":"Formation and Development of Deep Vein Thrombosis in Hip Fracture Patients With and Without Anticoagulation.","authors":"Chen Fei, Fan Xu, Wei Fan, Chen Wang, Wu-Qiang Jiang, Zhe Song, Kun Zhang, Peng-Fei Wang","doi":"10.1177/10760296261487841","DOIUrl":"10.1177/10760296261487841","url":null,"abstract":"<p><p>BackgroundContinuous ultrasound was done on newly admitted hip fracture patients to evaluate post-fracture anticoagulation efficacy, perioperative lower limb deep vein thrombosis timing, and thrombosis distribution/prognosis in those on different thromboprophylaxis.MethodsThis randomized clinical trial enrolled patients with fresh hip fractures (age >18 years; injury-to-admission time ≤24 h). Eligible patients without thrombosis on admission ultrasound were randomly assigned in a 2:1 ratio to the anticoagulation group or the non-anticoagulation group. The anticoagulation group received nadroparin calcium (Fraxiparine, 3800 IU/0.4 mL subcutaneously once daily) plus mechanical thromboprophylaxis with an intermittent plantar pressure pump. The non-anticoagulation group received mechanical thromboprophylaxis alone. Bilateral lower extremity venous ultrasound was performed daily throughout hospitalization. Venous blood was collected at four time points (admission, 1 day pre-op, 1 day post-op, 3 days post-op) for routine blood tests and D-dimer measurement. Thrombosis type, occurrence time, location, and laterality were recorded. This intensive ultrasound surveillance protocol was used solely for research purposes and is not the standard.ResultsThis study included 330 patients (193 females, 137 males), mean age 67.39 ± 16.69 years (18-94 years), injury-to-admission time ≤24 h, mean preoperative waiting time 3.48 ± 1.68 days, mean hospital stay 7.19 ± 2.64 days. There were 178 (53.9%) femoral neck fractures and 152 (46.1%) intertrochanteric and subtrochanteric fractures. Six patients with post-admission proximal thrombosis had pre-procedure inferior vena cava filter implantation; no pulmonary embolism occurred during hospitalization. Anticoagulant group (201 patients): 42 (20.89%) pre-op thrombosis, 81 (40.29%) post-op thrombosis. Non-anticoagulant group (129 patients): 26 (20.15%) pre-op thrombosis, 55 (42.64%) post-op thrombosis.ConclusionsContinuous ultrasound surveillance reveals that days 2-3 post-injury and the first postoperative day represent the periods of highest thrombotic risk in patients with acute hip fractures. However, because most detected DVTs were distal and asymptomatic, and no pulmonary embolism or death occurred in either group, the clinical value of routine, protocol-driven ultrasound screening has yet to be established. Selective screening guided by symptoms or high-risk features may offer a more clinically appropriate strategy. Future studies should determine whether early DVT detection in this population translates into improved patient-important outcomes.</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":"10760296261487841"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979291","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":"Machine Learning-Based Risk Prediction Models for Peripheral Artery Disease: A Nationally Representative Analysis of NHANES 1999-2004.","authors":"Haijun Feng, Jinfeng Xie, Kui Liu, Rentao Wang, Jianyong Liu, Yunfei Teng","doi":"10.1177/10760296261496971","DOIUrl":"https://doi.org/10.1177/10760296261496971","url":null,"abstract":"<p><p>BackgroundWe evaluated the association between small dense low-density lipoprotein (sdLDL) and peripheral artery disease (PAD) and developed prediction models using NHANES 1999-2004.MethodsThis weighted cross-sectional study included 3,415 participants (3,227 without PAD and 188 with PAD). PAD was defined by ankle-brachial index (ABI) <0.90; participants with ABI ≥1.40 or missing ABI were excluded. Survey-weighted logistic regression assessed the association between sdLDL and PAD. For machine learning, complete-case data (n=2,828) were split into training (70%) and test (30%) sets before feature selection and preprocessing. Correlation screening, LASSO, encoding, standardization, and SMOTE were restricted to the training set. Nine algorithms were evaluated using discrimination and calibration metrics.ResultssdLDL was not independently associated with PAD in the fully adjusted model (OR=1.01, 95% CI 0.94-1.10, P=0.69). LASSO retained eight predictor domains: age, body mass index, C-reactive protein, education, estimated glomerular filtration rate, hypertension, poverty-income ratio, and smoking. In the test set, gradient boosting machine achieved the highest AUC (0.833, 95% CI 0.777-0.889), followed by logistic regression (0.819) and XGBoost (0.811). SHAP analysis highlighted age, eGFR, and smoking-related variables as important contributors.Conclusions: sdLDL was not independently associated with PAD. Several models showed acceptable discrimination, with GBM performing numerically best and logistic regression remaining competitive. External validation in contemporary cohorts is required.</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":"10760296261496971"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140357","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":"Accuracy of HAS-BLED and BleedMAP Scores in Predicting Postoperative Bleeding in Anticoagulated Patients Undergoing non-Cardiac Surgery.","authors":"Thanaporn Poohirunkul, Yotsaya Kunlamas, Sarawut Siwamogsatham, Krittin Bunditanukul","doi":"10.1177/10760296251415186","DOIUrl":"10.1177/10760296251415186","url":null,"abstract":"<p><p>BackgroundThere are limited data on the performance of bleeding risk scores in predicting postoperative bleeding in anticoagulated patients undergoing elective non-cardiac surgery.ObjectivesTo evaluate the predictive accuracy of the HAS-BLED and BleedMAP scores for postoperative bleeding risk in this population.MethodsThis retrospective study enrolled anticoagulated patients undergoing elective surgery referred to the Preoperative Medical Consultation clinic. The C-statistic was used to evaluate the discriminatory performance of the HAS-BLED and BleedMAP scores in predicting overall bleeding following non-cardiac surgery. The predictive performance of the two scores was compared using DeLong's method.ResultsAmong 591 patients who had previously received anticoagulation therapy, 84.9% received warfarin, 9.5% enoxaparin, and 5.6% direct oral anticoagulants. Indications included atrial fibrillation (67.9%), venous thromboembolism (18.1%), and mechanical valve replacement (13.5%). Procedures were classified as minor (16.6%), low to moderate risk (46.4%), or high bleeding risk (37.1%). The mean HAS-BLED and BleedMAP scores were 2.35 ± 1.36 and 0.94 ± 0.81, respectively. At 1-month postoperative follow-up, the overall bleeding rate was 40.4%, with 2.5% classified as major bleeding events. The HAS-BLED score had a C-statistic of 0.512 (95% confidence intervals (CI): 0.434-0.591) for predicting overall bleeding, while the BleedMAP score showed moderate predictive ability (C-statistic: 0.581; 95% CI: 0.531-0.631). The two scores had no statistically significant difference (<i>P</i> = .13).ConclusionsThe HAS-BLED score showed limited discriminatory ability for postoperative bleeding in anticoagulated patients, though its negative predictive value was high. No significant difference in predictive performance was observed between the HAS-BLED and BleedMAP scores.</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":"10760296251415186"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12847687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055611","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":"Study on Deep Vein Thrombosis Incidence and Risk Factors in Orthopedic Trauma Patients with Chronic Hepatitis B: 579 Cases Analyzed.","authors":"Erdong Zhang, Qianye Li, Jiaqi Zhang, Haopei Li, Haofei Wang, Wenxiao Li, Lin Jin, Zhiyong Hou","doi":"10.1177/10760296251415188","DOIUrl":"10.1177/10760296251415188","url":null,"abstract":"<p><p>BackgroundChronic hepatitis B virus (HBV) infection remains highly prevalent worldwide, particularly in China. However, its influence on the risk of venous thromboembolism (VTE) following orthopedic trauma has not been well characterized. This study aimed to investigate the incidence and risk factors of deep vein thrombosis (DVT) in HBV-infected patients after lower extremity fractures.MethodsWe retrospectively reviewed the medical records of adult patients with chronic HBV infection who were hospitalized for lower extremity fractures at a tertiary trauma center between December 2013 and January 2024. Demographic, clinical, and laboratory data were collected. DVT was diagnosed using bilateral lower extremity Doppler ultrasonography. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. Receiver operating characteristic (ROC) curve analysis was used to determine optimal cutoff values for continuous predictors.ResultsAmong 579 eligible patients, the overall incidence of post-fracture DVT was 30.4%. Independent risk factors identified in multivariate analysis included multiple fractures (<i>P</i> < .001, OR = 4.009, 95% CI:2.080 ∼ 7.725), a history of cerebral infarction (<i>P</i> = .009, OR = .753, 95% CI:1.287 ∼ 5.886), a history of cirrhosis (<i>P</i> < .001, OR = 5.211, 95% CI:3.273 ∼ 8.297),and elevated HBsAg levels (<i>P</i> < .001, OR = 1.002, 95% CI: 1.001 ∼1.003). Higher hemoglobin levels (<i>P</i> < .001, OR = 0.979, 95% CI:0.970 ∼ 0.988) were independently associated with reduced DVT risk. In contrast, commonly used biomarkers such as D-dimer, fibrin degradation products (FDP), and liver function scores, including the Child-Pugh score and the Model for End-Stage Liver Disease (MELD) score, were not significant predictors in multivariate analysis.ConclusionsDVT is a common complication after lower extremity fractures in patients with chronic HBV infection. Multiple fractures, elevated HBsAg levels, prior stroke, and cirrhosis were independently associated with a higher risk of DVT, whereas higher hemoglobin levels were associated with a lower risk. These findings suggest that individualized thromboprophylaxis strategies may be considered in HBV-infected trauma 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":"10760296251415188"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12827917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021248","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":"Subclinical Cardiac Diseases and the Role of Extracellular Vesicles in Patients with Hemophilia A Treated on-Demand.","authors":"Yanan Zong, Maren Maanja, Todd T Schlegel, Martin Ugander, Jovan Antovic, Apostolos Taxiarchis, Roza Chaireti, Xiangdong Kong","doi":"10.1177/10760296261432444","DOIUrl":"10.1177/10760296261432444","url":null,"abstract":"<p><p>IntroductionPatients with hemophilia A (HA) can reach normal life expectancy and suffer from coronary artery disease (CAD). The study evaluates the likelihood of subclinical CAD evaluated by advanced electrocardiography (A-ECG), global hemostasis and extracellular vesicles (EVs) in Chinese patients with HA treated on-demand.Materials and MethodsPatients with HA (n = 42) and age-matched male controls (n = 37) were included. The likelihood of having CAD was evaluated by A-ECG. Fibrin formation and fibrinolysis were assessed by the overall hemostatic potential (OHP) assay. EVs derived from platelets (PEVs), endothelial cells (EEVs) and leukocytes (LEVs), and expressing phosphatidylserine (PS + EVs), tissue factor (TF + EVs) or P-selectin (CD62P + EVs) were measured by flow cytometry.ResultsThe likelihood of CAD evaluated by A-ECG did not differ between patients and controls. Fibrin formation and clot stability were significantly impaired in patients. Patients had higher PEVs and CD62P + EVs. CD62P + EVs counts were inversely correlated with OHP, velocity and clot lysis time. Subclinical CAD did not correlate with OHP or EVs.ConclusionControls and patients with HA treated on-demand exhibited no differences in A-ECG, but varied in fibrin formation and clot stability. Larger studies are required to explore the significance of this finding in the context of CAD risk 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":"10760296261432444"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147380448","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}