Cardiovascular & hematological agents in medicinal chemistry最新文献

{"title":"The Challenge of Detecting Heparin-induced Thrombocytopenia (HIT) in a Developing Country: A Systematic Review.","authors":"Hadi Rezaei, Mohammad Ghorbani, Hassan Mansouritorghabeh","doi":"10.2174/0118715257358047250226044013","DOIUrl":"https://doi.org/10.2174/0118715257358047250226044013","url":null,"abstract":"<p><strong>Introduction: </strong>Approximately 3% of patients treated with heparinoids develop heparin- induced thrombocytopenia (HIT). Although HIT is characterized by thrombocytopenia, type 2 HIT is associated with a high risk of thrombotic events in approximately 30-75% of cases. In some patients, thrombocytopenia represents the primary clinical manifestation of HIT. Early diagnosis of HIT is critical to prevent thrombotic complications by allowing timely replacement of heparin with an alternative anticoagulant. Clinical observations suggest a potential gap in the diagnosis and management of HIT among patients receiving heparinoid therapy in Iran.</p><p><strong>Aim: </strong>hence, this study aimed to compile and analyze published data on the frequency and prevalence of HIT across various provinces in Iran, a representative developing country. The aim of this systematic review was to identify and highlight potential gaps in the diagnosis of HIT within different regions of the country.</p><p><strong>Methods: </strong>To investigate this hypothesis, a systematic review was conducted to assess the prevalence of HIT and the adequacy of its detection in the country. Literature searches were performed using PubMed, Google Scholar, Web of Science, and local databases, yielding 81 articles. Following a rigorous evaluation, five studies met the inclusion criteria for the systematic review. The pooled analysis revealed an estimated HIT prevalence of 6.93% among the studied population. The mean age of participants ranged between 58 and 69 years, falling within the late-adolescent to early-elderly spectrum. The overall male-to-female ratio was 175:121 (59.2% male vs. 40.8% female).</p><p><strong>Results: </strong>This study highlights a significant gap in the diagnosis of HIT in the country, suggesting that similar challenges may exist in other developing countries.</p><p><strong>Conclusion: </strong>In conclusion, addressing this issue requires increased clinical awareness and improved diagnostic strategies to mitigate associated risks.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722735","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":"Oxidative Stress in Cardiovascular Diseases: Mechanisms and Exploring Advanced Therapies.","authors":"Dushyant -, Balram -, Gurvirender Singh, Nitish Kumar, Smita Narwal, Ashwani K Dhingra","doi":"10.2174/0118715257344485250207074727","DOIUrl":"https://doi.org/10.2174/0118715257344485250207074727","url":null,"abstract":"<p><p>The recognition of oxidative stress as a factor influencing the development and progression of cardiovascular diseases (CVDs) is growing. By producing such reactive oxygen species (ROS) in diverse areas within cells, including mitochondria and Nicotinamide Adenine Dinucleotide Phosphate Hydrogen (NADPH)-oxidases, they end up causing damage through the oxidation of lipids, proteins, and DNA. ROS indicates the beginning of inflammatory responses and endothelial dysfunction, which are necessary to produce obstructions in blood vessels and decreased blood vessel function. The fact that oxidative stress plays a significant role in CVD development draws more attention to the need for novel therapies that aim to correct redox imbalances. Therefore, natural polyphenols and antioxidants like vitamin C or E have shown their efficacy in lowering levels of ROS and protecting against the damage caused by oxidative stress. Anyone attempting to cure CVDs should focus on improving the safety and efficacy of antioxidant treatments and identifying which patients will benefit from them the most. This paper discusses not only advanced treatments but also the role played by oxidative stress in such CVD as high blood pressure, hypercholesterolemia, and ischemic heart disease.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517684","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":"Long-term Sustained Response to Lenalidomide after Clearance of Bone Marrow Blasts by Azacytidine in High-risk Myelodysplastic Syndromes with Del5q: A Case Report.","authors":"Pasquale Niscola, Marco Giovannini, Valentina Gianfelici, Carla Mazzone, Paolo de Fabritiis, Esther Natalie Oliva","doi":"10.2174/0118715257341062250130103015","DOIUrl":"https://doi.org/10.2174/0118715257341062250130103015","url":null,"abstract":"<p><strong>Introduction: </strong>This report discusses a rare case involving a patient with high-risk (HR) Del(5q) myelodysplastic syndrome (MDS) who achieved a long-term response to lenalidomide after having received six cycles of azacytidine. The latter treatment led to the clearance of blast cells from the bone marrow (BM).</p><p><strong>Case representation: </strong>As per current clinical practice, patients with HR MDS receive azacytidine continuously until the disease progresses or the occurrence of unmanageable side effects. However, in this case, the patient decided to interrupt hypomethylation therapy. Due to the patient's preference for oral therapy at home, the absence of blast cells, the ongoing need for transfusions, and a cytogenetic abnormality-predictive response to lenalidomide, the choice of the latter agent allowed for a sustained response lasting up to 68 months.</p><p><strong>Conclusion: </strong>Our observations suggest that further studies could explore the sequential use of azacytidine followed by lenalidomide after achieving BM blast clearance in patients with HR MDS with del(5q).</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415968","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":"Sildenafil Effect on Atrial Natriuretic Peptide Level in Pulmonary Hypertensive Rats.","authors":"Mukhallad A Aljanabi, Nasr Alrabadi, Sahar H Mahmoud, Razan Haddad, Karem H Alzoubi","doi":"10.2174/0118715257293794240516075211","DOIUrl":"10.2174/0118715257293794240516075211","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary Hypertension (PH) leads to changes in pulmonary vascular architecture, hypertrophy of the right ventricle, and heart failure. Sildenafil is a drug that can modulate PH by inducing smooth muscle relaxation and vasodilation.</p><p><strong>Aims: </strong>To investigate the ability of sildenafil to alleviate the monocritaline (MCT)-induced PH in rats and to estimate the role and its effect on the atrial natriuretic peptide (ANP) levels.</p><p><strong>Methods: </strong>28 adult male rats were divided randomly into four groups: Group A (control group; n=7). Group B (MCT-treated group; n=7) was given a single dose of MCT 60 mg/kg subcutaneously. Group C (The reversal group; n=7) received a single dose of MCT 60 mg/kg subcutaneously for three weeks and then sildenafil at 50 mg/kg/day, given daily for another three weeks. Group D (The prevention group; n=7) simultaneously received a single dose of MCT 60 mg/kg subcutaneously and sildenafil daily at 50 mg/kg for three weeks.</p><p><strong>Results: </strong>The animals in the prevention group showed a significant decrease in ANP levels compared to the reversal and MCT-treated groups. This decrease was associated with a significant reduction in the Fulton index ratio in the prevention group compared to the reversal group. The nitric oxide levels were also significantly higher in the reversal group than in the control group.</p><p><strong>Conclusion: </strong>Preventive sildenafil treatment was associated with a significant decrease in ANP levels and reduced MCT-induced cardiac hypertrophy in rats.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":"69-75"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156037","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":"Early Prognostic Instrumental and Laboratory Biomarkers in Post-MI.","authors":"Basheer Abdullah Marzoog","doi":"10.2174/0118715257281715240108092557","DOIUrl":"10.2174/0118715257281715240108092557","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Post-myocardial infarction (MI) changes have been frequently reported in the literature and are associated with determining the prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;The aim of this study is to find a prognosis marker for the favorability of determination of the medium-term outcomes in patients with acute MI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;MI patients' prognosis is poorly understood and requires further elaboration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;A single center, cross-sectional cohort study involved 211 patients' medical history with acute MI, for the period 2014-2019, had been evaluated retrospectively for 76 parameters. The data was collected from the Republic Rehabilitation Mordovian Hospital. The described measurement units were used in the local laboratories to describe the values. The descriptive values were expressed in the mean average and standard deviation. For statistical analysis, descriptive statistics, t-test independent by groups and dependent by numerical variables for repeated analysis for the same patients, multinomial logistic regression, Pearson's correlation coefficient, ROC analysis, and for clarification purposes, diagrams and bar figures were used. For performing the statistical analysis, the SPSS program, version 28 was used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Descriptive statistics showed a proportion of men to females 7:3. The mean age of the MI patients was 61.50 years (Std. Dev. ± 10.68), and the mean height of the sample was 171.00 cm (Std. Dev. ± 7.20). The mean body weight of the sample is 83.62 kg (Std. Dev. ± 12.35), and the body mass index (BMI) is 29.02 kg/m2 (Std. Dev. ± 5.07). The total hospitalization days are 14.79 (Std. Dev. ± 3.41). The mean heart rate (HR) beat per minute (bpm) was 79.03 (Std. Dev. ± 15.63), and the mean blood pressure was 138.53/84.09 mmHg (Std. Dev. ± 28.66/12.79). On the complete blood count (CBC), the mean level of the hemoglobin (Hb) 136.33 g/l (Std. Dev. ± 15.29), the mean level of the leukocytes (WBC) 8.76 /μl (Std. Dev. ± 2.77), the mean level of the red blood cells (RBC) 4.55 /μl (Std. Dev. ± 0.52), the mean level of the relative value of the lymphocytes 24.46 % (Std. Dev. ± 9.015), and the mean level of the thrombocytes 207.87 /μl (Std. Dev. ± 64.035). The mean erythrocytes segmentation rate (ESR) is 18.99 mm/hr (Std. Dev. ± 12.16). The regression analysis demonstrated that the dependent variable, complication, in particular, pericarditis, and the independent factor, concomitant disease, in particular, chronic heart failure, has a significant regression coefficient of 29.101 at p &lt;0.05. Furthermore, the dependent variable, complication, in particular, pneumonitis, and the independent factor, concomitant disease, particularly, arrhythmia, have a significant regression coefficient of 21.937 at p &lt;0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;An elevated level of CPK-MB/LDH/Troponin I is linked to the development of arrhythmia. Patient","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":"41-57"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577138","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":"The Genus <i>Anabasis</i>: A Review on Pharmacological and Phytochemical Properties.","authors":"Smail Amtaghri, Miloudia Slaoui, Mohamed Eddouks","doi":"10.2174/0118715257276051240111060414","DOIUrl":"10.2174/0118715257276051240111060414","url":null,"abstract":"<p><p>The genus <i>Anabasis</i> has long been used in phytomedicine. The studied parts of <i>Anabasis</i> species are used as antirheumatic, diuretic, antidotes against poison, anti-erosion, anti-ulcer, and antidiabetic agents, as well as against headache and skin diseases. The objective of the present review was to summarize the phytochemical and pharmacological aspects related to the genus <i>Anabasis</i>. The results of this literature analysis show that among all the species of the <i>Anabasis</i> (<i>A</i>) family,<i> A. aphylla, A. Iranica, A. aretioides,</i> and <i>A. articulata</i> showed antibacterial activity; <i>A. aretioides</i> and A. articulata have antioxidant activity, A. aretioides and A. articulata have antidiabetic activity, <i>A. articulata</i> has cytotoxic activity and <i>A. setifera, A. aretioides</i>, and <i>A. articulata</i> exhibit anti-inflammatory activity. The <i>Anabasis</i> genus contains saponins, and alkaloids, such as anabasine, anabasamine, lupinine, jaxartinine, and triterpenic sapogenins. The study of 15 <i>Anabasis</i> plants has identified 70 compounds with an array of pharmacological activities especially antibacterial, antioxidant, antidiabetic, cytotoxic, and anti-inflammatory activities. However, there is a need for further studies on <i>Anabasis</i> plants before they can be fully used clinically as a potential drug.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":"11-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522225","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":"Effect of <i>Syzygium cumini</i> on Oxidative Stress Induced Cardiac Cellular Anomalies.","authors":"Renu Bhadana, Vibha Rani","doi":"10.2174/0118715257273859231211112731","DOIUrl":"10.2174/0118715257273859231211112731","url":null,"abstract":"<p><strong>Introduction: </strong>Doxorubicin (Dox), an antineoplastic agent is used as a primary anticancerous drug against various types of cancers. However, its associated toxicity to the cardiovascular system is major. Literature has recorded the cases of mortality due to poor validation and lack of prediagnosis of Dox-induced cardiotoxicity. Therapeutic interventions using natural products having cardioprotective properties with low toxic outcomes hold therapeutic potential for future cardio-oncological therapies. <i>Syzygium cumini</i> (Black berry), a traditional Indian herbal plant, has been researched and found to exert cardioprotective, anti-inflammatory, and antioxidant activities, which have been credited due to the presence of polyphenols, flavonoids, and tannins.</p><p><strong>Methods: </strong>In the current research, we investigated the cardioprotective potential of Syzygium cumini against Doxorubicin-induced cardiotoxicity (DIC) in H9C2 cardiomyocytes. Methanolic seed extract preparation of <i>Syzygium cumini</i> was performed using the Soxhlet apparatus. Cell viability and cell death assays were performed to determine the cardiotoxic doses of Doxorubicin. Furthermore, the cardioprotective potential of <i>Syzygium cumini</i> extract against DIC was studied. Morphological and nuclear alterations in H9C2 cells were studied by microscopic assays using Giemsa, Haematoxylin-Eosin stain, and PI. The intracellular stress level and ROS production were studied using DCFH-DA followed by mitochondrial integrity analysis using fluorescent microscopic methods.</p><p><strong>Results: </strong>In the results, we investigated that Dox exerted a dose and time-dependent cardiotoxicity on H9C2 cardiomyocytes. Moreover, we observed that morphological and nuclear alterations caused by doxorubicin in dose-dependent manner were prevented by supplementing with Syzygium cumini polyphenols and it attenuated the oxidative stress in H9C2 cardiomyocytes effectively.</p><p><strong>Conclusion: </strong>Conclusively, <i>Syzygium cumini</i> possesses cardioprotective potential in H9C2 cardiomyocytes in dox-induced cardiotoxicity.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":"29-40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652443","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":"Correction of Warfarin Coagulopathy for Non-bleeding Patients in the Outpatient Setting at an Ambulatory Care Organization: Application of Vitamin K Guidance.","authors":"Aaminah Khan, David DeiCicchi, Peter Collins, Ashwini Ranade, Kathy Zaiken","doi":"10.2174/0118715257286369240527055010","DOIUrl":"10.2174/0118715257286369240527055010","url":null,"abstract":"<p><strong>Background: </strong>Warfarin is an effective anticoagulant but requires close International Normalized Ratio (INR) monitoring and may occasionally require correction of excessive anticoagulation. Current guidelines provide limited practical guidance on the administration of vitamin K for the management of supratherapeutic INR levels ≥ 5.0 in non-bleeding outpatients.</p><p><strong>Objectives: </strong>Based on expert consensus and guidelines, the Atrius Health Anticoagulation Management Services (AMS) has developed internal guidance for oral vitamin K use in highly selected populations. This study will describe the internal guidance for oral vitamin K use and present associated results and clinical outcomes.</p><p><strong>Methods: </strong>Episodes with INR > 5.0 were included, with vitamin K considered for episodes with INR ≥ 6. Moreover, compelling indications and exclusions to select ideal patients for vitamin K intervention were also defined.</p><p><strong>Results: </strong>Overall, episodes were managed conservatively; of the 246 collected episodes of excessive anticoagulation, in 18 episodes (7%), patients received vitamin K, and in 228 (93%) episodes, patients did not receive vitamin K. The mean index INR was 6.0 (range 5.0 - 10.5, SD 1.07), with nearly 57% of episodes achieving INR correction and 15% of episodes developing INR overcorrection. High thrombotic risk patients, regardless of hemorrhagic risk, were less likely to receive vitamin K. Three episodes (1.2%) resulted in bleeding complications. No thrombotic complications occurred during the 30-day follow-up of the index INR value ≥ 5.0.</p><p><strong>Conclusion: </strong>Our internal guidance is a novel, standardized approach that serves as a decision support tool for the management of warfarin-associated coagulopathy and vitamin K intervention using patient-specific characteristics and index INR values. This guidance may assist other anticoagulation management services with practical applications and require validation in a prospective clinical trial.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":"58-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285611","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":"Sodium Butyrate, A Gut Microbiota Derived Metabolite in Type 2 Diabetes Mellitus and Cardiovascular Disease: A Review.","authors":"Zeynab Sarlak, Narges Naderi, Bardia Amidi, Vajihe Ghorbanzadeh","doi":"10.2174/0118715257307380240820052940","DOIUrl":"10.2174/0118715257307380240820052940","url":null,"abstract":"<p><p>Type 2 diabetes is characterized by elevated blood glucose levels, leading to an increased risk of cardiovascular diseases. Sodium butyrate, the sodium salt of the short-chain fatty acid butyric acid produced by gut microbiota fermentation, has shown promising effects on metabolic diseases, including type 2 diabetes and cardiovascular diseases. Sodium butyrate demonstrates anti-inflammatory, anti-oxidative, and lipid-lowering properties and can improve insulin sensitivity and reduce hepatic steatosis. In this review, we investigate how sodium butyrate influences cardiovascular complications of type 2 diabetes, including atherosclerosis (AS), heart failure (HF), hypertension, and angiogenesis. Moreover, we explore the pathophysiology of cardiovascular disease in type 2 diabetes, focusing on hyperglycemia, oxidative stress, inflammation, and genetic factors playing crucial roles. The review suggests that sodium butyrate can be a potential preventive and therapeutic agent for cardiovascular complications in individuals with type 2 diabetes.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115915","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":"Emerging Biomarkers for Assessing Thrombotic Risk in Patients Receiving Direct Oral Anticoagulants (DOACs).","authors":"Ashmi Sabana M, Alwin Simon M","doi":"10.2174/0118715257335790241203061748","DOIUrl":"https://doi.org/10.2174/0118715257335790241203061748","url":null,"abstract":"<p><p>Direct Oral Anticoagulants (DOACs) have transformed the management of thrombotic disorders, offering a more convenient and effective alternative to traditional vitamin K antagonists (VKAs). However, assessing thrombotic risk in patients treated with DOACS remains crucial due to the potential for recurrent events. Current clinical risk scores have limitations in predicting and monitoring venous thromboembolism (VTE) risk in specific DOAC populations. Several emerging biomarkers show promise in assessing thrombotic risk in patients treated with DOACS. Genetic factors like VKORC1 and CYP2C9 variants are well-established determinants of warfarin response, but the genetic landscape for DOAC outcomes appears more complex. Rare variants and polygenic approaches may play a role in personalizing anticoagulation therapy. Elevated factor VIII levels are associated with increased VTE recurrence risk after anticoagulation withdrawal in cancer-associated thrombosis (CAT) patients. In contrast, the circulating tissue factor is not useful for predicting VTE in this setting. Soluble P-selectin has emerged as a good marker of VTE recurrence, and its inclusion in the Vienna CATS risk model improves VTE prediction in cancer patients. While these biomarkers hold promise, larger studies are needed to validate their utility and establish standardized assays. Caution is warranted in patients at high bleeding risk. Integrating clinical factors, genetics, and circulating biomarkers will likely optimize thrombotic risk assessment in patients treated with DOACS. Continued research is crucial to develop personalized anticoagulation strategies to balance thrombosis and bleeding risks.</p>","PeriodicalId":93924,"journal":{"name":"Cardiovascular & hematological agents in medicinal chemistry","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840609","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}