TH open : companion journal to thrombosis and haemostasis最新文献

{"title":"Anticoagulation-associated bleeding in patients screened for asymptomatic atrial fibrillation vs. usual care – A post-hoc analysis from the LOOP study","authors":"Emilie Katrine Kongebro, Søren Zöga Diederichsen, Lucas Yixi Xing, Ketil Jørgen Haugan, Claus Graff, Søren Højberg, Morten Salling Olesen, Derk Krieger, Axel Brandes, Lars Koeber, Jesper Hastrup Svendsen","doi":"10.1055/a-2202-4296","DOIUrl":"https://doi.org/10.1055/a-2202-4296","url":null,"abstract":"Background Atrial fibrillation (AF) prevalence is rising, however data on the bleeding risks associated with detection of subclinical AF are needed. Objective To determine the bleeding increment associated with implantable loop recorder (ILR) screening for subclinical AF and subsequent anticoagulation initiation compared to usual care. Methods This post-hoc study utilized LOOP trial data from 6004 elderly patients with stroke risks randomised to either ILR (n=1503) or usual care (n=4503). The mean follow-up time was 64.5 months, and none were lost to follow-up. The primary exposure was the initiation of oral anticoagulation, and the main outcome was the risk of major bleeding events following initiation of oral anticoagulants (OAC), determined by time-dependent cox regression. Secondly, we investigated antithrombotic prescription patterns and major bleeding events after antiplatelets treatment and in subgroups. Results OAC was initiated in 1019 participants with a mean age (yrs) at 78.8 (±4.67) in Control vs. 77.0 (±4.84) in ILR, p<0.0001. All cases of OAC discontinuation reached 202, and in AF-patients (n=910) alone paused 105 (72%) paticipants temporarily OAC and 40 (28%) ended OAC treatment completelety during follow-up. Major bleeding events totalled 221 (3.7%). Forty-seven major bleeding events followed an OAC initiation in 1019 participants (4.6%); 26 vs. 21 events in the control and ILR group respectively. The hazard ratio (HR) for major bleeding after OAC initiation compared to before was 2.08 (1.50-2.90) p<0.0001 overall; 2.81 (1.82-4.34) p<0.0001 for Control and 1.32 (0.78-2.23) p=0.31 for the ILR group (p=0.07 for interaction). Antiplatelet treatment resulted in an overall adjusted HR of 1.3 (0.96-1.75) p=0.09. For OAC-users aged ≥75 years in the ILR group, the rate of major bleeding was 1.73 (0.92-2.96) compared to 0.84 (0.36-1.66) for an age <75 years, and the rate of the corresponding Control subgroup aged ≥75 years was 2.20 (1.23-3.63) compared to 1.64 (0.82-2.93) for an age <75 years. Conclusion The individual risk of major bleeding increased two-fold after initiation of oral anticoagulation for all patients in this study. However, the patients screened for subclinical AF did not have a higher bleeding risk after initiation of anticoagulation compared to those in usual care.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"96 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135327082","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":"Impact of COVID-19 Pandemic on Temporal Trends of Hemostasis Test in France: A Retrospective Analysis of 9 Years of National Health Data.","authors":"Nûn K Bentounes,&nbsp;Richard Chocron,&nbsp;Aurélien Philippe,&nbsp;David M Smadja,&nbsp;Nicolas Gendron","doi":"10.1055/a-2165-1249","DOIUrl":"https://doi.org/10.1055/a-2165-1249","url":null,"abstract":"<jats:p>NA</jats:p>","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"7 4","pages":"e285-e288"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/63/10-1055-a-2165-1249.PMC10562010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224474","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":"Comparison of Venous Thromboembolism Outcomes after COVID-19 and Influenza Vaccinations","authors":"Manila Gaddh, David Scott, Waldemar E. Wysokinski, Robert D. McBane, Ana I Casanegra, Lisa Baumann Kreuziger, Damon Houghton","doi":"10.1055/a-2183-5269","DOIUrl":"https://doi.org/10.1055/a-2183-5269","url":null,"abstract":"Background: Published data on the risk of venous thromboembolism (VTE) with COVID-19 vaccines is scarce and inconclusive, leading to an unmet need for further studies. Methods: Retrospective, multicentered study of adult patients vaccinated for one of the three approved COVID-19 vaccines in the United States of America and a pre-COVID-19 cohort of patients vaccinated for influenza at two institutions: Mayo Clinic Enterprise sites and the Medical College of Wisconsin, looking at rate of VTE over 90 days. VTE was identified by applying validated natural language processing algorithms to relevant imaging studies. Kaplan-Meier Curves were used to evaluate rate of VTE and Cox proportional hazard models for incident VTE after vaccinations. Sensitivity analyses were performed for age, sex, outpatient vs inpatient status and type of COVID-19 vaccine. Results: 911,381 study subjects received COVID-19 vaccine [mean age 56.8 (SD 18.3) years, 55.3% females] and 442,612 received influenza vaccine [mean age 56.5 (SD 18.3) years, 58.7% females]. VTE occurred within 90 days in 1,498 (0.11%) of the total 1,353,993 vaccinations: 882 (0.10%) in the COVID-19 and 616 (0.14%) in the influenza vaccination cohort. After adjusting for confounding variables, there was no difference in VTE event rate after COVID-19 vaccination compared to influenza vaccination [adjusted hazard ratio 0.95 (95% confidence interval 0.85-1.05)]. No significant difference in VTE rates was observed between the two cohorts on sensitivity analyses. Conclusion: In this large cohort of COVID-19 vaccinated patients, risk of VTE at 90-days was low and no different than a pre-COVID-19 cohort of influenza vaccinated patients.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135344698","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":"Occurrence of Hospital-Associated Thrombosis in the Setting of Current Thromboprophylaxis Strategies: An Observational Cross-Sectional Study.","authors":"Chantal Visser,&nbsp;Marieke J H A Kruip,&nbsp;Janet Brantsma-Van der Graaf,&nbsp;Eric E van Thiel,&nbsp;Mark-David Levin,&nbsp;Peter E Westerweel","doi":"10.1055/a-2137-9531","DOIUrl":"https://doi.org/10.1055/a-2137-9531","url":null,"abstract":"<jats:p>N/A</jats:p>","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"7 3","pages":"e280-e284"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177792","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 Nonadherence to Direct Oral Anticoagulant Treatment in Patients with Atrial Fibrillation.","authors":"Sabine F B van der Horst,&nbsp;Tim A C de Vries,&nbsp;Gordon Chu,&nbsp;Roisin Bavalia,&nbsp;Helen Xiong,&nbsp;Kayleigh M van de Wiel,&nbsp;Kelly Mulder,&nbsp;Hanne van Ballegooijen,&nbsp;Joris R de Groot,&nbsp;Saskia Middeldorp,&nbsp;Frederikus A Klok,&nbsp;Martin E W Hemels,&nbsp;Menno V Huisman","doi":"10.1055/a-2161-0928","DOIUrl":"https://doi.org/10.1055/a-2161-0928","url":null,"abstract":"<p><p><b>Background</b>  For most patients with newly diagnosed atrial fibrillation (AF), direct oral anticoagulants (DOACs) are preferred over vitamin K antagonists. However, there is concern that the lack of monitoring may impair therapy adherence and therefore the anticoagulant effect. <b>Objective</b>  To assess 1-year DOAC nonadherence in patients with AF and a treatment indication of at least 1 year in the Dutch health care setting, and to identify predictors of nonadherence. <b>Methods</b>  We performed a near-nationwide historical cohort study in patients with a novel DOAC indication for AF. Data were obtained from a pharmacy database, covering 65% of all outpatient prescriptions dispensed in the Netherlands. The 1-year nonadherence was assessed by the proportion of days covered; the threshold was set at <80%. Robust Poisson regression analyses were performed to identify predictors of nonadherence. <b>Results</b>  A total of 46,211 patients were included and the 1-year nonadherence was 6.5%. We identified male sex (risk ratio [RR] 1.23, 95% confidence interval [CI]: 1.15-1.33), younger age (age ≥60 to <70 years: RR: 1.15, 95% CI: 1.00-1.33, age <60 years: RR: 2.22, 95% CI: 1.92-2.57; reference age ≥85 years), a reduced DOAC dose (RR: 1.10, 95% CI: 1.00-1.22), a twice-daily dosing regimen (RR: 1.21, 95% CI: 1.12-1.30), and treatment with apixaban (RR: 1.16, 95% CI: 1.06-1.26, reference rivaroxaban) or dabigatran (RR: 1.25, 95% CI: 1.14-1.37) as independent predictors of 1-year nonadherence. <b>Conclusion</b>  One-year nonadherence to DOACs was low yet relevant in patients with AF newly prescribed a DOAC. Understanding the predictors for nonadherence may help identify patients at risk.</p>","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"7 3","pages":"e270-e279"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163962","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 Patient with Recurrent Strokes: Approach to Coagulopathy.","authors":"Gabriel Alejandro Zúñiga,&nbsp;Pranav Kandula,&nbsp;Hardy Sandefur,&nbsp;Alfonso J Tafur","doi":"10.1055/a-2161-1262","DOIUrl":"https://doi.org/10.1055/a-2161-1262","url":null,"abstract":"<p><p>Despite anticoagulation recommendations, patients may present with recurrent events. While medication adherence is always a concern, assessment of anticoagulation failure demands a systematic approach, taking into account the potential limitations of anticoagulants and a review of differential diagnoses for comorbidities. We illustrate our approach in a case presentation.</p>","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"7 3","pages":"e262-e269"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10533221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149652","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":"Periinterventional Management of Edoxaban in Major Procedures: Results from the DRESDEN NOAC REGISTRY.","authors":"Christina Köhler,&nbsp;Luise Tittl,&nbsp;Ulrike Hänsel,&nbsp;Evelyn Hammermüller,&nbsp;Sandra Marten,&nbsp;Christiane Naue,&nbsp;Marianne Spindler,&nbsp;Laura Stannek,&nbsp;Kristina Fache,&nbsp;Jan Beyer-Westendorf","doi":"10.1055/s-0043-1774304","DOIUrl":"https://doi.org/10.1055/s-0043-1774304","url":null,"abstract":"<p><p><b>Background</b>  Edoxaban is a non-vitamin K dependent oral anticoagulant (NOAC) licensed for venous thromboembolism (VTE) treatment or stroke prevention in atrial fibrillation. Major surgical procedures are not uncommon in anticoagulated patients but data on perioperative edoxaban management are scarce. <b>Patients and Methods</b>  Using data from the prospective DRESDEN NOAC REGISTRY, we extracted data on major surgical procedures in edoxaban patients. Periinterventional edoxaban management patterns and rates of outcome events were evaluated until day 30 after procedure. <b>Results</b>  Between 2011 and 2021, 3,448 procedures were identified in edoxaban patients, including 287 (8.3%) major procedures. A scheduled interruption of edoxaban was observed in 284/287 major procedures (99%) with a total median edoxaban interruption time of 11.0 days (25-75th percentile: 5.0-18.0 days). Heparin bridging was documented in 183 procedures (46 prophylactic dosages, 111 intermediate and 26 therapeutic dosages). Overall, 7 (2.4%; 95% CI: 1.2-4.9%) major cardiovascular events (5 VTE, 2 arterial thromboembolic events) and 38 major bleedings (13.2%; 95% CI: 9.8-17.7%) were observed and 6 patients died (2.1%; 95% CI: 1.0-4.5%). Rates of major cardiovascular events with or without heparin bridging were comparable (4/137; 2.9%; 95% CI: 1.1-7.3% vs. 3/82; 3.7%; 95% CI: 1.3-10.2%). Major bleedings occurred numerically more frequent in patients receiving heparin bridging (23/137; 16.8%; 95% CI: 11.5-23.9%) versus procedures without heparin bridging (9/82; 11.0%; 95% CI: 5.9-19.6%). <b>Conclusion</b>  Within the limitations of our study design, real-world periprocedural edoxaban management seems effective and safe. Use of heparin bridging seems to have limited effects on reducing vascular events but may increase bleeding risk.</p>","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"7 3","pages":"e251-e261"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10516686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160889","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":"Surgery As a Trigger for Incident Venous Thromboembolism: Results from a Population-Based Case-Crossover Study.","authors":"Dana Meknas,&nbsp;Sigrid K Brækkan,&nbsp;John-Bjarne Hansen,&nbsp;Vânia M Morelli","doi":"10.1055/a-2159-9957","DOIUrl":"https://doi.org/10.1055/a-2159-9957","url":null,"abstract":"<p><p><b>Background</b>  Surgery is a major transient risk factor for venous thromboembolism (VTE). However, the impact of major surgery as a VTE trigger has been scarcely investigated using a case-crossover design. <b>Aim</b>  To investigate the role of major surgery as a trigger for incident VTE in a population-based case-crossover study while adjusting for other concomitant VTE triggers. <b>Methods</b>  We conducted a case-crossover study with 531 cancer-free VTE cases derived from the Tromsø Study cohort. Triggers were registered during the 90 days before a VTE event (hazard period) and in four preceding 90-day control periods. Conditional logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for VTE according to major surgery and after adjustment for other VTE triggers. <b>Results</b>  Surgery was registered in 85 of the 531 (16.0%) hazard periods and in 38 of the 2,124 (1.8%) control periods, yielding an OR for VTE of 11.40 (95% CI: 7.42-17.51). The OR decreased to 4.10 (95% CI: 2.40-6.94) after adjustment for immobilization and infection and was further attenuated to 3.31 (95% CI: 1.83-5.96) when additionally adjusted for trauma, blood transfusion, and central venous catheter. In a mediation analysis, 51.4% (95% CI: 35.5-79.7%) of the effect of surgery on VTE risk could be mediated through immobilization and infection. <b>Conclusions</b>  Major surgery was a trigger for VTE, but the association between surgery and VTE risk was in part explained by other VTE triggers often coexisting with surgery, particularly immobilization and infection.</p>","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"7 3","pages":"e244-e250"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10511275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172700","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 platelet anaphylatoxin receptor C5aR1 (CD88) is a promising target for modulating vessel growth in response to ischemia","authors":"H. Nording, Lasse Baron, Antje Lübken, Hossein Emami, Jacob von Esebeck, M. Meusel, Christian Sadik, N. Schanze, Daniel Dürschmied, J. Köhl, G. Münch, H. Langer","doi":"10.1055/a-2156-8048","DOIUrl":"https://doi.org/10.1055/a-2156-8048","url":null,"abstract":"n.a. (letter to the editor)","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48160361","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":"Adjudicating the Diagnosis of Immune Thrombocytopenia in a Clinical Research Study","authors":"Caroline Gabe, Syed Mahamad, Melanie St. John, Joanne Duncan, John Kelton, Donald M. Arnold","doi":"10.1055/a-2054-3923","DOIUrl":"https://doi.org/10.1055/a-2054-3923","url":null,"abstract":"<b>Background:</b> Establishing the diagnosis of immune thrombocytopenia (ITP) is challenging in clinical practice and research settings even for experienced hematologists because it is a diagnosis of exclusion. <b>Methods:</b> We developed criteria to adjudicate the diagnosis of ITP using patients enrolled in the McMaster ITP Registry. At each patient visit, the cause of the thrombocytopenia was determined by the treating physician according to published criteria using all available information. We adjudicated the cause of the thrombocytopenia for any patient whose diagnosis was uncertain, if the diagnosis changed from one follow-up visit to another, or if the thrombocytopenia occurred in the context of pregnancy. Adjudication was done independently by one of the principal investigators, an external hematologist and a research associate using predefined criteria. <b>Results:</b> The etiology of the thrombocytopenia was adjudicated for 130 patients (n= 195 clinic visits). Reasons for adjudication were: a change in diagnosis from one visit to the next (n= 77; 59.2%), no clear cause of the thrombocytopenia was identified (n=46; 35.4%), and pregnancy-related thrombocytopenia (n=7; 5.4%). After adjudication, the most common changes in diagnosis were from primary ITP to secondary ITP (n=10), from “unknown” diagnosis to either primary ITP (n=15) or non-immune thrombocytopenia (n=10), or a change in the cause of non-immune thrombocytopenia (n=10). The diagnosis did not change for 38 patients (29.7%) after adjudication. <b>Conclusions:</b> Adjudication led to a more accurate diagnosis for 92 of 130 (70.8%) patients enrolled in the registry who presented with thrombocytopenia. This process can improve the clinical diagnosis of ITP.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135598723","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}