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

{"title":"High Factor VIII Levels and Recurrent Thromboembolism in Patients with and without Inflammatory Bowel Disease: A Retrospective Comparative Study","authors":"G. E. Eagle, S. Schulman","doi":"10.1055/a-1827-7464","DOIUrl":"https://doi.org/10.1055/a-1827-7464","url":null,"abstract":"Background  The natural course of elevated factor VIII (FVIII) in patients with venous thromboembolism (VTE) and with or without inflammatory bowel disease (IBD) is not well described. Furthermore, the data on effectiveness and safety of extended anticoagulation in these patients are limited. Methods  We performed a retrospective chart review of all patients with VTE who had an elevated FVIII level (>1.5 IU/mL) during a period of 16 years. FVIII levels, duration of anticoagulation, recurrent thromboembolic events, and bleeding requiring hospitalization were captured and compared between patients with and without IBD. Results  Fourteen patients with IBD and 66 without IBD were followed for 8.0 years (standard deviation [SD] =  ±  3.5) and 5.6 years (SD =  ±  5.1), respectively. Among the 41 patients with repeat levels, FVIII remained elevated in most patients. None of the IBD patients had thromboembolic events or major bleeding during a mean of 5.6 years (SD =  ±  5.1) of anticoagulation. Three of five IBD patients who stopped anticoagulation had thromboembolic events at a median of 9 months after stopping, observed event rate of 12 per 100 patient-years. For the 66 non-IBD patients, the event rates of thromboembolism on and off anticoagulation were 1.6 and 7.2 per 100 patient-years, respectively, and of major bleeding on anticoagulation 0.8 per 100 patient-years. Conclusion  Elevated FVIII in patients with VTE is often a persistent risk factor. The cohort with VTE and elevated FVIII that we analyzed appeared to have a favorable benefit/risk ratio of extended anticoagulation.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"28 1","pages":"e147 - e153"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80353883","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 Burden of Hypercoagulability in COVID-19","authors":"M. Kim, A. George, L. Ganti, Derrick Huang, Matthew Carman","doi":"10.1055/a-1760-0445","DOIUrl":"https://doi.org/10.1055/a-1760-0445","url":null,"abstract":"The novel coronavirus disease 2019 (COVID-19) infection has widespread impact on multiple organ systems, including damage to endothelial cells. Various studies have found evidence for direct mechanisms by which interaction between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and endothelial cells lead to extensive damage to the latter, and indirect mechanisms, such as excessively elevated cytokines, can also result in the same outcome. Damage to the endothelium results in release of thrombotic factors and inhibition of fibrinolysis. This confers a significant hypercoagulability burden on patients infected or recovering from COVID-19 infection. In this case report, the authors report the case of a gentleman presenting with extensive deep vein thrombosis and pulmonary embolism, in the context of recent COVID-19 infection. The postulated mechanisms and management are discussed.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"1 1","pages":"e96 - e98"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89741116","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":"Public Awareness on Cancer-Associated Thrombosis among the Greek Population: First Findings from the ROADMAP-CAT Awareness Study","authors":"K. Souliotis, C. Golna, S. Nikolaidi, P. Dreden, Georgia Vatheia, G. Gerotziafas","doi":"10.1055/a-1742-0465","DOIUrl":"https://doi.org/10.1055/a-1742-0465","url":null,"abstract":"Background  Cancer-associated thrombosis (CAT) is the second cause of mortality after cancer itself. CAT is underestimated as a health challenge among oncologists, whereas the levels of awareness among patients and the public have not been systematically assessed and followed in the European Union countries. Aim  The Prospective Risk Assessment and Management of Patient with CAT (ROADMAP-CAT) Awareness study is an investigator-initiated, descriptive and nonexperimental study with a cross-sectional design and it explores CAT risk awareness among cancer patients and the general public in Greece to provide an impetus for health policy interventions and a benchmark against which impact of any future interventions may be assessed. Methods  A total of 1,003 participants aged above 18 years were contacted by phone after random selection from the national telephone catalogue. Participation was voluntary and completely anonymous, and a structured questionnaire was used to elicit responses. Data were analyzed using IBM SPSS version 25. Results  Among respondents, almost one-third (32.3%) reported CAT awareness, while only one in five (21.7%) were aware of the signs and symptoms of venous thromboembolism (VTE). Among patients with a personal history of cancer or of VTE, 47 and 58%, respectively, were aware of CAT risk. Of those aware of the association, 35.2% identified their treating physician as the main source of information. The level of awareness did not significantly differ by responders' demographics. Conclusion  The ROADMAP-CAT Awareness study revealed very low levels of awareness on CAT and VTE risk both among the general public and cancer patients in Greece. Awareness of the signs and symptoms of VTE was also particularly low. Treating physicians are not actively engaging in educating their patients about CAT. Public awareness of the increased risk of VTE among cancer patients is critical to prevent and diagnose the disease early. It is imperative that a structured campaign supports medical professionals to take the time to increase awareness and educate their patients on this matter if to improve morbidity and mortality of cancer patients.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"79 1","pages":"e89 - e95"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85054619","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":"Bibliometric Analysis of Publication Activity in the Field of GIANT Cell Arteritis: A SCOPUS-based Study","authors":"Syeda Beenish Bareeqa, Syeda Sana Samar, Sufiyan Kamal, F. Khan, Hafsa Shakeel, Kanza Ali, Syed Hasham Humayun, S. I. Ahmed","doi":"10.1055/a-1760-0340","DOIUrl":"https://doi.org/10.1055/a-1760-0340","url":null,"abstract":"Abstract Objective  Giant cell arthritis (GCA) is a type of vasculitis which is more common in female gender and is closely associated with Polymyalgia rheumatic. One of its important complication include visual impairment. The burden of disease is expected to be very high by 2050 and there is a need to compile the data on most influential studies on GCA to define future strategy to deal with this dangerous disease. Bibliometrics is a statistical analysis of published literature that reflects the value and impact of a particular publication within the specific field. Aim of our study is identify the most significant contributors and their quality of contribution in the field. Method  We conducted this analysis utilizing SCOPUS database using different related MeSH terms. After a detailed screening, the list of top-50 articles were presented in the results in descending order of their ranks on the basis of their total number of citation. Most of our data comprises of publications from 1971–2012. Result  The top-50 most cited articles on GCA were published between 1971 and 2012 with the median number of citations 274 ranging from 598–187. Annals of Internal Medicine was the top ranked journal with 13 publications from the list. The highly ranked author based on the number of publications was Hunder GG (20 publications) with h-index of 40, retaining affiliation with Mayo Clinic, Rochester, United States. Mayo Clinic was the most frequently mentioned institute among the affiliations. The United States was found to be the most productive country rendering most of the articles (64%). Conclusion  Our bibliometric analysis on Giant cell arteritis identifies the information which may direct future research contributions, identify field experts, guide researchers to fill knowledge gaps, and assist in research fund allocation.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"9 1","pages":"e80 - e88"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78470500","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":"Hypercoagulation Detected by Rotational Thromboelastometry Predicts Mortality in COVID-19: A Risk Model Based on a Prospective Observational Study","authors":"Lou M Almskog, A. Wikman, J. Svensson, M. Bottai, Mariann Kotormán, C. Wahlgren, M. Wanecek, J. van der Linden, A. Ågren","doi":"10.1101/2021.04.29.21256241","DOIUrl":"https://doi.org/10.1101/2021.04.29.21256241","url":null,"abstract":"ABSTRACT Background: Severe disease due to COVID-19 has been shown to be associated with hypercoagulation. The aim of this study was to assess Rotational Thromboelastometry (ROTEM®) as a marker of coagulopathy in hospitalized COVID-19 patients. Methods: This was a prospective, observational study where patients hospitalized due to a COVID-19 infection were eligible for inclusion. Conventional coagulation tests and ROTEM were taken after hospital admission, and patients were followed for 30 days. A prediction model including variables ROTEM EXTEM-MCF (Maximum Clot Firmness), which in previous data has been suggested a suitable marker of hypercoagulation, age and respiratory frequency was developed using logistic regression to evaluate the probability of death. Results: Out of the 141 patients included, 18 (13%) died within 30 days. In the final prediction model, the risk of death within 30 days for a patient hospitalized due to COVID-19 was increased with increased EXTEM-MCF, age and respiratory frequency. Longitudinal ROTEM data in the severely ill subpopulation showed enhanced hypercoagulation. In an in vitro analysis, no heparin effect on EXTEM-CT (Coagulation Time) was observed, supporting a SARS-CoV-2 effect on prolonged initiation of coagulation. Conclusions: Here we show that hypercoagulation measured with ROTEM predicts 30-days mortality in COVID-19. Longitudinal ROTEM data strengthen the hypothesis of hypercoagulation as a driver of severe disease in COVID-19. Thus, ROTEM may be a useful tool to assess disease severity in COVID-19 and could potentially guide anticoagulation therapy.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"61 1","pages":"e50 - e59"},"PeriodicalIF":0.0,"publicationDate":"2021-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80188829","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":"Idiopathic Renal Infarction and Anticoagulation.","authors":"Maurice I Khayat, Robert Nee, Dustin J Little, Stephen W Olson","doi":"10.1055/s-0039-1698757","DOIUrl":"https://doi.org/10.1055/s-0039-1698757","url":null,"abstract":"Idiopathic renal infarction (iRI) is rare and the pathophysiology is not well understood.1 There is no consensus treatment strategy for iRI, because previous studies have not reported long-term outcomes based on therapeutic intervention.2–15 We sought to determine if anticoagulation or nonanticoagulation was associated with a higher incidence of recurrent arterial thrombosis, de novo venous thrombosis, bleeding event, or development of long-term hypertension, proteinuria, or chronic kidney disease (CKD).","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"3 4","pages":"e331-e334"},"PeriodicalIF":0.0,"publicationDate":"2019-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1698757","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224473","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":"Catheter Ablation for Atrial Fibrillation in Patients with Hemophilia or von Willebrand Disease","authors":"P. R. van der Valk, E. Mauser-Bunschoten, J. F. van der Heijden, R. Schutgens","doi":"10.1055/s-0039-1698756","DOIUrl":"https://doi.org/10.1055/s-0039-1698756","url":null,"abstract":"Abstract Background Management of atrial fibrillation (AF) is complex in patients with bleeding disorders. Catheter ablation such as pulmonary vein isolation (PVI) has been suggested in cases with bleeding disorders. However, data on safety are missing. This report describes the outcome of PVI in patients with bleeding disorders. Methods A retrospective study in our hemophilia treatment center of patients who underwent a PVI in 2014 to 2018. PVI was done according to local protocol. Clotting factor was given periprocedural. Postprocedural anticoagulation was given for at least 4 weeks, with clotting factor suppletion if needed to maintain factor VIII (FVIII) levels >0.20 IU/mL. Results and Discussion Five patients with hemophilia and one with von Willebrand disease were included. Eight PVIs were performed. Target FVIII levels (>0.80 IU/mL) were met before the procedure. Postprocedural anticoagulation was given: vitamin K antagonist (VKA) or direct oral anticoagulant (DOAC) dabigatran. All patients obtained long-term sinus rhythm, in two patients after a second PVI. However, late recurrent AF occurred in one patient after 42 months. A notable incidence of groin bleeds was observed: two of eight interventions (25%) compared with 0.9% in the general population. Bleeding seemed to be related to agitation, early mobilization, and bridging of VKA with low molecular weight heparin (LMWH). No relevant bleeding was observed when on DOAC therapy. Conclusion PVI seems to be effective in the case of bleeding disorders. To reduce the groin bleeds agitation and early mobilization should be avoided and DOAC is preferred over bridging VKA with LMWH.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"134 1","pages":"e335 - e339"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80037118","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":"Risk of Recurrent Bleeding Events in Nonvalvular Atrial Fibrillation Treated with Vitamin K Antagonists: A Clinical Practice Research Datalink Study","authors":"R. Alikhan, C. Lefèvre, I. Menown, S. Lister, A. Bird, M. You, David J. Evans, C. Sammon","doi":"10.1055/s-0039-1698413","DOIUrl":"https://doi.org/10.1055/s-0039-1698413","url":null,"abstract":"Abstract Background There is little evidence on how the occurrence of a bleed in individuals on vitamin K antagonists (VKAs) impacts the risk of subsequent bleeds, and thromboembolic and ischemic events. Such information would help to inform treatment decisions following bleeds. Objective To estimate the impact of bleeding events on the risk of subsequent bleeds, venous thromboembolism (VTE), stroke, and myocardial infarction (MI) among patients initiating VKA treatment for new-onset nonvalvular atrial fibrillation (NVAF). Methods We conducted an observational cohort study using a linked Clinical Practice Research Datalink—Hospital Episode Statistics dataset. Among a cohort of individuals with NVAF, the risk of clinically relevant bleeding, VTE, stroke, and MI was compared between the period prior to the first bleed and the periods following each subsequent bleed. The rate and cost of general practitioner (GP) consultations, prescriptions, and hospitalizations were also compared across these periods. Results The risk of clinically relevant bleeding events was observed to be elevated at least twofold in all periods following the first bleeding event. The risk of VTE, stroke, and MI was not found to differ according to the number of clinically relevant bleeding events. The rate and cost of GP consultations, GP prescriptions, and hospitalizations were increased in all periods relative to the period prior to the first bleed. Conclusions The doubling in the risk of bleeding following the first bleed, taken alongside the stable risk of MI, VTE, and stroke, suggests that the risk–benefit balance for VKA treatment should be reconsidered following the first clinically relevant bleed.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"29 1","pages":"e316 - e324"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85508733","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":"Venous Thrombosis in Acquired Hemophilia: The Complex Management of Competing Pathologies","authors":"Manu Chhabra, Zhen Wan Stephanie Hii, J. Rajendran, K. Ponnudurai, B. Fan","doi":"10.1055/s-0039-1698414","DOIUrl":"https://doi.org/10.1055/s-0039-1698414","url":null,"abstract":"Abstract Introduction Venous thrombosis is rare in the setting of factor VIII (FVIII) deficiency. Cases of deep vein thrombosis (DVT) have been described in hemophiliacs after recent major surgery, or in association with the administration of FVIII concentrate and activated prothrombin complex concentrates, but occurrence of spontaneous DVT is even more uncommon. Aim We describe the challenging management of extensive DVT in a patient with acquired hemophilia A with concurrent hemorrhagic manifestations and review similar published cases. Methods We summarize a series of 10 cases with the following demographics: 6 males and 4 females; median age at presentation of 65 (21–80); mean inhibitor titer of 68.5 Bethesda Units (BU 1.9 to BU 350). Results Four cases were idiopathic and six had associated conditions (cancer [two cases], recent pregnancy [two cases], and recent surgery [two cases]). Three cases had an inferior vena cava filter inserted for acute lower limb DVT/pulmonary embolism. Inhibitor eradication was achieved with high-dose steroids with or without cyclophosphamide, and adjunct Rituximab administration was used in three cases. One patient received concurrent therapeutic plasma exchange (TPE). Inhibitor eradication was fastest with concurrent TPE at 6 days (range: 6–733 days). The 30-day survival was 90%. Conclusions There was adequate response of inhibitors to immunosuppression with steroids and cyclophosphamide therapy. For more refractory disease, Rituximab is emerging as a beneficial and cost-effective adjunct with better rates of complete remission, and the threshold for its use may be lowered in this complex cohort with dual competing pathologies.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"329 1","pages":"e325 - e330"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77593341","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":"Modelization of Blood-Borne Hypercoagulability in Myeloma: A Tissue-Factor-Bearing Microparticle-Driven Process","authors":"L. Papageorgiou, Kutaiba Alhaj Hussen, S. Thouroude, E. Mbemba, H. Cost, L. Garderet, I. Elalamy, A. Larsen, P. Van Dreden, M. Dimopoulos, M. Mohty, G. Gerotziafas","doi":"10.1055/s-0039-1700885","DOIUrl":"https://doi.org/10.1055/s-0039-1700885","url":null,"abstract":"Abstract Introduction Hypercoagulability is a common blood alteration in newly diagnosed chemotherapy naïve patients with multiple myeloma. The identification of the procoagulant potential of cancer cells, which is principally related to tissue factor (TF) expression, attracts particular interest. The mechanisms by which myeloma plasma cells (MPCs) activate blood coagulation have been poorly investigated. Aim To identify the principal actors related with MPCs that boost thrombin generation (TG). Methods TF and annexin V expression by MPCs and MPC-derived microparticles (MPC-dMPs) was analyzed by flow cytometry. TF activity (TFa) and TF gene expression were also determined. TG in the presence of MPCs or MPC-dMPs was assessed with the calibrated automated thrombogram assay (CAT) in normal human PPP and in plasma depleted of factor VII or XII. TG was also assessed in plasma spiked with MPCs and MPC-dMPs. Results MPC-dMPs expressed approximately twofold higher levels of TF as compared with MPCs. The TFa expressed by MPC-dMPs was significantly higher compared with that expressed by MPCs. MPCs and MPC-dMPs enhanced TG of human plasma. TG was significantly higher with MPC-dMPs compared with MPCs. Conclusion MPCs indirectly induce blood-borne hypercoagulability through the release of MPC-dMPs rich in TF. Since MPCs, expressing low TFa, represent a weak procoagulant stimulus, the hypercoagulability at the microenvironment could be the resultant of MPC-dMPs rich in TF.","PeriodicalId":94220,"journal":{"name":"TH open : companion journal to thrombosis and haemostasis","volume":"57 1","pages":"e340 - e347"},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86769796","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}