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Clinical and Applied Thrombosis/Hemostasis
Journal Prestige (SJR): 0.49  Citation Impact (citeScore): 1 Number of Followers: 32  Open Access journalISSN (Print) 1076-0296 - ISSN (Online) 1938-2723 Published by Sage Publications  [1174 journals]
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- Predictive Value of Systemic Immune-Inflammation index and
Neutrophil-to-Lymphocyte Ratio in Patients with Severe COVID-19
Authors: Wei Xia, Yafeng Tan, Shengmei Hu, Chengbin Li, Tao Jiang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Objective: It was initially reported that a novel coronavirus (COVID-19) had been identified in Wuhan, China, in December 2019.To date, COVID-19 is still threatening all humanity and has affected the public healthcare system and the world economic situation. Neutrophil-to-lymphocyte ratio (NLR) has also been demonstrated that associated with severity of COVID-19, but little is known about systemic immune-inflammation index (SII) relation with COVID-19. Methods: One hundred and twenty-five patients with diagnosed COVID-19 including non-severe cases (n = 77) and severe cases (n = 48) were enrolled in this study. Each patient of clinical characteristic information, blood routine parameters, and the haemogram-derived ratios were collected, calculated, and retrospectively analyzed. Receiver operating characteristics (ROC) was performed to investigate whether these parameters could be used to the predictive value of patients with severe COVID-19. Results: White blood cell count (WBC), neutrophil count (NEU), red cell volume distribution width (RDW), NLR, Platelet to lymphocyte ratio (PLR), neutrophil-to-platelet ratio (NPR), and SII were significantly higher in the severe groups than in the non-severe group (p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-29T05:16:14Z
DOI: 10.1177/10760296221111391
Issue No: Vol. 28 (2022)
- Admission Prevalence and Risk Factors of Deep Vein Thrombosis in Patients
with Spinal Cord Injury Complicated with Cervical Fractures
Authors: Bing Lv, Haiying Wang, Weifeng Li, Gefeng Han, Xiangdong Liu, Cheng Zhang, Zipeng Zhang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
The purpose of this study was to investigate the prevalence of deep vein thrombosis (DVT) and to clarify the risk factors of DVT in patients with acute spinal cord injury (SCI) complicated with cervical fractures at admission. From January 2018 to December 2021, a total of 175 patients with acute SCI complicated with cervical fractures in our hospital were retrospectively analyzed. Duplex ultrasound was used to diagnose the DVT. All patients' medical record data, including demographic variables, medical history, and laboratory results, were collected. The patients were divided into DVT group and non-DVT group according to ultrasound results. The prevalence of DVT was determined and risk factors of DVT were identified. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different factors. The prevalence of DVT at admission was 21.71%(38/175), including one (2.63%) with central DVT, thirty-two (84.21%) with peripheral DVT and five (13.16%) with mixed DVT. The multivariate analysis revealed that decreased lower extremity muscle strength, time from injury to admission, and D-dimer were risk factors for DVT at admission. The diagnostic value of D-dimer was the highest among these risk factors. In conclusion, in patients with acute SCI complicated with cervical fractures, the risk of DVT at admission is very high. Decreased lower extremity muscle strength, time from injury to admission, and D-dimer are risk factors for DVT. Moreover, D-dimer has the highest diagnostic value among these risk factors.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-28T05:20:45Z
DOI: 10.1177/10760296221108969
Issue No: Vol. 28 (2022)
- Predictive Role of Blood Cellular Indices and Their Relationship with
Endogenous Glycosaminoglycans as Determinants of Inflammatory Biomarkers
in Pulmonary Embolism
Authors: Bulent Kantarcioglu, Amir Darki, Fakiha Siddiqui, Emily Krupa, Mehmet Vural, Murat Kacmaz, Debra Hoppensteadt, Omer Iqbal, Walter Jeske, Jeanine Walenga, Cafer Adiguzel, Jawed Fareed
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionIn this study, we profiled the levels of blood cellular indices, endogenous glycosaminoglycans (GAGs) and inflammatory biomarkers in a cohort comprised of pulmonary embolism (PE) patients, to determine their inter-relationships. Identification of this relationship may provide insight to the complex pathophysiology of PE and the predictive role of blood cellular indices in acute PE patients.Materials and MethodsPlasma samples from PE patients and healthy controls were analyzed for thrombo-inflammatory biomarkers (IL-2, IL-4, IL-6, IL-8, IL-10, VEGF, IFN-ɣ, TNF-α, IL-1α, IL-1β, MCP-1, EGF, D-dimer, CRP and MMP-9) using biochip array and ELISA methods. The endogenous GAG levels were quantified using a fluorescence quenching method. The data regarding the blood cellular indices were collected through the review of patient medical records and analyzed to demonstrate their relationship.ResultsThe levels of inflammatory biomarkers and endogenous GAGs were elevated in acute PE patients compared to controls (P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-23T05:46:52Z
DOI: 10.1177/10760296221104801
Issue No: Vol. 28 (2022)
- Thrombotic and Hemorrhagic Issues Associated with Myeloproliferative
Neoplasms
Authors: Loula Papageorgiou, Ismail Elalamy, Patrick Vandreden, Grigoris T Gerotziafas
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Thrombotic and hemorrhagic complications are related to a significant rate of morbidity and mortality in patients with myeloproliferative neoplasms (MPNs), they are therefore called “thrombohemorrhagic” syndromes. Several clinical factors, such as age and presence of cardiovascular comorbidities are responsible for thrombotic complications. High blood counts, platelet alterations, presence of JAK2 mutation and possibly of other CHIP mutations such as TET2, DNMT3A, and ASXL1, procoagulant microparticles, NETs formation, endothelial activation and neo-angiogenesis are some of the parameters accounting for hypercoagulability in patients with myeloproliferative neoplasms. Bleeding complications emerge as a result of platelet exhaustion. They can be also linked to a functional deficiency of von Willebrand factor, when platelet counts rise above 1000G/L. The mainstay of management consists on preventing hemostatic complications, by antiplatelet and/or anticoagulant treatment and myelosuppressive agents in high-risk patients.Circumstances related to a high thrombohemorrhagic risk, such as pregnancy and the perioperative period, prompt for specific management with regards to anticoagulation and myelosuppression treatment type. In order to apply a patient-specific treatment strategy, there is a need for a risk score assessment tool encompassing clinical parameters and hemostasis biomarkers.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-23T05:46:39Z
DOI: 10.1177/10760296221097969
Issue No: Vol. 28 (2022)
- Predictive Value Analysis of in-Stent Restenosis Within Three Years in
Older Acute Coronary Syndrome Patients: A Two-Center Retrospective Study
Authors: Jing Zhou, Dayang Chai, Yuxiang Dai, Aichao Wang, Ting Yan, Shu Lu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
We aimed to investigate prognostic factors of in-stent restenosis (ISR) within 3 years in older acute coronary syndrome (ACS) patients after drug-eluting stent (DES) implantation and establish a clinical model for predicting ISR. We retrospectively collected 215 older ACS patients who followed coronary angiography (CAG) after DES implantation, divided into ISR group and non in-stent restenosis (non-ISR) group according to the results of reviewed CAG. Logistic regression analysis was performed to screen independent predictors related to ISR and build the clinical predictive model, which clinical application was assessed by decision curve analysis (DCA) and clinical impact curve (CIC). Kaplan-Meier survival curves for ISR by independent predictors. In multivariate logistic regression analysis showed that the red cell distribution width (RDW) was higher in ISR group compared with non-ISR (odds ratio (OR) = 1.54, 95% confidence interval (CI): 1.14–2.08, p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-16T05:43:21Z
DOI: 10.1177/10760296221107888
Issue No: Vol. 28 (2022)
- COVID-19 Infection in Patients with Comorbidities: Clinical and
Immunological Insight
Authors: Omnia El-Badawy, Nahla M. Elsherbiny, Doaa Abdeltawab, Doaa M. Magdy, Lamees M. Bakkar, Shimaa A. Hassan, Elham A. Hassan, Ahmed M. Thabet, Ahmed M. Ashmawy, Ehab F. Moustafa, Wael A. Abbas, Ahmad Bahieldeen Ahmad, Amal Rayan, Khaled Saad, Amira Elhoufey, Hosni A. M. Hussein, Ali A. Thabet, Asmaa M. Zahran
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
AimOur study's objectives were to study the clinical and laboratory characteristics that may serve as biomarkers for predicting disease severity, IL-10 levels, and frequencies of different T cell subsets in comorbid COVID-19 patients.MethodsSixty-two hospitalized COVID-19 patients with comorbidities were assessed clinically and radiologically. Blood samples were collected to assess the T lymphocyte subsets by flow cytometry and IL-10 levels by ELISA.ResultsThe most common comorbidities observed in COVID-19 patients were diabetes mellitus (DM), hypertension, and malignancies. Common symptoms and signs included fever, cough, dyspnea, fatigue, myalgia, and sore throat. CRP, ferritin, D dimer, LDH, urea, creatinine, and direct bilirubin were significantly increased in patients than controls. Lymphocyte count and CD4+ and CD8+ T-cells were significantly decreased in comorbid COVID-19 patients, and CD25 and CD45RA expression were increased. CD4+ and CD8+ regulatory T cells (Tregs) and IL-10 levels were significantly decreased in patients.ConclusionsMany parameters were found to be predictive of severity in the comorbid patients in our study. Significant reductions in the levels and activation of CD4+ and CD8+ T-cells were found. In addition, CD4+ and CD8+ Tregs were significant decreased in patients, probably pointing to a prominent role of CD8+ Tregs in dampening CD4+ T-cell activation.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-14T05:58:44Z
DOI: 10.1177/10760296221107889
Issue No: Vol. 28 (2022)
- Statins and Risk of Thrombosis in Critically ill Patients with COVID-19: A
Multicenter Cohort Study
Authors: Shmeylan Al Harbi, Raed Kensara, Ohoud Aljuhani, Ghazwa B. Korayem, Ali F. Altebainawi, Abdullah Al Harthi, Ramesh Vishwakarma, Alaa M. Alenazi, Abdulmajed Almutairi, Omar Alshaya, Sultan Alraddadi, Tareq Al Sulaiman, Latifah Aldakkan, Reem Mahboob, Kholoud Alaamer, Abdulrahman Alissa, Awatif Hafiz, Nada Aldhayyan, Sara Althewaibi, Farhan Alenezi, Nadeen Y. Alkhotani, Sara A. Alghamdi, Abeer A. Alenazi, Khalid Al Sulaiman
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
PurposeCoagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19.MethodsA multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary.ResultsA total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay.ConclusionThe use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-06T04:52:50Z
DOI: 10.1177/10760296221103864
Issue No: Vol. 28 (2022)
- The Efficacy and Safety of Anticoagulants in the Treatment of Cirrhotic
Portal Vein Thrombosis: A Systematic Review and Meta-Analysis
Authors: Zhiqi Zhang, Ying Zhao, Baofeng Han, Zhijun Zhu, Liying Sun, Xiangli Cui
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo evaluate the efficacy and safety of anticoagulant therapy in patients with cirrhotic PVT, and compare differences in efficacy and safety among different anticoagulants.MethodsWe comprehensively searched Pubmed, Cochrane Library, EMBASE, and ClinicalTrials.gov from inception to April 2022 for studies using anticoagulants for cirrhotic PVT. Meta-analysis was performed to calculate odds ratios (ORs) with 95% confidence intervals (CIs).Results3 RCTs and 14 cohort studies involving 1270 patients were included. Anticoagulant therapy can increase the recanalization rate compared with non-anticoagulation therapy (OR 4.44, 95% CI 3.11-6.32, I2 = 2.5%) and can decrease the extension rate of cirrhotic PVT (OR 0.33, 95% CI 0.18-0.62, I2 = 41.0%), without increasing the incidence of total bleeding (OR 1.21, 95% CI 0.75-1.97, I2 = 9.8%), major bleeding (OR 0.98, 95% CI 0.49-1.95, I2 = 19.7%), and variceal bleeding (OR 0.35, 95% CI 0.12-1.01, I2 = 39.9%). Subgroup analysis showed that VKA, LMWH, and DOACs could increase the recanalization rate of PVT and were not associated with the risk of bleeding. Studies that compared direct oral anticoagulants (DOACs) with warfarin directly showed that the recanalization rate of PVT in the DOACs group might be higher than that in the warfarin group (OR 30.99, 95% CI 7.39-129.87, I2 = 0.0%), and there was no difference in the rate of total bleeding (OR 0.30, 95% CI 0.01-8.65, I2 = 79.6%).ConclusionsAnticoagulants are safe and effective in patients with cirrhotic PVT. The rate of PVT recanalization associated with DOACs may be higher than warfarin.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-03T07:45:29Z
DOI: 10.1177/10760296221104797
Issue No: Vol. 28 (2022)
- Internal Validation of a Risk Scoring System for Venous Thromboembolism
After Total hip or Knee Arthroplasty
Authors: Akihiko Akamine, Naonobu Takahira, Masayuki Kuroiwa, Atsushi Tomizawa, Koichiro Atsuda
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
We developed a computerized clinical decision support system (CCDSS) for venous thromboembolism (VTE) risk assessment. We aimed to demonstrate its relevance and evaluate associations between risk level and VTE incidence in patients undergoing total hip/knee arthroplasty. In this case-control study, VTE was confirmed using ultrasonography/computed tomography angiography in 1098 adults at a tertiary care hospital over five years (2013-2018). Postoperative VTE incidence was classified into three risk levels (moderate, high, and highest). The overall VTE incidence was 11.7%, which increased with a risk level of 0%, 5.8%, and 12.8% in moderate-risk, high-risk, and highest-risk patients, respectively. Highest-risk patients were significantly more likely to develop VTE than high-risk patients (odds ratio [OR] 2.4; 95% confidence interval [CI] 1.2-5.5; p = 0.01). VTE development was more likely in patients with risk scores ≥4 relative to those with risk scores of 2–3 (OR 1.8; 95% CI 1.2-2.7; p = 0.003) and −1 to 1 (OR 3.3; 95% CI 1.6-7.7; p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-01T05:53:31Z
DOI: 10.1177/10760296221103868
Issue No: Vol. 28 (2022)
- The Association Between Mean Corpuscular Hemoglobin Concentration and
Prognosis in Patients with Acute Pulmonary Embolism: A Retrospective
Cohort Study
Authors: Zhishen Ruan, Dan Li, Yuanlong Hu, Zhanjun Qiu, Xianhai Chen
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionAcute pulmonary embolism (APE) is a typical cardiovascular emergency worldwide. Mean hemoglobin concentration (MCHC) is a standard indicator of anemia. Studies on the association between MCHC and APE are scarce. We aimed to investigate the relationship between MCHC and APE.MethodsClinical data were extracted from the Medical Information Bank for Intensive Care (MIMIC)-III. Adult (≥18 years) patients with APE admitted for the first time were included in this study. An analysis was conducted to evaluate the association between MCHC and the prognosis of patients by the Cox regression analysis, generalized additives models and Kaplan–Meier survival curves. The primary outcome was 30-day mortality, and the secondary outcomes were 1-year and 3-year mortality.ResultsA total of 813 patients who met the selection criteria were enrolled, of whom 130 (16.0%) died within 30 days of admission. Univariate Cox regression indicated that MCHC was significantly associated with mortality (30-day: HR = 0.74, 95% CI = 0.66–0.82, P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-01T05:53:19Z
DOI: 10.1177/10760296221103867
Issue No: Vol. 28 (2022)
- DOACs in Mechanical and Bioprosthetic Heart Valves: A Narrative Review of
Emerging Data and Future Directions
Authors: Rachel Ryu, Rebecca Tran
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
In the recent years, there has been significant transformation in the management of valvular heart disease (VHD), as a result of new minimally invasive technologies, such as the transcatheter aortic valve implantation (TAVI). Conventionally, mechanical heart valves require anticoagulation with warfarin to prevent thrombogenic events. Lately, there has been an uptrend in the usage of direct-acting oral anticoagulants (DOACs) in both mechanical and bioprosthetic heart valves. In clinical practice, there has shown to be notable heterogeneity in the antithrombotic regimen for patients. Recommendations from clinical guidelines and emerging data on DOAC use in these settings will be critically reviewed here. Future large, randomized-controlled trials are warranted to delineate the role of DOACs in patients receiving a bioprosthetic valve/TAVI or mechanical heart valve, with and without a baseline indication for anticoagulation or antiplatelets. Until clinical trial data from well-designed studies are available, providers must remain vigilant about DOAC use in patients with VHD, especially in patients with a bioprosthetic or mechanical heart valve.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-06-01T05:35:40Z
DOI: 10.1177/10760296221103578
Issue No: Vol. 28 (2022)
- Clinical Efficacy of Soluble Thrombomodulin, Tissue Plasminogen Activator
Inhibitor complex, Thrombin-Antithrombin
complex,α2-Plasmininhibitor-Plasmin complex in Pediatric Sepsis
Authors: Juanzhen Li, Jingyi Zhou, Hong Ren, Teng Teng, Biru Li, Ying Wang, Long Xiang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo investigated the clinical efficacy of Soluble thrombomodulin (sTM), tissue plasminogen activator inhibitor complex (t-PAI·C),thrombin-antithrombin complex (TAT),α2-plasmininhibitor-plasmin complex (PIC) in pediatric sepsis and pediatrics sepsis-induced coagulopathy (pSIC).MethodsWe prospectively collected patient data with sepsis diagnosed in the PICU of Shanghai Children's Medical Center from June 2019 to June 2021. sTM,t-PAI·C, TAT,PIC and classical coagulation laboratory tests (CCTs) were evaluated on the day of sepsis diagnosis.ResultsFifty-nine children were enrolled, There were significant differences in t-PAI·C (P = 0.001), Plt (P < 0.001), PT (P < 0.001), INR (P < 0.001), aPTT (P < 0.001), and TT (P = 0.048) between the pSIC and non-pSIC groups, logistic regression analysis showed that Plt (P = 0.032) was an independent risk factor for pSIC. Logistic regression analysis showed that sTM (P = 0.007) and Plt (P = 0.016) were independent risk factors for the outcome in pediatrics sepsis following discharge. The AUC of sTM combined with Plt on the mortality outcome of children with sepsis at discharge was 0.889 (95%CI: 0.781,0.956). which was better than that for PRISM III (AUC, 0.723), pSOFA (AUC, 0.764), and blood Lac (AUC, 0.717) when sepsis was diagnosed in the PICU.ConclusionsThe t-PAI·C increased in children with pSIC. The prediction of sepsis outcome using sTM combined with Plt was better than with PRISM III, pSOFA, or Lac.Further research is still needed in the future to explore the clinical value of sTM, TAT, PIC, and t-PAI·C in diagnosis and outcome of pediatrics sepsis and pSIC.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-23T05:09:13Z
DOI: 10.1177/10760296221102929
Issue No: Vol. 28 (2022)
- Response to “Critical Analysis of Apixaban Dose Adjustment
Criteria”
Authors: Stephen R. Mandt, Puneet Gaitonde, Antoinette Ajavon-Hartmann, Christian Klem, Anthony Chan, Arnaud Bastien
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-23T05:08:41Z
DOI: 10.1177/10760296221078841
Issue No: Vol. 28 (2022)
- Validation of the PESI Scale to Predict in-Hospital Mortality in Patients
with Pulmonary Thromboembolism Secondary to SARS CoV − 2 Infection
Authors: Oscar M Muñoz, Paula Ruiz-Talero, Catalina Hernández-Florez, Carlos Ernesto Lombo-Moreno, Martha Alejandra Casallas-Rivera, Carol Anne Mayorga-Hernández
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo evaluate the discriminative ability and the calibration of the Pulmonary Embolism Severity Index (PESI) to predict in-hospital mortality in patients with Pulmonary Embolism (PE) secondary to COVID 19 in two hospitals in Bogotá.MethodsExternal validation study of a prediction model based on a retrospective cohort of patients with PE secondary to COVID-19 treated at Hospital Universitario San Ignacio and Hospital universitario La Samaritana, between March 2020 and August 2021. Calibration of the scale was evaluated using the Hosmer-Lemeshow test and a calibration belt diagram. Discrimination ability was evaluated using a ROC curve.Results272 patients were included (median age 61.5 years, male 58.8%). PE was diagnosed in 45.6% of the patients at the time of admission. Of the remaining 54.4%, 95.9% received thromboprophylaxis until the time of diagnosis.17.6% of the patients died. Regarding calibration, the scale systematically underestimates risk in all classes of PESI. For class I, the ratio of observed/expected events was 4.4 vs 0.8%, class II 4.8 vs 1.8%, class III 15.2 vs 4.2%, class IV 14.3 vs 5.9% and class V 46.7 vs 5.8%. The calibration test rejected the adequate calibration hypothesis (p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-20T08:11:58Z
DOI: 10.1177/10760296221102940
Issue No: Vol. 28 (2022)
- Decreasing Plasma Fibrinogen Levels in the Intensive Care Unit Are
Associated with High Mortality Rates In Patients With Sepsis-Induced
Coagulopathy
Authors: Keisuke Mori, Yasuyuki Tsujita, Tetsunobu Yamane, Yutaka Eguchi
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Plasma fibrinogen levels increase in response to infection, but they could also decrease due to degradation as in severe coagulopathy. We evaluated 60 septic patients with their CRP levels over 5.00 mg/dL. The patients were classified into three groups based on the ratio of the maximum or minimum fibrinogen concentration within day 3 to the initial concentration on day 0: down-, flat, and uptrend groups (n = 15, 30, and 15, respectively). Both down- and flat trend groups showed reduced inflammatory markers on day 3, and the degree of platelet loss (103/μL) and the mortality rate (%) were more remarkable in the downtrend group ( − 108 vs − 42 [p = 0.026] and 46.7 vs 10.0 [p = 0.027]). On day 0, in total 12 and 9 patients were diagnosed with non-overt DIC in the down- and uptrend groups, of which 5 (41.7%) and 1 (11.1%) died within 28 days after admission. In conclusion, decreasing fibrinogen levels in the ICU are associated with high mortality in patients with sepsis followed by decreasing platelet counts, even when they are diagnosed with non-overt DIC.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-13T06:51:30Z
DOI: 10.1177/10760296221101386
Issue No: Vol. 28 (2022)
- Development and Validation of a Nomogram to Predict the Probability of
Venous Thromboembolism in Patients with Epithelial Ovarian Cancer
Authors: Yuhan Wang, Haijian Zhou, Guanglei Zhong, Zhaojie Fu, Yu Peng, Tingting Yao
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo identify predictive factors and develop a nomogram to predict the probability of venous thromboembolism for epithelial ovarian cancer patients. Methods: Our study cohort was composed of 208 EOC patients who had received initial treatment in Sun Yat-sen Memorial Hospital from January 2016 to March 2020. Clinicopathological variables predictive of VTE were identified using univariate logistic analysis. A multivariate logistic regression model was used to select the predictive factors used for nomogram. The accuracy of nomogram was evaluated by the Concordance index (C-index), the area under the receiver–operator characteristic (ROC) curve, area under concentration-time curve (AUC) and the calibration curve. Results: Advancing age (hazard ratio [HR], 1.042; 95% confidence interval [CI], 1.000-1.085; P = .048), higher D-dimer level (HR, 1.144; 95%CI, 1.020-1.283; P = .022), lower PR immunohistochemical positive rate (HR, 0.186; 95%CI, 0.034-1.065; P = .059) and higher Ki67 immunohistochemical positive rate (HR, 4.502; 95%CI, 1.637-12.380; P = .004) were found to be independent risk factors for VTE, and were used to construct the nomogram. The C-index for VTE prediction of the nomogram was 0.75. Conclusions: We constructed and validated a nomogram able to quantify the risk of VTE for EOC patients, which can be applied in recognizing EOC patients with high risk of VTE.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-13T06:51:26Z
DOI: 10.1177/10760296221095558
Issue No: Vol. 28 (2022)
- Association Between Monocyte Count and Preoperative Deep Venous Thrombosis
in Older Patients with hip Fracture: A Retrospective Study
Authors: Zhicong Wang, Qing Zhou, Hailong Liu, Jianjun Zhang, Zhonglun Zhu, Jijun Wu, Xue Chen, Yuehong Liu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
PurposeTo analyze the relationship between monocyte count and preoperative deep venous thrombosis (DVT) in older patients with hip fracture.MethodsConsecutive older patients with hip fracture undergoing surgery were included from January 2014 to December 2021. Monocyte count was measured on admission, and Doppler ultrasonography was performed for DVT screening prior to surgery. Univariate and multivariate logistic regression analyses were used to assess the association between monocyte count and DVT.ResultsA total of 674 patients were finally included, and 128 patients (19.0%) were diagnosed with preoperative DVT. Patients with DVT exhibited a higher monocyte count than patients without DVT [0.55 (0.43-0.72) × 109/L versus 0.49 (0.38-0.63) × 109/L, P = 0.007]. Multivariate logistic regression analysis showed that a high monocyte count (> 0.6 × 109/L) was independently associated with a higher risk of DVT (OR = 1.705, 95% CI: 1.121-2.593, P = 0.013), and for every 0.1 × 109/L increase in monocyte count, the risk of DVT increased by 8.5% (OR = 1.085, 95% CI: 1.003-1.174, P = 0.041). Other risk factors associated with DVT included intertrochanteric fracture (OR = 1.596, 95% CI: 1.022-2.492, P = 0.040), and elevated fibrinogen level (OR = 1.236, 95% CI: 1.029-1.484, P = 0.023).ConclusionA high monocyte count is associated with an increased risk of DVT in older patients with hip fracture. Future studies should evaluate the potential role of monocyte in the prevention and treatment of thrombosis.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-11T07:18:06Z
DOI: 10.1177/10760296221100806
Issue No: Vol. 28 (2022)
- Association of Neutrophil-to-Lymphocyte Ratio with the Risk of Fatal
Stroke Occurrence in Older Chinese
Authors: Zhi-bing Hu, Qiong-qiong Zhong, Ze-xiong Lu, Feng Zhu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundAssociations of neutrophil-to-lymphocyte ratio (NLR) and its longitudinal change with risk of fatal strokes are unclear in older populations.MethodsIn this retrospective analysis, a total of 27,799 participants were included and followed up for a mean of 14.3 years (standard deviation = 3.2). 838 stroke deaths were recorded. Cox proportional hazards regression was used to assess associations of NLR with fatal strokes.ResultsCompared to those in the first quartile and after adjustment for a series of factors, the participants in the highest neutrophil quartile had an increased risk of fatal all stroke (adjusted hazard ratio (aHR) = 1.45, 95% confidence interval (CI), 1.18–1.79) and fatal ischaemic stroke (aHR = 1.58, 95% CI, 1.17–2.12). Restricted cubic splines showed an increased trend of relationship between the NLR and fatal all stroke. The participants with the highest NLR quartile had an increased risk of fatal all stroke (aHR = 1.52, 95% CI, 1.23–1.88) and fatal ischaemic stroke (aHR = 1.59, 95% CI, 1.13–2.26), respectively; Similar associations repeated after further C-reactive protein adjustment; a 21% and a 32% increased risk of fatal all stroke and fatal ischaemic stroke showed in a continuous variable model. Those in NLR change with 5% increase had a 70% increased risk of fatal all stroke (aHR = 1.70, 95%CI, 1.13–2.57), compared to those in stable (−5%∼5%).ConclusionsHigher NLR was associated with an increased risk of fatal all stroke and fatal ischaemic stroke, and its longitudinal change increase of ≥ 5% was associated with an increased risk of fatal all stroke in a relatively healthy older population.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-11T07:17:41Z
DOI: 10.1177/10760296221098720
Issue No: Vol. 28 (2022)
- Venous Thromboembolism In Cancer Patients: “From Evidence to
Care”
Authors: Mercedes Salgado, Elena Brozos-Vázquez, Begoña Campos, Paula González-Villarroel, María Eva Pérez, María Lidia Vázquez-Tuñas, David Arias
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
This article seeks to review the current status of treatment and prevention of venous thromboembolic disease (VTE) in cancer patients after the addition of direct oral anticoagulants (DOAC) to the therapeutic arsenal available. The suitability of DOAC use in complex clinical situations, poorly represented in clinical trials, is controversial and difficult for care activity, making the recommendations in clinical practice guidelines the focus of special attention in this area. Recently, several randomized trials have compared low molecular weight heparin (LMWH) to DOAC for the management of CAT. Potential drug interactions with DOACs or the increased risk of bleeding in intraluminal tumors require special precautions, as do metastatic or primary brain disease and comorbid conditions, such as renal or liver failure, which are not suitably represented in pivotal studies. Furthermore, few data are available for situations involving elevated bleeding risk, with thrombocytopenia levels below the inclusion criterion of clinical trials, or recurrence during active anticoagulant therapy. Similarly, it is less clear that patients and physicians accept the presumption that oral DOAC administration is more convenient than subcutaneous LMWH, particularly when drug absorption may be compromised. The non-inclusion or under-representation of patients at higher risk for complications with anticoagulation in randomized clinical trials, makes their use complex in certain situations in health care. This paper provides a practical review of current clinical guideline recommendations regarding LMWH and/ or DOAC to treat and prevent CAT, as well as the most controversial clinical conditions for their use.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-11T07:16:59Z
DOI: 10.1177/10760296221098717
Issue No: Vol. 28 (2022)
- Magnitude and Associated Factors of Thrombocytopenia among Pregnant Women
Attending Antenatal Care Clinics at Dessie Comprehensive Specialized
Hospital, Northeast Ethiopia
Authors: Hussen Ebrahim, Bizuneh Kebede, Mihret Tilahun, Habtu Debash, Habtye Bisetegn, Melkam Tesfaye
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundThrombocytopenia is a common hematological abnormality during gestation. Pregnant women with severe thrombocytopenia may be associated with a higher risk of excessive bleeding during or after delivery. Therefore, the main aim of this study was to assess the magnitude and associated factors of thrombocytopenia among pregnant women attending antenatal care services at Dessie comprehensive and specialized hospital, Northeast Ethiopia.MethodsAn institution-based cross-sectional study was conducted from February to March 2021. Using a systematic random sampling technique, a total of 294 pregnant women were enrolled in the study. Structured interviewer-administered questionnaires were used to collect socio-demographic and clinical data of study participants. Four ml of venous blood were collected from each pregnant woman and a complete blood count was determined using DIRUI BF 6500 automated hematology analyzer. Data were entered into Epidata version 4.6.0 and then exported into SPSS version 24.0. Multivariate logistic regression was used to assess the association between dependent and independent variables. P-value < 0.05 was considered to be statistically significant.ResultsA total of 294 pregnant women who visited antenatal care services at Dessie comprehensive specialized hospital were included. The mean (±SD) age of the study participants was 29.7 (±6.1) years. The prevalence of thrombocytopenia among pregnant women was 9.9% (95% CI: 6.5, 13.6). A mild type of thrombocytopenia is the major type and accounted for 72.4% whereas moderate thrombocytopenia and severe thrombocytopenia accounted for 17.2% and 10.4% respectively among pregnant women. Multivariate logistic regression showed that urban residents (AOR: 0.206,95% CI, 0.055-0.748), gestational ages within the first trimester (AOR: 0.183, 95% CI, 0.057-0.593) and gestational ages within the second trimester (AOR = 0.264, 95% CI, 0.092-0.752) were significantly associated and independent predictors of thrombocytopenia in pregnant women.ConclusionIn this study, the prevalence of thrombocytopenia was 9.9% and the mild type of thrombocytopenia (72.4%) was higher than the other type of thrombocytopenia among pregnant women. In multivariate logistic regression analysis, residence and gestational age (trimester) were significantly associated with thrombocytopenia. Therefore, the platelet count should be routinely determined during the antenatal care visit for proper diagnosis and to minimize bleeding during and or after childbirth.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-11T07:16:48Z
DOI: 10.1177/10760296221097379
Issue No: Vol. 28 (2022)
- Correspondence on COVID-19 Vaccination and Acquired Haemophila A
Authors: Pathum Sookaromdee, Viroj Wiwanitkit
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-10T06:14:30Z
DOI: 10.1177/10760296221100808
Issue No: Vol. 28 (2022)
- D-dimer to Creatinine Ratio: A Novel Biomarker Associated with Gensini
Score in ST-Segment Elevation Myocardial Infarction Patients
Authors: Jiaojiao Yang, Yingjie Zhao, Yong Li, Jianmin Tang, Yipin Zhao
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveWe propose for the first time that D-dimer to creatinine ratio (DCR) may serve as a new clinical biomarker and explore its association with ST-segment elevation myocardial infarction (STEMI).Methods347 STEMI patients with complete D-dimer and creatinine were included in the analysis. According to the median of DCR value, patients were divided into the lower DCR group (DCR
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-10T06:14:09Z
DOI: 10.1177/10760296221099938
Issue No: Vol. 28 (2022)
- Differential Neutralization of Unfractionated Heparin and Enoxaparin by
Andexanet Alfa
Authors: Joseph Lewis, Omer Iqbal, Walter Jeske, Debra Hoppensteadt, Fakiha Siddiqui, Jawed Fareed
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionAndexanet alfa (andexanet) is an approved antidote used to reverse the bleeding effects of Direct Oral Anticoagulant (Direct-Xa agents) agents because it reverses anti-Xa activity. Unfractionated heparin (UFH) and low molecular weight heparins (LMWHs) exhibit anti-Xa activity. The purpose is to investigate the neutralization of UFH and LMWH by andexanet in activated clotting time (ACT), thrombelastography (TEG), and anti-Xa due to the protamine sulfate shortage.MethodsUFH and LMWH were studied with andexanet, PS, or saline as potential reversal agents/controls at varying concentrations in ACT, TEG, and anti-Xa and compared to each other.ResultsAndexanet partially neutralized both drugs several TEG parameters at high andexanet concentrations, but it was not as effective as protamine sulfate in any of the assays used. Most TEG parameters were correlated with andexanet concentration. In ACT, significant neutralization was demonstrated at many andexanet concentrations for UFH, but not LMWH. UFH was completely neutralized by PS in ACT, while LMWH was partially neutralized by PS in ACT. Andexanet alfa was a less effective neutralization agent than the protamine sulfate as it only partially neutralized UFH in ACT and was ineffective at neutralizing LMWH when tested at the same concentration as PS (10 ug/mL).ConclusionAndexanet partially neutralized UFH and LMWH with variability between assays, necessitating investigation into assay-dependent differences.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-10T06:13:29Z
DOI: 10.1177/10760296221099934
Issue No: Vol. 28 (2022)
- Plasminogen activator inhibitor-1, thrombin-antithrombin, and prothrombin
fragment F1+2 have higher diagnostic values than D-dimer for venous
thromboembolism after TKA
Authors: Yong Yang, Gangning Feng, Jiangbo Yan, Long Wu, Faxuan Wang, Dong Ding, Hui Wang, Qunhua Jin
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo investigate the diagnostic values of D-dimer, plasminogen activator inhibitor-1 (PAI-1), thrombin–antithrombin (TAT), and prothrombin fragment F1 + 2 (F1 + 2) for predicting venous thromboembolism (VTE) after total knee arthroplasty (TKA).MethodsUltrasonography and CTPA were performed to diagnose VTE in 252 patients who underwent TKAs. Plasma D-dimer, PAI-1, TAT, and F1 + 2 levels were assessed 1–3 days prior to operation (T1), second hour (T2), first (T3), and third day (T4) after the operation. Receiver–operating characteristic curves (ROC) analysis was conducted and pairwise compared to evaluate the diagnostic value of those biomarkers.ResultsPlasma D-dimer levels differed between patients with and without VTE significantly on T4, PAI-1, TAT, and F1 + 2 levels differed on T3 and T4. The areas under ROC of D-dimer, PAI-1, TAT and F1 + 2 levels were 0.645, 0.773, 0.771 and 0.797, respectively. The most feasible cutoff values of D-dimer, PAI-1, TAT and F1 + 2 in predicting VTE after TKA were 2.24 ug/ml, 35.96 ng/ml, 13.36 ng/mg and 11.1 ng/ml, respectively. Pairwise comparison of ROC curves revealed that D-dimer level had the lowest diagnostic accuracy, whereas PAI-1, TAT and F1 + 2 level had similar diagnostic accuracy. There were significant differences in duration of tourniquet time and duration of anesthesia between patients with and without VTE.ConclusionAfter TKA, using 2.24ug/mL as the threshold value of D-dimer is more accurate than using 0.5ug/mL in the monitoring of VTE, PAI-1, TAT and F1 + 2 are more valuable than D-dimer in predicting VTE. Duration of tourniquet and duration of anesthesia are risk factors for the development of VTE.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-10T06:13:20Z
DOI: 10.1177/10760296221097383
Issue No: Vol. 28 (2022)
- Correlation Between ApoE Gene Polymorphism and LEAD in Patients with T2DM
That are of Han Nationality in Northern China
Authors: Xiao Liu, Huimin Zhou, Xinyi Li, Rui Zhang, Chenxu Zhao, Yaru Zhou, Shunjiang Xu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
To investigate the correlation between ApoE gene polymorphism and the risk of lower extremity arterial disease (LEAD) in T2DM patients of Han nationality in northern China. One hundred and fifty patients with T2DM and 150 patients with T2DM combined with LEAD were enrolled in the study and assigned to the control group and the case group, respectively. The results revealed that the number of epsilon 2 (ε2) genotype carriers in the case group was significantly lower than that in the control group (case vs control: 8.0% vs 15.4%), and the distribution of the ε2 allele frequency was similar to that of the genotype (case vs control: 4.0% vs 8.4%). A binary logistic regression analysis revealed that age, waist-to-hip ratio (WHR), and gender were risk factors for T2DM with LEAD and that the ApoE ε2 carriers was a protective factor (odds ratio [OR] 0.380; 95% confidence interval [CI] 0.162-0.892; P = .026). In male subjects, ε2 carriers were more common in the control group (case vs control:7.8% vs 24.1%), while epsilon 4 (ε4) carriers were more common in the case group (case vs control: 23.3% vs 8.6%); the distribution of frequency of ε2 and ε4 alleles was more common in the control group and the case group, respectively (case vs control: 3.9% vs 12.1%, 12.8% vs 5.2%). In male, age and WHR were risk factors for the disease, and being an ε2 carrier was a protective factor. Being an ApoE gene ε2 carrier is a protective factor for LEAD in male patients with T2DM that are of Han nationality in northern China.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-10T06:13:07Z
DOI: 10.1177/10760296221092405
Issue No: Vol. 28 (2022)
- The Extensive Regulation of MicroRNA in Immune Thrombocytopenia
Authors: Yuerong Zhao, Siyuan Cui, Yan Wang, Ruirong Xu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
MicroRNA (miRNA) is a small, single-stranded, non-coding RNA molecule that plays a variety of key roles in different biological processes through post-transcriptional regulation of gene expression. MiRNA has been proved to be a variety of cellular processes involved in development, differentiation, signal transduction, and is an important regulator of immune and autoimmune diseases. Therefore, it may act as potent modulators of the immune system and play an important role in the development of several autoimmune diseases. Immune thrombocytopenia (ITP) is an autoimmune systemic disease characterized by a low platelet count. Several studies suggest that like other autoimmune disorders, miRNAs are deeply involved in the pathogenesis of ITP, interacting with the function of innate and adaptive immune responses. In this review, we discuss emerging knowledge about the function of miRNAs in ITP and describe miRNAs in terms of their role in the immune system and autoimmune response. These findings suggest that miRNA may be a useful therapeutic target for ITP by regulating the immune system. In the future, we need to have a more comprehensive understanding of miRNAs and how they regulate the immune system of patients with ITP.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-05-10T03:37:46Z
DOI: 10.1177/10760296221093595
Issue No: Vol. 28 (2022)
- Can We Improve on the Rapid Assessment of Clinically Relevant Levels of
Direct Acting Oral Anticoagulants (DOAC)'
Authors: Jeanine M. Walenga
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-27T07:44:27Z
DOI: 10.1177/10760296221096422
Issue No: Vol. 28 (2022)
- The Association of Triglyceride Glucose index for Coronary Artery Disease
in Postmenopausal Women
Authors: Jingyi Liu, Haiwei Bu, Zhenjiang Ding, Ying Zhang, Yongjie Chen, Yuxia Gao
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
This study aimed to explore the association between the triglyceride glucose (TyG) index and coronary artery disease (CAD) in postmenopausal women. This study enrolled 869 postmenopausal women and classified them into two groups: CAD group (n = 538) and control group (n = 331). The TyG index was significantly higher in patients with CAD than in controls (P 60 years), diabetes, ischemic stroke, systolic blood pressure (≥140), and ejection fraction (
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-26T06:47:55Z
DOI: 10.1177/10760296221094030
Issue No: Vol. 28 (2022)
- Effect of Revascularization on Exercise-Induced Changes in Cardiac and
Prothrombotic Biomarkers in Patients with Coronary Artery Disease
Authors: C. H. Hansen, J. Cwikiel, V. Bratseth, H. Arnesen, A. Flaa, I. Seljeflot
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
We examined whether resting levels and exercise-induced changes during exercise ECG stress test (EST) of cardiac Troponin T (cTnT), NT-proBNP and prothrombotic markers were affected by revascularization in patients with coronary artery disease (CAD).EST1 was performed before coronary angiography and revascularization, and patients (n = 20) with confirmed CAD, performed another EST (EST2) 9 weeks later. Blood samples were drawn at rest and within five min after termination of ESTs.cTnT and NT-proBNP increased during exercise at both ESTs (p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-19T07:31:28Z
DOI: 10.1177/10760296221094029
Issue No: Vol. 28 (2022)
- Incidence and Determinants of Chemotherapy Associated Thromboembolic
Events among Ethiopian Patients Treated for Solid Malignancy: A
Retrospective Cross-Sectional Study
Authors: Abdella Birhan Yabeyu, Shemsu Umer Hussen, Wondemagegnhu Tigneh, Atalay Mulu Fentie
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Venous thromboembolism is a common problem in patients treated for cancer, although the reported incidence varies widely between studies. This was the first study in its kind in Ethiopia and aimed to assess the incidence and determinants of chemotherapy associated thromboembolic events among patients treated for solid malignancy. An institution-based retrospective cross-sectional study was conducted from 1st March to 1st June, 2019 at adult oncology center of Tikur Anbessa Specialized Hospital. Systematic random sampling technique was employed to recruit 423 study participants. Patients who have received at least a single cycle of any chemotherapy regimen were included in the study. Khorana risk assessment tool was used to predict chemotherapy associated thrombosis. Descriptive statistics were used to summarize the data while multivariable logistic regression was employed to explore associations among variables of interest. The median age of study participants was 43 years, which ranged from 14 to 83 years. Majority of the study participants were treated for breast cancer. Thromboembolic events encountered in 43(10.2%) of patients, from which the commonest one being deep venous thrombosis 36 (85.7%), followed by myocardial infarction 5(11.9%). In multivariable logistic regression, blood transfusion, a primary site of cancer with gastrointestinal malignancy and performance status showed statistically significant association towards the occurrences of thromboembolic events. The incidence of chemotherapy associated thromboembolic events among patients treated for solid malignancy was comparable to other studies. Hence, other prospective randomized trials are needed to see the importance of thrombo-prophylaxis in such high-risk patients.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-18T01:46:11Z
DOI: 10.1177/10760296221091216
Issue No: Vol. 28 (2022)
- Detection of IgA Antiphospholipid Antibodies Does not Improve Thrombotic
Antiphospholipid Syndrome Classification: A two-Center Study
Authors: Zhenzhen Su, Zhuochun Huang, Jiuliang Zhao, Mengtao Li, Jing Hu, Xiaofeng Zeng, Chaojun Hu, Bin Yang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundThrombotic antiphospholipid syndrome (APS) is a systemic autoimmune disease; its diagnosis requires meeting both clinical and laboratory criteria. Prevalence rates of immunoglobulin (Ig) A anticardiolipin antibodies (aCL) and IgA anti-β2 glycoprotein I antibodies (aβ2GPI) remain unknown, and the clinical value of these antibodies to APS classification remains controversial. Therefore, we aimed to examine both items in the Chinese population.MethodsUsing chemiluminescence immunoassay, antiphospholipid antibodies (aPL) were quantified in 12,582 hospital-based general population, 278 thrombotic APS patients, and 233 healthy controls.ResultsIn the general population, the positive rates of IgA aCL and IgA aβ2GPI antibodies were 2.87% and 1.99%, respectively. Furthermore, isolated IgA aPL-positivity rate was 0.72% in patients with APS, which was comparable to those in the general population (0.68%, p = 1) and in healthy controls (0.43%, p = 1). Among the IgA aPL-positive individuals in the general population, isolated IgA-positive individuals had lower serum levels of IgA antibodies (p = 0.007 for IgA aCL and p = 0.059 for IgA aβ2GPI). Regarding to APS classification, adding IgA aPL into conventional aPL assays may not improve and may even deteriorate the net reclassification index for APS; besides, no association between thrombosis and IgA aPL was observed.Conclusionsthis study assessed the prevalence of various aPL in Chinese population. IgA aPL may not enhance the classification ability of established laboratory criteria for thrombotic APS. Our data do not support the addition of IgA aPL to conventional aPL assays.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-05T06:35:41Z
DOI: 10.1177/10760296221081129
Issue No: Vol. 28 (2022)
- Haemostatic Disarray Following COVID-19 Vaccine – a Case of Acquired
Haemophila A
Authors: Evelyn O'Shea, Orna Daly, Cleona Duggan, Maeve Crowley
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-05T06:35:10Z
DOI: 10.1177/10760296221077981
Issue No: Vol. 28 (2022)
- Thromboelastography for the Prevention of Perioperative Venous
Thromboembolism in Orthopedics
Authors: Dejing Fan, Ziyao Ouyang, Yanping Ying, Shuangxia Huang, Pinyue Tao, Xiao Pan, Shuyu Lu, Qini Pan
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
We have reviewed a large number of relevant literature to determine the deficiencies of orthopedics in the diagnosis and prevention of venous thromboembolism（VTE）events during the perioperative period, and found that the TEG technology has been widely used after liver transplantation, which may make up for the deficiencies. This review expounds the detection principle and latest thromboelastography (TEG) development, and highlights the advantages of TEG over previous screening methods in diagnosing hypercoagulability. By analyzing the correlation and consistency between TEG and conventional coagulation test, reliable indexes for diagnosing hypercoagulability and important parameters for guiding perioperative anticoagulation treatment were summarized. Furthermore, our work contributes to further studies of TEG in orthopedics. Based on the research results, we believe that TEG may help orthopedists to identify and predict VTE events, use anticoagulants, eventually reduce the occurrence of VTE events.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-05T06:34:50Z
DOI: 10.1177/10760296221077975
Issue No: Vol. 28 (2022)
- The Relevance of Anti-PF4 Antibody Isotypes and Endogenous
Glycosaminoglycans and their Relationship with Inflammatory Biomarkers in
Pulmonary Embolism Patients
Authors: Bulent Kantarcioglu, Amir Darki, Fakiha Siddiqui, Debra Hoppensteadt, Joseph Lewis, Roland Krämer, Cafer Adiguzel, Jawed Fareed
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionPrevious studies have shown that inflammation may contribute to the interplay of endogenous glycosaminoglycans (GAGs) and anti-PF4 antibodies. In this study, we quantified the levels of anti-PF4 antibody isotypes and endogenous GAGs together with inflammatory biomarkers in pulmonary embolism (PE) patients to determine whether there is a relationship in between. Identification of this relationship may provide insight to the complex pathophysiology of PE and HIT and may also be useful for development of potential prognostic, diagnostic and therapeutic interventions.Materials and MethodsPlasma samples from PE patients (n: 210) were analyzed for anti-PF4 antibody isotypes and various thrombo-inflammatory cytokines utilizing commercially available biochip array and ELISA methods. The endogenous GAG levels in PE patients’ plasma were quantified using a fluorescence quenching method. The collected data analyzed to demonstrate the relationship between various parameters.ResultsThe endogenous GAG levels were increased in the PE group (P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-01T06:07:16Z
DOI: 10.1177/10760296221091770
Issue No: Vol. 28 (2022)
- Acute Myocardial Injury Assessed by High-Sensitive Cardiac Troponin
Predicting Severe Outcomes and Death in Hospitalized Patients with
COVID-19 Infection
Authors: Falmata Laouan Brem, Miri Chaymae, Hammam Rasras, Manal Merbouh, Mohammed-Amine Bouazzaoui, Houssam Bkiyar, Naima Abda, Bazid Zakaria, Nabila Ismaili, Brahim Housni, Noha El Ouafi
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundCardiac injury has been linked to a poor prognosis during COVID-19 disease. Nevertheless, the risk factors associated are yet to be thoroughly investigated.ObjectivesWe sought to compare demographical characteristics and in-hospital outcomes in patients infected by the SARS-CoV-2 with and without cardiac injury, to further investigate the prevalence of acute cardiac injury as well as its impact on their outcomes in COVID-19-patients.MethodsWe included in a retrospective analysis, all COVID-19 patients admitted between October first and December first, 2020, at the University Hospital Center of Oujda (Morocco) who underwent a troponin assay which was systematically measured on admission. The study population was divided into two groups: cardiac-injured patients and those without cardiac injury. Clinical, biological data and in-hospital outcomes were compared between the two groups.Results298 confirmed COVID-19 cases were included. Our study found that compared to non-cardiac-injured, cardiac-injured patients are older, with higher possibilities of existing comorbidities including hypertension (68 [42.2%] vs 40 [29.2%], P = 0.02), diabetes (81 [50.3%] vs 53 [38.7%] P = 0.044), the need for mechanical ventilation, ICU admission and mortality. A Cox proportional hazards regression analysis shows a significantly increased risk of death among cardiac-injured COVID-19-patients as compared to non-cardiac injured. (HR, 1.620 [CI 95%: 2.562-1.024])ConclusionOur retrospective cohort found that old age, comorbidities, a previous history of CAD, were significantly associated with acute cardiac injury. COVID-19 patients with acute cardiac injury are at a higher risk of ICU admission, and death.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-01T06:06:55Z
DOI: 10.1177/10760296221090227
Issue No: Vol. 28 (2022)
- Hospital Variation and Associated Organizational Factors of
Pregnancy-Related Venous Thromboembolism in China
Authors: Qiongjie Zhou, Zhekun Zhao, Jinghui Xu, Yu Xiong, Xiaotian Li
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveIdentifying organizational factors affecting venous thromboembolism (VTE) incidence and variations between hospitals.MethodsFrom a 2019 survey of VTE and live births in 113 hospitals, organizational factors: (hospital type, characteristics, live birth number), resource availability: (D-dimer, B-scan ultrasonography of lower extremity veins, computed tomographic pulmonary angiography [CTPA], and competency: [risk assessment, use of anticoagulants and patient education], data were collected and the associations, weighted by live birth number, analyzed.ResultsOf 113 hospitals in China, 770,828 live births and 526 cases of VTE (68.2 per 100,000 live births) were reported. Nine hospitals lacked B-scan ultrasonography of lower extremity veins and 22 lacked CTPA. Prevalence rates of VTE rates were higher in general hospitals (Odds ratio [OR] = 4.251, 95% CI: 3.373-5.357), hospitals with live births < 10,000 (OR = 1.650-2.193), and hospitals without B-scan ultrasonography (OR = 1.661, 95% CI: 1.096-2.518). Hospitals implementing patient education, had a lower risk of VTE (OR = 0.296-0.374), and VTE rate decreased with the annual increase in live births.ConclusionsImproved hospital resource availability and competency, especially patient education, is vital for reducing VTE-related maternal mortality and morbidity risk.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-04-01T06:05:01Z
DOI: 10.1177/10760296221076148
Issue No: Vol. 28 (2022)
- Rotational Thromboelastometry Profile among Critically ill COVID-19
Patients
Authors: Indalecio Carboni Bisso, Iván Huespe, Eduardo Prado, Melina Garbarini, Marina Sol López, Luis Barrera, Marcos Las Heras, Jorge Sinner, Marta Martinuzzo
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-29T08:18:47Z
DOI: 10.1177/10760296221091213
Issue No: Vol. 28 (2022)
- TMAO as a Novel Predictor of Major Adverse Vascular Events and Recurrence
in Patients with Large Artery Atherosclerotic Ischemic Stroke
Authors: Yan-Yan Chen, Zu-Sen Ye, Nian-Ge Xia, Yun Xu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectivesTo explore the association of plasma trimethylamine N-oxide (TMAO) concentration with large artery atherosclerotic (LAA) ischemic stroke and its role in predicting neurological outcome and major vascular event recurrence.Materials and MethodsWe performed a case-control study that included patients with first-ever LAA stroke as cases (n = 291) and asymptomatic patients as controls (n = 235). Clinical data and venous blood samples were collected within 72 hours after stroke. All subjects were followed for 3 months. TMAO level was detected by liquid chromatography mass spectrometry (LC-MS). Logistic and Cox proportional hazard regression were performed to evaluate plasma TMAO concentration as a predictor of LAA stroke and major vascular event recurrence, respectively. Kaplan–Meier survival analysis was performed to compare major vascular event recurrence between patients with high and low TMAO concentration.ResultsAfter adjusting for traditional stroke risk factors, the plasma TMAO level was significantly higher in the LAA stroke group than the control group (OR = 1.031, 95% CI 1.024-1.037, P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-29T07:34:04Z
DOI: 10.1177/10760296221090503
Issue No: Vol. 28 (2022)
- Sulodexide: A Benefit for Cardiovascular Sequelae of Long COVID
Patients'
Authors: Győző Szolnoky, Alejandro José González-Ochoa
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-25T02:44:55Z
DOI: 10.1177/10760296221084300
Issue No: Vol. 28 (2022)
- The Pathophysiology of The Antiphospholipid Syndrome: A Perspective From
The Blood Coagulation System
Authors: R Arreola-Diaz, A Majluf-Cruz, LE Sanchez-Torres, J Hernandez-Juarez
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
The antiphospholipid syndrome (APS), a systemic autoimmune disease characterized by a hypercoagulability associated to vascular thrombosis and/or obstetric morbidity, is caused by the presence of antiphospholipid antibodies such as lupus anticoagulant, anti-β-2-glycoprotein 1, and/or anticardiolipin antibodies. In the obstetrical APS, antiphospholipid antibodies induce the production of proinflammatory cytokines and tissue factor by placental tissues and recruited neutrophils. Moreover, antiphospholipid antibodies activate the complement system which, in turn, induces a positive feedback leading to recruitment of neutrophils as well as activation of the placenta. Activation of these cells triggers myometrial contractions and cervical ripening provoking the induction of labor. In thrombotic and obstetrical APS, antiphospholipid antibodies activate endothelial cells, platelets, and neutrophils and they may alter the multimeric pattern and concentration of von Willebrand factor, increase the concentration of thrombospondin 1, reduce the inactivation of factor XI by antithrombin, increase the activation of factor XII, and reduce the activity of tissue plasminogen activator with the subsequent production of plasmin. All these effects result in less permeable clots, denser, thinner, and with more branched fibrin fibers which are more difficult to lysate. As a consequence, thrombosis, the defining clinical criterion of APS, complicates the clinical course of the patient.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-23T07:08:27Z
DOI: 10.1177/10760296221088576
Issue No: Vol. 28 (2022)
- Factor VIII, Fibrinogen and Heparin Resistance in COVID-19 Patients with
Thromboembolism: How Should We Manage the Anticoagulation Therapy'
Authors: Felicio Savioli, Maurício Claro, Fernando Jose da Silva Ramos, Laerte Pastore
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-21T07:52:56Z
DOI: 10.1177/10760296221087692
Issue No: Vol. 28 (2022)
- Report of Low Incidence of Thrombosis with Early Prophylaxis in
Hospitalized Patients with COVID-19 from Two Saudi Tertiary Centers
Authors: Tarek Owaidah, Khalid Maghrabi, Feras Alfraih, Alfadil Haroon, Khawar Siddiqui, Randa Alnounou, Hadeel AlOtair, Fatmah S Alqahtany, Mohannad Maghrabi, Mustafa Owaidah, Khalid AlSaleh
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundThrombotic events can increase the COVID-19 associated disease mortality. The administration of prophylactic anticoagulants had been shown to decrease the incidence of thrombosis, mortality, and ICU admission rates in COVID-19 patients.AimsThe present study investigates the rate of thrombosis with early anticoagulation prophylaxis, the various risk factors for thrombotic events, and the overall survival rate in hospitalized COVID-19 cases.MethodsIn this prospective observational study, 425 patients aged ≥14 years were included in the study who were hospitalized with COVID-19 related symptoms from March to October 2020 at two tertiary care hospitals in the Kingdom of Saudi Arabia. Venous thromboembolism (VTE) score was evaluated, and VTE prophylaxis was administered according to the hospital guidelines. Patients’ demographics, comorbidities, disease presentation, and sequential hematological profiles were also recorded. Samples were collected at different time points to determine the hematological profiles.ResultsOut of 425 with positive COVID-19 subjects, eight (1.9%) patients developed thrombosis during admission, with pulmonary embolism being the most common type. VTE prophylaxis was administered to 394 (92.7%) patients. These anticoagulants included enoxaparin (86.3%), heparin (12.7%), warfarin (0.8%) and apixaban (0.3%). Comorbid conditions were recorded in 253 (59.5%) patients. ICU admission rate was 28% (n = 119), with a median time to transfer to ICU of 1 day (r: 0-33 days). A trend of high VTE score (5.0) with ICU admission and mortality (P =
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-21T02:31:39Z
DOI: 10.1177/10760296221086286
Issue No: Vol. 28 (2022)
- Improving Care of Older Patients with Hemophilia During COVID-19 Pandemic,
Reducing the Risk of Venous Thrombosis with Home Exercises
Authors: Ufuk Demirci, Elif G. Umit, Hande Ozdemir, Derya Demirbag Kabayel, Ahmet Muzaffer Demir
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-18T07:27:54Z
DOI: 10.1177/10760296221087223
Issue No: Vol. 28 (2022)
- Efficacy of Yangxin Recipe in Combination with Conventional Western
Medicine in Treatment of Angina Pectoris of Coronary Heart Disease
Authors: Jiali Liu, Yaorong Dong, Xiaozhen Hu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo study the efficacy of Yangxin Recipe (YXR) in patients with stable angina pectoris of coronary heart disease and its impacts on coronary CT angiography.MethodsA total of 78 patients with coronary heart disease and angina pectoris were randomly divided into a control group (n = 39) and a YXR group (n = 39). The control group adopted conventional Western medicine while the YXR group received conventional western medicine + oral administration of YXR. After six months of continuous treatment, the clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, Pittsburgh Sleep Quality Index (PSQI), and the level of coronary CT vascular stenosis were observed.ResultsAfter treatment, the total effective rate of YXR was 92.31%, which was higher than (P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-15T08:15:11Z
DOI: 10.1177/10760296221076152
Issue No: Vol. 28 (2022)
- Assessment of Risk Factors for Drug Resistance of Dual Anti Platelet
Therapy After PCI
Authors: Lijie Zhang, Ying Lv, Jianyu Dong, Nana Wang, Zhan Zhan, Yuan Zhao, Shanshan Jiang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Since aspirin and clopidogrel are the widely and conventionally used drugs to treat acute myocardial infarction after percutaneous coronary intervention (PCI), it is important to explore potential risk factors of their resistance. The platelet aggregation rate with arachidonic acid (AA, PAg-AA%) and adenosine diphosphate (ADP, PAg-ADP%) of 219 PCI patients were measured after standard treatment for 24 h. The disease history and laboratory data (before PCI) were obtained. We found 101 (46.12%) patients to be aspirin-resistant, and PAg-ADP% was the most prominent risk factor of aspirin resistance. Clopidogrel resistance was present in 157 of 219 patients. Patients in the clopidogrel-resistant group carried more CYP2C19*3 or *2, which was associated with higher clopidogrel resistance in this group (69.11%, 47/68) than in the control group (64.29%, 36/56). Platelet count (109/L) and hemoglobin (g/L) were the prominent risk factors of clopidogrel resistance. Among the 219 patients, 98 showed dual antiplatelet drug resistance, for which platelet count (109/L) and monocyte count (g/L) were the risk factors. Aspirin resistance was found to usually accompany clopidogrel resistance.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-11T05:14:09Z
DOI: 10.1177/10760296221083674
Issue No: Vol. 28 (2022)
- Persistence of Platelets Activation Prior to Second Doses of Covid-19
Vaccine After Vaccine-Induced Immune Thrombotic Thrombocytopenia
Authors: Guillaume Roberge, Marc Carrier
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-11T05:14:05Z
DOI: 10.1177/10760296221086283
Issue No: Vol. 28 (2022)
- Patients’ Plasma Activity of Heparin, low-Molecular-Weight Heparin or no
Anticoagulants on Urine Based DOAC Test Strips
Authors: Job Harenberg, Svetlana Hetjens, Christel Weiss
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
DOAC Dipstick determines specifically the presence and absence of direct oral anticoagulants (DOACs) from patients’ urine samples and handmade test strips performed as well as the commercial version. To compare plasma activity (chromogenic substrate assays) from plasma samples with results from urine samples (DOAC test strips) of patients treated with heparin, low-molecular weight heparin (LMWH) and without anticoagulation. Plasma anti-factor Xa (aXa) activity was determined by Coamatic chromogenic substrate assay and compared to the presence of anticoagulants in urine by DOAC test strips. Patients were treated for least 5 days and samples were taken 4 hrs after administration in comparison to no treatment with an anticoagulant (n = 42). A total of 100 patients were included treated with heparin (n = 29), LMWH nadroparin (n = 29) or no anticoagulants (n = 42). Plasma aXa levels of patients treated with heparin (2 × 7.500 IU daily subcutaneously, 12 male, age 67.4 ± 11.5 years) were 0,18 IU/ml ± 0,15 IU/ml (mean, standard deviation), with LMWH (1 × 3000 IU daily subcutaneously, 15 male, age 64.2 ± 14.1 years) 0,17 IU/ml ± 0,16 IU/l, and with no anticoagulants (28 male, age 64.2 ± 15.6 years) 0,02 IU/ml ± 0.01 IU/ml. All factor Xa and thrombin inhibitor pad results of test strips were negative. We conclude that DOAC Dipstick has a high probability of not detecting heparin and LMWH in patients on treatment as well as in urine samples of patients not treated with an anticoagulant.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-11T05:13:46Z
DOI: 10.1177/10760296221083667
Issue No: Vol. 28 (2022)
- Andexanet Alfa Versus Prothrombin Complex Concentrates/Blood Products as
Apixaban/Rivaroxaban Reversal Agents: A Survey Among Pediatric
Hematologists
Authors: Vilmarie Rodriguez, Joseph Stanek, Bryce A. Kerlin, Amy L. Dunn
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Direct oral factor Xa inhibitors (DXIs) are approved for use in adult patients with non-valvular heart disease for stroke prevention, and the treatment/prevention of venous thromboembolism (VTE). Recent pediatric clinical trials have demonstrated safety and efficacy of direct oral anticoagulants (DOACs) in the treatment of VTE. However, there is a lack of evidence regarding the use of andexanet alfa and prothrombin complex concentrates (PCC) for anticoagulation reversal of DXIs in the pediatric population. To better understand current DXI reversal strategies in this age group, a 10-question survey was conducted among pediatric hematology members of the Hemostasis and Thrombosis Research Society. Seventeen percent completed the survey (27 of 163 pediatric hematology members) with 74% (n = 20) reporting their use of DXIs for the treatment and prevention of VTE. Forty-four percent (n = 12) would choose andexanet alfa as first-line treatment for life-threatening bleeding while 52% (n = 14) would use PCC first with one individual choosing recombinant factor VII for DXI reversal. Clinical studies of andexanet alfa and PCC for the management of DXI-associated life-threatening bleeding require further investigation in the pediatric population.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-11T05:11:50Z
DOI: 10.1177/10760296221078842
Issue No: Vol. 28 (2022)
- Direct Oral Anticoagulants for the Treatment of Cancer-Associated Venous
Thromboembolism: A Latin American Perspective
Authors: Rodrigo Abensur Athanazio, José Manuel Ceresetto, Luis Javier Marfil Rivera, Gabriela Cesarman-Maus, Kenny Galvez, Marcos Arêas Marques, Aldo Hugo Tabares, Carlos Alberto Ortiz Santacruz, Fernando Costa Santini, Luis Corrales, Alexander T. Cohen
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in patients with cancer. On the basis of results from randomized controlled trials, direct oral anticoagulants (DOACs) are now recommended for the treatment of cancer-associated VTE. The decision to use a DOAC requires consideration of bleeding risk, particularly in patients with gastrointestinal (GI) malignancies, the cost-benefit and convenience of oral therapy, and patient preference. While efficacy with apixaban, edoxaban, and rivaroxaban versus dalteparin has been consistent in the treatment of cancer-associated VTE, heterogeneity is evident with respect to major GI bleeding, with an increased risk with edoxaban and rivaroxaban but not apixaban. Although cost and accessibility vary in different countries of Latin America, DOACs should be considered for the long-term treatment of cancer-associated VTE in all patients who are likely to benefit. Apixaban may be the preferred DOAC in patients with GI malignancies and LMWH may be preferred for patients with upper or unresected lower GI tumors. Vitamin K antagonists should only be used for anticoagulation when DOACs and low molecular weight heparin are inaccessible or unsuitable.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-09T10:06:35Z
DOI: 10.1177/10760296221082988
Issue No: Vol. 28 (2022)
- Risk Factors of Cardiac Death for Elderly Patients with Severe Chronic
Kidney Disease after Percutaneous Coronary Intervention
Authors: Ying Zhang, Guangyao Zhai, Jianlong Wang, Yujie Zhou
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Aims: To identify risk factors for cardiac death of elderly and severe chronic kidney disease (CKD) patients with coronary atherosclerotic heart disease (CAHD) after percutaneous coronary intervention (PCI). Methods: 1010 CAHD-CKD patients over 60 years old who had CKD stage 3 or above and underwent PCI were followed up for at least 3 years. Cases of cardiac death were divided into groups. After univariate analysis of all variables, the variables with P 4.285 mmol/L OR = 1.44, 95%CI: 1.002∼2.069, P = .049, without statins OR = 2.015, 95%CI: 1.072∼3.789, P = .030. Conclusion: In elderly and serious CAHD-CKD patients after PCI, SVD PCI was a protective factor against cardiac death. However, SAP, CAHD-CKD combined with LEASO, K > 4.285 mmol/L, and no statins were independent risk factors of cardiac death for elderly patients with severe CKD after PCI.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-09T10:06:11Z
DOI: 10.1177/10760296221081848
Issue No: Vol. 28 (2022)
- Evaluation of DOAC Dipstick Test for Detecting Direct Oral Anticoagulants
in Urine Compared with a Clinically Relevant Plasma Threshold
Concentration
Authors: Lenna Örd, Toomas Marandi, Marit Märk, Leonid Raidjuk, Jelena Kostjuk, Valdas Banys, Karit Krause, Marika Pikta
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Measuring direct oral anticoagulant (DOAC) concentrations might be necessary in certain clinical situations but is not routinely performed. The DOAC Dipstick is a new rapid test for detecting DOACs in urine. The aim of this study was to evaluate the possible uses and limitations of the DOAC Dipstick and to compare visual analysis and DOASENSE Reader analysis of DOAC Dipstick pads. Plasma and urine samples were collected from 23 patients taking DOACs. DOAC concentrations in plasma and urine were measured by chromogenic substrate assays and in urine also by the DOAC Dipstick. Plasma concentrations were dichotomized at a threshold of ≥30 ng/mL. Patient samples were compared with samples from control individuals not using anticoagulants (n = 10) and with DOASENSE control urines. The Combur-10 test was used to measure parameters that may affect urine color and hence the interpretation of the DOAC Dipstick result. DOAC Dipstick test results were positive in 21/23 patient urine samples at a plasma DOAC concentration of ≥30 ng/mL and in 2/23 patient urine samples at a plasma DOAC concentration of
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-07T09:54:36Z
DOI: 10.1177/10760296221084307
Issue No: Vol. 28 (2022)
- A Retrospective Analysis of Hematologic Parameters in Patients with Early
Diabetic Kidney Disease
Authors: Xu Chen, Qinghua Wang, Chengbin Li
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo retrospectively analyze the hematologic parameters in patients with early Diabetic Kidney Disease (DKD) to define potential biomarkers that can be used to predict early DKD.Methods134 diabetic patients without nephropathy and 49 patients with early DKD were enrolled for this study and the hematologic parameters were retrospectively analyzed. Paired comparison was conducted by T-test and the predicting value of any statistically different parameter was tested using the Receiver Operating Characteristic curve (ROC) analysis model.ResultsThe number of Neutrophil (N) was higher (P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-03-07T09:54:19Z
DOI: 10.1177/10760296221083681
Issue No: Vol. 28 (2022)
- Regression Analysis to Estimate the Factor VIII Activity of Patients with
Hemophilia A Without Inhibitor who Received Emicizumab Therapy
Authors: Yuki Hatayama, Toru Motokura, Yuzuru Hosoda, Sayaka Suzuki, Hiroya Namba, Konami Kato, Nao Kojima, Takuya Horie, Takuya Iwamoto, Noriko Yamashita, Hitomi Ichikawa, Tetsuya Fukuda
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Background Emicizumab, a bispecific monoclonal antibody for hemophilia A (HA), has strong pharmacodynamic effects in several coagulation assays resulting in dosing difficulties with Factor VIII (FVIII) concentrates during bleeding emergencies.Materials and MethodsSingle and multiple regression models were studied to estimate FVIII activity using 27 archived plasma samples from three patients with HA without inhibitor under emicizumab treatment. Explanatory variables were FVIII chromogenic assay (CSA), Ad min1 , Ad min2 , the number of seconds of APTT, and the FVIII one-stage assay (OSA), which were measured without idiotype antibodies. The response variable was FVIII OSA measured with idiotype antibodies.ResultsIn the simple linear model, the FVIII CSA regression coefficient was 1.04 and the intercept was −14.55 (r2 = 0.95; p < 0.001). In the multiple regression model, FVIII OSA and FVIII CSA were selected based on the Akaike Information Criterion, with regression coefficients of 1.74 and 1.15, respectively, and an intercept of −92.03 (r2 = 0.96, p < 0.001).ConclusionsThe regression models can estimate the FVIII:C levels in patients with HA receiving emicizumab and would be useful in a bleeding emergency and/or surgery.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-28T11:54:36Z
DOI: 10.1177/10760296221082992
Issue No: Vol. 28 (2022)
- Venous Thromboembolism in Patients with Cancer Receiving Specialist
Palliative Care
Authors: Silvia Rosa Allende-Pérez, Gabriela Cesarman-Maus, Adriana Peña-Nieves, Amelia Arcos, Patricia Baz-Gutiérrez, Joanna Robles, Thomas W. LeBlanc
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ContextThe prevalence of venous thromboembolism (VTE) in patients with cancer is particularly high at disease progression and during relapse. Patients cared for in specialized palliative care units (SPCU) are rarely included in VTE studies. Objective: We sought to study the prevalence, clinical characteristics, and survival of individuals with VTE in an SPCU setting.MethodsWe retrospectively included 2707 consecutive individuals with active cancer managed at a SPCU. Data were summarized using descriptive statistics and frequency for categorical variables. Overall survival was estimated by Kaplan-Meier and comparisons by log-rank test. Thrombotic events were confirmed by imaging.ResultsWe studied 1984(73.3%) women and 723 (26.7%) men. The overall prevalence of thrombosis was 22.2% with only 6.2% occurring after initiating SPCU care, and was higher in women (24.6% vs 15.8%), particularly with gynecological tumors (cervical: 30.5%, ovarian: 29.2%). Median survival was slightly longer for patients without VTE (80 days [IQR21-334] and 69 days [IQR 25-235]; p = 0.03).ConclusionsPrevalence of VTE was high and varied by tumor origin. VTE may impact survival. Though median survival is short, some patients are followed over months, suggesting that in the absence of high bleeding risk, treatment for thrombosis in an attempt to decrease the morbidity of re-thrombosis should be considered. On the other hand, few patients developed symptomatic VTE during SPCU care, making generalized primary prophylaxis probably unwarranted. Customizing anticoagulation for the risk of hemorrhage and physical performance is essential.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-28T11:54:33Z
DOI: 10.1177/10760296221081121
Issue No: Vol. 28 (2022)
- How can Secondary Thromboprophylaxis in High-Risk Pregnant Patients be
Improved'
Authors: Lucia Stanciakova, Miroslava Dobrotova, Pavol Holly, Jana Zolkova, Lubica Vadelova, Ingrid Skornova, Jela Ivankova, Matej Samos, Tomas Bolek, Marian Grendar, Jan Danko, Peter Kubisz, Jan Stasko
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Low-molecular-weight heparin (LMWH) is suggested for thromboprophylaxis in pregnant women with previous venous thromboembolism (VTE). Anyway, there is only limited amount of studies evaluating the effect of LMWH on hemostatic parameters during pregnancy of patients with previous VTE and the need of secondary thromboprophylaxis. We therefore provide results of prospective and longitudinal assessment of changes in hemostasis in high-risk pregnant women at four times during pregnancy (T1–T4) and one time after the postpartum period (T5) used for individualized modification of thromboprophylaxis. In this study, the results of coagulation factor VIII (FVIII) and protein S (PS) activity, ProC Global ratio and anti-Xa activity were evaluated. Despite the thromboprophylaxis, an increased predisposition to thromboembolic complications was detected (significant increase in FVIII activity and decrease in PS function, ProC Global ratio not normalized even after the postpartum period – p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-28T02:13:36Z
DOI: 10.1177/10760296211070004
Issue No: Vol. 28 (2022)
- Safety and Efficacy Evaluation of Antithrombotic Therapy with Rivaroxaban
and Clopidogrel After PCI in Chinese Patients
Authors: Long Bai, Xiao-hong Yang, Ya-qing Zhou, Xiao-ran Cui, Ling-zhi Fu, Ji-dong Zhang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo investigate the efficacy and safety of the antithrombotic therapy using the oral anticoagulant rivaroxaban and clopidogrel in Chinese patients with acute coronary syndrome complicated with atrial fibrillation after percutaneous coronary intervention.MethodsA total of 100 patients were selected. Patients were randomly divided into two groups: the treatment group (rivaroxaban group) received a therapy of rivaroxaban and clopidogrel. The control group (warfarin group) receivied a combined treatment of warfarin, clopidogrel, and aspirin. The primary outcome endpoint was evaluated based on the adverse cardiac and cerebrovascular events within 12 months.ResultsA total of 8 (8.00%) main adverse cardiac and cerebrovascular events occurred during the 12 months of follow-up, including 5 (9.80%) in the warfarin group and 3 (6.10%) in the rivaroxaban group. The risk of having main adverse cardiac and cerebrovascular events in the two groups was comparable (P = 0.479). A total of 9 patients (9.00%) were found to have bleeding events, among which 8 patients (15.7%) were in the warfarin group, whereas only 1 patient (2.00%) was in the rivaroxaban group. Therefore, the risk of bleeding in the warfarin group was significantly higher than that in the rivaroxaban group (P = 0.047).ConclusionsIn Chinese patients with acute coronary syndrome complicated with atrial fibrillation, the efficacy of the dual therapy of oral anticoagulant rivaroxaban plus clopidogrel after percutaneous coronary intervention was similar to that of the traditional triple therapy combined with warfarin, aspirin and clopidogrel, but it has a better safety property, which has potential to widely apply to antithrombotic therapy after PCI
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-24T03:32:44Z
DOI: 10.1177/10760296221074681
Issue No: Vol. 28 (2022)
- A Suggested Link Between Antithrombin Dose and Rate of Recovery from
Disseminated Intravascular Coagulation in Patients with Severe Organ
Failure
Authors: Hiromitsu Kuroda, Hiroomi Tatsumi, Tomoko Sonoda, Yoshiki Masuda
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionThe efficacy of antithrombin (AT) supplementation against septic disseminated intravascular coagulation (DIC) may depend on various pre-existing factors, particularly the AT dose and multiple organ dysfunction severity. This study aimed to identify the impactful factors for early DIC recovery.MethodsPatients’ clinical records, including AT therapy and septic DIC data, were retrospectively extracted from January 2015 to December 2020. The patients were divided into those with early DIC recovery (n = 34) and those without (n = 37). Multivariate logistic regression analysis determined significant independent factors. Time-to-event analysis confirmed how these factors affected the DIC recovery time.ResultsThe AT dose per patient body weight (odds ratio [95% confidence interval]: 2.879 [1.031-8.042], P = 0.044) and pre-existing organ dysfunction severity (0.333 [0.120-0.920], P = 0.034) were significant independent factors affecting early DIC recovery. A higher AT dose significantly shortened the DIC recovery time among patients with severe organ dysfunction (P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-21T12:31:16Z
DOI: 10.1177/10760296221080942
Issue No: Vol. 28 (2022)
- Effect of Therapeutically Related Drugs on Coagulation-Anticoagulation
Balance in Acute Promyelocytic Leukemia
Authors: Mengyu Xiao, Pan Zhou, Kai Sun
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Acute promyelocytic leukemia (APL) usually presents with a series of coagulation-anticoagulation disturbance. Early administration of All-trans retinoic acid (ATRA) can reduce the risk of bleeding, but the potential for thrombosis needs to be addressed in some cases. The role of arsenic agent in correcting coagulation disorder remains to be studied, but oral arsenic agent shows potential advantages in coagulation recovery compared with intravenous agent, and chemotherapy can aggravate the progress of coagulation disease. In addition to early application of ATRA, avoiding invasive procedures and transfusion support can reduce the risk of bleeding. Whether the administration of heparin, thrombomodulin, recombinant factor VIIa or antifibrinolytics reduces the risk of bleeding and thrombosis associated with APL remains to be further explored, and their routine use outside of clinical trials is not recommended. This article reviews the effects of related drugs on coagulation-anticoagulation balance in APL patients.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-21T12:31:05Z
DOI: 10.1177/10760296221080166
Issue No: Vol. 28 (2022)
- Analysis of the Correlation Between the Ratio of Monocytes to High-Density
Lipoprotein Cholesterol and in-Stent Restenosis in Patients with Premature
Coronary Heart Disease
Authors: Bo-Wen Chen, Jia-Jing Liu, Jun-Hui Xing, Heng-Dao Liu, Yu-Zhen Wei, Xiao-Fei Xue, He-Ping Gu, Hai-Long Tao
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundHigh-density lipoprotein cholesterol (HDL-C) and monocytes are associated with coronary artery disease, and the ratio of monocytes to high-density lipoprotein (MHR) is associated with long-term adverse outcomes and the recurrence of atrial fibrillation. Currently, the trend of coronary heart disease proned to young people is becoming prominent. However, the relationship between MHR and in-stent restenosis (ISR) in patients with premature coronary heart disease (PCHD) has not been investigated. Therefore, we aimed to assess the relationship between MHR and ISR in patients with PCHD.MethodsWe retrospectively included 257 patients (men ≤ 55 years old, women ≤ 65 years old) with PCHD who underwent drug-eluting stent implantation and follow-up coronary angiography at the First Affiliated Hospital of Zhengzhou University from September 2016 to September 2019. Patients were divided into ISR and non-ISR groups depending on their follow-up coronary angiography results. Relative clinical information was recorded and analyzed. A receiver operating characteristic curve analysis was used to determine the optimum pre-procedural MHR cutoff value to predict ISR.ResultsLogistic regression analysis showed that MHR, smoking history, and fibrinogen were independent risk factors for ISR in patients with PCHD. The area under the receiver operating characteristic curve (AUC) of MHR was 0.750 (95% confidence interval, 0.695-0.820; P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-21T12:30:35Z
DOI: 10.1177/10760296221079334
Issue No: Vol. 28 (2022)
- The Predictor Potential Role of the Glucose to Potassium Ratio in the
Diagnostic Differentiation of Massive and Non-Massive Pulmonary Embolism
Authors: Ferit Boyuk
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveAcute pulmonary embolism (PE) is one of the main causes of death and has a course as massive (MPE) or non-massive (NMPE). The study investigates the indicator potential of Glucose to Potassium ratio (GPR) in the differential diagnosis of MPE and NMPE.Materials and MethodsThe study was designed as a retrospective cross-sectional clinical cohort in patients with PE. A total of 111 participants enrolled in the research separating two groups: MPE (n:54) and NMPE (n:67). The GPR was calculated by dividing serum glucose by potassium levels and its results were compared with D-Dimer, Pulmonary Artery Pressure (PAP), and C-Reactive Protein Test (CRP).ResultsD-Dimer was measured as 6.5 ± 5.7 µg/L in the MPE and found higher than the NMPE (3.9 ± 5.2 µg/L) (P = .019). CRP (100 ± 83.5 to 30.9 ± 42.7 mg/L; P = .0001) and PAP (49.5 ± 11.9 to 34.8 ± 7.3 mmHg; P = .0001) were found increased in the MPE. GPR strongly increased in the MPE (30.7 ± 7.5 to 24.9 ± 4.3; P = .0003) in line with CRP, D-Dimer and PAP. GPR showed a stronger diagnostic value (AUC: 0.733; P = .00001; Sensitivity:72%; Spesifity:70%; Cut-off: 26.5). PAP and GPR showed significant efficiency on occurrence of the MPE according to the binary logistic regression.ConclusionThe GPR, as a novel and cheap marker, can be useful for diagnostic differentiation of MPE from NMPE, but weaker than PAP and better than D-dimer.Type of Study and Level of EvidenceLevel-II, Retrospective clinical cohort study.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-21T12:30:16Z
DOI: 10.1177/10760296221076146
Issue No: Vol. 28 (2022)
- Position Paper on the Management of Pregnancy-Associated Superficial
Venous Thrombosis. Balkan Working Group for Prevention and Treatment of
Venous Thromboembolism
Authors: Darko Antic, Eleftheria Lefkou, Vladimir Otasevic, Ljiljana Banfic, Evangelos Dimakakos, Dan Olinic, Dragan Milić, Predrag Miljić, Sokol Xhepa, Igor Stojkovski, Matija Kozak, Doina Ruxandra Dimulescu, Tamara Kovačević Preradović, Jasminka Nancheva, Evelina Evtimova Pazvanska, Gregor Tratar, Grigoris T. Gerotziafas
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Venous thromboembolism (VTE) is a multifactorial disease that can possibly affect any part of venous circulation. The risk of VTE increases by about 2 fold in pregnant women and VTE is one of the major causes of maternal morbidity and mortality. For decades superficial vein thrombosis (SVT) has been considered as benign, self-limiting condition, primarily local event consequently being out of scope of well conducted epidemiological and clinical studies. Recently, the approach on SVT has significantly changed considering that prevalence of lower limb SVT is twice higher than both deep vein thrombosis (DVT) and pulmonary embolism (PE). The clinical severity of SVT largely depends on the localization of thrombosis, when it concerns the major superficial vein vessels of the lower limb and particularly the great saphenous vein. If untreated or inadequately treated, SVT can potentially cause DVT or PE. The purpose of this review is to discuss the complex interconnection between SVT and risk factors in pregnancy and to provide evidence-based considerations, suggestions, and recommendations for the diagnosis and treatment of this precarious and delicate clinical entity.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-21T11:17:01Z
DOI: 10.1177/1076029620939181
Issue No: Vol. 28 (2022)
- Variant Rs556621 on Chromosome 6p21.1 and the Risk of Ischemic Stroke in
Chinese Populations: A Meta-Analysis
Authors: Langxin Chen, Guiying Zhang, Qifu Li, Rong Lin
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
There are inconsistencies in the published findings on the association of variant rs556621 in an intergenic region on Chromosome 6p21.1 with the risk of developing ischemic stroke (IS) and a major IS subtype (large artery atherosclerosis, LAA) in Chinese populations. We conducted a meta-analysis to evaluate the association of variant rs556621 with IS/LAA risk using ten studies involving 3644 IS cases and 3692 controls (including seven studies involving 2268 LAA cases and 2268 controls) from China. The AA genotype increased IS risk (AA versus CC: odds ratio [OR] 1.19, 95% confidence interval [CI] 1.03-1.36, P = 0.015; AA versus CA + CC: OR 1.23, 95% CI 1.09-1.39, P = 0.001). Subgroup analysis also suggested that rs556621 contributed to the risk of IS both in Chinese Han and the miscellaneous group. However, these results were stable in Chinese Han but not in the miscellaneous group. When restricting our analysis to the LAA subtype, similar results were obtained. This meta-analysis is the first meta-analysis on the correlation between rs556621 and the susceptibility of IS/LAA and demonstrates that rs556621 is associated with IS/LAA risk in Chinese populations. Further meta-analysis warrants larger well-designed investigations to assess these effects.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-21T05:42:11Z
DOI: 10.1177/10760296221076479
Issue No: Vol. 28 (2022)
- An Update on the Status of Vaccine Development for SARS-CoV-2 Including
Variants. Practical Considerations for COVID-19 Special Populations
Authors: Bulent Kantarcioglu, Omer Iqbal, Joseph Lewis, Charles A. Carter, Meharvan Singh, Fabio Lievano, Mark Ligocki, Walter Jeske, Cafer Adiguzel, Grigoris T. Gerotziafas, Jawed Fareed
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
The progress in the development of various vaccine platforms against SARS-CoV-2 have been rather remarkable owing to advancement in molecular and biologic sciences. Most of the current vaccines and those in development focus on targeting the viral spike proteins by generating antibodies of varying spectrum. These vaccines represent a variety of platforms including whole virus vaccines, viral vector vaccines, nucleic acid vaccines representing RNA, DNA, and their hybrid forms.The therapeutic efficacy of these vaccines varies owing to their pharmacodynamic individualities. COVID-19 variants are capable of inducing different pathologic responses and some of which may be resistant to antibodies generated by current vaccines. The current clinical use of these vaccines has been through emergency use authorization until recently. Moreover, the efficacy and safety of these vaccines have been tested in substantial numbers of individuals but studies in special populations that better reflect the global population are pending results. These specialized populations include young children, immunocompromised patients, pregnant individuals, and other specialized groups. Combination approaches, molecularly modified vaccination approaches, and vaccines conferring longer periods of immunity are being currently being investigated, as well as pharmacovigilance studies.The continual transformation of SARS-CoV-2 and its variants are of concern along with the breakthrough infections. These considerations pose new challenges for the development of vaccination platforms. For this purpose, booster doses, combination vaccine approaches, and other modalities are being discussed. This review provides an updated account of currently available vaccines and those in advanced development with reference to their composition and mechanisms of action.A discussion on the use of vaccines in special populations including immunocompromised patients, pregnant women and other specialized populations are also included.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-15T05:31:51Z
DOI: 10.1177/10760296211056648
Issue No: Vol. 28 (2022)
- Construction of Risk Assessment Model for Venous Thromboembolism After
Colorectal Cancer Surgery: A Chinese Single-Center Study
Authors: Jianchang Yao, Yina Lang, Hua Su, Sheng Dai, Kejing Ying
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveA retrospective study was carried out to construct a postoperative venous thromboembolism (VTE) risk assessment model (RAM) applicable for Chinese colorectal cancer patients.Methods541 Patients who underwent colorectal cancer surgery from June 2019 to May 2020 at Sir-Run-Run-Shaw Hospital affiliated to Zhejiang University School of Medicine were enrolled in this study. Multi-factor analysis was used to determine the independent risk factors of VTE. A novel RAM of VTE which we called Sir-Run-Run-Shaw VTE RAM were constructed basing on the independent risk factors. Another study cohort consisted of 287 colorectal cancer patients underwent surgery from January 2021 to June 2021was used for model evaluation.ResultsThe incidence of VTE after colorectal cancer surgery was 12.0%(65/541). Among the 65 VTE Patients, DVT accounted for 92.3% (60/65) and DVT + PE accounted for 7.7% (5/65). Multi-factor analysis showed that age ≥ 69 years (P < 0.01), preoperative plasma D-dimer ≥ 0.49 mg/L (P = .004), stage IV of cancer (P = .018) and transfusion (P = .004) are independent risk factors of VTE after surgery. Sir-Run-Run-Shaw VTE RAM includes the above 4 factors, and the total score is 4 points. The score of the low, medium and high risk groups are 0, 1 and ≥2 points. The area under the ROC curve (AUC) of Sir-Run-Run-Shaw VTE RAM is 0.769, while Caprini RAM is 0.656. There is statistical difference between the two risk score tables (Z = 2.337, P = .0195).ConclusionA VTE RAM is constructed basing on a single center retrospective study. This score table may be applicable for Chinese patients with colorectal cancer surgery.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-15T05:31:11Z
DOI: 10.1177/10760296211073748
Issue No: Vol. 28 (2022)
- Benefit Profile of Thrombomodulin Alfa Combined with Antithrombin
Concentrate in Patients with Sepsis-Induced Disseminated Intravascular
Coagulation
Authors: Atsushi Murao, Takayuki Kato, Tetsunobu Yamane, Goichi Honda, Yutaka Eguchi
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Thrombomodulin alfa (TM-α, recombinant human soluble thrombomodulin) and antithrombin (AT) concentrate are anticoagulant agents for the treatment of disseminated intravascular coagulation (DIC). A post hoc analysis using data from 1198 patients with infection-induced DIC from the post-marketing surveillance of TM-α was conducted. To identify subgroups that benefit from combination therapy, the patients were a priori stratified into four groups by a platelet (Plt) count of 50 × 103/μL and plasma AT level of 50% (groups 1, 2, 3, and 4, with high Plt/high AT, high Plt/low AT, low Plt/high AT, and low Plt/low AT, respectively). Kaplan-Meier survival analysis showed significantly worse survival in groups 2 and 4 had than in group 1 (p = 0.0480, p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-15T04:28:09Z
DOI: 10.1177/10760296221077096
Issue No: Vol. 28 (2022)
- Low Mean Platelet Volume is Associated with Deep Vein Thrombosis in Older
Patients with Hip Fracture
Authors: Zhicong Wang, Xi Chen, Jijun Wu, Qing Zhou, Hailong Liu, Yuxuan Wu, Shuping Liu, Yuehong Liu
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
This study aimed to explore the association between mean platelet volume (MPV) and preoperative deep vein thrombosis (DVT) in older patients with hip fracture. A total of 352 consecutive older patients with hip fracture were included from January 2014 to December 2020. MPV values were measured on admission, and color Doppler ultrasonography was performed for DVT screening before the planned surgery. The receiver operating characteristic (ROC) curve was used to establish the optimal cut-off value for the prediction of DVT. Univariate and multivariate logistic regression analysis were used to examine the association between factors and DVT. The overall prevalence of preoperative DVT was 15.1%, and patients with DVT had a lower value of MPV than non-DVT patients (11.6 ± 1.2 fL vs 12.3 ± 1.4 fL, P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-14T08:33:38Z
DOI: 10.1177/10760296221078837
Issue No: Vol. 28 (2022)
- Predictive value of D-dimer in the clinical outcome of severe COVID19
patients: Are we giving it too much credit'
Authors: José P. Cidade, Luís Coelho, Vasco Costa, Rui Morais, Patrícia Moniz, Luís Morais, Pedro Fidalgo, António Tralhão, Carolina Paulino, David Nora, Bernardino Valerio, Vítor Mendes, Camila Tapadinhas, Pedro Póvoa
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundCOVID-19 is a new form of acute respiratory failure leading to multiorgan failure and ICU admission. Gathered evidence suggests that a 3-fold rise in D-dimer concentrations may be linked to poor prognosis and higher mortality.PurposeTo describe D-dimer admission profile in severe ICU COVID19 patients and its predictive role in outcomes and mortality.MethodsSingle-center retrospective cohort study. All adult patients admitted to ICU with COVID19 were divided into 3 groups: (1) Lower-values group (D-dimer levels < 3-fold normal range value [NRV] [500ng/mL]), Intermediate-values group (D-dimer ≥3-fold and
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-10T09:26:09Z
DOI: 10.1177/10760296221079612
Issue No: Vol. 28 (2022)
- Clinical Efficacy and Safety of Fanhdi®, a Plasma-Derived VWF/Factor VIII
Concentrate, in von Willebrand Disease in Spain: A Retrospective Study
Authors: Víctor Jiménez-Yuste, María Teresa Alvarez-Román, Ángeles Palomo Bravo, Bernardo J. Galmes, Maria del Mar Nieto Hernández, Olga Benítez Hidalgo, Cristina Marzo Alonso, Noelia Florencia Pérez González, Julia Coll, Ramiro Núñez, Marina Carrasco, Faustino García Candel, Jose Ramon Gonzalez-Porras, Carmen Hernández García, Maria José Varó Castro, Roser Mir
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo evaluate the efficacy and safety of a plasma-derived factor VIII concentrate containing von Willebrand Factor (pdVWF/FVIII) in standard clinical practice in von Willebrand Disease (VWD) patients.MethodsA retrospective, multicentric, observational study of VWD patients treated with Fanhdi®, a pdVWF/FVIII concentrate, from January 2011 to December 2017 was conducted at 14 centers in Spain. Efficacy and safety were evaluated for acute bleeding episodes, for prevention of bleeding in surgeries, and for secondary long-term prophylaxis.ResultsSeventy-two eligible patients, type 1, 2, 3 VWD (25%/38.9%/36.1%) were treated for spontaneous and traumatic bleeding (140 episodes, n = 41 patients), to prevent surgical bleeding (69 episodes, n = 43 patients); and for secondary long-term prophylaxis (18 programs, n = 13 patients). Replacement therapy with pdVWF/FVIII showed an excellent to good clinical efficacy in 96.7% of the bleeding episodes, 100% during surgical procedures and 100% during prophylaxis. No adverse events (AEs), nor serious AEs related to the product were observed.ConclusionsFanhdi® was effective, safe and well tolerated in the management of bleeding episodes, the prevention of bleeding during surgeries, and for secondary long-term prophylaxis in VWD patients.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-02T05:08:04Z
DOI: 10.1177/10760296221074348
Issue No: Vol. 28 (2022)
- Immune Thrombocytopenia (ITP): Relapse Versus de novo After COVID-19
Vaccination
Authors: Mona Al-Ahmad, Mona Al Rasheed, Neveen Shalaby, Tito Rodriguez-Bouza, Lulwa Altourah
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-02-02T05:07:08Z
DOI: 10.1177/10760296211073920
Issue No: Vol. 28 (2022)
- Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in
Patients with Non-Traumatic Subarachnoid Hemorrhage
Authors: Brian Phan, Lolita Fagaragan, Ali Alaraj, Keri S. Kim
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundA venous thromboembolism (VTE) bundle was launched in 2016 at the University of Illinois Hospital aiming to reduce the rate of VTE in the neurosurgical ICU. Main elements of the bundle included correct and early use of intermittent pneumatic compression and subcutaneous heparin.MethodsPatients with SAH were retrospectively identified from 2014 until 2018. VTE events were diagnosed using twice weekly lower-extremity venous Duplex ultrasound and chest computerized tomography when appropriate.ResultsA total of 133 patients was included in each group. The incidence of VTE was not significantly different before and after the bundle (15% vs. 12%, p = 0.47). No difference was found regarding new episode of intracranial hemorrhage secondary to SQH (1.5% vs. 2.1%, p = 0.65). Multivariate analysis demonstrated that longer ICU LOS, higher Caprini score, and presence of baseline lung diseases were associated with VTE development.ConclusionsWith a median Caprini score of 9, our patient population was found to be at high risk for developing VTE. The implementation of the VTE bundle did not significantly reduce the rate of VTE in patients with non-traumatic SAH at UIH.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-24T12:14:47Z
DOI: 10.1177/10760296221074682
Issue No: Vol. 28 (2022)
- Prothrombotic Milieu, Thrombotic Events and Prophylactic Anticoagulation
in Hospitalized COVID-19 Positive Patients: A Review
Authors: Michael Joseph Cryer, Serdar Farhan, Christoph C. Kaufmann, Bernhard Jäger, Aakash Garg, Prakash Krishnan, Roxana Mehran, Kurt Huber
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in significant morbidity and mortality worldwide. Although initial reports concentrated on severe respiratory illness, emerging literature has indicated a substantially elevated risk of thromboembolic events in patients with COVID-19 disease. Pro-inflammatory cytokine release has been linked to endothelial dysfunction and activation of coagulation pathways, as evident by elevated D-dimer levels and deranged coagulation parameters. Both macrovascular and microvascular thromboses have been described in observational cohort and post-mortem studies. Concurrently, preliminary data have suggested the role of therapeutic anticoagulation in preventing major thromboembolic complications in moderately but not critically ill patients. However, pending results from randomized controlled trials, clear guidance is lacking regarding the intensity and duration of anticoagulation in such patients. Herein, we review the existing evidence on incidence and pathophysiology of COVID-19 related thromboembolic complications and guide anticoagulation therapy based on current literature and societal consensus statements.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-24T12:14:28Z
DOI: 10.1177/10760296221074353
Issue No: Vol. 28 (2022)
- The Correlation Between MDR1 Gene Polymorphism and Clopidogrel Resistance
in People of the Hui and Han Nationalities
Authors: Jing Zhang, Zhi-Feng Dong, Cheng-Xue Bian, Xuan Zhang, Xiang-Bin Xin, Fang Chen
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
To investigate the differences in the correlation between multidrug resistance protein 1 (MDR1) (ABCB1) gene polymorphism and clopidogrel resistance in patients of the Hui and Han nationalities with percutaneous coronary intervention (PCI). A total of 377 subjects (154 people of Hui nationality, 223 people of Han nationality) with PCI were enrolled in the study. Each patient's platelet aggregation rate was induced by adenosine diphosphate and measured using light turbidimetry. Based on the results, the patients were divided into two groups: a clopidogrel resistance (CR) group and a non-clopidogrel resistance (NCR) group. Restrictive fragment-length polymorphism polymerase chain reaction technology was then used to determine the genotype and alleles at two loci (C3435 T[rs1045642] and C1236 T[rs1128503]), calculate the frequencies of the genotype and alleles at these two loci, and conduct correlation analysis. The incidence rate of clopidogrel resistance was 23.4%, and the frequencies of the TT genotype and T allele at C3435 T for patients of both nationalities were significantly higher in the CR group than in the NCR group (P < 0.05). There were no significant differences between the two groups in genotype or allele frequency at C1236 T. There was a significant difference in the distribution of C1236 T polymorphism between the two nationalities (P < 0.05), but there was no significant difference between the two nationalities in C3435 T polymorphism. Patients with a T allele at MDR1 C3435 T are more likely to show clopidogrel resistance, and no significant differences were identified in C3435 T gene polymorphism between the two nationalities.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-24T12:14:17Z
DOI: 10.1177/10760296211073272
Issue No: Vol. 28 (2022)
- Development and Validation of a Predictive Model for Chronic Kidney
Disease After Percutaneous Coronary Intervention in Chinese
Authors: Ying Zhang, Jianlong Wang, Guangyao Zhai, Yujie Zhou
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
AimThere is no model for predicting the outcomes for coronary heart disease (CHD) patients with chronic kidney disease (CKD) after percutaneous coronary intervention (PCI). To develop and validate a model to predict major adverse cardiovascular events (MACEs) in patients with comorbid CKD and CHD undergoing PCI.MethodsWe enrolled 1714 consecutive CKD patients who underwent PCI from January 1, 2008 to December 31, 2017. In the development cohort, we used least absolute shrinkage and selection operator regression for data dimension reduction and feature selection. We used multivariable logistic regression analysis to develop the prediction model. Finally, we used an independent cohort to validate the model. The performance of the prediction model was evaluated with respect to discrimination, calibration, and clinical usefulness.ResultsThe predictors included a positive family history of CHD, history of revascularization, ST segment changes, anemia, hyponatremia, transradial intervention, the number of diseased vessels, dose of contrast media>200 ml, and coronary collateral circulation. In the validation cohort, the model showed good discrimination (area under the receiver operating characteristic curve, 0.612; 95% confidence interval: 0.560, 0.664) and good calibration (Hosmer-Lemeshow test, P = 0.444). Decision curve analysis demonstrated that the model was clinically useful.ConclusionsWe created a nomogram that predicts MACEs after PCI in CHD patients with CKD and may help improve the screening and treatment outcomes.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-24T05:17:01Z
DOI: 10.1177/10760296211069998
Issue No: Vol. 28 (2022)
- Predictive Value of CHA2DS2 -VASc-HSF Score for Severity of Acute Coronary
Syndrome
Authors: Jingyi Liu, Yang Ma, Haiwei Bu, Wei Qin, Fei Shi, Ying Zhang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
CHADS2 and CHA2DS2-VASc scores have been used to assess the prognostic risk of thromboembolism in non-valvular atrial fibrillation patients. Recent studies have shown the utility of CHADS2 and CHA2DS2-VASc scores for evaluating the severity of coronary artery disease (CAD). The newly defined CHA2DS2-VASc-HSF score evaluates atherosclerosis and is associated with CAD severity. This study investigated the association between the CHA2DS2-VASc-HSF score and acute coronary syndrome (ACS) severity as assessed by the Gensini score and the number of vessels. Furthermore, this study also compared the diagnostic value of the CHADS2, CHA2 DS2-VASc, and CHA2DS2-VASc-HSF score for ACS. A total of 2367 eligible inpatients (ACS group [n = 2030]; non-CAD group [n = 337]) were consecutively enrolled in this study. Receiver operating characteristic curve diagnostic tests and logistic regression models were used to analyze the risk factors for ACS. The CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF scores were significantly higher in the ACS group than those in the control group. After adjusting for numerous traditional CAD risk factors, an increased CHA2DS2-VASc-HSF score was found to be an independent risk factor for patients with ACS (odds ratio 1.401, 95% confidence interval 1.044, −1.879; P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-21T12:23:53Z
DOI: 10.1177/10760296211073969
Issue No: Vol. 28 (2022)
- Multidisciplinary Team Care of Patients with Hemophilic Arthropathy: A
Qualitative Assessment of Contemporary Practice in the UK and Canada:
Canada/UK: MDT Practices for Hemophilia
Authors: Jean St-Louis, Pratima Chowdary, Gerry Dolan, Dawn Goodyear, Karen Strike, Debra Pollard, Jerry Teitel
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
We used a structured interview to explore approaches to comprehensive hemophilia and arthropathy care among 24 healthcare professionals (HCPs) from multidisciplinary teams (MDTs) in Canada and the UK. Represented MDTs typically comprise a hematologist, nurse, physiotherapist, and sometimes an orthopedic surgeon; pediatric (and some adult) MDTs also include a social worker/psychologist. HCPs emphasized the centrality of a team approach, facilitated through MDT meetings and involvement of all MDT members in patient care. In both countries, nurses and physiotherapists play critical, multifaceted roles. Respondents agreed that MDTs are crucial for successful transitioning, which can be facilitated by close collaboration between pediatric and adult MDTs, even when they are not co-located. Physiotherapists are instrumental in providing non-pharmacological pain relief. Hematologists or physiotherapists typically make orthopedic referrals, with the nurse, physiotherapist and hematologist working together in patient preparation for (and follow-up after) surgery. MDT best practices include a non-hierarchical team approach, ensuring that all MDT members know all patients, and regular MDT meetings. Together, these real-life insights from the MDT perspective emphasize the value of the MDT approach in comprehensive hemophilia care.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-21T02:20:37Z
DOI: 10.1177/10760296211070002
Issue No: Vol. 28 (2022)
- A Feasibility Study on the Identification of Potential Biomarkers in
Pulmonary Embolism Using Proteomic Analysis
Authors: Fredrik Granholm, Dan Bylund, Ganna Shevchenko, Sara B. Lind, Anders E. Henriksson
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Acute pulmonary embolism (PE) is a common emergency with a high morbidity and mortality. Most clinical presentations are non-specific and there is a lack of suitable biomarkers for PE. For example, the traditional D-dimer tests shows a rather high sensitivity for PE, but yet a rather low positive predictive value due to its lack of specificity. Research on novel biomarkers for PE is thus of interest to improve early diagnostics and reduce the number of unnecessary computed tomography pulmonary angiogram (CTPA) scans performed. In this study we evaluate the feasibility to use label-free quantitative proteomics to discover potential biomarkers for acute PE and to monitor changes in proteins levels in PE patients over time. Blood was collected from 8 patients with CTPA verified PE and from 8 patients presenting with same symptoms but with a negative CTPA. The samples were analyzed by liquid chromatography-mass spectrometry and thirteen protein concentrations were found to be significantly changed in PE patients compared to the CTPA negative controls. This exploratory study shows that proteomic analysis can be used to identify potential biomarkers for PE as well as to monitor changes of protein levels over time.The complement proteins play a part in PE but further studies are needed to clarify their specific role in the pathophysiological process and to look for more specific proteins.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-19T11:04:03Z
DOI: 10.1177/10760296221074347
Issue No: Vol. 28 (2022)
- Risk Factors for Pulmonary Embolism in ICU Patients: A Retrospective
Cohort Study from the MIMIC-III Database
Authors: Cheng-bin Huang, Chen-xuan Hong, Tian-hao Xu, Ding-yun Zhao, Zong-yi Wu, Liang Chen, Jun Xie, Chen Jin, Bing-zhang Wang, Lei Yang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Pulmonary embolism (PE) is a common and potentially lethal form of venous thromboembolic disease in ICU patients. A limited number of risk factors have been associated with PE in ICU patients. In this study, we aimed to screen the independent risk factors of PE in ICU patients that can be used to evaluate the patient's condition and provide targeted treatment. We performed a retrospective cohort study using a freely accessible critical care database Medical Information Mart for Intensive Care (MIMIC)-III. The ICU patients were divided into two groups based on the incidence of PE. Finally, 9871 ICU patients were included, among which 204 patients (2.1%) had pulmonary embolism. During the multivariate logistic regression analysis, sepsis, hospital_LOS (the length of stay in hospital), type of admission, tumor, APTT (activated partial thromboplastin time) and platelet were independent risk factors for patients for PE in ICU, with OR values of 1.471 (95%CI 1.001-2.162), 1.001 (95%CI 1.001-1.001), 3.745 (95%CI 2.187-6.414), 1.709 (95%CI 1.247-2.341), 1.014 (95%CI 1.010-1.017) and 1.002 (95%CI 1.001-1.003) (Ps
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-19T11:03:50Z
DOI: 10.1177/10760296211073925
Issue No: Vol. 28 (2022)
- Rivaroxaban with Aspirin Versus Aspirin for Peripheral Arterial Disease
and Intermittent Claudication. Rationale and Design of the COMPASS
CLAUDICATION Trial
Authors: Eduardo Ramacciotti, Leandro Barile Agati, Giuliano Giova Volpiani, Karen Falcão Brito, Camilla Moreira Ribeiro, Valéria Cristina Resende Aguiar, Lorenzo Storino Ramacciotti, Alexia Paganotti, Felipe Menegueti Pereira, Roberto Augusto Caffaro, Alexandre Fioranelli, Rogério Krakauer, Heron Rhydan Saad Rached, Nelson Wolosker, Sonia S. Anand, John W. Eikelboom, Renato Delascio Lopes
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundThe COMPASS trial demonstrated that in patients with peripheral arterial disease, the combination of rivaroxaban and aspirin compared with aspirin reduces the risk of major adverse limb events, but it is not known whether this combination can also improve symptoms in patients with intermittent claudication. The primary objective of this study is to evaluate the effect of the combination on claudication distance.Study designEighty-eight patients with intermittent claudication will be randomized to receive rivaroxaban 2.5 mg twice daily plus aspirin 100 mg once daily or aspirin 100 mg once daily for 24 weeks. The primary outcome is the change in claudication distance from the baseline to 24 weeks, measured by 6 min walking test and treadmill test. The primary safety outcome is the incidence of major bleeding and clinically relevant non-major bleeding according to the International Society on Thrombosis and Hemostasis criteria.SummaryThe COMPASS CLAUDICATION trial will provide high-quality evidence regarding the effect of the combination of rivaroxaban and aspirin on claudication distance in patients with peripheral arterial disease.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-19T11:03:46Z
DOI: 10.1177/10760296211073922
Issue No: Vol. 28 (2022)
- Dysregulation of Biomarkers of Hemostatic Activation and Inflammatory
Processes are Associated with Adverse Outcomes in Pulmonary Embolism
Authors: Iman Darwish, Jawed Fareed, Yevgeniy Brailovsky, Debra Hoppensteadt, Brett Slajus, Emily Bontekoe, Frank De Stefano, Trent Reed, Amir Darki
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionThe pathophysiology of pulmonary embolism (PE) represents complex, multifactorial processes involving blood cells, vascular endothelium, and the activation of inflammatory pathways. Platelet (P), endothelial (E), and leukocyte (L)-selectin molecules may play an important role in PE pathophysiology. We aimed to profile the biomarkers of inflammation, including selectins in PE patients, and compare them to healthy individuals.Materials and methods100 acute PE patients and 50 controls were included in this case control study. ELISA methods were used to quantify levels of selectins, inflammatory, and hemostatic biomarkers.ResultsIn PE patients, levels of selectin molecules as compared to controls convey increased P-selectin levels (95 ng/mL vs 40 ng/mL, p
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-19T11:02:47Z
DOI: 10.1177/10760296211064898
Issue No: Vol. 28 (2022)
- Prevention of nNon-Vitamin K Oral Anticoagulants-Related Gastrointestinal
Bleeding With Acid Suppressants: A Systematic Review and Meta-Analysis
Authors: Yongqi Dong, Song He, Xue Li, Zhihang Zhou
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Whether the use of acid suppressants can reduce non-vitamin K oral anticoagulants (NOACs)-related gastrointestinal bleeding (GIB) remains unclear. To systemically evaluate the effect of acid suppressants on the risk of GIB in patients treated with NOACs. All related studies were searched in four databases (Cochrane, Embase, PubMed, and Web of Science) from their establishment to August 10, 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to identify studies and Stata 16.0 software was used for meta-analysis, including sensitivity and subgroup analysis. Six retrospective cohort studies were included in this study. The use of acid suppressants significantly reduced the GIB risk in patients taking NOACs, with an overall relative risk (RR) of 0.70 (95% confidence interval [CI]: 0.61-0.82; P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-17T03:33:04Z
DOI: 10.1177/10760296211064897
Issue No: Vol. 28 (2022)
- Arterial-renal Syndrome in Patients with ESRD, a New Disease Paradigm
Authors: Jake Goldstein, Robert S Dieter, Vinod Bansal, Keaton Wieschhaus, Robert S Dieter, Emily Bontekoe, Debra Hoppensteadt, Jawed Fareed
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
BackgroundPatients with end-stage renal disease (ESRD) often present with an increased risk of cardiovascular disease. Conditions of compromised cardiovascular health such as atrial fibrillation (AFIB) and peripheral arterial disease (PAD) may alter biomarker levels in a way that reflects worsening ESRD. This study profiled biomarkers and laboratory parameters of endothelium dysfunction in patients with ESRD, categorized by additional AFIB and PAD conditions.MethodsCitrated blood samples were collected from 95 patients with ESRD. Biomarker levels were measured from plasma samples using sandwich ELISAs, including tissue plasminogen activator (tPA), D-dimer, and nitrotyrosine. Lab parameters, including BUN, calcium, creatinine, parathyroid hormone, phosphate, alkaline phosphatase, ferritin, transferrin, and total iron capacity, and patient comorbidities were obtained from patient medical records. The comorbidities were determined through provider notes, and evidence of applicable testing.Results14.89% of patients were found to have atrial fibrillation (n = 14), 30.85% of patients were found to have peripheral arterial disease (n = 29), and 6.38% of patients were found to have both peripheral arterial disease and atrial fibrillation (n = 6). When compared to patients with only ESRD, patients with ESRD and PAD showed elevated levels of D-Dimer (p = .0314) and nitrotyrosine (p = .0330). When compared to patients with only ESRD, patients with atrial fibrillation showed elevated levels of D-Dimer (p = .0372), nitrotyrosine (p = .0322), and tPA (p = .0198).ConclusionWhen compared to patients with just ESRD, patients with concomitant PAD had elevated levels of Nitrotyrosine and D-dimer; while patients with concomitant Afib had elevated levels of nitrotyrosine, D-dimer, as well as tPA.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-12T11:42:52Z
DOI: 10.1177/10760296211072820
Issue No: Vol. 28 (2022)
- A New Score for Determining Thrombus Burden in STEMI Patients: The MAPH
Score
Authors: Ozge Ozcan Abacioglu, Arafat Yildirim, Mine Karadeniz, Serkan Abacioglu, Nermin Yildiz Koyunsever, Ferhat Dindas, Mustafa Dogdus, Mustafa Kaplangoray
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Aimto investigate whether the MAPH score, which is a new score that combines blood viscosity biomarkers such as mean platelet volume (MPV), total protein and hematocrit, can be used to predict thrombus burden in ST-segment elevation myocardial infarction (STEMI) patients.MethodsA total of 473 consecutive patients with STEMI were included in the study. Intracoronary tirofiban/abciximab infusion was applied to patients with thrombus load ≥3 and these patients (n = 71) were defined as the patient group with high thrombus load. MPV, age, hematocrit and total protein values of the patients were recorded. High shear rate (HSR) and low shear rate (LSR) were calculated from total protein and hematocrit values. Cut-off values were determined for high thrombus load by using Youden index, and score was determined as 0 or 1 according to cut-offs. The sum of the scores was calculated as the MAPH score.ResultsThe mean age of the patients included in the study was 59.6 ± 12.6 (n = 354 male, 74.8%). There was no difference between the groups in terms of gender, HT and DM (P = .127, P = .402 and P = .576, respectively). In the group with high thrombus load; total protein, MPV and hematocrit values were higher (P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-12T11:42:23Z
DOI: 10.1177/10760296211073767
Issue No: Vol. 28 (2022)
- Efficacy of Recombinant Human Thrombopoietin for the Treatment of
Secondary Failure of Platelet Recovery After Allogeneic HSCT
Authors: Yigeng Cao, Mingyang Wang, Biao Shen, Fei Zhao, Rongli Zhang, Xin Chen, Yi He, Weihua Zhai, Qiaoling Ma, Jialin Wei, Yong Huang, Donglin Yang, Aiming Pang, Sizhou Feng, Erlie Jiang, Mingzhe Han
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Secondary failure of platelet recovery (SFPR) is a life-threatening complication that may affect up to 20% of patients after allogeneic hematopoietic stem cell transplantation (HSCT). In this study, to evaluate the efficacy of recombinant human thrombopoietin (rhTPO), we retrospectively analyzed 29 patients who received continuous rhTPO for the treatment of SFPR. Overall response and complete response were observed in 24 (82.8%) patients and 10 (34.5%) patients, at a median time of 21.5 days (range, 3-41 days) and 39.5 days (range, 7-53 days) after initiation of rhTPO treatment, respectively. Among the responders, the probability of keeping overall response and complete response at 1 year after response was 77.3% and 80.0%, respectively. In multivariate analysis, higher CD34+ cells (≥3 × 106/kg) infused during HSCT (HR: 7.22, 95% CI: 1.53-34.04, P = 0.01) and decreased ferritin after rhTPO treatment (HR: 6.16, 95% CI: 1.18-32.15, P = 0.03) were indicated to associate with complete response to rhTPO. Importantly, rhTPO was well tolerated in all patients without side effects urging withdrawal and clinical intervention. The results of this study suggest that rhTPO may be a safe and effective treatment for SFPR.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-12T02:47:29Z
DOI: 10.1177/10760296211068037
Issue No: Vol. 28 (2022)
- Serum GDF-15 Predicts In-Hospital Mortality and Arrhythmic Risks in
Patients With Acute Myocardial Infarction
Authors: Qiuping Mo, Liuan Zhuo, Zhihong Liao, Rongshan Li, Yu Chen, Jianfang Geng
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
This study aims to evaluate the association of serum growth differentiation factor 15 (GDF-15) with in-hospital mortality and arrhythmic risks in patients with acute myocardial infarction (AMI). A total of 296 consecutive patients with AMI were enrolled in our hospital from Jan. 2018 to Dec. 2020. Serum GDF-15 levels were measured at baseline. The primary endpoint was in-hospital all-cause mortality, and the secondary endpoint was major adverse cardiac events (MACEs) during hospitalization, defined as a composite of cardiovascular death, heart failure, sustained ventricular arrhythmias (ventricular tachycardia or ventricular fibrillation), and bleeding. During hospitalization, patients with a higher GDF-15 level had significantly higher incidences of in-hospital mortality (7.4% vs 1.4%; P = .02) and MACEs (9.5% vs 20.9%, P
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-10T12:45:58Z
DOI: 10.1177/10760296211063875
Issue No: Vol. 28 (2022)
- Frequency of Thrombotic Risk Factors in Patients with Chronic
Thromboembolic Pulmonary Hypertension and Acute Pulmonary Embolism: A
Case-Control Study
Authors: Mark W. Dodson, Meghan M. Cirulis, Haojia Li, Zhang Yue, Lynette M. Brown, C. Gregory Elliott
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious complication of acute pulmonary embolism (PE) which remains underdiagnosed. A better understanding of risk factors for CTEPH would improve our ability to predict which PE survivors are at risk. Several medical conditions—including malignancy, splenectomy, thyroid hormone supplementation, the presence of an intravascular device, inflammatory bowel disease, osteomyelitis, and non-O blood group—have been associated with increased risk of CTEPH, primarily in studies comparing patients with CTEPH to individuals with non-thrombotic conditions. Because many of these conditions increase thrombosis risk, it remains unclear whether their association with CTEPH reflects a general effect on thrombosis risk, or a specific effect on the risk of developing CTEPH as an outcome of thrombosis. We performed a case-control study comparing the frequencies of these conditions in patients with CTEPH versus patients with acute PE who did not develop CTEPH. The conditions studied were equally frequent in the CTEPH and PE cohorts, although there was a trend towards an increased frequency of splenectomy and non-O blood group among the CTEPH cohort. Thus, other than the possible exceptions of splenectomy and non-O blood group, the investigated medical conditions do not appear likely to increase the risk of CTEPH as an outcome of acute PE, and thus are unlikely to be useful in predicting CTEPH risk among PE survivors.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-08T01:10:31Z
DOI: 10.1177/10760296211073277
Issue No: Vol. 28 (2022)
- D-dimer kit with a High FDP/D-Dimer Ratio is Useful for Diagnosing
Thrombotic Diseases
Authors: Nozomi Ikeda, Hideo Wada, Yuhuko Ichikawa, Minoru Ezaki, Motoko Tanaka, Shinya Hiromori, Katsuya Shiraki, Isao Moritani, Akitaka Yamamoto, Hideto Shimpo, Motomu Shimaoka
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
IntroductionAlthough D-dimer is a useful biomarker of thrombosis, there are many D-dimer kits, with high and low fibrinogen and fibrin degradation products (FDP)/ D-dimer ratios.MethodsPlasma D-dimer levels were measured using three different kits in critically ill patients to examine the usefulness of such measurements for detecting the thrombotic diseases and determining the correlation with the FDP and FDP/D-dimer ratio.ResultsAlthough three D-dimer kits showed marked utility for diagnosing disseminated intravascular coagulation (DIC) and peripheral arterial and venous thromboembolism (PAVTE), the D-dimer levels determined using the three kits varied among diseases. Indeed, one D-dimer kit showed a high FDP/D-dimer ratio, and another kit showed a low FDP/D-dimer ratio. D-dimer kit with low FDP/D-dimer ratio tended to have high cut-off values and low specificity for diagnosing DIC and PAVTE. In D-dimer kit with high FDP/D-dimer ratio, FDP/D-dimer ratios in patients with thrombosis was significantly higher than that in patients without thrombosis.ConclusionAll three D-dimer kits show utility for detecting thrombotic diseases. However, the D-dimer levels determined using the kits varied due to differences in the FDP/D-dimer ratio. In combination with the FDP level, a D-dimer kit with a high FDP/D-dimer ratio may be useful.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-07T10:20:22Z
DOI: 10.1177/10760296211070584
Issue No: Vol. 28 (2022)
- Association Between Pre-delivery Coagulation Indicators and Invasive
Placenta Accreta Spectrum
Authors: Zhirong Guo, Xueyan Han, Huijing Zhang, Weiran Zheng, Huixia Yang, Jingmei Ma
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectivesTo analyze the association between pre-operational coagulation indicators and the severity of placenta accreta spectrum (PAS), as well as blood loss volume during operation.MethodsHospitalized patients of the obstetric department in a major hospital from 2018 to 2020 who were clinically and/or pathologically diagnosed with invasive PAS were included. Univariate and multivariate logistic regression and Poisson regression models were used to quantify the association between each of the 6 coagulation indicators and PAS severity (measured by FIGO grade) as well as maternal outcomes.ResultsNinety-five patients (46 FIGO grade 2 and 49 FIGO grade 3) were included. Higher PT [adjusted OR (aOR): 5.54; 95% CI, 1.80 to 17.07] and FDP (aOR: 1.19; 95% CI, 1.01–1.42) levels were associated with an increased risk of FIGO grade 3 after adjusting for covariates. D-dimer [incidence rate ratio (IRR): 1.19; 95% CI, 1.05 to 1.35)] and FDP (IRR: 1.03; 95% CI, 1.01–1.04) levels were significantly associated with higher blood loss volume after adjusting for covariates.ConclusionPreoperative coagulation indicators, especially PT, D-dimer and FDP, are associated with disease severity and blood loss volume during operation of invasive PAS. The underlying mechanism for the coagulation profile of PAS patients warrants further analysis.SynopsisPreoperative coagulation indicators, especially PT, D-dimer and FDP, are associated with disease severity and blood loss volume during operation among invasive placenta accreta spectrum patients.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-07T10:20:01Z
DOI: 10.1177/10760296211070580
Issue No: Vol. 28 (2022)
- The Relationship Between the Fibrinogen to Albumin Ratio and Early
Outcomes in Patients with Acute Pontine Infarction
Authors: Mingfeng Zhai, Shugang Cao, Jinghong Lu, Hui Xu, Mingwu Xia, Zongyou Li
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
Background and purposePrevious studies have indicated that fibrinogen and low serum albumin levels are associated with poor outcomes of acute ischemic stroke. The role of the fibrinogen-to-albumin ratio (FAR) as a novel inflammatory and thrombotic biomarker in acute ischemic stroke is unclear. This study aims to investigate the relationship between the FAR and 3-month outcomes of acute pontine infarction. Methods: Patients with acute pontine infarction were consecutively included. All patients were followed up at 3 months after onset, and the 3-month outcome was evaluated using modified Rankin Scale (mRS) scores. A score of 0 to 2 was defined as a good outcome, and a score ≥ 3 was defined as a poor outcome. Receiver operating curve (ROC) analysis was used to calculate the optimal cutoff values for patients with acute pontine infarction. Then, a binary logistic regression model was used to evaluate the risk factors for a poor outcome after acute pontine infarction. Results: A total of 264 patients with acute pontine infarction were included. Eighty (30.3%) patients were included in the poor outcome group. The optimal cutoff value of the FAR for predicting the 3-month outcome of acute pontine infarction was 8.199. The FAR was independently associated with a poor outcome at 3 months in patients with acute pontine infarction (odds ratio [OR] = 1.293, 95% confidence interval [CI]: 1.150-1.453). Conclusions: We found that a high FAR predicted poor 3-month outcomes in patients with acute pontine infarction.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-04T12:59:09Z
DOI: 10.1177/10760296211067260
Issue No: Vol. 28 (2022)
- The Impact of D-Dimer on Postoperative Deep Vein Thrombosis in Patients
with Thoracolumbar Fracture Caused by High-Energy Injuries
Authors: Haiying Wang, Bing Lv, Weifeng Li, Shunyi Wang
Abstract: Clinical and Applied Thrombosis/Hemostasis, Volume 28, Issue , January-December 2022.
ObjectiveTo investigate the dynamic variation of D-dimer and to evaluate the efficacy and accuracy of D-dimer level in patients with thoracolumbar fractures caused by high-energy injuries.MethodsA total of 121 patients with thoracolumbar fractures caused by high-energy injuries were retrospectively identified and included in this study. There were 83 males and 38 females, with an average age of 48.6 ± 11.2 years. All patients were treated with either screw fixation surgery or decompression fixation surgery. The D-dimer levels were measured 1 day before surgery and on the first, third, and fifth days after surgery. The dynamic variation of D-dimer and the effects of risk factors on D-dimer levels were analysed. A receiver operating characteristic (ROC) curve analysis was performed and the appropriate D-dimer cut-off level was determined for deep vein thrombosis (DVT) screening.ResultsDue to a trough on the third day, D-dimer levels grew in an unsustainable manner following surgery (P < 0.001). Patients with the operation time>120 min (P = 0.009) and those with an American Spinal Injury Association (ASIA) score A-C (P < 0.001) had higher D-dimer levels. The area under the curve of D-dimer was the greatest on the third day. Applying stratified cut-off values did not change the sensitivity, specificity and negative predictive value in the group with an operation time>120 min, and ASIA score A-C group.ConclusionsD-dimer levels elevated with fluctuation in patients with thoracolumbar fractures caused by high-energy injuries after surgery. Both operation time and ASIA score had an impact on D-dimer levels. Regarding DVT diagnoses, the diagnostic value of D-dimer was highest on the third day postoperatively, and stratified cut-off values by these two factors did not show better diagnostic efficacy compared with a collective one.
Citation: Clinical and Applied Thrombosis/Hemostasis
PubDate: 2022-01-04T03:43:30Z
DOI: 10.1177/10760296211070009
Issue No: Vol. 28 (2022)
