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Endovascular thrombectomy in wake-up stroke guided by arterial spin-labeling and fluid-attenuated inversion recovery versus diffusion-weighted imaging mismatch on MRI
ConclusionGuided by the ASL-DWI and FLAIR-DWI double mismatch, endovascular thrombectomy combined with standard medical treatment appears to yield superior functional outcomes in patients with WUS and large vessel occlusion compared to standard medical treatment alone. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - April 25, 2024 Category: Hematology Source Type: research

The foundation for investigating factor XI as a target for inhibition in human cardiovascular disease
AbstractAnticoagulant therapy is a mainstay in the management of patients with cardiovascular disease and related conditions characterized by a heightened risk for thrombosis. Acute coronary syndrome, chronic coronary syndrome, ischemic stroke, and atrial fibrillation are the most common. In addition to their proclivity for thrombosis, each of these four conditions is also characterized by local and systemic inflammation, endothelial/endocardial injury and dysfunction, oxidative stress, impaired tissue-level reparative capabilities, and immune dysregulation that plays a critical role in linking molecular events, environmen...
Source: Journal of Thrombosis and Thrombolysis - April 25, 2024 Category: Hematology Source Type: research

Layered plaque is associated with high levels of vascular inflammation and vulnerability in patients with stable angina pectoris
AbstractLayered plaque, a signature of previous plaque destabilization and healing, is a known predictor for rapid plaque progression; however, the mechanism of which is unknown. The aim of the current study was to compare the level of vascular inflammation and plaque vulnerability in layered plaques to investigate possible mechanisms of rapid plaque progression. This is a retrospective, observational, single-center cohort study. Patients who underwent both coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) for stable angina pectoris (SAP) were selected. Plaques were defined as any tissue...
Source: Journal of Thrombosis and Thrombolysis - April 22, 2024 Category: Hematology Source Type: research

Overall haemostatic potential assay for prediction of outcomes in venous and arterial thrombosis and thrombo-inflammatory diseases
We present a review of fibrin’s critical role as a central modulator of thro mbotic risk. The results of our studies demonstrating the OHP assay as a predictive biomarker in venous thromboembolism, chronic renal disease, diabetes mellitus, post-thrombotic syndrome, and COVID-19 are discussed. As a comprehensive and global measurement of fibrin generation and fibrinolytic cap acity, the OHP assay may be a valuable addition to future multi-modal predictive tools in thrombosis. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - April 22, 2024 Category: Hematology Source Type: research

Comparison of the PADUA and IMPROVE scores in assessing venous thromboembolism risk in 42,257 medical inpatients in China
The objective of this study is to compare the efficacy of the Padua and IMPROVE scoring models for assessing VTE risk in Chinese medical inpatients. We conducted a retrospective analysis of the clinical characteristics and thrombotic risk of 42,257 medical inpatients at a tertiary hospital in Guangdong, China, between 2021 and 2022. Logistic regression was used to assess thrombotic risk factors. The Receiver Operating Characteristic (ROC) curves, Area Under the Curve (AUC), sensitivity, and specificity were employed to evaluate the performance of the two models. Of the 42,257 patients included, 948 (2.24%) experienced VTE ...
Source: Journal of Thrombosis and Thrombolysis - April 21, 2024 Category: Hematology Source Type: research

Impaired fibrinolysis in patients with atrial fibrillation and elevated circulating lipopolysaccharide
This study is the first to demonstrate antifibrinolytic effects of elevated LPS in AF patients largely driven by enhanced PAI-1 release. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - April 21, 2024 Category: Hematology Source Type: research

Equivalent thrombotic risk with Warfarin, Dabigatran, or Enoxaparin after failure of initial direct oral anticoagulation (DOAC) therapy
ConclusionsIn this retrospective analysis of patients failing first line DOAC therapy, rates of 2nd recurrent thrombosis and bleeding did not differ among subsequently chosen anticoagulants. Our study provides evidence that the optimal 2nd anticoagulant is not clear, and the choice of 2nd anticoagulant should continue to balance patient preference, cost, and provider experience. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - April 21, 2024 Category: Hematology Source Type: research

Primary thromboprophylaxis in cancer outpatients – real-world evidence
ConclusionPrimary thromboprophylaxis in medium-to-high-risk cancer outpatients is a safe and effective practice in real-world settings. This study is the first Portuguese RWE on primary thromboprophylaxis, highlighting evidence for improving prophylactic strategies in this population.Graphical abstract (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - April 20, 2024 Category: Hematology Source Type: research

Haemostatic gene variations in cervical cancer-associated venous thrombosis: considerations for clinical strategies
In this study, the predictive capability of haemostatic gene SNPs on CC-related VTE and their prognostic value regardless of VTE were explored. Six SNPs in haemostatic genes were evaluated. A total of 401 CC patients undergoing chemoradiotherapy were enrolled in a retrospective cohort study. The implications for the time to VTE occurrence and overall survival (OS) were assessed. CAT considerably impacted the CC patients ’ OS (log-rank test,P <  0.001).SERPINE1 rs2070682 (T  >  C) showed a significant association with the risk of CC-related VTE (CC/CT vs. TT, log-rank test,P = 0.002; C allele, Cox model,...
Source: Journal of Thrombosis and Thrombolysis - April 20, 2024 Category: Hematology Source Type: research

Factor XI: structure, function and therapeutic inhibition
AbstractArterial and venous thromboembolism is a major medical concern that requires therapeutic anticoagulation in various medical fields to prevent its drastic consequences. Despite significant advances in anticoagulant therapy, thrombosis remains a leading cause of morbidity and mortality worldwide. Traditional anticoagulants like heparin and vitamin K antagonists (VKAs) have shown efficacy in preventing and treating thrombosis but come with an inherent risk of bleeding due to their non-specific inhibition of multiple coagulation factors. Subsequent direct oral anticoagulants (DOACs), targeting specific factors such as ...
Source: Journal of Thrombosis and Thrombolysis - April 16, 2024 Category: Hematology Source Type: research

Intravenous antiplatelet therapy in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
AbstractThe use of intravenous antiplatelet therapy during primary percutaneous coronary intervention (PPCI) is not fully standardized. The aim is to evaluate the effectiveness and safety of periprocedural intravenous administration of cangrelor or tirofiban in a contemporary ST-segment elevation myocardial infarction (STEMI) population undergoing PPCI. This was a multicenter prospective cohort study including consecutive STEMI patients who received cangrelor or tirofiban during PPCI at seven Italian centers. The primary effectiveness measure was the angiographic evidence of thrombolysis in myocardial infarction (TIMI) flo...
Source: Journal of Thrombosis and Thrombolysis - April 13, 2024 Category: Hematology Source Type: research

Evaluation of modified fixed dose four-factor prothrombin complex concentrate for warfarin reversal
AbstractNon-activated four-factor prothrombin complex concentrate (4  F-PCC) has emerged as the preferred reversal strategy for patients on warfarin with life-threatening bleeding. Current dosing recommendations for 4 F-PCC require pre-treatment international normalized ratio (INR) and bodyweight values, resulting in ordering and administration delays. Studies have shown that alternative dosing regimens are safe and efficacious. This retrospective, single-center, pre- and post-protocol analysis was conducted to assess the efficacy of a pharmacist driven modified fixed-dose 4 F-PCC regimen versus package insert weight- a...
Source: Journal of Thrombosis and Thrombolysis - April 6, 2024 Category: Hematology Source Type: research

One-year morbidity and mortality in patients treated with standard-dose and low-dose apixaban after acute large vessel occlusion stroke
This study hypothesized that patients with atrial fibrillation (AF) and LVO receiving low-dose DOACs have an increased risk of ischemic and hemorrhagic events. The study aimed to assess 1 year morbidity and mortality in patients treated with standard-dose and low-dose apixaban after LVO stroke. A post hoc analysis was performed using the acute LVO registry data, which enrolled patients with AF and LVO who received apixaban within 14  days of stroke onset. The incidences of ischemic events (ischemic stroke, acute coronary syndrome, acute myocardial infarction, and systemic embolism), major bleeding events, and death from a...
Source: Journal of Thrombosis and Thrombolysis - March 31, 2024 Category: Hematology Source Type: research

Impact of rise and fall phases of shear on platelet activation and aggregation using microfluidics
AbstractBlood flow disorders are often the result of the non-physiological narrowing of blood arteries caused by atherosclerosis and thrombus. The blood then proceeds through rising-peak-decreasing phases as it passes through the narrow area. Although abnormally high shear is known to activate platelets, the shear process that platelets undergo in small arteries is complex. Thus, understanding how each shear phase affects platelet activation can be used to improve antiplatelet therapy and decrease the risk of side effects like bleeding. Blood samples were sheared (68.8 ms,5200  s−1) in vitro by the microfluidic techniqu...
Source: Journal of Thrombosis and Thrombolysis - March 31, 2024 Category: Hematology Source Type: research