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New Anticoagulants in Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 574-585DOI: 10.1055/s-0029-1240018ABSTRACTAtrial fibrillation (AF) requires anticoagulation for prevention of arterial embolism, especially in the presence of defined risk factors summarized in the CHADS score (congestive heart disease, hypertension, age >75 years, diabetes, history of ischemic stroke or transient cerebral ischemia). Vitamin K antagonists as drugs of choice have several limitations. International normalized ratio (INR) adjustment to 2.0 to 3.0 may be difficult to maintain, and doses vary widely between patients. Inherited variations of the vitamin K epoxide reductase C1 enz...
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Different Models for Oral Anticoagulation Management May Be Applied Provided That Minimal Assistance Criteria Are Fulfilled: An Italian ExperienceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 568-573DOI: 10.1055/s-0029-1240017ABSTRACTThe efficacy of adjusted-dose oral anticoagulant therapy (OAT) in the prevention of thrombotic complications in various clinical conditions is well documented. Management of OAT requires a trained physician, an organized system of follow-up, reliable international normalized ratio monitoring, and good patient communication and education. Drug interactions with coumarins are a major cause of excessive anticoagulation and hence could be an important determinant of bleeding in patients on OAT.[...]© Thieme Medical PublishersGet connected:Table of content...
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Management Strategies for Optimal Control of Anticoagulation in Patients with Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 560-567DOI: 10.1055/s-0029-1240016AbstractMost patients with atrial fibrillation need anticoagulant treatment with vitamin K antagonists for prevention of thromboembolism, in particular ischemic stroke. Many studies show the efficacy of this treatment but also that it is difficult to keep patients who use vitamin K antagonists in the proper treatment range. Both a too low and a too high intensity of anticoagulation significantly increase the risk of adverse events. Hence repeated monitoring of the intensity of anticoagulation and dose adjustments are required. Management strategies that improv...
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Use and Underuse of Oral Anticoagulation for Stroke Prevention in Atrial Fibrillation: Old and New ParadigmsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe old and new paradigms of the use of oral anticoagulation. In the future, increased comprehensibility of stroke risk scores, development of a validated clinical bleed risk score, and new patient and physician user-friendly antithrombotic medication may contribute to improved adequate use of oral anticoagulation in AF patients.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Antithrombotic Prophylaxis in Elderly Patients with Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 548-553DOI: 10.1055/s-0029-1240015ABSTRACTThe burden of atrial fibrillation (AF) worldwide is projected to increase substantially over the next few decades in part due to an aging population. AF increases the risk of stroke approximately fivefold. The population-attributable risk for stroke by age is considerable: 1.5% for those individuals 50 to 59 years of age compared with 23.5% for those ≥80 years of age. Vitamin K antagonists (VKAs) like warfarin have been shown to greatly reduce the risk of stroke. However, despite their proven efficacy, VKAs remain underused, particularly among el...
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Anticoagulant Management in Patients with Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 543-547DOI: 10.1055/s-0029-1240014ABSTRACTAtrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with a high risk of embolic stroke (cause in 15% of all strokes and 30% of strokes in those >75 years of age). Anticoagulation with warfarin will reduce stroke risk by about two thirds. The main risks of anticoagulation, namely bleeding, can be minimized by maintaining anticoagulation control within the international normalized range range of 2.0 to 3.0 (target: 2.5). To have a public health impact, patients with AF need efficient and correct identification, with approp...
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Improving Antithrombotic Management in Patients With Atrial Fibrillation: Current Status and PerspectivesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 527-542DOI: 10.1055/s-0029-1240013ABSTRACTDespite overwhelming evidence of the benefits of risk-adjusted oral anticoagulation on stroke reduction in patients with atrial fibrillation (AF), there is still considerable undertreatment. A multidisciplinary expert group was formed to discuss issues surrounding anticoagulant treatment of patients with AF to try and achieve consensus on various aspects of the implementation of guidelines on oral anticoagulation therapy in AF. Panel members were cardiologists, hematologists, and laboratory and primary care physicians with specific expertise from Europ...
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Source Type: journals

Antithrombotic Management of Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 525-526DOI: 10.1055/s-0029-1240012© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - September 29, 2009 Category: Hematology Tags: PREFACE Source Type: journals

New Anticoagulants for Atrial FibrillationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 515-524DOI: 10.1055/s-0029-1234147ABSTRACTAtrial fibrillation is already the most common clinically significant cardiac arrhythmia and a common cause of stroke. Vitamin K antagonists are very effective for the prevention of cardioembolic stroke but have numerous limitations that limit their uptake in eligible patients with AF and reduce their effectiveness in treated patients. Multiple new anticoagulants are under development as potential replacements for vitamin K antagonists. Most are small synthetic molecules that target factor IIa (e.g., dabigatran etexilate, AZD-0837) or factor Xa (e.g., ...
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

Patent Foramen Ovale and Cryptogenic Stroke: A Matter of Age?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 505-514DOI: 10.1055/s-0029-1234146ABSTRACTA patent foramen ovale (PFO) enables a right-to-left shunt in about a quarter of the population. The marked association between cryptogenic stroke and PFO supports the hypothesis that paradoxical embolism could be a relevant cause of stroke. Although this association has been described in several studies for patients <55 years of age, only limited data are available on the role of PFO in older patients. Recent studies, however, have also shown a significant association between cryptogenic stroke and PFO in patients >55 years of age. The relations...
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

Systolic Heart Failure: A Prothrombotic StateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article focuses on this prothrombotic state and discusses the risk of thromboembolic events, pathophysiological mechanisms, and the potential role of anticoagulant treatment.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

Microparticles and Arterial DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the definitions, mechanisms of production, and links with pathophysiology of MPs in arterial disease, and thus whether or not they can contribute to improved patient care.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

Hormones and Cardiovascular Disease: A Shift in Paradigm with Clinical Consequences?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 478-487DOI: 10.1055/s-0029-1234143ABSTRACTSeveral endocrine disorders have been associated with an increased risk of cardiovascular disease (CVD) and mortality. In addition, even subtle hormonal disturbances may modulate the function of cardiovascular organs. In this article, we discuss in detail the contribution of thyroid hormones, cortisol, the somatotropic hormones, and prolactin in the development of CVD. We do not only discuss epidemiological evidence on the association between hormones and cardiovascular disease, but we also address possible pathophysiological mechanisms underlying this...
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

The Impact of the Fibrinolytic System on the Risk of Venous and Arterial ThrombosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 468-477DOI: 10.1055/s-0029-1234142ABSTRACTIn this review we discuss the association of overall hypofibrinolysis and individual fibrinolytic protein levels with venous and arterial thrombosis. Decreased overall fibrinolytic potential and high plasma levels of thrombin-activatable fibrinolysis inhibitor have been consistently associated with risk of venous thrombosis, whereas little evidence exists for a role of plasminogen, α2-antiplasmin, tissue plasminogen activator, and plasminogen activator inhibitor 1. Overall fibrinolytic potential has been associated with arterial thrombosis in youn...
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

Heritability of Clot FormationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 458-467DOI: 10.1055/s-0029-1234141ABSTRACTThe development of occlusive arterial and venous disease is contingent on the formation of a fibrin mesh that occurs following tissue damage and activation of the coagulation system. Clinical evidence indicates that fibrin structure and function are important determinants of cardiovascular risk, and the difference between clots formed from plasma and from purified fibrinogen highlights the importance of plasma factors in determining final clot structure. Twin, family, and case-control studies indicate there is a significant genetic contribution to vari...
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

The Metabolic Syndrome as a Risk Factor for Venous and Arterial ThrombosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 451-457DOI: 10.1055/s-0029-1234140ABSTRACTThe metabolic syndrome is a cluster of risk factors for atherosclerosis. Although a universally accepted definition is still lacking because available classifications present slightly different diagnostic criteria, the metabolic syndrome is now recognized as a serious public health problem that affects up to 45% of the population >50 years of age in the United States and ~20 to 25% of the adult population in Europe.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Source Type: journals

Hemostatic Abnormalities and Arterial ThrombosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 449-450DOI: 10.1055/s-0029-1234148© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - September 9, 2009 Category: Hematology Tags: PREFACE Source Type: journals

Impaired Platelet Procoagulant Mechanisms in Patients with Bleeding DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 447-447DOI: 10.1055/s-0029-1226014© Thieme Medical PublishersGet connected:Table of contents | FREE: Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Tags: ERRATA Source Type: journals

Vitamin K–Dependent Coagulation Factors DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 439-446DOI: 10.1055/s-0029-1225766ABSTRACTAll vitamin K–dependent coagulation factors require normal function of γ-glutamyl carboxylase and vitamin K epoxide reductase enzyme complex (VKORC1). Heritable dysfunction of γ-glutamyl carboxylase or of the VKORC1 complex results in the secretion of poorly carboxylated vitamin K–dependent proteins that play a role in coagulation. The following review will summarize the clinical manifestations of vitamin K–dependent coagulation factors deficiency I and II and will provide a detailed explanation about the gene and protein st...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Factor XIII DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 426-438DOI: 10.1055/s-0029-1225765ABSTRACTFactor XIII (FXIII) is a tetrameric zymogen (FXIII-AB) that is converted into an active transglutaminase (FXIIIa) by thrombin and Ca in the terminal phase of the clotting cascade. By cross-linking fibrin chains and α plasmin inhibitor to fibrin, FXIIIa mechanically stabilizes fibrin and protects it from fibrinolysis. Severe deficiency of the potentially active A subunit (FXIII-A) is a rare but severe hemorrhagic diathesis. Delayed umbilical stump bleeding is characteristic, and subcutaneous, intramuscular, and intracranial bleeding occurs with a r...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Factor XI DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 416-425DOI: 10.1055/s-0029-1225764ABSTRACTSevere factor XI (FXI) deficiency is an injury-related bleeding disorder common in Ashkenazi Jews and rare worldwide. In the past two decades, more than 180 mutations in the FXI gene have been reported in patients with FXI deficiency, five of which show a founder effect (Cys38Arg, Gln88Stop, Cys128Stop, Glu117stop, and Phe283Leu, the last two largely prevalent among Ashkenazi Jews). Inhibitors to FXI after exposure to plasma, FXI concentrates, or Rh immunoglobulin were described in patients with mutations resulting in null alleles. Treatment with low-d...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Factor X DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 407-415DOI: 10.1055/s-0029-1225763ABSTRACTFactor X (FX) deficiency is a rare, recessively inherited bleeding disorder representing 10% of all rare bleeding diseases and affecting 1 in every 1,000,000 people. Its clinical presentation places FX deficiency among the most severe of the rare coagulation defects, typically including hemarthroses, hematomas, and umbilical cord, gastrointestinal, and central nervous system bleeding. Phenotype diagnosis is based on the concomitant prolongation of the prothrombin time and activated partial thromboplastin time. Through the measurement of plasma level of...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Factor VII DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 400-406DOI: 10.1055/s-0029-1225762ABSTRACTThe complex formed between the procoagulant serine protease activated factor VII (FVII) and the membrane protein tissue factor, exposed on the vascular lumen upon injury, triggers the initiation of blood clotting. This review describes the clinical picture of FVII deficiency and provides information on diagnosis and management of the disease. FVII deficiency, the most common among the rare congenital coagulation disorders, is transmitted with autosomal recessive inheritance. Clinical phenotypes range from asymptomatic condition, even in homozygotes, to...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Combined Factor V and Factor VIII DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 390-399DOI: 10.1055/s-0029-1225761ABSTRACTCombined deficiency of factor V (FV) and factor VIII (FVIII) (F5F8D, or FV+FVIII) is a autosomal recessive bleeding disorder caused by mutations in genes encoding two components of the endoplasmic reticulum (ER)-Golgi intermediate compartment (ERGIC-53), that is, lectin mannose binding protein () and multiple coagulation factor deficiency 2 (), involved in the FV and FVIII intracellular transport rather than by DNA defects in the genes that encode the corresponding coagulation factors. F5F8D is estimated to be extremely rare (1:1,000,000) in the genera...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Factor V DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will provide a concise description of the FV protein and gene and will review the molecular, clinical, and therapeutic aspects of FV deficiency.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Congenital Prothrombin DeficiencyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 367-381DOI: 10.1055/s-0029-1225759ABSTRACTProthrombin deficiency is among the rarest inherited coagulation disorders, with a prevalence of ~1:2,000,000. Two main phenotypes can be distinguished: (1) hypoprothrombinemia (type I deficiency), characterized by concomitantly low levels of activity and antigen; and (2) dysprothrombinemia (type II deficiency), characterized by the normal or near-normal synthesis of a dysfunctional protein. In some cases, hypoprothrombinemia associated with dysprothrombinemia was also described in compound heterozygous defects. No living patient with undetectable plas...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Congenital Fibrinogen DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 356-366DOI: 10.1055/s-0029-1225758ABSTRACTInherited disorders of fibrinogen affect either the quantity (afibrinogenemia and hypofibrinogenemia) or the quality (dysfibrinogenemia) of the circulating fibrinogen or both (hypodysfibrinogenemia). Most often, patients with congenital fibrinogen disorders suffer from a bleeding diathesis but paradoxically may undergo severe thrombotic episodes. Pregnancy loss is another common clinical complication. Even in specialized laboratories, the precise diagnosis of some fibrinogen disorders may be challenging. Characterization of the molecular defect(s) is i...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Introduction: Rare Bleeding Disorders: General Aspects of Clinical Features, Diagnosis, and ManagementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 349-355DOI: 10.1055/s-0029-1225757ABSTRACTRare bleeding disorders (RBDs) are autosomal recessive diseases including the inherited deficiencies of coagulation factors such as fibrinogen, factor (F) II, FV, FV + FVIII, FVII, FX, FXI, FXIII, and multiple deficiency of vitamin K–dependent factors, with clinical manifestations ranging from mild to severe. They represent 3 to 5% of all the inherited coagulation deficiencies with a prevalence in the general population varying between 1 in 500,000 and 1 in 2 million, being higher in areas where consanguineous marriages are diffuse. D...
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Source Type: journals

Rare Bleeding DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 345-347DOI: 10.1055/s-0029-1225756© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - July 14, 2009 Category: Hematology Tags: PREFACE Source Type: journals

An Update on the Prevalence and Characterization of H-PF4 Antibodies in Asian-Indian PatientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 337-343DOI: 10.1055/s-0029-1222612ABSTRACTHeparin is the second most widely used anticoagulant/antithrombotic agent besides warfarin and is commonly used for various purposes such as treatment and surgical indications. A significant adverse effect of heparin treatment can occur when heparin binds platelet factor 4 (H-PF4) to form a complex that results in formation of H-PF4 antibodies, which in turn leads to platelet/endothelial cell activation followed by heparin-induced thrombocytopenia (HIT). Based on the heparin-induced platelet aggregation and enzyme-linked immunosorbent assay tests, the ...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Mental Depression and Cardiovascular Disease: A Multifaceted, Bidirectional AssociationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article aims to review the biological and clinical links between depression and cardiovascular disease.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Psoriasis and Atherothrombotic Diseases: Disease-Specific and Non–Disease-Specific Risk FactorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 313-324DOI: 10.1055/s-0029-1222610ABSTRACTPsoriasis is a chronic inflammatory, immune-mediated skin disease affecting 2 to 3% of the general population and may cause significant quality-of-life impairment. Psoriasis and psoriatic arthritis are associated with increased atherothrombotic diseases, including myocardial infarction, deep venous thrombosis, and reduced life span. Both disease-specific and non–disease-specific risk factors are likely to fuel one another in deleterious vicious circles. Disease-specific risk factors are those that are a direct consequence of psoriasis inflammatio...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Interpatient Phenotypic Inconsistency in Severe Congenital Hemophilia: A Systematic Review of the Role of Inherited ThrombophiliaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 307-312DOI: 10.1055/s-0029-1222609ABSTRACTIt is well known that the clinical phenotype of hemophilia may vary greatly among patients with the same apparent level of coagulation factor and the same genetic mutation. Thus, patients with severe hemophilia may experience a severe phenotype or only a milder bleeding tendency, suggesting some other moderating influence. To elucidate the mechanism of this heterogeneity, some investigators have recently suggested that inherited thrombophilic factors may play a role in the milder clinical presentation of severe hemophilia. In this review, we summarize ...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Platelet Function and Response to Aspirin: Gender-Specific Features and Implications for Female Thrombotic Risk and ManagementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews gender-specific differences in platelet function and response to aspirin. In contrast with men, women under 65 years of age do not benefit from aspirin therapy in primary prevention of coronary artery disease. Furthermore, the overall mortality after myocardial infarction is higher among women, which cannot simply be explained by age or individual treatment. Platelets play a central role in thrombo-ischemic events leading to myocardial infarction and ischemic stroke. Gender differences in platelet reactivity and “aspirin resistance” have been reported. Several studies using female platelets...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Thyroid Dysfunction and Hemostasis: An Issue Still UnresolvedEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 288-294DOI: 10.1055/s-0029-1222607ABSTRACTThyroid hormones exert various effects on the hemostatic system, as documented by the fact that subclinical or overt thyroid dysfunctions may be associated with hypocoagulable or hypercoagulable states. In this review, the hemostatic balance (primary hemostasis, coagulation factors, and fibrinolytic system) in different thyroid disorders is analyzed from a laboratory, pathogenic, and clinical point of view. Although limited, the published studies suggest that patients with hyperthyroidism or subclinical hypothyroidism have an increased thrombotic risk,...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Nonalcoholic Fatty Liver Disease as a Contributor to Hypercoagulation and Thrombophilia in the Metabolic SyndromeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 277-287DOI: 10.1055/s-0029-1222606ABSTRACTNonalcoholic fatty liver disease (NAFLD), comprising its whole spectrum of conditions ranging from simple steatosis to steatohepatitis (nonalcoholic steatohepatitis; NASH) and cirrhosis, is the most frequent liver disease in developed countries and is now regarded as the liver manifestation of the metabolic syndrome. Several studies indicate that NAFLD, especially in its necro-inflammatory form (NASH), is associated with a systemic proinflammatory/prothrombotic state, independently of shared metabolic risk factors. This suggests that NAFLD/NASH is not ...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Biological Influence of Physical Exercise on HemostasisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 269-276DOI: 10.1055/s-0029-1222605ABSTRACTSome of the benefits of physical activity may result from effects on hemostasis. However, the increased burden of cardiovascular complications and sudden death occurring during and immediately after exercise prompts investigation to elucidate the biological relationship between physical exercise and hemostatic function. Although both the hemostatic and fibrinolytic systems are strongly influenced by physical exercise, the outcomes of available studies to date are biased by several confounding variables, including the subjects investigated, the type, in...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Exercise in the Fight Against Thrombosis: Friend or Foe?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 261-268DOI: 10.1055/s-0029-1222604ABSTRACTThrombosis is a major cause of morbidity and mortality in Western countries and is associated with a range of chronic diseases such as cardiovascular disease, renal disease, diabetes, and various autoimmune conditions. Improved health care and approaches to the treatment of disease are leading to aging populations that will probably result in an increase in the incidence of thrombosis and associated manifestations over the next few decades. Adopting a physically active lifestyle through regular exercise has been proposed to lower the risk of developing...
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Source Type: journals

Coagulopathies and Thrombosis: Usual and Unusual Causes and Associations, Part IEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 257-259DOI: 10.1055/s-0029-1222603© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Tags: PREFACE Source Type: journals

Rodger L. Bick, M.D., Ph.D., FACP (1943–2008)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 255-255DOI: 10.1055/s-0029-1222602© Thieme Medical PublishersGet connected:Table of contents | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - May 19, 2009 Category: Hematology Tags: DEDICATION Source Type: journals

The Level of Laboratory Testing Required for Diagnosis or Exclusion of a Platelet Function Disorder Using Platelet Aggregation and Secretion AssaysEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 242-254DOI: 10.1055/s-0029-1220785ABSTRACTThe major advances from research on platelet molecular and cell biology, physiology, and pathophysiology over the past decades have not been adequately translated to clinical laboratory diagnosis. Hereditary platelet function disorders (PFDs) are at least as prevalent in the general population as von Willebrand disease (VWD) although PFDs tend not be as well recognized or evaluated. Clinical mucous and skin bleeding in patients with PFDs is prototypic of primary hemostasis disorders, and the bleeding pattern is not distinguishable from that of other pr...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Impaired Platelet Procoagulant Mechanisms in Patients with Bleeding DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 233-241DOI: 10.1055/s-0029-1220331ABSTRACTActivated platelets contribute to the arrest of bleeding by forming aggregates at sites of vascular injury and by providing a surface for assembling enzyme complexes involved in fibrin formation (platelet procoagulant activity; PCA). Impairment in the latter property of platelets has been observed in some disorders of hemostasis. In Scott syndrome, there is a defect in membrane vesiculation and in the surface expression of phosphatidylserine (PS), the phospholipid that is necessary for assembling the factor VIIIa/IXa (tenase) and factor Va/Xa (prothrom...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Glycoprotein Analysis for the Diagnostic Evaluation of Platelet DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 224-232DOI: 10.1055/s-0029-1220330ABSTRACTPlatelet glycoproteins subserve a wide variety of critical functions in blood platelets. Congenital deficiencies or functional abnormalities in platelet glycoproteins may produce serious bleeding disorders such as Glanzmann thrombasthenia or Bernard-Soulier syndrome. Other hematologic disorders, such as Fanconi anemia and various myelodysplastic syndromes, may also be associated with abnormalities in platelet glycoproteins. Additionally, several acquired disorders involving the major platelet glycoproteins are increasingly being recognized. The large n...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Role of Platelet Electron Microscopy in the Diagnosis of Platelet DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 213-223DOI: 10.1055/s-0029-1220329ABSTRACTThe electron microscope has proved to be a useful tool to study and understand the biology of platelets and to classify many platelet disorders. After a technical overview, this article reviews syndromes originating from platelet organelle, cytoskeleton, and membrane defects for which electron microscopy plays a role in the diagnostic process, such as gray platelet syndrome, Paris-Trousseau syndrome, storage pool diseases, MYH9-related thrombocytopenias, or Wiskott-Aldrich syndrome. Particular focus is given to the ultrastructural aspect of platelets i...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Genetic Testing in the Diagnostic Evaluation of Inherited Platelet DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 204-212DOI: 10.1055/s-0029-1220328ABSTRACTInherited disorders of platelets give rise to rare bleeding syndromes through defects of platelet function and/or platelet production. Platelet function testing by biological and immunologic assays can identify the loss or abnormal functioning of specific receptor systems, signaling pathways, storage organelles, or enzymatic activities essential for adhesion, activation, and aggregation. In vitro culture of megakaryocytes can help identify the origin of familial thrombocytopenias, and electron microscopy can point to ultrastructural defects and giant p...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

MYH9-Related Platelet DisordersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 189-203DOI: 10.1055/s-0029-1220327ABSTRACTMyosin heavy chain 9 (MYH9)-related platelet disorders belong to the group of inherited thrombocytopenias. The MYH9 gene encodes the nonmuscle myosin heavy chain IIA (NMMHC-IIA), a cytoskeletal contractile protein. Several mutations in the MYH9 gene lead to premature release of platelets from the bone marrow, macrothrombocytopenia, and cytoplasmic inclusion bodies within leukocytes. Four overlapping syndromes, known as May-Hegglin anomaly, Epstein syndrome, Fechtner syndrome, and Sebastian platelet syndrome, describe different clinical manifestations o...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Diagnostic Evaluation of Platelet Function Disorders in Neonates and Children: An UpdateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 181-188DOI: 10.1055/s-0029-1220326ABSTRACTInvestigation of platelet function disorders in infants and small children requires the collaborative efforts of clinicians and clinical laboratories. A detailed personal, family, and medication history, and a search for additional clinical phenomena may help to direct diagnostic laboratory investigations. Testing for these disorders in young children presents several challenges: the requirement of relatively large volumes of blood, lack of standardization, and the absence of well-established age-specific reference ranges. Neonates show the most notabl...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Whole Blood Platelet Aggregometry and Platelet Function TestingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will also discuss other whole blood testing processes for assessing platelet function, particularly as applied to assessing the effect of antiplatelet medication.[...]© Thieme Medical PublishersGet connected:Table of contents | Abstract | Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Light Transmission Aggregometry and ATP Release for the Diagnostic Assessment of Platelet FunctionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 158-167DOI: 10.1055/s-0029-1220324ABSTRACTLight transmission aggregometry (LTA) is the gold standard for the study of patients with defects of platelet function. Use of LTA in clinical practice for predicting the risk of thrombosis or monitoring the pharmacologic effects of antiplatelet agents should be discouraged, because not only is the monitoring of treatment with antiplatelet agents (with any laboratory test) not indicated at present, but also the lack of standardization of the technique for LTA makes it additionally unsuitable for this purpose. The need for standardization of LTA has rec...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals

Screening Tests of Platelet Function: Update on Their Appropriate Uses for Diagnostic TestingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Semin Thromb Hemost 2009; 35: 150-157DOI: 10.1055/s-0029-1220323ABSTRACTGlobal tests of platelet function are often used as screening tests during the laboratory investigation of individuals with suspected hemostatic defects. Because global tests of platelet function do not enable specific diagnosis of platelet disorders, they are normally performed as the first part of a two-step strategy that requires further testing with more specialized assays of platelet function to confirm or refute the diagnosis. The most commonly proposed rationale for testing global platelet function as a first-line investigation is that normal te...
Source: Seminars in Thrombosis and Hemostasis - May 3, 2009 Category: Hematology Source Type: journals