Journal of Thrombosis and Haemostasis最新文献

英文中文

Corrigendum to “Evaluation of a microfluidic flow assay to screen for von Willebrand disease and low von Willebrand factor levels” “评价筛选血管性血友病和低血管性血友病因子水平的微流体流动试验”的勘误表。

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.12.012

Marcus Lehmann , Katrina Ashworth , Marilyn Manco-Johnson , Jorge Di Paola , Keith B. Neeves , Christopher J. Ng

引用次数: 0

Corrigendum to ‘Real-world use of protein C concentrate for the treatment of patients with protein C deficiency: an international registry’ “蛋白C浓缩物用于治疗蛋白C缺乏症患者的实际使用：国际注册”的更正：[Journal of Thrombosis and heemostasis 23(11)(2025) 3569-3577]。

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.12.001

Marilyn Manco-Johnson , Paul Brons , Paul Knoebl , Michael Wang , Csaba Siffel , Peter L. Turecek , Hanna T. Gazda

引用次数: 0

Factor XII locking in (for contact activation through disulfide control) 因子十二锁定（通过二硫控制激活触点）

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.11.002

Coen Maas , Philip J. Hogg

引用次数: 0

Racing toward a common biology of venous thromboembolism prophylaxis: the small interfering RNA fibrinogen knockdown strategy 冲向静脉血栓栓塞预防的共同生物学：小干扰RNA纤维蛋白原敲低策略

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.09.045

Annie M. Apffel, Emily Mosher, Matthew D. Neal

引用次数: 0

Bleeding risk prediction models in varied clinical scenarios 不同临床情况下出血风险预测模型

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.10.010

Mark Goldin , Ermioni Oikonomou , Alex C. Spyropoulos

引用次数: 0

Reduced vs full-dose direct oral anticoagulants for extended treatment of cancer-associated venous thromboembolism: a systematic review and meta-analysis of randomized trials 减少与全剂量直接口服抗凝剂用于癌症相关静脉血栓栓塞的延长治疗：随机试验的系统回顾和荟萃分析

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.09.026

Larissa A. de Lucena , Amanda G. Duarte , Larissa C. Hespanhol , Juliana Muniz , Nicole Félix , Kleyton Medeiros , C. Michael Gibson

Background

Patients with cancer-associated venous thromboembolism (VTE) are at high risk of recurrent thrombosis and bleeding during prolonged anticoagulation. While full-dose direct oral anticoagulants (DOACs) are widely used, the safety and efficacy of reduced-dose regimens for extended treatment remain uncertain.

Objectives

This study compared the safety and efficacy of reduced-dose vs full-dose DOACs in the extended treatment of cancer-associated VTE.

Methods

We conducted a systematic review and meta-analysis of randomized controlled trials comparing reduced- and full-dose DOACs in adults with active cancer and VTE. Searches were performed in PubMed, Embase, and the Cochrane Library. The primary outcomes were a composite of VTE recurrence, major bleeding, or clinically relevant nonmajor bleeding, and the combined risk of major or clinically relevant nonmajor bleeding.

Results

Three randomized controlled trials comprising 2361 patients were included. Two trials evaluated apixaban 2.5 mg vs 5 mg twice daily, and 1 evaluated rivaroxaban 10 mg vs 20 mg once daily. Reduced-dose DOACs were associated with a lower risk of the composite outcome (relative risk, 0.77; 95% CI, 0.64-0.93; P = .006) and reduced bleeding (relative risk, 0.76; 95% CI, 0.62-0.93; P = .008) than full-dose DOACs. No significant differences were observed in major bleeding, clinically relevant nonmajor bleeding, VTE recurrence, or all-cause mortality when analyzed individually.

Conclusions

Reduced-dose DOACs appear as effective as full-dose regimens for extended treatment of cancer-associated VTE, with a lower risk of bleeding. These findings support their use as a safer long-term anticoagulation strategy in selected patients.

导论：癌症相关性静脉血栓栓塞（VTE）患者在长期抗凝治疗期间血栓复发和出血的风险很高。虽然全剂量直接口服抗凝剂（DOACs）被广泛使用，但减少剂量方案用于长期治疗的安全性和有效性仍不确定。目的：比较减少剂量与全剂量DOACs在癌症相关性静脉血栓栓塞延长治疗中的安全性和有效性。方法：我们对随机对照试验（rct）进行了系统回顾和荟萃分析，比较了活动性癌症和静脉血栓栓塞的成人减少剂量和全剂量DOACs。检索在PubMed、Embase和Cochrane图书馆进行。主要结局是静脉血栓栓塞复发、大出血或临床相关的非大出血，以及大出血或临床相关的非大出血的综合风险。结果：纳入3项随机对照试验，共2361例患者。两项试验评估阿哌沙班2.5 mg与5 mg每日两次，一项试验评估利伐沙班10 mg与20 mg每日一次。与全剂量DOACs相比，减少剂量DOACs与较低的复合结局风险（RR 0.77; 95% CI 0.64-0.93; p=0.006）和减少出血（RR 0.76; 95% CI 0.62-0.93; p=0.008）相关。单独分析时，在大出血、临床相关的非大出血、静脉血栓栓塞复发或全因死亡率方面没有观察到显著差异。结论：对于癌症相关性静脉血栓栓塞的延长治疗，减少剂量的doac与全剂量方案一样有效，且出血风险更低。这些发现支持它们作为一种更安全的长期抗凝策略在特定患者中使用。

{"title":"Reduced vs full-dose direct oral anticoagulants for extended treatment of cancer-associated venous thromboembolism: a systematic review and meta-analysis of randomized trials","authors":"Larissa A. de Lucena , Amanda G. Duarte , Larissa C. Hespanhol , Juliana Muniz , Nicole Félix , Kleyton Medeiros , C. Michael Gibson","doi":"10.1016/j.jtha.2025.09.026","DOIUrl":"10.1016/j.jtha.2025.09.026","url":null,"abstract":"<div><h3>Background</h3><div>Patients with cancer-associated venous thromboembolism (VTE) are at high risk of recurrent thrombosis and bleeding during prolonged anticoagulation. While full-dose direct oral anticoagulants (DOACs) are widely used, the safety and efficacy of reduced-dose regimens for extended treatment remain uncertain.</div></div><div><h3>Objectives</h3><div>This study compared the safety and efficacy of reduced-dose vs full-dose DOACs in the extended treatment of cancer-associated VTE.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of randomized controlled trials comparing reduced- and full-dose DOACs in adults with active cancer and VTE. Searches were performed in PubMed, Embase, and the Cochrane Library. The primary outcomes were a composite of VTE recurrence, major bleeding, or clinically relevant nonmajor bleeding, and the combined risk of major or clinically relevant nonmajor bleeding.</div></div><div><h3>Results</h3><div>Three randomized controlled trials comprising 2361 patients were included. Two trials evaluated apixaban 2.5 mg vs 5 mg twice daily, and 1 evaluated rivaroxaban 10 mg vs 20 mg once daily. Reduced-dose DOACs were associated with a lower risk of the composite outcome (relative risk, 0.77; 95% CI, 0.64-0.93; <em>P</em> = .006) and reduced bleeding (relative risk, 0.76; 95% CI, 0.62-0.93; <em>P</em> = .008) than full-dose DOACs. No significant differences were observed in major bleeding, clinically relevant nonmajor bleeding, VTE recurrence, or all-cause mortality when analyzed individually.</div></div><div><h3>Conclusions</h3><div>Reduced-dose DOACs appear as effective as full-dose regimens for extended treatment of cancer-associated VTE, with a lower risk of bleeding. These findings support their use as a safer long-term anticoagulation strategy in selected patients.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 2","pages":"Pages 573-582"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lipoprotein(a) prolongs ex vivo plasma clot lysis times through effects on clot formation rate and fibrin structure 脂蛋白(a)通过影响凝块形成速率和纤维蛋白结构延长离体血浆凝块溶解时间。

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.10.009

Justin R. Clark , Frances S. Sutherland , Julia M. Assini , Luke Daichedt , Robert Szabla , Murray W. Junop , Marlys L. Koschinsky , Michael B. Boffa

Background

Elevated levels of lipoprotein(a) (Lp[a]) are a causal risk factor for atherosclerotic cardiovascular disease. Similarities between the apolipoprotein(a) (apo[a]) component of Lp(a) and plasminogen suggest that antifibrinolytic properties may account for the pathological effects of Lp(a). However, the antifibrinolytic effects of apo(a) do not appear to be retained by the complete Lp(a) particle.

Objectives

We evaluated the effects of Lp(a), apo(a), and various apo(a) variants on clot formation and lysis times, thrombin generation, plasminogen activation, and fibrin architectures in ex vivo plasma clots. We also constructed predictive protein models to gain insight into the apo(a)-plasminogen interaction.

Results

Apo(a) strongly inhibited fibrinolysis, an effect dependent on the presence of the apo(a) protease domain and mediated by Lys216 in this domain. Modeling of apo(a) suggests that Lys216 is blocked from binding to plasminogen in the Lp(a) particle by the presence of the apoB-containing lipoprotein. Lp(a) and apo(a) shortened plasma clot formation times, and accounting for this revealed a small but significant prolongation of fibrinolysis by Lp(a). The procoagulant effects involved the development of lysis-resistant clot architectures and were mediated through the strong lysine-binding site in apo(a) kringle IV type 10. In addition, Lp(a) (but not apo[a]) accelerated thrombin generation.

Conclusions

The strong antifibrinolytic effects of apo(a) do not appear to be retained in the complete Lp(a) particle. However, Lp(a) and apo(a) displayed procoagulant effects, in part dependent on the kringle 4–like lysine-binding site. Further analysis is required to determine whether these reported procoagulant effects of Lp(a) impact thrombosis in vivo.

背景：脂蛋白(a) （Lp(a)）水平升高是动脉粥样硬化性心血管疾病的一个因果危险因素。Lp(a)的载脂蛋白(a)（载脂蛋白(a)）成分与纤溶酶原之间的相似性表明，抗纤溶特性可能解释了Lp(a)的病理作用。然而，载脂蛋白(a)的抗纤溶作用似乎并没有被完整的脂蛋白(a)颗粒所保留。目的：我们评估了脂蛋白(a)、载脂蛋白(a)和各种载脂蛋白(a)变异对离体血浆凝块血栓形成和溶解时间、凝血酶生成、纤溶酶原激活和纤维蛋白结构的影响。我们还构建了预测蛋白模型，以深入了解载脂蛋白(a)-纤溶酶原的相互作用。结果：载脂蛋白(a)强烈抑制纤维蛋白溶解，这种作用依赖于载脂蛋白(a)蛋白酶结构域的存在，并由该结构域的Lys216介导。载脂蛋白(a)的模型表明，含有载脂蛋白b的脂蛋白存在，可以阻止Lys216与Lp(a)颗粒中的纤溶酶原结合。Lp(a)和载脂蛋白(a)缩短了血浆凝块形成时间，考虑到这一点，我们发现Lp(a)可以小幅但显著地延长纤溶作用。促凝作用涉及抗裂解凝块结构的发展，并通过apo(a) kringle IV型10强赖氨酸结合位点介导。此外，Lp(a)（而不是载脂蛋白(a)）加速凝血酶的产生。结论：载脂蛋白(a)的强抗纤溶作用似乎不会保留在完整的Lp(a)颗粒中。然而，Lp(a)和载脂蛋白(a)显示出促凝作用，部分依赖于KIV10赖氨酸结合位点。需要进一步分析以确定这些报道的Lp(a)的促凝作用是否影响体内血栓形成。

{"title":"Lipoprotein(a) prolongs ex vivo plasma clot lysis times through effects on clot formation rate and fibrin structure","authors":"Justin R. Clark , Frances S. Sutherland , Julia M. Assini , Luke Daichedt , Robert Szabla , Murray W. Junop , Marlys L. Koschinsky , Michael B. Boffa","doi":"10.1016/j.jtha.2025.10.009","DOIUrl":"10.1016/j.jtha.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Elevated levels of lipoprotein(a) (Lp[a]) are a causal risk factor for atherosclerotic cardiovascular disease. Similarities between the apolipoprotein(a) (apo[a]) component of Lp(a) and plasminogen suggest that antifibrinolytic properties may account for the pathological effects of Lp(a). However, the antifibrinolytic effects of apo(a) do not appear to be retained by the complete Lp(a) particle.</div></div><div><h3>Objectives</h3><div>We evaluated the effects of Lp(a), apo(a), and various apo(a) variants on clot formation and lysis times, thrombin generation, plasminogen activation, and fibrin architectures in <em>ex vivo</em> plasma clots. We also constructed predictive protein models to gain insight into the apo(a)-plasminogen interaction.</div></div><div><h3>Results</h3><div>Apo(a) strongly inhibited fibrinolysis, an effect dependent on the presence of the apo(a) protease domain and mediated by Lys216 in this domain. Modeling of apo(a) suggests that Lys216 is blocked from binding to plasminogen in the Lp(a) particle by the presence of the apoB-containing lipoprotein. Lp(a) and apo(a) shortened plasma clot formation times, and accounting for this revealed a small but significant prolongation of fibrinolysis by Lp(a). The procoagulant effects involved the development of lysis-resistant clot architectures and were mediated through the strong lysine-binding site in apo(a) kringle IV type 10. In addition, Lp(a) (but not apo[a]) accelerated thrombin generation.</div></div><div><h3>Conclusions</h3><div>The strong antifibrinolytic effects of apo(a) do not appear to be retained in the complete Lp(a) particle. However, Lp(a) and apo(a) displayed procoagulant effects, in part dependent on the kringle 4–like lysine-binding site. Further analysis is required to determine whether these reported procoagulant effects of Lp(a) impact thrombosis <em>in vivo</em>.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 2","pages":"Pages 701-715"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Higher citrullinated histone H3 is associated with postthrombotic syndrome: a cohort study 高瓜氨酸组蛋白H3与血栓后综合征相关：一项队列研究

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.10.013

Julia Krupa-Zabiegała , Patryk Stanisław Michel , Konrad Stępień , Maciej Polak , Joanna Natorska , Anetta Undas

Background

Postthrombotic syndrome (PTS) is a serious complication of deep vein thrombosis (DVT), linked to persistent inflammation and impaired thrombus resolution. Enhanced formation of neutrophil extracellular traps (NETs) is involved in DVT pathogenesis.

Objectives

We investigated whether increased NET formation, associated with an unfavorable fibrin clot phenotype, predisposes to the development of PTS.

Methods

We studied 179 patients with DVT. Three months after diagnosis and initiation of anticoagulant therapy, citrullinated histone H3 (H3cit), thrombin generation, clot permeability, clot lysis time, and inflammatory markers were measured. PTS severity was assessed at 12 to 14 months by the Villalta score. During a median 53-month follow-up, we recorded recurrent venous thromboembolism and venous ulcers.

Results

Patients with PTS (n = 43, 24.0%) had 68.8% higher H3cit levels compared with those without PTS (P < .001). In the whole group, H3cit showed a positive association with Villalta scores (R = .596; P < .001). Higher H3cit was linked to denser fibrin clots (ie, clot permeability; R = −.352; P < .001), slower fibrinolysis (ie, clot lysis time; R = .287; P < .001), and higher interleukin 6 (R = .429; P < .001), but not C-reactive protein or thrombin generation. In multivariable analysis, higher H3cit per 1 ng/mL at 3 months was independently associated with PTS (odds ratio, 5.50; 95% CI, 2.52-12.01). Patients with recurrent venous thromboembolism (n = 43, 24.0%) had 37.8% higher H3cit concentrations compared with those without recurrence (P < .001). Venous ulcer formation was not related to this marker.

Conclusion

This study is the first to show that enhanced NET formation following DVT may contribute to PTS and its severe forms, at least in part through unfavorable fibrin clot properties.

背景：血栓形成后综合征（PTS）是深静脉血栓形成（DVT）的严重并发症，与持续炎症和血栓溶解受损有关。增强中性粒细胞胞外陷阱（NETs）的形成参与了DVT的发病机制。目的：我们研究NETs的增加是否与不利的纤维蛋白凝块表型相关，从而导致PTS的发生。方法：对179例深静脉血栓患者进行研究。在诊断和抗凝治疗后3个月，检测瓜氨酸组蛋白H3 （H3cit）、凝血酶生成、血栓通透性（Ks）、溶解时间（CLT）和炎症标志物。12-14个月时采用Villalta评分评估PTS严重程度。在中位53个月的随访中，我们记录了复发性静脉血栓栓塞（VTE）和静脉溃疡。结果：PTS患者（n= 43,24.0%）的H3cit水平比其他患者高68.8%(结论：该研究首次表明，DVT后NETs形成增强可能导致PTS及其严重形式，至少部分原因是不利的纤维蛋白凝块特性。

{"title":"Higher citrullinated histone H3 is associated with postthrombotic syndrome: a cohort study","authors":"Julia Krupa-Zabiegała , Patryk Stanisław Michel , Konrad Stępień , Maciej Polak , Joanna Natorska , Anetta Undas","doi":"10.1016/j.jtha.2025.10.013","DOIUrl":"10.1016/j.jtha.2025.10.013","url":null,"abstract":"<div><h3>Background</h3><div>Postthrombotic syndrome (PTS) is a serious complication of deep vein thrombosis (DVT), linked to persistent inflammation and impaired thrombus resolution. Enhanced formation of neutrophil extracellular traps (NETs) is involved in DVT pathogenesis.</div></div><div><h3>Objectives</h3><div>We investigated whether increased NET formation, associated with an unfavorable fibrin clot phenotype, predisposes to the development of PTS.</div></div><div><h3>Methods</h3><div>We studied 179 patients with DVT. Three months after diagnosis and initiation of anticoagulant therapy, citrullinated histone H3 (H3cit), thrombin generation, clot permeability, clot lysis time, and inflammatory markers were measured. PTS severity was assessed at 12 to 14 months by the Villalta score. During a median 53-month follow-up, we recorded recurrent venous thromboembolism and venous ulcers.</div></div><div><h3>Results</h3><div>Patients with PTS (<em>n</em> = 43, 24.0%) had 68.8% higher H3cit levels compared with those without PTS (<em>P</em> < .001). In the whole group, H3cit showed a positive association with Villalta scores (R = .596; <em>P</em> < .001). Higher H3cit was linked to denser fibrin clots (ie, clot permeability; R = −.352; <em>P</em> < .001), slower fibrinolysis (ie, clot lysis time; R = .287; <em>P</em> < .001), and higher interleukin 6 (R = .429; <em>P</em> < .001), but not C-reactive protein or thrombin generation. In multivariable analysis, higher H3cit per 1 ng/mL at 3 months was independently associated with PTS (odds ratio, 5.50; 95% CI, 2.52-12.01). Patients with recurrent venous thromboembolism (<em>n</em> = 43, 24.0%) had 37.8% higher H3cit concentrations compared with those without recurrence (<em>P</em> < .001). Venous ulcer formation was not related to this marker.</div></div><div><h3>Conclusion</h3><div>This study is the first to show that enhanced NET formation following DVT may contribute to PTS and its severe forms, at least in part through unfavorable fibrin clot properties.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 2","pages":"Pages 633-643"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potential utility of the new ISTH overt disseminated intravascular coagulation scoring system for mortality risk assessment of patients with sepsis, hematopoietic neoplasms, and solid cancers: a nation-wide database study in Japan 新的ISTH显性DIC评分系统在脓毒症、造血肿瘤和实体癌患者死亡风险评估中的潜在效用：日本的一项全国性数据库研究。

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.10.006

Akane Shinkai , Takashi Ito , Ema Hashiguchi , Michiko Katsuno , Yutaka Umemura , Kazuma Yamakawa , Kohji Okamoto , LOCOMOCO Study Group

Background

Disseminated intravascular coagulation (DIC) is characterized by systemic activation of coagulation pathways within the microvasculature, ultimately resulting in multiorgan dysfunction. The International Society on Thrombosis and Haemostasis (ISTH) subcommittee has recently introduced the 2025 overt DIC scoring system for clinical diagnosis.

Objectives

This study aimed to evaluate the clinical relevance of the 2025 ISTH overt DIC scoring system and its proposed cutoff values for the mortality risk assessment in patients with diverse underlying diseases.

Methods

Patient data were extracted from the Japan Medical Data Center database, focusing on individuals diagnosed with sepsis, hematopoietic neoplasms, or solid cancers. Patients were included only if baseline levels of fibrinogen, platelets, prothrombin time (PT), and fibrin-related markers were available on the day of admission. Restricted cubic spline models were applied to evaluate nonlinear associations between coagulation parameters and in-hospital death.

Results

Data from 8181 patients with sepsis, 7548 patients with hematopoietic neoplasms, and 11 614 with solid cancers revealed a marked increase in mortality associated with fibrinogen < 2 g/L, platelets < 100 × 10⁹/L, PT >14 seconds, and D-dimer > 3 mg/L. Among these, PT prolongation and elevated D-dimer demonstrated the strongest associations with mortality. Across all 3 disease groups, in-hospital mortality showed a consistent positive correlation with the ISTH DIC sum score.

Conclusion

These findings support the prognostic utility of the 2025 ISTH overt DIC scoring system and its proposed cutoff values in evaluating mortality risk among patients with sepsis, hematopoietic malignancies, and solid cancers.

背景：弥散性血管内凝血（DIC）的特点是微血管内凝血途径的系统性激活，最终导致多器官功能障碍。国际血栓和止血学会（ISTH）小组委员会最近推出了用于临床诊断的2025显性DIC评分系统。目的：本研究旨在评估ISTH显性DIC评分系统2025的临床相关性及其在不同基础疾病患者死亡风险评估中的截止值。方法：从日本医疗数据中心数据库中提取患者数据，重点是诊断为败血症、造血肿瘤或实体癌的个体。只有在入院当天纤维蛋白原、血小板、凝血酶原时间（PT）和纤维蛋白相关标志物的基线水平可用时，患者才被纳入研究。应用限制三次样条模型评价凝血参数与院内死亡之间的非线性关系。结果：8181例败血症患者、7548例造血肿瘤患者和11614例实体癌患者的数据显示，纤维蛋白原9/L、PT >4秒和d -二聚体> 3mg /L与死亡率显著增加相关。其中，PT延长和d -二聚体升高与死亡率的相关性最强。在所有三种疾病组中，住院死亡率与ISTH DIC总评分呈一致的正相关。结论：这些发现支持了ISTH显性DIC评分系统2025的预后效用，以及它在评估脓毒症、造血恶性肿瘤和实体癌患者死亡风险时提出的截止值。

{"title":"Potential utility of the new ISTH overt disseminated intravascular coagulation scoring system for mortality risk assessment of patients with sepsis, hematopoietic neoplasms, and solid cancers: a nation-wide database study in Japan","authors":"Akane Shinkai , Takashi Ito , Ema Hashiguchi , Michiko Katsuno , Yutaka Umemura , Kazuma Yamakawa , Kohji Okamoto , LOCOMOCO Study Group","doi":"10.1016/j.jtha.2025.10.006","DOIUrl":"10.1016/j.jtha.2025.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Disseminated intravascular coagulation (DIC) is characterized by systemic activation of coagulation pathways within the microvasculature, ultimately resulting in multiorgan dysfunction. The International Society on Thrombosis and Haemostasis (ISTH) subcommittee has recently introduced the 2025 overt DIC scoring system for clinical diagnosis.</div></div><div><h3>Objectives</h3><div>This study aimed to evaluate the clinical relevance of the 2025 ISTH overt DIC scoring system and its proposed cutoff values for the mortality risk assessment in patients with diverse underlying diseases.</div></div><div><h3>Methods</h3><div>Patient data were extracted from the Japan Medical Data Center database, focusing on individuals diagnosed with sepsis, hematopoietic neoplasms, or solid cancers. Patients were included only if baseline levels of fibrinogen, platelets, prothrombin time (PT), and fibrin-related markers were available on the day of admission. Restricted cubic spline models were applied to evaluate nonlinear associations between coagulation parameters and in-hospital death.</div></div><div><h3>Results</h3><div>Data from 8181 patients with sepsis, 7548 patients with hematopoietic neoplasms, and 11 614 with solid cancers revealed a marked increase in mortality associated with fibrinogen < 2 g/L, platelets < 100 × 10<sup>9</sup>/L, PT >14 seconds, and D-dimer > 3 mg/L. Among these, PT prolongation and elevated D-dimer demonstrated the strongest associations with mortality. Across all 3 disease groups, in-hospital mortality showed a consistent positive correlation with the ISTH DIC sum score.</div></div><div><h3>Conclusion</h3><div>These findings support the prognostic utility of the 2025 ISTH overt DIC scoring system and its proposed cutoff values in evaluating mortality risk among patients with sepsis, hematopoietic malignancies, and solid cancers.</div></div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"24 2","pages":"Pages 608-617"},"PeriodicalIF":5.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Insights from a genome-wide association study of factor IX activity 因子IX活性全基因组关联研究的见解

IF 5 2区医学 Q1 HEMATOLOGY

Journal of Thrombosis and Haemostasis

Pub Date : 2026-02-01 DOI: 10.1016/j.jtha.2025.10.025

Paul S. de Vries

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Journal of Thrombosis and Haemostasis

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀