C. Legnani, M. Cini, S. Testa, A. Tosetto, C. Dellanoce, Stefania Bellesso, G. Carli, I. Nichele, Laura Lissandrini, S. Zorzi, E. Antonucci, G. Palareti
Direct oral anticoagulants (DOAC) measurement is recommended in specific conditions. A point-of-care testing should be used in emergency to qualitatively rule out relevant DOAC concentrations. The DOAC-CHECK Study aims to evaluate whether the use of CoaguChek® Pro II (Roche Diagnostics International Ltd, Rotkreuz, Switzerland) coagulation testing device can provide reliable information in patients treated with DOAC. The study was carried out in two FCSA (Italian Federation of Thrombosis Centers) centers. We choose 3 different concentration thresholds for our analysis (30, 50 and 100 ng/mL) and by ROC curves the ideal cut-off point was selected to be the one that yielded a sensitivity of at least 95% associated with the highest possible specificity. 512 patients were enrolled. For Edoxaban and Rivaroxaban, both CoaguChek® Pro II prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests showed a sensitivity >95% corresponding to satisfying specificity values; negative predictive values resulted in the range 90-100%. At variance, CoaguChek® Pro II PT and aPTT tests did not seem to be useful for identifying Apixaban and Dabigatran concentrations higher than the pre-defined thresholds. Our results suggest that CoaguChek® Pro II coagulation testing device can be used to qualitatively identify relevant concentrations of Edoxaban or Rivaroxaban, but not of Apixaban or Dabigatran.
在特定情况下，建议直接口服抗凝血剂(DOAC)测量。紧急情况下应采用即时检测，定性排除相关的DOAC浓度。DOAC- check研究旨在评估CoaguChek®Pro II(罗氏诊断国际有限公司，Rotkreuz，瑞士)凝血检测设备是否可以为DOAC治疗患者提供可靠的信息。该研究是在两个FCSA(意大利血栓形成中心联合会)中心进行的。我们选择了3种不同的浓度阈值(30,50和100 ng/mL)进行分析，并通过ROC曲线选择理想的截止点，即产生至少95%的灵敏度并具有最高可能的特异性的截止点。512名患者入组。对于依多沙班和利伐沙班，CoaguChek®Pro II凝血酶原时间(PT)和活化部分凝血活酶时间(aPTT)检测均显示敏感性为bb0 95%，符合满意的特异性值;阴性预测值的范围为90-100%。不同的是，CoaguChek®Pro II PT和aPTT试验似乎无法识别阿哌沙班和达比加群浓度高于预先设定的阈值。我们的研究结果表明，CoaguChek®Pro II凝血试验装置可用于定性鉴定依多沙班或利伐沙班的相关浓度，但不能用于阿哌沙班或达比加群的相关浓度。
{"title":"Evaluation of Coaguchek®Pro II coagulation testing device performance to assess direct oral anticoagulant action. The DOAC-CHECK study","authors":"C. Legnani, M. Cini, S. Testa, A. Tosetto, C. Dellanoce, Stefania Bellesso, G. Carli, I. Nichele, Laura Lissandrini, S. Zorzi, E. Antonucci, G. Palareti","doi":"10.4081/btvb.2022.37","DOIUrl":"https://doi.org/10.4081/btvb.2022.37","url":null,"abstract":"Direct oral anticoagulants (DOAC) measurement is recommended in specific conditions. A point-of-care testing should be used in emergency to qualitatively rule out relevant DOAC concentrations. The DOAC-CHECK Study aims to evaluate whether the use of CoaguChek® Pro II (Roche Diagnostics International Ltd, Rotkreuz, Switzerland) coagulation testing device can provide reliable information in patients treated with DOAC. The study was carried out in two FCSA (Italian Federation of Thrombosis Centers) centers. We choose 3 different concentration thresholds for our analysis (30, 50 and 100 ng/mL) and by ROC curves the ideal cut-off point was selected to be the one that yielded a sensitivity of at least 95% associated with the highest possible specificity. 512 patients were enrolled. For Edoxaban and Rivaroxaban, both CoaguChek® Pro II prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests showed a sensitivity >95% corresponding to satisfying specificity values; negative predictive values resulted in the range 90-100%. At variance, CoaguChek® Pro II PT and aPTT tests did not seem to be useful for identifying Apixaban and Dabigatran concentrations higher than the pre-defined thresholds. Our results suggest that CoaguChek® Pro II coagulation testing device can be used to qualitatively identify relevant concentrations of Edoxaban or Rivaroxaban, but not of Apixaban or Dabigatran.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126517700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Poretto, E. Borella, Giacomo Turatti, M. Marobin, E. Campello, D. Tormene, P. Simioni, L. Spiezia
We retrospectively evaluated the prevalence of non-O blood type – the most frequently inherited prothrombotic factor – and inherited thrombophilia (IT) in a group of women with recurrent spontaneous abortion (RSA). All consecutive women with a history of early unexplained RSA who underwent a screening for IT between December 2008 and December 2021 were considered for enrolment. A group of healthy, age-matched women with ≥1 normal pregnancy and no adverse pregnancy outcomes acted as controls. Two hundred and seventeen women were enrolled. The adjusted odds ratio (aOR) of RSA in non-O vs. O blood type was 1.37 (95% CI, 1.04-2.78), and in women with vs. without IT was 1.26 (95% CI, 1.08-3.61); aOR of RSA in women with non-O blood type and IT was 2.52 (95% CI, 1.12-5.47). We observed a significant association between non-O blood group or IT and RSA. The concomitant presence of non-O blood group and IT further increases RSA risk.
{"title":"Association between non-O blood type and early unexplained recurrent spontaneous abortion in women with and without inherited thrombophilia","authors":"Anna Poretto, E. Borella, Giacomo Turatti, M. Marobin, E. Campello, D. Tormene, P. Simioni, L. Spiezia","doi":"10.4081/btvb.2022.47","DOIUrl":"https://doi.org/10.4081/btvb.2022.47","url":null,"abstract":"We retrospectively evaluated the prevalence of non-O blood type – the most frequently inherited prothrombotic factor – and inherited thrombophilia (IT) in a group of women with recurrent spontaneous abortion (RSA). All consecutive women with a history of early unexplained RSA who underwent a screening for IT between December 2008 and December 2021 were considered for enrolment. A group of healthy, age-matched women with ≥1 normal pregnancy and no adverse pregnancy outcomes acted as controls. Two hundred and seventeen women were enrolled. The adjusted odds ratio (aOR) of RSA in non-O vs. O blood type was 1.37 (95% CI, 1.04-2.78), and in women with vs. without IT was 1.26 (95% CI, 1.08-3.61); aOR of RSA in women with non-O blood type and IT was 2.52 (95% CI, 1.12-5.47). We observed a significant association between non-O blood group or IT and RSA. The concomitant presence of non-O blood group and IT further increases RSA risk.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127202762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The year 1222 has traditionally been accepted as the University of Padua’s founding date. The University of Padua is a prestigious center for learning and research, and over the centuries, it has produced luminaries in the most significant disciplines, including medicine, law, philosophy, theology, literature, engineering, astronomy, physics, politics, and religion. The Studium of the teaching of Medicine began around 1250 with the establishment of the Collegium of Medical and Arts Doctors. The history of Medicine at Padua University is extraordinarily rich and counts on the contribution of masters such as Vesalius, Falloppia, Girolamo Fabrici d’Acquapendente, William Harvey, Vallisneri, Ramazzini, Morgagni and many others including Galileo Galilei himself. This year marks the 800th anniversary of the University of Padua, and to commemorate this historic event, the Editor has asked the three of us to summarize the university’s most significant contributions to the fields of hemostasis and thrombosis over the past eight decades. Among all, it should be mentioned the relevant contribution of Prof. Antonio Girolami, who was the founder of the group of Thrombosis and Hemostasis in Padua and one of the Italian and international leaders in the field of the diagnosis and treatment of congenital bleeding disorders. However, due to the large number of outstanding scientists and significant research conducted in these fields at Padua University, it was extremely difficult for us to provide a concise summary of the university’s numerous contributions. Eventually, we concluded that it would be more useful to share with the Readers the experiences we have had over the past several decades, focusing on specific aspects of our research, work, and life at Padua University, and attempting to highlight the aspects that we believe have contributed most to the advancement of knowledge in the fields of thrombosis and hemostasis. Therefore, three topics have been selected and presented separately in a narrative format as pieces of our lives and of the history of our university.
{"title":"Thrombosis and hemostasis at the University of Padua: a reappraisal on the occasion of its 800th year of history","authors":"P. Simioni, V. Pengo, P. Prandoni","doi":"10.4081/btvb.2022.52","DOIUrl":"https://doi.org/10.4081/btvb.2022.52","url":null,"abstract":"The year 1222 has traditionally been accepted as the University of Padua’s founding date. The University of Padua is a prestigious center for learning and research, and over the centuries, it has produced luminaries in the most significant disciplines, including medicine, law, philosophy, theology, literature, engineering, astronomy, physics, politics, and religion. The Studium of the teaching of Medicine began around 1250 with the establishment of the Collegium of Medical and Arts Doctors. The history of Medicine at Padua University is extraordinarily rich and counts on the contribution of masters such as Vesalius, Falloppia, Girolamo Fabrici d’Acquapendente, William Harvey, Vallisneri, Ramazzini, Morgagni and many others including Galileo Galilei himself. This year marks the 800th anniversary of the University of Padua, and to commemorate this historic event, the Editor has asked the three of us to summarize the university’s most significant contributions to the fields of hemostasis and thrombosis over the past eight decades. Among all, it should be mentioned the relevant contribution of Prof. Antonio Girolami, who was the founder of the group of Thrombosis and Hemostasis in Padua and one of the Italian and international leaders in the field of the diagnosis and treatment of congenital bleeding disorders. However, due to the large number of outstanding scientists and significant research conducted in these fields at Padua University, it was extremely difficult for us to provide a concise summary of the university’s numerous contributions. Eventually, we concluded that it would be more useful to share with the Readers the experiences we have had over the past several decades, focusing on specific aspects of our research, work, and life at Padua University, and attempting to highlight the aspects that we believe have contributed most to the advancement of knowledge in the fields of thrombosis and hemostasis. Therefore, three topics have been selected and presented separately in a narrative format as pieces of our lives and of the history of our university.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115598431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Tormene, E. Campello, C. Simion, Anna Poretto, P. Prandoni, P. Simioni
Antithrombin, protein C and S defects are well-recognized inherited risk factors for venous thromboembolism (VTE). Although these defects have been reported to increase the risk of VTE in fertile women under combined oral contraceptives (COCs), the magnitude of this association is uncertain. In a sub-analysis of a prospective cohort study, we evaluated the incidence of VTE occurring during treatment with COCs in fertile women who were family members of a proband with an objectively diagnosed VTE event and a documented defect of antithrombin, protein C or S. Of the 197 women of child-bearing age from 88 families who qualified for this analysis in a 17-year period, 112 (57%) were carriers of an inherited defect (23 antithrombin, 41 protein C and 48 protein S), whereas the remaining 85 were free from these abnormalities. Estrogen-progestin therapy was used by 19 of the 112 (17%) carriers of inherited thrombophilia for an overall period of 276 months, and by 17 of the 85 (20%) non-carriers for an overall period of 992 months. VTE events developed in 12 of the 19 (63%) carriers, leading to a monthly event rate of 4.3% (95% CI: 2.2 to 7.6), and in 2 of the 17 (12%) non-carriers, leading to a monthly rate of 0.2% (95% CI: 0.02 to 0.7), for a relative risk of 21 (95% CI, 4.7 to 92). Among family members of probands with inherited defects of antithrombin, protein C or S defects, the use of estrogen-progestin therapy in carriers of these abnormalities results in a risk of VTE events that is more than 20 times as high as that expected in non-carriers. Accordingly, the systematic screening for thrombophilia in these families has the potential to identify those subjects in whom this kind of hormonal treatment should be strongly discouraged.
{"title":"Combined oral contraceptives and the risk of venous thromboembolism carriers of antithrombin, protein C or S deficiency: Sub-analysis of a prospective cohort study","authors":"D. Tormene, E. Campello, C. Simion, Anna Poretto, P. Prandoni, P. Simioni","doi":"10.4081/btvb.2022.42","DOIUrl":"https://doi.org/10.4081/btvb.2022.42","url":null,"abstract":"Antithrombin, protein C and S defects are well-recognized inherited risk factors for venous thromboembolism (VTE). Although these defects have been reported to increase the risk of VTE in fertile women under combined oral contraceptives (COCs), the magnitude of this association is uncertain. In a sub-analysis of a prospective cohort study, we evaluated the incidence of VTE occurring during treatment with COCs in fertile women who were family members of a proband with an objectively diagnosed VTE event and a documented defect of antithrombin, protein C or S. Of the 197 women of child-bearing age from 88 families who qualified for this analysis in a 17-year period, 112 (57%) were carriers of an inherited defect (23 antithrombin, 41 protein C and 48 protein S), whereas the remaining 85 were free from these abnormalities. Estrogen-progestin therapy was used by 19 of the 112 (17%) carriers of inherited thrombophilia for an overall period of 276 months, and by 17 of the 85 (20%) non-carriers for an overall period of 992 months. VTE events developed in 12 of the 19 (63%) carriers, leading to a monthly event rate of 4.3% (95% CI: 2.2 to 7.6), and in 2 of the 17 (12%) non-carriers, leading to a monthly rate of 0.2% (95% CI: 0.02 to 0.7), for a relative risk of 21 (95% CI, 4.7 to 92). Among family members of probands with inherited defects of antithrombin, protein C or S defects, the use of estrogen-progestin therapy in carriers of these abnormalities results in a risk of VTE events that is more than 20 times as high as that expected in non-carriers. Accordingly, the systematic screening for thrombophilia in these families has the potential to identify those subjects in whom this kind of hormonal treatment should be strongly discouraged.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126559709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
[This abstract book contains the abstracts presented at the 27th National Congress of the Società Italiana per lo Studio dell'Emostasi e della Trombosi (SISET)]
[本摘要书在意大利血肿与血栓研究学会第27届全国大会上展出的摘要]
{"title":"27th SISET National Congress | Perugia, 2-5 November 2022","authors":"S. I. P. L. S. D. E. T. -. Siset","doi":"10.4081/btvb.2022.57","DOIUrl":"https://doi.org/10.4081/btvb.2022.57","url":null,"abstract":"[This abstract book contains the abstracts presented at the 27th National Congress of the Società Italiana per lo Studio dell'Emostasi e della Trombosi (SISET)]","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125669945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Albisinni, Tommaso Marrazzo, Arta Karruli, S. Manduca, G. Nobile, N. Galdieri, M. de Feo
Aortic arch thrombosis represents a severe condition which usually requires surgical treatment in specialized centers. Treatments described in literature are mostly surgery or sodium heparin infusion. Here we describe an off-label use of alteplase in aortic arch thrombosis in a patient in whom sodium heparin treatment failed and surgery was not possible due to the site of thrombus. We report the case of a 34-year-old postpartum patient who was admitted to our hospital for aortic arch thrombosis. She had no genetic disorders for hypercoagulability, only a family history for ischemic cerebrovascular accident. As treatment with sodium heparin failed and surgery was not possible due to the site of thrombus, she received a low-dose, ultra-slow-flow treatment with alteplase for 75 hours with successful removal of the thrombus. No side effects from alteplase were observed. Considering the safety and efficacy in this patient, as well as the easiness by which it can be reproduced in the majority of clinical settings, this treatment may be a viable option in cases of aortic arch thrombosis when conventional treatments are not applicable or available.
{"title":"Successful treatment of aortic arch mural thrombosis with low-dose, ultra-slow-flow thrombolysis: a case report and literature review","authors":"R. Albisinni, Tommaso Marrazzo, Arta Karruli, S. Manduca, G. Nobile, N. Galdieri, M. de Feo","doi":"10.4081/btvb.2022.44","DOIUrl":"https://doi.org/10.4081/btvb.2022.44","url":null,"abstract":"Aortic arch thrombosis represents a severe condition which usually requires surgical treatment in specialized centers. Treatments described in literature are mostly surgery or sodium heparin infusion. Here we describe an off-label use of alteplase in aortic arch thrombosis in a patient in whom sodium heparin treatment failed and surgery was not possible due to the site of thrombus. We report the case of a 34-year-old postpartum patient who was admitted to our hospital for aortic arch thrombosis. She had no genetic disorders for hypercoagulability, only a family history for ischemic cerebrovascular accident. As treatment with sodium heparin failed and surgery was not possible due to the site of thrombus, she received a low-dose, ultra-slow-flow treatment with alteplase for 75 hours with successful removal of the thrombus. No side effects from alteplase were observed. Considering the safety and efficacy in this patient, as well as the easiness by which it can be reproduced in the majority of clinical settings, this treatment may be a viable option in cases of aortic arch thrombosis when conventional treatments are not applicable or available.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123535782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this essay is to re-consider the peculiar type of thrombogenesis observed in severe cases of COVID-19 infection, focusing on the multiple interconnected networks involved, such as inflammation, blood coagulation, fibrinolysis, and immune responses. These linked mechanisms can be assimilated to the “Complex Systems” (CS), that play a capital role in various domains: from physics to chemistry, biology and medicine, to social and behavioral sciences. CS are characterized by eliciting variable responses: their final results can be contradictory and often unpredictable. In fact, in severe COVID-19 various outcomes can occur, such as macro- and micro-thrombosis, vasculitis, hemorrhage, hyper and hypo fibrinolysis, distorted inflammatory and immune response, and others. The insight supplied by the CS theory in understanding thrombogenesis in COVID-19 can be useful in several ways. It recalls the importance of a “holistic” view of multiple patterns of signs, symptoms and biomarkers; stresses the added value of global versus mechanistic tests, particularly in coagulation and fibrinolysis; suggests building up small trials of selected patients in a perspective of precision medicine; discourages passive transfer of therapeutic choices from no- COVID to COVID patients; and finally indicates that some treatments, as the anti-inflammatory and the anti-coagulant ones, should be initiated as early as possible, so to avoid worsening of the condition by repetitive feedback and shortcut mechanisms.
{"title":"A re-appraisal of thrombogenesis in COVID-19, seen as a multiple Complex System","authors":"S. Coccheri","doi":"10.4081/btvb.2022.48","DOIUrl":"https://doi.org/10.4081/btvb.2022.48","url":null,"abstract":"The aim of this essay is to re-consider the peculiar type of thrombogenesis observed in severe cases of COVID-19 infection, focusing on the multiple interconnected networks involved, such as inflammation, blood coagulation, fibrinolysis, and immune responses. These linked mechanisms can be assimilated to the “Complex Systems” (CS), that play a capital role in various domains: from physics to chemistry, biology and medicine, to social and behavioral sciences. CS are characterized by eliciting variable responses: their final results can be contradictory and often unpredictable. In fact, in severe COVID-19 various outcomes can occur, such as macro- and micro-thrombosis, vasculitis, hemorrhage, hyper and hypo fibrinolysis, distorted inflammatory and immune response, and others. The insight supplied by the CS theory in understanding thrombogenesis in COVID-19 can be useful in several ways. It recalls the importance of a “holistic” view of multiple patterns of signs, symptoms and biomarkers; stresses the added value of global versus mechanistic tests, particularly in coagulation and fibrinolysis; suggests building up small trials of selected patients in a perspective of precision medicine; discourages passive transfer of therapeutic choices from no- COVID to COVID patients; and finally indicates that some treatments, as the anti-inflammatory and the anti-coagulant ones, should be initiated as early as possible, so to avoid worsening of the condition by repetitive feedback and shortcut mechanisms.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125633181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Puccetti, Vincenzo Sammartano, Federico Caroni, Margherita Malchiodi, P. Calzoni, Eleonora Franceschini, Lucrezia Galasso, M. Bocchia
Coronavirus disease 2019 (COVID-19) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection called for a specific and massive vaccination campaign. Acquired hemophilia A (AHA) is a potential life-threatening coagulopathy. Hematological- targeted autoimmune conditions including immune thrombocytopenia, vaccine-induced thrombotic thrombocytopenia and AHA emerged during large-scale vaccination against SARS-CoV-2 and contributed to vaccination hesitation. The aim of the present study was to evaluate the putative recurrence of AHA after vaccination against SARS-CoV-2 with mRNA vaccines (BNT162b2 and mRNA- 1273) in patients with relatively recent history of AHA. Thirteen patients (8 women and 5 men, mean age = 63.1±16.6 years) with AHA in the previous two-to-five years were enrolled in the study. Platelet count, prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen and Factor VIII levels were evaluated 48 hours prior to each vaccine dose and 10 days post-vaccination. Clinical self-assessment and remote video visits were performed in the presence of even minor hemorrhagic signs. No major bleeding events were detected at any time-point, including evaluation at 30 days after the 3rd vaccine dose. No significant hemorrhagic changes were observed, in particular no thrombocytopenia and/or significant alterations in PTT and Factor VIII emerged across subjects. Patients with a previous history of AHA of various etiology do not seem to have an increased recurrence risk after a COVID-19 vaccination course of 3 doses with either mRNA vaccine. This finding supports this specific safety aspect in the face of the possible continuation of the vaccination campaign based on the trend of the COVID-19 pandemic.
{"title":"Safety of COVID-19 mRNA vaccination in patients with history of acquired hemophilia A: a case series","authors":"L. Puccetti, Vincenzo Sammartano, Federico Caroni, Margherita Malchiodi, P. Calzoni, Eleonora Franceschini, Lucrezia Galasso, M. Bocchia","doi":"10.4081/btvb.2022.40","DOIUrl":"https://doi.org/10.4081/btvb.2022.40","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection called for a specific and massive vaccination campaign. Acquired hemophilia A (AHA) is a potential life-threatening coagulopathy. Hematological- targeted autoimmune conditions including immune thrombocytopenia, vaccine-induced thrombotic thrombocytopenia and AHA emerged during large-scale vaccination against SARS-CoV-2 and contributed to vaccination hesitation. The aim of the present study was to evaluate the putative recurrence of AHA after vaccination against SARS-CoV-2 with mRNA vaccines (BNT162b2 and mRNA- 1273) in patients with relatively recent history of AHA. Thirteen patients (8 women and 5 men, mean age = 63.1±16.6 years) with AHA in the previous two-to-five years were enrolled in the study. Platelet count, prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen and Factor VIII levels were evaluated 48 hours prior to each vaccine dose and 10 days post-vaccination. Clinical self-assessment and remote video visits were performed in the presence of even minor hemorrhagic signs. No major bleeding events were detected at any time-point, including evaluation at 30 days after the 3rd vaccine dose. No significant hemorrhagic changes were observed, in particular no thrombocytopenia and/or significant alterations in PTT and Factor VIII emerged across subjects. Patients with a previous history of AHA of various etiology do not seem to have an increased recurrence risk after a COVID-19 vaccination course of 3 doses with either mRNA vaccine. This finding supports this specific safety aspect in the face of the possible continuation of the vaccination campaign based on the trend of the COVID-19 pandemic.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114513438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Parambi, N. Ziliotto, F. Bernardi, M. Baroni, R. Browne, D. Jakimovski, B. Weinstock-Guttman, R. Zivadinov, M. Ramanathan
The individual roles of cholesterol pathway biomarkers (CPB) and hemostasis inhibitors with neuroimaging outcomes were previously investigated in multiple sclerosis (MS). The purpose of this extension study was to investigate potential crosstalk between plasma CPB [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and apolipoproteins (Apo) ApoA-I, ApoAII, ApoB, ApoC-II and ApoE] and hemostasis inhibitors [heparin cofactor-II (HCII), protein C (PC), protein S (PS), thrombomodulin, ADAMTS13 and PAI-1] in a cohort of 127 MS patients, and 40 healthy individuals (HI). The associations were assessed with regressions. In MS patients, HCII was positively associated with TC, LDL-C, HDL-C and ApoA-I (p=0.028, 0.027, 0.002 and 0.027, respectively) but negatively associated with ApoCII (p=0.018). PC was positively associated with ApoC-II (p=0.001) and ApoB (p=0.016) whereas PS was associated with TC (p=0.024) and ApoE (p=0.003) in MS. The ApoC-II associations were not observed in HI. The negative association between ApoC-II and HCll was an exception amongst other positive associations between CPB and hemostasis inhibitors in MS. CPB do not modulate the PC associations with neurodegeneration in MS.
胆固醇通路生物标志物(CPB)和止血抑制剂在多发性硬化症(MS)中对神经影像学结果的个体作用先前进行了研究。本扩展研究的目的是研究127例MS患者和40例健康人(HI)血浆CPB[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和载脂蛋白(Apo) ApoA-I、ApoAII、ApoB、ApoC-II和ApoE]和止血抑制剂[肝素辅助因子- ii (HCII)、蛋白C (PC)、蛋白S (PS)、血栓调节蛋白、ADAMTS13和PAI-1]之间潜在的串扰。通过回归分析来评估这些关联。在MS患者中，HCII与TC、LDL-C、HDL-C和ApoA-I呈正相关(p分别为0.028、0.027、0.002和0.027)，与ApoCII呈负相关(p=0.018)。PC与ms患者的ApoC-II (p=0.001)和ApoB (p=0.016)呈正相关，而PS与TC (p=0.024)和ApoE (p=0.003)呈正相关。HI患者未观察到ApoC-II相关。ApoC-II和hcl之间的负相关是MS中CPB和止血抑制剂之间的其他正相关中的一个例外，CPB不调节PC与MS中神经变性的关联。
{"title":"Crosstalk between hemostasis inhibitors and cholesterol biomarkers in multiple sclerosis","authors":"R. Parambi, N. Ziliotto, F. Bernardi, M. Baroni, R. Browne, D. Jakimovski, B. Weinstock-Guttman, R. Zivadinov, M. Ramanathan","doi":"10.4081/btvb.2022.41","DOIUrl":"https://doi.org/10.4081/btvb.2022.41","url":null,"abstract":"The individual roles of cholesterol pathway biomarkers (CPB) and hemostasis inhibitors with neuroimaging outcomes were previously investigated in multiple sclerosis (MS). The purpose of this extension study was to investigate potential crosstalk between plasma CPB [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and apolipoproteins (Apo) ApoA-I, ApoAII, ApoB, ApoC-II and ApoE] and hemostasis inhibitors [heparin cofactor-II (HCII), protein C (PC), protein S (PS), thrombomodulin, ADAMTS13 and PAI-1] in a cohort of 127 MS patients, and 40 healthy individuals (HI). The associations were assessed with regressions. In MS patients, HCII was positively associated with TC, LDL-C, HDL-C and ApoA-I (p=0.028, 0.027, 0.002 and 0.027, respectively) but negatively associated with ApoCII (p=0.018). PC was positively associated with ApoC-II (p=0.001) and ApoB (p=0.016) whereas PS was associated with TC (p=0.024) and ApoE (p=0.003) in MS. The ApoC-II associations were not observed in HI. The negative association between ApoC-II and HCll was an exception amongst other positive associations between CPB and hemostasis inhibitors in MS. CPB do not modulate the PC associations with neurodegeneration in MS.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"97 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130897894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Baroni, P. Ferraresi, N. Ziliotto, D. Bortolotti, P. Acciarri, N. Martinelli, G. Marchetti, Matteo Coen, F. Bernardi
The anticoagulant protein S (PS) binds phospholipids with very high affinity, but PS interaction with lipoproteins and lipidrich atherosclerotic plaques remains still poorly defined. We investigated PS in plasma lipoproteins and in atherosclerotic plaques from ten patients undergoing endarterectomy. PS was detected by Western blotting after exposure of the necrotic core to liposomes and was found to maintain its ability to bind phosphatidylserine micelles. The amounts of PS bound to low/very low-density lipoproteins in patient’ plasmas were higher and more variable than those detected in healthy subjects. A direct correlation between bound PS and low-density lipoproteins (LDL), plasma levels was found only in patients (r=0.921, p<0.001), thereby leading to hypothesize that the PS-phospholipids binding may increase by oxidative processes of LDL in atherosclerotic patients. The presence of the PS into the necrotic core of atherosclerotic plaques and on the surface of lipoproteins, particularly the atherogenic LDL, suggests a LDL-based delivery of PS to the atherosclerotic plaques and emphasizes the deep link between plasma lipids and coagulation in cardiovascular diseases.
{"title":"Protein S on the surface of plasma lipoproteins: a potential mechanism for protein S delivery to the atherosclerotic plaques?","authors":"M. Baroni, P. Ferraresi, N. Ziliotto, D. Bortolotti, P. Acciarri, N. Martinelli, G. Marchetti, Matteo Coen, F. Bernardi","doi":"10.4081/btvb.2022.45","DOIUrl":"https://doi.org/10.4081/btvb.2022.45","url":null,"abstract":"The anticoagulant protein S (PS) binds phospholipids with very high affinity, but PS interaction with lipoproteins and lipidrich atherosclerotic plaques remains still poorly defined. We investigated PS in plasma lipoproteins and in atherosclerotic plaques from ten patients undergoing endarterectomy. PS was detected by Western blotting after exposure of the necrotic core to liposomes and was found to maintain its ability to bind phosphatidylserine micelles. The amounts of PS bound to low/very low-density lipoproteins in patient’ plasmas were higher and more variable than those detected in healthy subjects. A direct correlation between bound PS and low-density lipoproteins (LDL), plasma levels was found only in patients (r=0.921, p<0.001), thereby leading to hypothesize that the PS-phospholipids binding may increase by oxidative processes of LDL in atherosclerotic patients. The presence of the PS into the necrotic core of atherosclerotic plaques and on the surface of lipoproteins, particularly the atherogenic LDL, suggests a LDL-based delivery of PS to the atherosclerotic plaques and emphasizes the deep link between plasma lipids and coagulation in cardiovascular diseases.","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129735450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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