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Talking about assisted reproductive techniques and thromboembolic risk: everything we always wanted to know 谈到辅助生殖技术和血栓栓塞风险:我们一直想知道的一切
Pub Date : 2022-09-13 DOI: 10.4081/btvb.2022.43
G. Tiscia, E. Grandone
The last report on Assisted Reproductive Technologies (ART) showed a steady increase in the annual number of treatment cycles worldwide. The most common techniques of autologous ART - in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) - require the use of exogenous gonadotropins with possible adverse effects [...].
上一份关于辅助生殖技术(ART)的报告显示,全世界每年治疗周期的数量稳步增加。最常见的自体抗逆转录病毒治疗技术——体外受精(IVF)和胞浆内单精子注射(ICSI)——需要使用外源性促性腺激素,可能产生不良反应[…]。
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引用次数: 0
Major bleedings in mechanical prosthetic heart valves patients on Vitamin K antagonist treatment. Data from the PLECTRUM Study 维生素K拮抗剂治疗机械人工心脏瓣膜大出血患者。数据来自PLECTRUM研究
Pub Date : 2022-07-27 DOI: 10.4081/btvb.2022.34
D. Poli, E. Antonucci, G. Palareti, R. Facchinetti, Pietro Falco, Giuseppina Serricchio, T. Lerede, L. Masciocco, P. Gresele, S. Testa
Patients with mechanical prosthetic heart valves (MHV) need vitamin K antagonist (VKA) treatment, due to the high thrombotic risk. The need to evaluate the bleeding risk of these patients is of great clinical relevance. This is an observational retrospective multicenter study among Centers affiliated to the Italian Federation of Anticoagulation Clinics on MHV patients, with the aim to evaluate the risk of major bleeding (MB) and associated risk factors. 2357 patients with MHV were included in the study, patients were followed for 24.081 pt-years; 246 patients had MB (rate 1.0 ×100 pt-yrs), 54 were intracranial hemorrhage (rate 0.22 ×100 pt-yrs). Patients with MB were significantly older, more affected by peripheral obstructive arterial disease (POAD) and atrial fibrillation (AF), and presented a history of previous MB, with respect to patients who did not bleed. Patients with MB showed a trend for lower time in therapeutic range (TTR), and a significant number of patients had a TTR in the lower quartile. Patients with MB had a higher mortality rate with respect to patients who did not bleed (p=0.001). The history of previous bleeding, the presence of POAD or of AF, and a TTR in the lowest quartile, were significantly associated with MB. MHV patients treated with VKAs followed by Anticoagulation Clinics, showed a low bleeding risk. Risk factors associated with major bleeding are older age, the presence of POAD or AF, the history of previous bleeding, and poor quality of anticoagulation. Patients who experienced MB during anticoagulation are at high risk of death.
机械人工心脏瓣膜(MHV)患者由于血栓形成风险高,需要维生素K拮抗剂(VKA)治疗。评估这些患者的出血风险具有重要的临床意义。这是一项多中心观察性回顾性研究,隶属于意大利抗凝诊所联合会的中心对MHV患者进行研究,目的是评估大出血(MB)的风险和相关危险因素。2357例MHV患者纳入研究,随访24.081 pt-year;MB 246例(发生率1.0 ×100),颅内出血54例(发生率0.22 ×100)。与没有出血的患者相比,MB患者明显年龄较大,更容易受外周阻塞性动脉疾病(POAD)和心房颤动(AF)的影响,并且有既往MB病史。MB患者的治疗时间范围(TTR)有降低的趋势,有相当数量的患者的TTR处于较低的四分位数。MB患者的死亡率高于未出血患者(p=0.001)。既往出血史、POAD或AF的存在以及最低四分位数的TTR与MB显著相关。接受vka治疗的MHV患者在抗凝治疗后出血风险较低。与大出血相关的危险因素有年龄较大、存在POAD或AF、既往出血史和抗凝治疗质量差。抗凝期间发生MB的患者死亡风险高。
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引用次数: 0
Clonal hematopoiesis and inflammation: a link with thrombosis and malignancy 克隆造血和炎症:与血栓和恶性肿瘤的联系
Pub Date : 2022-07-21 DOI: 10.4081/btvb.2022.38
T. Barbui
Not available
不可用
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引用次数: 0
The amazing genetic complexity of anucleated platelets 无核血小板惊人的遗传复杂性
Pub Date : 2022-07-15 DOI: 10.4081/btvb.2022.33
L. Bury, P. Gresele
Not available
不可用
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引用次数: 1
Iatrogenic pseudoaneurysm of inferior epigastric artery: not only a surgical complication 医源性腹下动脉假性动脉瘤:不仅仅是一种手术并发症
Pub Date : 2022-07-14 DOI: 10.4081/btvb.2022.25
Rossana Corso, Andrea Coppola, Stefano Grazioli, Cristina Dedionigi, N. Tandurella, M. Venturini, F. Dentali
A 77-year-old lady with a longstanding scleroderma, presented to the Emergency Department for a state of severe malnutrition and fluid dysphagia. On physical examination, she presented an abdominal palpable swelling, with an associated large, posterior ecchymosis. A pseudoaneurysm of the right inferior epigastric artery was diagnosed on a color Doppler ultrasound examination. After collegial discussion with the surgical and interventional-radiologist team, a percutaneous exclusion of the pseudoaneurysm through thrombin injection was successfully performed, and no complications were reported. After a thorough anamnestic record, the possible cause of the pseudoaneurysm was discovered: a few days before hospital admission the general practitioner did some intradermoclysis in the abdominal wall to hydrate the patient, damaging the inferior epigastric artery wall with subsequent development of the pseudoaneurysm. The patient completely recovered, returned home after two weeks in a subacute facility, and is awaiting evaluation for the scleroderma follow up from a rheumatologist.
一位患有长期硬皮病的77岁女士,因严重营养不良和液体吞咽困难而被送到急诊科。体格检查时,她表现为腹部可触及的肿胀,并伴有较大的后部瘀斑。彩色多普勒超声检查诊断为右腹下动脉假性动脉瘤。在与外科和介入放射科医生团队共同讨论后,通过注射凝血酶进行经皮假性动脉瘤排除手术成功,无并发症报告。经过详细的记忆记录,发现了假性动脉瘤的可能原因:住院前几天,全科医生在腹壁做了一些皮内灌洗术来给病人补水,破坏了腹壁下动脉壁,导致假性动脉瘤的发生。患者完全康复,在亚急性设施住了两周后返回家中,正在等待风湿病专家对硬皮病随访的评估。
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引用次数: 1
Circulating albumin-to-fibrinogen ratio may be a risk indicator for venous thromboembolism: findings from a population-based prospective cohort study 循环白蛋白与纤维蛋白原比率可能是静脉血栓栓塞的危险指标:一项基于人群的前瞻性队列研究的发现
Pub Date : 2022-07-14 DOI: 10.4081/btvb.2022.36
S. Kunutsor, S. Kurl, A. Voutilainen, J. Laukkanen
Circulating albumin and fibrinogen levels, commonly considered as inflammatory markers, have been shown to be associated with venous thromboembolism (VTE) risk. Circulating albumin-to-fibrinogen ratio (AFR) has been proposed as a novel inflammatory biomarker, but its association with VTE risk has not been investigated. We aimed to assess the prospective association of AFR with VTE risk. Circulating albumin and fibrinogen levels were measured at baseline in 2,284 men aged 42-61 years. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated. During a median follow-up of 27.0 years, 156 VTE cases were recorded. In analysis adjusted for established risk factors, the HR (95% CI) for VTE comparing extreme tertiles of AFR was 1.53 (1.02-2.32), which remained similar on further adjustment for prevalent cancer, 1.52 (1.01-2.30). The associations of circulating albumin or fibrinogen with VTE risk were modest. Circulating AFR may be a stronger risk indicator for VTE compared with albumin or fibrinogen alone.
循环白蛋白和纤维蛋白原水平,通常被认为是炎症标志物,已被证明与静脉血栓栓塞(VTE)风险相关。循环白蛋白与纤维蛋白原比率(AFR)已被提出作为一种新的炎症生物标志物,但其与静脉血栓栓塞风险的关系尚未被研究。我们的目的是评估AFR与静脉血栓栓塞风险的前瞻性关联。研究人员对2284名42-61岁男性的循环白蛋白和纤维蛋白原水平进行了基线测量。估计95%置信区间(ci)的风险比(hr)。在27.0年的中位随访期间,记录了156例静脉血栓栓塞病例。在对已确定的危险因素进行校正的分析中,VTE比较AFR极端分位数的HR (95% CI)为1.53(1.02-2.32),进一步校正流行癌症的HR(1.52)(1.01-2.30)保持相似。循环白蛋白或纤维蛋白原与静脉血栓栓塞风险的关联不大。与单独的白蛋白或纤维蛋白原相比,循环AFR可能是一个更强的静脉血栓栓塞危险指标。
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引用次数: 0
Vaccine-induced immune thrombotic thrombocytopenia following AstraZeneca (ChAdOx1 nCoV-19) vaccine: report of two cases 阿斯利康(ChAdOx1 nCoV-19)疫苗诱导的免疫性血栓性血小板减少2例报告
Pub Date : 2022-05-23 DOI: 10.4081/btvb.2022.23
R. Santoro, R. Minici, M. Leotta, Mariapia Falbo, L. Elia, F. Leo, A. Ierardi, Alessandra Strangio, Simona Prejanò
Vaccination with ChAdOx1 nCoV-19 can result in vaccine-induced immune thrombotic thrombocytopenia (VITT). This phenomenon mimics heparin-induced thrombocytopenia, yet it does not require heparin as a trigger. This case report highlights the potentially lifethreatening complication associated with ChAdOx1 nCov-19 vaccine, clinical presentation, diagnostic approach, and treatment. We report two cases of vaccine-induced immune thrombotic thrombocytopenia after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. We attribute these thrombotic conditions to the vaccine due to the remarkable temporal relationship. The proposed mechanism of VITT is a production of antibodies against platelet factor-4 resulting in massive platelet activation. Healthcare providers should be aware of the possibility of such a fatal complication, and the vaccine recipients should be warned about the symptoms of VITT.
接种ChAdOx1 nCoV-19可导致疫苗诱导的免疫性血栓性血小板减少症(VITT)。这种现象类似于肝素诱导的血小板减少症,但它不需要肝素作为触发因素。本病例报告强调了与ChAdOx1 nCov-19疫苗相关的潜在危及生命的并发症、临床表现、诊断方法和治疗。我们报告两例接种第一剂ChAdOx1 nCoV-19疫苗后疫苗诱导的免疫性血栓性血小板减少症。由于显著的时间关系,我们将这些血栓形成条件归因于疫苗。VITT的机制是产生抗血小板因子-4的抗体,导致大量血小板活化。医疗保健提供者应该意识到这种致命并发症的可能性,并且疫苗接种者应该被警告VITT的症状。
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引用次数: 0
A nitric oxide-donor pravastatin hybrid drug exerts antiplatelet and antiatherogenic activity in mice 一种一氧化氮供体普伐他汀混合药物在小鼠体内具有抗血小板和抗动脉粥样硬化活性
Pub Date : 2022-05-23 DOI: 10.4081/btvb.2022.19
S. Momi, G. Guglielmini, Giulia Ciarroca Taranta, Elisabetta Giglio, A. Monopoli, P. Gresele
Aim of the present study was to compare the lipid-lowering, antithrombotic and antiatherogenic properties of NCX-6550, nitropravastatin, a nitric-oxide donating derivative of pravastatin, with those of pravastatin in hypercholesterolemic mice. LDL receptor-deficient mice (LDLR–/–) on a normal diet (ND) showed enhanced cholesterol levels as compared to wild type (WT) mice (6.8±1.2 mmol/L and 2.8±0.82 mmol/L, respectively). High fat diet (HFD) induced a large enhancement of cholesterolemia in LDLR–/– mice (23.7±5.7 mmol/L, p<0.0001 vs LDLR–/– ND and WT mice. Treatment with NCX 6550 (48 mg/kg), but not with equimolar pravastatin, reduced cholesterol in LDLR–/–HFD. Platelet adhesion to collagen under high shear rate (3000 sec–1) was significantly higher in LDLR–/– than in normal mice, and further enhanced in LDLR–/–HFD (-27%, p<0.0001 vs untreated). NCX 6550 (48 mg/kg), but not pravastatin, reduced platelet adhesion, especially in LDLR–/–HFD. U46619-induced platelet aggregation ex vivo was also inhibited by NCX 6550 (48 mg/kg) but not by the parent compound. Finally, photochemically-induced acute (1 hr) femoral artery thrombosis and delayed (21 days) intimal thickening was assessed. Thrombus size was larger in LDLR–/– on HFD than in normocholesterolemic mice (0.46±0.04 vs 0.18±0.08 mg) and it was reduced by NCX 6550 (48 mg/kg) (0.08±0.02 mg, p<0.0001), but not by pravastatin (0.4±0.01 mg p=NS). Intimal thickening was greater in hypercholesterolemic than in normal mice (I/M normal=0.53±0.16, LDLR–/–=1.1±0.15, LDLR–/–HFD=1.75 ±0.25). Both NCX 6550 and pravastatin reduced intimal thickening in normal (-95% and -74.5%, respectively) and LDLR–/– mice (-98% and -91%), while in strongly hyperlipidemic animals (LDLR–/–HFD) NCX 6550 was more effective than pravastatin (-98% vs -65%, p<0.0001). NCX 6550 shows greater antithrombotic and antiatherogenic activity than pravastatin in highly hypercholesterolemic mice.
本研究的目的是比较硝酸普伐他汀衍生物硝基普伐他汀NCX-6550与普伐他汀对高胆固醇血症小鼠的降脂、抗血栓和抗动脉粥样硬化的作用。与野生型(WT)小鼠相比,正常饮食(ND)的LDL受体缺陷小鼠(LDLR - / -)的胆固醇水平升高(分别为6.8±1.2 mmol/L和2.8±0.82 mmol/L)。高脂饮食(HFD)诱导LDLR - / -小鼠胆固醇血症显著升高(23.7±5.7 mmol/L,与LDLR - / - ND和WT小鼠相比p<0.0001)。ncx6550 (48 mg/kg)治疗,而不是等莫量普伐他汀治疗,降低了LDLR - / - hfd患者的胆固醇。在高剪切速率(3000秒- 1)下,LDLR - / -组血小板与胶原的粘附性显著高于正常小鼠,LDLR - / - hfd组血小板与胶原的粘附性进一步增强(-27%,p<0.0001)。ncx6550 (48 mg/kg),而不是普伐他汀,降低血小板粘附,特别是LDLR - / - hfd。ncx6550 (48 mg/kg)对u46619诱导的体外血小板聚集也有抑制作用,但母体化合物对u46619无抑制作用。最后,评估光化学诱导的急性(1小时)股动脉血栓形成和延迟(21天)内膜增厚。HFD组LDLR - / -的血栓大小大于正常胆固醇血症小鼠(0.46±0.04 mg vs 0.18±0.08 mg), NCX 6550 (48 mg/kg)(0.08±0.02 mg, p<0.0001)可减少血栓大小,但普伐他汀(0.4±0.01 mg p=NS)不能减少血栓大小。高胆固醇血症小鼠的内膜增厚大于正常小鼠(I/M正常=0.53±0.16,LDLR - / - =1.1±0.15,LDLR - / - hfd =1.75±0.25)。NCX 6550和普伐他汀在正常小鼠(分别为-95%和-74.5%)和LDLR - / -小鼠(分别为-98%和-91%)中减少内膜增厚,而在强烈高脂血症动物(LDLR - / - hfd)中,NCX 6550比普伐他汀更有效(-98%对-65%,p<0.0001)。ncx6550在高胆固醇血症小鼠中表现出比普伐他汀更强的抗血栓和抗动脉粥样硬化活性。
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引用次数: 0
Comparison among three different bleeding scores and the thrombin generation assay to assess the different hemorrhagic phenotypes in patients with FVII deficiency 比较三种不同的出血评分和凝血酶生成测定来评估FVII缺乏患者不同的出血表型
Pub Date : 2022-05-23 DOI: 10.4081/btvb.2022.12
S. Pasca, C. Santoro, C. Ambaglio, M. Napolitano, M. Milan, Letizia Natali, S. Nannizzi, F. Mori, P. Simioni, E. Zanon
Defining the bleeding risk in patients with FVII-deficiency is not easy. Aim of this study is to define correlation and differences between three different scores and the thrombin generation assay (TGA) in correctly evaluating the hemorrhagic phenotype in a group of FVII-deficient patients. Fifty-seven patients patients with FVII-deficiency whose hemorrhagic phenotype was assessed by Mariani, ISTH/SSC- Bleeding Assessment Tool (BAT) and Di Minno scores, and by the TGA, were enrolled in this study. TGA parameters (LagTime, Peak, ttPeak, ETP - endogenous thrombin potential) highlighted how both LagTime and ttPeak can discriminate major bleeders from the others, while the same conclusion could not be reached by the ETP and Peak. However, no TGA parameter was found to be useful in separating the mild hemorrhagic phenotype from the moderate one. Scores and TGA were found to be able to only define the severe hemorrhagic phenotypes. None of the methods was able to exactly discriminate the other phenotypes. Given these results, there is therefore a risk of either underestimating or overestimating the potential bleeding risk in patients with non-severe FVII-deficiency.
确定fvii缺乏患者的出血风险并不容易。本研究的目的是确定三种不同评分与凝血酶生成测定(TGA)在正确评估一组fvii缺陷患者出血表型方面的相关性和差异。57例fvii缺乏症患者采用Mariani、ISTH/SSC-出血评估工具(BAT)和Di Minno评分以及TGA进行出血表型评估。TGA参数(LagTime, Peak, ttPeak, ETP -内源性凝血酶电位)强调了LagTime和ttPeak如何区分大出血患者,而ETP和Peak无法得出相同的结论。然而,没有发现TGA参数可用于区分轻度出血表型和中度出血表型。发现评分和TGA只能定义严重出血表型。没有一种方法能够准确地区分其他表型。鉴于这些结果,因此存在低估或高估非严重fvii缺乏症患者潜在出血风险的风险。
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引用次数: 0
Treatment of venous thromboembolism in pregnancy: findings from the RIETE Registry 妊娠期静脉血栓栓塞的治疗:来自RIETE登记处的发现
Pub Date : 2022-05-23 DOI: 10.4081/btvb.2022.28
P. Prandoni, F. Bilora, R. Pesavento, Giorgina Salgueiro, Á. Blanco‐Molina, R. Lopez-reyes, M. Monreal, And the RIETE Investigators
Venous thromboembolism (VTE) is one of the leading cardiovascular etiologies of maternal morbidity and mortality. Indeed, pulmonary embolism (PE) accounts for approximately 9% of pregnancy-related deaths. In addition, pregnancy-related deep-vein thrombosis (DVT) can lead to (severe) post-thrombotic syndrome [...]
静脉血栓栓塞(VTE)是产妇发病率和死亡率的主要心血管病因之一。事实上,肺栓塞(PE)约占妊娠相关死亡的9%。此外,与妊娠相关的深静脉血栓形成(DVT)可导致(严重的)血栓后综合征[…]
{"title":"Treatment of venous thromboembolism in pregnancy: findings from the RIETE Registry","authors":"P. Prandoni, F. Bilora, R. Pesavento, Giorgina Salgueiro, Á. Blanco‐Molina, R. Lopez-reyes, M. Monreal, And the RIETE Investigators","doi":"10.4081/btvb.2022.28","DOIUrl":"https://doi.org/10.4081/btvb.2022.28","url":null,"abstract":"Venous thromboembolism (VTE) is one of the leading cardiovascular etiologies of maternal morbidity and mortality. Indeed, pulmonary embolism (PE) accounts for approximately 9% of pregnancy-related deaths. In addition, pregnancy-related deep-vein thrombosis (DVT) can lead to (severe) post-thrombotic syndrome [...]","PeriodicalId":186928,"journal":{"name":"Bleeding, Thrombosis, and Vascular Biology","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123228101","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}
引用次数: 0
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Bleeding, Thrombosis, and Vascular Biology
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