Research and Practice in Thrombosis and Haemostasis最新文献

{"title":"Response to: “DOACs for Left Ventricular Thrombus: Persistent Equipoise Despite New Observational and Randomized Data”","authors":"Hossam Elbenawi , Kirsten Lipps , Samuel Heller Jr. , David A. Liedl , Raymond C. Shields , Ana I. Casanegra , Stanislav Henkin , Thom W. Rooke , Paul W. Wennberg , Waldemar E. Wysokinski , Robert D. McBane , Damon E. Houghton","doi":"10.1016/j.rpth.2025.103340","DOIUrl":"10.1016/j.rpth.2025.103340","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103340"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing survival with vitamin K antagonists, low-molecular-weight heparin, and direct oral anticoagulants in patients with cancer—a systematic review and meta-analysis","authors":"Vasiliki Xirou ,&nbsp;Anika Patel ,&nbsp;Maria Fernanda Albuja Altamirano ,&nbsp;Rishabh Singh ,&nbsp;Jason Gusdorf ,&nbsp;Kevin Barnum ,&nbsp;Megan McNichol ,&nbsp;Justine Ryu ,&nbsp;Jeffrey I. Zwicker ,&nbsp;Thita Chiasakul ,&nbsp;Rushad Patell","doi":"10.1016/j.rpth.2025.103268","DOIUrl":"10.1016/j.rpth.2025.103268","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) is a frequent complication in malignancy. Low-molecular-weight heparins and direct oral anticoagulants have replaced vitamin K antagonists (VKAs) as the standard of care for cancer-associated VTE. Nonetheless, clinical trials have not established a survival benefit of these agents compared with VKA.</div></div><div><h3>Objectives</h3><div>We conducted a systematic review and meta-analysis to compare survival in cancer patients receiving VKA vs other anticoagulants.</div></div><div><h3>Methods</h3><div>We searched Embase, Web of Science, PubMed, <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, and Cochrane from inception until April 10, 2025, focusing on the use of VKA and non-VKA in cancer patients. Primary outcome was mortality and secondary outcomes included thromboembolism and bleeding.</div></div><div><h3>Results</h3><div>Of 11,198 studies screened, 14 studies (70,025 patients) were included. VKA were associated with lower mortality than non-VKA in observational studies (odds ratio [OR], 0.84; 95% CI, 0.78-0.91; <em>I</em>² = 81%; <em>n</em> = 6 studies) but not in randomized controlled trials (OR, 0.99; 95% CI, 0.86-1.13; <em>I</em>² = 0%; <em>n</em> = 8 studies). In subgroup analysis, follow-up period of &gt;6 months (OR, 0.85; 95% CI, 0.79-0.92; <em>I</em>² = 75%), solid malignancies (OR, 0.81; 95% CI, 0.75-0.88; <em>I</em>² = 78%), and indication of VTE only (OR, 0.89; 95% CI, 0.83-0.96; <em>I</em>² = 42%) demonstrated improved survival with VKA.</div></div><div><h3>Conclusion</h3><div>The use of VKA was associated with lower mortality than non-VKA anticoagulation in patients with cancer in observational studies but not in randomized trials. The analysis was limited by high heterogeneity, which must be considered when interpreting results.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103268"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring ADAMTS-13 conformation in immune-mediated thrombotic thrombocytopenic purpura: toward personalized management","authors":"Bérangère S. Joly ,&nbsp;Elien Roose ,&nbsp;Charlotte Dekimpe ,&nbsp;Karen Vanhoorelbeke ,&nbsp;Agnès Veyradier ,&nbsp;Paul Coppo","doi":"10.1016/j.rpth.2025.103288","DOIUrl":"10.1016/j.rpth.2025.103288","url":null,"abstract":"<div><h3>Background</h3><div>Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a life-threatening thrombotic microangiopathy caused by an autoimmune-driven deficiency of ADAMTS-13. Despite remission, relapses remain a major concern for patients and are currently predicted by monitoring ADAMTS-13 activity.</div></div><div><h3>Objectives</h3><div>This study evaluated the association between ADAMTS-13 conformation and relapse risk in patients with iTTP during follow-up.</div></div><div><h3>Methods</h3><div>We conducted a retrospective monocentric study involving patients with iTTP with ADAMTS-13 monitoring from 2008 to 2020. ADAMTS-13 antigen and conformation were assessed in plasma samples using our 3H9-ELISA and 1C4-ELISA, respectively.</div></div><div><h3>Results</h3><div>Fifteen patients with iTTP were monitored for a median of 7 years (IQR, 6-11) with a total of 479 plasma samples. Based on annual relapse rate (RR; median, 0.5), they were categorized as low (group 1; RR, &lt;0.50, <em>n</em> = 8) or high relapsers (group 2; RR, ≥0.50, <em>n</em> = 7). ADAMTS-13 activity normalized between iTTP relapses in all patients. However, the time from normalization with an open conformation to relapse was shorter in group 2 (5 vs 21 months; <em>P</em> &lt; .001). Median annual ADAMTS-13 activity differ significantly between groups (54.1% vs 50.0%; <em>P</em> = .1893). A trend suggested greater time spent in an open conformation in group 2 (0.6 vs 0.2; <em>P</em> = .1427). Rituximab was effective in group 1, while group 2 patients often required alternative therapies.</div></div><div><h3>Conclusion</h3><div>Persistent open ADAMTS-13 conformation in remission samples was observed more frequently in patients with higher relapse risk and could potentially serve as a biomarker for detecting low levels of circulating autoantibodies. This potential biomarker requires prospective validation before it can be used to guide individualized iTTP management.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103288"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine-based point-of-care detection of direct oral anticoagulant activity in acute stroke—accuracy at anti-Xa thresholds relevant for intravenous thrombolysis","authors":"Stefan T. Gerner ,&nbsp;Alina Braemer ,&nbsp;Martin B. Juenemann ,&nbsp;Anne Mrochen ,&nbsp;Tobias Braun ,&nbsp;Linus Olbricht ,&nbsp;Norma J. Diel ,&nbsp;Ulrich J. Sachs ,&nbsp;Hagen B. Huttner ,&nbsp;Omar Alhaj Omar","doi":"10.1016/j.rpth.2025.103331","DOIUrl":"10.1016/j.rpth.2025.103331","url":null,"abstract":"<div><h3>Background</h3><div>Rapid assessment of direct oral anticoagulant (DOAC) activity is essential in acute ischemic stroke (AIS), particularly because intravenous thrombolysis (IVT) may be considered at anti-Xa levels ≤ 100 ng/mL. Laboratory drug-specific assays; however, are often limited by availability and turnaround time. A urine-based point-of-care (POC) test may provide a rapid alternative.</div></div><div><h3>Objectives</h3><div>To determine the diagnostic accuracy of a urine-based POC dipstick for detecting clinically relevant DOAC activity at (1) the established screening threshold (≥30 ng/mL) and (2) the IVT-relevant threshold (≥100 ng/mL), using calibrated plasma DOAC levels as a reference standard.</div></div><div><h3>Methods</h3><div>In this prospective diagnostic accuracy study (UPTURN trial), consecutive AIS patients underwent urine-based POC testing. Dipstick results, recorded as visual and automatic readouts, were analyzed against plasma DOAC activity. Relevant anticoagulant activity was defined as anti-Xa ≥30 ng/mL; the IVT eligibility threshold was defined as anti-Xa &lt;100 ng/mL. Factor Xa inhibitors were quantified using drug-specific chromogenic anti-Xa assays; dabigatran activity was measured using Biophen DTI. Diagnostic accuracy metrics were calculated with exact 95% CIs. Time-to-result was compared between POC testing and plasma assays.</div></div><div><h3>Results</h3><div>Among 101 AIS patients (55 with DOAC intake), the urine-based dipstick test reliably identified relevant anticoagulatory activity (anti-Xa ≥30 ng/mL) with a sensitivity of 100% and specificity of 96.3% (automated readout). Visual interpretation yielded similar accuracy. For higher anti-Xa levels (≥100 ng/mL), sensitivity remained 100%, though specificity decreased (74.4%). A double-positive visual result increased specificity to 92.8% at 84.4% sensitivity. Median time to result was 19 minutes for urine testing versus 144 minutes for blood-based assays. Test performance was consistent across DOAC agents, dosages, and intake timing. Visual grading enabled semiquantitative discrimination of DOAC levels.</div></div><div><h3>Conclusion</h3><div>Urine-based DOAC dipstick testing is a rapid, accurate, and reliable method for detecting anticoagulatory activity in AIS patients, providing a valuable tool to guide acute therapeutic decisions. Future studies are warranted to validate its clinical impact and broader applicability, especially in the emergency setting.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103331"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet lipidome alterations in septic shock: a matched case-control study","authors":"Emma de Cartier d’Yves ,&nbsp;Melanie Dechamps ,&nbsp;Jérôme Ambroise ,&nbsp;Anik Forest ,&nbsp;Caroline Daneault ,&nbsp;Alessandro Campion ,&nbsp;Valentine Robaux ,&nbsp;Julien De Poortere ,&nbsp;Marie Octave ,&nbsp;Audrey Ginion ,&nbsp;Laurence Pirotton ,&nbsp;Gabriele Muscia ,&nbsp;Claudia Tersteeg ,&nbsp;Damien Gruson ,&nbsp;Marie-Astrid Van Dievoet ,&nbsp;Jonathan Douxfils ,&nbsp;Hélène Haguet ,&nbsp;Laure Morimont ,&nbsp;Marc Derive ,&nbsp;Virginie Montiel ,&nbsp;Christophe Beauloye","doi":"10.1016/j.rpth.2025.103332","DOIUrl":"10.1016/j.rpth.2025.103332","url":null,"abstract":"<div><h3>Background</h3><div>Platelets play a central role in hemostatic and inflammatory responses during septic shock, with lipids being essential for their function. However, the specific lipidomic alterations occurring in platelets during septic shock remain poorly understood.</div></div><div><h3>Objectives</h3><div>This study aimed to characterize platelet lipidomic changes in septic shock and investigate their associations with disease severity.</div></div><div><h3>Methods</h3><div>In this matched case-control study, platelets were isolated from 49 septic shock patients and 47 nonseptic controls (matched for age, gender, and comorbidities). Lipidomic profiling was performed using untargeted lipidomics to identify significant alterations in the platelet lipidome. Associations among lipid changes, clinical data, and plasma biomarkers of coagulopathy and inflammation were explored.</div></div><div><h3>Results</h3><div>More than 60% of the annotated platelet lipids were significantly altered in septic shock. Cholesteryl esters, sphingomyelins, lysophosphatidylcholines, and ether-lipids were significantly reduced, while ceramide levels increased. Fatty acyl chain remodeling displayed distinct patterns, with polyunsaturated fatty acids increasing in triacylglycerols and decreasing in phospholipids. Lipid alterations were strongly associated with thrombocytopenia, and lysophosphatidylcholine levels inversely correlated with disease severity, as indicated by the Sequential Organ Failure Assessment score.</div></div><div><h3>Conclusions</h3><div>Septic shock induces significant disruptions in the platelet lipidome, with the extent of these alterations correlating with sepsis-associated thrombocytopenia severity. The observed changes affect multiple lipid classes, surpassing those reported under physiological conditions or in other diseases. These findings highlight the impact of sepsis-driven dysregulated inflammation and coagulopathy on platelet lipid composition, providing new insights into sepsis pathophysiology.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103332"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etranacogene dezaparvovec in people with hemophilia B and without adeno-associated virus serotype 5 neutralizing antibodies: a 4-year subgroup analysis of the Health Outcomes with Padua Gene; Evaluation in Hemophilia B (HOPE-B) trial","authors":"Priyanka Raheja ,&nbsp;Niamh O’Connell ,&nbsp;Peter Verhamme ,&nbsp;Peter Kampmann ,&nbsp;Richard S. Lemons ,&nbsp;Fei Wang ,&nbsp;Sean Gill ,&nbsp;Paul E. Monahan ,&nbsp;Sandra Le Quellec ,&nbsp;Frank W.G. Leebeek","doi":"10.1016/j.rpth.2025.103321","DOIUrl":"10.1016/j.rpth.2025.103321","url":null,"abstract":"<div><h3>Background</h3><div>In the phase 3 Health Outcomes with Padua Gene; Evaluation in Hemophilia B (HOPE-B) trial, a single dose of etranacogene dezaparvovec was administered to people with severe or moderately severe hemophilia B following a lead-in period (≥6 months) during which they received factor (F)IX prophylaxis. Participants were enrolled regardless of adeno-associated virus serotype 5 (AAV5)-neutralizing antibody (NAb) status at screening.</div></div><div><h3>Objectives</h3><div>To determine efficacy, pharmacokinetic, and safety outcomes over 4 years postgene therapy in HOPE-B participants who were NAb-negative (NAb−).</div></div><div><h3>Methods</h3><div>Participants provided serum samples for AAV5 NAb determination using an <em>in vitro</em> AAV5 transduction inhibition assay prior to etranacogene dezaparvovec infusion. Participants who were AAV5 NAb− at this time point were examined in the post hoc subgroup analysis.</div></div><div><h3>Results</h3><div>In NAb− participants (<em>N</em> = 33), the mean adjusted annualized bleeding rate was significantly reduced between months 7 and 48 postetranacogene dezaparvovec vs lead-in (0.57 vs 3.80; <em>P</em> &lt; .0001). In years 1 to 4, the annualized bleeding rates were 0.99, 0.72, 0.41, and 0.41, respectively (<em>P</em> &lt; .0001 vs lead-in; <em>N</em> = 33 throughout). The mean (SD) endogenous FIX activity was 40.6 IU/dL (18.6) at month 6 postinfusion (<em>N</em> = 33), remained stable, and was 39.0 IU/dL (16.8) at year 4 (<em>N</em> = 33). Exogenous FIX consumption decreased by 99% during months 7 to 48 vs the lead-in period, and no NAb− participant returned to continuous FIX prophylaxis for 4 years postinfusion. No treatment-related oncogenic events or persistent late hepatotoxicity were observed.</div></div><div><h3>Conclusion</h3><div>Etranacogene dezaparvovec proved to be highly effective, superior to FIX prophylaxis for bleeding protection, and safe for 4 years postinfusion in NAb− persons with severe or moderately severe hemophilia B.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103321"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mutations of six amino acid residues in a B domain-deleted blood coagulation factor VIII have a cumulative effect on increasing its secretion","authors":"Bo Shi ,&nbsp;Philip Olivares ,&nbsp;Leonid A. Parunov ,&nbsp;Yideng Liang ,&nbsp;Haarin Chun ,&nbsp;Wells W. Wu ,&nbsp;Vijaya L. Simhadri ,&nbsp;Pratima Bajgain ,&nbsp;Wojciech Jankowski ,&nbsp;Margarita Krivega ,&nbsp;Julia Poniatowski ,&nbsp;Elizabeth Del Greco ,&nbsp;Ivan Krivega ,&nbsp;Svetlana A. Shestopal ,&nbsp;Abu Hasanat Md Zulfiker ,&nbsp;Zuben E. Sauna ,&nbsp;Andrey G. Sarafanov","doi":"10.1016/j.rpth.2025.103325","DOIUrl":"10.1016/j.rpth.2025.103325","url":null,"abstract":"<div><h3>Background</h3><div>High levels of factor VIII (FVIII) expression are needed for various applications to treat Hemophilia A. Besides deletion of the B-domain (BDD) and codon-optimization, F309S mutation, and other 5 mutations (X5) in FVIII were previously described to increase its expression.</div></div><div><h3>Objectives</h3><div>To investigate whether combining the 6 aforementioned mutations (X6) results in a further increase of FVIII expression.</div></div><div><h3>Methods</h3><div>The 5 (X5) and 6 (X6) mutations were introduced into a BDD-FVIII (wild-type [WT]), and proteins were expressed in cell cultures with different transgene copy numbers, purified, and tested for specific activity, binding to von Willebrand factor and a low-density lipoprotein receptor-related protein fragment, tyrosine sulfation levels and immunogenicity in silico and in human T-cell culture. The 6 mutations were also reproduced in full-length FVIII (FL-FVIII) and tested for secretion levels.</div></div><div><h3>Results</h3><div>From the single-copy transgene cell lines, secretion levels of X5 and X6 increased 1.6-fold and 2.3-fold, respectively, compared with WT. These levels increased proportionally with increasing transgene copy number, approaching saturation. The specific activity, binding to von Willebrand factor and lipoprotein receptor-related protein fragment, and assessments of immunogenicity of X6 in model systems were similar to WT, while tyrosine sulfation levels, were moderately lower at the highest gene dose. However, the 6 mutations reproduced in FL-FVIII did not result in increased secretion.</div></div><div><h3>Conclusion</h3><div>Combining the 6 mutations in BDD-FVIII improved its expression and did not affect general protein properties, making it promising for future product development. The data also indicate that BDD-FVIII and FL-FVIII have different expression mechanisms.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103325"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life and mental health in autoimmune thrombotic thrombocytopenic purpura patients in the caplacizumab era","authors":"Julia Weisinger ,&nbsp;Christina Tites ,&nbsp;Laurent Gilardin ,&nbsp;Aki Baba ,&nbsp;Ygal Benhamou ,&nbsp;Elie Azoulay ,&nbsp;Jean-Francois Augusto ,&nbsp;Thomas Papo ,&nbsp;Claire Cartery ,&nbsp;Olivier Moranne ,&nbsp;Gabriel Choukroun ,&nbsp;Loïc Lièvre ,&nbsp;Jehane Fadlallah ,&nbsp;Pascale Poullin ,&nbsp;Arnaud Jaccard ,&nbsp;Claire Presne ,&nbsp;Bérangère Joly ,&nbsp;Agnès Veyradier ,&nbsp;Raida Bouzid ,&nbsp;Paul Coppo","doi":"10.1016/j.rpth.2025.103297","DOIUrl":"10.1016/j.rpth.2025.103297","url":null,"abstract":"<div><h3>Background</h3><div>Despite improvement in acute care of immune-mediated thrombotic thrombocytopenic purpura (iTTP), numerous studies showed that patients with iTTP have inferior mental health and health-related quality of life (HRQoL). Caplacizumab led to shorter hospitalization, less plasma exchange, and improved survival in iTTP and might influence long-term HRQoL.</div></div><div><h3>Objectives</h3><div>We aimed to address the impact of iTTP on HRQoL, posttraumatic stress disease, depression, and anxiety, as well as the possible role of caplacizumab on improving these features.</div></div><div><h3>Methods</h3><div>We conducted a survey among patients with iTTP enrolled in the French thrombotic microangiopathy registry: patients completed the Short Form (SF)-36 HRQoL, the Hospital Anxiety and Depression Scale screening for anxiety and depression, and the Posttraumatic Stress Disorder Checklist for DSM-IV posttraumatic stress disease questionnaires. Results were compared to those of a sample of the French general population.</div></div><div><h3>Results</h3><div>A total of 101 patients with iTTP in remission (45 patients previously treated with caplacizumab and 56 patients without caplacizumab) and 76 healthy controls were included. Patients with iTTP had significantly lower scores in all domains in the SF-36 survey and higher anxiety and depression scores than healthy controls. Advanced age was associated with improved SF-36 scores, lower anxiety scores and less severe anxiety cases. Furthermore, the use of caplacizumab led to a lower risk of severe anxiety.</div></div><div><h3>Conclusion</h3><div>Based on our results, HRQoL is decreased in patients with iTTP, and depression and anxiety are more prevalent. Caplacizumab treatment might influence long-term mental and psychological outcomes in iTTP by shortening the duration of treatment with plasma exchange.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103297"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and complications in low-dose vs standard-dose unfractionated heparin anticoagulation for extracorporeal membrane oxygenation: a systematic review and meta-analysis","authors":"Wincy Wing-Sze Ng ,&nbsp;Rex Wan-Hin Hui ,&nbsp;Ka-Chun Leung ,&nbsp;Pauline Yeung Ng ,&nbsp;Chun-Wai Ngai ,&nbsp;Simon Wai-Ching Sin ,&nbsp;Chun-Fung Sin","doi":"10.1016/j.rpth.2025.102732","DOIUrl":"10.1016/j.rpth.2025.102732","url":null,"abstract":"<div><h3>Background</h3><div>Controversies exist in anticoagulation practices in extracorporeal membrane oxygenation (ECMO). It is uncertain whether the intensity of anticoagulation affects ECMO outcomes.</div></div><div><h3>Objectives</h3><div>To conduct a meta-analysis to determine whether anticoagulation intensity affects ECMO outcomes.</div></div><div><h3>Methods</h3><div>The Medical Literature Analysis and Retrieval System Online, Embase, and Central Register of Controlled Trials’ databases were searched from inception to October 2024 for trials comparing the use of low-dose (LD) and standard-dose unfractionated heparin anticoagulation in patients on ECMO. The primary outcome was short-term mortality. Secondary outcomes included major bleeding events, intracranial hemorrhage (ICH), oxygenator changes, systemic thrombotic events, and ECMO duration. Data were pooled using a random-effects meta-analysis. The risk-of-bias was assessed using the Cochrane Risk-of-Bias 2 tool for randomized controlled trials and the Risk-of-Bias in Non-Randomized Studies of Interventions for nonrandomized controlled trials.</div></div><div><h3>Results</h3><div>Seven studies with 619 patients were included. LD anticoagulation was associated with significant reduction in the relative risk (RR) of mortality compared to standard-dose anticoagulation (RR, 0.69; 95% CI, 0.52-0.91; <em>I</em>² = 38%). Patients receiving LD anticoagulation had significantly lower risk of ICH (RR, 0.29; 95% CI, 0.13-0.63, <em>I</em>² = 0%), while the risk of major bleeding events was not significantly different between groups (RR, 0.78; 95% CI, 0.51-1.21; <em>I</em>² = 55%). LD anticoagulation did not significantly increase the risk of oxygenator changes (RR, 1.54; 95% CI, 0.94-2.53; <em>I</em>² = 42%) or systemic thrombotic events (RR, 1.27; 95% CI, 0.88-1.84; <em>I</em>² = 0%).</div></div><div><h3>Conclusion</h3><div>This meta-analysis suggests that LD unfractionated heparin anticoagulation is associated with significantly better survival and a lower risk of ICH without an increase in the risk of thrombotic events. LD anticoagulation should be considered a reasonable strategy in ECMO.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 102732"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“DOACs for Left Ventricular Thrombus: Persistent Equipoise Despite New Observational and Randomized Data”: comment","authors":"Artur Dziewierz ,&nbsp;Piotr Jarosz ,&nbsp;Tomasz Rakowski","doi":"10.1016/j.rpth.2025.103339","DOIUrl":"10.1016/j.rpth.2025.103339","url":null,"abstract":"","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"10 1","pages":"Article 103339"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}