Research and Practice in Thrombosis and Haemostasis最新文献

英文中文

Health literacy in pediatric thrombosis: a landscape analysis 儿童血栓形成的健康素养：景观分析。

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2024.102653

Denise Bastas , Athena Mancini , Gina Wong , Leonardo R. Brandão , Sindi Mukaj , Jennifer Vincelli , Diandra Rollan , Laura Avila

Background

Health literacy can influence self-management, leading to improved health outcomes in pediatric patients with venous thrombotic events (VTEs).

Objectives

To assess general health literacy in adolescents and parents/caregivers of children diagnosed with VTE, and their perception and satisfaction with overall thrombosis-related knowledge, thrombosis knowledge compared to that of other conditions, and beliefs regarding thrombosis knowledge importance.

Methods

Patients aged 10 to 18 years with VTE history and parents/caregivers of patients aged 0 to 18 years with VTE attending clinic were recruited in this cross-sectional study. Health literacy was measured using the Rapid Estimate of Literacy in Medicine Short Forms (Adolescent and Adult), the Health Literacy Assessment Scale for Adolescents, and the e-Health Literacy Scale. Self-reported perception, satisfaction, comparative knowledge, and beliefs regarding thrombosis knowledge were assessed using researcher-generated questions.

Results

In total, 101 participants (50 adolescents, 51 parents/caregivers) were recruited at a median of 27 months (25th-75th percentile; 12-62 months) post-VTE diagnosis. Overall, 74% of adolescents and 59% of parents/caregivers had ≥1 measure indicating low general health literacy. Only half the participants thought their thrombosis knowledge was similar to that of other diseases. Satisfaction with thrombosis-related knowledge was 44%; 96% agreed that learning about thrombosis was important. Adolescents reported higher satisfaction with their knowledge than parents/caregivers, but satisfaction was not associated with demonstrated thrombosis knowledge.

Conclusion

Most participants had low general health literacy levels, and more than half were not satisfied with their thrombosis-related knowledge. Adolescents tended to overestimate their knowledge. Effective strategies to support health literacy in this population are needed.

背景：健康素养可以影响自我管理，从而改善患有静脉血栓事件（vte）的儿科患者的健康结果。目的：评估诊断为静脉血栓栓塞儿童的青少年和父母/照顾者的一般健康素养，以及他们对血栓形成相关知识的总体认知和满意度，血栓形成知识与其他疾病的比较，以及血栓形成知识重要性的信念。方法：本横断面研究招募10 ~ 18岁静脉血栓栓塞病史患者及0 ~ 18岁静脉血栓栓塞就诊患者的家长/照顾者。健康素养的测量使用医学简表（青少年和成人）、青少年健康素养评估量表和电子健康素养量表。自我报告的感知、满意度、比较知识和关于血栓形成知识的信念使用研究者生成的问题进行评估。结果：共招募了101名参与者（50名青少年，51名父母/照顾者），中位数为27个月(25 -75个百分点；静脉血栓栓塞诊断后12-62个月)。总体而言，74%的青少年和59%的父母/照顾者的测量值≥1，表明一般健康素养较低。只有一半的参与者认为他们对血栓形成的了解与对其他疾病的了解相似。对血栓相关知识的满意度为44%；96%的人认为了解血栓形成很重要。青少年报告对他们的知识的满意度高于父母/照顾者，但满意度与血栓形成的知识无关。结论：大多数参与者一般健康素养水平较低，超过一半的人对血栓相关知识不满意。青少年往往高估自己的知识。需要有效的战略来支持这一人群的卫生知识普及。

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引用次数: 0

Plasma microRNA-145-5p as a diagnostic biomarker for acute deep vein thrombosis

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2024.102671

Christopher Antoun , Vårin Eiriksdatter Wikan , Øyvind Øverli , Thor Ueland , Gholamreza Jafari Yeganeh , Sigrid Kufaas Brækkan , Ellen Brodin , John-Bjarne Hansen

Background

Identification of new biomarkers for acute deep vein thrombosis (DVT) that could lower the need for diagnostic imaging to confirm or rule out the diagnosis would be advantageous. microRNA-145-5p (miR-145) has the potential to be a diagnostic marker for acute DVT, but its diagnostic performance has not been evaluated in consecutive patients referred to the hospital with suspected DVT.

Objectives

The aim of this study was to assess the diagnostic performance of miR-145 for the diagnosis of acute lower extremity DVT.

Methods

Patients consecutively referred to the emergency room at Akershus University Hospital (Norway) due to suspicion of acute DVT between June 2021 and July 2023 were included. Within 24 hours of admission, blood was collected for assessment of plasma miR-145 (index test), and whole-leg compression ultrasound (reference standard) was used to confirm or rule out DVT. Cohen’s d effect size and area under the receiver operating curve (AUC) were used to estimate the diagnostic performance of miR-145 and D-dimer.

Results

Among 360 included patients, 101 (28%) were diagnosed with DVT. miR-145 showed poor diagnostic performance, as indicated by a Cohen’s d of −0.002 (95% CI, −0.241 to 0.216) and an AUC of 0.59 (95% CI, 0.51-0.67). For D-dimer, Cohen’s d was 1.66 (95% CI, 1.43-1.89), and the AUC was 0.92 (95% CI, 0.86-0.96).

Conclusion

Plasma levels of miR-145 showed poor diagnostic performance for lower extremity acute DVT among persons referred to the emergency room with clinical signs and symptoms of DVT.

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引用次数: 0

Thromboprophylaxis in multiple myeloma

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2025.102685

Laurent Frenzel

引用次数: 0

Beyond platelet activation: dysregulated lipid metabolism in defining risk and pathophysiology of VITT

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2025.102677

Hannah Stevens , James D. McFadyen , Natalie A. Mellett , David J. Lynn , Thy Duong , Corey Giles , Jane James , Rochelle Botten , Georgina Eden , Miriam Lynn , Paul Monagle , Peter J. Meikle , Sanjeev Chunilal , Karlheinz Peter , Huyen Tran

Background

VITT has emerged as a rare but serious adverse event linked primarily to adenoviral vector COVID-19 vaccinations, such as ChAdOx1-S (Oxford/AstraZeneca) vaccination. The syndrome is characterized by thrombosis with thrombocytopenia, elevated D-dimer, and pathologic platelet factor 4 antibodies within 42 days of vaccination.

Objectives

Despite dysregulated lipid metabolism underpinning many thrombotic conditions, the role of lipid alterations in VITT remains unexplored. Here, we examined the plasma lipidome of patients with VITT and compared it with those following ChAdOx1-S vaccination and with unprovoked venous thromboembolism (VTE) to understand the role of lipids in VITT pathophysiology.

Methods

This was a multicenter, prospective cohort study evaluating plasma lipidomics in newly diagnosed VITT samples, which were compared with both healthy controls following ChAdOx1-S vaccination and with unprovoked VTE.

Results

Comparison with ChAdOx1-S controls reveals a distinct lipid signature in VITT, characterized by elevations in phosphatidylserine and ceramide species, alongside reductions in several plasmalogens and acylcarnitine species. Notably, similarities between VITT lipid profiles and insulin resistance phenotypes suggest potential metabolic susceptibility. While few significant associations were found between VITT and VTE, an inverse correlation with several acylcarnitine species was demonstrated. Given the known anticoagulant role of acylcarnitine species, these findings suggest a plausible mechanistic pathway elevating the thrombotic potential of VITT above that of standard VTE.

Conclusion

These findings underscore the important role of lipid metabolism in VITT pathophysiology and highlight the complex interplay between lipids, coagulation, and pathologic thrombosis.

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引用次数: 0

Should a history of venous thromboembolism be considered a contraindication for scuba diving? 静脉血栓栓塞史是否应视为水肺潜水的禁忌症？

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2024.102647

Mathilde Vannini , Jean-François Schved , David M. Smadja , Viktoria E.M. Jung , Laetitia Mauge , Olivier Sanchez , Nicolas Gendron

The question of whether scuba diving is safe for patients with a history of venous thromboembolism (VTE) remains unanswered. Cases of VTE have been reported after decompression accidents but not following properly conducted dives. However, the risk of VTE and bleeding on anticoagulant therapy during diving has yet to be defined. Medical diving societies make different recommendations regarding the risk of scuba diving in patients with a history of VTE and/or hereditary thrombophilia and regarding the bleeding risk under anticoagulation associated with dives. There is no epidemiologic or pathophysiologic evidence described in the literature to support a direct association between VTE and diving. Therefore, VTE cannot be considered as a definite contraindication for scuba diving. Further studies are needed to conclusively establish the risk of VTE associated with diving and to guide the development of medical guidelines by diving societies.

对于有静脉血栓栓塞（VTE）病史的患者，水肺潜水是否安全的问题仍然没有答案。减压事故后发生静脉血栓栓塞的病例有报道，但不是在正确的潜水后发生的。然而，在潜水期间抗凝治疗静脉血栓栓塞和出血的风险尚未确定。对于有静脉血栓栓塞和/或遗传性血栓形成病史的患者进行水肺潜水的风险，以及与潜水相关的抗凝治疗下的出血风险，医疗潜水协会提出了不同的建议。文献中没有描述流行病学或病理生理学证据来支持静脉血栓栓塞和潜水之间的直接联系。因此，静脉血栓栓塞不能被认为是水肺潜水的明确禁忌症。需要进一步的研究来最终确定与潜水相关的静脉血栓栓塞风险，并指导潜水协会制定医疗指南。

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引用次数: 0

Investigating tissue factor pathway inhibitor and other protease and protease inhibitors and their association with major adverse aortic events in patients with abdominal aortic aneurysm 探讨组织因子途径抑制剂及其他蛋白酶和蛋白酶抑制剂与腹主动脉瘤患者主要不良主动脉事件的关系。

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2024.102645

Hamzah Khan , Abdelrahman Zamzam , Farah Shaikh , Gustavo Saposnik , Muhammad Mamdani , Mohammad Qadura

Background

Abdominal aortic aneurysm (AAA) is characterized by the proteolytic breakdown of the extracellular matrix, leading to dilatation of the aorta and increased risk of rupture. Biomarkers that can predict major adverse aortic events (MAAEs) are needed to risk stratify patients for more rigorous medical treatment and potential earlier surgical intervention.

Objectives

The primary objective was to identify the association between baseline levels of these biomarkers and MAAEs over a period of 5 years.

Methods

Baseline levels of 3 proteases (matrix metalloproteinases 7, 8, and 10) and 3 protease inhibitors (tissue factor pathway inhibitor [TFPI], SerpinA12, SerpinB3) were investigated. Plasma levels of these biomarkers were quantified in 134 patients with AAA and 134 matched controls. Patients were followed for a 5-year period during which MAAEs were documented. The association between these markers and MAAEs was evaluated using Cox regression and Kaplan–Meier survival curves.

Results

TFPI was significantly elevated in patients with AAA and significantly associated with MAAE during the 5-year period (hazard ratio, 1.52; 95% CI, 1.15-2.01; P = .003) after adjusting for covariates. Kaplan–Meier survival analyses demonstrated that patients in the high TFPI group (defined as plasma levels >25.961 ng/mL) had significantly reduced freedom from the need for aortic repair and MAAEs.

Conclusion

These findings suggest that TFPI may serve as a valuable prognostic marker for the risk of MAAEs within 5 years in patients with AAA, potentially offering new tools for the medical management of patients with AAA.

背景：腹主动脉瘤（AAA）的特征是细胞外基质的蛋白水解分解，导致主动脉扩张和破裂的风险增加。需要能够预测主动脉主要不良事件（maae）的生物标志物来对患者进行风险分层，以便进行更严格的药物治疗和潜在的早期手术干预。目的：主要目的是确定5年内这些生物标志物的基线水平与maae之间的关系。方法：检测3种蛋白酶（基质金属蛋白酶7、8、10）和3种蛋白酶抑制剂（组织因子途径抑制剂[TFPI]、SerpinA12、SerpinB3）的基线水平。在134例AAA患者和134例匹配对照中，对这些生物标志物的血浆水平进行了量化。对患者进行为期5年的随访，记录maae。使用Cox回归和Kaplan-Meier生存曲线评估这些标记物与maae之间的相关性。结果：AAA患者的TFPI在5年期间显著升高，且与MAAE显著相关(风险比，1.52；95% ci, 1.15-2.01；P = .003)。Kaplan-Meier生存分析表明，高TFPI组（定义为血浆水平bb0 25.961 ng/mL）的患者无需主动脉修复和maae的自由度显著降低。结论：这些研究结果表明，TFPI可作为AAA患者5年内maae风险的有价值的预后指标，可能为AAA患者的医疗管理提供新的工具。

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引用次数: 0

Prevalence and clinical impact of disseminated intravascular coagulation in acute aortic dissection: a nationwide cohort study

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2024.102656

Shuhei Murao , Yutaka Umemura , Hirotaka Mori , Yoshinobu Seki , Takayuki Ikezoe , Kohji Okamoto , Satoshi Fujimi , Kazuma Yamakawa

Background

Acute aortic dissection is a life-threatening cardiovascular emergency with high mortality rates. Disseminated intravascular coagulation (DIC) is a critical complication in patients with acute aortic dissection; however, its incidence and impact on outcomes remain inconclusive.

Objectives

This study aimed to evaluate DIC prevalence and prognosis in patients with aortic dissection.

Methods

We conducted a multicenter retrospective cohort study using data from the Japan Medical Data Center claims database between 2014 and 2022. DIC was diagnosed based on the criteria of the Japanese Association for Acute Medicine (JAAM-2) and the International Society on Thrombosis and Haemostasis (ISTH). We compared the in-hospital mortality between patients with and without DIC and assessed the impact of coagulopathy using various coagulation profiles.

Results

Among the 3037 patients, 40% underwent surgery and 60% did not undergo surgery. The prevalence rates of JAAM-2 DIC and ISTH DIC were 21% and 9.4%, respectively. In-hospital mortality was significantly higher in the DIC group than in the non-DIC group, and this trend was consistently observed in the surgery and nonsurgery groups. Increased DIC scores correlated with higher in-hospital mortality. With the progression of coagulopathy, characterized by thrombocytopenia, elevated prothrombin time-international normalized ratio, prolonged activated partial thromboplastin time, increased D-dimer, and decreased fibrinogen levels, in-hospital mortality also increased.

Conclusion

The presence of DIC, as identified by both the JAAM-2 and ISTH criteria, was associated with increased in-hospital mortality in patients with acute aortic dissection. Therefore, further studies are needed to improve the clinical outcomes of these patients.

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引用次数: 0

The detrimental impact of ferritin “normal” ranges on diagnosis of bleeding disorders in women

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2024.102674

Michelle Sholzberg , Grace H. Tang

引用次数: 0

Intrinsic pathway activation in patients with antiphospholipid syndrome and healthy controls

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2025.102694

Dagmar J.M. van Mourik , Valérie L.B.I. Jansen , Michiel Coppens , Saskia Middeldorp , Hugo ten Cate , Harry R. Büller , Henri M.H. Spronk , Magdolna Nagy , Thijs E. van Mens

Background

Antiphospholipid syndrome (APS) is a thrombotic autoimmune disease. Activation of the intrinsic coagulation pathway contributes to inflammatory and cardiovascular diseases, but its role in APS is unknown. Increased release of neutrophil extracellular traps and reduced effectiveness of direct oral anticoagulants support the hypothesis of increased intrinsic pathway activation in patients with APS, which is relevant considering the ongoing development and clinical testing of intrinsic pathway inhibitors.

Objectives

To compare in vivo intrinsic pathway activation of patients with APS and healthy controls.

Methods

Patients with APS without recent thrombotic or obstetric events and healthy controls were investigated. ELISAs were used to measure activated coagulation factors in complex with the natural inhibitors antithrombin or C1-esterase inhibitor in plasma. The primary outcome of this study was factor (F)XII activation, which initiates the intrinsic pathway. Secondary outcomes included activation of downstream intrinsic coagulation FXI and FIX.

Results

Plasma of 73 patients with APS and 19 healthy controls showed no significant difference in activated FXII-inhibitor complexes. The concentrations of activated FXI and FIX and inhibitor complexes likewise did not differ between the groups. A subanalysis of patients with APS by anticoagulant use showed no difference for FXII and FXI activation.

Conclusion

Intrinsic pathway activation in patients with APS without recent thrombotic or obstetric events did not differ significantly compared with healthy controls.

{"title":"Intrinsic pathway activation in patients with antiphospholipid syndrome and healthy controls","authors":"Dagmar J.M. van Mourik , Valérie L.B.I. Jansen , Michiel Coppens , Saskia Middeldorp , Hugo ten Cate , Harry R. Büller , Henri M.H. Spronk , Magdolna Nagy , Thijs E. van Mens","doi":"10.1016/j.rpth.2025.102694","DOIUrl":"10.1016/j.rpth.2025.102694","url":null,"abstract":"<div><h3>Background</h3><div>Antiphospholipid syndrome (APS) is a thrombotic autoimmune disease. Activation of the intrinsic coagulation pathway contributes to inflammatory and cardiovascular diseases, but its role in APS is unknown. Increased release of neutrophil extracellular traps and reduced effectiveness of direct oral anticoagulants support the hypothesis of increased intrinsic pathway activation in patients with APS, which is relevant considering the ongoing development and clinical testing of intrinsic pathway inhibitors.</div></div><div><h3>Objectives</h3><div>To compare <em>in vivo</em> intrinsic pathway activation of patients with APS and healthy controls.</div></div><div><h3>Methods</h3><div>Patients with APS without recent thrombotic or obstetric events and healthy controls were investigated. ELISAs were used to measure activated coagulation factors in complex with the natural inhibitors antithrombin or C1-esterase inhibitor in plasma. The primary outcome of this study was factor (F)XII activation, which initiates the intrinsic pathway. Secondary outcomes included activation of downstream intrinsic coagulation FXI and FIX.</div></div><div><h3>Results</h3><div>Plasma of 73 patients with APS and 19 healthy controls showed no significant difference in activated FXII-inhibitor complexes. The concentrations of activated FXI and FIX and inhibitor complexes likewise did not differ between the groups. A subanalysis of patients with APS by anticoagulant use showed no difference for FXII and FXI activation.</div></div><div><h3>Conclusion</h3><div>Intrinsic pathway activation in patients with APS without recent thrombotic or obstetric events did not differ significantly compared with healthy controls.</div></div>","PeriodicalId":20893,"journal":{"name":"Research and Practice in Thrombosis and Haemostasis","volume":"9 1","pages":"Article 102694"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Altered clot structure in pregnant women who will develop postpartum hemorrhage

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis

Pub Date : 2025-01-01 DOI: 10.1016/j.rpth.2025.102683

Claire de Moreuil , Brigitte Pan-Petesch , François Anouilh , Dino Mehic , Theresa Schramm , Christoph Friedl , Alisa S. Wolberg , Francis Couturaud , Johanna Gebhart , Cihan Ay , Ingrid Pabinger

引用次数: 0

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