Thrombosis research最新文献

{"title":"Exploring anti-Xa activity and its correlation with C-Reactive Protein in Intensive Care Unit patients receiving a therapeutic dosage of nadroparin","authors":"Chaja N. Klein , Freek van Gorp , Matthieu C.J. Bosman , Frederikus A. Klok , Lenneke E.M. Haas","doi":"10.1016/j.thromres.2025.109541","DOIUrl":"10.1016/j.thromres.2025.109541","url":null,"abstract":"","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"257 ","pages":"Article 109541"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145555150","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":"Suboptimal management of cancer-associated thrombotic microangiopathies in newly diagnosed and known cancers: A 15-year provincial retrospective cohort study","authors":"Jessica Krahn ,&nbsp;Haowei Sun Linda","doi":"10.1016/j.thromres.2025.109556","DOIUrl":"10.1016/j.thromres.2025.109556","url":null,"abstract":"<div><div>Cancer-associated thrombotic microangiopathy (CA-TMA) is a rare condition with high mortality. The mainstay treatment is anti-cancer treatment. We conducted a retrospective cohort study of all adults hospitalized with CA-TMA in a Canadian province between 2008 and 2023 to examine treatment patterns, quality of care, and outcomes. Eighteen patients were included, with a median age of 57.4 years. At presentation, nine (50 %) patients were newly diagnosed with malignancy, seven (39 %) had progressive or relapsed disease, and two (11 %) had stable disease. CA-TMA treatment included therapeutic plasma exchange (TPE, 13; 72 %), anti-cancer therapy (6; 33 %), and supportive transfusions (4; 22 %). Fifteen (83 %) patients died within three months. Anti-cancer therapy, but not TPE, was associated with higher TMA response (67 % vs 8 %) and longer survival (median 85 vs 9 days), although findings are limited by small sample size and generalizability. We identified suboptimal management including prolonged exposure to TPE, low rates of oncology consultation within 30 days of discharge, and low rates of initiation of cancer-directed therapies, especially in newly diagnosed cancers. Earlier recognition of CA-TMA is crucial, as prompt oncology consultation and initiation of cancer-directed therapy may improve outcomes.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"257 ","pages":"Article 109556"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701910","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":"FVIIa-AT complexes in patients with acute ischemic stroke: Impact on clinical outcomes","authors":"Marek Kachnic ,&nbsp;Martyna Matysiewicz ,&nbsp;Joanna Natorska ,&nbsp;Jan P. Bembenek ,&nbsp;Elżbieta Szczygieł-Pilut ,&nbsp;Anetta Undas","doi":"10.1016/j.thromres.2025.109551","DOIUrl":"10.1016/j.thromres.2025.109551","url":null,"abstract":"<div><h3>Background</h3><div>Plasma levels of activated factor VII-antithrombin complexes (FVIIa-AT) reflect indirectly tissue factor (TF)-FVII interaction. We investigated FVIIa-AT in acute ischemic stroke (AIS) and its prognostic value.</div></div><div><h3>Methods</h3><div>We prospectively studied 88 AIS patients (median age 75 years), of whom 67 (76.1 %) received thrombolysis. Plasma FVIIa-AT levels, fibrin clot properties, i.e. clot lysis time (CLT), fibrin clot permeability (Ks), and protein carbonyl (PC) levels were measured on admission, at 24 h, and at 3 months. Stroke-related mortality and functional outcomes (modified Rankin Scale, mRS) were assessed at 3 months.</div></div><div><h3>Results</h3><div>Baseline FVIIa-AT (median 134.7 (IQR, 118.2–149.8 pM)), correlated with age (<em>r</em> = 0.51; <em>p</em> &lt; 0.001), NIHSS (<em>r</em> = 0.54; <em>p</em> &lt; 0.001), Ks (<em>r</em> = 0.32; <em>p</em> = 0.002), CLT (<em>r</em> = 0.34; <em>p</em> = 0.001), PC (<em>r</em> = 0.36; <em>p</em> &lt; 0.001), and mRS at 3 months (<em>r</em> = 0.51; p &lt; 0.001). After 24 h, FVIIa-AT increased by 8.3 % (<em>p</em> &lt; 0.001) and correlated with NIHSS (<em>r</em> = 0.52; p &lt; 0.001), PC (<em>r</em> = 0.35; <em>p</em> = 0.001), and mRS (<em>r</em> = 0.59; p &lt; 0.001). At 24 h, thrombolysis had no impact on FVIIa-AT. After 3 months, FVIIa-AT decreased by 20.9 % compared to baseline (<em>p</em> &lt; 0.0001). Baseline and 24-hour FVIIa-AT levels increased the odds of hemorrhagic transformation at 48 h (OR = 1.62, 95 %CI 1.09–2.42 and OR = 1.46, 95 %CI 1.04–2.03) and mRS &gt; 2 at 3 months (OR = 1.48, 95 %CI 1.12–1.95 and OR = 1.61, 95 %CI 1.23–2.10, respectively). Stroke-related mortality was associated with FVIIa-AT solely at 24 h (OR = 1.59, 95 %CI 1.18–2.14).</div></div><div><h3>Conclusions</h3><div>FVIIa-AT levels are linked to acute stroke severity and worse clinical outcomes, in association with prothrombotic fibrin clot properties and enhanced protein carbonylation.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"257 ","pages":"Article 109551"},"PeriodicalIF":3.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616914","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-related biomarkers and catheter-associated thrombosis in critically ill children: An exploratory study","authors":"Hem Regmi ,&nbsp;Irene Li ,&nbsp;Stephanie Prozora ,&nbsp;Anish Sharda ,&nbsp;Veronika Shabanova ,&nbsp;E. Vincent S. Faustino ,&nbsp;CRETE Trial and ATLAS Investigators","doi":"10.1016/j.thromres.2025.109534","DOIUrl":"10.1016/j.thromres.2025.109534","url":null,"abstract":"<div><h3>Background</h3><div>Platelets release different substances when activated, such as during critical illness when children are inflamed. We explored the associations of catheter-associated deep venous thrombosis (CADVT), clinically relevant bleeding (CRB) and prophylactic enoxaparin with biomarkers of platelet activation and inflammation in critically ill children.</div></div><div><h3>Methods</h3><div>We analyzed platelet-poor plasma collected from critically ill children &lt;18 years old with central venous catheter (CVC) enrolled in 2 multicenter studies conducted between 2017 and 2024. Blood was obtained on the day of, day after and 4 days after insertion of the CVC. Children were monitored daily for CRB and systematically surveilled for CADVT using ultrasonography. P-selectin, CD40L, platelet factor 4, RANTES, human thrombospondin 1, IL-1β, IL-2, IL-6, IL-8 and TNF-α were measured using immunosorbent assays.</div></div><div><h3>Results</h3><div>We studied plasma from 126 children (median: 9.6 years; interquartile range: 1.2, 15.3 years), of whom 24 received prophylactic enoxaparin. CADVT developed in 37.6 % and CRB in 31.0 % of children. Among children without prophylactic enoxaparin, CADVT was associated with high P-selectin and IL-6. A biomarker-augmented model with P-selectin and IL-6 seemed to perform better than a clinical model with age group, severity of illness and platelet count in identifying critically ill children with CADVT. CRB was associated with high platelet factor 4, while prophylactic enoxaparin was associated with high TNF-α.</div></div><div><h3>Conclusions</h3><div>Our findings suggest the role of platelet activation in CADVT in critically ill children. Once confirmed, these biomarkers may be used to identify critically ill children who would benefit from pharmacologic prophylaxis.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109534"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507026","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":"Validation of the Japanese Association for Acute Medicine-2 disseminated intravascular coagulation criteria to predict critical bleeding in patients with trauma: A nationwide cohort study in Japan","authors":"Masaki Takahashi ,&nbsp;Takeshi Wada ,&nbsp;Takumi Tsuchida ,&nbsp;Hirotaka Mori ,&nbsp;Yutaka Umemura ,&nbsp;Kazuma Yamakawa ,&nbsp;Kohji Okamoto","doi":"10.1016/j.thromres.2025.109532","DOIUrl":"10.1016/j.thromres.2025.109532","url":null,"abstract":"<div><h3>Background</h3><div>Trauma-induced coagulopathy (TIC) significantly impacts trauma prognosis, necessitating early intervention. The Japanese Association for Acute Medicine (JAAM) disseminated intravascular coagulation (DIC) criteria are one of the indicators for TIC, and modified criteria, JAAM-2 DIC criteria, have recently been proposed. We aimed to investigate the predictive ability of the JAAM-2 DIC criteria and its components for critical bleeding during the acute trauma phase.</div></div><div><h3>Methods</h3><div>This retrospective observational study used a nationwide Japanese database, including 2.7 million patients admitted between 2014 and 2023. We included adult inpatients transported by emergency medical services due to trauma. The JAAM-2 DIC scores on admission were calculated based on platelet count, prothrombin time-international normalized ratio (PT-INR), and fibrinogen/fibrin degradation products (FDP). The primary endpoint was critical bleeding, defined as a composite of death within 24-h or massive transfusion (receiving ≥10 units of red blood cells transfusion within 2 days). We investigated the relationship between the JAAM-2 DIC score, its components, and outcomes using the area under the receiver operating characteristic curve (AUC).</div></div><div><h3>Results</h3><div>Among the 10,834 patients with trauma, 1.7 % had critical bleeding. The JAAM-2 DIC score had an AUC of 0.802, with PT-INR showing the highest AUC of 0.836 among its components. The FDP score distribution was more irregular than the others, weakening the JAAM-2 DIC score's association with prognosis.</div></div><div><h3>Conclusion</h3><div>The JAAM-2 DIC criteria can predict critical bleeding in trauma. Identifying and revising FDP scoring issues in JAAM-2 DIC criteria for trauma improved AUC for predicting critical bleeding.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109532"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514031","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":"The fibrinolytic system in disease: From molecular pathways to clinical outcomes","authors":"Mohamed Nazem Alibrahim ,&nbsp;Khaled A. Sahli ,&nbsp;Fahad S. Alshehri","doi":"10.1016/j.thromres.2025.109504","DOIUrl":"10.1016/j.thromres.2025.109504","url":null,"abstract":"<div><div>The fibrinolytic system, essential in maintaining hemostatic balance, tightly regulates blood clot dissolution through a complex interplay of activators (e.g., t-PA, u-PA), inhibitors (e.g., PAI-1, α2-antiplasmin), and modulators such as thrombin-activatable fibrinolysis inhibitor (TAFI). Dysregulation of fibrinolysis contributes significantly to various pathological states. In liver diseases, alterations in fibrinolytic proteins, including elevated tissue plasminogen activator (t-PA) and reduced plasminogen activator inhibitor-1 (PAI-1), predispose patients variably toward bleeding or thrombosis, with clinical implications for management in liver transplantation and cirrhosis. In cardiovascular disease, impaired fibrinolysis, characterized by increased clot density and elevated PAI-1, associates with heightened risks of myocardial infarction, stroke, and peripheral arterial disease, driving current therapeutic strategies toward enhancing fibrinolytic potential. Sepsis frequently induces fibrinolytic shutdown, driven by elevated PAI-1 and TAFI, exacerbating microthrombosis, disseminated intravascular coagulation (DIC), and organ dysfunction, emerging therapeutic targets include PAI-1 modulation. In trauma, fibrinolytic dysregulation manifests as either hyperfibrinolysis, primarily induced by shock-associated elevations in t-PA, or fibrinolysis shutdown, often following severe tissue injury, each demanding distinct therapeutic approaches such as timely antifibrinolytic administration (tranexamic acid) or experimental profibrinolytic treatments. This review highlights critical insights into fibrinolytic mechanisms across these clinical conditions, advocating further research toward refining diagnostics, personalized interventions, and targeted modulation of the fibrinolytic system to optimize clinical outcomes.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109504"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318667","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":"Contemporary reperfusion therapies in patients with intermediate- and high-risk pulmonary embolism","authors":"Burton H. Shen ,&nbsp;Divya A. Shankar ,&nbsp;Nicholas A. Bosch ,&nbsp;Allan J. Walkey ,&nbsp;Gregory Piazza ,&nbsp;Elizabeth S. Klings ,&nbsp;Anica C. Law","doi":"10.1016/j.thromres.2025.109523","DOIUrl":"10.1016/j.thromres.2025.109523","url":null,"abstract":"<div><h3>Background</h3><div>Without clear guidelines, contemporary use of reperfusion therapy for intermediate-risk and high-risk pulmonary embolism (PE) may vary widely. We assessed variation and trends in use of reperfusion therapies (systemic thrombolysis, catheter-directed thrombolysis, mechanical thrombectomy) and how practices change when hospitals adopt mechanical thrombectomy.</div></div><div><h3>Methods</h3><div>Using the national Premier Inc. AI Database (2016–2022), we identified adults with intermediate-risk or high-risk PE. For each reperfusion therapy, our primary outcome was intraclass correlation coefficient (ICC, representing between-hospital variation unexplained by patient/hospital characteristics; <em>a priori</em>, ICC &gt; 15 % deemed “high” variation) and proportion trends over time with hierarchical regression models and assessed trends in use. Among hospitals that adopted mechanical thrombectomy, we conducted interrupted time series analysis to assess changes in use of systemic thrombolysis, catheter-directed thrombolysis, and any reperfusion therapy.</div></div><div><h3>Results</h3><div>We assessed 13,777 patients (11,846 intermediate-risk; 1931 high-risk PE) admitted in the US between 2016 and 2022. High variation was observed in catheter-directed thrombolysis (intermediate-risk: ICC 23.1 %; high-risk: ICC 23.8 %) and thrombectomy use (intermediate-risk: ICC 35.4 %; high-risk: ICC 25.1 %). Mechanical thrombectomy use increased from 0.6 % to 14.3 % between 2016 and 2022 (<em>p</em> &lt; 0.001). Hospital adoption of mechanical thrombectomy was associated with a deceleration in growth of catheter-directed thrombolysis rates.</div></div><div><h3>Conclusions</h3><div>Among patients with intermediate-risk and high-risk PE in the US, reperfusion therapy use varies widely, and the use of mechanical thrombectomy increased between 2016 and 2022. At hospitals adopting mechanical thrombectomy, thrombectomy supplants catheter-directed thrombolysis without increasing total use of reperfusion therapy. These results raise questions about standardization of care, optimal resource allocation, and impact on patient outcomes.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109523"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145419434","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":"Predicting clinically relevant bleeding in new-onset atrial fibrillation patients initiating oral anticoagulant therapy: External validation of the AF-BLEED score","authors":"S.F.B. van der Horst ,&nbsp;G. Chu ,&nbsp;J. Seelig ,&nbsp;E.M. Trinks-Roerdink ,&nbsp;L. Voorhout ,&nbsp;T.A.C. de Vries ,&nbsp;A.P. van Alem ,&nbsp;R.J. Beukema ,&nbsp;L.V.A. Boersma ,&nbsp;M.A. Brouwer ,&nbsp;H. ten Cate ,&nbsp;L.M. Faber ,&nbsp;J.R. de Groot ,&nbsp;Y.L. Gu ,&nbsp;F.R. den Hartog ,&nbsp;J.S.S.G. de Jong ,&nbsp;Y. de Jong ,&nbsp;C.J.H.J. Kirchhof ,&nbsp;F.S. Kleijwegt ,&nbsp;F.A. Klok ,&nbsp;M.V. Huisman","doi":"10.1016/j.thromres.2025.109533","DOIUrl":"10.1016/j.thromres.2025.109533","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation/flutter (AF/AFL) is associated with an increased stroke risk, for which oral anticoagulation (OAC) is often indicated. Bleeding risk assessment is crucial in these patients to mitigate bleeding complications, yet AF guidelines do not recommend the use of any bleeding risk score (e.g., HAS-BLED) due to concerns about predictive accuracy. The AF-adapted VTE-BLEED (AF-BLEED) score was developed to predict major bleeding (MB) post-OAC initiation.</div></div><div><h3>Aims</h3><div>Evaluate the incidence of clinically relevant bleeding, and externally validate the AF-BLEED score in new-onset AF/AFL patients.</div></div><div><h3>Methods</h3><div>Patients enrolled in the DUTCH-AF registry, who started OAC at diagnosis were studied. AF-BLEED categorized patients as low-risk (score ≤ 3) or high-risk (score &gt; 3) for bleeding. Outcomes were first (i) MB and (ii) composite MB and clinically relevant non-major bleeding (CRNMB), with death and OAC discontinuation as competing events. Discrimination (cumulative AUC [AUCt]) was evaluated at 180 days and 2 years.</div></div><div><h3>Results</h3><div>4647 patients (AF-BLEED low-risk: 94.0 %) were included. Cumulative MB incidences for low- and high-risk patients were 0.58 % (95 %CI 0.34–0.82 %) and 1.65 % (0.04–3.26 %) at 180 days (<em>p</em> 0.04), and 1.82 % (1.39–2.26 %) and 5.07 % (2.26–7.87 %) at 2 years (p &lt; 0.001), respectively. Cumulative CRNMB/MB incidences for low- and high-risk patients were 1.81 % (1.39–2.24 %) and 4.13 % (1.62–6.65 %) at 180 days (<em>p</em> 0.01), and 6.37 % (5.58–7.16 %) and 9.68 % (5.91–13.45 %) at 2 years (<em>p</em> 0.04), respectively. Discrimination was poor to moderate for both outcomes at both time windows, ranging between 0.51 and 0.62.</div></div><div><h3>Conclusion</h3><div>Although AF-BLEED was associated with subsequent risk of clinically relevant bleeding, its discriminative ability was poor, limiting the practical utility in its current form.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109533"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517379","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":"von Willebrand factor and fibrin monomer - induced septic shock coagulation typing: Clinical comparison between thrombotic thrombocytopenic purpura - like syndrome and sepsis - induced coagulopathy with prognostic implications","authors":"Yi Liu ,&nbsp;Weili Zhao ,&nbsp;Qingqing Huang ,&nbsp;Xiaohong Wan ,&nbsp;Zongfang Ren ,&nbsp;Jinxi Yue ,&nbsp;Jin Yang ,&nbsp;Chen Han ,&nbsp;Bangting Zhang ,&nbsp;Haoling Zhang ,&nbsp;Wangzheqi Zhang ,&nbsp;Jingjing Zhang","doi":"10.1016/j.thromres.2025.109536","DOIUrl":"10.1016/j.thromres.2025.109536","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to investigate the pathological mechanisms, clinical features, and prognostic differences between thrombotic thrombocytopenic purpura-like syndrome (TTP-like syndrome) and sepsis-induced coagulopathy (SIC) in patients experiencing septic shock. The findings will provide a basis for subtype-guided diagnosis and treatment of coagulation disorders.</div></div><div><h3>Methods</h3><div>In this single-center retrospective cohort, 250 septic shock patients were divided into TTP-like syndrome (<em>n</em> = 101), SIC (<em>n</em> = 113), and control (<em>n</em> = 36) groups. Platelet count, vWF, FM, Sequential Organ Failure Assessment (SOFA) scores, and 28-day mortality were analyzed to compare coagulation phenotypes and outcomes.</div></div><div><h3>Results</h3><div>The TTP-like syndrome group was characterized by thrombocytopenia, with a median platelet (PLT) decline rate of 49.10 %. This group also exhibited markedly elevated vWF antigen levels, averaging 334.66 ± 80.04 %. Additionally, all patients in this group presented with multiple organ dysfunction syndrome (MODS) at a rate of 100 %. In contrast, the SIC group demonstrated more severe platelet consumption, with a median PLT of 42 × 10⁹/L, elevated fibrinogen degradation product (FM) levels (median 9.22 μg/mL), and a significantly higher 28-day mortality rate (35.40 % vs. 11.88 % in the TTP-like group). The patterns of organ injury varied between the two groups; the SIC group displayed more pronounced liver (SOFA 1.43 ± 1.08) and renal (SOFA 1.41 ± 1.47) involvement, while the TTP-like syndrome group predominantly exhibited circulatory (SOFA 2.46 ± 1.45) and respiratory (SOFA 2.53 ± 0.76) dysfunction. vWF and FM had some predictive value for 28-day mortality, with area under the curve values of 0.59 and 0.60, respectively.</div></div><div><h3>Conclusion</h3><div>TTP-like syndrome and SIC represent heterogeneous coagulation phenotypes in septic shock, with differences in biomarkers, organ injury, and prognosis. A vWF- and FM-guided subtype classification may improve individualized treatment strategies and prognostic management.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109536"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517454","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":"MicroRNA dynamics and their link to platelet function following acute ST-segment elevation myocardial infarction","authors":"Oliver Buchhave Pedersen ,&nbsp;Erik Lerkevang Grove ,&nbsp;Steen Dalby Kristensen ,&nbsp;Leonardo Pasalic ,&nbsp;Anne-Mette Hvas ,&nbsp;Peter H. Nissen","doi":"10.1016/j.thromres.2025.109518","DOIUrl":"10.1016/j.thromres.2025.109518","url":null,"abstract":"<div><h3>Background</h3><div>Reduced effect of antiplatelet therapy has been observed in patients with ST-segment elevation myocardial infarction (STEMI). MicroRNA (miR) expression may serve as biomarkers for platelet function and the effect of antiplatelet therapy.</div></div><div><h3>Aim</h3><div>In acute STEMI patients, we investigated changes in miR expression from the acute event to a more stable phase, and evaluated their association with platelet function at both time points to assess their potential as biomarkers of antiplatelet therapy efficacy.</div></div><div><h3>Methods</h3><div>Patients admitted with acute STEMI for primary percutaneous coronary intervention were included and treated according to guidelines. Samples were collected within 24 h after admission and at 2–3 months after enrolment. Expression of candidate miRs, platelet reactivity markers evaluated by flow cytometry, platelet impedance aggregometry and serum thromboxane B₂ were measured at both time points.</div></div><div><h3>Results</h3><div>Samples were obtained in 44 STEMI patients. Two miRs (miR-15a-5p and miR-21-5p) showed lower, whereas five (miR-26b-5p, miR-126-3p, miR-150-5p, miR-223-3p and miR-423-5p) showed higher expression at follow-up than at baseline. At baseline, miR-26b-5p expression consistently correlated with the expression of the fibrinogen receptor on activated platelets, across different agonists (rho: from 0.29 to 0.32, <em>p</em> &lt; 0.05). At follow-up, miR-93-5p expression was associated with platelet aggregation using various agonists (rho: from −0.39 to −0.47, <em>p</em> &lt; 0.02).</div></div><div><h3>Conclusions</h3><div>Seven miRs were differentially expressed at follow-up compared to baseline. Several miRs were linked to platelet function at baseline and follow-up, suggesting that a single miR may not be sufficient as a biomarker for platelet function and the effect of antiplatelet therapy.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"256 ","pages":"Article 109518"},"PeriodicalIF":3.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356313","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}