Pub Date : 2025-01-03DOI: 10.1016/j.tru.2025.100199
Daniella Veloria , Benjamin Wang , Ran Ran , David Ha , Robert Diep , Calvin Diep
{"title":"Reduced versus full apixaban lead-in dosing following parenteral treatment of acute venous thromboembolism","authors":"Daniella Veloria , Benjamin Wang , Ran Ran , David Ha , Robert Diep , Calvin Diep","doi":"10.1016/j.tru.2025.100199","DOIUrl":"10.1016/j.tru.2025.100199","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1016/j.tru.2025.100198
Jonatan Ahrén , MirNabi Pirouzifard , Björn Holmquist , Jan Sundquist , Kristina Sundquist , Bengt Zöller
Background
Multimorbidity, i.e. two or more non-communicable diseases (NCDs), has been associated with venous thromboembolism (VTE), but whether multimorbidity is a predictor for incident VTE is unknown.
Aims
To examine the associations between multimorbidity and its severity with risk of incident VTE, and examine the association between nine different disease clusters and incident VTE.
Methods
A cohort study using landmark analysis of 2,694,442 individuals. Swedish national registers were linked and three landmarks (L1, L2, L3), i.e. baselines, were created with 14-, nine- and four-year follow-up times, respectively. Two or more NCDs defined multimorbidity and ≥5 marked multimorbidity severity. A hazard ratio (HR) with 95 % confidence interval (CI) for VTE was calculated and adjusted for sex, education and year of birth. Death and emigration were treated as competing events.
Results
A total of 2,694,442 individuals were included. Multimorbidity was associated with incident VTE in all three analyzed landmarks: adjusted HR for VTE was 2.47 (95%CI 2.24–2.72) for L1, HR was 2.23 (95%CI 2.11–2.36) for L2, and HR was 2.16 (95%CI 2.03–2.29) for L3. HR increased with multimorbidity severity. For instance, HRs for multimorbidity with five or more NCDs was 4.29 (95%CI 2.53–7.28) in L1 analysis, 4.45 (95%CI 3.64–5.45) in L2 analysis and 4.83 (95%CI 4.20–5.55) in L3 analysis. Moreover, seven of nine different multimorbidity disease clusters were predictors for VTE.
Conclusion
This study demonstrated proof-of-concept that multimorbidity is a novel dose-graded predictor for VTE. Further studies will determine the usefulness of multimorbidity for VTE prediction in different clinical settings.
{"title":"Multimorbidity is associated with risk of incident venous thromboembolism – A nationwide proof-of-concept study","authors":"Jonatan Ahrén , MirNabi Pirouzifard , Björn Holmquist , Jan Sundquist , Kristina Sundquist , Bengt Zöller","doi":"10.1016/j.tru.2025.100198","DOIUrl":"10.1016/j.tru.2025.100198","url":null,"abstract":"<div><h3>Background</h3><div>Multimorbidity, i.e. two or more non-communicable diseases (NCDs), has been associated with venous thromboembolism (VTE), but whether multimorbidity is a predictor for incident VTE is unknown.</div></div><div><h3>Aims</h3><div>To examine the associations between multimorbidity and its severity with risk of incident VTE, and examine the association between nine different disease clusters and incident VTE.</div></div><div><h3>Methods</h3><div>A cohort study using landmark analysis of 2,694,442 individuals. Swedish national registers were linked and three landmarks (L1, L2, L3), i.e. baselines, were created with 14-, nine- and four-year follow-up times, respectively. Two or more NCDs defined multimorbidity and ≥5 marked multimorbidity severity. A hazard ratio (HR) with 95 % confidence interval (CI) for VTE was calculated and adjusted for sex, education and year of birth. Death and emigration were treated as competing events.</div></div><div><h3>Results</h3><div>A total of 2,694,442 individuals were included. Multimorbidity was associated with incident VTE in all three analyzed landmarks: adjusted HR for VTE was 2.47 (95%CI 2.24–2.72) for L1, HR was 2.23 (95%CI 2.11–2.36) for L2, and HR was 2.16 (95%CI 2.03–2.29) for L3. HR increased with multimorbidity severity. For instance, HRs for multimorbidity with five or more NCDs was 4.29 (95%CI 2.53–7.28) in L1 analysis, 4.45 (95%CI 3.64–5.45) in L2 analysis and 4.83 (95%CI 4.20–5.55) in L3 analysis. Moreover, seven of nine different multimorbidity disease clusters were predictors for VTE.</div></div><div><h3>Conclusion</h3><div>This study demonstrated proof-of-concept that multimorbidity is a novel dose-graded predictor for VTE. Further studies will determine the usefulness of multimorbidity for VTE prediction in different clinical settings.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-13DOI: 10.1016/j.tru.2024.100196
Michelle Edwards , Kathy Seddon , Elin Baddeley , Anne Gulbech Ording , Mark Pearson , Isabelle Mahe , Simon Mooijaart , Frederikus A. Klok , Simon I.R. Noble , SERENITY consortium
The role of public involvement (PI) in biomedical research has never been greater, with accumulating evidence demonstrating its ability to improve the quality of research and the likelihood of translating findings into clinical practice. As the demand for meaningful PI in research continues to grow, research teams are required to provide more than a tokenistic acknowledgement of the role of public contributors to the success of a project.
This paper presents an overview of PI as a whole and specifically reflects on how it has added value, to an international cancer associated thrombosis research program. It introduces tools designed to guide teams unfamiliar with PI, introducing the Public Involvement in Research Impact Toolkit (PIRIT) which provides a structure for planning and reporting on PI activities from the study inception through conduct, to its impact.
{"title":"Involving patients and the public in cancer associated thrombosis research: A strategy for success","authors":"Michelle Edwards , Kathy Seddon , Elin Baddeley , Anne Gulbech Ording , Mark Pearson , Isabelle Mahe , Simon Mooijaart , Frederikus A. Klok , Simon I.R. Noble , SERENITY consortium","doi":"10.1016/j.tru.2024.100196","DOIUrl":"10.1016/j.tru.2024.100196","url":null,"abstract":"<div><div>The role of public involvement (PI) in biomedical research has never been greater, with accumulating evidence demonstrating its ability to improve the quality of research and the likelihood of translating findings into clinical practice. As the demand for meaningful PI in research continues to grow, research teams are required to provide more than a tokenistic acknowledgement of the role of public contributors to the success of a project.</div><div>This paper presents an overview of PI as a whole and specifically reflects on how it has added value, to an international cancer associated thrombosis research program. It introduces tools designed to guide teams unfamiliar with PI, introducing the Public Involvement in Research Impact Toolkit (PIRIT) which provides a structure for planning and reporting on PI activities from the study inception through conduct, to its impact.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"18 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.tru.2024.100194
Bárbara Lacerda Teixeira, André Grazina, Ricardo Carvalheiro, Tiago Mendonça, Tiago Pereira da Silva, António Fiarresga, Ruben Ramos, Duarte Cacela, João Reis, Ana Galrinho, Luís Almeida Morais, Rui Cruz Ferreira
Background
The hemodynamic definition of pulmonary hypertension (PH) was updated, lowering the mean pulmonary arterial pressure (PAP) threshold to 20 mmHg and the pulmonary vascular resistance (PVR) to 2 Wood units. The impact of these revised criteria on the number of patients reclassified as PH has not been extensively studied, namely in chronic thromboembolic pulmonary hypertension (CTEPH) population. Since the true incidence of CTEPH after acute pulmonary embolism (PE) is debatable, we aimed to analyze the incidence of CTEPH after high-risk forms of acute PE according to the new 2022 ESC/ERS hemodynamic criteria.
Methods
A prospective registry of consecutive intermediate-high- and high-risk PE patients submitted to catheter directed therapies (CDT) in a tertiary center was used. Clinical, echocardiographic, computed tomography angiography (CTA), right heart catheterization (RHC) and digital subtraction pulmonary angiogram (DSPA) data were collected at admission and at 3 months.
Results
Among 25 patients, RHC revealed that 36 % of patients met the criteria for PH per the new guidelines, compared to 16 % under the previous definition (p = 0.010), resulting in 20 % being reclassified. Mean PAP and PVR differed significantly according to both definitions. Under the new definition, additional parameters of RHC also showed significant differences (p < 0.05). Perfusion defects were noted in 33 % of PH patients on DSPA but not on CTA, while the remained displayed them on both modalities. Among patients without PH, 31.3 % exhibited perfusion defects.
Conclusion
According to the new updated criteria for PH, 36 % of intermediate-high- and high-risk PE patients met the criteria of CTEPH at 3 months of follow-up. With a possible rising incidence of CTEPH, special monitoring and management is crucial.
{"title":"Revisiting hemodynamic definition: Incidence of chronic thromboembolic pulmonary hypertension following acute intermediate-high and high-risk pulmonary embolism","authors":"Bárbara Lacerda Teixeira, André Grazina, Ricardo Carvalheiro, Tiago Mendonça, Tiago Pereira da Silva, António Fiarresga, Ruben Ramos, Duarte Cacela, João Reis, Ana Galrinho, Luís Almeida Morais, Rui Cruz Ferreira","doi":"10.1016/j.tru.2024.100194","DOIUrl":"10.1016/j.tru.2024.100194","url":null,"abstract":"<div><h3>Background</h3><div>The hemodynamic definition of pulmonary hypertension (PH) was updated, lowering the mean pulmonary arterial pressure (PAP) threshold to 20 mmHg and the pulmonary vascular resistance (PVR) to 2 Wood units. The impact of these revised criteria on the number of patients reclassified as PH has not been extensively studied, namely in chronic thromboembolic pulmonary hypertension (CTEPH) population. Since the true incidence of CTEPH after acute pulmonary embolism (PE) is debatable, we aimed to analyze the incidence of CTEPH after high-risk forms of acute PE according to the new 2022 ESC/ERS hemodynamic criteria.</div></div><div><h3>Methods</h3><div>A prospective registry of consecutive intermediate-high- and high-risk PE patients submitted to catheter directed therapies (CDT) in a tertiary center was used. Clinical, echocardiographic, computed tomography angiography (CTA), right heart catheterization (RHC) and digital subtraction pulmonary angiogram (DSPA) data were collected at admission and at 3 months.</div></div><div><h3>Results</h3><div>Among 25 patients, RHC revealed that 36 % of patients met the criteria for PH per the new guidelines, compared to 16 % under the previous definition (p = 0.010), resulting in 20 % being reclassified. Mean PAP and PVR differed significantly according to both definitions. Under the new definition, additional parameters of RHC also showed significant differences (p < 0.05). Perfusion defects were noted in 33 % of PH patients on DSPA but not on CTA, while the remained displayed them on both modalities. Among patients without PH, 31.3 % exhibited perfusion defects.</div></div><div><h3>Conclusion</h3><div>According to the new updated criteria for PH, 36 % of intermediate-high- and high-risk PE patients met the criteria of CTEPH at 3 months of follow-up. With a possible rising incidence of CTEPH, special monitoring and management is crucial.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"17 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic kidney disease (CKD) is associated with cerebrovascular diseases (CVDs) due to chronic systemic inflammation. This study aimed to estimate perioperative and long-term outcomes in Chinese patients undergoing carotid artery stenting (CAS) who had different stages of CKD.
Method
This retrospective study enrolled 888 patients undergoing CAS for carotid artery stenosis. Patients were classified into normal, mild, moderate, and severe CKD and dialysis groups based on their renal function. The primary endpoint was long-term survival from a major adverse event (MAE), which was predefined as the development of a stroke, myocardial infarction (MI), or death during a 10-year long-term follow-up.
Results
Perioperative rates for MAE were 1.5 %, 1.8 %, 3.0 %, 10.3 %, and 9.1 % for the five categories (p < 0.001). There was no death within the perioperative 30 days. The estimated 5-year death-free survival rates decreased with worsening renal function (92.2 % vs. 82.7 % vs. 76.9 % vs. 61.4 % vs. 58.6 %, p < 0.001). The long-term MAE-free survival was 94.7 % vs. 91.0 % vs. 80.2 % vs. 63.7 % vs. 52.2 % for the groups, with the differences being significant between normal to moderate CKD and severe CKD and hemodialysis-dependent cases. Cox regression analysis revealed that dialysis (HR = 3.216 (95%CI: 1.662, 6.223), p = 0.001), severe CKD (HR = 4.592 (95%CI: 2.348, 8.982), p < 0.001), hypertension (HR = 1.977 (95%CI: 1.292, 3.024), p = 0.002), coronary artery disease (HR = 1.509 (95%CI: 1.037, 2.196), p = 0.032) and diabetes mellitus (HR = 2.459 (95%CI: 1.482, 4.079), p < 0.001) were predictors of long-term MAE after CAS.
Conclusion
Risk of perioperative and long-term MAE increased with CKD severity. Patients with normal to moderate CKD benefited from MAE-free survival after CAS. However, preventive CAS appeared to be inappropriate in severe CKD or hemodialysis cases with asymptomatic carotid stenosis, particularly in those with a number of comorbidities.
目的慢性肾脏疾病（CKD）与脑血管疾病（cvd）相关，是慢性全身性炎症所致。本研究旨在评估中国不同阶段CKD患者行颈动脉支架植入术（CAS）的围手术期和远期预后。方法回顾性研究888例颈动脉狭窄患者。根据肾功能将患者分为正常、轻度、中度、重度CKD和透析组。主要终点是主要不良事件（MAE）的长期生存，在10年的长期随访中，主要不良事件被定义为中风、心肌梗死（MI）或死亡。结果5类MAE的手术成功率分别为1.5%、1.8%、3.0%、10.3%、9.1% (p <；0.001)。围手术期30天内无死亡病例。估计的5年无死亡生存率随着肾功能恶化而下降(92.2% vs. 82.7% vs. 76.9% vs. 61.4% vs. 58.6%, p <；0.001)。两组患者的长期无mae生存率分别为94.7% vs. 91.0% vs. 80.2% vs. 63.7% vs. 52.2%，其中正常至中度CKD和重度CKD以及血液透析依赖患者之间的差异具有统计学意义。Cox回归分析显示，透析组（HR = 3.216 (95%CI: 1.662, 6.223), p = 0.001），重度CKD组(HR = 4.592 (95%CI: 2.348, 8.982), p <；0.001)、高血压（HR = 1.977 (95%CI: 1.292, 3.024), p = 0.002）、冠状动脉疾病（HR = 1.509 (95%CI: 1.037, 2.196), p = 0.032）、糖尿病(HR = 2.459 (95%CI: 1.482, 4.079), p <；0.001)是CAS术后长期MAE的预测因子。结论随CKD严重程度的增加，围手术期和远期MAE的发生风险增加。正常至中度CKD患者受益于CAS后的无mae生存期。然而，预防性CAS似乎不适合严重CKD或无症状颈动脉狭窄的血液透析患者，特别是那些有许多合并症的患者。
{"title":"Long-term survival and cerebrovascular events after carotid artery stenting in patients with chronic kidney disease","authors":"Qiaoming Jiang , Jiangkai Yu , Yutao Zhao , Bichao Wang , Xixiang Gao , Yingchun Xiao","doi":"10.1016/j.tru.2024.100193","DOIUrl":"10.1016/j.tru.2024.100193","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic kidney disease (CKD) is associated with cerebrovascular diseases (CVDs) due to chronic systemic inflammation. This study aimed to estimate perioperative and long-term outcomes in Chinese patients undergoing carotid artery stenting (CAS) who had different stages of CKD.</div></div><div><h3>Method</h3><div>This retrospective study enrolled 888 patients undergoing CAS for carotid artery stenosis. Patients were classified into normal, mild, moderate, and severe CKD and dialysis groups based on their renal function. The primary endpoint was long-term survival from a major adverse event (MAE), which was predefined as the development of a stroke, myocardial infarction (MI), or death during a 10-year long-term follow-up.</div></div><div><h3>Results</h3><div>Perioperative rates for MAE were 1.5 %, 1.8 %, 3.0 %, 10.3 %, and 9.1 % for the five categories (<em>p</em> < 0.001). There was no death within the perioperative 30 days. The estimated 5-year death-free survival rates decreased with worsening renal function (92.2 % vs. 82.7 % vs. 76.9 % vs. 61.4 % vs. 58.6 %, <em>p</em> < 0.001). The long-term MAE-free survival was 94.7 % vs. 91.0 % vs. 80.2 % vs. 63.7 % vs. 52.2 % for the groups, with the differences being significant between normal to moderate CKD and severe CKD and hemodialysis-dependent cases. Cox regression analysis revealed that dialysis (HR = 3.216 (95%CI: 1.662, 6.223), <em>p</em> = 0.001), severe CKD (HR = 4.592 (95%CI: 2.348, 8.982), <em>p</em> < 0.001), hypertension (HR = 1.977 (95%CI: 1.292, 3.024), <em>p</em> = 0.002), coronary artery disease (HR = 1.509 (95%CI: 1.037, 2.196), <em>p</em> = 0.032) and diabetes mellitus (HR = 2.459 (95%CI: 1.482, 4.079), <em>p</em> < 0.001) were predictors of long-term MAE after CAS.</div></div><div><h3>Conclusion</h3><div>Risk of perioperative and long-term MAE increased with CKD severity. Patients with normal to moderate CKD benefited from MAE-free survival after CAS. However, preventive CAS appeared to be inappropriate in severe CKD or hemodialysis cases with asymptomatic carotid stenosis, particularly in those with a number of comorbidities.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"17 ","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.tru.2024.100195
Dr Emmanouil S. Papadakis MD, MSc, Dr Lucy A. Norris PhD
{"title":"Improving management of catheter related thrombosis (CRT) in cancer patients by incorporating real world data. The value of cancer VTE registries","authors":"Dr Emmanouil S. Papadakis MD, MSc, Dr Lucy A. Norris PhD","doi":"10.1016/j.tru.2024.100195","DOIUrl":"10.1016/j.tru.2024.100195","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"17 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143160938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1016/j.tru.2024.100190
Eric Manderstedt , Christina Lind-Halldén , Christer Halldén , Johan Elf , Peter J. Svensson , Gunnar Engström , Olle Melander , Aris Baras , Luca A. Lotta , Bengt Zöller , for the Regeneron Genetics Center
Background
Tissue factor (TF), encoded by the F3 gene, is the main initiator of blood coagulation. The molecular epidemiology of the F3 gene and the relation to venous thromboembolism (VTE) remains to be determined.
Objectives
The aim was to determine the molecular epidemiology and the importance of F3 variants for incident VTE by analysis of the population-based MDC study (Malmö Diet and Cancer), consisting of unselected middle-aged and older individuals.
Methods
The exons of F3 were analyzed in a total of 28,794 individuals from the MDC cohort, and of these, 2584 (9 %) were affected by VTE during follow‐up (1991–2018). Qualifying variants used in gene-collapsing analysis were defined as loss-of-function or non-benign (PolyPhen-2) missense variants with minor allele frequency less than 0.1 %.
Results
Exon sequencing of the F3 gene identified 61 different variants, 3′ UTR variants (n = 5), 5′ UTR variants (n = 9) synonymous (n = 10), in frame insertion (n = 1), splice region variants (n = 2), missense (n = 33) or loss-of-function variants (n = 1). No associations between common F3 gene variants and incident VTE were found. Seventeen rare variants were classified as qualifying and included in collapsing analysis (16 non-benign missense and 1 loss-of-function variants). The prevalence of F3 qualifying variants was 0.14 %. Seven individuals with F3 qualifying variants had VTE, while 34 individuals had no VTE. The adjusted VTE model was significant (hazard ratio = 2.1 [95 % confidence interval, 1.02–4.48], P-value = 0.045).
Conclusions
Qualifying F3 gene variants are very rare, indicating a constrained gene. Rare but not common variation in the F3 gene may be involved in VTE.
{"title":"Tissue factor (F3) gene variants and thrombotic risk among middle-aged and older adults: A population-based cohort study","authors":"Eric Manderstedt , Christina Lind-Halldén , Christer Halldén , Johan Elf , Peter J. Svensson , Gunnar Engström , Olle Melander , Aris Baras , Luca A. Lotta , Bengt Zöller , for the Regeneron Genetics Center","doi":"10.1016/j.tru.2024.100190","DOIUrl":"10.1016/j.tru.2024.100190","url":null,"abstract":"<div><h3>Background</h3><div>Tissue factor (TF), encoded by the <em>F3</em> gene, is the main initiator of blood coagulation. The molecular epidemiology of the <em>F3</em> gene and the relation to venous thromboembolism (VTE) remains to be determined.</div></div><div><h3>Objectives</h3><div>The aim was to determine the molecular epidemiology and the importance of <em>F3</em> variants for incident VTE by analysis of the population-based MDC study (Malmö Diet and Cancer), consisting of unselected middle-aged and older individuals.</div></div><div><h3>Methods</h3><div>The exons of <em>F3</em> were analyzed in a total of 28,794 individuals from the MDC cohort, and of these, 2584 (9 %) were affected by VTE during follow‐up (1991–2018). Qualifying variants used in gene-collapsing analysis were defined as loss-of-function or non-benign (PolyPhen-2) missense variants with minor allele frequency less than 0.1 %.</div></div><div><h3>Results</h3><div>Exon sequencing of the <em>F3</em> gene identified 61 different variants, 3′ UTR variants (n = 5), 5′ UTR variants (n = 9) synonymous (n = 10), in frame insertion (n = 1), splice region variants (n = 2), missense (n = 33) or loss-of-function variants (n = 1). No associations between common <em>F3</em> gene variants and incident VTE were found. Seventeen rare variants were classified as qualifying and included in collapsing analysis (16 non-benign missense and 1 loss-of-function variants). The prevalence of <em>F3</em> qualifying variants was 0.14 %. Seven individuals with <em>F3</em> qualifying variants had VTE, while 34 individuals had no VTE. The adjusted VTE model was significant (hazard ratio = 2.1 [95 % confidence interval, 1.02–4.48], <em>P-value</em> = 0.045).</div></div><div><h3>Conclusions</h3><div>Qualifying <em>F3</em> gene variants are very rare, indicating a constrained gene. Rare but not common variation in the <em>F3</em> gene may be involved in VTE.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"17 ","pages":"Article 100190"},"PeriodicalIF":0.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-25DOI: 10.1016/j.tru.2024.100191
Francisco José Pelegrín Mateo , Teresa Quintanar Verdúguez , Dialina Brilhante , Asia Ferrández Arias , Alejandra Romano Cardozo , Eva Martínez de Castro , José Muñoz Langa , Elena Brozos Vázquez , María Vallamayor Delgado , Berta Obispo Portero , Enrique Gallardo , José Rubio Pérez , Isaura Fernández Pérez , Ignacio García Escobar , Silvia García Adrián , José Antonio Santiago Crespo , Lola Rodríguez-Nogueira , Gretel Benítez López , Paula Jimenez-Fonseca , Andrés Muñoz Martín
Background
Catheter related thrombosis (CRT) is the most frequent non-infectious complication associated with central venous access devices (CVAD), with a reported incidence between 13 % and 66 % in symptomatic and asymptomatic patients, respectively, with several factors influencing its development.
Methods
CRT events recorded in TESEO, an international, multicentric, and prospective cancer-associated thrombosis registry were assessed. Descriptive analyses were conducted.
Results
Between July 2018 and December 2023, 2,567 patients were included in TESEO. Of these, 245 patients developed CRT and were included in this analysis. Mean age was 60.5 years (SD 12.3). Peripherally inserted central catheters (PICC) were present in 42.1%, totally implanted ports (PORT) in 40.9% while 17% had missing data. The most common reported comorbidities were arterial hypertension (28.6%) and dyslipidemia (28.2%). Other thromboembolism associated risk factors were present in ≤10% of patients.
Venous thromboembolism (VTE) related symptoms occurred in 70.2% of cases at presentation. Pulmonary embolism (PE) was present in 6.5%, being clinically suspected in 56.2% of cases. The diagnosis was mainly unilateral (81.3%) and 50% were central. Arterial and venous rethrombosis was present in 0.8% and 4.9% of cases respectively. Minor bleeding episodes occurred in 2.5% of cases, while major/clinically relevant episodes were present in 3.6%.
Conclusions
Usual VTE associated risk factors were infrequent in the TESEO registry population. CRT was symptomatic in most cases, with reduced complication rates after treatment.
{"title":"Catheter – related thrombosis in cancer patients: Data from the registry of thrombosis and nEoplasia of SEOM (TESEO)","authors":"Francisco José Pelegrín Mateo , Teresa Quintanar Verdúguez , Dialina Brilhante , Asia Ferrández Arias , Alejandra Romano Cardozo , Eva Martínez de Castro , José Muñoz Langa , Elena Brozos Vázquez , María Vallamayor Delgado , Berta Obispo Portero , Enrique Gallardo , José Rubio Pérez , Isaura Fernández Pérez , Ignacio García Escobar , Silvia García Adrián , José Antonio Santiago Crespo , Lola Rodríguez-Nogueira , Gretel Benítez López , Paula Jimenez-Fonseca , Andrés Muñoz Martín","doi":"10.1016/j.tru.2024.100191","DOIUrl":"10.1016/j.tru.2024.100191","url":null,"abstract":"<div><h3>Background</h3><div>Catheter related thrombosis (CRT) is the most frequent non-infectious complication associated with central venous access devices (CVAD), with a reported incidence between 13 % and 66 % in symptomatic and asymptomatic patients, respectively, with several factors influencing its development.</div></div><div><h3>Methods</h3><div>CRT events recorded in TESEO, an international, multicentric, and prospective cancer-associated thrombosis registry were assessed. Descriptive analyses were conducted.</div></div><div><h3>Results</h3><div>Between July 2018 and December 2023, 2,567 patients were included in TESEO. Of these, 245 patients developed CRT and were included in this analysis. Mean age was 60.5 years (SD 12.3). Peripherally inserted central catheters (PICC) were present in 42.1%, totally implanted ports (PORT) in 40.9% while 17% had missing data. The most common reported comorbidities were arterial hypertension (28.6%) and dyslipidemia (28.2%). Other thromboembolism associated risk factors were present in ≤10% of patients.</div><div>Venous thromboembolism (VTE) related symptoms occurred in 70.2% of cases at presentation. Pulmonary embolism (PE) was present in 6.5%, being clinically suspected in 56.2% of cases. The diagnosis was mainly unilateral (81.3%) and 50% were central. Arterial and venous rethrombosis was present in 0.8% and 4.9% of cases respectively. Minor bleeding episodes occurred in 2.5% of cases, while major/clinically relevant episodes were present in 3.6%.</div></div><div><h3>Conclusions</h3><div>Usual VTE associated risk factors were infrequent in the TESEO registry population. CRT was symptomatic in most cases, with reduced complication rates after treatment.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"17 ","pages":"Article 100191"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142419742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Identification of hypofibrinogenemia is particularly important in obstetrics since this predicts progression to severe Post-Partum Haemorrhage (PPH).
Objectives
To evaluate the usability of qLabs® FIB at the bedside of patients with PPH.
Methods
The qLabs® FIB test was performed using a drop of whole blood from a citrated laboratory tube sampled from each parturient with PPH >1 L by a trained user. A usability survey was completed by each clinician performing the test.
Results
During the evaluation, 101 qLabs® FIB tests were performed. One hundred completed surveys and 58 free comments were collected. Satisfaction was achieved in 84 % of tests. Usability in emergency setting, timeliness of results, and the results display were considered positive. The qLabs® FIB results were obtained in <3 min for concentrations below 3 g/L whilst the median time to paired laboratory results was 60 (20–120) minutes. The lower a patient's fibrinogen level, the faster the qLabs® FIB result.
Conclusion
The usability study was the first step in the validation process of the qLabs® FIB point of care device in obstetric settings.
{"title":"Usability study of the qLabs® FIB: A new point-of-care system for functional fibrinogen testing","authors":"Maxence Hureau , Anne-Sophie Bouthors , Lucie Deroo , Anne-Sophie Baptiste , Agnès Le Gouez , Mathias Rossignol , Frederic J. Mercier , Agnès Rigouzzo","doi":"10.1016/j.tru.2024.100192","DOIUrl":"10.1016/j.tru.2024.100192","url":null,"abstract":"<div><h3>Background</h3><div>Identification of hypofibrinogenemia is particularly important in obstetrics since this predicts progression to severe Post-Partum Haemorrhage (PPH).</div></div><div><h3>Objectives</h3><div>To evaluate the usability of qLabs® FIB at the bedside of patients with PPH.</div></div><div><h3>Methods</h3><div>The qLabs® FIB test was performed using a drop of whole blood from a citrated laboratory tube sampled from each parturient with PPH >1 L by a trained user. A usability survey was completed by each clinician performing the test.</div></div><div><h3>Results</h3><div>During the evaluation, 101 qLabs® FIB tests were performed. One hundred completed surveys and 58 free comments were collected. Satisfaction was achieved in 84 % of tests. Usability in emergency setting, timeliness of results, and the results display were considered positive. The qLabs® FIB results were obtained in <3 min for concentrations below 3 g/L whilst the median time to paired laboratory results was 60 (20–120) minutes. The lower a patient's fibrinogen level, the faster the qLabs® FIB result.</div></div><div><h3>Conclusion</h3><div>The usability study was the first step in the validation process of the qLabs® FIB point of care device in obstetric settings.</div></div>","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"17 ","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.tru.2024.100188
Lucy A. Norris, Emmanouil S. Papadakis
{"title":"Nitrous oxide and VTE – no laughing matter","authors":"Lucy A. Norris, Emmanouil S. Papadakis","doi":"10.1016/j.tru.2024.100188","DOIUrl":"10.1016/j.tru.2024.100188","url":null,"abstract":"","PeriodicalId":34401,"journal":{"name":"Thrombosis Update","volume":"16 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666572724000300/pdfft?md5=cca7db39af55ba8c3355b4e96dc70579&pid=1-s2.0-S2666572724000300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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