Peripheral arterial disease (PAD) is a common vascular problem in which progressive narrowing of the arteries due to atherosclerosis reduces blood flow in the lower extremities. This study aimed to assess the prevalence of asymptomatic PAD in patients admitted to an internal medicine ward as well as the risk factors for the onset of the condition. This study included 98 institutionalized patients without a history of PAD. Based on the value of ankle-brachial index (ABI), PAD was classified as mild (0.7-0.9), moderate (0.5-0.7) or severe (<0.5). A detailed lower extremity doppler ultrasound was performed on patients with an ABI index <0.9 to provide more accurate information on peripheral arterial disease. The prevalence of asymptomatic PAD was 10.2%. The mean age of patients with positive ABI was 74. The main risk factors associated with PAD are smoking, chronic kidney disease, dyslipidemia, obesity, hypertension and type 2 diabetes. ABI is a useful and simple tool for detecting asymptomatic PAD. It is also crucial for early diagnosis, prevention and treatment, which can reduce the risk of cardiovascular adverse events as well as limb complications.
外周动脉疾病（PAD）是一种常见的血管问题，由于动脉粥样硬化导致动脉逐渐变窄，从而降低了下肢的血流量。本研究旨在评估内科病房住院患者中无症状 PAD 的患病率以及发病的风险因素。这项研究包括 98 名无 PAD 病史的住院患者。根据踝肱指数（ABI）值，PAD 被分为轻度（0.7-0.9）、中度（0.5-0.7）和重度（<0.5）。对 ABI 指数小于 0.9 的患者进行了详细的下肢多普勒超声检查，以提供更准确的外周动脉疾病信息。无症状 PAD 的发病率为 10.2%。ABI阳性患者的平均年龄为74岁。与 PAD 相关的主要风险因素包括吸烟、慢性肾病、血脂异常、肥胖、高血压和 2 型糖尿病。ABI 是检测无症状 PAD 的有用而简单的工具。它对于早期诊断、预防和治疗也至关重要，可以降低心血管不良事件和肢体并发症的风险。
{"title":"Ankle brachial index for the diagnosis of asymptomatic lower extremity peripheral arterial disease","authors":"Francesco Cicconi","doi":"10.4081/btvb.2024.128","DOIUrl":"https://doi.org/10.4081/btvb.2024.128","url":null,"abstract":"Peripheral arterial disease (PAD) is a common vascular problem in which progressive narrowing of the arteries due to atherosclerosis reduces blood flow in the lower extremities. This study aimed to assess the prevalence of asymptomatic PAD in patients admitted to an internal medicine ward as well as the risk factors for the onset of the condition. This study included 98 institutionalized patients without a history of PAD. Based on the value of ankle-brachial index (ABI), PAD was classified as mild (0.7-0.9), moderate (0.5-0.7) or severe (<0.5). A detailed lower extremity doppler ultrasound was performed on patients with an ABI index <0.9 to provide more accurate information on peripheral arterial disease. The prevalence of asymptomatic PAD was 10.2%. The mean age of patients with positive ABI was 74. The main risk factors associated with PAD are smoking, chronic kidney disease, dyslipidemia, obesity, hypertension and type 2 diabetes. ABI is a useful and simple tool for detecting asymptomatic PAD. It is also crucial for early diagnosis, prevention and treatment, which can reduce the risk of cardiovascular adverse events as well as limb complications.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141674775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria J. Fernandez Turizo, R. Patell, Jeffrey I. Zwicker
Comprehensive protein analyses of plasma are made possible by high-throughput proteomic screens, which may help find new therapeutic targets and diagnostic biomarkers. Patients with cancer are frequently affected by venous thromboembolism (VTE). The limited predictive accuracy of current VTE risk assessment tools highlights the need for new, more targeted biomarkers. Although coagulation biomarkers for the diagnosis, prognosis, and treatment of VTE have been investigated, none of them have the necessary clinical validation or diagnostic accuracy. Proteomics holds the potential to uncover new biomarkers and thrombotic pathways that impact the risk of thrombosis. This review explores the fundamental methods used in proteomics and focuses on particular biomarkers found in VTE and cancer-associated thrombosis.
{"title":"Identifying novel biomarkers using proteomics to predict cancer-associated thrombosis","authors":"Maria J. Fernandez Turizo, R. Patell, Jeffrey I. Zwicker","doi":"10.4081/btvb.2024.120","DOIUrl":"https://doi.org/10.4081/btvb.2024.120","url":null,"abstract":"Comprehensive protein analyses of plasma are made possible by high-throughput proteomic screens, which may help find new therapeutic targets and diagnostic biomarkers. Patients with cancer are frequently affected by venous thromboembolism (VTE). The limited predictive accuracy of current VTE risk assessment tools highlights the need for new, more targeted biomarkers. Although coagulation biomarkers for the diagnosis, prognosis, and treatment of VTE have been investigated, none of them have the necessary clinical validation or diagnostic accuracy. Proteomics holds the potential to uncover new biomarkers and thrombotic pathways that impact the risk of thrombosis. This review explores the fundamental methods used in proteomics and focuses on particular biomarkers found in VTE and cancer-associated thrombosis.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"17 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cancer-associated thrombosis (CAT) results from the hemostatic system being dysregulated by the progression of cancer. Despite common clinical manifestations, the mechanisms of CAT may vary greatly because cancers develop along distinct biological trajectories that are imposed by the interaction between the tumor cell genome, the epigenome, the surrounding microenvironment, and the tissue of origin. The coagulome, or repertoire of coagulation effectors, expressed by stromal, inflammatory, and cancer cells at the tumor-vascular interface and systemically, reflects this biological variability. Complex landscapes of coagulant and non-coagulant cellular populations are revealed by single-cell RNA sequencing analyses conducted on unperturbed human cancer tissues. Additionally, through mediators of cell-cell interactions, soluble coagulants, and extracellular vesicles containing tissue factor, podoplanin, and other effectors, coagulomes are projected into the pericellular milieu and systemic circulation. As this complexity is currently outside of the clinical paradigm, one could argue that better CAT management could result from a more individualized analysis of coagulomes in cancer patients.
{"title":"Coagulome and tumor microenvironment: impact of oncogenes, cellular heterogeneity and extracellular vesicles","authors":"Nadim Tawil, L. Adnani, Janusz Rak","doi":"10.4081/btvb.2024.109","DOIUrl":"https://doi.org/10.4081/btvb.2024.109","url":null,"abstract":"Cancer-associated thrombosis (CAT) results from the hemostatic system being dysregulated by the progression of cancer. Despite common clinical manifestations, the mechanisms of CAT may vary greatly because cancers develop along distinct biological trajectories that are imposed by the interaction between the tumor cell genome, the epigenome, the surrounding microenvironment, and the tissue of origin. The coagulome, or repertoire of coagulation effectors, expressed by stromal, inflammatory, and cancer cells at the tumor-vascular interface and systemically, reflects this biological variability. Complex landscapes of coagulant and non-coagulant cellular populations are revealed by single-cell RNA sequencing analyses conducted on unperturbed human cancer tissues. Additionally, through mediators of cell-cell interactions, soluble coagulants, and extracellular vesicles containing tissue factor, podoplanin, and other effectors, coagulomes are projected into the pericellular milieu and systemic circulation. As this complexity is currently outside of the clinical paradigm, one could argue that better CAT management could result from a more individualized analysis of coagulomes in cancer patients.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"9 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Patell, Jeffrey I. Zwicker, Rohan Singh, Simon Mantha
The goal of machine learning (ML) is to create informative signals and useful tasks by leveraging large datasets to derive computational algorithms. ML has the potential to revolutionize the healthcare industry by boosting productivity, enhancing safe and effective patient care, and lightening the load on clinicians. In addition to gaining mechanistic insights into cancer-associated thrombosis (CAT), ML can be used to improve patient outcomes, streamline healthcare delivery, and spur innovation. Our review paper delves into the present and potential applications of this cutting-edge technology, encompassing three areas: i) computer vision-assisted diagnosis of thromboembolism from radiology data; ii) case detection from electronic health records using natural language processing; iii) algorithms for CAT prediction and risk stratification. The availability of large, well-annotated, high-quality datasets, overfitting, limited generalizability, the risk of propagating inherent bias, and a lack of transparency among patients and clinicians are among the challenges that must be overcome in order to effectively develop ML in the health sector. To guarantee that this powerful instrument can be utilized to maximize innovation in CAT, clinicians can collaborate with stakeholders such as computer scientists, regulatory bodies, and patient groups.
{"title":"Machine learning in cancer-associated thrombosis: hype or hope in untangling the clot","authors":"R. Patell, Jeffrey I. Zwicker, Rohan Singh, Simon Mantha","doi":"10.4081/btvb.2024.123","DOIUrl":"https://doi.org/10.4081/btvb.2024.123","url":null,"abstract":"The goal of machine learning (ML) is to create informative signals and useful tasks by leveraging large datasets to derive computational algorithms. ML has the potential to revolutionize the healthcare industry by boosting productivity, enhancing safe and effective patient care, and lightening the load on clinicians. In addition to gaining mechanistic insights into cancer-associated thrombosis (CAT), ML can be used to improve patient outcomes, streamline healthcare delivery, and spur innovation. Our review paper delves into the present and potential applications of this cutting-edge technology, encompassing three areas: i) computer vision-assisted diagnosis of thromboembolism from radiology data; ii) case detection from electronic health records using natural language processing; iii) algorithms for CAT prediction and risk stratification. The availability of large, well-annotated, high-quality datasets, overfitting, limited generalizability, the risk of propagating inherent bias, and a lack of transparency among patients and clinicians are among the challenges that must be overcome in order to effectively develop ML in the health sector. To guarantee that this powerful instrument can be utilized to maximize innovation in CAT, clinicians can collaborate with stakeholders such as computer scientists, regulatory bodies, and patient groups.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"52 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yishi Tan, M. Carrier, Nicola Curry, Michael Desborough, Kathryn Musgrave, Marie Scully, Tzu-Fei Wang, Mari Thomas, Simon J Stanworth
Individuals who have thrombocytopenia and cancer-associated thrombosis (CAT) are difficult to manage because they have a high risk of bleeding and recurrent thrombosis. The International Society on Thrombosis and Haemostasis guidelines for the management of thrombocytopenia in patients with CAT suggest two main approaches: either complete anticoagulation with transfusion support if necessary, or dose-modified anticoagulation while the platelet count is <50×109/L. Nevertheless, rather than being based on information from randomized controlled trials (RCTs), these recommendations were based on expert consensus. Recent research from two different countries has shown how this cohort’s management and results vary widely. While the United Kingdom study, Cancer-Associated Venous Thrombosis and Thrombocytopenia, found no significant differences in bleeding or recurrent thrombosis between full dose and modified dose groups, the North American Thrombocytopenia Related Outcomes with Venous thromboembolism study demonstrated a significantly lower risk of bleeding events in those receiving modified dose anticoagulation compared to full dose, without an increased risk of recurrent VTE. Therefore, an RCT is required to assess the best course of action for patients with CAT and thrombocytopenia. To define the standard of care for the management of patients with CAT and thrombocytopenia, a full-scale trial called the START randomized trial (STrategies for Anticoagulation in patients with thRombocytopenia and cancer-associated Thrombosis) is an international, multi-site pilot study that compares the use of platelet transfusions plus higher dose anticoagulation to modified dose anticoagulation in patients with thrombocytopenia and CAT receiving anticoagulation.
血小板减少症和癌症相关性血栓形成（CAT）患者出血和复发性血栓形成的风险很高，因此很难管理。国际血栓与止血学会（International Society on Thrombosis and Haemostasis）血小板减少症患者管理指南提出了两种主要方法：一种是完全抗凝，必要时输血支持；另一种是在血小板计数<50×109/L时进行剂量调整抗凝。然而，这些建议并非基于随机对照试验（RCT）的信息，而是基于专家共识。最近来自两个不同国家的研究表明，这一人群的管理和结果差异很大。英国的 "癌症相关静脉血栓和血小板减少症 "研究发现，全剂量组和调整剂量组在出血或复发性血栓形成方面无显著差异，而北美的 "血小板减少症与静脉血栓栓塞相关结果 "研究则表明，与全剂量相比，接受调整剂量抗凝治疗的患者发生出血事件的风险显著降低，但复发性 VTE 的风险并未增加。因此，需要进行一项 RCT 研究来评估 CAT 和血小板减少症患者的最佳治疗方案。为了确定治疗 CAT 和血小板减少症患者的标准，一项名为 START 随机试验（STrategies for Anticoagulation in patients with thRombocytopenia and cancer-associated Thrombosis）的全面试验是一项国际性、多地点试点研究，该试验比较了接受抗凝治疗的血小板减少症和 CAT 患者使用血小板输注加高剂量抗凝与调整剂量抗凝的情况。
{"title":"Cancer complicated by thrombosis and thrombocytopenia: still a therapeutic dilemma","authors":"Yishi Tan, M. Carrier, Nicola Curry, Michael Desborough, Kathryn Musgrave, Marie Scully, Tzu-Fei Wang, Mari Thomas, Simon J Stanworth","doi":"10.4081/btvb.2024.115","DOIUrl":"https://doi.org/10.4081/btvb.2024.115","url":null,"abstract":"Individuals who have thrombocytopenia and cancer-associated thrombosis (CAT) are difficult to manage because they have a high risk of bleeding and recurrent thrombosis. The International Society on Thrombosis and Haemostasis guidelines for the management of thrombocytopenia in patients with CAT suggest two main approaches: either complete anticoagulation with transfusion support if necessary, or dose-modified anticoagulation while the platelet count is <50×109/L. Nevertheless, rather than being based on information from randomized controlled trials (RCTs), these recommendations were based on expert consensus. Recent research from two different countries has shown how this cohort’s management and results vary widely. While the United Kingdom study, Cancer-Associated Venous Thrombosis and Thrombocytopenia, found no significant differences in bleeding or recurrent thrombosis between full dose and modified dose groups, the North American Thrombocytopenia Related Outcomes with Venous thromboembolism study demonstrated a significantly lower risk of bleeding events in those receiving modified dose anticoagulation compared to full dose, without an increased risk of recurrent VTE. Therefore, an RCT is required to assess the best course of action for patients with CAT and thrombocytopenia. To define the standard of care for the management of patients with CAT and thrombocytopenia, a full-scale trial called the START randomized trial (STrategies for Anticoagulation in patients with thRombocytopenia and cancer-associated Thrombosis) is an international, multi-site pilot study that compares the use of platelet transfusions plus higher dose anticoagulation to modified dose anticoagulation in patients with thrombocytopenia and CAT receiving anticoagulation.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"119 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Because cancer is a strong prothrombotic, there is an increased risk of thromboembolism, which includes ischemic stroke, especially in the first six to twelve months following a cancer diagnosis. The risk of ischemic stroke differs according to the location and stage of cancer. Given that the risk increases prior to a cancer diagnosis, stroke may be the initial sign of occult cancer. Although data on the risk, treatment, and outcomes of cancer-associated stroke are more limited than those on cancer-associated venous thromboembolism, the condition is still recognized as a thrombotic complication of cancer. Up to 10% of ischemic stroke patients also have a concurrent cancer diagnosis, and these patients seem to have higher short-term mortality and morbidity rates. With more people expected to survive longer after cancer treatment and an increasing number of cancer survivors, the burden of stroke among cancer patients is predicted to rise. This narrative review aims to provide an overview of the pathophysiologic mechanisms, treatment options, and epidemiology of ischemic stroke, including cancer screening for those who have cryptogenic (unexplained) stroke.
{"title":"Cancer-associated ischemic stroke: current knowledge and future directions","authors":"Ronda Lun, Deborah M. Siegal","doi":"10.4081/btvb.2024.117","DOIUrl":"https://doi.org/10.4081/btvb.2024.117","url":null,"abstract":"Because cancer is a strong prothrombotic, there is an increased risk of thromboembolism, which includes ischemic stroke, especially in the first six to twelve months following a cancer diagnosis. The risk of ischemic stroke differs according to the location and stage of cancer. Given that the risk increases prior to a cancer diagnosis, stroke may be the initial sign of occult cancer. Although data on the risk, treatment, and outcomes of cancer-associated stroke are more limited than those on cancer-associated venous thromboembolism, the condition is still recognized as a thrombotic complication of cancer. Up to 10% of ischemic stroke patients also have a concurrent cancer diagnosis, and these patients seem to have higher short-term mortality and morbidity rates. With more people expected to survive longer after cancer treatment and an increasing number of cancer survivors, the burden of stroke among cancer patients is predicted to rise. This narrative review aims to provide an overview of the pathophysiologic mechanisms, treatment options, and epidemiology of ischemic stroke, including cancer screening for those who have cryptogenic (unexplained) stroke.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"37 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcello Di Nisio, Matteo Candeloro, Nicola Potere, Ettore Porreca, J. I. Weitz
Venous thromboembolism (VTE) is a relatively common complication in cancer patients with potentially dire consequences. Anticoagulants are the mainstay of treatment of cancer-associated VTE. The anticoagulants most often used are low-molecular-weight heparin (LMWH) and direct oral factor (F) Xa inhibitors, which include apixaban, edoxaban, and rivaroxaban. Most guidelines recommend primary VTE prophylaxis with LMWH, apixaban, or rivaroxaban after abdominal or pelvic cancer surgery, or in high-risk ambulatory cancer patients. Both oral FXa inhibitors and LMWH have limitations. LMWH requires daily subcutaneous injections, and because of its renal clearance, its use may be problematic in patients with severe kidney disease. The risk of bleeding with oral FXa inhibitors may be higher than with LMWH in patients with intraluminal gastrointestinal or genitourinary cancers. Other problems with oral FXa inhibitors include potential drug-drug interactions and dosing issues in patients with thrombocytopenia or severe kidney or liver disease. Therefore, there remains a need for convenient and safer anticoagulants for VTE treatment in cancer patients. FXI has emerged as a potentially safer target for anticoagulants than FXa because FXI is essential for thrombosis, but mostly dispensable for hemostasis. This review summarizes the currently available therapeutic options for cancer-associated VTE, highlights knowledge gaps, and discusses the potential of FXI inhibitors to address key unmet clinical needs in this vulnerable patient population.
{"title":"Factor XI inhibitors: a new option for the prevention and treatment of cancer-associated thrombosis","authors":"Marcello Di Nisio, Matteo Candeloro, Nicola Potere, Ettore Porreca, J. I. Weitz","doi":"10.4081/btvb.2024.118","DOIUrl":"https://doi.org/10.4081/btvb.2024.118","url":null,"abstract":"Venous thromboembolism (VTE) is a relatively common complication in cancer patients with potentially dire consequences. Anticoagulants are the mainstay of treatment of cancer-associated VTE. The anticoagulants most often used are low-molecular-weight heparin (LMWH) and direct oral factor (F) Xa inhibitors, which include apixaban, edoxaban, and rivaroxaban. Most guidelines recommend primary VTE prophylaxis with LMWH, apixaban, or rivaroxaban after abdominal or pelvic cancer surgery, or in high-risk ambulatory cancer patients. Both oral FXa inhibitors and LMWH have limitations. LMWH requires daily subcutaneous injections, and because of its renal clearance, its use may be problematic in patients with severe kidney disease. The risk of bleeding with oral FXa inhibitors may be higher than with LMWH in patients with intraluminal gastrointestinal or genitourinary cancers. Other problems with oral FXa inhibitors include potential drug-drug interactions and dosing issues in patients with thrombocytopenia or severe kidney or liver disease. Therefore, there remains a need for convenient and safer anticoagulants for VTE treatment in cancer patients. FXI has emerged as a potentially safer target for anticoagulants than FXa because FXI is essential for thrombosis, but mostly dispensable for hemostasis. This review summarizes the currently available therapeutic options for cancer-associated VTE, highlights knowledge gaps, and discusses the potential of FXI inhibitors to address key unmet clinical needs in this vulnerable patient population.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"37 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140971340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Guest Editors: Anna Falanga, Benjamin Brenner, Alok A. Khorana
Dear Colleagues, We are pleased to present this volume of the Proceedings and the Abstracts of the 12th International Conference on Thrombosis and Hemostasis Issues in Cancer (ICTHIC) being held in Bergamo, Italy, May 17-19, 2024. Cancer-associated thrombosis – which includes both venous and arterial events in its clinical manifestations and involves cancer biology, hemostatic proteins, platelets and many other players in its subclinical terrain – is an old problem. Yet it makes its way into the newest of new themes in cancer medicine, including new paradigms of treatment which continue to be complicated by this very old effect [...]
{"title":"Welcome to the 12th ICTHIC!","authors":"Guest Editors: Anna Falanga, Benjamin Brenner, Alok A. Khorana","doi":"10.4081/btvb.2024.138","DOIUrl":"https://doi.org/10.4081/btvb.2024.138","url":null,"abstract":"Dear Colleagues,\u0000We are pleased to present this volume of the Proceedings and the Abstracts of the 12th International Conference on Thrombosis and Hemostasis Issues in Cancer (ICTHIC) being held in Bergamo, Italy, May 17-19, 2024.\u0000Cancer-associated thrombosis – which includes both venous and arterial events in its clinical manifestations and involves cancer biology, hemostatic proteins, platelets and many other players in its subclinical terrain – is an old problem. Yet it makes its way into the newest of new themes in cancer medicine, including new paradigms of treatment which continue to be complicated by this very old effect [...]","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"14 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The advantages of patient and public involvement (PPI) in research are becoming more widely known, however different research organizations have different rates of adoption. Comparably, some groups provide tokenistic participation in the research process, which is inconsistent with the extent to which PPI partners are truly involved. Recent developments in the field of cancer-associated thrombosis (CAT) research have shown how crucial PPI is to the foundation of the entire research process, from formulating the research question to disseminating the findings. This manuscript aims to present an overview of PPI within the framework of CAT research and demonstrate how, when used appropriately, PPI can improve a project’s overall success, rigor, and relevance.
患者和公众参与（PPI）在研究中的优势正被越来越多的人所认识，但不同的研究机构采用的比例却不尽相同。同样，有些团体只是象征性地参与研究过程，这与患者和公众参与伙伴真正参与的程度不符。癌症相关血栓形成 (CAT) 研究领域的最新进展表明，从提出研究问题到传播研究结果，PPI 对整个研究过程的基础至关重要。本手稿旨在介绍在 CAT 研究框架内的 PPI 概述，并说明如果使用得当，PPI 如何能够提高项目的整体成功率、严谨性和相关性。
{"title":"Patient and public involvement in cancer-associated thrombosis research: necessary or glorified tokenism?","authors":"Simon Noble","doi":"10.4081/btvb.2024.125","DOIUrl":"https://doi.org/10.4081/btvb.2024.125","url":null,"abstract":"The advantages of patient and public involvement (PPI) in research are becoming more widely known, however different research organizations have different rates of adoption. Comparably, some groups provide tokenistic participation in the research process, which is inconsistent with the extent to which PPI partners are truly involved. Recent developments in the field of cancer-associated thrombosis (CAT) research have shown how crucial PPI is to the foundation of the entire research process, from formulating the research question to disseminating the findings. This manuscript aims to present an overview of PPI within the framework of CAT research and demonstrate how, when used appropriately, PPI can improve a project’s overall success, rigor, and relevance.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"23 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anticoagulant therapy is recommended for cancer-related venous thromboembolism (VTE). Recurrent VTE prevention is the main goal of this treatment. The majority of evidence-based practice guidelines recommend anticoagulant treatment for at least 6 months. Based on individual assessment of potential benefits and risks, tolerability, drug availability, patient preference, and cancer activity, active cancer patients should continue anticoagulant treatment beyond the 6-month course. When cancer is no longer active or the risk outweighs the benefit, anticoagulant therapy is usually stopped after 3-6 months. Until recently, there was little data on the risk of recurrent VTE in cancer-associated VTE patients after stopping anticoagulants. New results and evidence synthesis have emerged in the last 3 years. Recurring VTE occurs in over 30% in the 5 years after treatment discontinuation. In the first six months, recurrence rates are 10-15%. Recurrences reach 31% at 2 years and stabilize between 2 and 5. Duration of prior anticoagulation does not affect cumulative recurrence. The high risk of recurrent VTE after discontinuing treatment supports guidelines to continue anticoagulant treatment if cancer is active. Stopping anticoagulants after 3-6 months may not be ideal, so randomized clinical trials should be conducted quickly. This review highlights the need to improve cancer patients' primary VTE prevention efforts.
{"title":"Risk of recurrent venous thromboembolism in cancer patients after discontinuation of anticoagulant therapy","authors":"G. E. Raskob","doi":"10.4081/btvb.2024.124","DOIUrl":"https://doi.org/10.4081/btvb.2024.124","url":null,"abstract":"Anticoagulant therapy is recommended for cancer-related venous thromboembolism (VTE). Recurrent VTE prevention is the main goal of this treatment. The majority of evidence-based practice guidelines recommend anticoagulant treatment for at least 6 months. Based on individual assessment of potential benefits and risks, tolerability, drug availability, patient preference, and cancer activity, active cancer patients should continue anticoagulant treatment beyond the 6-month course. When cancer is no longer active or the risk outweighs the benefit, anticoagulant therapy is usually stopped after 3-6 months. Until recently, there was little data on the risk of recurrent VTE in cancer-associated VTE patients after stopping anticoagulants. New results and evidence synthesis have emerged in the last 3 years. Recurring VTE occurs in over 30% in the 5 years after treatment discontinuation. In the first six months, recurrence rates are 10-15%. Recurrences reach 31% at 2 years and stabilize between 2 and 5. Duration of prior anticoagulation does not affect cumulative recurrence. The high risk of recurrent VTE after discontinuing treatment supports guidelines to continue anticoagulant treatment if cancer is active. Stopping anticoagulants after 3-6 months may not be ideal, so randomized clinical trials should be conducted quickly. This review highlights the need to improve cancer patients' primary VTE prevention efforts.","PeriodicalId":517891,"journal":{"name":"Bleeding, Thrombosis and Vascular Biology","volume":"28 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140971504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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