ADAMTS13: An Emerging Target in Stroke Therapy

Thrombosis is the main pathogenesis of acute ischemic stroke (AIS). The main treatments for stroke either have limited efficacy or increase the risk of bleeding. ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) is a metal protease that can effectively break down VWF (Von Willebrand Factor, VWF), the key factor in thrombus formation. Previous studies have proven that the abnormality of its activity is associated with many diseases. In recent years, it has been found that ADAMTS13 is closely related to stroke. We focus on the relationship between ADAMTS13 and acute ischemic stroke, combining with the structure and function of ADAMTS13 and find that ADAMTS13 is expected to become a new therapeutic target for acute ischemic stroke.
Source: Frontiers in Neurology - Category: Neurology Source Type: research

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Conclusion: This review suggests patients with RVO have an increased risk of cardiovascular events and all-cause mortality. More studies are needed to determine the highest risk periods for cardiovascular events and mortality after RVO and whether immediate cardiovascular evaluation and intervention will improve outcomes.
Source: RETINA - Category: Opthalmology Tags: Review Source Type: research
Conclusions: There is limited evidence in the literature supporting the practice of RN-performed bone marrow procedures. Our review revealed a robust program with excellent clinical and diagnostic outcomes that can be emulated by other institutions interested in pursuing RN-performed bone marrow procedures.
Source: AJN - Category: Nursing Tags: Cultivating Quality Source Type: research
Publication date: Available online 8 August 2019Source: Canadian Journal of CardiologyAuthor(s): Leszek Drabik, Małgorzata Konieczyńska, Anetta UndasAbstractBackgroundFormation of dense fibrin clots has been reported in both atrial fibrillation (AF) and ischemic stroke. We have previously demonstrated that such clot properties can predict thromboembolism and major bleeding in AF patients treated with vitamin K antagonists (VKA). In this longitudinal cohort study, we evaluated whether impaired fibrinolysis is associated with clinical outcomes in AF.MethodsIn 236 patients with AF receiving with vitamin K antagonists (VKA),...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Authors: Kreuziger LB, Massicotte MP Abstract Mechanical circulatory support (MCS) is the overarching term that encompasses the temporary and durable devices used in patients with severe heart failure. MCS disturbs the hematologic and coagulation system, leading to platelet activation, activation of the contact pathway of coagulation, and acquired von Willebrand syndrome. Ischemic stroke and major hemorrhage occur in up to 30% of patients. Hematologists are an essential part of the MCS team because they understand the delicate balance between bleeding and clotting and alteration of hemostasis with antithrombotic th...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
Authors: Zayat R, Ahmad U, Stoppe C, Khattab MA, Arab F, Moza A, Tewarie L, Goetzenich A, Autschbach R, Schnoering H Abstract Low-level hemolysis (LLH) after left ventricular assist device implantation contributes to thromboembolic events (TE). Free plasma hemoglobin (fHb) scavenges nitric oxide (NO), which causes endothelial dysfunction and activates platelets. fHb also interacts with von Willebrand factor (vWF). We hypothesized that improved hemodynamic and enhanced NO signaling in HeartMate II (HMII) patients with LLH taking the phosphodiesterase-5 inhibitor sildenafil may reduce the risk of TE.From 2011 to 2015...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0038-1660852Hemostasis is a dynamic process that starts in utero. The coagulation system evolves with age, as evidenced by marked physiological differences in the concentration of the majority of hemostatic proteins in early life compared with adulthood. This concept, known as “developmental hemostasis,” has important biological and clinical implications. Overall, impaired platelet function, along with physiologically reduced levels of vitamin K–dependent and contact coagulation factors, may cause poorer clot firmness even in healthy neonates. However, increased activity...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
CONCLUSIONS: We experienced good results with AT cessation in specific HMII patients. The simultaneous onset of AvWS and high TAT values could explain at least in part the low thromboembolic rate in HMII patients without VKA. PMID: 29237991 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
Semin Thromb Hemost DOI: 10.1055/s-0037-1607982Ventricular-assist devices (VADs) have seen increased utilization in the pediatric population. Formerly, this therapeutic modality was limited to only the pulsatile VAD, EXCOR (Berlin Heart GmbH). However, the continuous flow VAD devices, HeartMate II (Abbott Inc.) and HeartWare (Medtronic Inc.), are now increasingly used in this population. Postoperatively, VAD patients are acutely anticoagulated using unfractionated heparin, often beginning 24 to 48 hours after VAD placement. Once the patient is stabilized and ready to transition to a lower acuity or outpatient setting, low-...
Source: Seminars in Thrombosis and Hemostasis - Category: Hematology Authors: Tags: Review Article Source Type: research
Purpose of review: Von Willebrand factor (VWF) is a large multidomain, multimeric glycoprotein that plays an essential role in regulating the balance between blood clotting and bleeding. Aberrant VWF regulation can lead to a spectrum of diseases extending from bleeding disorders [Von Willebrand disease (VWD)] to aberrant thrombotic thrombocytopenic purpura (TTP). Understanding the biology of VWF expression and secretion is essential for developing novel targeted therapies for VWF-related hemostasis disorders. Recent findings: A number of recent elegant in-vitro and in-vivo studies will be highlighted, including the discov...
Source: Current Opinion in Hematology - Category: Hematology Tags: VASCULAR BIOLOGY: Edited by Edward F. Plow Source Type: research
Authors: Baumann Kreuziger L, Massicotte MP Abstract Mechanical circulatory support (MCS) provides a bridge to heart transplant in children and adults with life-threatening heart failure and sustains patients ineligible for transplant. Extracorporeal membrane oxygenation (ECMO) provides temporary support for patients in cardiac or pulmonary failure through external gas exchange and continuous flow of blood. Because the median time to heart transplant exceeds event-free time on ECMO, pulsatile left ventricular assist devices (LVADs) are used to support infants and children. Continuous flow LVADs are preferred in ado...
Source: Hematology ASH Education Program - Category: Hematology Tags: Hematology Am Soc Hematol Educ Program Source Type: research
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