Novel Insights and New Developments Regarding Coagulation Revealed by Studies of the Anti-Factor IXa/Factor X Bispecific Antibody, Emicizumab.
Novel Insights and New Developments Regarding Coagulation Revealed by Studies of the Anti-Factor IXa/Factor X Bispecific Antibody, Emicizumab. Arterioscler Thromb Vasc Biol. 2020 Apr 02;:ATVBAHA120312919 Authors: Yada K, Nogami K Abstract Emicizumab is a humanized anti-FIX/FX (factor IXa/X) bispecific monoclonal antibody that mimics FVIIIa (activated factor VIII) cofactor function. The hemostatic efficacy of emicizumab has been confirmed in clinical studies of patients with hemophilia A, irrespective of the presence of FVIII inhibitors. Emicizumab differs in some properties from FVIIIa molecule. Emicizumab requires no activation by thrombin and is not inactivated by activated protein C, but emicizumab-mediated coagulation is regulatable and maintains hemostasis. A small amount of FIXa (activated factor IX) is required to initiate emicizumab-mediated hemostasis, whereas tissue factor/FVIIa (activated factor VII)-mediated Fxa (activated factor X) and thrombin activation initiates FVIIIa-mediated hemostasis. Fibrin formation, followed by fibrinolysis, appears to be similar between emicizumab- and FVIIIa-mediated hemostasis. These results suggest possible future uses of emicizumab for treating hemorrhagic diseases other than hemophilia A and reveal previously unobservable behaviors of procoagulation and anticoagulation factors in conventional hemostasis. Here, we have reviewed novel insights and new developments regarding coagulation highlighted by emicizuma...
CONCLUSIONS: Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists. PMID: 32483642 [PubMed - in process]
In a recent  retrospective analysis in 325 non-valvular atrial fibrillation (NVAF) patients treated with novel oral anticoagulants (NOAC), authors suggested a higher risk of thrombosis in obese/overweight vs. other patients, particularly those treated with dabigatran; and a higher risk of bleeding, particularly related to factor Xa inhibitors (rivaroxaban, apixaban). They proposed that obesity moderated the NOAC effects, differently for different NOACs. However a) the study did not test for moderation [(warfarin vs.
In conclusion, we report the case of tunneled hemodialysis catheter-related complete obstruction of the right brachiocephalic vein in a lupus nephritis patient undergoing hemodialysis. Clinicians should be aware of this potential complication when tunneled hemodialysis catheters are used and consider the next vascular access type before a tunneled hemodialysis catheter has been indwelled for the long term. PMID: 32484005 [PubMed - as supplied by publisher]
Objective: The characteristics of right heart intracardiac mass in hepatitis B virus infection patients are not well known. Our aim is to describe their ultrasonographic features and nature of such masses. Methods: We retrospectively reviewed imaging reports of hepatitis B virus infection patients from January 2014 to December 2018. Patients with a confirmed finding of right heart intracardiac mass were included, whose pathology reports and contrast-enhanced images were analyzed. Various masses were compared to a general control group from a published study. Results: Thirty-eight cases were finally included. Differ...
Authors: Kokubo Y, Watanabe M, Higashiyama A, Honda-Kohmo K PMID: 32475866 [PubMed - as supplied by publisher]
Conclusions: Patients with granulomatosis with polyangiitis in first years after diagnosis have higher risk of venous thromboembolism than coronary artery disease. This finding is probably related to hypercoagulability induced by the disease and its therapy. PMID: 32476955 [PubMed - in process]
Authors: Ronconi G, Teté G, Kritas SK, Gallenga CE, Caraffa A, Ross R, Conti P Abstract Acute severe respiratory syndrome coronavirus-2 (SARS-CoV-2) caused a global pandemic coronavirus disease 2019 (COVID-19). In humans, SARS-CoV-2 infection leads to acute respiratory distress syndrome which presents edema, hemorrhage, intra-alveolar fibrin deposition, and vascular changes characterized by thrombus formation, micro-angiopathy and thrombosis. These clinical signs are mediated by pro-inflammatory cytokines. In recent studies it has been noted that COVID-19 pandemic can affect patients of all ages, including c...
CONCLUSIONS: CM in vitro is procoagulant and prothrombotic. CM in vivo can augment myocardial damage and can be prohemostatic in the presence of bleeding. CM's procoagulant and antifibrinolytic activities likely involve, at least in part, its ability to bind factor Xa and enhance thrombin generation. Future work is needed to clarify CM's pathophysiology and its mechanistic influences on hemostasis or thrombosis. PMID: 32102568 [PubMed - as supplied by publisher]
CONCLUSIONS: Our findings establish PS as an important in vivo inhibitor of FIXa. Disruption of the interaction between PS and FIXa causes an increased rate of thrombus formation in mice. This newly discovered function of PS implies an unexploited target for antithrombotic therapeutics. PMID: 29419409 [PubMed - as supplied by publisher]
CONCLUSIONS: Taken together, our data indicate that (1) thrombin increases the platelet thrombus volume; (2) tissue factor drives the formation of fibrin outside of the platelet thrombus; (3) limitation of platelet adhesion redirects fibrin from bottom to top of the thrombus; (4) a lower shear rate promotes thrombus coverage with fibrin; (5) the fibrin distribution pattern determines thrombus microelasticity; and (6) the thrombus-forming process is reduced in patients with diverse hemostatic defects. PMID: 26848157 [PubMed - as supplied by publisher]