Analysis of the quality of reporting of randomized controlled trials in anticoagulant versus antiplatelet medication for venous thromboembolism prophylaxis as governed by the CONSORT statement
AbstractRandomized controlled trials (RCTs) are the gold standard research in evaluating healthcare interventions. The CONSORT (Consolidated Standards of Reporting Trials) statement improves the quality of RCTs in an evidence-based approach. To evaluate the reporting quality of published RCTs concerning the use of anticoagulants versus antiplatelet agents for venous thromboembolism prophylaxis according to the CONSORT statement.  Electronic databases were searched for English-language RCTs involving patients who received either anticoagulant or antiplatelet medication for prophylaxis of deep vein thrombosis and pulmon...
Source: Journal of Thrombosis and Thrombolysis - October 17, 2020 Category: Hematology Source Type: research

Rotational thromboelastometry results are associated with care level in COVID-19
AbstractHigh prevalence of thrombotic events in severely ill COVID-19 patients have been reported. Pulmonary embolism as well as microembolization of vital organs may in these individuals be direct causes of death. The identification of patients at high risk of developing thrombosis may lead to targeted, more effective prophylactic treatment. The primary aim of this study was to test whether rotational thromboelastometry (ROTEM) at admission indicates hypercoagulopathy and predicts the disease severity, assessed as care level, in COVID-19 patients. The study was designed as a prospective, observational study where COVID-19...
Source: Journal of Thrombosis and Thrombolysis - October 17, 2020 Category: Hematology Source Type: research

Vascular-specific epicardial adipose tissue in predicting functional myocardial ischemia for patients with stable chest pain
AbstractThe relationship between vascular-specific epicardial adipose tissue (vEAT) volume and myocardial ischemia measured by fractional flow reserve (FFR) was not well investigated. Patients with typical and atypical chest pain undergoing coronary computed tomographic angiography scan followed by invasive coronary angiography in combination with FFR examination within one month were retrospectively included. EAT volume and CT attenuation was calculated. The patient with FFR  ≤ 0.8 in at least one vessel was referred to as functional ischemia. The mean age of all patients was 61.7 ± 8...
Source: Journal of Thrombosis and Thrombolysis - October 17, 2020 Category: Hematology Source Type: research

Bivalirudin dosing during prolonged intermittent renal replacement therapy: a case report
AbstractAs patients transition between dialysis modalities, and from the intra- to the inter-dialytic period, medications with a narrow therapeutic index that are cleared in dialysis may require dose adjustments and close monitoring. Three cases of patients receiving bivalirudin while converting from continuous to prolonged intermittent renal replacement therapy are reported. Details provided include flow rates and ultrafiltrate volume. In these cases, it appears pre-emptive dose adjustments may be unwarranted, and clinicians should be aware of potential rebound after cessation of dialysis. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - October 17, 2020 Category: Hematology Source Type: research

Coagulopathy, endothelial dysfunction, thrombotic microangiopathy and complement activation: potential role of complement system inhibition in COVID-19
AbstractCoronavirus disease-2019 (COVID-19) is a rapidly evolving health crisis caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is a novel disease entity and we are in a learning phase with regards to the pathogenesis, disease manifestations, and therapeutics. In addition to the primary lung injury, many patients especially the ones with moderate to severe COVID-19 display evidence of endothelial damage, complement activation, which leads to a pro-coagulable state. While there are still missing links in our understanding, the interplay of endothelium, complement system activation, and i...
Source: Journal of Thrombosis and Thrombolysis - October 15, 2020 Category: Hematology Source Type: research

Difference of coagulation features between severe pneumonia induced by SARS-CoV2 and non-SARS-CoV2
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - October 15, 2020 Category: Hematology Source Type: research

Cellular model systems to study cardiovascular injury from chemotherapy
AbstractIn spite of all the efforts for generating efficient pharmacological treatment options for cancer patients, the unwanted side effect of these substances on the cardiovascular system is becoming a major issue for cancer survivors. The fast pacing oncology field necessitate the quest for more accurate and reliable preclinical screenings. hiPSCs derived cardiomyocytes, endothelial and vascular smooth muscle cells provide unlimited source of physiologically relevant cells that could be used in the screening platforms. Cells derived from hiPSCs can measure drug induced alterations to different aspect of the heart includ...
Source: Journal of Thrombosis and Thrombolysis - October 13, 2020 Category: Hematology Source Type: research

Significant reductions in apoptosis-related proteins (HSPA6, HSPA8, ITGB3, YWHAH, and PRDX6) are involved in immune thrombocytopenia
In this study, a total of 829 proteins were identified, and the fold-change cut-off was set at 1.5 (patients vs controls); a t otal of 26 proteins were upregulated, and 69 proteins were downregulated. The bioinformatics analysis indicated that some differentially expressed proteins were associated with apoptosis. KEGG enrichment analysis showed that the apoptosis-related proteins were closely related to the PI3K-Akt signall ing pathway. PRM demonstrated that apoptosis-related proteins were significantly decreased in ITP patients, which further confirmed the important effect of apoptosis on ITP pathogenesis. We hypothesised...
Source: Journal of Thrombosis and Thrombolysis - October 12, 2020 Category: Hematology Source Type: research

Clinical presentations and outcomes in pulmonary embolism patients with cancer
AbstractTo study whether a diagnosis of cancer affects the clinical presentation and outcomes of patients with pulmonary embolism (PE). A retrospective analysis was performed of all consecutive patients diagnosed with PE on a computed tomography scan from 2014 to 2016 at an urban tertiary-referral medical center. Baseline characteristics, treatment decisions, and mortality data were compared between study subjects with and without a known diagnosis of active cancer. There were 581 subjects, of which 187 (33.0%) had a diagnosis of cancer. On average, cancer subjects tended to be older (64.8 vs. 58.5  years, p 
Source: Journal of Thrombosis and Thrombolysis - October 12, 2020 Category: Hematology Source Type: research

Direct oral anticoagulants versus vitamin K antagonists in patients with atrial fibrillation and cancer a meta-analysis
ConclusionsIn comparison to VKA, DOACs were associated with a significant reduction of the rates of thromboembolic events and major bleeding complications in patients with AF and cancer. Further studies are needed to confirm our results. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - October 12, 2020 Category: Hematology Source Type: research

Platelet microvesicles are associated with the severity of coronary artery disease: comparison between peripheral and coronary circulation
AbstractMicrovesicles (MVs) have recently emerged as markers of thrombosis. Furthermore, there is an unexplained residual thrombotic risk is observed in patients with acute coronary syndrome (ACS) and/or stable coronary artery disease (CAD), despite treatment. We measured platelet (PMVs) and erythrocyte (ErMVs) in patients with ACS and stable CAD, both in the peripheral and coronary circulation. We studied consecutive eligible patients during a coronary angiography. Blood samples were collected from the stem of the left coronary artery and femoral artery. PMVs were significantly increased in CAD patients compared to contro...
Source: Journal of Thrombosis and Thrombolysis - October 11, 2020 Category: Hematology Source Type: research

Clopidogrel increases risk of pneumonia compared with aspirin in acute ischemic minor stroke patients
AbstractAntiplatelet agents may increase the risk of infections via suppressing platelet-mediated immune response. Here we assessed the contribution of clopidogrel versus aspirin to the development of pneumonia during an acute ischemic stroke admission. A retrospective cohort study was conducted of acute ischemic stroke patients who were admitted to our hospital from 2015 to 2018. Included patients received uninterrupted clopidogrel or aspirin therapy and did not take other antiplatelet agents throughout their stay. The interest outcome was development of pneumonia after stroke. Conditional logistic regression model after ...
Source: Journal of Thrombosis and Thrombolysis - October 9, 2020 Category: Hematology Source Type: research

Hemorrhagic lesions associated with anticoagulant therapy: a pictorial review
AbstractAnticoagulant therapy is a treatment that can cause bleeding complications in many anatomical structures. Intracranial, intramuscular and intraabdominal bleeding are internal bleeding that can be secondary to anticoagulated therapy. The prognosis of these hemorrhages can be very good, depending on the anatomical region involved, or they can be fatal. Early recognition of especially intracranial and renal hemorrhages is important for prognosis. For diagnosis, CT and / or MRI should be evaluated according to the region. Internal bleeding should be kept in mind in cases such as sudden hemoglobin decrease or change in ...
Source: Journal of Thrombosis and Thrombolysis - October 9, 2020 Category: Hematology Source Type: research

Trends in anticoagulation management services following incorporation of direct oral anticoagulants at a large academic medical center
This study aims to describe trends that occurred following the incorporation of DOACs into AMS at a large academic medical center. A retrospective chart review of pharmacist-run AMS was used to compare patients on DOAC therapy versus other types of anticoagulation, including warfarin and parenteral agents. Primary outcomes included trends in the number of unique patients, management encounters, and telephone encounters throughout the study period. Secondary outcomes included trends in new encounters, and changes in patient characteristics, resources utilized, and patient satisfaction scores. A total of 2976 unique patients...
Source: Journal of Thrombosis and Thrombolysis - October 9, 2020 Category: Hematology Source Type: research

The impact of proton therapy on cardiotoxicity following radiation treatment
AbstractCardiac disease following radiation therapy represents a major consideration in the treatment of a variety of malignancies. Damage to the heart can manifest in a variety of pathologies including ischemic cardiac disease, cardiomyopathy, valvular dysfunction, arrhythmias, and pericarditis. This damage has been shown to directly relate to cardiac radiation dose and to stem from a range of cellular pathways that are often related to fibrosis. The importance of minimizing radiation dose to the heart is especially critical in the pediatric population and when treating disease sites adjacent to the heart. Proton therapy ...
Source: Journal of Thrombosis and Thrombolysis - October 8, 2020 Category: Hematology Source Type: research

Filter clotting with continuous renal replacement therapy in COVID-19
AbstractCoronavirus disease 2019 (COVID-19) appears to be associated with increased arterial and venous thromboembolic disease. These presumed abnormalities in hemostasis have been associated with filter clotting during continuous renal replacement therapy (CRRT). We aimed to characterize the burden of CRRT filter clotting in COVID-19 infection and to describe a CRRT anticoagulation protocol that used anti-factor Xa levels for systemic heparin dosing. Multi-center study of consecutive patients with COVID-19 receiving CRRT. Primary outcome was CRRT filter loss. Sixty-five patients were analyzed, including 17 using an anti-f...
Source: Journal of Thrombosis and Thrombolysis - October 6, 2020 Category: Hematology Source Type: research

Occurrence of pulmonary embolism related to COVID-19
AbstractRecent reports have suggested an increased risk of pulmonary embolism (PE) related to COVID-19. The aim of this cohort study is to compare the incidence of PE during a 3-year period and to assess the characteristics of PE in COVID-19. We studied consecutive patients presenting with PE (January 2017 –April 2020). Clinical presentation, computed tomography (CT) and biological markers were systematically assessed. We recorded the global number of hospitalizations during the COVID-19 pandemic and during the same period in 2018-2019. We included 347 patients: 326 without COVID-19 and 21 with COVI D-19. Patients wi...
Source: Journal of Thrombosis and Thrombolysis - October 5, 2020 Category: Hematology Source Type: research

The experience of Hamad General Hospital collaborative anticoagulation clinic in Qatar during the COVID-19 pandemic
AbstractHamad General Hospital Anticoagulation Clinic is one of the largest collaborative-practice clinics of its type in Qatar. The patients being followed at this clinic are typically complex and vulnerable. During the coronavirus disease 2019 pandemic, measures were implemented at the clinic to minimize the exposure of patients and healthcare providers to the acute respiratory syndrome coronavirus-2 and to promote social distancing. These measures included extending INR-recall period, transitioning to direct oral anticoagulant drugs whenever feasible, home visits to elderly and immunocompromised patients for INR testing...
Source: Journal of Thrombosis and Thrombolysis - October 3, 2020 Category: Hematology Source Type: research

Thromboelastography findings in critically ill COVID-19 patients
AbstractThe rate of venous and arterial thrombotic events among patients infected with severe acute respiratory syndrome coronavirus-2 (SAR-CoV-2) is high. This may be due to a hypercoagulable state induced by the severe inflammation that results from the SAR-CoV-2 infection. We aimed to determine hypercoagulable states ’ incidence based on thromboelastography study and its association with thrombotic events in critically ill patients with coronavirus disease 2019 (COVID-19). Fifty-two COVID-19 patients who had thromboelastography study were retrospectively included. All patients received pharmacologic thrombopro phy...
Source: Journal of Thrombosis and Thrombolysis - October 3, 2020 Category: Hematology Source Type: research

Procoagulant microparticles are associated with arterial disease in patients with systemic lupus erythematosus
AbstractMicroparticles (MPs) have been associated with inflammatory and thrombotic disease. High levels of MPs have been identified in patients with systemic lupus erythematosus (SLE) and associated with cardiovascular disease. We analyzed the procoagulant activity of MPs and its  correlation with arteriosclerosis and arterial thrombosis in SLE patients. Eighty-seven patients with SLE were included: 22 (25.3%) with associated antiphospholipid syndrome (APS), 32 (36.8%) without antiphospholipid antibodies (aPL) and 33 (37.9%) with aPL but without APS. Subclinical arterioscle rosis, defined as the presence and number of...
Source: Journal of Thrombosis and Thrombolysis - October 2, 2020 Category: Hematology Source Type: research

Incidence and risk factors for PTT prolongation in patients receiving low-dose unfractionated heparin thromboprophylaxis
AbstractLow-dose unfractionated heparin (LDUH) prophylaxis decreases the incidence of venous thromboembolism (VTE) in hospitalized patients, but increases the risk of bleeding events. Patients who develop a prolonged activated partial thromboplastin time (aPTT) while on LDUH may be at higher risk for bleeding complications. To determine the incidence and risk factors for aPTT prolongation in hospitalized patients receiving LDUH thromboprophylaxis, we performed a retrospective pharmacoepidemiologic cohort study of adult patients admitted to an academic medical center from September 2013 through September 2015. Among 3857 pa...
Source: Journal of Thrombosis and Thrombolysis - October 1, 2020 Category: Hematology Source Type: research

Cardiomyocyte microvesicles: proinflammatory mediators after myocardial ischemia?
AbstractMyocardial infarction is a frequent complication of cardiovascular disease leading to high morbidity and mortality worldwide. Elevated C-reactive protein (CRP) levels after myocardial infarction are associated with heart failure and poor prognosis. Cardiomyocyte microvesicles (CMV) are released during hypoxic conditions and can act as mediators of intercellular communication. MicroRNA (miRNA) are short non-coding RNA which can alter cellular mRNA-translation. Microvesicles (MV) have been shown to contain distinct patterns of miRNA from their parent cells which can affect protein expression in target cells. We hypot...
Source: Journal of Thrombosis and Thrombolysis - September 24, 2020 Category: Hematology Source Type: research

Detailed thrombogenicity phenotyping and 1 year outcomes in patients undergoing WATCHMAN implantation: (TARGET-WATCHMAN) a case –control study
AbstractThe relation of device related thrombosis (DRT) and major bleeding after left atrial appendage closure (LAAC) to laboratory thrombosis and hemostasis markers has not been studied. We performed a prospective case control study to identify clinical characteristics and laboratory markers in patients who developed DRT and major bleeding following WATCHMAN LAAC. Thromboelastography, platelet aggregation (PA), urinary 11-dehydrothromboxane B2 (UTX), fibrinogen,d-dimer, thrombin time and von Willebrand factor activity were determined at baseline, immediately following, and at 45 and 180  days post-LAAC (n =&th...
Source: Journal of Thrombosis and Thrombolysis - September 24, 2020 Category: Hematology Source Type: research

Cardiovascular risk factor in MPN patients
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - September 24, 2020 Category: Hematology Source Type: research

Effects of body composition on the procoagulant imbalance in obese patients
AbstractObesity is associated with increased thrombotic risk and hypercoagulability whose main driver is an excess of coagulation factor VIII relative to protein C. The aims of this study were to evaluate the association between factor VIII, protein C, factor VIII-to-protein C ratio and bioimpedance parameters of body composition in obese patients. We analysed blood from 69 obese patients and 23 non-obese healthy controls. Plasma levels of factor VIII, protein C, and factor VIII-to-protein C ratio were correlated with total fat, visceral fat, and muscle mass. Compared to controls, obese patients had significantly higher fa...
Source: Journal of Thrombosis and Thrombolysis - September 22, 2020 Category: Hematology Source Type: research

Correction to: Acute pulmonary embolism in COVID-19 related hypercoagulability
In the original version of the article, the sequence"name/surname" of the authors was processed incorrectly. The correct sequence (name/surname) is:"Lorenzo Cerruti, Francesca Boscaro, Francesco Poletto, Elena Campello, Luca Spiezia, Paolo Simioni". This has been corrected with this erratum. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - September 21, 2020 Category: Hematology Source Type: research

Determinants of ST-segment elevation myocardial infarction as clinical presentation of acute coronary syndrome
AbstractAntiplatelet agents and statin therapies are widely used in patients with known cardiovascular disease. Plaque rupture (PR) and plaque erosion (PE) are the most frequent underlying mechanisms of acute coronary syndromes (ACS). The conditions and medications that are associated with ST-segment elevation myocardial infarction (STEMI) following PR or PE have not been systematically studied. A total of 838 ACS patients (494 with STEMI, 344 with NSTE-ACS) who were diagnosed with PR or PE by optical coherence tomography were included. The patients were categorized into two groups based on underlying pathology, and the ba...
Source: Journal of Thrombosis and Thrombolysis - September 20, 2020 Category: Hematology Source Type: research

Predicting the risk for major bleeding in elderly patients with venous thromboembolism using the Charlson index. Findings from the RIETE
AbstractOld patients receiving anticoagulant therapy for venous thromboembolism (VTE) are at an increased risk for bleeding. We used data from the RIETE registry to assess the prognostic ability of the Comorbidity Charlson Index (CCI) to predict the risk for major bleeding in patients aged  >  75 years receiving anticoagulation for VTE beyond the third month. We calculated the area under the receiver-operating characteristic curve (AUC), the category-based net reclassification index (NRI) and the net benefit (NB). We included 4303 patients with a median follow-up of 706 days (interqu artile range...
Source: Journal of Thrombosis and Thrombolysis - September 17, 2020 Category: Hematology Source Type: research

Mutations in inherited fibrinogen disorders correlated with clinical features in the Chinese population
AbstractTwo probands with unknown reasons for low fibrinogen activity were considered to investigate the association between mutations in inherited fibrinogen disorders (IFDs) and clinical features in the Chinese population. A routine coagulation test was conducted on a Sysmex CS5100 coagulation analyzer, and Sanger sequencing was employed to analyze mutations. A PubMed database search through May 2020 was performed to identify relevant studies regarding the congenital fibrinogen disorder epidemic in China. A common heterozygous missense mutation (c.1233G  >  A p.Arg35His), a novel heterozygous mutation (c...
Source: Journal of Thrombosis and Thrombolysis - September 15, 2020 Category: Hematology Source Type: research

The administration of rtPA before mechanical thrombectomy in acute ischemic stroke patients is associated with a significant reduction of the retrieved clot area but it does not influence revascularization outcome
AbstractBoth intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatments for acute ischemic stroke (AIS) in selected cases. Recanalization may occur following IVT without the necessity of further interventions or requiring a subsequent MT procedure. IVT prior to MT (bridging-therapy) may be associated with benefits or hazards. We studied the retrieved clot area and degree of recanalization in patients undergoing MT or bridging-therapy for whom it was possible to collect thrombus material. We collected mechanically extracted thrombi from 550 AIS patients from four International stroke cente...
Source: Journal of Thrombosis and Thrombolysis - September 15, 2020 Category: Hematology Source Type: research

Prognostic implications of the rapid recruitment of coronary collaterals during ST elevation myocardial infarction (STEMI): a meta-analysis of over 14,000 patients
AbstractAcute coronary collateralisation of an infarct-related arterial (IRA) territory may be identified during angiography for ST elevation myocardial infarction (STEMI). Whether the presence or absence of these collaterals affects outcomes remains uncertain. A search of EMBASE, MEDLINE and Cochrane Library, using the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines was conducted to identify studies which reported on the association between coronary collaterals and in-hospital and longer term mortality, left ventricular ejection fraction (LVEF), risk of repeat acute myocardial infarc...
Source: Journal of Thrombosis and Thrombolysis - September 14, 2020 Category: Hematology Source Type: research

Incidence of venous thromboembolism and bleeding after pulmonary lobectomy: evaluating the timing for thromboprophylaxis
AbstractVenous thromboembolism (VTE) is an important postoperative complication after major lung cancer resective surgery, such as lobectomy. It is recommended to start chemical thromboprophylaxis within the first 12 h following the procedure. Postoperative bleeding is also a relevant complication in patients with predisposing conditions. However, the criterion for classifying a patient as “high risk of bleeding” is not standardized and is left to the expertise of the attending physician or surgeon. We aim to describe the incidence and risk factors for postoperative VTE and hemorrhage after pulmonary lobectomy;...
Source: Journal of Thrombosis and Thrombolysis - September 13, 2020 Category: Hematology Source Type: research

Increased intracranial hemorrhage of mechanical thrombectomy in acute ischemic stroke patients with atrial fibrillation
This study aimed to investigate the potential association between AF and outcomes after MT in AIS patients. A post-hoc analysis of a multi-center prospective clinical trial was conducted. Before and after propensity score matching (PSM), the clinical features were compared between patients with and without AF. Multivariable logistic regression and mediation analyses were performed to assess the relationship between AF and ICH. Of the total 245 patients, 123 patients were included in the AF group. After PSM, the AF group showed more retrieval attempts (P = 0.004), comparable favorable outcome (P =&thins...
Source: Journal of Thrombosis and Thrombolysis - September 11, 2020 Category: Hematology Source Type: research

Dynamic changes in fibrinogen and D-dimer levels in COVID-19 patients on nafamostat mesylate
AbstractCritical illnesses associated with coronavirus disease 2019 (COVID-19) are attributable to a hypercoagulable status. There is limited knowledge regarding the dynamic changes in coagulation factors among COVID-19 patients on nafamostat mesylate, a potential therapeutic anticoagulant for COVID-19.  First, we retrospectively conducted a cluster analysis based on clinical characteristics on admission to identify latent subgroups among fifteen patients with COVID-19 on nafamostat mesylate at the University of Tokyo Hospital, Japan, between April 6 and May 31, 2020. Next, we delineated the chara cteristics of all pa...
Source: Journal of Thrombosis and Thrombolysis - September 11, 2020 Category: Hematology Source Type: research

Acquired and modifiable cardiovascular risk factors in patients treated for cancer
This article summarizes acquired and modifiable risk factors in both pediatric and adult patients treated for cancer. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - September 11, 2020 Category: Hematology Source Type: research

Functional testing of tranexamic acid effects in patients undergoing elective orthopaedic surgery
AbstractTranexamic acid (TXA) can reduce blood loss and transfusion rates in orthopaedic surgery. In this regard, a new viscoelastometric test (TPA-test, ClotPro), enables the monitoring of TXA effects. This prospective observational study evaluated and correlated TXA plasma concentrations (cTXA) following intravenous and oral administration in patients undergoing elective orthopaedic surgery with lysis variables of TPA-test. Blood samples of 42 patients were evaluated before TXA application and 2, 6, 12, 24 and 48  h afterwards. TPA-test was used to determine lysis time (LT) as well as maximum lysis (ML) and cTXA was...
Source: Journal of Thrombosis and Thrombolysis - September 11, 2020 Category: Hematology Source Type: research

Pulmonary Embolism Response Team activation during the COVID-19 pandemic in a New York City Academic Hospital: a retrospective cohort analysis
AbstractCoronavirus disease 2019 (COVID-19) is associated with increased rates of deep vein thrombosis (DVT) and pulmonary embolism (PE). Pulmonary Embolism Response Teams (PERT) have previously been associated with improved outcomes. We aimed  to investigate whether PERT utilization, recommendations, and outcomes for patients diagnosed with acute PE changed during the COVID-19 pandemic. This is a retrospective cohort study of all adult patients with acute PE who received care at an academic hospital system in New York City between March 1st and April 30th, 2020. These patients were compared against historic controls ...
Source: Journal of Thrombosis and Thrombolysis - September 9, 2020 Category: Hematology Source Type: research

Diagnosis, management, and outcomes of venous thromboembolism in COVID-19 positive patients: a role for direct anticoagulants?
AbstractCoronavirus disease 2019 (COVID-19) has been associated with an increased risk of thromboembolic complications due to systemic coagulation activation. Little is known about the role of direct anticoagulants (DOACs) in COVID-19 related thrombosis. In this audit we sought to distinguish COVID-19 hospitalised patients with a diagnosis of venous thromboembolism (VTE) and record their outcomes over a period of 3  months (01/02/2020–30/04/2020). A total of 1583 patients were diagnosed with laboratory proven COVID-19 disease. Amongst them, 38 patients (0.82%) suffered VTE (median age 68 years, male/female:...
Source: Journal of Thrombosis and Thrombolysis - September 9, 2020 Category: Hematology Source Type: research

Platelet count trends and response to fondaparinux in a cohort of heparin-induced thrombocytopenia suspected patients after pulmonary endarterectomy
AbstractA definitive diagnosis of heparin-induced thrombocytopenia (HIT) is difficult to make, especially in patients undergoing cardiac surgery. In this retrospective cohort study, we assessed the platelet count trends and the response to fondaparinux in a population of patients of suspected HIT after pulmonary endarterectomy (PEA). Patients enrolled in this study were over the age of 18  years, and survived longer than 7 days after PEA between January 1, 2011 and December 31, 2015. HIT likelihood was assessed by the 4 T’s score and interpreted by our institutional algorithm. 54 patients were operated...
Source: Journal of Thrombosis and Thrombolysis - September 6, 2020 Category: Hematology Source Type: research

Should patients treated with oral anti-coagulants be operated on within 48  h of hip fracture?
AbstractTo investigate if patients treated with oral anticoagulants (OAC) have delayed surgical intervention (more than 48  h) compared to patients without OAC therapy, and if there is an impact to surgery timing on hospitalization length and mortality. A retrospective cohort study of all patients aged over 65 registered with a new diagnosis of hip fracture who underwent surgery in one of the general hospitals run by C lalit, Israel between 01/01/2014 and 31/12/2017. Data was retrieved for patient demographics, OAC treatment, and Charlson comorbidity index. 5828 patients were operated for hip fractures, mean age was 8...
Source: Journal of Thrombosis and Thrombolysis - September 4, 2020 Category: Hematology Source Type: research

Markers of coagulation dysfunction and inflammation in diabetic and non-diabetic COVID-19
AbstractCoagulation dysfunction and inflammatory status were compared between diabetic and non-diabetic COVID-19 patients. The standardized mean difference (SMD) and its 95% confidence interval (CI) was computed for the difference of inflammatory and hypercoagulability markers. The levels of serum ferritin (standardized mean difference-SMD: 0.47, CI 0.17 –0.77, p = 0.002), C-reactive protein (SMD = 0.53, CI 0.20–0.86, p = 0.002), interleukin-6 (SMD = 0.31, CI 0.09–0.52, p = 0.005), fibrinogen (SMD = 0.31, CI 0.09–0.5...
Source: Journal of Thrombosis and Thrombolysis - September 4, 2020 Category: Hematology Source Type: research

Routine surveillance of pelvic and lower extremity deep vein thrombosis in stroke patients with patent foramen ovale
AbstractPatent foramen ovale (PFO) is a potential conduit for paradoxical embolization to the systemic atrial circulation of a thrombus originating in the venous system. In a selected group of subjects, the prevalence of deep vein thrombosis (DVT) was assessed. Subjects were identified if they underwent magnetic resonance venography (MRV) pelvis and lower extremity doppler (LE-VDU) for assessment of DVT with PFO. The primary outcome measure was to report the number of patients with paradoxical embolization as their suspected etiology of stroke due to the presence of DVT, which then will be considered as determined stroke. ...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2020 Category: Hematology Source Type: research

Emerging cancer therapies and cardiovascular risk
AbstractThe cardiovascular (CV) toxicity profiles of traditional cancer therapies such as anthracyclines and radiation therapy are familiar to many cardiologists. With the development and widespread use of additional cancer therapeutics, CV toxicities related to these agents are becoming more common. Cardiovascular specialists are often integrated into the care team for individuals with cancer and knowledge of the CV toxicities of cancer therapeutics has become essential. In this review, we provide a clinically focused summary of the current data regarding CV toxicities of common cancer therapies and identify potential man...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2020 Category: Hematology Source Type: research

Massive pulmonary embolism in patients with extreme bleeding risk: a case series on the successful use of ultrasound-assisted, catheter directed thrombolysis in a district general hospital
We describe a case series of 3 patients presenting with massive PE, each with extreme risk of bleeding and contra-indication to systemic thrombolysis, treated successfully with ultrasound-assisted, catheter directed thrombolysis (U-ACDT). Our experience of this novel technique using the EkoSonic Endovascular System (Ekos, BTG, London, UK) on carefully selected patients has demonstrated the potential to improve clinical status in shocked patients, with minimal bleed risk. There have been several clinical studies evaluating the Ekos system. Both the ULTIMA and SEATTLE II studies have shown significant reductions in RV/LV rat...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2020 Category: Hematology Source Type: research

Association between the uric acid and hypertension in community-based Chinese population: stratified analysis based on body mass index and age
This study was performed with a group of 4012 Chinese population aged 30 to 92  years old. Subjects were divided into four groups according to the quartiles of uric acid (UA) concentration [First group: ≤ 231 μmol/L (reference), Second group: 231-289 μmol/L, Third group: 289-362 μmol/L, Fourth group: >  362 μmol/L]. Hypertension was defined as newly measured blood pressure ≥ 140/90 mmHg or taking antihypertensive drugs. Stratified analysis based on BMI (
Source: Journal of Thrombosis and Thrombolysis - September 2, 2020 Category: Hematology Source Type: research

Exercise testing and cardiac rehabilitation in patients treated for cancer
AbstractCardiovascular disease (CVD) is a major competing cause of morbidity and mortality in patients with cancer. Cancer treatment can have detrimental short- and long-term cardiovascular effects. Moreover, cancer patients may have a significant loss in cardiorespiratory fitness, a key CVD risk factor, during and after cancer treatment. Exercise training has emerged as a potential intervention to improve fitness and reduce the risk of CVD in cancer. In this review, we discuss the role of cardiorespiratory fitness to predict cancer and CVD outcomes, as well as explore the impact of exercise training to improve fitness and...
Source: Journal of Thrombosis and Thrombolysis - September 2, 2020 Category: Hematology Source Type: research

Differentiating biochemical from clinical heparin resistance in COVID-19
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - September 2, 2020 Category: Hematology Source Type: research

New perspectives in cardio-oncology
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - September 2, 2020 Category: Hematology Source Type: research

Anticipating the long-term cardiovascular effects of COVID-19
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - September 2, 2020 Category: Hematology Source Type: research

Effects of clinical depression on left ventricular dysfunction in patients with acute coronary syndrome
We examined 131 consecutive acute coronary syndrome (ACS) patients to assess whether depression increased the risk for developing LV dysfunction, and to determine the effects of platelet serotonin signaling in this relationship. Major depression was assessed using the Structured Clinical Interview and depressive symptoms were measured using the Beck Depression Inventory (BDI), with BDI  ≥ 10 defined as abnormal. LV dysfunction was defined as LVEF ≤ 45%. Platelet serotonin response was measured by serotonin augmented platelet aggregation and platelet serotonin receptor density. Mean age of ...
Source: Journal of Thrombosis and Thrombolysis - September 1, 2020 Category: Hematology Source Type: research