A case report of severe bleeding due to lupus anticoagulant hypoprothrombinemia syndrome
We present a 74-years-old woman with history of myelodysplastic syndrome, admitted to the Emergency Department due to spontaneous mucocutaneous bleeding. Coagulation assays revealed prolonged prothrombin time and activated partial thromboplastin time with evidence of an immediate acting inhibitor. Antithrombotic therapy usage, drug ingestion, disseminated intravascular coagulation, liver dysfunction and sepsis were excluded. Patient was admitted for close monitoring and etiological evaluation. A comprehensive bleeding diathesis workup was performed showing factor II levels severely decreased and transient positive lupus an...
Source: Journal of Thrombosis and Thrombolysis - September 12, 2019 Category: Hematology Source Type: research

Prevalence and relevance of abnormal glucose metabolism in acute coronary syndromes: insights from the PLATelet inhibition and patient Outcomes (PLATO) trial
AbstractDiabetes mellitus (DM) and abnormal glucose metabolism are associated with cardiovascular (CV) disease. We investigated the prevalence and prognostic importance of dysglycaemia in patients with acute coronary syndromes (ACS) in the PLATelet inhibition and patient Outcomes (PLATO) trial. Diabetes was defined as known diabetes or HbA1c  ≥ 6.5% or non-fasting glucose ≥ 11.1 mmol/L on admission, prediabetes as HbA1c ≥ 5.7% but
Source: Journal of Thrombosis and Thrombolysis - September 11, 2019 Category: Hematology Source Type: research

Direct oral anticoagulants: a review on the current role and scope of reversal agents
AbstractNew guideline recommendations prefer direct oral anticoagulants (DOACs) over warfarin in DOAC-eligible patients with atrial fibrillation and patients with venous thromboembolism. As expected with all antithrombotic agents, there is an associated increased risk of bleeding complications in patients receiving DOACs that can be attributed to the DOAC itself, or other issues such as acute trauma, invasive procedures, or underlying comorbidities. For the majority of severe bleeding events, the widespread approach is to withdraw the DOAC, then provide supportive measures and “watchful waiting” with the expect...
Source: Journal of Thrombosis and Thrombolysis - September 11, 2019 Category: Hematology Source Type: research

Survey of confidence in use of stroke and bleeding risk calculators, knowledge of anticoagulants, and comfort with prescription of anticoagulation in challenging scenarios: SUPPORT-AF II study
AbstractHalf of patients with atrial fibrillation (AF) and elevated stroke risk do not receive anticoagulation (AC). Explanations for undertreatment may relate to provider lack of confidence with or knowledge of the CHA2DS2-VASc stroke calculator, unfamiliarity with direct oral anticoagulants (DOACs), or uncertainty about use of AC after bleeding events or other challenging patient scenarios. We surveyed cardiology and primary care providers (PCPs) within a large healthcare system to investigate prescriber knowledge, confidence, and comfort prescribing AC for AF in challenging scenarios. Of 112 providers invited, 70 (63%) ...
Source: Journal of Thrombosis and Thrombolysis - September 11, 2019 Category: Hematology Source Type: research

Determination of the cut-off prothrombin time to estimate plasma rivaroxaban overdose status
AbstractLaboratory monitoring of rivaroxaban (RIV) is required under certain conditions. Mass spectrometry and anti-factor Xa assays are the recommended methods, which may not be readily available. Prothrombin time (PT) is the most widely used and simple coagulation assay. To set the cutoff PT and international normalized ratio (INR) to estimate RIV overdose status. RIV-spiked pooled normal plasma was used. PT test was performed using a CA-7000 coagulometer and Thromborel S reagent. The precise measurement of RIV concentration at the cut-off PT was evaluated according to the Clinical and Laboratory Standard Institute (CLSI...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2019 Category: Hematology Source Type: research

Ticagrelor after pharmacological thrombolysis in patients with ST-segment elevation myocardial infarctions: insight from a trial sequential analysis
AbstractFew randomized controlled trials (RCTs) have compared ticagrelor to clopidogrel after thrombolytic therapy in patients with ST-segment elevation myocardial infarction (STEMI). To assess the quality of the current evidence, a trial sequential analysis (TSA) of all the available RCTs was performed. A literature search through electronic databases for relevant RCTs was completed. Trial sequential boundaries were applied to the meta-analysis to guard against statistical error, calculate the information size (IS), and assess the quality of the currently available evidence. The safety outcome was bleeding at 30-days and ...
Source: Journal of Thrombosis and Thrombolysis - September 10, 2019 Category: Hematology Source Type: research

Age-related burden and characteristics of embolic stroke of undetermined source in the real world clinical practice
AbstractFew data are available on age-related burden and characteristics of embolic stroke of undetermined source (ESUS) in the real world clinical practice. The aim of our study was to provide information about it. We retrospectively analyzed data of patients consecutively admitted to our Stroke Unit along 1  year (2017, November 1st–2018, October 31st). The etiology of ischemic stroke was defined at hospital discharge; ESUS was considered as a subset of cryptogenic stroke, and defined according to the 2014 international criteria. In the analyzed period, 306 patients, 52.3% females, mean age ±&thi...
Source: Journal of Thrombosis and Thrombolysis - September 7, 2019 Category: Hematology Source Type: research

Factors associated with women ’s adherence to postpartum thromboprophylaxis
AbstractPostpartum low-molecular-weight heparin (LMWH) thromboprophylaxis is indicated for a substantial proportion of women. We assessed women ’s adherence to postpartum thromboprophylaxis and the factors associated with adherence. This retrospective cohort study was conducted at a university hospital during 2018. Parturients for whom a recommendation for LMWH prophylaxis was given at discharge from the maternity ward were contacted at t he end of the recommended post-discharge course of LMWH, and were invited to participate in a telephone survey. The main outcome measures were optimal (>  80%) and suboptimal adherence (
Source: Journal of Thrombosis and Thrombolysis - September 6, 2019 Category: Hematology Source Type: research

The role of anticoagulation in pylephlebitis: a retrospective examination of characteristics and outcomes
AbstractPylephlebitis, or suppurative thrombophlebitis of the portal vein, typically occurs in the context of an intraabdominal infection or abdominal sepsis. Antibiotics are the mainstay of treatment. The role of anticoagulation in the management of pylephlebitis is controversial, and data regarding its impact on outcomes is limited. The records of 67 consecutive patients with pylephlebitis treated at our institution over a 19  year period were retrospectively reviewed. Data was gathered regarding their baseline characteristics, presentations, management, and outcomes. Patients who did and did not receive anticoagula...
Source: Journal of Thrombosis and Thrombolysis - September 6, 2019 Category: Hematology Source Type: research

Incidence of residual perfusion defects by lung scintigraphy in patients treated with rivaroxaban compared with warfarin for acute pulmonary embolism
AbstractResidual perfusion defects (RPD) as detected by lung scintigraphy occur in over 50% of patients with acute pulmonary embolism (PE) treated with vitamin K antagonists but there is lack of data in patients treated with direct oral anticoagulants. The aim of this retrospective study was to estimate the incidence of RPD detected by ventilation perfusion (VQ) scan at 3 –6 months in patients with first acute symptomatic PE treated with rivaroxaban compared to warfarin. Consecutive eligible patients treated with rivaroxaban as part of a previous study were identified. The Monash Health Radiology database was used to...
Source: Journal of Thrombosis and Thrombolysis - September 6, 2019 Category: Hematology Source Type: research

A case of acute pancreatitis-induced microangiopathic hemolytic anemia with thrombocytopenia
We report a case of acute pancreatitis induced MAHA-T with end organ dysfunction and a normal ADAMTS13 level. Following three TPEs, the patient ’s clinical status, blood counts and hemolytic markers stabilized. Improvement occurred even after TPE was discontinued. The optimal management of AP-induced MAHA-T is poorly understood. Many centres are reporting good outcomes with the early initiation of TPE. MAHA-T associated with acute pancrea titis is often treated with early initiation of TPE. However, the value of TPE in altering the natural history of the condition is not well understood. Further study is required to ...
Source: Journal of Thrombosis and Thrombolysis - September 6, 2019 Category: Hematology Source Type: research

Extended prophylaxis of venous thromboembolism with betrixaban in acutely ill medical patients with and without cancer: insights from the APEX trial
AbstractAcutely ill medical patients with cancer are at increased risk of venous thromboembolism (VTE). Thromboprophylaxis is recommended in the presence of cancer, but its safety is not known. The aim of this study was to assess the efficacy and safety of extended prophylaxis with betrixaban in cancer patients enrolled in the APEX trial. APEX was a randomized, double-blind trial comparing oral betrixaban 80  mg qd administered for 35–42 days with subcutaneous enoxaparin 40 mg qd administered for 10 ± 4 days. Patients with acute medical illness and a history of cancer or activ...
Source: Journal of Thrombosis and Thrombolysis - September 6, 2019 Category: Hematology Source Type: research

Intravenous unfractionated heparin dosing in obese patients using anti-Xa levels
AbstractThere is limited guidance on intravenous dosing of unfractionated heparin in obese patients. The purpose of this study was to determine the efficacy and safety of a standard unfractionated heparin (UFH) protocol in obese patients based on total body weight (TBW) or adjusted body weight (ABW) to reach two consecutive therapeutic anti-Xa levels. This was a retrospective observational cohort study conducted in a large academic medical center. Adults received a standard UFH protocol between January 1, 2013 to December 31, 2015. Inclusion criteria included age ≥ 18 years of age, weight ≥ 100 kg with a BMI ≥ 30 ...
Source: Journal of Thrombosis and Thrombolysis - September 5, 2019 Category: Hematology Source Type: research

ADAMTS13 activity is associated with early neurological improvement in acute ischemic stroke patients treated with intravenous thrombolysis
AbstractAlthough intravenous thrombolysis (IVT) with recombinant tissue-plasminogen-activator represents a highly effective treatment in acute ischemic stroke patients, not every patient benefits. We hypothesized that pretreatment levels of mediators of hemostasis (VWF and ADAMTS13) and dimethylarginines (ADMA and SDMA) are associated with early neurological improvement and outcome after IVT in ischemic stroke. Moreover we aimed to investigate the link between ADAMTS13 and markers of inflammation (CRP, IL-6, MMP-9 and MCP-1). In 43 patients with acute ischemic stroke treated with IVT blood samples for determination of the ...
Source: Journal of Thrombosis and Thrombolysis - September 3, 2019 Category: Hematology Source Type: research

Interactions between clopidogrel and traditional Chinese medicine
AbstractThe use of traditional Chinese medicine (TCM) has obtained more and more acceptance all over the world due to its multi-target and multi-level function characteristics. Clopidogrel is a major therapeutic option to reduce atherothrombotic events in patients with acute coronary syndrome, recent myocardial infarction, recent stroke or established peripheral arterial disease. These patients probably take TCM. Are there any interactions between clopidogrel and TCM? Whether TCM will affect the efficacy of clopidogrel or increase the adverse reactions of bleeding? Clarifying this information will help physicians make bett...
Source: Journal of Thrombosis and Thrombolysis - August 30, 2019 Category: Hematology Source Type: research

Determinants of anticoagulant therapy in atrial fibrillation at discharge from a geriatric ward: cross sectional study
AbstractOral anticoagulants (OACs) are effective in preventing stroke in older people with atrial fibrillation (AF), but they are often underused in this particularly high-risk population. The aim of the study was to identify health and functional determinants of oral anticoagulant therapy (OA) in AF at discharge from a geriatric sub-acute ward. A cross-sectional study was conducted and patients who presented with atrial fibrillation were analyzed. They were interviewed, examined, assessed with comprehensive geriatric assessment protocol, and had their hospital records analyzed. Relative risks for OA were counted and multi...
Source: Journal of Thrombosis and Thrombolysis - August 30, 2019 Category: Hematology Source Type: research

Ticagrelor and tirofiban in pregnancy and delivery: beyond labels
We report the second pregnancy-associated acute myocardial infarction case successfully treated with ticagrelor before and after primary percutaneous coronary intervention with drug eluting stent implantation on left coronary artery, but also the first report on use of bridging antiplatelet therapy with tirofiban during temporary withdrawal of ticagrelor because of a C-section. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - August 30, 2019 Category: Hematology Source Type: research

Cancer-associated thromboembolism: antithrombotic management of hospitalized patients
AbstractCancer increases risk for venous thromboembolism. Incident thrombocytopenia increases hemorrhagic risk. Hospitalized adults with a cancer diagnosis who received subcutaneous dalteparin in doses adjusted according to platelet count were retrospectively evaluated. Outcomes of interest included nadir platelet counts, transfusions, thromboembolism, and hemorrhage. During a 2-year period of observation, 1854 cancer patients received individualized inpatient treatment with dalteparin. Transfusion was required in 38 of 77 (49.4%) patients with nadir platelet counts    0.9 for all comparisons). Among hospital...
Source: Journal of Thrombosis and Thrombolysis - August 29, 2019 Category: Hematology Source Type: research

Prolonged activated partial thromboplastin time after prophylactic-dose unfractionated heparin in the post-operative neurosurgical setting: case series and management recommendations
We present three patients with normal baseline coagulation parameters in whom pharmacologic thromboprophylaxis with SC UFH resulted in a marked prolongation of the aPTT, leading to  adverse outcomes in two patients. These cases demonstrate the uncertain kinetics of SC UFH and effect on aPTT, suggesting the significance of routine aPTT monitoring in high-risk settings. Given the wide variation in presentations of therapeutic or supratherapeutic values of aPTT in the perioperat ive neurosurgical setting, we propose a practical standardized approach to the evaluation and management of aPTT prolongation following prophyla...
Source: Journal of Thrombosis and Thrombolysis - August 27, 2019 Category: Hematology Source Type: research

Outcomes associated with under-dosing of rivaroxaban for management of non-valvular atrial fibrillation in real-world Japanese clinical settings
AbstractThe approved dose of oral anticoagulant rivaroxaban for patients with non-valvular atrial fibrillation (NVAF) in Japan is 15  mg once daily (od) in patients whose creatinine clearance is ≥ 50 mL/min, but recent real-world studies have demonstrated that these patients often received less than the recommended dose due to bleeding concerns. The effect of under-dosing on safety and effectiveness outcomes remains uncle ar. We used 1-year follow-up data from the XAPASS, a real-world Japanese prospective, single-arm, observational study. Of the 11,308 patients, 6521 patients who completed a 1-ye...
Source: Journal of Thrombosis and Thrombolysis - August 20, 2019 Category: Hematology Source Type: research

Prothrombotic clot properties can predict venous ulcers in patients following deep vein thrombosis: a cohort study
This study suggests that formation of denser fibrin clots with impaired fibrinolysis predisposes to post-thrombotic venous ulcers. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - August 20, 2019 Category: Hematology Source Type: research

Resolution of acute lower extremity deep vein thrombosis with rivaroxaban compared to warfarin
AbstractThrombosis resolution is an important component of treatment for deep vein thrombosis (DVT) and multiple anticoagulants are now available. It is unknown whether rivaroxaban contributes to a higher degree of thrombus resolution compared to conventional anticoagulation with warfarin. Our objective was to compare thrombus resolution for rivaroxaban versus warfarin treated patients with acute lower extremity DVT. Consecutive patients treated for proximal or distal lower extremity DVT with rivaroxaban were identified from the Mayo Thrombophilia Clinic Anticoagulants Registry (November 2015 –June 2016) and compared...
Source: Journal of Thrombosis and Thrombolysis - August 17, 2019 Category: Hematology Source Type: research

Pharmacokinetic/pharmacodynamic assessment of a novel, pharmaceutical lipid –aspirin complex: results of a randomized, crossover, bioequivalence study
AbstractAspirin (acetylsalicylic acid, ASA) can lead to gastrointestinal mucosal injury through disruption of its protective phospholipid bilayer. A liquid formulation of a novel pharmaceutical lipid –aspirin complex (PL-ASA) was designed to prevent this disruption. We sought to determine the pharmacokinetic (PK)/pharmacodynamic (PD) characteristics of PL-ASA compared with immediate release aspirin (IR-ASA). In this active-control crossover study, 32 healthy volunteers were randomized to recei ve 1 of 2 dose levels (a single dose of 325 mg or 650 mg) of either PL-ASA or IR-ASA. After a 2-week washout period...
Source: Journal of Thrombosis and Thrombolysis - August 16, 2019 Category: Hematology Source Type: research

The need for an adapted initiation nomogram during Fiix prothrombin time monitoring of warfarin
AbstractThe new Fiix prothrombin time (Fiix-PT) and its derived Fiix-normalized ratio (Fiix-NR) is affected only by reductions in coagulation factors (F) II and X, the two factors responsible for the antithrombotic effect of vitamin K antagonists (VKA). Due to insensitivity to reductions in the short half-life FVII, the Fiix-NR rises later than standard PT-INR during warfarin initiation. To describe a warfarin initiation nomogram adapted for monitoring with Fiix-NR, anticoagulation development was assessed during use of standard PT-INR based initiation nomogram and after adapting the initiation nomogram for Fiix-NR monitor...
Source: Journal of Thrombosis and Thrombolysis - August 10, 2019 Category: Hematology Source Type: research

Assessment of the reporting quality of RCTs for novel oral anticoagulants in venous thromboembolic disease based on the CONSORT statement
AbstractRandomized controlled trials (RCTs) are the cornerstone of evidence based medicine. Ιt is crucial that RCTs have transparent reporting to facilitate their interpretation. The purpose of the present study is the evaluation of the reporting quality of RCTs for novel oral anticoagulants (NOACs) in venous thromboembolism (VTE) based on the CONSORT statement. MEDLINE was meticulously searched, while quoted references by retrieved RCTs were manually screened. The primary objective was to establish the mean CONSORT compliance of RCTs for NOACs in VTE. Secondary objectives were the calculation of compliance per C...
Source: Journal of Thrombosis and Thrombolysis - August 10, 2019 Category: Hematology Source Type: research

Pulmonary embolism response team implementation improves awareness and education among the house staff and faculty
AbstractA subset of high-risk pulmonary embolism (PE) patients requires advanced therapy beyond anticoagulation. Significant variation in delivery of care has led institutions to standardize their approach by developing Pulmonary Embolism Response Team (PERT). We sought to assess the impact of PERT implementation on house staff and faculty education. After implementation of PERT, we employed a targeted educational intervention aimed to improve PERT awareness, familiarity with treatment options, role of echocardiogram and Doppler ultrasound, and knowledge of acute PE risk stratification tools. We conducted an anonymous surv...
Source: Journal of Thrombosis and Thrombolysis - August 8, 2019 Category: Hematology Source Type: research

Combined effect of a direct oral anticoagulant edoxaban and an inhibitor of activated thrombin-activatable fibrinolysis inhibitor on clot lysis
AbstractFibrinolysis is regulated by the thrombin/thrombin-activatable fibrinolysis inhibitor (TAFI) system. Thus, anticoagulants and inhibitors of TAFI are expected to accelerate fibrinolysis. The combined effects of an anticoagulant and a TAFIa inhibitor on fibrinolysis remain unknown. The aim of this study was to evaluate the combined effect of edoxaban, an oral direct factor Xa (FXa) inhibitor, and a TAFIa inhibitor, potato tuber carboxypeptidase inhibitor (PCI) on tissue-type plasminogen activator (t-PA)-induced clot lysis in human plasma in vitro. Pooled human plasma (containing 180  ng/mL t-PA and 0.1 nM t...
Source: Journal of Thrombosis and Thrombolysis - August 8, 2019 Category: Hematology Source Type: research

Appropriateness of thrombophilia testing in patients in the acute care setting and an evaluation of the associated costs
AbstractThrombophilia testing is rarely recommended in acute care settings due to the high likelihood of false-positive and false-negative results. Inappropriately performing these tests in the acute care setting is associated with inaccurate interpretation and an increased economic burden. In this retrospective analysis, the appropriateness of thrombophilia tests ordered for patients in an acute care setting was evaluated in terms of both clinical utility and economic costs. This analysis included adult inpatients discharged from an academic community medical center from November 1, 2016 to November 1, 2017 who received t...
Source: Journal of Thrombosis and Thrombolysis - August 6, 2019 Category: Hematology Source Type: research

Clinical profile of direct oral anticoagulants versus vitamin K anticoagulants in octogenarians with atrial fibrillation: a multicentre propensity score matched real-world cohort study
AbstractAtrial fibrillation (AF) is the most common arrhythmia in clinical practice and its prevalence increases with age. Few data are available about the clinical performance of direct oral anticoagulant (DOACs) in patients aged  ≥ 80 years with AF. The aim of our propensity score matched cohort study was to compare the safety and efficacy of DOACs versus well-controlled VKA therapy among octogenarians with AF in real life setting. Data for this study were sourced from the multicenter prospectively maintained Atrial Fibrillation Research Database (NCT03760874), which includes all AF patients followe...
Source: Journal of Thrombosis and Thrombolysis - August 5, 2019 Category: Hematology Source Type: research

Use of P2Y12 inhibitors among Medicaid beneficiaries between 2008 and 2018
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - August 3, 2019 Category: Hematology Source Type: research

Right ventricular dysfunction is superior and sufficient for risk stratification by a pulmonary embolism response team
AbstractSeveral risk stratification tools are available to predict short-term mortality in patients with acute pulmonary embolism (PE). The presence of right  ventricular (RV) dysfunction is an independent predictor of mortality and may be a more efficient way to stratify risk for patients assessed by a Pulmonary Embolism Response Team (PERT). We evaluated 571 patients presenting with acute PE, then stratified them by the pulmonary embolism severity ind ex (PESI), by the BOVA score, or categorically as low risk (no RV dysfunction by imaging), intermediate risk/submassive (RV dysfunction by imaging), or high risk/massi...
Source: Journal of Thrombosis and Thrombolysis - August 2, 2019 Category: Hematology Source Type: research

Warfarin induced leukocytoclastic vasculitis: an extraordinary side effect
AbstractWarfarin is one of the most commonly used anticoagulants in the management of thromboembolic events. Herein we report a rare case of warfarin induced leukocytoclastic vasculitis in a patient with history of rheumatic heart disease and a mechanical mitral valve prosthesis who presented with heart failure and palpable purpura. Upon clinical suspicion of cutaneous small vessel vasculitis, a comprehensive laboratory panel was performed. Warfarin induced vasculitis was suspected when withdrawal of warfarin, due to rising INR, led to improvement of the skin lesions. The diagnosis was finally confirmed when re-instatement...
Source: Journal of Thrombosis and Thrombolysis - August 2, 2019 Category: Hematology Source Type: research

Coronary artery fistulae
AbstractCoronary artery fistulae (CAF) are rare congenital or acquired in which a connection forms between one of the coronary arteries and a heart chamber or with other vessels. This paper describes three cases of CAF along with their initial presentation, imaging findings and management. The first case is a rare form of CAF in which the left circumflex coronary artery fistula empty into left ventricle. We discuss the different types of CAF along with their prevalence and the different imaging tools that could be utilized to identify CAF. There is no unifying consensus on treatment strategy for symptomatic fistulae and we...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research

Comparative clinical outcomes between direct oral anticoagulants and warfarin among elderly patients with non-valvular atrial fibrillation in the CMS medicare population
AbstractAtrial fibrillation (AF) prevalence increases with age;>  80% of US adults with AF are aged ≥ 65 years. Compare the risk of stroke/systemic embolism (SE), major bleeding (MB), net clinical outcome (NCO), and major adverse cardiac events (MACE) among elderly non-valvular AF (NVAF) Medicare patients prescribed direct oral anticoagulants (DOACs)vs warfarin. NVAF patients aged ≥ 65 years who initiated DOACs (apixaban, dabigatran, and rivaroxaban) or warfarin were selected from 01JAN2013-31DEC2015 in CMS Medicare data. Propensity score matching was used to balance DOAC and warfari...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research

Does the administration of sonothrombolysis along with tissue plasminogen activator improve outcomes in acute ischemic stroke? A systematic review and meta-analysis
AbstractThis meta-analysis was conducted to assess the safety and efficacy of sonothrombolysis along with intravenous recombinant tissue plasminogen activator, alteplase (IV rtPA), in the management of acute ischemic stroke. Electronic databases were searched under different meSH terms without the restriction of time and language. 1415 studies were analyzed and seven studies that matched the inclusion criteria were selected. Multiple safety and efficacy outcomes were extracted. Our pooled analysis demonstrated that there is no significant difference between sonothrombolysis group and control group in preventing mortality (...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research

Intravascular cells and circulating microparticles induce procoagulant activity via phosphatidylserine exposure in heart failure
AbstractRelatively little information is known about the definitive role of phosphatidylserine (PS) in the hypercoagulability of heart failure (HF). Our objectives were to assess the levels of PS exposure on microparticles (MPs) and blood cells (BCs) in each group of HF patients and to evaluate their procoagulant activity (PCA). HF patients in each NYHA functional class II –IV (II n = 30, III n = 30, IV n = 30) and healthy controls (n = 25) were enrolled in the present study. PS exposure on MPs, BCs was analyzed with flow cytometry. MPs were classified based on ...
Source: Journal of Thrombosis and Thrombolysis - June 29, 2019 Category: Hematology Source Type: research

Associations between use of prasugrel vs clopidogrel and outcomes by type of acute coronary syndrome: an analysis from the PROMETHEUS registry
AbstractWe sought to investigate the utilization of prasugrel and its association with outcomes relative to clopidogrel in three typical subgroups of ACS in a real-world setting. Prasugrel is superior to clopidogrel for reducing risk of ischemic events in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI), but is associated with an increased risk of bleeding complications. PROMETHEUS was a retrospective multicenter observational study of 19,913 ACS patients undergoing PCI from 8 centers in the United States between 2010 and 2013. Major adverse cardiovascular events (MACE) were define...
Source: Journal of Thrombosis and Thrombolysis - June 8, 2019 Category: Hematology Source Type: research

Vincristine induces procoagulant activity of the human lymphoblastic leukemia cell line Jurkat through the release of extracellular vesicles
AbstractThromboembolic events are frequent and serious complications of acute lymphoblastic leukaemia treatment. The importance of chemotherapy in the pathogenesis of this increased risk is enhanced by the fact that thrombosis rarely occurs at diagnosis. Our study aims at investigating the effect of chemotherapy on pro-coagulant activity (PCA), phosphatidylserine (PS) exposure, tissue factor (TF) activity and derived extracellular vesicles (EV) of Jurkat cells. Jurkat cells were treated with two commonly used chemotherapeutics: Vincristine (VCR) or Daunorubicin (DNR), at relevant concentrations. PCA of cells and derived EV...
Source: Journal of Thrombosis and Thrombolysis - June 7, 2019 Category: Hematology Source Type: research

The fading role of triple therapy in patients with atrial fibrillation and acute coronary syndrome: a Bayesian network meta-analysis
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - June 7, 2019 Category: Hematology Source Type: research

Correction to: Patient selection and methods of surgical left atrial appendage exclusion
In the original version of the article copyright information of Figure  2 was not included in the figure legend. (Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - June 7, 2019 Category: Hematology Source Type: research

What are the difficulties in conducting randomised controlled trials of thromboprophylaxis in myeloma patients and how can we address these? Lessons from apixaban versus LMWH or aspirin as thromboprophylaxis in newly diagnosed multiple myeloma (TiMM) feasibility clinical trial
AbstractRoutine thromboprophylaxis (TP) in newly-diagnosed multiple myeloma (NDMM) patients comprises either aspirin for standard risk patients or low molecular weight heparin for high risk patients. Studies using DOACs in cancer patients include few with myeloma. The aim of this feasibility clinical trial was to establish the foundations for creating a multicentre trial and identify any safety concerns with apixaban. Patient perspectives were sought. NDMM patients were stratified according to VTE risk and randomised to either standard TP or apixaban 2.5  mg BD and reviewed every 3 weeks throughout their chemothe...
Source: Journal of Thrombosis and Thrombolysis - June 5, 2019 Category: Hematology Source Type: research

Paradoxical migration of an arterial embolus upstream from the fistula during a percutaneous thrombectomy procedure
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - June 5, 2019 Category: Hematology Source Type: research

Efficacy and safety of rivaroxaban on the resolution of left atrial/left atrial appendage thrombus in nonvalvular atrial fibrillation patients
AbstractData on LA/LAA thrombus resolution after rivaroxaban treatment has not been established. The aim of the present study was to compare the efficacy and safety on the resolution of LA/LAA thrombus between rivaroxaban and warfarin in nonvalvular atrial fibrillation (AF) patients. 80 AF patients with LA/LAA thrombus between January 2013 and June 2016 were randomized divided into warfarin group (n  = 40) and rivaroxaban group (n = 40). Compared to warfarin group, thrombin time (TT; p 
Source: Journal of Thrombosis and Thrombolysis - June 5, 2019 Category: Hematology Source Type: research

Off-pump technique and replacement therapy for coronary artery bypass surgery in a patient with hemophilia B
AbstractAntithrombotic treatment and perioperative management in patients with hemophilia remains a challenge. As life expectancy in these patients is increasing, a concern about cardiovascular diseases is emerging. Herein we present the case of a 68  year-old patient with mild hemophilia B and multivessel coronary disease who underwent coronary artery bypass grafting (CABG) surgery. Off-pump surgery with continuous infusion FIX treatment was performed successfully with stable factor IX levels, and no bleeding or thrombotic complications. There is a paucity of cases reported regarding management of CABG in this popula...
Source: Journal of Thrombosis and Thrombolysis - May 31, 2019 Category: Hematology Source Type: research

Concurrent presentation of a hemorrhagic pericardial effusion and venous thromboembolism in malignancy: a systematic review of case studies
AbstractThe concurrent presentation of symptomatic malignant pericardial hemorrhage and venous thromboembolism is a rare event that poses a clinical dilemma. Existing VTE guidelines do not indicate when, or if, anticoagulation therapy should be started after the treatment of the pericardial bleed. We performed a systematic review to compile the published clinical evidence on the occurrence of coexisting pericardial hemorrhage and VTE in cancer patients and to describe the clinical presentations and bleeding and thrombosis outcomes before and after anticoagulation therapy. We studied published case reports on patients with ...
Source: Journal of Thrombosis and Thrombolysis - May 27, 2019 Category: Hematology Source Type: research

Genetic factors affecting thrombosis in patients with essential thrombocythemia by heparin treatment
(Source: Journal of Thrombosis and Thrombolysis)
Source: Journal of Thrombosis and Thrombolysis - May 24, 2019 Category: Hematology Source Type: research

Influence of factor XII deficiency on activated partial thromboplastin time (aPTT) in critically ill patients
AbstractFXII deficiency results in spontaneous prolongation of activated partial thromboplastin time (aPTT), which is widely used to monitor thromboprophylaxis. Misinterpretation of spontaneously prolonged aPTT may result in omission of thromboembolic treatment or even unnecessary transfusion of blood products. This retrospective analysis was performed to calculate a threshold level of FXII resulting in aPTT prolongation. 79 critically ill patients with spontaneous prolongation of aPTT were included. A correlation analysis and a ROC curve for aPTT prolongation predicted by FXII level were created to find the FXII threshold...
Source: Journal of Thrombosis and Thrombolysis - May 23, 2019 Category: Hematology Source Type: research

Assessing the accuracy of ICD-10 codes for identifying acute thromboembolic events among patients receiving anticoagulation therapy
AbstractInternational classification of disease (ICD) codes can improve the efficiency of epidemiological research provided the codes accurately identify outcomes of interest. The purpose of this retrospective  cross-sectional study is to evaluate the accuracy of ICD-10 codes for identifying thromboembolic events occurring during anticoagulation therapy. Medical charts of patients hospitalized for any reason while receiving anticoagulant therapy between September 1, 2017 and December 31, 2017 were revie wed by two reviewers blinded to ICD-10 code status. Following identification of confirmed acute thromboembolic ...
Source: Journal of Thrombosis and Thrombolysis - May 23, 2019 Category: Hematology Source Type: research

Carbon monoxide inhibits the anticoagulant activity of Mojave rattlesnake venoms type A and B
AbstractThe Mojave rattlesnake is a unique species of pit viper that expresses either a highly potent phospholipase A2 (PLA2)-dependent neurotoxin containing venom nearly devoid of fibrinogenolytic metalloproteinases (venom type A) or a hemotoxic venom with a high percentage of metalloproteinases and PLA2 without any neurotoxin present (venom type B) depending on its geographical location in the Southwestern United States and Mexico. Given that PLA2 have been demonstrated to affect coagulation, it was hypothesized that the anticoagulant effects of both type A and B venoms could be assessed by thrombelastography, and determ...
Source: Journal of Thrombosis and Thrombolysis - May 23, 2019 Category: Hematology Source Type: research

Catheter-related right internal jugular vein large thrombus formation after inadvertently malposition in the cranial direction
We report a rare case of an inadvertently malposition of a catheter using ultrasound in the right internal jugular vein, the catheter tip went in the cranial direction at an acute angle. The misplacement caused severe discomfort and a large thrombosis of right internal jugular vein. We also show that a large CVC-related thrombosis formation treatment, CVC is kept under close surveillance, recovered satisfactorily and possibly avoid thrombus embolization in cancer patients guided by ultrasound. It needs to be vigilant for ultrasound assessment and surveillance in the perioperative period in cancer patients with indwelling C...
Source: Journal of Thrombosis and Thrombolysis - May 23, 2019 Category: Hematology Source Type: research