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Journal of Thrombosis and Thrombolysis

Megan Z Roberts, G Eric Gaskill, Julie Kanter-Washko, T Rogers Kyle, Brittany C Jones, Nicole M Bohm
Patients with sickle cell disease (SCD) experience initial and recurrent venous thromboembolism (VTE) more commonly and at a younger age than the general population, and it confers a higher mortality for patients with SCD. However, limited evidence is available to guide anticoagulant use for VTE treatment in this population. The primary objective of this study is to characterize the effectiveness and safety of direct oral anticoagulants (DOAC) and warfarin for VTE treatment among patients with SCD. This single-center retrospective study includes adult patients with SCD who were diagnosed with VTE...
March 19, 2018: Journal of Thrombosis and Thrombolysis
Diana A Gorog
The stability of an arterial thrombus, determined by its structure and ability to resist endogenous fibrinolysis, is a major determinant of the extent of infarction that results from coronary or cerebrovascular thrombosis. There is ample evidence from both laboratory and clinical studies to suggest that in addition to inhibiting platelet aggregation, antithrombotic medications have shear-dependent effects, potentiating thrombus fragility and/or enhancing endogenous fibrinolysis. Such shear-dependent effects, potentiating the fragility of the growing thrombus and/or enhancing endogenous thrombolytic activity, likely contribute to the clinical effectiveness of such medications...
March 17, 2018: Journal of Thrombosis and Thrombolysis
Gang Zheng, Qian Tang, Ping Shang, Xiao-Yun Pan, Hai-Xiao Liu
Arthroscopic knee surgery is the most commonly performed orthopedic procedure worldwide and whether thromboprophylaxis should be undertaken after knee arthroscopy is still controversial. To evaluate the efficacy of thromboprophylaxis for deep venous thrombosis (DVT) and venous thromboembolism (VTE) after knee arthroscopic surgery. A meta-analysis was conducted using data from eight randomized trials (4148 patients) to compare thromboprophylaxis with placebo or no prophylactic treatment in patients undergoing knee arthroscopy...
March 16, 2018: Journal of Thrombosis and Thrombolysis
Amihai Rottenstreich, Netanel Zacks, Geffen Kleinstern, Bruria Hirsh Raccah, Batia Roth, Nael Da'as, Yosef Kalish
The role of drug-level monitoring among patients using direct-acting oral anticoagulant (DOAC) is unclear. We aimed to investigate its 'real-life' utilization and effect on clinical management. A review of records of patients who underwent DOAC level testing during 2013-2017. Overall, 212 patients (median age 77 years) underwent 292 DOAC measurements [apixaban (n = 147), rivaroxaban (n = 102), dabigatran (n = 43)]. Monitoring volume increased by 460% during study period. DOAC level testing was performed during routine follow-up in 51 (17...
March 12, 2018: Journal of Thrombosis and Thrombolysis
Tufan Çınar, Mert Ilker Hayıroğlu, Veysel Ozan Tanık, Emre Aruğaslan, Muhammed Keskin, Mahmut Uluganyan, Ahmet Öz, Metin Çağdaş, Ahmet Taha Alper
Prosthetic valve thrombosis (PVT) is a potentially life-threatening complication associated with high morbidity and mortality. The CHA2DS2-VASc is a clinical score used to determine thromboembolism risk in non-valvular atrial fibrillation patients. Therefore; in this study, we aimed to determine predictive value of the CHA2DS2-VASc score for development of PVT in patients with mechanical prosthetic valve. This was a retrospective study included 417 consecutive patients with mechanic prosthetic valve in whom transesophageal echocardiography (TEE) was performed due to different clinical indications from January 2004 to June 2016...
March 9, 2018: Journal of Thrombosis and Thrombolysis
Renato D Lopes, Patricia O Guimarães, Mark Crowther, Elaine Hylek, Gilson S Feitosa-Filho, Luiz E Ritt, Nivaldo Filgueiras, David A Garcia
To discuss and share knowledge about advances in the care of patients with thrombotic disorders, the Tenth International Symposium of Thrombosis and Anticoagulation was held in Salvador, Bahia, Brazil, on September 22 and 23, 2017. This scientific program was developed by clinicians for clinicians and was promoted by two major clinical research institutes-the Brazilian Clinical Research Institute and the Duke Clinical Research Institute of the Duke University School of Medicine. Comprising academic presentations and open discussion, the symposium had as its primary goal to educate, motivate, and inspire internists, cardiologists, hematologists, and other physicians by convening national and international visionaries, thought-leaders, and dedicated clinician-scientists...
March 9, 2018: Journal of Thrombosis and Thrombolysis
Dylan L Steen
No abstract text is available yet for this article.
March 7, 2018: Journal of Thrombosis and Thrombolysis
Ryan J Winstead, Komal Pandya, Jeremy Flynn, George A Davis, Adam Sieg, Maya Guglin, Aric Schadler, Rickey A Evans
Recombinant, activated factor VIIa (rFVIIa) is used during cardiac surgeries to mitigate refractory coagulopathic bleeding. The purpose of this study was to examine whether rFVIIa use in orthotopic heart transplant (OHT) recipients was associated with a higher incidence of thromboembolic (TE) events compared to patients who did not. A single-center, retrospective, cohort study was performed on OHT recipients who received rFVIIa for refractory coagulopathic bleeding from January 2013 to December 2015. Patients were evaluated for up to 6 months after transplantation and assessed for TE events, rejection, readmissions, graft survival, and patient survival...
March 5, 2018: Journal of Thrombosis and Thrombolysis
Mijntje M I Schellekens, Mayte E van Alebeek, Renate M Arntz, Nathalie E Synhaeve, Noortje A M M Maaijwee, Hennie C Schoonderwaldt, Maureen J van der Vlugt, Ewoud J van Dijk, Loes C A Rutten-Jacobs, Frank-Erik de Leeuw
BACKGROUND: The role of hypercoagulable states and preceding infections in the etiology of young stroke and their role in developing recurrent ischemic events remains unclear. Our aim is to determine the prevalence of these conditions in patients with cryptogenic stroke at young age and to assess the long-term risk of recurrent ischemic events in patients with and without a hypercoagulable state or a recent pre-stroke infection with Borrelia or Syphilis. PATIENTS AND METHODS: We prospectively included patients with a first-ever transient ischemic attack or ischemic stroke, aged 18-50, admitted to our hospital between 1995 and 2010...
February 26, 2018: Journal of Thrombosis and Thrombolysis
Tian-Yuan Xiong, Yan-Biao Liao, Yuan Feng, Ming-Yue Zhao, Zhen-Gang Zhao, Yi-Jian Li, Xiao-Jing Liu, Mao Chen
The imaging finding of hypo-attenuated leaflet thickening (HALT) on bioprosthesis after transcatheter aortic valve replacement (TAVR) has been reported. The underlying mechanism is not clear, but leaflet thrombosis is speculated to be the cause. Heterogeneous antiplatelet responses may play a role in the process. This is a prospective, single-center pilot study in patients who received successful TAVR from June 2012 to November 2016. HALT on post-procedural multi-detector computed tomography. We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance...
February 24, 2018: Journal of Thrombosis and Thrombolysis
Jeremy W Vandiver, K Diane Beavers
Anticoagulant therapy and antiplatelet therapy are used regularly for prevention of arterial and venous thrombosis, and combinations of the two drug classes are seen with relative frequency in clinical practice. While co-prescribing is as high as 39-55% in some real-world cohort studies, the number of patients that meet criteria for combination therapy based on the overall body of evidence is likely much lower. This may not always be realized by prescribers, and many patients may be continued on long term combination therapies that provide little additional benefit, and carry significant risk for harm...
February 24, 2018: Journal of Thrombosis and Thrombolysis
Carolin Hoyer, Alexandra Filipov, Eva Neumaier-Probst, Kristina Szabo, Anne Ebert, Angelika Alonso
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs) have gained increasing importance for stroke prevention in patients with non-valvular atrial fibrillation (AF). With changing prescription practice, among other factors, clinicians can expect to see rising numbers of patients with ischemic stroke and pre-existing NOAC therapy. Few data exist regarding a potential impact of NOAC on stroke severity and outcome. AIMS: To evaluate the impact of pre-admission NOAC therapy on ischemic stroke severity...
February 23, 2018: Journal of Thrombosis and Thrombolysis
Yasuhiko Kubota, Mary Cushman, Neil Zakai, Wayne D Rosamond, Aaron R Folsom
TV viewing is associated with risk of arterial vascular diseases, but has not been evaluated in relation to venous thromboembolism (VTE) risk in Western populations. In 1987-1989, the Atherosclerosis Risk in Communities Study obtained information on the frequency of TV viewing in participants aged 45-64 and followed them prospectively. In individuals free of prebaseline VTE (n = 15, 158), we used a Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident VTE according to frequency of TV viewing ("Never or seldom", "Sometimes", "Often" or "Very often")...
February 21, 2018: Journal of Thrombosis and Thrombolysis
Joseph J Shatzel, Molly M Daughety, Vinay Prasad, Thomas G DeLoughery
Three previous reports of PFO closure for secondary stroke prevention failed to find any significant benefit. Recently however, three conflicting reports were published suggesting a benefit in select patients. Although we are enthusiastic for PFO closure in appropriate patients, caution is warranted in the extrapolation of this data and the application of this intervention to broader patient groups. Only small minorities of stroke patients are likely to benefit from PFO closure, the intervention has a notable complication rate, and it has not been compared against modern anticoagulation options...
February 20, 2018: Journal of Thrombosis and Thrombolysis
Fabio Mangiacapra, Iginio Colaiori, Elisabetta Ricottini, Antonio Creta, Giuseppe Di Gioia, Ilaria Cavallari, Edoardo Bressi, Marialessia Capuano, Emanuele Barbato, Germano Di Sciascio
We investigated the impact of suboptimal platelet reactivity on clinical outcomes after percutaneous coronary intervention (PCI). We enrolled 500 patients with stable coronary artery disease undergoing elective PCI. Platelet reactivity was measured before PCI using the VerifyNow P2Y12 assay. Primary endpoint was the incidence of ischemic or bleeding events at 1 month and 5 years. Patients with high platelet reactivity (HPR) showed significantly higher rates of ischemic events both during the 1st month after PCI (HR 2...
February 15, 2018: Journal of Thrombosis and Thrombolysis
Jacob E Kurlander, Geoffrey D Barnes, Michelle A Anderson, Brian Haymart, Eva Kline-Rogers, Scott Kaatz, Sameer D Saini, Sarah L Krein, Caroline R Richardson, James B Froehlich
To understand how physicians from various specialties perceive coordination of care when managing peri-procedural anticoagulation. Cross-sectional survey of cardiologists, gastroenterologists, and primary care physicians (PCPs) in an integrated health system (N = 251). The survey began with a vignette of a patient with atrial fibrillation co-managed by his PCP, cardiologist, and an anticoagulation clinic who must hold warfarin for a colonoscopy. Respondents' experiences and opinions around responsibilities and institutional support for managing peri-procedural anticoagulation were elicited using multiple choice questions...
February 8, 2018: Journal of Thrombosis and Thrombolysis
Zhi-Jun Guo, Hai-Tao Liu, Ze-Mei Bai, Qiang Lin, Bao-Hong Zhao, Qian Xu, Yan-Hong Zeng, Wen-Qiu Feng, Hai-Tao Zhou, Fei Liang, Ji-Yan Cui
Acute pulmonary embolism (APE) is a serious disease which is life-threatening. Since it is crucial for APE patients to assess the changes of cardiac function safely and timely, the imaging research of cardiac morphology and function is becoming more and more important. The correlation of computed tomography (CT) measured cardiac parameters and pulmonary obstruction index (POI) was analyzed to discuss the morphological changes of the heart of APE patients in order to provide a new method to evaluate cardiac functions accurately and effectively...
February 7, 2018: Journal of Thrombosis and Thrombolysis
Maliha Khan, Travis M Cox, Mohammed Nassif, Mohanad A Alzubaidi, Naveen Garg, Wei Qiao, Fleur M Aung, Thein Hlaing Oo, Cristhiam M Rojas-Hernandez
Patients with hematological malignancies often have severe thrombocytopenia, which poses problems when making thrombosis management decisions. A retrospective study was conducted to analyze the clinical outcomes associated with different management options in acute leukemic patients with thrombocytopenia (≤ 50 × 109/L) following an acute venous thromboembolic event. A total of 74 patients were divided into three treatment groups: observation only (n = 30); anticoagulation (n = 23); or inferior vena cava placement (n = 21)...
February 7, 2018: Journal of Thrombosis and Thrombolysis
Yadong Shi, Wanyin Shi, Liang Chen, Jianping Gu
To review the clinical evidence for ultrasound-accelerated catheter-directed thrombolysis (UACDT) using the EKOS system in the treatment of deep vein thrombosis (DVT) in terms of case selection, procedural outcomes, clinical outcomes and safety outcomes. A systematic literature search strategy was used to identify the use of the EKOS system in the treatment of DVT using the following electronic databases: MEDLINE, EMBASE, the Cochrane databases and the Web of Science. The references in the relevant literature were also screened...
February 7, 2018: Journal of Thrombosis and Thrombolysis
Robert Diep, Ara Metjian
Essential thrombocythemia (ET) is an indolent myeloproliferative neoplasm characterized by megakaryocyte hyperplasia, thrombocytosis, thrombotic and hemorrhagic complications, and potential transformation into myelofibrosis and acute myeloid leukemia. The vast majority of cases are driven by a somatic mutation in JAK2, CALR, or MPL. CALR, a gene that codes for the calcium-binding chaperone calreticulin, is the predominant mutation in patients with non-mutated JAK2 essential thrombocythemia, accounting for 20-25% of the overall somatic mutation frequency in ET...
February 6, 2018: Journal of Thrombosis and Thrombolysis
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