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Journal of Thrombosis and Thrombolysis

Kay T Htun, Mabel J Y Ma, Agnes Y Y Lee
Patients with acute leukemia frequently develop catheter-related thrombosis (CRT) despite concurrent thrombocytopenia. The incidence, treatment and outcomes of this complication are poorly documented. We undertook this study to determine the incidence of CRT in patients with acute leukemia and assess the safety and effectiveness of a treatment strategy using a platelet-adjusted low molecular weight heparin (LMWH) dosing protocol. Patients (18 years and older) with newly diagnosed acute leukemia from January 2014 to December 2015 who received central venous catheters were included...
July 16, 2018: Journal of Thrombosis and Thrombolysis
F Dentali, S Barco, S Pegoraro, M N D Di Minno, D Mastroiacovo, F Pomero, C Lodigiani, F Bagna, M Sartori, G Barillari, N Mumoli, M Napolitano, S M Passamonti, R Benedetti, W Ageno, M Di Nisio
After acute proximal deep vein thrombosis (DVT) the thrombotic mass decreases, especially during the first months of anticoagulation. The persistence of residual vein obstruction (RVO) may predict future recurrence in patients with cancer-associated DVT. We aimed to evaluate the proportion of patients with RVO after an episode of cancer associated isolated distal DVT (IDDVT), to identify variables associated with RVO, and to provide initial evidence of its association with recurrent VTE. We performed a post-hoc analysis of a multicenter cohort study of patients with isolated cancer-associated acute IDDVT...
July 16, 2018: Journal of Thrombosis and Thrombolysis
Stefano Forlivesi, Bruno Bonetti, Manuel Cappellari
To rationally plan acute services, the proportion of ischemic strokes that may be eligible for revascularization treatments should be estimated. We aimed to estimate the proportion of patients directly admitted to an Italian Comprehensive Stroke Center who may be eligible for intravenous thrombolysis (IVT), combined IVT and endovascular thrombectomy (ET), or direct ET according to the current guidelines. We conducted a retrospective analysis based on data prospectively collected from 876 consecutive adult ischemic stroke patients who were directly admitted to the Stroke Unit of the University Hospital of Verona within 12 h of stroke onset...
July 14, 2018: Journal of Thrombosis and Thrombolysis
Ahmet Guner, Macit Kalcik, Mustafa Ozan Gursoy, Sabahattin Gunduz, Mehmet Ozkan
No abstract text is available yet for this article.
July 4, 2018: Journal of Thrombosis and Thrombolysis
Marino Scherillo, Plinio Cirillo, Dario Formigli, Giulio Bonzani, Paolo Calabrò, Paolo Capogrosso, Pio Caso, Giovanni Esposito, Rosario Farina, Paolo Golino, Tonino Lanzillo, Franco Mascia, Ciro Mauro, Federico Piscione, Girolamo Sibilio, Bernardino Tuccillo, Bruno Villari, Bruno Trimarco
Dual antiplatelet therapy (DAPT) is a cornerstone of treatment for patients with acute coronary syndromes (ACS). Mounting evidences have opened the debate about the optimal DAPT duration. Considering the ACS-pathophysiology, the most recent guidelines recommend DAPT in all ACS patients for at least 12 months unless there are contraindications such as excessive risk of bleeding. Thus, it can be considered acceptable earlier discontinuation if the risk of morbidity from bleeding outweighs the anticipated benefit...
June 26, 2018: Journal of Thrombosis and Thrombolysis
Gerald Chi, Megan K Yee, Arzu Kalayci, Mathieu Kerneis, Fahad AlKhalfan, Roxana Mehran, Christoph Bode, Jonathan L Halperin, Freek W A Verheugt, Peter Wildgoose, Martin van Eickels, Gregory Y H Lip, Marc Cohen, Eric D Peterson, Keith A A Fox, C Michael Gibson
Among atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI), rivaroxaban with background antiplatelet therapy significantly reduced the first occurrence of bleeding compared to triple therapy with warfarin. This study hypothesized that total bleeding events, including those beyond the first event, would be reduced with rivaroxaban-based regimens. In the PIONEER AF-PCI trial, 2099 patients in the modified intention-to-treat population were randomized to three groups and followed for 12 months: (1) rivaroxaban 15 mg once daily plus a P2Y12 inhibitor (N = 696); (2) rivaroxaban 2...
June 26, 2018: Journal of Thrombosis and Thrombolysis
Babikir Kheiri, Mohammed Osman, Ahmed Abdalla, Tarek Haykal, Mahmoud Barbarawi, Yazan Zayed, Michael Hicks, Sahar Ahmed, Ghassan Bachuwa, Mustafa Hassan, Deepak L Bhatt
Dual antiplatelet therapy with aspirin and clopidogrel are recommended as adjuncts to fibrinolytic-treated patients with ST-elevation myocardial infarction (STEMI). However, the role of switching to ticagrelor within 24 h of fibrinolytics compared with clopidogrel continuation in this setting is uncertain. Hence, we conducted a comprehensive search of electronic databases for all randomized clinical trials (RCTs) that evaluated the safety and efficacy of ticagrelor versus clopidogrel after fibrinolytic therapy in patients with STEMI...
June 22, 2018: Journal of Thrombosis and Thrombolysis
José Sérgio Nascimento Silva, Isly Maria Lucena de Barros, Fabiano Lima Cantarelli, Rodrigo Cantarelli Alves, Felipe José de Andrade Falcão, Josefa Martinelly Dos Santos Silva, Flávio Roberto Azevedo de Oliveira, Rodrigo Pinto Pedrosa
To verify the frequency and predictors associated with stent thrombosis (ST) in a developing country. Observational, case-control study including 2535 consecutive patients undergoing percutaneous coronary intervention (PCI) in two reference hospitals in Brazil, from October 2013 to December 2015. ST patients were matched to controls in a 1:3 ratio for gender, age, procedure indication, and performing hospital. From the total sample, 65 (2.5%) ST occurred and were matched with 195 controls (age 64.9 ± 11...
June 21, 2018: Journal of Thrombosis and Thrombolysis
Vance G Nielsen, Timothy D Ward, Paul M Ford
INTRODUCTION: Copper poisoning is associated with severe multiorgan injury and potentially death if chelation therapy is not administered. Of interest, while important gastrointestinal and urinary tract hemorrhage is associated with copper poisoning, very little is known concerning the nature of copper induced coagulopathy. METHODS: Using thrombelastography, we assessed changes in coagulation kinetics in human plasma following exposure to copper concentrations encountered during poisoning...
June 21, 2018: Journal of Thrombosis and Thrombolysis
Vance G Nielsen, Paul M Ford
Aminocaproic acid (EACA) availability has recently been decreased whereas tranexamic acid (TXA) is still available as an antifibrinolytic agent to decrease blood loss associated with procedures involving cardiopulmonary bypass (CPB) by inhibiting plasmin mediated platelet activation. Given that the clinical inclination is to substitute TXA for EACA, we sought to compare the antifibrinolytic efficacy of the two agents using the clinically accepted molar ratio of EACA:TXA (7.9:1) that prevents platelet activation in a viscoelastic based system under a variety of conditions in human plasma; 25-50% therapeutic concentration (EACA 32...
June 20, 2018: Journal of Thrombosis and Thrombolysis
Guy Witberg, Jalal Bathish, Tamir Bental, Dorit Leshem-Lev, Abid Assali, Ran Kornowski, Eli Lev
To assess the effect of cessation of dual antiplatelet therapy (DAPT) regimens containing 2nd generation P2 Y12 inhibitors on platelet reactivity, in patients who completed 12 months of DAPT following an acute myocardial infarction. Clinical data has shown an increased cardiovascular risk in the 90 days following cessation of DAPT. One possible explanation is a transient platelet hyper-reactivity after cessation of treatment. Data from patients treated with 2nd generation P2 Y12 inhibitors is scarce. Patients who completed 12 month DAPT with prasugrel/ticagrelor underwent serial assessment of platelet reactivity (on DAPT and 1, 4 and 12 weeks post cessation)...
June 19, 2018: Journal of Thrombosis and Thrombolysis
Daryoush Samim, Pedro Marques-Vidal, Lorenzo Alberio, Gérard Waeber, Marie Méan
The predictive value of factor V Leiden and the G20210A prothrombin mutation regarding recurrent venous thromboembolism (VTE) is limited and does not influence subsequent patient management. Systematic testing for such genetic thrombophilia should be avoided, but to which extent such testing is practiced in a Swiss Hospital is unknown. To examine the current practice of factor V Leiden and/or G20210A prothrombin mutation testing in a University Hospital, and to assess the clinical consequences of testing on patients...
June 19, 2018: Journal of Thrombosis and Thrombolysis
Takao Sato, Yoshifusa Aizawa, Naomasa Suzuki, Yuji Taya, Sho Yuasa, Shohei Kishi, Tomoyasu Koshikawa, Koichi Fuse, Satoshi Fujita, Yoshio Ikeda, Hitoshi Kitazawa, Minoru Takahashi, Masaaki Okabe
Filter-no reflow (FNR) is a phenomenon wherein flow improves after the retrieve of distal protection. Near-infrared spectroscopy with intravascular ultrasound (NIRS-IVUS) enables lipid detection. We evaluated the predictors of FNR during PCI using NIRS-IVUS. Thirty-two patients who underwent PCI using the Filtrap® for acute coronary syndrome (ACS) were enrolled. The culprit plaque (CP) was observed using NIRS-IVUS. Total lipid-core burden index (T-LCBI) and maximal LCBI over any 4-mm segment (max-LCBI4mm) within CP were evaluated...
June 18, 2018: Journal of Thrombosis and Thrombolysis
Babikir Kheiri, Tarek Haykal, Ahmed Abdalla, Mohammed Osman, Sahar Ahmed, Khansa Osman, Ghassan Bachuwa, Mustafa Hassan, Deepak L Bhatt
No abstract text is available yet for this article.
June 15, 2018: Journal of Thrombosis and Thrombolysis
Manuel Cappellari, Gianni Turcato, Stefano Forlivesi, Nicola Micheletti, Giampaolo Tomelleri, Bruno Bonetti, Giovanni Merlino, Roberto Eleopra, Monia Russo, Roberto L'Erario, Alessandro Adami, Carolina Gentile, Anna Gaudenzi, Sandro Bruno, Paolo Bovi
In clinical practice, direct oral anticoagulants (DOACs) are often started earlier (≤ 7 days) than in randomized clinical trials after stroke. We aimed to develop a nomogram model incorporating time of DOAC introduction ≤ 7 days of stroke onset in combination with different degrees of stroke radiological/neurological severity at the time of treatment to predict the probability of unfavorable outcome. We conducted a multicenter prospective study including 344 patients who started DOAC 1-7 days after atrial fibrillation-related stroke onset...
June 15, 2018: Journal of Thrombosis and Thrombolysis
Andrew B Hughey, Xiaokui Gu, Brian Haymart, Eva Kline-Rogers, Steve Almany, Jay Kozlowski, Dennis Besley, Gregory D Krol, Syed Ahsan, Scott Kaatz, James B Froehlich, Geoffrey D Barnes
Randomized controlled trials (RCTs) examining warfarin use for stroke prevention in atrial fibrillation (AF) may not accurately reflect real-world populations. We aimed to determine the representativeness of the RCT populations to real-world patients and to describe differences in the characteristics of trial populations from trial eligible patients in a real-world setting. We hypothesized that a significant fraction of real-world patients would not qualify for the RE-LY, ROCKET-AF, and ARISTOTLE trials and that real-world patients qualifying for the studies may have more strokes and bleeding events...
June 14, 2018: Journal of Thrombosis and Thrombolysis
Ji-Zheng Qin, Shao-Jie Wang, Chun Xia
Endothelial nitric oxide synthase (eNOS) encoded by nitric oxide synthase 3 (NOS3), can generate nitric oxide (NO) which serves as an important deterrent to the pathogenesis of thrombosis by modulating the activation, adhesion and aggregate formation of platelets. Three serum miRNAs (miR-195, miR-532 and miR-582) have been suggested as biomarkers for the diagnosis of deep vein thrombosis (DVT), however their potential roles in DVT is not clear. The effect of miRNAs inhibiting the expression of NOS3 was evaluated in vitro...
June 13, 2018: Journal of Thrombosis and Thrombolysis
Majed S Al Yami, Hisham A Badreldin, Abdelhameed H Mohammed, Ahmed M Elmubark, Mohammed Y Alzahrani, Abdulmajeed M Alshehri
Low molecular weight heparins (LMWHs) are considered the standard of care for the treatment of venous thromboembolism (VTE) associated with cancer. We conducted a meta-analysis to evaluate the safety and efficacy of direct oral anticoagulants (DOACs) in patients with cancer. We systematically searched Medline for potential randomized-control clinical trials (RCTs) and post-hoc analyses. For each study, data on recurrent VTE, major or clinically relevant non-major bleeding (CRNMB), and major bleeding (MB) were extracted...
June 12, 2018: Journal of Thrombosis and Thrombolysis
Craig I Coleman, Alexander G G Turpie, Thomas J Bunz, Jan Beyer-Westendorf
A paucity of real-world data evaluating rivaroxaban in provoked venous thromboembolism (VTE) exists. We assessed the effectiveness and safety of rivaroxaban versus warfarin in provoked VTE patients treated in routine practice. Using MarketScan claims data from 1/2012 to 12/2016, we identified adults who had ≥ 1 primary hospitalization/emergency department discharge diagnosis code for VTE (index event) and a provoking factor, received rivaroxaban or warfarin as their first outpatient oral anticoagulant within 30-days of the index event and had ≥ 12-month of insurance coverage prior the index VTE...
June 7, 2018: Journal of Thrombosis and Thrombolysis
Eiman Ghaffarpasand, Maneli D Tehrani, Jolanta Marszalek, Gerald Chi
Intracardiac thrombus most commonly develops in the left atrial appendage (LAA) and left ventricle (LV) in the setting of atrial fibrillation (AF) and post-myocardial fibrillation (MI), respectively. Current guidelines recommend that patients with post-MI LV or LAA thrombus should be treated with vitamin K antagonist (VKA). However, the use of VKA may be limited by bleeding complications, interactions with various food and drugs, and a narrow therapeutic window requiring frequent monitoring. Thus, non-VKA oral anticoagulants (NOACs) have been attempted as an off-label use for the treatment of intracardiac thrombosis in light of their favorable pharmacologic profile...
June 6, 2018: Journal of Thrombosis and Thrombolysis
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