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Journal of Thrombosis and Thrombolysis

Mark Goldin, Jessica Cohen, Alex Makhnevich, Colm Mulvany, Meredith Akerman, Liron Sinvani
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. Hospitalized, medically ill older adults have increased risk; despite guidelines, data suggest suboptimal pharmacologic prophylaxis rates. Factors influencing provider prescribing non-compliance are unclear. We aimed to describe VTE prophylaxis practices and identify risk factors for, and outcomes of, prescribing non-compliance. A retrospective study was conducted of hospitalized adults aged ≥ 75 years, admitted to the medicine service of a large academic tertiary center from May 1, 2014 to June 30, 2015...
January 12, 2018: Journal of Thrombosis and Thrombolysis
Brett J Carroll, Samuel Z Goldhaber, Ping-Yu Liu, Gregory Piazza
Obesity is a well-established risk factor for pulmonary embolism (PE). However, treatment of PE in obese patients is challenging because of limited outcomes data, especially with advanced therapies such as catheter-based fibrinolysis. We assessed the efficacy and safety of ultrasound-facilitated, catheter-directed fibrinolysis in obese patients with submassive and massive PE enrolled in the SEATTLE II Trial. Eligible patients had a right ventricular-to-left ventricular (RV/LV) diameter ratio ≥ 0.9 on chest computed tomography (CT)...
January 10, 2018: Journal of Thrombosis and Thrombolysis
R Ghazvinian, A Gottsäter, J L Elf
Anticoagulant treatment of acute pulmonary embolism (PE) has traditionally been hospital-based. The lesser need for monitoring with the increasingly used direct acting oral anticoagulants (DOAC) in comparison to warfarin potentially facilitates outpatient treatment of PE with these drugs. This study aimed to evaluate efficacy and safety of outpatient treatment of PE with DOAC. We extracted data from the Swedish quality registry for patients on oral anticoagulation (AuriculA) for all 245 patients in the southernmost hospital region in Sweden (1...
January 5, 2018: Journal of Thrombosis and Thrombolysis
Johannes Blumenstein, Steffen Daniel Kriechbaum, Jürgen Leick, Alexander Meyer, Won-Keun Kim, Jan Sebastian Wolter, Maisun Abu-Samra, Kay Weipert, Matthias Bayer, Oliver Dörr, Claudia Walther, Christian W Hamm, Holger Nef, Christoph Liebetrau, Helge Möllmann
The use of thrombus aspiration (TA) prior to primary percutaneous coronary intervention (PPCI) has undergone a radical change in intervention guidelines. The clinical implications, however, are still under scrutiny. This study investigated the clinical effects and outcome of TA before PPCI in patients with ST-segment elevation myocardial infarction (STEMI). Overall 1027 patients with STEMI were analyzed in this retrospective, propensity score-adjusted, multicenter study. The primary endpoints were in-hospital and long-term mortality...
December 23, 2017: Journal of Thrombosis and Thrombolysis
Kazunori Otsui, Junichiro Yamamoto, Nobutaka Inoue
Work-related stressors are potential causes of cardiovascular diseases (CVDs) and stroke; however, the pathophysiological mechanisms by which occupational stress induces and exacerbates CVDs remain unclear. The global thrombosis test (GTT) is a novel in vitro assay for evaluating both thrombotic reactions and subsequent thrombolysis. The time required to form an occlusive thrombus with the GTT, called as the occlusion time (OT), and the time to lyse the thrombus, the lysis time (LT), are markers of thrombotic and thrombolytic reactions, respectively...
December 22, 2017: Journal of Thrombosis and Thrombolysis
Katelyn W Sylvester, Clara Ting, Andrea Lewin, Peter Collins, John Fanikos, Samuel Z Goldhaber, Jean M Connors
Despite the ease of use of direct oral anticoagulants (DOACs), these agents remain high risk medications and their clinical efficacy can be impacted by factors such as patient adherence, drug procurement barriers, bleeding leading to discontinuation, and prescribing that deviates from approved dosing regimens. Clinical monitoring of patients on DOACs should be performed by clinicians who specialize in anticoagulation and are familiar with the nuances of DOAC dosing, monitoring, and other components of anticoagulation management including peri-procedural management and care transitions...
December 22, 2017: Journal of Thrombosis and Thrombolysis
Anna Vittoria Mattioli, Antonio Manenti, Alberto Farinetti
No abstract text is available yet for this article.
December 22, 2017: Journal of Thrombosis and Thrombolysis
Hande Kizilocak, Nihal Ozdemir, Gürcan Dikme, Begum Koc, Tiraje Celkan
Purpura fulminans in neonates is a rapidly progressive thrombotic disorder manifesting as hemorrhagic skin infarction and disseminated intravascular coagulation. Being inherited in an autosomal dominant manner, it is a medical emergency. Clinical presentations of patients may vary depending on the genetic mutations. Retinal and intracranial hemorrhages are the worst clinical scenarios with persistent morbidity. During acute phase, fresh frozen plasma, protein C concentrates and anticoagulant therapy should be administered rapidly...
December 21, 2017: Journal of Thrombosis and Thrombolysis
Catarina Ruivo, Fernando Montenegro Sá, Luís Graça Santos, Joana Correia, Adriana Belo, João Morais
Despite the known protective cardiovascular effect of aspirin, former studies identified its prior exposure to an acute coronary syndrome (ACS) as an independent risk factor for adverse events. However, those studies did not reflect contemporary approaches. In the current study, we determine whether patients exposed to aspirin before an ACS have a worse cardiovascular risk profile and if it predicts higher risk of recurrent cardiovascular events or mortality. A cohort of patients enrolled in a national registry of ACS was analyzed according to prior exposure to aspirin...
December 21, 2017: Journal of Thrombosis and Thrombolysis
Peng Ai, Bangli Shen, Hao Pan, Kui Chen, Jihang Zheng, Fengjun Liu
This study was aim to investigate the specific mechanisms of miR-411 in vein wall fibrosis remodeling. Vein wall fibrosis injury-induced deep venous thrombosis (DVT) rat model was well established. The expression of miR-411 at mRNA levels and Collagen I, hypoxia-inducible factor (HIF)-1α together with matrix metalloproteinase (MMP)-2 at protein levels in vein wall tissues and vascular smooth muscle cells (VSMCs) following transfection were determined using quantitative real-time PCR (qRT-PCR) and western blotting, respectively...
December 20, 2017: Journal of Thrombosis and Thrombolysis
Vincenzo Russo, Anna Rago, Andrea Antonio Papa, Antonio D'Onofrio, Paolo Golino, Gerardo Nigro
Patients with atrial fibrillation (AF) are predisposed to a hypercoagulable state and are at an increased risk for thromboembolic events when undergoing procedures. This study investigated the long-term efficacy and safety of newly initiated anticoagulation with dabigatran versus uninterrupted vitamin K antagonist (VKA) therapy in patients with AF scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC). Consecutive adult patients with persistent AF scheduled to undergo DCC were included in the study...
December 19, 2017: Journal of Thrombosis and Thrombolysis
Rachael F Grace, Daniel J DeAngelo, Kristen E Stevenson, Donna Neuberg, Stephen E Sallan, Yasser R Abou Mourad, Julie Bergeron, Matthew D Seftel, Caroline Kokulis, Jean M Connors
Treatment for acute lymphoblastic leukemia (ALL) in adults confers a high risk of venous thromboembolic (VTE) complications. We describe the implementation and results of prophylactic anticoagulation guidelines in adults (18-50 years) treated on a Dana-Farber Cancer Institute ALL pediatric inspired consortium protocol from 2007 to 2013. A high rate of asparaginase related toxicity events, including thrombosis, resulted in a protocol amendment adding guidelines for prophylactic anticoagulation and a modified asparaginase dose and schedule...
December 19, 2017: Journal of Thrombosis and Thrombolysis
Yusuke Ito, Kengo Noguchi, Yoshiyuki Morishima, Kyoji Yamaguchi
In the original publication of the article, the sentence in "Result" section have been incorrectly published as: "Three lines of tPA Tg rats were generated and analyzed by Southern blotting to confirm the presence of the transgene in genomic DNA. When rat DNA was digested with EcoRI and hybridized to the tPA probe described in "Materials and methods", a 1.0 kb band was detected (Fig. 1a, b). One founder line was selected because of its high copy number (about ten copies) of tPA gene and itansgene) and 4.4 kb (endogenous gene) reding appearance, body weight, hematology, and systematization...
December 16, 2017: Journal of Thrombosis and Thrombolysis
Shigeyuki Ebara, Mikio Marumo, Jun Mukai, Makoto Ohki, Kagehiro Uchida, Ichiro Wakabayashi
Although oxidization of LDL is known to be a crucial step for atherosclerotic progression, the significance of oxidized HDL remains to be clarified. The purpose of this study was to determine the relationships of oxidized HDL with blood coagulation and fibrinolysis in patients with diabetes. The subjects were outpatients with type 2 diabetes (n = 163; median hemoglobin A1c, 6.9%). Activities of blood coagulation and fibrinolysis were evaluated by levels of thrombin-anti-thrombin complex (TAT) and plasmin-α2 plasmin inhibitor complex (PIC), respectively...
December 15, 2017: Journal of Thrombosis and Thrombolysis
Rona Zuker-Herman, Irit Ayalon Dangur, Ron Berant, Elinor Cohen Sitt, Libbi Baskin, Yossi Shaya, Shachaf Shiber
Lower extremity deep vein thrombosis (DVT) is a frequent cause of admission to the emergency departments (ED). Although the gold standard for diagnosis is the Duplex ultrasound examination, the current study used for diagnosis of DVT in the ED by emergency physicians is the point-of-care compression ultrasound (POCUS). To compare the sensitivity and specificity of the two-point and three-point compression ultrasound (2PCUS and 3PCUS respectively) for diagnosis of lower extremity DVT in an ED management. We prospectively recruited outpatients who were admitted to the ED with suspected lower extremity DVT...
December 14, 2017: Journal of Thrombosis and Thrombolysis
Nathaniel R Smilowitz, Gregory Katz, Jill P Buyon, Robert M Clancy, Jeffrey S Berger
Systemic lupus erythematosus (SLE) is a significant risk factor for cardiovascular disease. The relationship between SLE and perioperative cardiovascular risks following non-cardiac surgery is uncertain. We investigated associations between a diagnosis of SLE and outcomes following major non-cardiac surgery in a large national database from the United States. Patients age ≥ 18 years requiring major non-cardiac surgery were identified from Healthcare Cost and Utilization Project's National Inpatient Sample data from 2004 to 2014...
December 11, 2017: Journal of Thrombosis and Thrombolysis
Hyoshim Shin, Min-Chul Cho, Rock Bum Kim, Chang-Hun Kim, Nack-Cheon Choi, Soo-Kyung Kim, Eun-Ha Koh
Apixaban is effective and safe for preventing stroke, and its usage has increased exponentially in recent years. However, data concerning the therapeutic range of apixaban is limited. This study determined the trough and peak levels of apixaban-specific anti-factor Xa activity (AFXaA) in acute ischemic stroke patients with non-valvular atrial fibrillation (NVAF) in Korea. The study included 85 patients who received apixaban. Blood samples were taken to measure the trough and peak levels of AFXaA using a chromogenic anti-factor assay, as well as prothrombin time (PT) and activated partial thromboplastin time (aPTT)...
December 2, 2017: Journal of Thrombosis and Thrombolysis
Paul A Gurbel, Kevin P Bliden, Junhong Zhu, Emanuel Troullos, Robert Centofanti, Sistine Jarvis, Palak Venkataraman, Udaya S Tantry
Aspirin is the dominant antiplatelet therapy for cardiovascular disease. Naproxen is frequently used in aspirin-treated patients and may influence the antiplatelet effect of aspirin. We evaluated the pharmacodynamic interaction (lower bound of the one-sided 95% CI for serum TxB2 inhibition < 95%) between 220 mg immediate-release naproxen sodium (once or twice daily) and 81 mg daily immediate release aspirin at various dosing intervals. There was no interaction during the first day of concurrent treatment...
December 2, 2017: Journal of Thrombosis and Thrombolysis
Megan K Yee, Tarek Nafee, Yazan Daaboul, Serge Korjian, Fahad AlKhalfan, Mathieu Kerneis, Cara Wiest, Samuel Z Goldhaber, Adrian F Hernandez, Russell D Hull, Alexander T Cohen, Robert A Harrington, C Michael Gibson
Hospitalized acute medically ill patients with a history of venous thromboembolism (VTE) are at increased risk for recurrent VTE. We characterized the efficacy and safety of betrixaban for prevention of recurrent VTE in these high risk patients. The APEX trial randomized 7513 acutely ill hospitalized medical patients at risk for developing VTE to receive either betrixaban for 35-42 days or enoxaparin for 10 ± 4 days to prevent VTE. This exploratory post-hoc analysis assessed the efficacy and safety of betrixaban versus enoxaparin among subjects with and without prior VTE...
November 29, 2017: Journal of Thrombosis and Thrombolysis
Manuel Cappellari, Gianni Turcato, Massimo Zannoni, Stefano Forlivesi, Antonio Maccagnani, Antonio Bonora, Giorgio Ricci, Gian Luca Salvagno, Gianfranco Cervellin, Bruno Bonetti, Giuseppe Lippi
The exposure to air pollutants may increase both incidence and mortality of stroke. We aimed to investigate the association of short- and medium-term exposure to particulate matter (PM) and nitrogen dioxide (NO2) with the outcome of intravenous thrombolysis (IVT) for stroke. We conducted a retrospective analysis based on data prospectively collected from 944 consecutive IVT-treated stroke patients. The main outcome measure was 3-month mortality. The secondary outcome measures were causes of neurological deterioration (≥ 1 NIHSS point from baseline or death < 7 days), including intracerebral hemorrhage, cerebral edema (CED), and persistence or new appearance of hyperdense cerebral artery sign...
November 28, 2017: Journal of Thrombosis and Thrombolysis
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