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Journal of Thrombosis and Thrombolysis

Wesley Zemrak, Francis Manuel, Kathryn E Smith, Stephen Rolfe, Timothy Hayes, Robert L Trowbridge, Brian Carlone, David Seder
BACKGROUND: Four-factor PCC is the recommended standard of care for acute warfarin reversal but optimal dosing is unknown. We aim to show that a low-dose strategy is often adequate and may reduce the risk of thromboembolic events when compared to manufacturer-recommended dosing. METHODS: A weight-based dosing strategy of 15-25 units/kg was established as the institutional standard of care in May 2015. This retrospective, before-and-after cohort analysis included patients receiving 4F-PCC according to a manufacturer-recommended (n = 122) or a low-dose (n = 83) strategy...
November 15, 2018: Journal of Thrombosis and Thrombolysis
Stanislava Jakubicek, Stefan Krebs, Alexandra Posekany, Julia Ferrari, Jozef Szabo, Pavel Siarnik, Wilfried Lang, Marek Sykora
DWI-FLAIR mismatch has been recently proven to identify patients with unknown onset stroke (UOS) eligible for thrombolysis. However, this concept may exclude patients from thrombolysis who may eventually benefit as well. We aimed to examine the feasibility, safety and potential efficacy of thrombolysis in wake-up stroke (WUS) and UOS patients using a modified DWI-FLAIR mismatch allowing for partial FLAIR positivity. WUS/UOS patients fulfilling the modified DWI-FLAIR mismatch and treated with intravenous thrombolysis (IVT) were compared to propensity score matched WUS/UOS patients excluded from IVT due to FLAIR positivity...
November 10, 2018: Journal of Thrombosis and Thrombolysis
Fredrik Björck, Hayder Kadhim, Anders Själander
Warfarin is well studied in patients with non-valvular atrial fibrillation (AF). It has low complication rates for patients achieving individual Time in Therapeutic Range (iTTR) > 70%. The risk scores SAMe-TT2 R2 and PROSPER are designed to predict future TTR, but are derived from a heterogeneous population with generally low iTTR. The aim of this study was to evaluate predictors for high and low iTTR in an AF population in Sweden, where there is a generally good anticoagulation control. A retrospective register study based on Swedish warfarin dosing system AuriculA, including 28,011 AF patients starting treatment during 1 January 2006 to 31 December 2011...
November 8, 2018: Journal of Thrombosis and Thrombolysis
Paul Gurbel, Udaya Tantry, Steven Weisman
The concomitant use of low-dose aspirin for cardioprotection and non-steroidal anti-inflammatory agents for pain relief is prevalent, particularly in the elderly for whom cardiovascular disease and pain are common co-morbidities. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) are known to interfere with the antiplatelet effect of aspirin through competitive binding with COX-1. While the clinical significance of this interference is still unclear, this review sought to assess the body of literature which has evaluated the potential attenuation of the anti-platelet effect of aspirin when dosed concomitantly with an NSAID...
November 7, 2018: Journal of Thrombosis and Thrombolysis
Jian-Zhong Xu, Shi-Tao Lu, Yang Yu
No abstract text is available yet for this article.
November 7, 2018: Journal of Thrombosis and Thrombolysis
Sophie Samuel, Niral Patel, Mary F McGuire, Miguel Salazar, Thuy Nguyen
Routine screening of high-risk asymptomatic trauma or surgical patients for venous thromboembolism (VTE) is controversial. Studies suggest against screening while others recognize that some patients at high risk may benefit. The purpose of this pilot study is to evaluate the benefit of routine screening using doppler ultrasonography for the early detection of deep venous thrombosis (DVT) in post-operative neurosurgical patients. This was a quasi-experimental study at a major academic tertiary care medical center...
November 3, 2018: Journal of Thrombosis and Thrombolysis
Vance G Nielsen
Snake venom contains a myriad of classes of enzyme which have been investigated for medicinal and toxinological purposes, including phospholipase A2 (PLA2 ), which is responsible for anticoagulant, myotoxic and neurotoxic effects. Given the importance of PLA2 , the purposes of the present investigation were to characterize the coagulation kinetic behavior of a PLA2 purified from Crotalus adamanteus venom (Ca-PLA2 ) in human plasma with thrombelastography and determine if carbon monoxide could inhibit its activity...
October 29, 2018: Journal of Thrombosis and Thrombolysis
Andrea L Porter, Amanda R Margolis, Carla E Staresinic, Michael W Nagy, Rebecca R Schoen, Cheryl A Ray, Christopher D Fletcher
The 2012 American College of Chest Physicians' guidelines recommended a 12-week INR follow-up interval may be appropriate for patients on stable warfarin doses. Limited evidence supports this recommendation. A single-arm, prospective cohort study over 24 months was completed in a Veterans Affairs anticoagulation clinic to determine the long-term feasibility and safety of implementing an extended INR follow-up interval in Veterans on stable doses of warfarin. Participants were required to have a stable warfarin dose for 6 months prior to enrollment...
October 27, 2018: Journal of Thrombosis and Thrombolysis
Abrar Ahmad, Kristina Sundquist, Karolina Palmér, Peter J Svensson, Jan Sundquist, Ashfaque A Memon
A single genetic biomarker is unable to accurately predict the risk for venous thromboembolism (VTE) recurrence. We aimed to: (a) develop a multiple single nucleotide polymorphisms (SNPs) model to predict the risk of VTE recurrence and (b) validate a previously described genetic risk score (GRS) and compare its performance with the model developed in this study. Twenty-two SNPs, including established and putative SNPs associated with VTE risk, were genotyped in the Malmö thrombophilia study cohort (MATS; n = 1465, follow-up ~ 10 years) by using TaqMan PCR...
October 27, 2018: Journal of Thrombosis and Thrombolysis
Clarissa Maria Gomes de Almeida, Fauze Camargo Maluf, Feres Camargo Maluf, Nelson Gaburo, Ana Flávia Saraceni, Cesar de Almeida-Neto
Severe life-threatening thromboembolism may be caused exclusively by the presence of an acute CMV infection or due to the association of this agent and other thrombogenic factors. We report a case of an immunocompetent young female patient who presented a pulmonary embolism associated with acute CMV infection. The patient did not have any other apparent cause of thrombosis. She was successfully treated with rivaroxaban for 6 months without further episodes. To the best of our knowledge, this is the first report of a pulmonary embolism associated with CMV treated with a direct oral anticoagulant...
October 23, 2018: Journal of Thrombosis and Thrombolysis
Hairong Zhou, Yanjuan Che, Xiuhua Fu, Hong Wei, Xiuying Gao, Yanxuan Chen, Shaopeng Zhang
To investigate the association of single nucleotide polymorphisms (SNPs) within tissue factor pathway inhibitor-2 (TFPI-2) gene polymorphisms and additional gene-environment interaction with coronary atherosclerosis risk. Generalized multifactor dimensionality reduction (GMDR) was used to screen the best interaction combination among 4 SNPs, smoking and alcohol drinking. Logistic regression was performed to investigate association between 4 SNPs within TFPI-2 gene and coronary atherosclerosis risk. Coronary atherosclerosis risk was significantly higher in carriers with the A allele of rs34489123 within TFPI-2 gene than those with GG genotype (GA+AA versus GG), adjusted OR (95% CI) = 1...
October 20, 2018: Journal of Thrombosis and Thrombolysis
Xicheng Zhang, Yuanhu Jing, Hongfei Sang, Zhaolei Chen, Yuan Sun, Xiaoqiang Li
Stent implantation is the common treatment method for iliac vein (IV) occlusion. IV stents usually enter into the inferior vena cava (IVC) to partially or completely cover the contralateral IV, but it is still uncertain whether this can increase the risk of thrombosis in the contralateral IV. The purpose of this study was to investigate the effect of the stent position on the bilateral IVs patency. A total of 261 patients with symptomatic IV lesions, including 177 patients with non-thrombotic iliac vein lesions (NIVLs) and 84 patients with thrombotic iliac vein lesions (TIVLs), were implanted with IV stents between July 2007 and June 2017...
October 16, 2018: Journal of Thrombosis and Thrombolysis
Paul Frappé, Quentin Brosse, Benjamin Seffert, Hervé Décousus, Laurent Bertoletti
A clinical score was recently proposed to rule out concomitant DVT in patients with a clinical suspicion of SVT. This study aimed to assess the external validity of this score in patients from the STEPH study. We performed a post-hoc analysis of data from the STEPH study. The STEPH study was a prospective multicenter community-based study conducted during a 1-year period in the resident adult population of the Greater Saint-Etienne urban area (France). Every patient with a clinical suspicion of SVT underwent a venous compression ultrasonography, to confirm SVT and to assess the presence of a concomitant DVT or not...
October 13, 2018: Journal of Thrombosis and Thrombolysis
Ming Y Lim, Charles S Greenberg
Over the next decade, there is a predicted shortage of nonmalignant hematologist to maintain the workforce in the United States. To address this, the American Society of Hematology described the creation of the healthcare systems-based hematologist (SBH). The role of SBH has the potential to provide high-value, cost-conscious care to the healthcare system. In 2011, an Anticoagulation and Bleeding Management Medical Directorship position for a SBH was created at our healthcare system. We described our 6-year experience as SBH at a 750-bed tertiary academic medical center to improve clinical outcomes while reducing costs...
October 13, 2018: Journal of Thrombosis and Thrombolysis
Saagar K Sanghvi, David M Harris
Stress-induced cardiomyopathy (SCM), is a reversible cardiomyopathy characterized by transient systolic dysfunction following an acute physiologic stress. Thromboembolism occurs at a high frequency in patients with intracardiac thrombus secondary to SCM, with one systematic review reporting a rate of 33.3%. The risk of thrombus formation following SCM has been associated with left-ventricular (LV) contraction abnormalities, catecholaminergic surge, and other associated comorbidities. However, established guidelines for screening and management of intracardiac thrombus in the setting of SCM do not exist at present due to a lack of sufficient clinical trial data...
October 11, 2018: Journal of Thrombosis and Thrombolysis
Drakeria Barr, Quovadis J Epps
Stroke and venous thromboembolism continues to be a major cause of morbidity and mortality worldwide. The use of anticoagulation therapy has proven effective in the prevention of stroke and management of thromboembolism; however, initiating treatment may bear clinical burden given the capacity of these agents to cause bleeding. Originally, warfarin has been primarily used, but with the approval of direct oral anticoagulants, therapeutic recommendations have shifted to direct oral anticoagulants for first line therapy for venous thromboembolism for patients without cancer...
October 8, 2018: Journal of Thrombosis and Thrombolysis
Xiaomiao Qiu, Junjun Zhou, Weiting Wang, Zhuanyou Zhao, Lida Tang, Shuangyong Sun
In recent years, oral factor Xa inhibitors have become a research focus as anticoagulant drugs. Zifaxaban is the first oral FXa inhibitor to enter clinical trials in China. The aim of this study was to determine the inhibitory effect of zifaxaban on thrombosisthrough a model ofinferior vena cava (IVC) thrombosis in rabbits. IVC thrombosis model was established by electrical injury and stenosis, and zifaxaban was administered (p.o.) for 5 consecutive days, then coagulation indicators and bleeding were observed...
October 8, 2018: Journal of Thrombosis and Thrombolysis
Yaping Xu, Wei Wang, Jing Zhao, Jiahuan Wang, Tingting Zhao
This study had three objectives: (1) to investigate healthcare professionals' knowledge, attitude, and practice toward clinically applying graduated compression stockings, (2) to analyze the influencing factors, and (3) to provide data to support departments that develop health policies. A self-administered web-based survey was completed by 1,444 healthcare professionals, including physicians and nurses from 15tertiary hospitals and four secondary hospitals from 10 provinces in China. Reliability analysis and exploratory factor analysis were used to evaluate the researcher-designed questionnaire's reliability and validity...
October 6, 2018: Journal of Thrombosis and Thrombolysis
Stefano Forlivesi, Manuel Cappellari, Claudio Baracchini, Federica Viaro, Adriana Critelli, Carmine Tamborino, Simone Tonello, Silvia Vittoria Guidoni, Martina Bruno, Silvia Favaretto, Alessandro Burlina, Emanuele Turinese, Franco Ferracci, Sandro Zambito Marsala, Salvatrice Bazzano, Federica Orlando, Michelangelo Turazzini, Silvia Ricci, Morena Cadaldini, Floriana De Biasia, Sandro Bruno, Anna Gaudenzi, Michele Morra, Alessandra Danese, Roberto L'Erario, Monia Russo, Giampietro Zanette, Domenico Idone, Anna Maria Basile, Matteo Atzori, Maela Masato, Elisabetta Menegazzo, Francesco Paladin, Agnese Tonon, Giorgio Caneve, Giulio Bozzato, Alessandro Campagnaro, Simona Carella, Piero Nicolao, Roberta Padoan, Francesco Perini, Antonella De Boni, Alessandro Adami, Bruno Bonetti, Paolo Bovi
Intravenous thrombolysis (IVT) is the treatment of choice for most patients with acute ischemic stroke. According to the recently updated guidelines, IVT should be administered in absence of absolute exclusion criteria. We aimed to assess the proportion of ischemic strokes potentially eligible and actually treated with IVT, and to explore the reasons for not administering IVT. We prospectively collected and analyzed data from 1184 consecutive ischemic stroke patients admitted to the 22 Stroke Units (SUs) of the Veneto region from September 18th to December 10th 2017...
October 5, 2018: Journal of Thrombosis and Thrombolysis
Tomáš Bolek, Matej Samoš, Ingrid Škorňová, Lucia Stančiaková, Ján Staško, Barbora Korpallová, Peter Galajda, Peter Kubisz, Marián Mokáň
Proton pump inhibition (PPI) reduces gastrointestinal bleeding on direct oral anticoagulants. However, PPI may affect dabigatran on-treatment levels; and there is no information regarding the effect of PPI on xabans on-treatment activity. Thus, the aim of this study was to determine the impact of PPI on therapeutic anti-Xa activity in rivaroxaban- and apixaban-treated patients with atrial fibrillation (AF). This single-centre pilot prospective study enrolled 77 consecutive xabans-treated patients (42 rivaroxaban-treated and 35 apixaban-treated patients) with AF...
October 4, 2018: Journal of Thrombosis and Thrombolysis
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