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Clinical and Applied Thrombosis/hemostasis

Scott C Woller, Scott M Stevens, David A Kaplan, Matthew T Rondina
No abstract text is available yet for this article.
January 2018: Clinical and Applied Thrombosis/hemostasis
Rachel B Britt, Jamie N Brown
Parenteral vitamin K1 (phytonadione) is used for anticoagulant reversal, and a boxed warning exists with intravenous and intramuscular administration due to the possibility of severe reactions, including fatalities. These reactions resemble hypersensitivity or anaphylaxis, including anaphylactoid reaction, and have led to shock and cardiac and/or respiratory arrest. The objective of this review is to summarize the available literature detailing the anaphylactic/anaphylactoid reactions with parenteral vitamin K1 in order to better characterize the reaction and provide a more in-depth understanding of its importance...
January 2018: Clinical and Applied Thrombosis/hemostasis
Vilhelm Sjögren, Bartosz Grzymala-Lubanski, Henrik Renlund, Peter J Svensson, Anders Själander
Low-molecular-weight heparin (LMWH) is often recommended as a bridging therapy during temporary interruptions in warfarin treatment, despite lack of evidence. The aim of this study was to see whether we could find benefit from LMWH bridging. We studied all planned interruptions of warfarin within the Swedish anticoagulation register Auricula during 2006 to 2011. Low-molecular-weight heparin bridging was compared to nonbridging (control) after propensity score matching. Complications were identified in national clinical registers for 30 days following warfarin cessation, and defined as all-cause mortality, bleeding (intracranial, gastrointestinal, or other), or thrombosis (ischemic stroke or systemic embolism, venous thromboembolism, or myocardial infarction) that was fatal or required hospital care...
November 2017: Clinical and Applied Thrombosis/hemostasis
Alok Ravindra Amraotkar, David Day Song, Diana Otero, Patrick James Trainor, Imtiaz Ismail, Vallari Kothari, Ayesha Singh, Joseph B Moore, Shesh Nath Rai, Andrew Paul DeFilippis
Platelet count has been shown to be lower and mean platelet volume (MPV) to be higher in acute myocardial infarction (MI). However, it is not known whether these changes persist post-MI or if these measures are able to distinguish between acute thrombotic and non-thrombotic MI. Platelet count and MPV were measured in 80 subjects with acute MI (thrombotic and non-thrombotic) and stable coronary artery disease (CAD) at cardiac catheterization (acute phase) and at >3-month follow-up (quiescent phase). Subjects were stratified using stringent clinical, biochemical, histological, and angiographic criteria...
November 2017: Clinical and Applied Thrombosis/hemostasis
Giuseppe Colucci, Dimitrios A Tsakiris
The utility of thrombophilia testing in clinical practice is still a matter of debate because studies have not shown a benefit in the reduction of recurrent venous thromboembolism (VTE) risk in patients with thrombosis, despite the clearly higher VTE risk for first thrombosis. Screening for thrombophilia is indicated in selected patients. Particularly in selected young patients, especially women of childbearing age, the knowledge of the genetic thrombophilic defect may help in specific situations to decrease the risk of VTE events...
November 2017: Clinical and Applied Thrombosis/hemostasis
Arjun Swami, Varinder Kaur
von Willebrand disease (vWD) is the most common inherited disorder of hemostasis and comprises a spectrum of heterogeneous subtypes. Significant advances have been made in understanding von Willebrand factor ( vWF) gene mutations, resultant physiologic deficits in the vWF peptide, and their correlation to clinical presentation. Diagnostic tests for this disorder are complex, and interpretation requires a thorough understanding of the underlying pathophysiology by the practicing physician. The objective of this review is to summarize our current understanding of pathophysiology, laboratory investigations, and evolving treatment paradigm of vWD with the availability of recombinant von Willebrand factor...
November 2017: Clinical and Applied Thrombosis/hemostasis
Thomas Delate, Stephanie M Meisinger, Daniel M Witt, Daniel Jenkins, James D Douketis, Nathan P Clark
BACKGROUND: Bridge therapy is associated with an increased risk of major bleeding in patients with atrial fibrillation and venous thromboembolism (TE) without a corresponding reduction in TE. The benefits of bridge therapy in patients with mechanical heart valve (MHV) prostheses interrupting warfarin for invasive procedures are not well described. METHODS AND RESULTS: A retrospective cohort study was conducted at an integrated health-care delivery system. Anticoagulated patients with MHV interrupting warfarin for invasive diagnostic or surgical procedures between January 1, 2006, and March 31, 2012, were identified...
November 2017: Clinical and Applied Thrombosis/hemostasis
Bruno Soriano Pignataro, Kenji Nishinari, Rafael Noronha Cavalcante, Guilherme Centofanti, Guilherme Yazbek, Mariana Krutman, Guilherme Andre Zotelle Bomfim, Igor Yoshio Imagawa Fonseca, Marcelo Passos Teivelis, Nelson Wolosker, Solange Moraes Sanches, Eduardo Ramacciotti
PURPOSE: To study the safety and efficacy of rivaroxaban-a direct oral anticoagulant-use in patients with active cancer and venous thromboembolism (VTE). PATIENTS AND METHODS: Retrospective cohort study of 400 patients with active cancer and associated VTE, defined as deep venous thrombosis and/or pulmonary embolism. This single-center study was carried out from January 2012 to June 2015. The aim of this study was to determine the efficacy and safety, using the incidence of recurrent symptomatic VTE and major bleeding, respectively, throughout the treatment with rivaroxaban...
October 2017: Clinical and Applied Thrombosis/hemostasis
Pierre-Olivier Sevenet, Daniel A Kaczor, Francois Depasse
Factor VII (FVII) deficiency is a rare inheritable bleeding disorder affecting 1/500 000 individuals. Clinical manifestations are heterogeneous, from asymptomatic to severe and potentially fatal bleeding. These clinical manifestations do not correlate well with FVII plasma levels. For this reason, FVII-deficient patient management during surgery or for long-term prophylaxis remains challenging. Laboratory testing for FVII activity is, however, the first-line method for FVII deficiency diagnosis and is helpful for managing patients in combination with clinical history...
October 2017: Clinical and Applied Thrombosis/hemostasis
Jorge D Ramos, Martin F Casey, Aristotelis Bamias, Ugo De Giorgi, Joaquim Bellmunt, Lauren C Harshman, Sylvain Ladoire, Yu-Ning Wong, Ajjai S Alva, Jonathan E Rosenberg, Matthew D Galsky, Evan Y Yu
BACKGROUND: The Khorana score is a predictive risk model for venous thromboembolism (VTE) in patients with cancer planning to receive chemotherapy. Urothelial carcinoma and variant histologies (UC/VH) were underrepresented in the model. We sought to evaluate whether the Khorana score predicts for VTE in a retrospective multinational data set of patients with metastatic UC/VH. METHODS: Patients diagnosed with metastatic UC/VH who received chemotherapy were eligible...
October 2017: Clinical and Applied Thrombosis/hemostasis
Lauren P Cote, Steven Greenberg, Joseph A Caprini, Alfonso Tafur, Chris Choi, Francisco J Muñoz, Andris Skride, Beatriz Valero, José Antonio Porras, Maurizio Ciammaichella, Luis Manuel Hernández-Blasco, Manuel Monreal
BACKGROUND: The outcome of patients with upper extremity deep vein thrombosis (UEDVT) has not been consistently compared with that in patients with lower extremity deep vein thrombosis (LEDVT). METHODS: We used the Registro Informatizado de Enfermedad Trombo Embólica (RIETE) registry to compare the outcomes during the course of anticoagulant therapy in patients with UEDVT versus outcomes in patients with LEDVT. RESULTS: As of August 2015, 37,366 patients with acute DVT had been enrolled in RIETE: 35094 (94%) had LEDVT, 1334 (3...
October 2017: Clinical and Applied Thrombosis/hemostasis
Ileana Muster, Thorsten Haas, Daniel Quandt, Oliver Kretschmar, Walter Knirsch
Anticoagulation using intravenous bolus administration of unfractionated heparin (UFH) aims to prevent thromboembolic complications in children undergoing cardiac catheterization (CC). Optimal UFH dosage is needed to reduce bleeding complications. We analyzed the effect of bolus UFH on activated clotting time (ACT) in children undergoing CC focusing on age-dependent, anesthesia-related, or disease-related influencing factors. This retrospective single-center study of 183 pediatric patients receiving UFH during CC analyzed ACT measured at the end of CC...
October 2017: Clinical and Applied Thrombosis/hemostasis
Alfonso J Tafur, Fadi E Shamoun, Salma I Patel, Denisse Tafur, Fabiola Donna, M Hassan Murad
We summarize the evidence for the safety and efficacy of catheter-directed thrombolysis (CDT) with and without ultrasound-assisted therapy for treating submassive and massive pulmonary embolism (PE) in a systematic review. The primary efficacy outcome was mortality. Outcomes were pooled across studies with the random-effects model. Twenty-four studies enrolled 700 patients in total; 653 received mechanical thromboembolectomy treatments for PE (mortality rate, 9% [95% confidence interval (CI), 6%-13%], P = ...
October 2017: Clinical and Applied Thrombosis/hemostasis
Craig I Coleman, Gregory J Fermann, Erin R Weeda, Philip S Wells, Veronica Ashton, Concetta Crivera, Thomas J Bunz, Peter Wildgoose, Jeff R Schein, W Frank Peacock
OBJECTIVE: We sought to compare the length of stay (LOS) and total costs for patients with pulmonary embolism (PE) treated with either rivaroxaban or parenterally bridged warfarin. METHODS: This retrospective claims analysis was performed in the Premier Database from November 2012 to March 2015. Adult patients were included if they had a hospital encounter for PE (an International Classification of Diseases, Ninth Revision code = 415.1×) in the primary position, a claim for ≥1 diagnostic test for PE on day 0 to 2, and initiated rivaroxaban or parenteral anticoagulation/warfarin...
October 2017: Clinical and Applied Thrombosis/hemostasis
Aisling Barrett, Barry Kevane, Patricia Hall, Fionnuala Ní Áinle, Tomás Breslin
In this prospective review of cancer screening in unselected patients with unprovoked venous thromboembolism (VTE) presenting to a large teaching hospital in the Republic of Ireland, we aimed to determine the effects of the implementation of the National Institute for Health and Care Excellence screening policy in a "real-world" population. Within our institution, 64 individuals presented with unprovoked VTE during the study period, of whom 47 underwent a screening computed tomography (CT) scan. Two cases of previously undiagnosed cancer were identified...
October 2017: Clinical and Applied Thrombosis/hemostasis
Ting-Chun Lin, Jiann-Der Lee, Ya-Hui Lin, Rey-Yue Yuan, Hsu-Huei Weng, Ying-Chih Huang, Meng Lee, Chih-Ying Wu, Huan-Lin Hsu, Chia-Yu Hsu, Tsong-Hai Lee, Shan-Jin Liu, Yeu-Jhy Chang, Chien-Hung Chang, Tsung-I Peng, Chia-Wei Liou, Ku-Chou Chang, Yi-Ting Pan, Yen-Chu Huang
BACKGROUND: The risk of symptomatic infarct swelling has been reported to be higher in patients treated with recombinant tissue plasminogen activator (rt-PA). The aim of this study was to evaluate the timing of symptomatic infarct swelling after rt-PA treatment. METHODS: We retrospectively analyzed 14 868 patients with acute ischemic stroke from a stroke registry databank. We recruited patients with massive middle cerebral artery (MCA) infarction and symptomatic infarct swelling and excluded those with parenchymal or symptomatic hemorrhage...
October 2017: Clinical and Applied Thrombosis/hemostasis
Craig D Seaman, Mariya Apostolova, Jonathan Yabes, Diane M Comer, Margaret V Ragni
INTRODUCTION: Improved life expectancy of persons with hemophilia (PWHs) has led to a greater interest in the role of age-related chronic diseases, such as hypertension, in this cohort. Several observational studies have reported an increased prevalence of hypertension in PWHs; however, this has not been assessed using a large, national database in the United States. AIMS: We hypothesized the prevalence of hypertension is increased in PWHs and compared the prevalence of hypertension and associated risk factors among patients with and without hemophilia...
October 2017: Clinical and Applied Thrombosis/hemostasis
S R Kalpana, G Bharath, C N Manjunath, Rita Christopher
BACKGROUND AND AIM: Chronic rheumatic heart disease (RHD) patients who undergo valve replacement with mechanical valves require lifelong anticoagulation. Acenocoumarol, a vitamin K antagonist has a narrow therapeutic range and wide inter-individual variability. Our aim was to investigate the influence of polymorphisms of VKORC1 and CYP2C9 genes on the mean daily dose requirement of acenocoumarol. METHODS: 205 chronic RHD patients, with mechanical heart valves and on acenocoumarol therapy, were recruited...
October 2017: Clinical and Applied Thrombosis/hemostasis
Yanhui Yang, Xian Zhang, Donglei Zhang, Huiyuan Li, Li Ma, Min Xuan, Hongmei Wang, Renchi Yang
Human monocytes are heterogeneous and play an important role in autoimmune diseases. However, the distribution and function of monocyte subsets remain unclear in primary immune thrombocytopenia (ITP). In this study, we determined the frequencies of monocyte subsets in 71 untreated patients with active ITP and 49 healthy controls by flow cytometry. Compared with controls, the frequency of nonclassical monocytes was significantly increased in patients with active ITP but decreased after complete remission. The intermediate subset was also increased in patients with active ITP and produced the highest levels of tumor necrosis factor α and interleukin 1β...
October 2017: Clinical and Applied Thrombosis/hemostasis
David Green, Lu Tian, Philip Greenland, Kiang Liu, Melina Kibbe, Russell Tracy, Sanjiv Shah, John T Wilkins, Mark D Huffman, Yihua Liao, Donald Lloyd Jones, Mary M McDermott
BACKGROUND: Platelet adhesion is mediated by von Willebrand factor (vWF), and disintegrin-like and metalloprotease domain with thrombospondin type-1 motif, number 13 (ADAMTS13) is a protease that cleaves vWF. A change in the balance between vWF and ADAMTS13 in favor of thrombosis might occur shortly before ischemic cardiovascular (CV) events. OBJECTIVE: To determine whether vWF, ADAMTS13, and the ratio of vWF and ADAMTS13 change during the months preceding an acute CV event...
October 2017: Clinical and Applied Thrombosis/hemostasis
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