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Clinical and Applied Thrombosis/hemostasis

Takumi Aota, Hideo Wada, Naoki Fujimoto, Yoshiki Yamashita, Takeshi Matsumoto, Kohshi Ohishi, Kei Suzuki, Hiroshi Imai, Masanobu Usui, Shuji Isaji, Toshimasa Uchiyama, Yoshinobu Seki, Naoyuki Katayama
We evaluated the diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 232 patients with suspected DIC without hematopoietic injury or infection. The diagnoses of the patients were as follows: DIC (n = 116), pre-DIC (n = 54), and non-DIC (n = 63). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic analysis. The area under the curve and odds ratio for the global coagulation test (GCT) scores in the diagnosis of "DIC" were high, whereas those for the diagnosis of "DIC and pre-DIC" were low, suggesting that the addition of a reduced platelet count (RPC), antithrombin (AT), and soluble fibrin (SF)/thrombin AT (TAT) complex was required to diagnose DIC and pre-DIC...
October 11, 2016: Clinical and Applied Thrombosis/hemostasis
Tahir Bezgin, Cihangir Kaymaz, Özgür Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Nihal Özdemir
BACKGROUND: Venous thromboembolism (VTE) is a common and potentially lethal disorder that manifests mainly as deep vein thrombosis (DVT) of the extremities or pulmonary embolism (PE) and occurs as a consequence of genetic and environmental risk factors. We aimed to assess the role of inherited thrombophilia as a causative or additive factor in the development of VTE. METHODS: The study included 310 patients (female: 154; mean age: 52.3 ± 16.9 years) with a first episode of VTE and 289 age- and sex-matched healthy controls...
October 11, 2016: 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 3, 2016: Clinical and Applied Thrombosis/hemostasis
E Pandya, N Masood, Y Wang, I Krass, B Bajorek
The computerized antithrombotic risk assessment tool (CARAT) is an online decision-support algorithm that facilitates a systematic review of a patient's stroke risk, bleeding risk, and pertinent medication safety considerations, to generate an individualized treatment recommendation. The CARAT was prospectively applied across 2 hospitals in the greater Sydney area. Its impact on antithrombotics utilization for thromboprophylaxis in patients with nonvalvular atrial fibrillation was evaluated. Factors influencing prescribers' treatment selection were identified...
September 26, 2016: Clinical and Applied Thrombosis/hemostasis
Mateja Kaja Jezovnik, Jawed Fareed, Pavel Poredos
INTRODUCTION: Although the role of inflammation in DVT has been investigated in different studies, there is no definite answer as to whether increased systemic inflammation is the cause or the consequence of DVT. AIM: To follow inflammatory parameters in a cohort of patients with idiopathic DVT. METHODS: Out of 49 patients with an acute idiopathic DVT, which were investigated four months after an acute episode (DEVTA 1), 43 patients were included in the follow-up study investigating inflammatory markers and hemostatic markers of endothelial damage five years after an acute DVT (DEVTA 2)...
September 22, 2016: Clinical and Applied Thrombosis/hemostasis
Mariya H Apostolova, Craig D Seaman, Diane M Comer, Jonathan G Yabes, Margaret V Ragni
BACKGROUND: von Willebrand factor (VWF) is a biomarker for endothelial damage. Increased VWF levels are observed in hypertension (HTN) and disorders of endothelial dysfunction, for example, atherosclerotic heart disease (ASHD) and diabetes. Whether low VWF protects against HTN is unknown. METHODS: To determine prevalence and risk factors for HTN in patients with von Willebrand disease (VWD), we conducted a cross-sectional analysis of discharge data from the National Inpatient Sample, 2009 to 2011...
September 21, 2016: 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...
September 21, 2016: Clinical and Applied Thrombosis/hemostasis
Nil Guler, Schuharazad Abro, Marty Emanuele, Omer Iqbal, Debra Hoppensteadt, Jawed Fareed
BACKGROUND: Poloxamer-188 (MST-188) is effective in the repair/recovery of damaged cell membranes. MST-188 is a promising agent for protecting blood cell viability. The aim of the study is to test the hypothesis that MST-188 can extend the duration of platelet function. MATERIALS AND METHODS: Blood samples were collected from 20 healthy volunteers. MST-188 (10 or 2 mg/mL) containing platelet-rich plasma (PRP) was prepared with 2 procedures. First, PRP prepared from MST-188 added whole blood (WB); second, MST-188 was added to PRP...
September 20, 2016: Clinical and Applied Thrombosis/hemostasis
Xingyang Yi, Zhao Han, Qiang Zhou, Wen Cheng, Jing Lin, Chun Wang
OBJECTIVE: Conflicting data exist as to whether proton-pump inhibitors (PPIs) diminish the efficacy of clopidogrel. The aim of this study was to investigate the association between cytochrome P450 (CYP) genetic variants and clinical adverse outcomes of concomitant use of PPIs and clopidogrel by patients. METHODS: We consecutively enrolled 523 patients with ischemic stroke receiving clopidogrel. Platelet aggregation was measured before and after 7 to 10 days of clopidogrel treatment...
September 16, 2016: 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...
September 16, 2016: Clinical and Applied Thrombosis/hemostasis
Armen V Gyulkhandanyan, David J Allen, Sergiy Mykhaylov, Elena Lyubimov, Heyu Ni, John Freedman, Valery Leytin
Availability of universal marker for the diagnosis of platelet apoptosis is an important but currently unresolved goal of platelet physiology investigations. Mitochondrial inner transmembrane potential (ΔΨm) depolarization is frequently used as a marker of apoptosis in nucleated cells and anucleate platelets. Since ΔΨm depolarization in platelets is also frequently associated with concurrent induction of other apoptotic responses, it may appear that ΔΨm depolarization is a good universal marker of platelet apoptosis...
September 16, 2016: Clinical and Applied Thrombosis/hemostasis
Wan-Ting Huang, William C Cang, Katrina L Derry, James R Lane, Annette von Drygalski
A 4-factor prothrombin complex concentrate (4F-PCC, Kcentra®) was recently approved in the United States for the reversal of vitamin K antagonist-associated major bleeding, but it is often used to reverse coagulopathy in patients with liver disease (LD). This single-center, retrospective study analyzed the efficacy and safety of 4F-PCC administered in patients with and without LD. Prothrombin time/International Normalized Ratio (PT/INR) reversal with 4F-PCC was attempted in 85 patients; LD was documented in 31 patients...
September 14, 2016: Clinical and Applied Thrombosis/hemostasis
Jacob T Beyer, Kelly E Schoeppler, Giorgio Zanotti, Gregory M Weiss, Scott W Mueller, Robert MacLaren, Douglas N Fish, Tyree H Kiser
Unfractionated heparin (UFH) is a frequently utilized indirect anticoagulant that induces therapeutic effect by enhancing antithrombin (AT)-mediated procoagulant enzyme inhibition. In suspected heparin resistance (HR) during cardiopulmonary bypass, AT activity may be decreased and AT supplementation helps restore UFH responsiveness. The benefit of AT supplementation in HR over longer durations of UFH therapy is unclear. The objective of this study was to describe and evaluate the use of AT III concentrate in the intensive care units (ICUs) at our institution for improving UFH therapy response over 72 hours...
September 13, 2016: Clinical and Applied Thrombosis/hemostasis
Marcelo Sanmartín-Fernández, Domingo Marzal-Martín
Despite direct oral anticoagulants (DOACs) have overcome the most relevant limitations of vitamin K antagonists, many patients with atrial fibrillation are not receiving the appropriate anticoagulant therapy. In addition, when patients are anticoagulated with DOACs, some of them are not taking the dose recommended in the summary of product characteristics. This may be related, at least in part, to the concern about the applicability of findings from randomized clinical trials to real-life patients. In this context, performing studies in daily clinical practice to assess the efficacy and safety of DOACs in real-world setting is mandatory...
September 13, 2016: Clinical and Applied Thrombosis/hemostasis
Mouna Sassi, Taher Chakroun, Saoussen Chouchène, Ilhem Hellara, Hamdi Boubaker, Mohamed Habib Grissa, Ines Khochtali, Mohsen Hassine, Faouzi Addad, Ismail Elalamy, Semir Nouira
There is evidence that diet and variation in lipid metabolism can influence blood coagulation, but little is known about the effect of Ramadan fasting on plasmatic coagulation pattern. We investigated the effect of Ramadan fasting on thrombin generation (TG) in patients with cardiovascular disease (CVD) risks, and we aimed to assess the effect of lipid profile on TG parameters. The study was conducted in 36 adults having at least 2 CVD risks and in 30 healthy controls. Coagulation pattern was assessed by both classical clotting times and TG test...
September 9, 2016: Clinical and Applied Thrombosis/hemostasis
Mouna Sassi, Taher Chakroun, Elisabeth Mbemba, Patrick Van Dreden, Ismail Elalamy, Annette K Larsen, Grigoris T Gerotziafas
BACKGROUND: A documented relationship between ovarian cancer and thrombosis does exist. Low-molecular-weight heparins (LMWHs) are cornerstone drugs in the primary prevention and treatment of venous thromboembolic events in patients with cancer. However, cancer cells may alter the efficiency of these antithrombotic agents. OBJECTIVE: We aimed to characterize the procoagulant phenotype of human epithelial ovarian adenocarcinoma cells, IGROV1, and to compare the capacity of tinzaparin and enoxaparin to inhibit thrombin generation triggered by these cells...
September 7, 2016: Clinical and Applied Thrombosis/hemostasis
Aida Moeini, Hiroko Machida, Tsuyoshi Takiuchi, Erin A Blake, Marianne S Hom, Toshio Miki, Osamu Matsuo, Koji Matsuo
OBJECTIVE: Recent studies have demonstrated that surgical menopause results in a significantly increased risk of nonalcoholic fatty liver disease (NAFLD) in women with endometrial cancer. In addition, venous thromboembolism (VTE) is known to be one of the major prognostic factors for decreased survival in endometrial cancer. Given the fact that coagulation factors are produced in the liver, the correlation between NAFLD and VTE was examined in endometrial cancer. METHODS: A retrospective study was conducted to examine patients with endometrial cancer who underwent surgical staging including oophorectomy between 2000 and 2013 (n = 714)...
August 31, 2016: Clinical and Applied Thrombosis/hemostasis
Azza Abdel Gawad Tantawy, Amira Abdel Moneam Adly, Eman Abdel Rahman Ismail, Mai Abdelazeem
BACKGROUND: Patients with sickle cell disease (SCD) are at high risk of renal dysfunction and cardiovascular morbidity. The association between cystatin C and renal function is well known, however, cystatin C has recently emerged as a strong predictor of cardiovascular events and adverse outcomes in patients with and without kidney disease, mostly related to both inflammation and atherosclerosis. AIM: To determine cystatin C levels in 53 children and adolescents with SCD compared to 40 age- and sex-matched healthy controls and assess its relation to markers of hemolysis, iron overload, sickle vasculopathy, and carotid intima-media thickness (CIMT)...
August 31, 2016: Clinical and Applied Thrombosis/hemostasis
Charles J Glueck, Vybhav Jetty, Naila Goldenberg, Parth Shah, Ping Wang
We compared thrombophilia and hypofibrinolysis in 6 men with Klinefelter syndrome (KS), without previously known familial thrombophilia, who had sustained deep venous thrombosis (DVT)-pulmonary emboli (PE) or mesenteric artery thrombosis on testosterone replacement therapy (TRT). After the diagnosis of KS, TRT had been started in the 6 men at ages 11, 12, 13, 13, 19, and 48 years. After starting TRT, DVT-PE or mesenteric artery thrombosis was developed in 6 months, 1, 11, 11, 12, and 49 years. Of the 6 men, 4 had high (>150%) factor VIII (177%, 192%, 263%, and 293%), 3 had high (>150%) factor XI (165%, 181%, and 193%), 1 was heterozygous for the factor V Leiden mutation, and 1 was heterozygous for the G20210A prothrombin gene mutation...
August 31, 2016: Clinical and Applied Thrombosis/hemostasis
Samia Ben Sassi, Nahla Touati, Hela Baccouche, Cyrine Drissi, Neila Ben Romdhane, Fayçal Hentati
OBJECTIVE: Data regarding cerebral venous thrombosis in North Africa are scarce. This study aims to identify the clinical features, risk factors, outcome, and prognosis of cerebral venous thrombosis in Tunisia. METHODS: Data of 160 patients with radiologically confirmed cerebral venous thrombosis, hospitalized in Mongi Ben Hmida National Institute of Neurology (Tunis, Tunisia), were retrospectively collected and analyzed. RESULTS: The mean age was 37...
August 31, 2016: Clinical and Applied Thrombosis/hemostasis
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